By Amy Yurkanin

A new kind of hospital could be coming to the Alabama Black Belt.

Bullock County Hospital, a small facility located in Union Springs, about one hour southeast of Montgomery, has started the application process to become a Rural Emergency Hospital.

“It’s a designation for hospitals that have reached the point where they don’t have any other option but closure,” said Danne Howard, deputy director of the Alabama Hospital Association. “It allows them to remain open instead of leaving a void in that community.“

Congress created the Rural Emergency Hospital designation in 2020 and the first hospitals to switch over started last year.

In order to become a Rural Emergency Hospital, facilities must close inpatient beds. They keep emergency departments open to provide 24-hour care in the community. In exchange, they receive increased payments from Medicare and Medicaid.

Officials from the hospital did not return calls seeking comment. Earlier this month, they posted an official notice that 95 employees could be affected by layoffs. In a short article in the Union Springs Herald, hospital executive Amanda Trawick said the hospital is not closing.

“I am hoping to lay the rumors to rest about us closing,” Trawick told the paper. “We are transitioning to become a Rural Emergency Hospital. In order to do this, we did have to close our Adult Psych and Geriatric Psych programs.“

The Sheps Center for Health Services Research at the University of North Carolina-Chapel Hill has a list of 23 hospitals that have switched from acute care to Rural Emergency Hospitals. Almost all are located in the South and Midwest. Four hospitals in Mississippi and two in Georgia have switched to Rural Emergency Hospitals.

Malissa Valdes, a spokesperson for the Alabama Department of Mental Health, said the change would affect access to inpatient psychiatric beds in the area. The department had used Bullock County Hospital to provide inpatient care for people in need of psychiatric services. The hospital also houses substance use treatment and detox beds.

The general fund budget recently approved by the Alabama Senate included $1 million to keep the psychiatric beds at Bullock County Hospital. The state already has a shortage of inpatient psychiatric beds, especially in rural counties.

Rural Emergency Hospitals must have transfer agreements with larger hospitals. Their average length of stay for patients must not exceed 24 hours annually.

Many rural hospitals in Alabama and across the country have struggled financially in recent years and several have closed.

“A lot of the hospitals in the rural areas, there is a disproportionate amount of uninsured patients,” Howard said. “If things stay the same, all our rural hospital will struggle.”

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