Lee County Commissioners vote to switch EMS provider to MedEx

Lee County Commissioners held a second public hearing Oct. 20 on an EMS franchise service for the county.

At the Oct. 6 commissioners’ meeting, officials held the first public hearing on the county’s ambulance franchise. Read the Oct. 6 conversation here.

The county’s contract with FirstHealth of the Carolinas, awarded in 2021, expires June 30, 2026. After reviewing vendor applications, the EMS Advisory Committee recommended continuing with FirstHealth. .However, commissioners voted 4-3 to prepare an ordinance awarding the contract to competing bidder MedEx Medical Transport Service instead.

MedEx Presents Lower-Cost Alternative

MedEx CEO Dillan Lowe presented a detailed proposal addressing what he called a “misconception that MedEx is not professional.” Lowe highlighted MedEx’s role as the primary 911 provider in Forsyth County, where the company operates two 24-hour trucks handling 7,000 calls annually, comparable to Lee County’s needs.

MedEx presented two options: Option 1, matching the RFP requirements at $1.5 million plus 5% annually, and Option 2 at $1.3 million plus 5% annually, which includes a second base location for improved response times and advanced AI-powered dispatch software. Lowe emphasized MedEx’s commitment to a seamless transition, including offers to retain current FirstHealth employees.

MedEx compared its total proposal cost of $8,288,466 to FirstHealth’s $20,850,000, describing the $12 million price difference as significant cost savings for the county.

Commissioner Taylor Vorbeck shared a conversation with a resident who approached her about their experience at Central Carolina Hospital. The resident had a heart rate of 129 and thought he was dying. He waited six hours at CCH and could not get transferred out of the hospital. The resident said he would never go back to CCH, even though his primary physician is there.

Vorbeck asked Lowe if MedEx handles inter-hospital transfers.

“Exclusive franchise; it’s non-emergency, discharges, etc; we never have patients waiting six hours; most are 60 minutes,” Lowe said. “We would bring enough trucks.”

Vorbeck described it as a “catch-22” where hospitals are blamed for not transferring patients, but ambulance providers can’t take them outside the county.

“We can fix that,” Lowe said.

FirstHealth Defends Current Service, Open to Cost Negotiation

Matt Prestwood, president of Moore Regional Hospital-Hoke, provided an update on FirstHealth’s operations and broke down 2025 operating costs totaling $6 million to provide service. He noted that FirstHealth serves as the primary 911 provider in four counties, handling 45,000 calls annually, including 10,000 in Lee County.

During questioning, Vorbeck pressed Prestwood on response times. Prestwood confirmed FirstHealth’s average response time was 7.55 minutes within the last year and has consistently stayed under eight minutes.

Prestwood clarified that inter-facility transports outside the county are not included in the current contract, but said FirstHealth is open to discussions with Central Carolina Hospital about providing that service. He noted that in 2023, FirstHealth implemented significant wage adjustments, with starting pay now at $21 per hour.

Commissioner Cameron Sharpe asked directly: “MedEx can do it cheaper; why?”

“We know the cost of the service that we can provide; we can’t speak for them,” Prestwood responded.

“There’s just a big discrepancy,” Sharpe said. “Do you think it’s feasible to deliver the same product?”

“Not as we see it,” Prestwood replied.

Commissioner Mark Lovick asked if FirstHealth would be willing to negotiate on cost. Prestwood said yes.

Assistant County Manager Jennifer Gamble reminded commissioners they could instruct staff to renegotiate the contract if they were not satisfied. “If the board is not ready, you don’t have to do it this evening,” Gamble said.

Public Comments Highlight Cost Concerns

Former Lee County Commissioner Tim Sloane spoke during the public hearing, emphasizing taxpayer benefits over provider preference.

“I won’t say I’m against FirstHealth, because I appreciate and respect everyone there. But I’m concerned with taxpayers’ benefits and decisions being made on it,” Sloane said. “The $12 million difference could serve the EMS in the county.”

Sloane urged commissioners to “take a second look at the proposals” and consider concerns about ambulances in the more rural areas of the county raised by the firefighters committee a decade ago that he said remain relevant today.

