A city or county may provide ambulance service as a governmental activity or may regulate such service provided by private operators or non-profit, general-welfare corporations. No county may provide, license, franchise, or contract for ambulance service within a city or in another county without approval from the city’s governing body, and the same restriction applies to cities. T.C.A. §§ 7-61-101–104.
State regulation of emergency medical service agencies and licensing of emergency medical personnel is provided in the Emergency Medical Services Act of 1983. T.C.A. §§ 68-140-501, et seq. There are four levels of emergency medical care provider certification in Tennessee: Emergency Medical Responder (EMR), Emergency Medical Technician (EMT), Advanced Emergency Medical Technician (AEMT), and paramedic.
An EMT, physician, or nurse is required to attend every patient transported by an ambulance in Tennessee. T.C.A. § 68-140-159.
The complete Rules of the Tennessee Department of Health, Bureau of Health Licensure and Regulation, Division of Emergency Medical Services concerning the provision of emergency medical services by ambulance and first responder agencies may be found at http://share.tn.gov/sos/rules/1200/1200-12/1200-12.htm.