Regular, life-saving dialysis treatments resumed Friday for 21 former Grady Memorial Hospital patients -- most of them uninsured, illegal immigrants -- after the hospital and a national dialysis provider struck a new, three-year deal.
The agreement puts to rest, at least until 2014, the ongoing dilemma of who would care for the immigrants after Grady shuttered its outpatient dialysis unit nearly two years ago.
The patients with end-stage renal disease were cut off from regular dialysis last week after a one-year, $750,000 contract between Grady and Massachusetts-based Fresenius Medical Care to care for the patients expired Aug. 31. People with end-stage renal disease can die within weeks without regular dialysis treatment.
Almost all landed in emergency departments for dialysis, said Dorothy Leone-Glasser, president of Advocates for Responsible Care. One woman flew to her native Honduras Wednesday after passing out at home and ending up in the ER.
The new deal will cost Grady , which has seen its financial situation deteriorate rapidly this year, less than half of what it spent under prior deals with Fresenius. The hospital will pay Fresenius $15,500 per patient per year -- roughly $325,000 annually over the three-year term, said Grady spokesman Matt Gove.
“It’s more than we wanted to pay, but I do think that the amount recognizes that Grady can’t cover the cost alone and that Fresenius was willing to really participate in the cost … so we’re thankful for that,” he said.
The per-person charge allows flexibility to adjust the rate if a patient becomes insured or makes other arrangements, Gove added.
Fresenius has worked to forge partnerships in Atlanta with medical providers who share its concerns about patient care, company spokeswoman Jane Kramer said in a statement.
Advocates say a permanent solution is still needed.
“I’d like to see all the other providers that operate in Georgia come to the table,” Leone-Glasser said. “It makes us a stronger community.”
The immigrants have been in limbo since Grady closed the dialysis unit in 2009. Illegal immigrants and some legal immigrants aren’t eligible for Medicare, which provides dialysis for most Americans with end-stage renal disease.
Grady officials said the outpatient unit was losing $4 million annually. Since then, the hospital, which faces a budget shortfall of up to $25 million this year, has spent more than $2 million to continue care for the patients. Fresenius, dialysis provider DaVita Inc. and Emory Healthcare are also caring for an additional 12 former Grady patients for free.
It's still unclear what will happen long-term, but the new three-year deal allows more time to work with other providers and community leaders to come up with a solution, Gove said.
Advocates for tougher immigration enforcement say illegal immigration puts more pressure on an already strained health care system. When hospitals have to pay for illegal immigrants, the cost gets shifted to insured, paying patients, said Bob Dane, a spokesman for the Washington-based Federation for American Immigration Reform.
“We’re all paying the costs,” he said.
Ana Aguiniga said returning to Mexico isn't an option for her boyfriend’s father, who is one of the dialysis patients. The 60-year-old’s entire family is in the U.S. and there would be no one to care for him, she said.
Bineet Kaur, an immigrant from India, said she hopes a long-term solution worked out. Kaur came to the U.S. in 2000 on a visa and stayed after it expired.
The 28-year-old was initially turned away from Grady’s ER after being screened last Saturday but was admitted three days later after fluid building up in her body left her short of breath with chest pains. It had been eight days since her last dialysis session -- the longest she’s gone without treatment.
“We are just stressed out,” she said. “We don’t have any more strength.”
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