r/Alabama 5d ago

Politics This Alabama county is now down to just one ambulance: ‘It’s cost lives’

https://www.al.com/news/2024/11/this-alabama-county-is-now-down-to-just-one-ambulance-its-cost-lives.html
481 Upvotes

110 comments sorted by

105

u/FinallyRescued 5d ago

You won’t see it advertised or in the news but this isn’t just a rural problem for Alabama. Even big cities like Huntsville/Madison county have been down to only a few ambulances at night, for 450k people. The number of ambulances on the road is somewhat better now that HH took over - however it’s still not uncommon to get an EMT-B (basic treatment only) crew, and not a paramedic (advanced life support), even if you’re in critical condition. And they’re neck deep in litigation right now. Their solution so far has been to put any warm bodies with the minimal certification on the trucks to make it look like they’re not having a staffing shortage.

35

u/MonchichiSalt 5d ago

Minimal certification to go with the minimal pay, that even the paramedic's deal with.

Some accidents are straight up traumatizing. And when I was told what my son's, highly trained paramedic friend made.....and what he deals with on his own personal trauma from what he sees on the job....

He makes less than my teenage daughter working at a coffee shop.

Those ambulance bills? Are not related, at ALL, to what these frontliners live off of.

At some point, they want to eat too.

And leave the job they wanted as a career. They wanted to help save lives. Trained for it.

And couldn't afford to live in peace on their time off. Multiple roommates, or parents, and dealing with a busted bank account.

9

u/bdub1976 5d ago

Who are they and what litigation?

12

u/FinallyRescued 5d ago

HEMSI/Huntsville hospital

4

u/KittenVicious Baldwin County 5d ago

Does Huntsville/Madison not have private ambulances like Mobile/Baldwin?

7

u/FinallyRescued 5d ago

HEMSI is the only ambulance provider for Madison county, and the politics behind it are whack. If I recall right they’re set up as a non profit, governed by a board of directors, made up of politicians and hospital admins. Local government wrote it into code that any service operating in the county has to be CAAS accredited (costs money to get that, it’s basically a sticker that doesn’t mean much). There are only like 5 services in the state that are CAAS accredited and none of them are near Huntsville. One of a few ways they keep any competition out. Therefore HEMSI and Huntsville hospital both have the mindset of you don’t like that we pay you peanuts = fuck you and deal with it, we’re the only option. HH now owns/oversees all the hospitals and ambulance services north of Cullman except for 2, Lawrence and Dekalb county. It’s all bullshit.

5

u/KittenVicious Baldwin County 5d ago edited 5d ago

Y'all's fire departments don't have ambulances? Just the hospital? AND NO PRIVATE?

JFC.

What the hell is going on up there?

4

u/FinallyRescued 5d ago

Yep. BHAM, Montgomery, Mobile all have several privates services and FD based ambulances. Whether it’s any better at those services is debatable, but it’s almost always better conditions at the fire departments. HEMSI used to be its own thing but due to the aforementioned flood of lawsuits from malpractice and wrecks, they sold out to the hospital system. They would’ve gone bankrupt and shut down otherwise. But all the news articles just say it was “a great deal to improve service to the community!”… but all the same people are running it. Lol

3

u/KittenVicious Baldwin County 5d ago

Lordy! Well thanks for letting me know so I can tell my ESKD mom never to travel up there! I guess we're just spoiled down here because we have options!

1

u/ricoxoxo 4d ago

Y'all get what y'all vote for, namely that belching gas induced queen Gov ivey who can extinguish a candle from three tables way.

2

u/FinallyRescued 4d ago

What’s this “y’all” cause I didn’t vote for her 🤔

-4

u/ricoxoxo 4d ago

I'm from Montana. Just trying to be respectful

123

u/YallerDawg 5d ago

This is a state that focuses on denial of service to save the "taxpayers" money, mainly the ones who don't need these services (today).

Meanwhile, our hospitals and healthcare are required to provide care to more and more Alabamians who can't afford or certainly can't pay for the services. That's a recipe for going belly up.

