Atlanta Progressive News

(APN) ATLANTA — Grady Health System officials on Monday, July 13, 2009, set in motion a series of steps that could lead to a change in how Grady delivers dialysis treatment.

Officials also announced the merger of two neighborhood health clinics in order to maximize efficiency and save money.

DIALYSIS CENTER TARGETED FOR CLOSURE

The Grady Memorial Hospital Corporation (GMHC) voted Monday to give staff permission to begin negotiating a contract with the world’s largest provider of dialysis products and services, Fresenius Medical Care, to care for the 96 patients currently using Grady Memorial Hospital’s woefully outdated dialysis center.

Since CEO Michael Young took over 10 months ago, he has targeted areas in which Grady could save money, with the dialysis center at or near the top of the list.

Denise Williams, Senior Vice President of Operations, and Rhonda Scott, Chief Nursing Officer, argued Monday the decades-old dialysis center, located on the ninth floor at Grady, is cramped and ill-equipped to properly handle current patient needs.

“We have growing patient concerns,” Williams said. “It’s a very undesirable situation.”

The center is losing $2.5 million every year, including $2 million on outpatient services and $500,000 on inpatient services. Before Williams and Scott got involved, the dialysis center was losing nearly $4 million a year.

The patient mix at the center breaks down as follows: 20 percent paying patients; 21 percent undocumented, uninsured immigrant patients from Fulton and DeKalb Counties; 14 percent uninsured patients from other counties; 10 percent “pending payment”; 8 percent prisoners from Fulton and DeKalb; and 27 percent documented, uninsured patients from Fulton and DeKalb.

GMHC Chairman Pete Correll noted that the State of Georgia and the taxpayers of Fulton, DeKalb, and other counties have decided they no longer want to pay for the center.

“What do we do about an untenable situation?” Correll asked. “We as Grady still have to figure out a way treat a hundred people.”

Williams laid out three options: close the center, build a new, off-site facility, or farm out the treatment to another company.

She and Scott recommended the Board enter into a contract with Fresenius, a company that has 25 centers within 25 miles of Grady Memorial Hospital.

Lisa Borders, Chair of the Henry W. Grady Foundation, pointed out during Williams’s presentation that her father receives dialysis treatment at the Fresenius center on 14th Street, which is only 2.5 miles from Grady.

Officials said Fresenius centers are equipped with modern technology, have much more space, offer better parking options, and are accessible via public transportation, most notably MARTA’s paratransit service for disabled riders.

“By partnering with Fresenius, it certainly gives our patients a lot more options,” Scott said. “It would be a 1000 percent improvement if we moved to one of these centers.”

Williams said Fresenius is “eager” to work with Grady and are looking to enter into a three-year contract with the system.

If the two sides successfully negotiate a contract, then officials could vote to approve the transition at the next GMHC meeting in September.

Some citizens at Monday’s meeting expressed concerns about the plan to close the dialysis center. The Rev. Timothy McDonald, Co-chair of the Grady Coalition, said his group is “somewhat conflicted” about what to do with the center, acknowledging, “this is a hard decision.”

“There must be assurances put in place… that all [patients] are taken care of,” McDonald said. “Some are going to fall through the cracks. How do we track those that fall through?”

TWO COMMUNITY CLINICS MERGE

The Center Hill Health Center on Atlanta Industrial Parkway ceased operation on July 7, 2009, and all patients from that clinic are now receiving treatment at the Otis W. Smith Health Center on Martin Luther King Drive, which is about four miles away.

Before completing the merger, officials sent a letter and Q&A sheet to Center Hill patients explaining the changes. In those documents, obtained by Atlanta Progressive News, officials assure patients that their medical records will be transferred, medical care will not change, and treatment plans will not change.

“There is a chance” patients’ old doctors and/or nurses may not transfer to Otis Smith, the documents read, but Grady assured patients old doctors will work with new doctors to keep treatment and care accurate. A list of doctors working at Otis Smith is included with the documents.

Matt Gove, Senior Vice President for Marketing and Strategic Planning, told APN Center Hill closed because it only saw about seven patients per day at the time of closure and that Center Hill did not contain as many quality services as Otis Smith.

He said some Center Hill patients were already visiting Otis Smith based on Grady’s examination of trends in clinic records.

By examining Grady’s clinic numbers, APN found that between January and May 2009, Center Hill saw an average of 189 patients per month while Otis Smith saw an average of 764, nearly four times as many patients.

Overall, visits to Grady’s eight neighborhood clinics is up 20 percent from May 2008 to May 2009.

But several citizens expressed concerns Monday that Grady will close other health centers, especially the DeKalb Grady Health Center on Warren Street; South DeKalb Health Center on Rainbow Drive; and Lindbergh Women and Children’s Center on Buford Highway.

“That’s going to be the line in the sand as far as the new Grady is concerned,” State Sen. Vincent Fort (D-Atlanta) warned if more clinics close.

Officials did not discuss the situation surrounding any other clinics on Monday, deciding to continue the discussion and delay any action until at least September 2009.

“There is no intention by this Board at all to reduce clinic visits,” Correll said Monday. “Closure and shrinkage is not our objective.”

About the author:

Jonathan Springston is a Senior Staff Writer, reachable at jonathan@atlantaprogressivenews.com

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