Next step in Erlanger transition lies with Hamilton County commissioners

Staff Photo by Matt Hamilton / Erlanger Hospital is seen on Dec. 15, 2020.
Staff Photo by Matt Hamilton / Erlanger Hospital is seen on Dec. 15, 2020.

The next step toward transitioning Erlanger Health System from a governmental entity to an independent nonprofit organization will take place at next week's Hamilton County Commission meeting.

Commissioners will vote on a resolution requesting that the Hamilton County legislative delegation propose an amendment to the private act that established Erlanger Health System as it exists today.

The resolution seeks to allow the county to evaluate whether the continued operation of Erlanger Health System as a hospital authority - which is a public entity governed by a politically-appointed board of trustees - is "an effective or beneficial governmental function."

If the county determines it isn't, the resolution requests permission to dissolve the authority so that Erlanger would be "owned and/or operated by a non-governmental entity to promote the provision of high-quality health care services for years to come."

Two weeks ago, Hamilton County and Erlanger officials announced they had been working for nine months in private on plans to restructure the health system as an independent nonprofit in an effort to level the playing field with the system's private competitors.

Hamilton County Attorney Rheubin Taylor said during an agenda-setting meeting of the commission Wednesday that approval by the commission is needed before the General Assembly can begin the next step of the process, which would require amending state law.

Two weeks ago, Hamilton County Mayor Jim Coppinger asked the commission to approve funds to hire a lawyer representing the county in the transition, marking the first public signal that change is likely coming for the health system - which was founded in 1891 after Baron Emile d'Erlanger, a European financier with local railroad holdings, donated $5,000 to establish Chattanooga's first hospital.

Over 130 years, Erlanger has grown to become one of the nation's largest public hospital systems, comprising six hospitals across Southeast Tennessee, including the only children's hospital within 100 miles, a hospital in Murphy, North Carolina, and an academic teaching program affiliated with the University of Tennessee College of Medicine.

Erlanger brings in more than $1 billion net revenue annually and employed just more than 6,300 full- and part-time workers as of June 30, making it Hamilton County's largest employer.

It's also home to the region's only Level 1 trauma center, which treats the most severe injuries, and the Southeast Regional Stroke Center, which provides the highest level of stroke care and is one of the nation's busiest stroke centers.

On top of those costly specialty services, the health system is the largest area provider for low-income and uninsured patients. Last year, Erlanger provided around $150 million worth of uncompensated care - a figure that has grown 36% in four years.

Contact Elizabeth Fite at or 423-757-6673. Follow her on Twitter @ecfite.

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