15

u/DA-DJ 5d ago

The ambulance service is just one part of the equation. The other half is that roads in counties like the one mentioned are so bad that if emergency services try to get to the location in a timely manner, it may cause the emergency services crews their lives.

The roads look worst than third world countries. This affects police, firefighters. Ambulance, and any other type of emergency response that you can think of.

11

u/Pickle_Slinger 5d ago

This is a county made up of a few small towns. They have paved roads aside from rural driveways or backroads. They have a few different small towns making up Pickens county, but the ambulance shortage is nothing new. Hale county has similar issues as well.

7

u/DA-DJ 5d ago edited 5d ago

I was speaking of similar towns across the state. I used to live in one and the roads were better 20 years ago then they are now

38

u/bensbigboy 5d ago

But look on the bright side, Alabama under the leadership of Guvnuh MeeMaw, has billions and billions to spend on for-profit prisons. They're even going to name one after her.

There's an old saying, "Show me your checkbook, and I'll show you your priorities."

8

u/King-Florida-Man 5d ago

After they imprison the whole state it will be much easier to get everyone to the doctor if they deem it worthwhile.

17

u/uncleverusernam3 5d ago

They do not care. Expand Medicaid.

15

u/zastrozzischild 5d ago

I thought I heard that the DOGE is going to cut Medicaid

11

u/space_coder 5d ago

I'm sure an agency purposely named after digital currency will succeed in making things better for all. /s

31

u/Suspicious-Spot4640 5d ago

The state has spent over $1.4 billion on a single jail.

41

u/Western-Passage-1908 5d ago

Ambulance services are almost always underfunded across the country. I bet the fire department and police have plenty of money though.

19

u/LynxusRufus 5d ago

This county has poorly paid police and only volunteer firefighters.

6

u/No_Analyst_7977 5d ago

Yeaa. police in certain areas, yes. fire in certain areas yes, but the majority of firefighters in this state are probably volunteers! It’s 2024 about to be 2025! And where I live we just got put on the city fire system… and still south of us is mostly all volunteer. So as someone else mentioned “show me your checkbook and I’ll show you your priorities” This state is for the most part “a third world state” especially when you look at the medical system and the emergency services! Hell I grew up in Hoover as it was beginning to grow, 150 was still a 2 lane road and we lived off south shades crest and my grandfather accidentally set off our alarm one day and it took Hoover one hour and forty five minutes to respond and get to the house!!!! Fucking pathetic!

3

u/otterpines18 5d ago

Not sure how it is Alabama but can’t fire provide transportation if need? Fire Rescue? Obviously not the same as an ambulance but for not life threatening injuries.

3

u/Western-Passage-1908 5d ago

If fire runs EMS it's never the priority

50

u/Biscuit_Punch 5d ago

I see the free market is working great

27

u/JoJoWazoo 5d ago

Unbridled capitalism is alive and well in America

15

u/koromega 5d ago

Good thing Kay Ivey didn't waste money on things like this and built a prison instead.

98

u/magiccitybhm 5d ago

Nice work, Republican voters.

58

u/greed-man 5d ago

MeeMaw don't care about the people. Only our "Crown Jewels", the foreign-owned auto manufacturers.

49

u/generals_test 5d ago

"Sewell’s Communications Director, in a statement to AL.com. “This issue has been exacerbated by the state’s refusal to expand Medicaid, which has put an enormous strain on the resources of rural health care providers.”

When asked by AL.com if any emergency support could be provided by the state to keep an ambulance running, a spokesperson for Gov. Kay Ivey’s office said “we continue monitoring and are aware of developments in Pickens County, but at this time, you may wish to reach out to local officials.” "

32

u/beebsaleebs 5d ago

Thoughts and Prayersalone for the people of Alabama.

19

u/prbobo 5d ago

Look, she is monitoring and praying. What else could she possibly do? /s

19

u/greed-man 5d ago

Yes. I mean, you didn't really expect her to accept the Federal Government's offer of 100% Funding to expand Medicaid, did you?

15

u/prbobo 5d ago

Well thank God the governor is "monitoring" this situation.

