How would you choose to spend four hours of your day? For more than 8,000 people in Alabama, that time is a matter of life or death. Many spend it on a dialysis machine -- the only way they can eliminate waste and unwanted water from their blood.

Despite the critical nature, some patients would rather forgo treatment than travel to a clinic. That is, until the state stepped in.

For at least three hours a day, three days a week, Henry Kelly gets hooked up to a dialysis machine for treatment. He uses the time in the chair to think about why it's important for him to be here.

"My mom, my brother were all on dialysis," Kelly recalls, "and they passed away on dialysis."

High blood pressure issues led him to dialysis treatment, a chronic illness that affected his brother and mother before their deaths. Kelly's mother also suffered from diabetes. He says she died following one of many long trips home from treatment.

His mother didn't live to see the Davita Center open in 2013. It serves 32 people in four different counties. More importantly, it's only minutes away from residents who need it.

Before the Davita Center was built, rural Perry County dialysis patients had two options for treatment: Drive the 30 minutes to Selma in Dallas County or double the distance to about 55 minutes by going to Demopolis in Marengo County. When factoring in the round trip, the time for treatment was simply too overwhelming for some patients.

"You had people choosing not to go to dialysis, and when that happens you die." explained Ron Sparks, appointed Director of the Black Belt Commission by Governor Robert Bentley. He learned early of the lack of health care options in rural counties.

"The lack of health care in these rural areas is a serious problem," Sparks says, "especially when it comes to dialysis."

Francis Ford set out to change that. She's a retired nurse and the health care coordinator in Perry County. A woman determined to stop the dying. "We didn't just only write letters ourselves, but we got patients to write, we got local citizens to write in the community. We had the support of our commissioners..."

And, she found the support of the governor. Bob Riley was in office at the time, and Chad Nichols was then head of the Black Belt Commission. He had a personal interest. His grandfather was a dialysis patient who lived in Perry County. He traveled to Selma for treatment.

"Going to dialysis, he was in a major car accident," Nichols remembered. "So I saw the impact it had on him..."

The first hurdle for Nichols and Ford was getting rid of a 1975 state health regulation that required a hospital within 25 miles of a dialysis center. Back in '75 there were 128 hospitals in Alabama. Today, there are just 92 and at least 10 have closed in the past 3 years .

"Shocked," Nichols reacted, "but also sadden that a state regulation was on the books that was, in my view, really impacting the quality of life and impacting or making life and death decisions at a time for people who didn't have the ability to travel to get care."

The state health department eliminated the rule back in 2005. More than 10 years and two governors later, Perry County finally has its own dialysis center.

"I don't think many people realize if you have not walked in the shoes of a person on dialysis, you don't know the hardship it is and the burden it is on that person's family," Ford expressed.

Henry Kelly no longer travels to Selma for treatment. He now comes to the Davita Center not far from where he lives. It means less time on the road and more time to think about life beyond the chair.

With the rule change, more centers can open in rural counties. But those areas usually run into other problems like health care costs. Since an overwhelming number of dialysis patients living in rural counties depend on public assistance, the reimbursement rate for the center is low. That means it's difficult for companies to make a profit.

If you have high blood pressure or diabetes you could be at risk for becoming a dialysis patient. 

CLICK HERE to visit the Alabama Kidney Foundation where you can find risk factors that could help save your life.

Copyright 2015 WSFA 12 News. All rights reserved.

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