Birmingham, AL Non-Emergency Medical Transportation Permit: Council Vote, $1 Million Policy, Van Rules (2027)

Birmingham regulates NEMT companies as vehicles for hire. Title 12, Chapter 16 of the city code names non-emergency medical transport as its own class of service, and no company may run one on city streets until the City Council grants it an operating authority permit by resolution. The permit comes with a certificate of public necessity and convenience (CPNC) for each vehicle, and each driver needs a police operator’s permit. Applications run through the Birmingham Police Department’s Business Compliance Unit.

Who needs a Birmingham NEMT permit

Ordinance 21-184, adopted November 30, 2021, rewrote the class. A non-emergency medical transport service is a vehicle for hire that is:

1. Engaged by prearrangement.
2. A sedan, van, minivan, bus, or accessible vehicle.
3. Carrying walking or wheelchair passengers to and from medical appointments.
4. Including rides under the Alabama Medicaid NET program, which pays transporters through vouchers.

The code defines operating as picking up or dropping off a paid passenger within the city, and the city includes its police jurisdiction. A company based outside the city with no Birmingham permit may bring riders in, but Section 12-16-47 bars it from picking anyone up there, so a round trip to a Birmingham clinic needs the permit. Council agendas from 2022 through September 2026 carry resolutions granting NEMT permits to companies based in Birmingham and in nearby towns such as Bessemer, Hoover, and Hueytown, most for one or two vehicles.

One line pulls the other way. The chapter’s list of vehicles that are not vehicles for hire still includes “ambulance and other medical transport service vehicles.” The council has kept granting NEMT permits since the 2021 rewrite: it granted one on May 19, 2026 (Resolution No. 1010-26), and another was on its September 8, 2026 consent agenda. If you think your vans fall under that exclusion, put the question to the Business Compliance Unit in writing and keep its answer.

What the class does not allow

A vehicle under a NEMT certificate may not give emergency rides, carry riders lying down, make intra-hospital transfers, cruise for riders, take on-demand calls, or offer any other service in the chapter. The code counts a ride as prearranged when it is booked at least half an hour ahead. Section 12-16-2 bars a vehicle permitted for NEMT from working as a taxicab, and Section 12-16-65 bars every vehicle for hire from carrying medical specimens or biohazards, on pain of losing the CPNC. If you planned to run lab samples between clinics, keep that work in a vehicle with no Birmingham CPNC.

State rules that touch Birmingham

Under PSC Rule 770-X-10-.02-.01, the Alabama Public Service Commission’s passenger authority covers a trip that runs to a city whose limits or police jurisdiction do not touch the starting city’s, or that starts or ends outside every city. Trips that stay inside Birmingham, or run between Birmingham and a bordering city, are exempt from the PSC, though any pickup in Birmingham still needs the city permit.

Statewide, Alabama Medicaid runs NET without a broker: riders book through the NET call center and choose a transporter from the NET Transporters Directory. The Alabama guide explains how to get approved and listed.

How to get the operating authority permit

1. Buy the insurance first. Section 12-16-5 requires a single-limit policy of at least $1,000,000 from an insurer authorized in Alabama, covering personal injury and property damage, with the city named as additional insured. File a current certificate in person with the city clerk, listing the VIN of every vehicle, and make sure it promises the clerk’s office 30 days’ written notice before cancellation. No permit or business license issues until the clerk has it. See NEMT insurance requirements.
2. Get the application from the Business Compliance Unit. The police department supplies the forms, and you swear to them under oath. They ask for:
   • every owner, member, officer, director, and stockholder, with addresses and ownership shares
   • unpaid judgments against any of them, and every arrest or conviction, traffic offenses included, in the past five years
   • the location of your depots and terminal
   • each vehicle’s make, model, seats, year, plate, VIN, and owner
   • your trade name, insignia, and color scheme
   • statements that you are at least 21, a U.S. citizen or a permanent resident allowed to work, and keep a publicly listed phone number
   • a drug testing policy for your employees
3. Pay the $100 filing fee and return the application to the unit. The police review it and report to the council, and the council cannot consider it before that report.
4. Have each vehicle inspected. See the vehicle rules below.
5. Wait for the council vote. Applications go through the council’s Transportation and Infrastructure Committee to a council meeting, often on the consent agenda. The January 17, 2023 agenda shows NEMT applications with the committee’s recommendation and one without. Under Section 12-16-15, the council weighs the number of vehicles for hire already running, whether existing service meets the need, traffic effects, and your character, experience, and proposed service. If it finds a need, it adopts a resolution granting the permit, and the police issue a CPNC for each vehicle.
6. Get your business license. The Tax and License Division, Room TL-100 at City Hall, issues it once the police confirm your inspections and the clerk has your insurance. Renewals are due January 1 and late after February 15.
7. Permit every driver before they carry a rider, as described below.

