Fulton Ties Grady Funds to Fiscal Disclosure, Grady Seeks Help from Other Counties
(APN) ATLANTA — The Fulton County Board of Commissioners voted January 21, 2009, to give Grady Health System $50 million for 2009, down from $80 million last year and $100 million in 2007.
While Fulton’s Budget Committee recommended cutting the allocation down to $76.5 million for 2009, Commissioners decided to only give $50 million and place the remaining $26.5 million in something called “the contingency non-agency line item” where it will remain for the time being.
Before giving Grady any more money, Commissioners want officials to provide a monthly report that includes documentation of patients’ incomes and their counties of residence.
The Board also wants information regarding standard of care that includes policies and procedures of the hospital as well as an annual audit that verifies that expenditures are being made for indigent residents of Fulton County, which will be conducted by an independent auditor.
“Transparency and accountability are the two principles we are trying to follow this year,” Commissioner Emma Darnell told Atlanta Progressive News in an interview.
“We cannot afford to award $76 million to anybody without the documentation, so we can say to the people of Fulton County this quality service was delivered to the indigent population of Fulton County,” Darnell said.
Darnell said Commissioners have been asking Grady for years for this kind of documentation but never received it.
As a result, Commissioners found out after the fact that millions of dollars from Fulton went to pay for indigent residents of other counties in 2007.
“We have got to be accountable for every dime we spend and we have to show every person in Fulton County why we paid $50 million,” Darnell said. “Fulton County residents are not interested in paying for the indigent care for out-of-county residents.”
Fulton and DeKalb are the only two counties in Georgia that contribute any public money to Grady even though the safety net hospital serves patients from all over Georgia, especially Metro Atlanta’s indigent population.
On January 14, 2009, Michael Ayres, Senior Vice President of Grady Health System, sent a letter to the Cobb County Manager’s office, requesting payment for $10,062,010.99, which Grady says represents the value of indigent care provided by Grady last year to residents of Cobb County.
“Please make the payment for your residents to Grady Memorial Hospital Corporation and forward to the attention of,” Grady’s treasurer, Robert Losier, the letter states.
According to the Atlanta Journal-Constitution newspaper, Grady sent similar letters to about 100 other counties, with Clayton, Cobb, and Gwinnett receiving the highest bills.
The other counties have not responded positively to the letters so far.
Both Fulton and Dekalb Counties appoint members to the Fulton-DeKalb Hospital Authority (FDHA), a board that managed Grady until bowing to pressures to privatize last year, upon which time the nonprofit Grady Memorial Hospital Corporation (GMHC) took over.
In addition to providing more documentation about how the money is being spent, Fulton wants to renegotiate the Memorandum of Understanding, a contract between the two that dictates what Grady is supposed to do and what Fulton pays for.
Grady officials appear willing to cooperate with the requests. Grady CEO Michael Young tried to tamp down speculation that the Commissioners’ vote last week represents a funding cut.
“This isn’t a cut,” Young said in an email to APN. “We asked for around $80 million and nearly the full amount is earmarked in the budget. It’s simply a matter of providing the commissioners with the information they want in order to receive the full allocation. We are happy to work with the commission to get them whatever they need.”
“I am hopeful and have every reason to believe that Grady officials share our concerns,” Darnell told APN. “I am hopeful and I expect in the next few weeks we will be able to have a mutual agreement.”
Darnell told APN that if Grady is going to remain a viable institution, Fulton and DeKalb cannot carry the burden forever.
“It’s very clear to us from all the numbers we have received that unless Grady gets significant support from the State, even if it’s [just for] trauma care it will be impossible for Grady to provide quality indigent care,” Darnell said.
“It’s just asking too much,” she added. “Two counties just can’t do it. There are no two counties in America that can pay for a large, public teaching hospital [like Grady].”
About the author:
Jonathan Springston is a Senior Staff Writer for The Atlanta Progressive News, and is reachable is jonathan@atlantaprogressivenews.com.
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