Commissioners Vote to Change Course

After public comments concluded, Commissioner Samantha Martin made a motion to give the contract to MedEx.

Chair Kirk Smith sought clarification: “So what I understand you to say is that you want the franchise ordinance… that you wish to move to make MedEx identified as the vendor?”

Martin agreed, but Gamble clarified the procedural step: “This is the second reading of the EMS Franchise Recommendation. So, the motion would be to bring the first ordinance with MedEx back to the board at their next agenda meeting.”

Gamble noted that, as written, the ordinance is not prepared that way and would need to be rewritten to reflect MedEx as the vendor.

Smith restated the motion: “The motion is to prepare for the first reading of MedEx as the vendor for the EMS Services for the County.”

The vote overrides the EMS Advisory Committee’s recommendation to continue with FirstHealth. 

The rewritten ordinance naming MedEx as the recommended vendor will return for first reading at the Nov. 3 meeting. Following that meeting, Gamble said the county will negotiate a contract with MedEx based on the board’s direction. The final contract and second reading will occur at a future date following negotiations, though the timeline depends on how long it takes to finalize the contract for board approval. 

The ordinance must be approved at two consecutive meetings before the franchise can be finalized.

Hotel Development Standards Text Amendment Referred to Planning Board

The board discussed a Unified Development Ordinance (UDO) text amendment request regarding setback requirements for hotels, motels, and tourist courts.

Land Use Attorney Nil Ghosh applied on behalf of a development firm to change setback requirements for hotel developments adjacent to residential properties.

The current ordinance requires a 50-foot buffer between hotel or motel buildings and parking areas, and property zoned for residential use. Ghosh’s proposal would reduce the parking setback to 20 feet if the adjoining residential property is vacant and larger than 20 acres, while maintaining the 50-foot separation for buildings.

The text change is needed for a specific hotel developer whose project conflicted with the existing zoning code. Sanford City Council approved the change in August, and Broadway’s commissioners approved it in September.

While there were no comments from the public addressed, the commissioners voted to refer the amendment to the planning board for review rather than taking immediate action. Once a UDO text amendment is approved by the Joint Planning Commission, it is forwarded to each jurisdiction’s planning board for a vote, before going to the respective governing board for final action before implementation.

Lee County Athletic Park Economic Impact Presentation

Tourism Development Authority (TDA) Executive Director Wendy Bryan presented data on the economic impact of the Lee County Athletic Park (LCAP), which opened earlier this year.

Bryan reported the park attracted approximately 40,000 people during its first six weeks of operation. The TDA is tracking visitor patterns, demographics, and spending to measure the park’s economic impact on the county.

Hotel operators have reported seeing ball players staying in Lee County, though some weekends have limited availability due to pre-planned events like weddings and car shows competing for rooms.

Transportation Planning and Safety Action Plan

Commissioners moved two items to the consent agenda: a resolution endorsing socioeconomic data for travel demand modeling and planning for the Lee County Comprehensive Transportation Plan, and a commitment letter of leadership for the Lee County Safety Action Plan.

The Safety Action Plan, a partnership among Lee County, Sanford, and Broadway, establishes a goal for a 50 percent reduction in the rate of fatal and serious injury crashes by 2040. The plan represents a shift to making roadway safety the top priority in all land use and transportation planning, design, operations, and maintenance decisions.

Military Service Recognition

Commissioners adopted a resolution to recognize Nov. 4–11 as Green Light for Military Service week to honor U.S. military personnel transitioning from active duty.

Commissioners Robert Reives and Kirk Smith serve on the board as veterans, and veteran Sherry Lynn Womack serves on the Lee County Board of Education.

In observance of Operation Green Light, the board encourages residents and businesses to display a green light to show appreciation for the service and sacrifice of the nation’s veterans.

The next meeting is Nov. 3 at 6 p.m.

Oct. 21, 2025

Diara J. Townes

Engagement Journalist

Diara is an award-winning journalist covering environment, government and business, with a focus on marginalized communities and local stories.

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