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Lee County board directs staff to prepare first-reading ordinance naming MedEx as EMS vendor after contested public hearing
Summary
After a contested public hearing with competing proposals from MedEx and First Health, the Lee County Board of Commissioners voted by voice to direct staff to prepare a first-reading ordinance identifying MedEx as the county's EMS franchise vendor; the board held the public hearing and closed it before making the direction. Public commenters and provider representatives raised staffing, cost, transfer practices and patient-billing concerns.
The Lee County Board of Commissioners on Oct. 20 closed a public hearing on the county's emergency medical services (EMS) franchise and voted by voice to ask staff to prepare a first-reading ordinance naming MedEx (also styled Medex/MedX in material presented) as the vendor to provide county EMS services.
MedEx CEO Dylan Lowe told the commissioners that his company's proposal includes two options that would meet the RFP requirements for five ALS units distributed across the county, with a second base location, modern fleet and AI-enabled dispatch software. Lowe said MedEx's bid relies on billing revenue from transports and nonemergency work and asserted that the company could operate at a lower subsidy than the incumbent. He told the board MedEx would hire displaced employees, furnish new ambulances and make Lee County a priority for resources.
Representatives of the incumbent, First Health, urged the board to weigh continuity, staffing and wage commitments. Matt Presswood, who said he serves as president for First Health's regional EMS operations, outlined First Health's cost structure for Lee County (citing a 2025 example total of about $6,009,000) and said the provider currently meets or exceeds contract performance metrics, including a cited 7.55-minute average response time against a 9-minute target.
Public commenters were sharply split. Tim Sloan, a former county commissioner and a Central Carolina Hospital board member, urged caution about an $8 million subsidy being spent by the county and warned that changes to interfacility-transfer arrangements could harm the hospital and patient access. First Health staff, local paramedics and other residents described prior successful investment in local training, equipment and continuity under the incumbent contract. Supporters of MedEx, including a consultant for the bidder and the MedEx CEO, argued MedEx's statewide scale, disaster-response relationships and revenue model would allow lower county subsidy and quick surge capacity.
After the hearing closed the board made a motion and voted by voice to prepare a first-reading ordinance naming MedEx as the county's EMS franchise vendor and to bring the ordinance back for formal adoption. The motion passed by voice vote; no roll-call tally was recorded in the public transcript.
What happens next
Staff will draft the ordinance language and return to the board for a formal first reading and subsequent required steps before a final contract is adopted. The board's direction to prepare an ordinance does not itself award the contract; the transcript records the board's procedural commitment to return the drafted ordinance for future consideration.
Key quotes
"Medex delivers a modern, cost effective forward-thinking EMS system" ' Dylan Lowe, MedEx CEO.
"Our team has exceeded every metric within the contract" ' Matt Presswood, First Health regional EMS.
Ending
The board closed the public hearing and instructed staff to prepare the first-reading ordinance naming MedEx; commissioners said further contract terms, negotiation and a subsequent vote will follow at future meetings.
