Arkansas Code
Chapter 266 - Ambulance Licensing Act
§ 14-266-105. Grant of authority

(a) Cities of the first class, cities of the second class, and counties may:
(1)
(A) Enact and establish standards, rules, and regulations that are equal to or greater than those established by the state concerning emergency medical services and emergency medical services personnel, emergency and nonemergency ambulances, and ambulance companies, as defined under §§ 20-13-201 — 20-13-209 and 20-13-211.
(B) However, the standards, rules, and regulations shall not be less than those established by this state;

(2) Establish, own, operate, regulate, control, manage, permit, franchise, license, and contract with, exclusively or otherwise, emergency medical services, ambulances, ambulance companies, and their relative properties, facilities, equipment, personnel, and any aspects attendant to emergency medical services and ambulance operations, whether municipally owned or otherwise, including without limitation:
(A) Rates;
(B) Fees;
(C) Charges; and
(D) Other assessments the cities and counties consider proper to provide for the health, safety, and welfare of their citizens;

(3) Establish an emergency medical healthcare facilities board, hereinafter called “emergency medical services board” or “EMS board”, under the Public Facilities Boards Act, § 14-137-101 et seq., and exercise all the powers conferred in this chapter and the power conferred under the Public Facilities Boards Act, § 14-137-101 et seq., either alone or in conjunction with the EMS board;
(4) Provide emergency medical services to its residents and to the residents of the county, surrounding counties, and municipalities within those counties, but only if the governing bodies of the counties and municipalities request and authorize the service under § 14-14-101, §§ 14-14-103 — 14-14-110, or the Interlocal Cooperation Act, § 25-20-101 et seq.; and
(5) Regulate:
(A)
(i) All intracity patient transports, all intercity patient transports, and all intracounty patient transports originating from within the regulating city.
(ii) However, this chapter does not restrict or allow:
(a) Local regulation of ambulances owned and operated by a licensed hospital for its own admitted patients, except as provided in subdivisions (a)(5)(B) and (a)(5)(D) of this section; or
(b) County regulation of transportation provided by a medical facility;

(B)
(i) Patient transports, by the patient's choice of either the emergency medical service provided by the regulating city, regulating county, or the emergency medical service that is owned and operated by the licensed hospital for its own admitted patients, to the regulating city or regulating county originating from a medical facility outside the regulating city or cooperative governmental unit.
(ii) If the medical facility does not operate an emergency medical service and the patient has chosen to be transported by the medical facility, then the patient shall be transported by the emergency medical service provided by the city or county in which the medical facility is located;

(C) Patient transports originating from within the regulating city or county by emergency medical service providers with an existing special purpose license issued by the Department of Health on July 31, 2009; and
(D) Patient transports authorized by the regulating city's or county's franchised emergency medical service provider if the provider has entered into a mutual aid agreement with a third-party ambulance service, including without limitation a hospital-owned ambulance service to provide patient transports, and if the franchised emergency medical service provider cannot provide patient transports in a timely manner under the franchise agreement.

(b)
(1) A city or county regulating ambulance companies that contracts with private ambulance companies under this chapter shall permit those companies to offer ambulance services outside its boundaries.
(2) A city or county regulating ambulance services, when the municipality or county owns or operates those ambulance services, shall provide ambulance services to those surrounding areas whose governing bodies request and authorize those ambulance services but only if mutually agreeable contracts can be reached to provide those ambulance services.
(3) All direct and indirect costs of extending those ambulance services shall be borne entirely by patient-user fees or subsidies provided by the patient, municipality, or county to whom those ambulance services are rendered.
(4) The city or county extending ambulance services beyond its boundaries is not required to subsidize or otherwise extend financial support to render those ambulance services.

(c) The city or county has the same authority to regulate nonemergency ambulance services.