November 2017
Homeplace & Community

Alabama’s Rural Hospital Emergency

Will urgent intervention preserve lifesaving care at small hospitals, or is a medical desert on the horizon for many of the state’s rural residents?


Wilcox County leaders George Alford, left, and John Clyde Riggs are working hard to save J. Paul Jones Hospital.

Country living can be wonderful until emergencies occur in rural areas without hospitals or clinics to provide lifesaving care.

It’s been that way for years in Alabama’s Black Belt region and positive changes often take years to materialize, if ever.

Wilcox County is a prime example of current medical problems confronting officials there, as well as throughout the affected area.

J. Paul Jones Hospital has treated patients for the past 60 years, but its days appear to be numbered and plans now are to convert it to an urgent care center and accompanying ambulance service.

The same situation confronts other small hospitals throughout rural Alabama and leaders are doing all they can to reverse a trend that has thousands of residents worrying every day.

When and if it happens in Wilcox County, up to 40 jobs may be lost in an area that already has, for many years, the highest unemployment rates in the state.

According to the Kaiser Family Foundation last year, when rural hospitals close or drastically reduce their services, doctors tend to leave or it becomes more difficult for patients to see specialists.

The foundation report found that transportation was more of an issue for elderly and low-income residents, making them more likely to delay or avoid needed medical care.

Money or lack thereof once again has a hospital on the chopping block and George Alford is enough of a realist to know it may take Congressional intervention or some other form of financial assistance to keep it open.

Alford is chairman of the Wilcox County Hospital Board and recently led U.S. Rep. Terri Sewell on a tour of the facility.

"Alabama’s rural hospitals have been struggling for years, largely due to inadequate reimbursements, low volume and high operating costs," said Sewell, who grew up in nearby Selma and knows the importance of keeping them open.

According to the congresswoman, reimbursements for medical services that have already been rendered "are simply insufficient to cover operational costs at these facilities."

She said closure of the hospital in Wilcox County will create a "medical desert" in the region, forcing residents to travel 40 miles or more to the nearest open one.

Those who enjoy hunting and fishing look upon Wilcox County as a recreational paradise. If the hospital is forced to close, as is planned, the result could be devastating.

"The economy in this county is so bad it’s hard to support it," said Alford, who knows from personal experience just how important rural hospitals are.

He had just finished shaving and showering 16 years ago when he felt the first pangs he knew were signs of a heart attack.

Dr. Sumpter Blackmon and J. Paul Jones Hospital Administrator Elizabeth Kennedy have decades of medical experience in Wilcox County.


Alford was able to drive himself to the hospital in Camden, where initial treatment stabilized him for the subsequent trip to Montgomery’s Jackson Hospital about 80 miles away.

Accompanying him to the hospital was Dr. Sumpter Blackmon, who is looked upon by Wilcox County residents as a white-frocked angel.

"I can still remember asking for a ‘clot buster shot’ and telling Dr. Blackmon I wanted to see my children before I died," Alford said during a recent interview.

Blackmon did more than treat Alford on the spot; he accompanied him to the hospital.

The initial treatment he received at Wilcox County’s little hospital has provided Alford with a 16-year breathing bonus. Without it, he tells family and friends, he had his doubts that he’d have been able to survive.

"I can recite story after story about how important this hospital has been to the people of Wilcox County," Alford said. "Broken bones, stitches, snake bites … you name it, we’ve handled it."

Talk is one thing, but facts don’t lie when they are bolstered by specific details and Alford issued a statement to county residents about the impending closure possibility.

He noted that Wilcox County has a poverty rate of about 40 percent, an unemployment rate of 13 percent – the highest in Alabama – and a declining population of less than 12,000.

As a result, Alford said it is "nearly impossible for our small rural hospital to survive as it currently operates."

Between Oct. 1, 2016, and May 31, 2017, the hospital had charges of nearly $4 million involving the emergency room alone, according to Alford, who said reimbursements fell far below what is needed to stay afloat.

He backed that up with an illustration that should be easy to understand for those who watch their nickels and dimes.

"If you have an item for sale in a retail situation that cost you $50 and you are required to sell it for $5 to $10, you wouldn’t be in business very long," he said. "I believe these figures speak for themselves."


U.S. Rep. Terri Sewell, left, and J. Paul Jones Hospital Administrator Elizabeth Kennedy tour the facility that might have to close.

In a never-say-die effort by the Wilcox County Commission, a penny sales tax increase was approved overwhelmingly. But a projected economic lift of $550,000 unfortunately appears to be a case of too little, too late.

Losing $1 million a year is enough to give any manager a case of the blahs and Alford knew there wasn’t much of a solution after years of a downward spiral.

He had heard the claims of some in the county that it was a case of "crying wolf," but this was the real thing and there wasn’t much to do except fold the hospital tent and prepare to convert it to an urgent care facility.

Wilcox isn’t the only county in Alabama having the same hospital problems, but it’s doubly embarrassing because it is the home of Kay Ivey, who was elevated from lieutenant governor to governor earlier this year.

Ivey became Alabama’s leader as a result of her predecessor’s resignation. Since then, she has commiserated with Wilcox residents, especially when visiting friends back home.

Other than that, there isn’t much she can do to help her home county save its hospital; but if anybody can do it, Ivey is the one to do so.

Wilcox County residents would even provide the red ribbons on a Christmas present if it ever comes about.


Alvin Benn is a freelance writer from Selma.