Lee County public hearing on EMS franchise draws hours of testimony; commissioners schedule work session

Lee County commissioners heard more than three hours of public testimony and provider responses Tuesday as they considered whether to retain First Health as the county's 911 EMS franchise or award the contract to Medex.

Members of the EMS advisory board opened the hearing. "Our decisions were based solely on North Carolina General Statute 153A-250 and the requirements outlined in the RFA," Jessica Miller said, noting the advisory group reviewed vendor proposals, requested follow-up information, and came to a recommendation for the county.

Dozens of public speakers — including county paramedics, volunteer fire chiefs and residents — urged the board to weigh clinical capability and workforce stability as heavily as cost. "What is the value of a life in Lee County?" senior paramedic Natalie Vaughn asked, arguing that First Health has invested in training, equipment and employee benefits that support clinical readiness. Several volunteer chiefs, including Robbie Wilkins and David Nance, said Medex had not consulted local departments about stationing ambulances and warned of potential response gaps under Medex's proposed "peak hours" apparatus plan.

Speakers supporting Medex disputed claims that the company lacks the training or experience to run 911 services. Donna Hertel, Medex owner, defended the company's bid and operational plan and said Medex did market research to align pay and benefits with local needs. Consultant Richard Rutherford and operations staff said Medex's proposal includes hiring plans and in-house training and that their lower bid reflects a business model that also anticipates point-to-point transport work if franchising rules allow it.

First Health representatives emphasized their track record under the current contract. "Over the time that we've had the contract, we have picked up over 29,000 calls," Matt Presswood said, adding that the system has met metrics and that First Health has adjusted pay floors and benefits in recent years. First Health said it bills all payers and evaluates financial assistance on a case-by-case basis.

Commissioners pressed both vendors on specifics: how many ALS units would be staffed in Lee County, whether base rent and station housing costs were included in bids, how 2023 wage increases affected costs, and whether Medex had negotiated potential station space with volunteer departments. Vendors provided figures for proposed staffing, explained dispatch and ALS-intercept protocols, and reiterated that Lee County dispatch would continue to control 911 deployments.

The budgetary gap between bids emerged as a persistent concern: multiple speakers cited roughly a $12 million difference between the proposals and asked how that could be achieved without cutting care. Medex said its business model anticipates additional revenue streams (point-to-point transports) that are currently limited by the county's exclusive franchise ordinance; First Health said rising salary and benefit costs account for a large portion of its higher bid.

After questions and debate, Commissioner Reeves offered a motion to delay immediate action and hold a work session with the EMS advisory committee to review the contracts and outstanding issues; the board voted in favor and set the session for Dec. 19. No contract award or formal vote on the franchise was taken at the meeting.

Next steps: the board will meet in a work session to review financial assumptions, staffing models and potential lease/placement issues raised by volunteers and providers before any formal selection or vote.