City-funded health-care study finds residents leaving county for inpatient care; hospital certificate-of-need work proposed

City staff and the Enterprise Health Care Authority presented a multi-phase health-care assessment showing that 57% of Coffee County residents who sought inpatient or acute hospital care in 2023 received it outside the county, a finding consultants described as “eye opening.” Jonathan (city staff) outlined the city’s financial contribution to the study and turned the presentation over to Wes Averett of the Enterprise Health Care Authority, who reviewed the PYA consulting firm’s findings and options for next steps.

The study, prepared by PYA, compared two ways to count hospital capacity and demand: total beds licensed in the county and beds actually staffed for daily use. “When you look at the total number of available beds in Coffee County based off the population of Coffee County, 30 to 34 bed surplus,” Averett said. But when counting staffed beds—the beds actually resourced for daily care—PYA found “a slight deficit of 8 to 12 beds,” a difference Averett said likely contributes to patient outflow.

PYA’s provider-needs assessment showed larger workforce gaps. The consultant reported Coffee County had a 2024 deficit of about 55.9 providers (physicians plus nonphysician providers) across specialties and forecast a need of roughly 70.4 providers by 2028. “The single largest deficit that they represent is with internal medicine,” Averett said, and the portal-based analysis behind the report allowed drilldowns by specialty and ZIP code.

PYA also evaluated the state certificate-of-need (CON) framework—identified in the report by the acronym SHPTA in the executive summary—and flagged legal and procedural items the city would need to address before filing. Averett summarized that, by the county-level rules PYA used, the total beds metric suggested no immediate numerical CON justification but that “something is driving residents outside of your county to seek acute care needs,” and recommended exploring whether existing local providers might be willing to sell or transfer licensed beds in order to change capacity and justify a CON filing.

City staff provided cost context: the initial (phase 1) work on the study cost about $117,000 in total and the city has paid roughly $57,000 while the Enterprise Health Care Authority has paid about $20,000. PYA proposed an addendum for phase 2—work scoped toward preparing a CON application and related financial modeling—at a high-end estimate of about $70,000. That proposal would produce a “go/no-go” package the authority and city leadership could use to decide whether to proceed with a formal state filing.

Council members asked what the 57% figure represents and whether the data separate patients diverted for lack of beds from those who chose to seek care elsewhere; Averett said the underlying data do not distinguish diversion from choice. He also pointed the council to a set of “key stakeholder interviews” in the packet documenting local providers’ perspectives and potential local strategies.

No formal city action was taken at the meeting; staff and the authority asked the council to study the materials and consider next steps. Jonathan said he expects follow-up briefings and suggested some decisions might require closed-session discussion because they could involve potential provider negotiations.

Why it matters: Coffee County’s outflow for inpatient care and the projected shortfall in providers implicate both public-health capacity and local economic and emergency-response planning; pursuing a CON would be a multistep, state-level process with upfront consulting costs and legal and operational implications for local hospitals and health providers.

What comes next: The council and the Enterprise Health Care Authority will review the PYA phase-1 findings and the proposed phase-2 addendum. PYA offered to tailor additional work based on direction from the city and the authority; no vote to accept the addendum occurred at the meeting.