There are certain stories that never leave you.
As lawmakers, we spend a lot of time talking about policy – percentages, reimbursement rates, regulations, and studies. Those details matter. But behind every policy debate are real people and real families whose lives are shaped by the decisions we make.
I carry with me the story of a two-year-old child in Alabama who became unresponsive. The family did everything right. They called for help immediately.
Then they waited. And waited.
More than an hour passed before an ambulance arrived.
I think about another story – one that happened on Christmas morning. Two sons stood helplessly in their home as their father struggled to breathe. They called for help and prayed it would come in time. It didn’t.
The ambulance arrived more than an hour later. Those sons watched their father die.
Sadly, there are dozens of stories like this every year in Alabama, particularly in rural communities where emergency medical services are stretched thin and distances are long.
The heartbreaking truth is that sometimes the ambulance isn’t late because the system fails to respond. Sometimes the ambulance simply isn’t there.
In many rural areas, there may be only one ambulance serving an entire community. When that ambulance is dispatched, it could be miles away transporting a patient to an emergency room – even when that patient never needed emergency room care in the first place.
Why does that happen?
Because under the current system, ambulance services are typically only reimbursed if they transport a patient to the hospital. If a trained EMS professional evaluates a patient, treats them on scene, and determines they do not need to go to the emergency room, the service may receive little or no reimbursement. That creates a powerful incentive to transport – even when it isn’t medically necessary.
The result is predictable. Low-acuity patients are taken to already overcrowded emergency rooms. Ambulances can be tied up for hours waiting to transfer those patients. And the rural community they came from may be left with no immediate emergency coverage.
Then the next call comes in. And someone else waits.
This is why I support reforms like HB400/SB269, which help stabilize ambulance reimbursement while protecting patients from surprise medical bills. But it’s also why we must go further.
This legislation would allow emergency medical services to be reimbursed for treating patients on scene without requiring transport to an emergency room. This “treat in place” approach empowers EMS professionals to provide the right care at the right time while keeping ambulances available for true emergencies.
It also aligns with efforts being advanced by Gov. Kay Ivey through Alabama’s rural healthcare transformation initiatives. By equipping ambulances with telehealth technology, EMS personnel can connect directly with physicians while treating patients on site – bringing medical expertise directly into rural communities.
This isn’t just about saving money, though it will reduce unnecessary healthcare costs. It’s about saving time. And in emergency medicine, time is often the difference between life and death.
No parent should have to watch the clock while their child lies unresponsive. No sons should watch their father take his final breath while waiting for help that is still miles away.
We cannot prevent every tragedy. But we can build a system that gives every Alabamian – no matter where they live – the best possible chance when they dial 911.
For me, this isn’t just a policy discussion. It’s about making sure that when the next family calls for help, an ambulance is there. And it gets there in time.
State Rep. Ed Oliver represents House District 81, which includes portions of Lee and Tallapoosa counties, in the Alabama House Of Representatives. He serves as Chairman of the House Military and Veterans Affairs Committee.
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