Mecklenburg County's ambulance provider is delivering some of the best patient care in the region even as it struggles to keep pace with its own response-time targets, according to a newly completed independent study that puts county commissioners in the position of either paying millions more or accepting slower ambulance arrivals. The 104-page evaluation, based on fiscal year 2025 data, found Medic had its busiest year in history last year, with response times steadily increasing across the system.
The study, conducted by consulting firm Healthcare Strategies, concluded that Medic is not currently reaching the county's compliance goal for how quickly ambulances arrive on high-priority calls, according to WSOC TV. At the same time, the consultants found that Medic patients receive some of the best care in Mecklenburg County, a distinction the report ties to the agency's clinical performance even as its logistics strain under population growth.
A Six-Million-Dollar Question
The central recommendation facing commissioners is stark: either find more funding or accept longer response times. Bumping the highest-priority call standard from 10 minutes 59 seconds to 11 minutes 59 seconds would be the most affordable option, according to consultant JP Peterson, as cited by WSOC TV. That single extra minute is the difference between holding the line financially and covering the cost of keeping ambulances arriving as fast as they do now.
Commissioners previously heard a version of that math in the spring, when Healthcare Strategies President Bill Bullard told the board that keeping the current, faster response benchmark would require roughly a $6 million annual subsidy or rate increases, according to WSOC TV's earlier reporting. Bullard also told commissioners that Medic's cardiac arrest survival performance was among the smoothest and best his consulting team had observed in 54 years, underscoring the gap between the agency's clinical results and its response-time compliance.
Fire Departments Want Paid for Their Time
Beyond the funding-or-delay dilemma, the study also recommended compensating fire departments for first-responder-only calls that end up saving Medic money, and it went further by recommending the elimination of first-responder-only calls altogether. That recommendation strikes at a dispute that has simmered for more than a year between Medic and municipal fire agencies across the county.
Charlotte Fire Department said it is working with Medic, Mecklenburg County and other stakeholders to identify the best path forward, though the department has not signed a new long-term contract with Medic and instead has an extension of its existing agreement. Charlotte Fire prioritizes reducing the time its crews are committed to medical calls and plans to reduce responses to lower-acuity calls where a fire response may not be necessary, reasoning that doing so would let firefighters and fire trucks stay available for serious emergencies. Fire Chief Johnson will remain involved in discussions about the study and its recommendations, and the department said it continues to review what the report lays out.
The friction over compensation is not new. Contract disputes between Medic and local fire departments escalated last year when Charlotte Fire requested $1.8 million annually, up from $500,000, and Huntersville requested $1.6 million, up from $106,000, to keep providing first-responder medical coverage under Medic's framework, according to WSOC TV's reporting from April 2025. Municipal leaders have long argued the current arrangement drains their own resources; Davidson Mayor Rusty Knox told WFAE that when a local fire truck is held up waiting at a medical call for an ambulance, the town loses half of its on-shift fire response capacity.
A Temporary Truce While the Study Played Out
While the study was underway, Medic signed a one-year contract with Charlotte, Huntersville and Cornelius fire departments to keep first-responder coverage running. That arrangement followed a bridge deal Charlotte Fire and Medic struck last summer featuring 90-day renewal terms after nearly a year of tense negotiations, according to WCNC, which allowed firefighters to keep making medical responses under Medic's oversight while county leaders waited on the consultants' findings.
Medic has adjusted its response strategy before. In 2023, the agency instituted a two-tiered model targeting an 10:59 arrival time for high-acuity calls while allowing non-emergency, low-acuity calls to take up to 90 minutes without lights or sirens, per EMS1. Medic's dispatch model today also diverts some low-acuity 911 callers to a nurse triage line or connects them with rideshare services rather than sending an ambulance at all, a tool the WSOC TV report notes is already in use to preserve ambulance availability for the most severe calls.
County Dollars Already Moving, Bigger Decisions Ahead
Mecklenburg County commissioners have already put money behind part of the fix. The county approved $11.2 million for Medic in the fiscal year 2026-27 budget, according to the Lake Norman Beacon, split between $8.5 million for one-time capital, technology and recruitment spending and $2.3 million to establish a $25.53 per hour minimum wage for agency staff. That funding addresses staffing and equipment, but it does not resolve the underlying response-time and first-responder compensation questions the study raises.
Those bigger calls now fall to the EMS Study Committee, which was tasked with prioritizing the study's recommendations and will likely keep debating response-time standards and first-responder medical-call changes over the next year, per WSOC TV. The stakes are heightened by how much regional growth has already reshaped demand on the system: Mecklenburg County logged a record 147 traffic fatalities in 2024, the highest total of any county in North Carolina, adding to the emergency call volume that Medic and local fire crews are stretched to cover.
Separately, Medic's finances have drawn scrutiny for how it recoups unpaid ambulance bills. The agency collected $2.5 million in 2024 by intercepting state tax refunds and lottery winnings through North Carolina's debt setoff program, making it the highest-collecting public agency in the state under that program, according to WFAE's earlier reporting. That revenue stream sits alongside the response-time and funding debate as commissioners weigh how to pay for an ambulance system serving a county that keeps growing faster than its emergency infrastructure.
