Lee County’s EMS award chronology reveals transparency, taxpayer, partisan, protocol and ethics concerns

A review of public meetings, commissioners’ actions, public citizens’ statements and county announcements reveals months of allegations over transparency, bidding procedures and taxpayer costs before negotiations with MedEx collapsed.

Local media has intertwined the state auditor’s recent engagement letter with Lee County Government with the award of the EMS contract.

Public record requests have not yet been released, so here are facts citizens may consider in the meantime.

TIMELINE

TRANSPARENCY CONCERNS

On July 3, 2025, the county attorney shared a public meeting notice for the public EMS Advisory Committee.

1. Review and approve minutes.
2. Hear presentations and ask questions of EMS applicants.
3. Discussion concerning the applications.
4. May vote to recommend an applicant to the Board of Commissioners.

However, Lee County’s website explodes with transparency concerns when examining all county committees, each listing the members’ names and addresses, except for the EMS Advisory Committee, as seen here. View the website’s list as it appeared on June 29, 2026:

• Adult Care Home Community Advisory Committee
• Agriculture Advisory Board
• Americans with Disabilities Act (ADA)
• Board of Elections
• Board of Equalization & Review
• Capital Area Workforce Development Board
• Consolidated Human Services Agency Board
• Cemetery Board of Trustees
• Central Carolina Community College Board of Trustees
• Industrial Facilities, Pollution Control Financing Authority
• Johnston-Lee Harnett Community Action
• Joint Environmental Affairs Board
• Joint Planning Commission
• Jury Commission
• Lee County Fire Advisory Board
• Lee County Juvenile Crime Prevention Council
• Lee County Planning Board
• Lee Soil and Water Conservation Board of Supervisors
• Library Board of Trustees
• Parks & Recreation Commission
• Sanford Planning Board
• Sanford Area Growth Alliance
• Sanford-Lee County Airport Authority
• Trillium Mental Health Board
• Senior Services Advisory Board
• Transportation Advisory Board
• Youth Council

TAXPAYER, TRANSPARENCY and PROTOCOL CONCERNS

At the Oct. 6, 2025, commissioners’ meeting, Jeff White, MedEx Chief Operations Officer, made clarifications after the advisory committee recommended FirstHealth for the EMS contract. He said they had the first meeting in June 2025 with the advisory committee and four subsequent meetings, each with presentations. He said the meetings demonstrated a lack of consistency in how applications were evaluated. “We were told the board should not consider cost when making a recommendation.”

“At one point during the final advisory session, staff urged the board to delay the vote, the board took a break, after it was told all decisions must be made in a public forum,” but White said that meeting “abruptly stopped after that…This brings concerns to transparency…When we were finally informed, we were given a prewritten spoken letter,” White said about the prewritten letter being on hand during the meeting when all votes were required to be public contradicted transparency.

“That’s twelve million dollars of taxpayer savings,” White said about the committee’s lack of taxpayer concern.

One of the most surprising things that surprised us was claims of our inexperience,” White said about MedEx employing over 486 people. “It handles twice the call volume.”

MedEx has had over 330,000 transports in the past five years. It was the only private company given the opportunity to be a teaching institution, showing it has a “proven track record.”

FIRST MENTION OF IMPROPERIETY ALLEGATIONS, TAXPAYER,  PARTISAN AND NEGOTIATION PROMISE CONCERNS

Lee County Commissioners held a second public hearing Oct. 20.

The commissioners overrode the committee’s recommendation for FirstHealth and voted 4-3 to prepare an ordinance awarding the contract to competing bidder MedEx Medical Transport Service instead.

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.

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.

MedEx’s Chief Executive Officer Dillon Lowe explained how they could provide a $12 million lower proposal than FirstHealth. Lowe explained they handled a variety of transports, including 911, inter-facilities and that more trucks would be added when needed. MedEx could bill for transport to insurance companies and for non-emergency transports. It predicted about 6,000 transports for Lee County.

Democrats, Cameron Sharpe, Robert Reives, and Mark Lovick voted against MedEx.

All four Republicans: Andre Knecht, Kirk Smith, Taylor Vorbeck and Samantha Martin voted for MedEx.

Lee County Attorney Whitney Parrish is a Democrat, and Lee County Manager Lisa Minter is unaffiliated.

Parrish provides legal counsel for committees.

Minter oversees the administrative processes of committee policies and procedures.

Both attend committee meetings on occasion for advisory purposes.

