Caldwell County approves ambulance franchise for Surg nonemergency transport

Caldwell County commissioners on Feb. 23 approved a franchise allowing Surg Nonemergency Medical Transport to operate stretcher ambulance service in the county.

During a public hearing, Trevor Key, who framed the county's licensing requirement, told commissioners that under North Carolina law and county ordinance any vehicle carrying a stretcher must be a licensed ambulance and operate under an EMS provider franchise. Ryan Graff, owner of Surg, said the company plans to provide scheduled, nonemergency stretcher transport — for example, hospital discharges and doctor appointments — on a private-pay basis and to help relieve emergency ambulances tied up on long, nonurgent transfers. "Surg stands for safe, urgent, reliable, gentle, and efficient," Graff said, describing the service as a supplement to county EMS.

Commissioners questioned the business model and liability limits. Graff said Surg would not bill insurance directly for most trips and would operate on private-pay contracts with facilities; he said the company staffs each vehicle with at least two EMTs. A commissioner asked about insurance limits; Graff said the general liability certificate on hand listed $1,500,000 in coverage and agreed to provide an updated certificate dated after Oct. 2024. County staff confirmed the county attorney had reviewed the proposed franchise agreement.

With no members of the public signed up to comment, the board closed the hearing and moved to adopt the franchise. The motion carried by voice vote.

The franchise authorizes Surg to operate nonemergency stretcher ambulance runs subject to the county agreement and state licensing; emergency 911 ambulance responses remain the responsibility of the county's EMS providers.