Grady Extends Dialysis Deadline amidst Human Rights Inquiry
(APN) ATLANTA — The Grady Health System decided last week to continue providing free dialysis care through a private provider for another month, Atlanta Progressive News has learned.
Grady closed its outpatient dialysis clinic in October 2009 and agreed to provide free treatment through Fresenius Medical Care for about 50 undocumented, uninsured patients until January 03, 2010. During that time, the hospital informed patients they would have to find alternative, long-term treatment options.
Atlanta Progressive News learned in December that a contract between Grady and Fresenius guarantees the hospital will pay for treatment for patients they refer to Fresenius at a discounted rate for dialysis services through September 2010.
Grady officials have said they will only continue paying for such an arrangement through Febuary 03, 2010. It is unclear, however, how that would be consistent with the contract, which states that Grady would have to provide Fresenius with 90 day notice in order to discontinue the reimbursements.
Meanwhile, the Inter-American Commission on Human Rights has asked the US government to investigate the matter according to a December 05, 2010, letter obtained by Atlanta Progressive News.
“In a note of today’s date, the Commission requested information from the Government of the United States concerning Mrs. Reina Andrade, Mrs. Anabel Quintanilla, and other undocumented immigrants, specifically regarding their health and the situation described in your request,” Santiago Canton, Executive Secretary, wrote in a letter to the two plaintiffs.
The Commission cited the following from its letter to the US government: “Without prejudice to the possible adoption of precautionary measures, the Commission hereby respectfully requests that Your Excelleney take the measures necessary to provide, within a period of 7 days from the date of receipt of this communication, the information that Your Excellency’s Government deems pertinent with regard to the petitioners allegations as well as information concerning the possibilities for medical treatment available to Mrs. Reina Andrade, Mrs. Anabel Quintanilla and other similarly situated, and the alternative which they might have to access the dialysis treatment that their condition requires.”
“The U.S. Government has seven (7) days to respond to the Commission’s request for information and then, legal counsel for the undocumented immigrants may comment on that response. At that point the Commission will decide whether to officially grant the request for precautionary measures,” GARC said in a press release.
“We believe it is the right thing to do to help work with patients to find a long-term solution,” Matt Gove, a spokesperson for Grady, told APN. “Our goal has been to be that bridge between the clinic that no longer exists and a long-term solution for the patients.”
The Grady Memorial Hospital Corporation (GMHC), the private, non-profit board that controls the daily operations of the system, announced in August 2009 its intent to close the outpatient clinic and began offering patients other options.
As previously reported by APN, Grady sent letters to uninsured patients informing them of the closure and provided them a list of nearby private dialysis providers along with three options for future care: return to their country of origin, move to another state where they may qualify for emergency Medicaid services, or seek treatment through an emergency room.
Patient advocates blasted this plan as unrealistic and cruel, arguing that, among other issues, uprooting the patients would disrupt their treatment and severely compromise their health.
Illegal immigrants are not eligible for Medicare and legal immigrants must wait five years before qualifying. Georgia cut emergency Medicaid services to illegal immigrants in 2006.
Some patients who are US citizens qualify for Medicaid but have yet to meet Georgia’s in-state residency requirements.
Grady hired a company called MexCare, a network of over 30 hospitals, dialysis treatment centers, and physicians in Latin America that provides assistance in placing patients in facilities close to their home, to help patients who choose to leave the United States.
“A Mexican citizen has a much better chance of finding long-term government assistance from the Mexican government than they do in Georgia,” Gove said. “There are programs in Mexico, state-sponsored programs, that assist with transplants and long-term care. That’s part of what MexCare is helping patients with.”
Gove said Grady introduces patients to MexCare, who discuss with patients their best options based on proximity to family and access to care.
Should a patient decide to leave the United States, Gove said Grady pays MexCare a flat fee of $18,000 per patient, money that covers airline travel, three months of dialysis care, and other fees.
Grady Advocates for Responsible Care (GARC) has monitored remaining dialysis patients for about six months to ensure no one falls through the cracks.
As previously reported by APN, at least two of the original 92 clinic patients have died from complications due to not having dialysis, according to advocates.
“I know of three people who took MexCare who didn’t get what was promised,” Dorothy Leone-Glasser, a leader of GARC, told APN Tuesday. “If Grady knows of people who took MexCare and got the full benefits, then that’s great but we don’t know them.”
Leone-Glasser said her group knows of some patients who did receive airline assistance but others had to get such assistance through the Mexican Consulate. She told APN she knows of no one who left the United States who received a full three months of care.
“They were given a few treatments and that’s it,” she said. “The patients who go back there are left paying for the treatments themselves.”
Several dialysis patients are engaged in a class action lawsuit against Grady. They have argued Grady’s clinic closure violates patients’ state and federal constitutional rights to health care service and represents medical abandonment, placing the patients’ lives in danger and causing them mental anguish.
Fulton County Superior Court Judge Ural Glanville dismissed the suit on December 15, 2009, but advocates are appealing the case to the Georgia Supreme Court.
APN had previously reported that advocates would be appealing to the Georgia Court of Appeals; however, their attorneys believed the Georgia Supreme Court was the appropriate venue because constitutionality and equity questions were involved.
Gove told APN Tuesday the hospital will continue working with patients over the next 30 days to find a long-term solution and did not speculate whether Grady would continue its current arrangement with Fresenius after February 03.
Leone-Glasser said advocates and patients would continue pursuing legal action but also said seeking help from state lawmakers is important.
“We obviously need to change Medicaid and Medicare benefits in this state,” she said. “The real answer is getting the elected officials involved who have not heard our pleas. They are the people who need to be involved.”
The Georgia General Assembly will reconvene on January 11, 2010.
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Jonathan Springston is a Senior Staff Writer for Atlanta Progressive News and is reachable at firstname.lastname@example.org.
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