During the second public hearing, citizen David Smoak said he had experience with federal contracts and that what he heard “kind of perked his ear up,” about the “allegations of possible impropriety during the bidding process. I don’t  know if this has been discussed behind the scenes during the bidding process or if it has already been investigated…Hopefully this will be investigated to see if they’re in good merit or not,” Smoak said about the EMS Advisory Committee. He warned that discrepancies in the bidding process meant there could be solutions to resolve it, but concerns needed investigating.

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.

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

TAXPAYERS SPEAK

On Nov. 17, 2025, Jessica Miller spoke to commissioners during a public hearing on the EMS franchise selection on behalf of the EMS Advisory Committee because she is on the committee. She said after each organization’s presentations they carefully reviewed and discussed the information and what they had learned and formed interview questions. She said their answers were considered before any decisions were made. Miller said the advisory board had over 50 years of combined experience in the medical field.

Allen Rummel sent a letter, and the chairperson read the letter. He’d quoted the First Health discount process and said it had socialized the discount by making the county pick up the discounted amount. He said First Health should restructure the discount process to omit the taxpayer requirement of paying for the discounted differences.

Mary Hawley Oats, an EMS Advisory Committee member, said she was a school nurse supervisor and had served on the board of health for 15 years. She said the board’s duty was to choose which organization had the best service, not the best cost. She said the meeting were open to the public and in the public domain. She said the First Health preference was a unanimous decision across the board. She was concerned that MedEx was not a sole 911 provider but had a liaison organization to assign transports. “We never had conversations as a committee outside of the open meeting process.”

Tim Sloan spoke in favor of MedEx. He said that 12.5 million difference was a difficult decision. The money and process should be taken more seriously. I never even heard who was on the committee. As a board member of CCH, he said he’d heard how patients choosing to leave the county cost taxpayers and now it would cost them 12.5 m more by choosing First Health. “You have to consider the twelve and a half million dollars,” Sloan said about the taxpayer burden.

“We base our decisions clinically,” supporter of First Health and an EMS professional Matthew Bright said. He said that because CCH can’t handle a broken neck, patients were sent to UNC. He said the problem with MedEx would be the patient would be sent to CCH and be billed for that and then sent to UNC or another hospital and be filled again.

FirstHealth representatives presented during the public hearing. Jonathan Davis, Chief Operating Officer of FirstHealth of the Carolinas and president of Moore Regional Hospital, outlined the company’s current services, including 24/7 on-call fleet maintenance and full equipment support.

Matt Prestwood of Moore Regional Hospital over EMS presented data showing FirstHealth has invested $1.7 million in Lee County during the current contract period, including new trucks and mobile data terminals. He reported an average response time of nine minutes and noted Central Carolina Hospital accounted for 5,131 transports during the contract period. FirstHealth also operates a First Responder Program in partnership with the Sanford Fire Department.

CANCELED MEDEX CONTRACT

On April 17, 2026, after negotiating meetings between Lee County and MedEx failed, the county canceled the service contract.

FIRSTHEALTH EMS CONTRACT ON BUDGET

On June 1, 2026, during the Lee County Public Hearing for the 2026-27 Budget, Jim Womack, spouse of Lee County Board of Education Chairperson Sherry Womack, explained why the EMS franchise award needed investigation after it appeared on the budget proposal. (View the video at 1:13). He also suggested a solution. The county could award a one-year contract to FirstHealth and “justify that by saying no bidder held to the original bid,” and later return to the bidding process for a five-year contract, and that would save taxpayers $10 million.

On June 8, 2026, Lee County announced FirstHealth as the county’s EMS provider. This was after FirstHealth had originally offered services at $20.9 million and had said it was willing to negotiate the fee, but added $347,459 to the fee to cover expenses from their personnel turnover.

The fee proposal from FirstHealth of the Carolinas, Inc.:

July 1, 2026-June 30, 2027, $2,525,000 and an additional $347,459

July 1, 2027-June 30, 2028, $3,450,000

July 1, 2028-June 30, 2029, $4,400,000

July 1, 2029-June 30, 2030, $5,050,000

July 1, 2030-June 30, 2031, $5,450,000

Total = $21,222,459

On June 29, 2026, David Smoak shared his professional perspective.

“Having an outside agency come and review the contracting process of a small county should be welcomed. On its face, it appears that local taxpayers are now locked into paying millions of dollars more for local EMS services than the original bids should have allowed. There are multiple stages in these complicated, expensive budgets, to begin with, the RFP (Request for Proposal) through the contract finally being awarded and completed. Each stage should be examined to ensure that the citizen and taxpayers’ interests were being prioritized and a final report identifying why the lowest bidder was eliminated as the suitable candidate should be produced for public scrutiny.”

June 29, 2026

Stephanie M. Sellers

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