NEW HANOVER COUNTY — There’s a new ambulance service in town, yet the county and VitaLink, a subsidiary of Novant Health, have indicated there is no room at the table for its services.
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Simon Dart, founder of Arrive Transport, is seeking New Hanover County’s permission to operate non-emergency transport vehicles for residents confined to stretchers.
However, New Hanover County has an exclusive franchise agreement with Novant, in place since the healthcare chain bought New Hanover Regional Medical Center in 2021. The agreement, which is good through June 2028, stipulates all non-emergency transports be handled by VitaLink.
Dart said he has been working on bringing stretcher transport to New Hanover County for a year, calling the area underserved. Conversations with the county started around six months ago, as Dart submitted a franchise agreement request. Though it was rejected, he has continued to push the county to reconsider.
“We’re not just advocating for ourselves,” Dart said. “We’re just advocating that if there’s public need, companies should be able to come in to fill that need.”
He also went before the Wilmington City Council during public comment on April 1 and said the county had stopped responding to his requests. He emailed top New Hanover County officials again the following day, informing them he spoke before the city, with council members encouraging him to continue to making contact.
“We have already reached out to others within the New Hanover administration, but they have stopped responding to our emails,” Dart wrote to Assistant County Manager Lisa Wurtzbacher. Dart also copied County Manager Chris Coudriet on the April 2 email.
Coudriet responded: “I understand the policy we have is one where you don’t agree. That noted, we have a franchise agreement with Novant; Novant holds the rights to medical and non-medical transport. Unless Novant indicates it needs augmented support or wishes to forgo its service rights, I do not believe there is an action the county can take administratively to meet your expectations.”
Though Arrive’s vehicles are driven by licensed EMTs, the company doesn’t take 911 calls; instead, it is available to schedule stretcher-supported rides from the hospital or to doctors appointments, events or even to a family home for end-of-life care.
“We will facilitate one last trip for somebody who wants to go do something with their family,” Dart said. “That just gives them a little bit of closure at the end.”
Open since February 2024, Arrive is already operating wheelchair transport in New Hanover, Brunswick and Pender counties. But when patients are unable to sit up, a stretcher-accomodating vehicle, sometimes an ambulance, is needed.
In Brunswick County, the transport company has completed a franchise agreement, required to operate ambulatory vehicles in a municipality. Combined with wheelchair transports across the three counties, Arrive has completed 4,029 rides since it began 14 months ago with the expectation to double that amount by the end of the year.
Franchise agreements are not inherently exclusive; Brunswick and Pender counties have contracts with various EMS services, though both counties have recently experienced clashes between their organizations.
Upon franchise agreement negotiation last year, Southport EMS was resistant to the new stand-by requirements initiated by Brunswick County, though the two resolved the dispute in October. Pender County’s problems with its private EMS providers ended with a commissioner resolution to take over a nonprofit’s private services in March. Dart told PCD he was waiting for things to settle there before seeking out an agreement for Arrive in Pender County.
Though the Arrive founder applauded Novant for its emergency response in New Hanover County and noted Arrive was not trying to get into the emergency calls business, he said Novant is falling short of the county’s needs when it comes to non-emergency transport.
“We met with individuals for the last year,” Dart said. “We met with facilities, hospice companies, and we found that it was just every single person, and every single group we talked to just said transportation is such an issue.”
Aside from requests from the general public, Arrive has 11 contracts with various facilities, including hospice, rehab, and elderly care, in New Hanover alone, each one representing multiple stretcher requests per week Arrive is not allowed to fulfill. Dart said when he first launched the company, two to three requests for a stretcher ride would come in daily, that number “increasing dramatically” when VitaLink would be closed or in the evenings when they limit their vehicles. VitaLink also shuts down when winds exceed 50 miles per hour, per Dart.
Though Arrive has been unable to advertise and fulfill stretcher requests, Dart said his team still receives three or four calls per week.
“We often get calls from the staff of Lower Cape Fear Hospice as they struggle to get respite patients to their New Hanover facility late at night,” he said. “We have spoken with their executive team on this matter and are ready to supply a dedicated vehicle for their facility as we truly believe in their mission to bring peace to individuals in their last moments.”
Port City Daily attempted to reach several facilities in town to learn of their experiences. While some employees confirmed there was a general problem with the current transportation offerings, no one followed up by press upon a request for an in-depth conversation.
