An Atlanta legislator Tuesday toughened politicians' threat to force the transfer of management of Grady hospital to a nonprofit group if local officials fail to act.

Rep. Mike Jacobs (R-Atlanta) introduced a bill to force Grady Memorial Hospital to make the change.

The bill is clearly a shot across the bow of the Fulton and DeKalb commissions, which are deciding whether to approve the shift of power at Grady.

Fulton is expected to vote on the change Wednesday; DeKalb, on Feb. 26. Several commissioners from both counties have said they remain undecided. Some are engaged in last-minute negotiations to add provisions to the agreement.

The lease agreement would define the division of power between the Grady board and the new nonprofit.

State Republican leaders and Atlanta business people have promised millions of extra dollars for the financially strapped Grady in exchange for the shift of power from the politically appointed Grady board to a nonprofit corporation.

Jacobs said time is running out for Fulton and DeKalb approve the power shift, one of the last steps in the process. He noted that only about 10 days remain in the session for a bill to pass one house, then move to the other for consideration.

Grady also would be affected by legislation that could send millions of dollars to hospitals that specialize in trauma care.

"We do not want Fulton and DeKalb to run out the clock beyond this legislative schedule," Jacobs said. The two county commissions need to "get it done and approve the lease in short order."

He added that the bill "is not just a threat ... Fulton and DeKalb should take it seriously."

The bill has some teeth, authorizing legal action by a citizen or the state attorney general to force the change. It also threatens loss of trauma funding and removal of the hospital directors.