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.

Greene County Commission holds special meeting on status of the ambulance service

Nick Wilson Chief of EMS with ambulance

By: John Zippert,
Co-Publisher

On Thursday, November 12th, the Greene County Commission held a special meeting to consider concerns with the operation and governance of the Greene County Ambulance Service.
The meeting was called to respond to concerns raised by Dr. Marcia Pugh, CEO of the Hospital, who was appointed to represent the Commission on the Board of Directors of the Ambulance Service. In an earlier Commission work session, Dr. Pugh voiced concerns over the fact that the Board of the Ambulance Service was not holding regular meetings, not having financial reports, and generally operating in an unaccountable manner.
The Ambulance Service director moved its operational office from the Eutaw City Hall to the former Warrior Academy building without consultation and approval by the its Board of Directors. Members of the County Commission, including new Chair Roshonda Summerville, members Lester Brown and Corey Cockrell also said they were unaware that the Ambulance Service had moved from City Hall.
Louis Jines, Chair of the Ambulance Board explained that the Board of Directors had not been meeting because of the COVID-19 pandemic. Commissioner Cockrel asked, “has the Board considered virtual meetings by phone or zoom”. Jines answered that the Internet service in his home area near Forkland was inadequate for virtual meetings.
Walter Staples, a military veteran serving on the Ambulance Board said, “Since I have been on the Board our role was to maintain the vehicles and medical supplies. We don’t have enough money coming in to require a budget.”
Dr. Pugh also indicated that the Ambulance Service had not picked up a patient recently from the Nursing Home who needed to be transported to Tuscaloosa for medical testing.
Nick Wilson, Director of the Ambulance Service said he was overwhelmed with other cases that day and was not able to pick up the person because it was not an emergency call. Wilson also questioned whether it was appropriate to air these complaints in a Greene County Commission meeting.
Commissioner Brown said the Commission would likely be sued if there was a serious problem and someone decided to sue the Ambulance Service.” Your board must meet, function and make decisions, follow your by-laws and act legally to avoid bringing complaints and lawsuits against the Ambulance Service and County Commission,” explained Brown.
Dr. Pugh said, “This is why the board needs to meet, review finances and policies and resolve problems before they are brought to the County Commission.”
Nick Martin and deputy chief, Zack Bolding, expressed some frustration with the process. “The County Commission gives the Ambulance Service only $28,000 toward our budget. We have had to raise money from other sources and private donors. In the 15 months that I have been director, no one from the County Commission has come to visit us at City Hall or Warrior Academy,” said Wilson.
Commission Brown said, “If you hold Board meetings, like your by-laws require and you invite us, we will come. Two of us can come at a time. We invited you to a budget meeting and a working session to discuss the problems but you did not come.”
The Commission’s counsel, Attorney Hank Sanders referred the Ambulance Board to its by-laws, “You have two members appointed by the Chair of the Commission, two members appointed by the City of Eutaw, and one each from the Towns of Forkland, Boligee and Union. All these political entities just had elections and the Mayors and the Commission Chair have the right to name your Board members. You need to check with them, get your board appointments and reorganize and operate properly under your by-laws.”
Attorney Sanders further advised that, “Your by-laws provide for the Ambulance Board to make an annual report to the Commission and the public, at the end of each fiscal year, on your contracts, leases, association memberships, finances, capital and operating budgets; major activities; compliance with local, state and federal regulations; and a statement of goals and objectives for the next year.”
The special meeting ended on a note of unity that the Ambulance Board would meet, reconstitute itself, discuss problems and plans and report back to the Commission and municipal entities with a clearer picture of its goals and needs for the future.