TUSKEGEE, Alabama (STPNS) -- The 321-page hospital feasibility study results can be easily summarized ? Tuskegee residents want urgent care. And you don?t need to dig much deeper through the pages to see the study also provides a plan to get it.

Right now, though, according to the study, Tuskegee can?t support a full-scale, full-service hospital in the community. On any day of the year, only three Tuskegee residents and seven Macon County residents occupy a hospital bed in the state. It is impossible to support the high cost of operating a hospital with only three patients per day.



The findings show John A. Andrew Hospital closed 20 years ago for reasons unknown to a notable percentage of the surveyed Macon County residents. It wasn?t due to a lack of uninsured patients, nor was it the number of people in the county. It closed because no one went there ? infrequent utilization.

?What surprised me was that people said John A. Andrew Hospital closed because of the number of uninsured people in the county,? said Jonathan Dunning, CEO of the Birmingham-based Central Alabama Comprehensive Health (CACH), who also heads Integrated Health Systems of Alabama (ISHA) the group that conducted the study. ?Actually, 85 percent of the people who live here have health insurance.

?And, of all counties in Alabama without a hospital, guess which one is the largest?? Dunning continued. ?Macon.?

In light of this, the study is optimistic, advising that the fastest, most financially-viable way for Macon County to provide urgent medical care to its citizens is for Comprehensive Health, a Federally Qualified Health Center (FQHC), to occupy the Reed Center. Here?s why:

? As an FQHC, Comprehensive Health is supported by the United States Federal Government with significantly-higher reimbursements than private primary care for its Medicare and Medicaid patients. Approximately 60 percent of Macon County residents are Medicare or Medicaid eligible.

? Comprehensive Health is financially secure. Not only that, it?s bursting at the seams. Louis Maxwell, Chair of the Tuskegee CACH board said CACH is ready to expand, no matter where it happens. Maxwell said CACH will be expanding its hours soon, with the expansion of services to follow soon after.

? Comprehensive Health requires no additional revenue to enact this plan. No new taxes.

? CARE Ambulance Services, already located in Tuskegee, has agreed to house itself in the Reed Center if Comprehensive Health moves in. That means stabilization services would be on-hand at the center regarding an emergency. The long ride to Opelika or Tallassee or Montgomery would start with emergency treatment by CARE staff at the Reed Center.

? With Comprehensive Health in the Reed Center, it could open a FQHC satellite clinic on the Tuskegee University Campus. About 3,000 students with immediate access to health services is one way to strengthen ties between the city and TU, and TU is all for it.

Now, what options exist if the wait continues for the Reed Center to re-open under the Macon County Health Care Authority?s control? Who knows. The authority has sold or returned its medical equipment, hasn?t offered services in the building for about 10 months and has a plan that involves borrowing more money to re-open the center but can?t build the collateral to do so.

Also, they have no doctor. And like Dunning said, ?Few people choose a health care center because of the building.?

The Macon County Health Care Authority receives one penny of every dollar earned in Macon County to pay off the bond that funded the Thomas Reed Ambulatory Care Center. If a person earns $20,000 in a year, $200 is paying for the approximately $4 million Reed Center.

The Reed Center, though, which was opened as a primary care operation after being heralded as an urgent care facility, sits next door to the Macon County Department of Health ? less than one mile from two other primary care clinics, one of which being CACH.

?One is going to go out of business,? Dunning said at a town hall meeting Monday night (Oct. 1) about the two centers being located so close to one another. ?In a community of this size you can?t duplicate health care services. The buildings, the people and the money need to come together.?

And Dunning, as a professional health care provider in the business of treating anyone who walks through his doors, truly believes cooperation is the right way to go.

The Authority does not. It has stuck to its guns and beat that dead horse for months now. And while the Authority?s meetings -- if they?re even held -- consist of complaining and gossip, CACH is growing.

The Authority may claim it?s plan to morph an urgent care center into a hospital is identical to the results of ISHA?s study, but it isn?t. Comprehensive Health, with its high reimbursements, has the support of the seemingly-infinite wealth of the federal government and a host of businessmen who know how to keep an operation like this afloat.

The Authority, unfortunately, has none of that. It contains no one successful at running an urgent care facility and couldn?t even get its reimbursements for Medicaid and Medicare from the Federal Government. It may say it?s on the road to getting a hospital in this county, but, with so low utilization numbers for Macon County residents in state hospitals, the only viable option for emergency medical service is a Critical Access Hospital ? and though there are several people, including Tuskegee Mayor Johnny Ford, working to change the federal law, Tuskegee isn?t eligible for one of these because it?s within 35 miles of another emergency care center.

Dunning said, even though the study recommends a Critical Access Hospital, that this rule has yet be bent for anyone.

But again, Dunning, who heads both ISHA and CACH, is not playing politics and is not trying to convince Macon County into giving him an easy way to expand his profits.

Dunning may run ISHA, but it?s the largest network of health care providers in the state, and the information provided in the study was compiled not by a totalitarian hand, but is the direct opinions of 310 people in Macon County and by a committee of successful health care officials.

The people say they want urgent care, and the study lays out a plan to get it. So, if some are troubled by a potential conflict of interest in this study, let the facts speak for themselves.

And if anyone agrees with the recommendations of the study, remember, the people of Macon County own the Reed Center, and as owners they elect the general managers of the facility.

The 2008 elections are just around the corner.