Greene County Emergency Medical Services
faces financial and operating crisis

Zack Bolding, Acting Director of GEMS, presented a report at EMS meeting

At its regular monthly meeting, on May 3, 2022 at Eutaw City Hall, the Greene County Emergency Medical Services (GEMS) Board of Directors heard a dire report of financial and operating crisis facing the county’s ambulance service.

Zack Bolding, Acting Director of GEMS, presented a report of difficult conditions facing the ambulance service, in terms of its equipment, personnel, inadequate base of operations, low reimbursement rates and overall operational finances. The picture he painted was one of imminent collapse and curtailed services unless the County Commission, municipal governments, major employers and others in need of the ambulance service do something to help support the operating and physical equipment budgets of the GEMS.

Joe Lee Powell, current Board Chairperson indicated, “We called this meeting, invited sponsoring organizations and we need to hear the situation and try to act to save our ambulance service. We have used contributions to the GEMS Board over the past few months to help make the payroll. We know there are financial and equipment problems, which we can solve if we work together.”

Bolding presented a detailed written report of the status of the ambulance service. “We are providing an ALS-1 ambulance service (a vehicle with a driver and paramedic on board), on a 24/7 basis. We are doing this with one usable ambulance and two other transport vehicles, which are well behind their safe-service life, in terms of mileage and wear and tear.”

Bolding indicated that the ambulance service must operate under the laws of Alabama, which have minimal vehicle and personnel standards, which they are barely meeting, to meet state requirements and standards.

Bolding said, “Greene County is the second most rural county in Alabama, behind Wilcox County. We have 660 total square miles, including 13 square miles of water with a 2020 population of 7,730 or 12 per square mile. It is very difficult to serve such a large county in and area, coupled with roadways like Interstate20/59 and State Highways 43,11,14 and 39,
which traverse our county and bring accidents and other situations that require ambulance services.”

“Beyond the emergency services, we also transport patients to hospitals, specialists and other regular treatments, like dialysis, wound care and cancer care. We need three (3) running modern equipped and staffed
ambulance vehicles to handle the demand. We have one 2018 ambulance in running order; we have a second ambulance box, which is awaiting remount and replacement on a new body, which will be ready this summer; a 1995 ambulance and a 1981 ambulance that are past their safe-service life,” said Bolding.

Bolding also pointed out that he had to recruit new staff since he took over the system from Nick Wilson, who in turn was selected as director when Bennie Abrams and Stanley Lucius retired in 2020. “ Abrams and Lucius ran the service as best they could without a lot of help and support, including in effect volunteering a lot of their time, instead of being paid. To run a modern efficient system, you must pay all of your staff under Fair Labor Standards, with minimums and overtime, The staff must also receive health and life insurance benefits, which we have arranged for the first time, ” said Bolding.

Bolding also decried the condition of the old Warrior Academy site, which the GEMS is using as its base of operations. He complained of inoperable toilets, no showers, inadequate food preparation services,
no areas for staff to clean and wash their clothes, which are often contaminated by blood, mud and other things, as part of daily operations.

Bolding included a chart in his report indicating that the service rates, charged by GEMS are below allowable Medicare, Medicaid and third-party insurance payer reimbursement rates and could be raised to bring in greater revenues. The GEMS Board approved a contract with Capstone Claims in Tuscaloosa to remedy some of these problems by raising service rates for ambulance services, to bring in greater revenues.

Bolding report indicated service revenues of $617,179 for calendar year 2021, although he estimated that the operational budget, including all costs was around a million dollars a year. This leaves a deficit of $300,000 to $400,000 in expenses over revenues, not including cost for capital improvements, ambulances and equipment.

Powell said, “The Greene County EMS needs help and support from the county, municipalities, employers, bingos and others to save the ambulance service. One quarter of a mil in property taxes, per year, about $40,000, is not enough to cover the full costs of this service.”

Powell suggested a meeting on May 17, 2022 at 3:00 PM at the Eutaw City Hall with the GEMS Board, County Commissioners, Mayors, large employers and other to work on the problems of the ambulance service. The GEMS Board passed a motion for this meeting and requested that Zack Bolding prepare an operating budget and a capital improvements budget for the sponsors and partners of the ambulance service to review at that time and make commitment to save the ambulance system for Greene County.