Caldwell County approves non-emergency ambulance franchise for Surge Medical Transport
February 25, 2026 | Caldwell County, North Carolina
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The Caldwell County Board of Commissioners on Feb. 23 approved a franchise agreement allowing Surge Non Emergency Medical Transport to operate stretcher-capable, non-emergency ambulance runs in the county.
Staff and applicants said the franchise is required under state law for any vehicle that carries a stretcher and that Surge’s service would free county paramedic-level ambulances to focus on emergency calls. "North Carolina does not have something referred to as a stretcher van, so anything that hauls a stretcher must be an ambulance," said Trevor Key during the public hearing, explaining the statutory basis for the franchise request.
Ryan Graff, owner of Surge, described the company’s existing ambulatory and wheelchair-transport operations and said the firm would operate private-pay, scheduled stretcher transports for nursing homes, hospices and hospital discharges. "SURGE stands for safe, urgent, reliable, gentle, and efficient," Graff said, describing the company’s focus on safety and smooth patient movement. Graff said Surge would staff stretcher ambulances with at least two EMTs and initially offer two stretcher-capable vehicles (one primary and one backup).
Board members asked about billing, insurance and contract review. Graff said the company would invoice facilities for private-pay trips and provided an insurance figure during questioning; county staff requested an updated certificate of insurance. Commissioners confirmed the county attorney had reviewed the franchise agreement.
No members of the public signed up to speak. After closing the hearing, a commissioner moved to adopt the franchise agreement with Surge; the motion carried.
The franchise permits non-emergency stretcher transport by Surge under the terms presented to the board; the county requested an updated certificate of insurance and confirmed the contract review by county counsel. The board did not record an oral change to the contract on the record during the meeting. The franchise is intended to reduce noncritical long-distance pulls by county ambulances and prioritize paramedic resources for emergencies.
Staff and applicants said the franchise is required under state law for any vehicle that carries a stretcher and that Surge’s service would free county paramedic-level ambulances to focus on emergency calls. "North Carolina does not have something referred to as a stretcher van, so anything that hauls a stretcher must be an ambulance," said Trevor Key during the public hearing, explaining the statutory basis for the franchise request.
Ryan Graff, owner of Surge, described the company’s existing ambulatory and wheelchair-transport operations and said the firm would operate private-pay, scheduled stretcher transports for nursing homes, hospices and hospital discharges. "SURGE stands for safe, urgent, reliable, gentle, and efficient," Graff said, describing the company’s focus on safety and smooth patient movement. Graff said Surge would staff stretcher ambulances with at least two EMTs and initially offer two stretcher-capable vehicles (one primary and one backup).
Board members asked about billing, insurance and contract review. Graff said the company would invoice facilities for private-pay trips and provided an insurance figure during questioning; county staff requested an updated certificate of insurance. Commissioners confirmed the county attorney had reviewed the franchise agreement.
No members of the public signed up to speak. After closing the hearing, a commissioner moved to adopt the franchise agreement with Surge; the motion carried.
The franchise permits non-emergency stretcher transport by Surge under the terms presented to the board; the county requested an updated certificate of insurance and confirmed the contract review by county counsel. The board did not record an oral change to the contract on the record during the meeting. The franchise is intended to reduce noncritical long-distance pulls by county ambulances and prioritize paramedic resources for emergencies.
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