Atlanta Progressive News

Grady Health System CEO Michael Young and staff paid a visit to the First Iconium Baptist Church in East Atlanta Monday night to speak to members of the Grady Coalition and other concerned citizens.

Young promised earlier this summer to make quarterly visits to the Rev. Timothy McDonald’s church to deliver Grady status updates and field questions from the audience.

Topics of discussion included funding from Fulton and DeKalb Counties, potential action from the Georgia General Assembly in 2010, Medicare reimbursements, and the state of the neighborhood clinics.

“Funding from the counties is our biggest challenge,” Young said to the about two dozen people in attendance.

Young said DeKalb County has agreed to pay $23 million for the coming year, up from $20 million. Obtaining full funding from Fulton, however, remains difficult.

“The actual hard dollar amount we have received from Fulton has remained the same since about 1992,” he said. Fulton has “tentatively” approved $51 million for 2010 but Young said he would like to see that number reach $60 million.

The Fulton County Board of Commissioners have stepped up pressure on Grady this year, demanding some oversight about how their money is spent at Grady.

“There’s some of us who believe Fulton and DeKalb should not cut Grady but at the same time there is nothing wrong with looking at Grady first,” State Sen. Vincent Fort (D-Atlanta), a Grady Coalition co-chair, said. “It is a legitimate concern that it not be a blank check to Grady, that there be some accountability involved.”

Some community members have publicly expressed concerns that Grady may try to close one or more neighborhood clinics in an effort to save money. Young promised that there is no discussion about closing clinics at this time.

In fact, the CEO said Grady is looking to expand one clinic in Fulton and build a new clinic in DeKalb, dubbing it a “supercenter” where patients could receive comparable treatment and services that they receive at Grady Memorial Hospital.

Young did not specify clinic locations or give a timeline on these clinics but has expressed in the past a willingness to expand on the supercenter idea.

The elephant in the room Monday was the dialysis clinic, which Grady closed in October. Because of ongoing litigation, Young could not get too specific on the issue.

(A judge dismissed the class action suit against Grady brought by a group of uninsured, undocumented dialysis patients on Tuesday but an appeal is forthcoming. Check back with Atlanta Progressive News for a full story.)

“It’s a service we didn’t do very well,” Young said of dialysis at Grady, noting specifically the outdated equipment. “I’m not saying we would never [offer dialysis again] but there are plenty of private places making profit off of paying patients. It’s time they maybe take some nonpaying patients.”

Grady Advocates for Responsible Care, a group that has worked with many of the former dialysis patients on their class action suit against the hospital, has approached other private dialysis providers like DaVita and DCI to see if those companies could pick up some of the slack.

Both companies have been eager to meet but nothing has happened beyond discussions. Grady entered into a contract with Fresenius Medical Care to provide dialysis to many of the clinic’s original 96 patients.

Fresenius has agreed to provide services to the undocumented, uninsured patients who are still in limbo but only until Jan. 3.

Young said Monday Grady is on track to provide $320 million of free care in 2009, an $80 million increase over last year. He partially attributed the increase to the arrival of 100,000 new, uninsured patients to Grady this year.

So far, Young has had little luck in finding help elsewhere.

“We have asked the other hospitals to contribute and each hospital has come back and said no,” he said. “I’ve spoken to all the county commissioners in the contiguous area and they are not interested because they think they are not liable.”

Young warned there could be a “draconian increase” in drug copayments in 2010 if Fulton County does not provide at least $60 million.

Rev. McDonald suggested working through the Grady Foundation, the health system’s fundraising arm, to set aside funds for patients who may occasionally not be able to afford copayments.

“I would be glad to work with this group, churches, corporations…to raise money,” Young said.

On Medicaid, Young noted Peach State, one of three Medicaid providers that worked with Grady, ended its contract with the system five months ago, citing several factors.

But Young said the other two Medcaid providers “can’t wait to get these patients” and there should be no interruption of service.

One particular sticking point with many audience members Monday was fundraising, specifically how Grady has managed to raise so much money for capital expenses but not operations.

“The donors tell us what to do with it,” Young said. “They want to see their gift work over several years. We’re the best capitalized bankrupt hospital in America.”

Grady is on track to raise about $300 million and has already spent $100 million of it on capital improvements like new beds and medical equipment.

“I’m asking every donor for operations funding,” Young said. “One guy out of 50 gave one unrestricted donation for operations and we spent it on operations. They want to see their gift is covering a 15, 20 year period.”