The state Legislature's failure to approve long-term trauma care funding cast a shadow over a crowning day for Grady Memorial Hospitalon on Monday.

The heads of the old Grady board and the new Grady nonprofit corporation signed a lease agreement Monday to transfer control of the hospital from the old board to the new, a move planned for a year and expected to draw millions in additional funding from numerous sources.

The highlight of the nonprofit board's second meeting was release of a letter from the Woodruff Foundation pledging $200 million.

But Grady board chairwoman Pam Stephenson's belief that state leaders failed to fulfill promises of long-term funding for trauma care in Georgia, particularly for cash-strapped Grady, led to a caveat to the lease agreement.

Stephenson said the agreement will not become final until the state quantifies its funding for Grady in the budgets for 2008 and 2009.

"We want to know the money," Stephenson said.

She echoed widespread disappointment in the health care community that the state, although providing some funding boosts for health care, failed to adopt a popular plan to provide $74 million a year for trauma care.

The governor, lieutenant governor and House speaker fueled expectations during tough negotiations on the Grady restructuring that the state would provide more money for trauma care. But the Legislative session ended Friday with no action on a bill to add $10 to car registration fees and channel the proceeds to trauma hospitals.

In the 2008 budget, the state approved a one-time bump of $58 million for trauma care, of which Grady expects to receive about $24 million.

In addition, the state increased Medicaid reimbursements with a formula expected to give Grady another $10 million.

The assurances could come in a letter, she said, or some other mutually acceptable form.

"Cash works," she said.

A spokesman for Gov. Sonny Perdue said Monday the state is willing to provide a financial breakdown.

"Once the budgets are set ... it doesn't seem a difficult task," spokesman Bert Brantley said.

But there are hurdles, he said. The state Trauma Commission must divvy up the $58 million. It is expected to meet next week.

And the governor may sign the 2009 budget as late as mid-May, he said.

Pete Correll, the head of the new Grady nonprofit, supported Stephenson's demand and echoed her disappointment with the lawmakers inaction on trauma funding.

"It's a perfectly reasonable thing to do," he said.

The lease signing culminates a long campaign to transfer control of the hospital from the old, politically appointed Grady board to the nonprofit Grady Memorial Hospital Corp. and a board stocked with powerful corporate and community leaders. The transfer is expected to be complete May 1.

The new board members signed a separate letter vowing to raise an additional $100 million for the hospital, which as operated in the red for years.