Voters Hold The Future For Pickens County Ambulances
Maintaining ambulance coverage in rural Pickens County in the future may well depend on county voters approving a referendum on the ballot in the May 19th primary elections. Simply put, it authorizes the Pickens County Commission to levy an additional issuance fee on each vehicle license and registration in the county with the proceeds, "...earmarked and used only to provide ambulance service in the county."
The referendum is seen as an opportunity for Pickens County residents to keep the county from suffering another dangerous gap in ambulance services such as the one that forced it to rely on assistance from Lamar County and severely increased response time.
In April, the Alabama legislature approved legislation aimed at stabilizing fragile rural ambulance services by requiring insurance companies to pay higher, sustainable reimbursement rates tied to Medicare, preventing potential service closures.
Signed by Gov. Ivey, the bill authorizes payments for "treat in place" services—treating patients on-site without ambulance transport to a hospital. That provision is crucial for areas with limited nearby medical facilities such as Pickens County which lost its primary care medical center in 2020 due to some of the same stresses faced by ambulance services - unsustainable financial conditions, reduced patient numbers, and funding issues.
Senate Bill 269 was sponsored by Greensboro Democrat Senator Bobby Singleton; it addresses many of the issues faced by rural ambulance services, but it is not a solution for the tremendous day-to-day expenses of insurance, ambulance maintenance, fuel, administration and salaries. “Running an ambulance service, two trucks around the clock, and keeping your paramedics at the pay it takes to keep them is an uphill battle all the time to provide funding,” says Pickens/Tuscaloosa County State Representative Ron Bolton.
Bolton points to maintaining a professional staff as a critical cost. "You have to be able to sustain wages. Right night Pickens County is paying $20.00 an hour for a paramedic. They can go across the state line into Mississippi where insurance and reimbursements are significantly higher and they can make a higher wage."
NorthStar EMS stopped services in Pickens County in late 2024/early 2025 because of these financial challenges and low call volumes, forcing the county to look for new options. Lamar County and the Alabama Fire College stepped in to help but solutions need to be long term.
If the referendum fails, county officials worry that cutbacks may have to start with the loss of one of the two current ambulances. With already long transport times, that will increase delays, which during the past crisis resulted in unneeded loss of lives.
The Pickens County Commission is not required to provide ambulance coverage, but officials point out it is not a luxury but a necessity for the entire population.
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