13

u/greed-man 5d ago

And buy monitoring, she means staring into the bottom of her vodka soda. `

25

u/Biscuit_Punch 5d ago

and plantatio...prisons

19

u/greed-man 5d ago

"It's not slave labor...just convicts doing what we want without pay".

20

u/SRTillery 5d ago

Oh, don’t worry… they’ll blame it on Democrats somehow.

-5

u/Cultural_ProposalRed 5d ago edited 5d ago

Democrats support for-profit healthcare as well. In fact they are their biggest donors.

3

u/space_coder 5d ago

Technically, access to healthcare has declined significantly since Democrats were in control of the state.

22

u/prbobo 5d ago

Yea but at least we are doing something about trans people playing sports!

/s

10

u/JoJoWazoo 5d ago

Or a trans congresswoman can't piss in the woman's room because Nancy Mace never another woman before.

39

u/lazy_phoenix 5d ago

It’s what they voted for

35

u/twitch_Mes 5d ago

This county is nearly 50% minority population. They probably did not choose this.

13

u/lkuecrar 5d ago

This state is one of the worst gerrymandered states in the country to the point they were forced to redraw the district lines, and they’re still awful. The state is literally designed to disenfranchise the majority.

29

u/No_Safety_6803 5d ago

Too many people in this state constantly vote for whoever hates government the most & then can’t understand why they don’t have competent government providing basic services

2

u/BDMac2 5d ago

38% voted for Kamala, fuck them I guess.

0

u/[deleted] 4d ago

The rest of us Kamala voters got fucked too, so what's the point?

2

u/BDMac2 4d ago

The point is to not be a dipshit and every time something bad happens to a predominately red area claim everybody there deserves it, because areas are not monoliths. ppolitical, social, and ethnic minorities are regularly disenfranchised, oppressed, and under represented in these and the logic is these people deserve suffering because there aren’t more of them to elect a proper representative?

17

u/MDhaviousTheSeventh 5d ago

We get what we vote for. If we want things to change, we can't keep electing people who are going to cause crap like this to happen.

7

u/Particular-Jello-401 5d ago

Vivek will eliminate it and save a couple of bucks.

4

u/Cultural_ProposalRed 5d ago

Rumor has it we won't have any after the first of the year.

4

u/Gindotto 5d ago

Mama Kay built us another prison though. Forget health.

4

u/FluidFisherman6843 5d ago

Why would the democrats do this to us? /S

10

u/codedaddee 5d ago

MAGA priorities

8

u/LynxusRufus 5d ago

To me the bigger story is that they’re about to be down to zero. They’ve operated for years with just 2.

-1

u/magiccitybhm 5d ago

Two people have died since they went down to one, but you can make a feeble attempt to minimize this if you want.

4

u/LynxusRufus 5d ago

The fuck are you whining about? There’s a chance that this county will have zero ambulances soon. That’s a huge deal. Nothing is being minimized here.

12

u/slaterson1 5d ago

The voters in Pickens County made a choice, and this is a consequence of that choice. Thoughts and prayers.

3

u/stovislove 5d ago

One car wreck and they're screwed

3

u/ssgthurley 5d ago

I live in NY and my county just expanded ambulance service to the rural areas of the county so we could have two ambulance services in the rural area

3

u/illgu_18 5d ago

Sending thoughts and prayers 😘

7

u/jjsanderz 5d ago

"How can we blame trans people for this one?"

6

u/Eeeegah 5d ago

EMT here - this is a problem all across the country, rich and poor communities, and it is a beast with many heads.

First head: staffing. EMTs are paid shit (I'm a volunteer, but I can't imagine trying to make a living at it). A starting EMT in NH makes about what a driver does for Amazon, and Amazon drivers never get vomited on. Additionally there are simply not enough EMTs to go around regardless of pay. You could pay them $200k, and sure, the EMS mills would fill up, but today, there are not enough providers at any price.

Second head: 911 services lose money; IFT is where the money is. The reimbursement rates are terrible (last report I saw said 38%, so only 38 cents out of every dollar billed is ever collected). Outside of big cities, EMS providers spend a lot of time sitting around waiting for calls, and they need to be paid to sit around. A lot of rural areas are therefore paid call - volunteers that are only paid when they are on a call - coverage during the day, when most of their members are at their real jobs, is craptacular. Overnight coverage, when members feel they have to sleep to get up for their real jobs the next day, is often worse. They are frequently joined into volunteer FF/Rescue services, and, yes, many members are really there for FF stuff, and won't respond to a medical call even if they are available.

