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October 1, 2007
Campus dialogues outline complex issues facing Grady

By Kim Urquhart

The doctors, residents and health students who serve on the front lines at Grady Health System, providing care to the uninsured and underinsured every day, know how to save lives. They turned out in a sea of white coats at two separate events last week to learn what can be done to save the hospital that is critical to the health of Georgia citizens and a linchpin of medical education, training one-quarter of all the doctors in the state.

With the financially troubled hospital facing the very real prospect of closure, new business models and new forms of financial support need to fall into place — and soon, according to a recent report of the Metro Atlanta Chamber of Commerce task force on Grady.

In response, the Fulton-DeKalb Hospital Authority on Sept. 24 unanimously adopted a resolution to explore a new governing structure. Fulton County Commissioner Lynn Riley, a panelist at an event later that day organized by the statewide, student-led nonprofit HealthSTAT (Health Students Taking Action Together), used her opening statement to share the news.

“It was very encouraging to see that we are making forward progress on a collaborative effort to retain the unique gemstone that we have in the Grady Health System as it serves not only the indigent of Fulton and DeKalb counties, but also the trauma patients as well being a premier school of medicine for students of Emory and Morehouse schools of medicine,” said Riley, underlining Grady’s significance. Riley was one of seven panelists representing various stakeholders who offered their views on what they see as sustainable solutions to the significant challenges facing the hospital.

Adding to the on-campus dialogue on Grady was Georgia Lt. Gov. Casey Cagle, who visited Emory earlier that day to show his support for the faculty physicians, residents and fellows who deliver nearly 85 percent of the medical care at Grady under contract with the Fulton-DeKalb Hospital Authority. Cagle, too, stressed the importance of “financial stability” for Grady, and called for a business model to be put into place, as it has been at other Georgia hospitals, “that ensures deliverables are met in a timely manner.”

Grady faces a cash shortfall projected at $120 million. Without an infusion of capital for the troubled hospital, North Georgia could lose its only Level I trauma center and the state could lose its only poison control center, largest burn unit and other major centers of excellence in HIV/AIDS and infectious diseases, sickle cell, stroke, mental health, cancer and more, serving more than 1 million inpatient and out-patient visits per year.

Emory supports the governing structure the Grady authority has agreed to consider. A 501(c)3 nonprofit organization will allow Grady to enter into new and significant revenue streams and reimbursable services. The Grady authority has agreed to consider such a plan, and will work with a new advisory group of civic, government and business leaders to explore handing over daily control to a nonprofit board. The advisory group has 60 days to report back to the authority.

Both Cagle and HealthSTAT panelist State Rep. Sharon Cooper, who heads the state legislators’ task force on Grady, said that a new governance structure would not affect the hospital’s mission to care for Atlanta’s uninsured and indigent population. “We must ensure the right balance that will allow us to offset the charitable care that exists, but that doesn’t mean we will push non-paying patients away,” Cagle said.

The issues that plague Grady reflect a larger ailment facing the health care industry nationwide, such as the growing number of the uninsured. “How do we sustain Grady without looking at the health care crisis in the state of Georgia? It’s not an isolate,” said HealthSTAT panelist Rita Valenti, a nurse and 20-year veteran of Grady.

That Grady is a significant issue on the minds of many in the Emory community was driven home in President Jim Wagner’s State of the University address on Sept. 25. “We’re not merely watching the situation [at Grady] closely, but we’re devoting enormous resources of time, energy and brainpower to bring about a positive resolution,” Wagner said. “Today we are encouraged somewhat that so many in the community are working to be constructively engaged to pursue solutions that will lead not merely to allowing Grady to survive, but to thrive.”

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