Above: Loretta Wilson, EMS Administrators, and newest BLS provider Richard Cox

It is no secret that the Greene County Emergency Services (GCEMS) has been left destitute by the poor financial decisions of its previous administration. The IRS alone requests $10,000 per month for delinquent taxes. During the most recent EMS board meeting, current Operations Manager Brady Greene highlighted the importance of municipal intervention to prevent a state takeover of the services. Failure to rectify the past could ultimately result in the services becoming a state-centered institution instead of a community-oriented nonprofit.

As of now, the GCEMS can set its own standards of care and take into account the unique needs of the county’s citizens. “Anything we make goes back to the community,” Greene stated during his presentation. The current staff understands the population they serve, allowing them to host events that offer critical, life-saving education. A state takeover would prioritize operational costs and supersede any decisions of the local government. The state would hire without peer review and be given enhanced immunity. The citizens and local governments would have no bearing on the quality of service provided. 

Earliest known records kept at the GCEMS headquarters tell a tale rooted in mismanagement and neglect. The previous administrators failed to provide adequate financial and patient records to comply with state regulations, leading the EMS into its current crisis. 

For years, there were no operational budgets. There were no taxes paid. There were no retirement reimbursements paid. There were no vehicle maintenance schedules. There were no headquarters repairs. 

Now, the GCEMS would need assistance of $150,996 per month, with estimated cost categories as follows: payroll and taxes $125,620 per month, fleet operations and maintenance $12,162 per month, and standard operational costs $13,214 per month. 

While the 2026 EMS Reform Act will increase revenues starting October 1st, it is not feasible for the services to be fully funded by reimbursements alone. Patient billing reimbursements are sporadic and unpredictable, so GCEMS often waits months to receive them. Many counties subsidize their emergency services to offer more funding sources while protecting patients from unexpected costs. Here in Greene County, however, the GCEMS operates as an independent nonprofit institution, only receiving what municipalities, organizations, and citizens choose to donate. Commissioner Garria Spencer reminded meeting attendees that the commission assisted Greene County Hospital with $200,000 to aid its own tax delinquency. The EMS services have always “been on an island out there on their own,” said EMS Board Chairman Nat Winn.

The ambulance service is operating with 7 personnel: 1 EMR/driver,  2 BLS providers, 1 ALS provider in training, and 3 ALS providers who also serve in management positions. It is an understatement to say the company is stretched thin to serve Greene County’s 647 square miles and estimated population of 7,067. Yet, they still dutifully answer every call to the best of their abilities. Management often works up to 96-hour shifts just to ensure there is a capable workforce that meets state regulations. If GCEMS does not adhere to emergency service laws, it could result in suspension of services, revocation of licenses, and debilitating lawsuits. 

Management team members have shelled out thousands of dollars to ensure compliance with the laws governing EMS services. EMS Vice Chair Loretta Wilson recently spent over $3,000 to rescue an ambulance, full of expensive medical equipment, from a mechanic lien in North Alabama. Admins have stocked the ambulance with IV equipment, bought uniforms, and even put gas in the tank, all of which are examples of how these men have contributed more than what is listed in their job descriptions. The men of GCEMS are committed to ensuring that the people of Greene County are protected and given high-quality,  life-saving care. “Just because Greene County is rural does not mean the residents deserve less than the absolute best that is possible compared to any other county,” said Greene.

The very entity that has saved countless county lives now needs a savior. A united front from those that they serve is their only hope. “We may as well brace ourselves,” Winn began, “Billing is not going to cover costs. There’s going to be a continuous shortfall. The commission and municipalities are going to need to subsidize the ambulance service.”