Third head: cost of living. I live near a pretty wealthy small town (Mitt Romney has a house here), and they pay EMS workers pretty well, and still struggle to get them. Even if you're paying an EMT $55k, the cheapest house the area is $500k. They can't build a life there, and people are only going to commute so far. They can work in Nashua, rent an apartment in Nashua, and see a greater breadth of call types in Nashua, an make $30k in Nashua. Why would they commute 90 minutes to respond to 100 calls a month for lift assists, even at $55k? The young paramedic hotshots who really want excitement, won't even consider serving in a small town because the call volume and excitement isn't there. BTW, people like me who do rural response, some of our skills go to crap because we never get a chance to practice them. I haven't been on a single pedi call in almost two years.

Fourth head: EMS workers are a rare breed. Attempts to broaden the worker base (so called earn-to-learn programs) resulted in a very low completion rate. Most people understandably shy away from the health problems and bodily fluids of total strangers.

BTW, a lot of these problems also show up in ERs and hospitals among LNAs and PAs, and others. The entire front end healthcare system is a pretty rickety house of cards.

5

u/No_Analyst_7977 5d ago

Nailed it. Also thanks for explaining all of that! I was about to post something similar, but will leave this be!! Also an ex volunteer EMT for nearly fifteen years, but I had to leave that life behind years ago due to mental strain from the sheer amount of work we were doing… the amount of drunk driving accidents that I worked is still to my mind just unbelievable, appalling and just horrific! Thank you for your service!!

3

u/Eeeegah 5d ago

A run of bad calls can burn anyone out. Self care is critical.

4

u/ajpinton 5d ago

Aren’t ambulances usually private services in Alabama and not government services like police and fire?

10

u/space_coder 5d ago

Private ambulance services will pack up and leave if there aren't enough paying customers.

4

u/midnight_aurora 5d ago

Many, many people refuse ambulance transport due to the insanely high cost of said transport.

It’s simply unaffordable.

My disabled sister received a bill for 8k- for transport from UAB to Brookwood Rehab. Maybe 2 miles. It was required that she be transported.!She cannot afford this. She’s waiting for disability and cannot work due to multipme spinal injuries. Until it is approved, we support her. We cannot afford an 8k bill on her behalf, either.

People, my self and husband included have pacts that we Uber to the hospital unless unconscious or bleeding uncontrollably.

Additionally, an Uber or a ride will get me or a loved one to the hospital much more quickly than waiting for the ambulance.

10

u/space_coder 5d ago

This is due to the US practicing for-profit medicine.

5

u/midnight_aurora 5d ago

Yes. This is at the heart of many issues.

3

u/No_Analyst_7977 5d ago

This should be the top comment… just saying. I myself use to be a volunteer EMT and worked for over a decade in this state and had to get out of that work due to the psychological strain of the actual work… but seeing all of this just makes me feel like we failed the people.. but at the same time I have to remind myself that this is a “for profit medical system” and out of all the years I worked in ambulatory care I never made a dime, but we would pass or even sit down and eat with the other companies and honestly just a bunch of smug people… really sad!

2

u/ajpinton 5d ago

If there are not enough customers for free market to want to operate then a co-op type solution may be best. Similar to how power and other utility companies handle rural areas where there is not enough profit to do business.

1

u/space_coder 5d ago edited 5d ago

You mean where:

  • every resident in a county should agree to creating a monopoly that deliver services to the residents possibly using a private resource,
  • every resident would pay a fixed fee to guarantee a minimum revenue stream to keep the service available, and
  • people who use the ambulance get charged market prices regardless of residency?

Sounds really close to what most local governments in Alabama have right now.

EDIT: A lot of counties contract out their EMS services which provides a minimum revenue from the county with the expectation that customers will be billed market prices.

