Tennessee Code Title 7. Consolidated Governments and Local Governmental Functions and Entities § 7-61-102

(a) Ambulance service is hereby designated as an essential service in the state of Tennessee.

(b) All county governing bodies are authorized and directed to make provisions to ensure that at least one (1) licensed ambulance service is available within their county. This may be provided as a county service, but can also be accomplished through other means, including, but not limited to: providing a license or franchise to a private company; contracting with a public, private, or nonprofit entity for the service; entering into an interlocal agreement with one (1) or more local governments; or entering into an agreement with a hospital or other healthcare facility. A county is not required to appropriate county revenues for ambulance service if the service can be provided by any other means.

(c) Municipal governing bodies are also authorized to make provisions for ambulance service within the boundaries of a municipality. A municipality shall not provide and maintain, license, franchise, or contract for ambulance service outside its corporate boundaries without the approval of the county governing body, in the case of unincorporated areas, or the municipal governing body if the area to be served lies within the boundaries of another municipality.

(d) A county shall not provide and maintain, license, franchise, or contract for ambulance service within the boundaries of a municipality that has made provisions for ambulance service without the approval of the municipal governing body of the area to be served.

(e) The governing body of any county or city may adopt and enforce reasonable regulations to control the provision of private or nonprofit ambulance service.