Repeals GS 153A-250, which allowed counties, by ordinance, to franchise ambulance service.

Prohibits a county manager or EMS administrator delegated authority to act on behalf of the county from being required to sign a document or otherwise approve a modification in the level of care being provided by a provider within the county's emergency management system. Specifies that this does not apply if the provider is a city located within the county or the county responsible for the emergency management system.