Exploring 2026’s Health Policy Heartaches With AI Transformations

Rebuilding Unicoi County Hospital in a Flood Plain: Risks and Perspectives

Update Will Unicoi County Hospital Face the Same Fate Again? The devastation wrought by Hurricane Helene in September 2024 left the Unicoi County Hospital in Erwin, Tennessee, in ruins, forcing patients and staff to seek refuge on the roof as they awaited helicopters to rescue them from the chaos below. After extensive analysis and evaluation, the decision has been made to rebuild this 10-bed facility. However, the chosen site, located on low-lying farmland behind a Walmart, raises significant concerns about its flood risk. Indeed, recent studies suggest that the new site may be even more vulnerable than its predecessor. The Unsettling Decision to Rebuild Ballad Health, the organization behind the hospital, announced plans to invest $44 million in the reconstruction. Yet, experts from climate data companies Fathom and First Street assert that the new plot is located in a floodplain that could be inundated by a 100-year flood event. As Oliver Wing from Fathom poignantly remarked, "The proposed site is so obviously a flood plain geomorphologically. You don’t need a model to see that." This situation raises troubling questions about the process and criteria relied upon for this devastatingly high-stakes decision. Understanding Flood Risk in a Changing Climate As climate change continues to intensify storms and alter weather patterns, hospitals—especially those situated near waterways—are facing increased flood risks. The outdated FEMA flood maps do not account for the nuanced and complex realities of today’s climate; last updated in 2008, they do not designate the new Unicoi site as a flood hazard zone. This oversight, compounded by the incomplete nature of FEMA's flood assessments, poses a significant risk to the community of Unicoi. Local Guidelines Are Necessary Chad Berginnis, executive director of the Association of State Floodplain Managers, notes that the hospital's planning should not ignore governmental agency data from Fathom and First Street. Instead, the new construction should adhere to recommended building standards set forth by the American Society of Civil Engineers, which emphasize the importance of elevating structures significantly to protect against catastrophic flooding. Berginnis warns that any construction must take into account potential elevations of 8 to 18 feet to ensure the facility can withstand floods as severe as those created by Hurricane Helene. The Community's Voice: An Uneasy Acceptance Local residents are understandably concerned about rebuilding the hospital in a location known for flooding. Survivor Angel Mitchell, airlifted to safety during the hurricane, expressed her disbelief at the decision to rebuild so close to the flood-prone area. Despite the necessity of having a hospital nearby in northeastern Tennessee, community members like Mitchell are acutely aware that they are at the mercy of a health care monopoly, leaving them with little option but to accept a setup fraught with danger. "It’s ridiculous," she stated, emphasizing, "We want to go somewhere to heal, not somewhere to worry." The delicate balance between urgent health care needs and safe facility planning cannot be overstated. The Importance of Modern Flood Dynamics Understanding the importance of accurate flood risk assessments becomes crucial as health care systems adjust to evolving threats posed by climate change. Hospitals across the United States are at risk; KFF Health News data has identified at least 170 hospitals susceptible to significant or dangerous flooding. This alarming statistic amplifies the need for improved construction practices, comprehensive planning, and dynamic infrastructure that can better mitigate the consequences of natural disasters. Building a Resilient Future The reconstruction of Unicoi County Hospital provides a pivotal opportunity to rethink how communities integrate health infrastructure and environmental risks. While representatives from Ballad Health, along with various professionals, assure that plans are being made to create a “safe hospital,” it remains vital that local input and modern flood forecasts be central to the planning process. The health care industry must prioritize resilience, drawing from the lessons learned in the catastrophic aftermath of Hurricane Helene. As it stands, the plans for the rebuilt Unicoi County Hospital present not only a test of engineering integrity but also an opportunity for communities to lean into collaborative decision-making that incorporates cutting-edge data, superior design practices, and a commitment to safeguarding the local population.