S.C. Code Ann. § 6-1-190

(A) As used in this section: (1) "Ambulance service" means a public or private entity that is a licensed provider who has obtained the necessary permits and licenses for the transportation of persons who are sick, injured, wounded, or otherwise incapacitated. (2) "County" means a county of this State. (3) "Municipality" means a municipal corporation created pursuant to Chapter 1, Title 5 or a municipal government or governing body as the use of the term dictates. (B)(1) Ambulance service is hereby designated as an essential service in this State. (2) Each county governing body in this State shall ensure that at least one licensed ambulance service is available within the county. This may be provided as a county service, but also may be accomplished through other means including, but not limited to: (a) providing a license or franchise to a private company; (b) contracting with a public, private, or nonprofit entity for the service; (c) entering into an intergovernmental agreement with one or more local governments; or (d) entering into an agreement with a hospital or other health care facility. (3) 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 also are authorized to make provisions for ambulance service within the boundaries of the municipality. A municipality may 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 may 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 municipality may adopt and enforce reasonable regulations to control the provision of private or nonprofit ambulance service. (F) Two or more counties and municipalities may enter into agreements with each other and with persons providing both emergency and nonemergency ambulance service for a county or counties on a countywide basis, for joint or cooperative action to provide for ambulance service. Code Commissioner's Note At the direction of the Code Commissioner, SECTION 6-1-2020, as added by 2022 Act No. 164, SECTION 1, was redesignated as SECTION 6-1-190.