Commissioners direct staff to draft ordinance naming Medex as preferred EMS franchise vendor after contested public hearing

At its Oct. 20, 2025 meeting, the Lee County Board of Commissioners voted to direct staff to prepare a first-reading ordinance naming Medex as the county's preferred emergency medical services (EMS) franchise vendor, following a second public hearing that featured competing bids from Medex and First Health and extensive public comment.

The public hearing brought presentations from Medex and First Health, questions from commissioners and more than a dozen residents, health-care and industry representatives. Medex chief executive Dylan Lowe told commissioners his company’s proposal included two options he said would meet the county’s request-for-proposal standards and reduce response delays in rural areas; he described Option 1 as a $1.5 million proposal in year one with 5% annual increases and said an alternative option would begin at $1.3 million with the same annual inflation, and asserted Medex could hire displaced employees and provide new ambulances. First Health representatives, including Matt Presswood and CEO Mickey Foster, outlined the incumbent provider’s operating costs and workforce numbers, saying their 2025 cost to provide Lee County EMS totaled roughly $6.0 million and detailing a 45-FTE staffing requirement and recent wage increases to recruit paramedics and EMTs.

Commissioners repeatedly pressed both bidders on interfacility transfers, response-time guarantees for rural areas, technology integration with Lee County dispatch and how each company planned to staff peak demand. Medex said it would use additional nonemergency resources, a second in-county base and advanced routing software to reduce long-response outliers. First Health emphasized its multi‑county experience, a local paramedic academy and current contract performance: First Health staff said the division’s 2024 average emergency response time in Lee County was 7.55 minutes and outlined roughly $3.73 million in wages and $747,000 in benefits for Lee County personnel in 2025.

Public speakers were sharply divided. Central Carolina Hospital board member and former county commissioner Tim Sloan warned that interfacility transfers affect hospital operations and urged the board to weigh impacts on the hospital. First Health employees and local residents described investments in training, equipment and community ties. Supporters of Medex, including a consultant for Medex, argued the company had scaled disaster-response and federal contracts and could deliver services at lower subsidy cost. Medex and First Health each drew questions about payroll, nonemergency transport revenue, and projected ambulance counts.

After public comment and questions, a motion to prepare a first-reading ordinance naming Medex as the EMS franchise vendor carried; commissioners voted in favor by voice and by show of hands. The motion directed staff to draft the ordinance and bring it back to the board for the formal first reading; the board did not adopt a final franchise ordinance or contract at the meeting.

Next steps include contract negotiation and the formal ordinance readings required by county rules; staff and bidders indicated they expected to return with draft contract language and cost details. The county retained discretion to accept or reject any negotiated contract when it returns for formal consideration.

Details on staffing, exact contract years, year-by-year subsidy totals and final vote tallies were not recorded in the motions section of the meeting minutes and will be set in subsequent negotiations or future board action.