DeKalb County Holds Public Hearing on Grady Hospital Lease
(APN) DECATUR — Residents of DeKalb County met Thursday night, February 21, 2008, to discuss the Grady Hospital lease agreement, which would transfer day-to-day control from the Fulton-DeKalb Hospital Authority (FDHA) to the Grady Memorial Hospital Corporation (GMHC), a private, 501(c)(3).
Fulton County Commissioners approved the lease Wednesday, February 20, 2008, and DeKalb commissioners are expected to vote on it February 26, 2008.
DeKalb Commissioners Larry Johnson and Connie Stokes held the meeting to listen to the public’s input and take it into consideration before making a decision.
“You have our commitment that we will address each response from tonight we have to be deliberate,” Stokes said.
The dozens in attendance included doctors, medical students, and professors from Emory University and Morehouse College, in addition to Grady doctors and nurses, as well as other concerned citizens.
Speakers were about evenly divided between those who favor a transfer of power to a 501(c)(3) and those who do not.
“We’ve been searching for another viable option [but] we haven’t found one,” Anjli Aurora, president of HealthStat, said of the power transfer. “If someone else can tell us about another [option], we’d love to hear it.”
Several members of HealthStat, or Health Students Taking Action Together, spoke Thursday and strongly urged DeKalb commissioners to approve the lease.
“The only way to keep Grady open is to approve the lease,” Dr. Joyce Akwe, another HealthStat member, said. “There is no viable alternative at this point.”
“We’re hearing from people this is the only way to do it,” Bert Skellie, member of an advocacy group called the Grady Coalition, said. “There are other ways.”
Skellie said Commissioners did not have to sign off on the lease as written and could make some amendments to make sure patients and services at Grady are protected.
The lease states Grady will still operate as a safety net and charity hospital for the indigent and uninsured.
While the new GMHC will be required to “provide the major service lines at substantially the same levels,” the lease does not define what service lines are and the GMHC would only have to consult with the FDHA prior to ceasing any major medical service lines.
Previous drafts of the lease would have given the FDHA veto power over proposed cuts made by the GMHC.
“There’s no protection at all,” Skellie added.
Several speakers worried the transfer to a private, nonprofit corporation would eliminate the transparency and accountability.
“Grady is our baby and we don’t want to see it in the hands of foster parents,” Joel Finegold said. “There is no transparency. We need the transparency of a directly elected board.”
DeKalb Commissioners, working with lawyers for the FDHA and the new GMHC, have drawn up several revisions that could help ensure a suitable level of accountability.
These include requiring the GMHC to have at least two DeKalb residents, to provide reports to Fulton and DeKalb on its financial and quarterly performance, and to hold public meetings.
Additionally, the FDHA could not receive its annual $2.5 million rental payment from the GMHC until the FDHA provides the GMHC with an annual budget describing how the money is spent that is approved by Fulton and DeKalb counties.
Other speakers tried to assure the community Grady doctors and nurses would ensure that Grady’s mission remains intact.
“Regardless of what you think of the business community, the medical staff will not let the mission of Grady change,” Dr. Art Kellerman, an Associate Professor at Emory and Grady ER doctor, said.
The Metro Atlanta Chamber of Commerce and other business leaders are said to have pledged to deliver millions of dollars on the condition the FDHA relinquish control.
Yet the people who have committed to giving Grady this money remain anonymous.
“Make yourself known,” James Murtagh urged. “Who are you? We must know the details of this deal.”
Upon commencement of the lease, Grady would receive $50 million immediately followed by an additional $150 million over three years.
Business leaders have pledged to raise another $100 million over three years, but it is unclear if anyone will follow through on delivery.
The Georgia General Assembly, growing impatient with the prolonged process, is pressuring Grady to make the transfer soon or else.
“The big fight for Grady is at the State Capitol,” State Rep. James Watson (D-Decatur) said Thursday. “I think the State does have a responsibility to make sure Grady stays sound.”
State leaders have also promised verbally to deliver financial assistance to Grady upon a power shift to a 501(c)(3).
“We don’t take our decision lightly I’m not going to be pressured into making a decision,” Commissioner Johnson said.
Fulton County Commissioner Emma Darnell, one of two Members who opposed the lease, released a statement obtained by Atlanta Progressive News.
“Major provisions of the document provide for the transfer of the operating assets of the Hospital valued at over $1.5 billion dollars to the Corporation in addition to the authority to determine what current services to Grady patients will be cut or shifted to an Affiliated Entity,'” Darnell said.
“The term ‘indigent care’ was not defined. For this reason, by cutting or eliminating certain services to indigent patients without the consent of the Hospital Board, [the Board]… would have delegated its responsibility for providing quality health care to indigent Fulton County residents to a private corporation,” Darnell said.
“Grady is a public hospital with a public purpose,” Darnell stated. “As public officers, we are answerable only to the residents of Fulton and DeKalb Counties. This duty and responsibility cannot be transferred for any personal or political benefit.”
“Threats are violent acts. We do not respond to threats,” Darnell added.
Darnell also took issue with the fact that the new lease allows for the transfer without getting a determination letter of tax exempt status from the Internal Revenue Service of the US.
Other terms not defined in the lease are “safety net hospital” and “emergency services,” Darnell said.
Thus, the debate over Grady, and the promises made by the FDHA and their attorneys have shifted time and time again.
No one seems to be holding the FDHA accountable to numerous provisions in the original resolution to create the nonprofit corporation, or even in earlier versions of the lease, including receiving tax exempt status recognition from the IRS, getting written confirmation of the alleged private donations, getting written confirmation of State support, or allowing the FDHA to have a say over the possibility of major cuts in service.
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