The glossary entry on the certificate of public convenience and necessity explains how this kind of need-based permit works in other places. New Orleans runs a similar hearing-based CPNC.

Birmingham permit fees

Chapter 16 sets these fees, as of October 2026.

Fee	Amount	When
Operating authority application	$100	With the application
Operating authority renewal	$100	Each December
Adding a vehicle	$25	With each written request
Driver operator’s permit	$30, plus a $25 money order for the fingerprint card	With each driver’s application
Operator’s permit renewal or replacement	$10	At renewal or on loss

Each driver also pays for the state criminal history check, by certified check or money order payable to the Alabama Bureau of Investigation, and Section 12-16-31 asks for a second cashier’s check or money order, payable to the Treasury of the United States, for a comprehensive background check.

Vehicle rules in Birmingham

An accessible vehicle, under the code, is a minivan, van, or bus that meets the Americans with Disabilities Act and has a lift or a ramp safe for a wheelchair rider, enough headroom, and wheelchair tie-downs. It never covers stretchers or beds. For lift and ramp choices, see choosing a wheelchair van for NEMT.

• Tracking and contact. Every vehicle for hire carries a working GPS and a two-way radio or cell phone while in service (Section 12-16-3).
• Yearly inspection. In the month the current police sticker expires, an ASE or AATI certified mechanic, a technician qualified under 49 CFR 396.19, or a licensed repair shop checks 21 items, from the foot and emergency brakes and steering to tires, mirrors, seat belts, air bags, and heat and air conditioning. The vehicle must meet the federal inspection standards in Appendix G to 49 CFR Chapter III, Subchapter B, and you keep the paperwork while the inspection is valid.
• Age. No vehicle more than 10 years old, counted from July 31 of the tenth year after its model year.
• Equipment. A readily reachable UL-approved fire extinguisher, a working spare and jack if the vehicle has a spare, and the maker’s seating capacity sticker or plate.
• Random checks. Police may inspect at any time. A vehicle that fails gets a correction slip and 15 days to fix it, or it stops carrying riders.

Drivers keep a trip log with the driver’s name and permit number, time on and off duty, the fare, and where and when each rider got in and out. You keep it at least one year, and an electronic log counts.

Driver operator’s permits

No one drives a vehicle for hire in Birmingham without a police operator’s permit. Under Sections 12-16-29 and 12-16-31, each driver:

• is at least 21, a U.S. citizen or a permanent resident allowed to work, and an Alabama resident with an Alabama license
• speaks, reads, and writes English
• has no felony, crime of force, crime of moral turpitude, or illegal possession or sale of alcohol or controlled substances in the past five years, and no criminal conviction, probation, or forfeited bond for any offense in that time
• has no more than two at-fault crashes and fewer than 12 license points in the past three years
• gives fingerprints taken by the police, a signed request for a state criminal history check, and a referral letter from a permitted vehicle-for-hire company

Section 12-16-29 also calls for a physician’s exam under the federal driver standards before the first permit and each renewal, while the 2021 rewrite of Section 12-16-31 asks for the physician’s certificate only from drivers who need a CDL. Ask the Business Compliance Unit which it applies. File renewals at least 30 days before a permit expires. Drivers wear a collared shirt with sleeves, full-length trousers, and closed shoes, and may not refuse a rider because of a disability. For the checks most brokers and facilities add, see NEMT driver requirements.

Keeping the permit

Renew the operating authority each December with the $100 fee, a sworn statement that your application facts have not changed, and each driver’s current driving record, criminal background record, and health status. Keep that driver list on file with the police all year.

Report any change in your application to the Tax and License Division in writing within 10 days, tell the city clerk within 72 hours when you sell a permitted vehicle, and notify the city before you move your terminal, which must meet zoning. The council may suspend or revoke a permit for a code violation or more than 60 days without operating, and a vehicle with no rides for more than 60 days can lose its CPNC. A lapsed policy costs you the certificates it covers: on June 17, 2025, after a public hearing, the council adopted Resolution No. 968-25 revoking a NEMT company’s certificate because it had not filed the required liability insurance with the city clerk. Police may also impound a vehicle that runs for hire without its CPNC.

Where Birmingham’s Medicaid riders are approved

Birmingham spans two counties, and Alabama Medicaid splits them between district offices. Its NET coordinators list dated July 9, 2026 gives:

• Jefferson County: the Birmingham District Office, 600 Beacon Parkway West, Suite 300, 205-414-9413.
• Shelby County: the Gadsden District Office, staffed at 501 Dexter Avenue in Montgomery, 334-242-4092.

Call the office for the riders you plan to serve, ask to be approved as a NET transporter, and have your city permit in hand when you do.