Dart added the Arrive team even talked with Novant employees about issues transporting patients from New Hanover Regional Medical Center’s emergency department. Arrive still gets calls from the ER occasionally, per Dart.
Port City Daily asked Novant to confirm if this was true, though a spokesperson did not answer the question. PCD also asked for VitaLink’s average weekly ride requests and how many rides it could not fulfill. Rick O’Donnell, senior director of mobile integrated health, provided the following via email:
“In 2024, VitaLink non-emergency ambulance transport requested an outside mutual-aid ambulance to transport a patient within New Hanover County 9 times out of 12,400 transports.”
O’Donnell added mutual aid agreements are very common and are in place should VitaLink experience more demand than normal.
He pointed out VitaLink’s 98% completion rate for non-emergency ride requests, the same number reported in a needs assessment performed by New Hanover County Health Director Jon Campbell in October 2024.
In response to a request from Wurtzbacher, Campbell compiled Novant’s self-reported data on non-emergency transport from 2021 to 2023. The completion rate increased from 95.6% to 98.6% over this period, with on-time performance (defined as within 30 minutes of scheduled time) above 90%.
The data provided in the needs assessment shows Novant outsourced between 1% and 4% of its ride requests for a total of 825 rides out of 32,458 over the three-year period.
Given these metrics, Campbell reported in an email he thought additional non-emergency medical transportation services were “not needed at this time” and the current exclusive franchise agreement with Novant was “effectively meeting public demand.”
The heath director made this assessment on Oct. 25, 2024. Four days later, Dart would receive a letter rejecting his franchise request from Wurtzbacher.
Dart told Port City Daily this was frustrating to see in light of the experiences he collected from facilities in town, though he has continued to try and showcase the need for Arrive to the county.
“They have told us point blank they will do nothing without Novant approval,” Dart said.
Dart said he has moved on from requesting a franchise agreement and instead is asking the county to conduct its own investigation into what he says is a gap in demand. But that’s not the only problem; Dart said the community is also experiencing price gouging of rides.
“We got a call the other day, somebody just wanted to go three miles down the road, they were transferring facilities, I think it was from Bradley Creek over to another facility in this area,” Dart said. “And Novant was going to charge him $850 for essentially a minute ride.”
He said he would understand if that was Novant’s going rate, but noted his team has made calls to VitaLink for similar rides and gotten estimates “all over the place.”
PCD asked Novant to explain how its pricing system works; O’Donnell did not address the question in response. He did claim the rides were covered by most major commercial insurance companies along with Medicare and Medicaid.
As for Arrive, Dart said the company can usually transport someone within New Hanover County for $400, but noted the team was flexible on the price. While insurance coverage is an option, Dart said, like the county, Medicare and Medicaid operate exclusively with Novant.
Arrive does offer charity care when vehicles are available; it has four operational in New Hanover County. Dart said he asked the county if Arrive could provide free stretcher transport, though this is not allowed either.
“We’re not going to give up,” Dart said, noting he plans to go before the county commissioners at the board’s April 21 meeting.
At the Wilmington City Council meeting a few weeks ago, Dart told the board he was prompted by the county to come before them, yet the city does not grant franchise agreements and was not involved in the sale of NHRMC to Novant. City attorney Meredith Everhart confirmed in an email to Dart the city’s lack of control over the current transport system.
However, during the meeting some council members spoke in favor of Arrive’s need. Mayor Bill Saffo recounted a personal story of a relative who called for a stretcher ride but said they were denied one.
“I saw it first-hand,” Saffo said. “So how far are we short?”
“Very far,” Dart responded, explaining he had a petition signed from “almost every elderly care facility and rehab center,” noting they suffered potential financial loss or injury to patients because demand can’t be met.
But for now Arrive’s growth in New Hanover County continues to stall. County spokesperson Alex Riley confirmed this week “no amendments to the EMS System Plan or the exclusive franchise agreement are being considered by the county.”
Dart told PCD that Arrive is losing money going to bat against the county, noting earlier in the process the company worked with an attorney.
“But we’ve just kind of decided if people aren’t even allowed to have free rides here, and if people are being forced to die in hospital beds because they can’t get a ride back home to be surrounded by families, we’re gonna see this one through,” he said.
Reach journalist Brenna Flanagan at brenna@localdailymedia.com
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