Fulton County Commission Chairman John Eaves’ plan to ease the flow of taxpayer dollars to treat needy Grady Memorial Hospital patients narrowly survived board scrutiny on Wednesday.
In typical fashion for the complex relationship between the county and the safety net hospital, the resolution was matched with rancor. A 4-3 vote followed a tense debate. The commission also went on record opposing the Grady corporation’s plan to close two neighborhood clinics to save $1.8 million, and Vice Chair Emma Darnell launched a subtle attack on the corporation’s track record since taking over operations in 2008.
The commission voted to accept the recommendations of an ad hoc committee, formed last month at Eaves’ urging, for smoothing out a contract dispute that resulted in $9.9 million withheld from Grady last year and $10 million withheld the year before. The county eventually paid in both cases, but it remained at odds with the hospital on how to prove that Fulton’s money is used to treat only Fulton indigent and uninsured patients.
Eaves made repeated calls for calm during the debate. Enforcing speaking time limits, he twice cut off Vice Chair Emma Darnell. Commissioner Tom Lowe argued with County Attorney David Ware over meeting procedure after Ware told him a call for a question required a second. In Commissioner Liz Hausmann’s failed attempt to omit homeless patients as qualified for funding, board members became confused about what they were voting on and had to start over.
Commissioner William “Bill” Edwards, who voted against the recommendations along with Hausmann and Darnell, took issue with the composition of the committee. It included representatives of the county, the Grady corporation and the Fulton-DeKalb Hospital Authority, along with an objective technical adviser.
“You pick the wrong people, and you get the wrong result,” Edwards said. “I would love to see the people who pay the taxes involved in the happenings at Grady Hospital, guys.”
For the time being, the recommendations will remain just that. Ware’s office will use them to draft changes to the county’s 2009 contract with the hospital authority, which will take another commission vote to change. The hospital authority board also must approve the changes. Ware said that, meantime, the $13 million quarterly installment due to Grady on Sunday will be paid.
“I think we’re all pleased that the commission voted that way,” Grady spokesman Matt Gove said. “We absolutely believe that those recommendations will help. What it will allow is a more streamlined process that won’t involve as many man hours.”
The commission also voted 5-2, Hausmann and Lowe opposed, to urge the Fulton-DeKalb Hospital Authority to enforce its lease with the Grady corporation and keep the Otis W. Smith Health Center in southwest Atlanta and South DeKalb Health Center in Decatur opened.
Hausmann said she understands the clinics had the least amount of use and there are other clinics nearby. Darnell, who introduced the resolution, countered that people in her part of the county know that’s not the case.
“Commissioner Hausmann, it is a transportation problem that makes this so severe,” Darnell said. “These people are elderly, they are single mothers who don’t have transportation.”
Darnell called the county’s director of internal audits, Anthony Nicks, to the podium and had him explain that Grady was $37.4 million in the red in 2009 because of balance sheet adjustments. That included $15.9 million in debt forgiven by Emory University and $202,000 in debt forgiven by Morehouse College.
Darnell said Grady is struggling just like all other charity hospitals in the country, and it’s time for suburban counties to start chipping in, instead of just Fulton and DeKalb.
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