An ambulance utility is a specific type of rate structure that may be used for funding ambulance transportation, providing it meets the requirements of RCW 35.21.766. In 2005, the Legislature directed JLARC to review ambulance utilities established and operated by cities or towns. JLARC's review compares ambulance utilities operated by ten cities to statutory requirements and, where applicable, provides recommendations for specific actions cities should take to meet those requirements. This review should serve as a useful guide to other cities considering establishing an ambulance utility and to others interested in ambulance services provided by cities.