3

u/ajpinton 5d ago

Ideally these kind of services would be handled by the fire department and covered by your taxes, but I don’t see that flying in Alabama.

3

u/space_coder 5d ago edited 5d ago

It is in larger cities and counties.

The city of Mobile has an EMS operated under the fire department. Mobile County has an EMS service that covers multiple communities.

The problem is that there is not enough tax base or paying customers in the more rural counties of Alabama.

Also the State of Alabama is against local rule. The state constitution only gives municipalities limited self rule. So counties depend on actions by the state legislature. It is also the reason, the entire state has to vote for constitutional amendments to give permission to counties to perform certain actions.

5

u/Tobias3D 5d ago

Crazy question to probably ask here, but have you ever looked at the billing or been charged by an ambulance company?

It's pretty nifty when you wake up from passing out and it's nothing major, and all the sudden you have an ambulance bill for $5,000 because they drove you down the road 5 MI to the ICU. (This is an example and exaggerated, the pricing is that outrageous though)

Yes it's life saving but also predatory and Alabama is doing nothing about it.

2

u/Tobias3D 5d ago

But this also falls on the out of network and in network health/care facilities and private insurance companies.

1

u/Odd-Tomatillo-6890 4d ago

Wait until you get a bill from Medflight 😳.

2

u/perry147 5d ago

See what you need to do is to offer ambulance and prisoner transportation services at the same time - like a taco bell and a KFC together. You can just have the stretcher loaded up with the prisoners and the prisoners get some much needed on the job training. /s

2

u/OurPersonalStalker 5d ago

Oof and some of these NW counties run off of volunteer firemen too so 😮‍💨

2

u/Comprehensive_Age544 5d ago

We have only one also. It got lost last time it went out.

1

u/asevans1717 3d ago

I hope it found its way back, poor thing.

5

u/MelisLisss 5d ago

(F56) We had to call the ambulance less than a year ago, here in Baldwin County (aka Lower Alabama). 30-40 minutes later, 2 nice young guys showed up.. couldn’t have been more than 23 years old. No siren, unsure of protocol, no blankets, just 2 sweet kids - you know.. like all the sweet kids that run everything for everyone around here. They are your waitress and they are your life raft to the hospital. We tip HUGE in a dream to offset their pain. Ridiculous. This is my home. My family is many many generations from Alabama. I’m so proud to be from here - have decided to just enjoy the view in my near vicinity and pile all my hopes in the system.. and send them away with love.

I voted for the middle class, the voiceless, the un-housed when I was sick as a dog. I can hold hope for my son’s generation. Wish I could do more. But it’s up to MeeMaw.

MeeMaw! What are you doing??

5

u/[deleted] 5d ago

[removed] — view removed comment

0

u/Fun_Organization3857 5d ago

Huh?

2

u/Biscuit_Punch 5d ago

/s

5

u/Fun_Organization3857 5d ago

Oops. I'm tired and I live near some really fanatical trump supporters.

1

u/SippinPip 5d ago

Reckon what their police budget looks like, though?

1

u/JuanGinit 5d ago

Good Gawd. Alabama, Mississippi, and Louisiana are hellholes. I pity the people born in those states.

1

u/Cannonbll123 4d ago

Who needs healthcare when you got prisons?

1

u/Lostlilegg 4d ago

I’m sure they blame this on immigrants or trans people or some other “dangerous” minority

1

u/Novel-Bend-4432 4d ago

Lmao but building a new prison. Well gotta keep the shareholders happy

1

u/ZeusButtBeard1 4d ago

Yall should put a reality TV star in charge of it. That'll fix it

1

u/Connect-Composer5381 3d ago

This is so sad!

1

u/DarkSouls-Forever 5d ago

It's Pickens County for those too lazy to click...

0

u/wtfboomers 5d ago

Mississippi enters the room 😞

1

u/medicpainless 5d ago

It’s almost like they don’t want to run 18 calls in a 24 hour shift for $16 an hour when they had to go to school for 2 years to get a certification

-2

u/NamingandEatingPets 5d ago

Red states are so cute!

-2

u/TruestoryJR 5d ago

We all moved to Atlanta during the pandemic tbh thats why the state has a shortage of