Georgia considers ‘significant’ cash lifeline to Grady as AMC closure looms

State and local officials are discussing a new aid package that could shift state and federal funds to Grady Memorial Hospital after the surprise announcement last week that Atlanta’s only other high-level trauma center will soon be shuttered, according to several people with direct knowledge of the talks.

The discussions follow Wellstar’s announcement last week that it would close the 460-bed Atlanta Medical Center in November, a century-old hospital that is a linchpin in metro Atlanta’s fragile health care safety net for the poor. The closure would immediately increase the strain on Grady and other regional hospitals.

Republican Gov. Brian Kemp’s office said Friday that he has met recently with health care executives, elected officials and community advocates to “collectively put together a long-term plan” after Wellstar Health System announced without warning it would close the facility.

“We are encouraged by these discussions and will continue to do everything we can to ensure Georgians continue to have access to care,” said Kemp spokesman Andrew Isenhour. He wouldn’t comment specifically on what is being negotiated.

It’s not clear where the money would originate, but the state could tap federal coronavirus relief money from legislation approved last year by the Democratic-controlled Congress over the objections of Republicans. One official didn’t give an precise estimate but characterized the potential investment as “significant.”

“We’re digging into the situation to fill the gap that may be created by this scenario,” Kemp said at a campaign stop in Atlanta. “We’re still trying to fully understand what that means, what other resources other medical facilities and hospitals have here in the metro area that we need to serve that need.”

Credit: Steve Schaefer

Credit: Steve Schaefer

The discussions cap a tumultuous week for the future of metro Atlanta’s health care system.

The Atlanta Journal-Constitution first reported last week that Atlanta Medical Center, commonly referred to as AMC, will shut its doors on Nov. 1. Wellstar said the downtown Atlanta hospital, which serves thousands of uninsured patients, could not sustain mounting financial losses.

Kemp’s critics immediately seized on the fact that the governor has opposed Medicaid expansion, leaving federal dollars on the table that could have aided the flailing hospital. Wellstar said in a statement last week that Medicaid expansion alone would not have saved the facility from closing.

Democrat Stacey Abrams, who is challenging Kemp in November, held a virtual press conference on Friday to accuse Kemp of playing “political games with Georgians’ health.” Abrams said that Georgia is forfeiting billions of dollars every year due to Kemp’s failure to expand Medicaid, and has instead offered “piecemeal solutions” and “half measures” that aren’t working.

“We know that Georgia is in the midst of a hospital closure crisis, one that has been exacerbated by Brian Kemp,” Abrams said. “The closure of Atlanta Medical Center will have wide-ranging, devastating implications for Georgia, from farther travel times to worse health care outcomes and a greater strain on our remaining hospitals.”

Credit: Steve Schaefer

Credit: Steve Schaefer

Kemp has opposed full Medicaid expansion as too costly and too inflexible for its recipients. Instead, he has promoted a “Georgia-based solution” that requires new enrollees to meet work, activity or academic requirements. His plan was recently upheld by a federal judge.

Research has shown, however, that Medicaid expansion helps hospitals stay open and bolsters residents’ access to emergency care.

Atlanta City Council President Doug Shipman also said at the Abrams press conference that many of the nation’s cities that Atlanta competes with for events and business relocations have invested in Level 1 trauma centers.

“Other cities understand that health care isn’t just about health. It is about the economic vitality of their entire city and region,” he said. “I don’t think that infusion of some short-term cash is going to do it. That’s a Band-Aid on an open wound.”

Even as Kemp is talking about Grady taking on more patients, officials of DeKalb and Fulton county, which help fund Grady, are expressing mounting concerns about its future viability. DeKalb lawmakers are considering rushing a substantial new payment to help the hospital in the wake of AMC’s expected closure.

Some officials aren’t eager to let Wellstar off the hook. A coalition of federal lawmakers sent a letter to Wellstar’s chief executive last week, urging the health care giant to “reverse course.” And Atlanta Mayor Andre Dickens dispatched a letter Friday, demanding that Wellstar provide “immediate answers to the community.”

“Let me be clear: Wellstar still has a responsibility to this community as well,” wrote Dickens. He is seeking details about the plans to transition patient care to prevent any gaps in services and how the health care system will ensure that patients who need emergency care will be able to receive it.

“We will continue to engage these partners to quickly identify potential resources and services to meet the needs of our community and mitigate any detrimental impacts from your decision to close Atlanta Medical Center,” he wrote.

Grady Health System chief executive John Haupert has said the AMC closure is “incredibly tragic” and would increase the strain on the downtown Atlanta hospital, which would be the city’s only Level 1 trauma center capable of treating the most serious injuries.

Credit: JOHN SPINK / AJC

Credit: JOHN SPINK / AJC

Fulton County Manager Dick Anderson said $42.5 million of the roughly $60 million that Fulton usually gives annually to Grady goes toward indigent care – with the rest offsetting indebtedness projects, like construction. He said Grady estimates the need for indigent care is $80 to $85 million a year.

“We’ve always felt like Grady is the cornerstone of the Atlanta medical network,” he said.

High-level Fulton officials feel other area hospitals, many of which are in better financial shape, are going to have to step up.

The urgency began earlier this year when Wellstar closed the emergency room and regular hospital beds at its facility in East Point, which was Fulton’s only ER south of I-20. Worries spiked to another level when Wellstar announced its intent to close the main AMC campus.

“Grady is already feeling the closing of one hospital. I don’t have a crystal ball, but we don’t know the fallout from hospital No. 2 closing,” said Fulton Commissioner Khadijah Abdur-Rahman, a Democrat. She said she isn’t sure her county is in a financial position to help with these closures.

“Grady is going to feel that,” she said. “Grady is going to have an ask and we’ve got to be prepared to fill that ask.”

- Staff writers Ariel Hart and Anjali Huynh contributed to this report.