Grady dialysis patients band together to face new deadline on care

They decided they would fight together to keep their care.

Today was supposed to be the deadline on care for these patients. But Grady officials presented a new deadline with new consequences. In a letter sent late last month to patients, Grady told them that the hospital will continue their care only if the patients show that they are working to find long-term care elsewhere.

In order to continue the care, the patients must contact the hospital by Feb. 12 and show that such plans are in the works. If they don't, the letter said, "we will have no choice but to assume that you have taken responsibility for your long term care and are no longer in need of our assistance through Fresenius [its contracted provider]."

The solidarity among patients has grown since Grady's outpatient dialysis clinic closed in October. Many patients found care elsewhere, but about 40  --  nearly all of them low-income, illegal immigrants -- said they had no place else to go.

Grady has continued to provide free care through a contract with the private dialysis company Fresenius. That contract runs through September, but hospital officials want the patients to find their own care before then. Several deadlines have come and gone on ending Grady's care.

The Atlanta Journal-Constitution first reported preliminary plans to close the Grady dialysis clinic last May.

Rather than acting individually, the patients now have an attorney and a health care advocate, both of whom provide free counsel.

On Tuesday, advocate Dorothy Leone-Glasser advised several that if they had to meet with the Grady workers, they should not sign anything on the spot. She said they should get a copy of any proposal in writing, and bring it back to her and the attorney to review.

She said about six patients met with her Tuesday. In the past they have come together in groups of 20 or more, she said.

Leone-Glasser said she believes Grady's latest deadline is aimed atapplying pressure on patients individually.

"They act as a group together,"  Leone-Glasser said. "There's more power in numbers and Grady sees that."

Grady officials said they are doing all they can to help the patients find care elsewhere. The hospital has offered to help patients relocate to other states or their home countries, where Grady officials say they would have a greater chance of receiving government assistance. The hospital also has spent hundreds of thousands of dollars providing them with months of free care at Fresenius,  hospital spokesman Matt Gove said.

The idea that Grady is trying to isolate patients is "absurd," Gove said. "We want to work with them on their long-term plans."

He said Grady is struggling financially and cannot provide care for all these patients forever.

He acknowledged that the patients had cut off communication with Grady before it sent the letter and deadline last month. The action was intended to bring them back to the table.

"The lack of communication is a problem," Gove said. The extended care, he said, "is not an open-ended commitment on Grady's part."

If patients do not contact Grady by Feb. 12, it does not necessarily mean their care will cease the next day. But their lack of cooperation will be taken into consideration as the hospital considers its next steps. And eventually, Gove said, that could mean cutting off their care.

The patients, guided by their advocates, have acted in unison in several ways. They have filed a lawsuit accusing Grady of patient abandonment and requesting the court order Grady to continue outpatient dialysis. That suit was dismissed, and the attorney, Lindsay Jones, said he will file an appeal.

The patients also have requested the help of an international group called the Inter-American Commission on Human Rights. While the commission has no binding power over Grady or American officials, it recently requested that the U.S. government take steps to ensure that these Grady patients have access to care.

Glasser, the advocate, said many of the patients have lost trust in Grady's effort to help them find care elsewhere. She said some who relocated were unable to receive government assistance for care. Gove, for his part, said several patients have relocated and successfully obtained that aid.

Adolfo Sanchez, a 32-year-old patient, said he has not received the latest letter. He showed up Tuesday for treatment at Fresenius expecting to receive some news, but he didn’t hear anything.

“It makes me sick to be thinking all the time if they’re going to extend the deadline, or when the last day is that I’m going to receive treatment," Sanchez said.

MundoHispánico reporter Linda Carolina Pérez contributed to this article.

Support real journalism. Support local journalism. Subscribe to The Atlanta Journal-Constitution today. See offers.

Your subscription to the Atlanta Journal-Constitution funds in-depth reporting and investigations that keep you informed. Thank you for supporting real journalism.