Grady Offers 6-Month Reprieve to Patients of Dialysis Clinic

Craig Schneider, Atlanta Journal-Constitution, September 14, 2009

Grady Memorial Hospital is offering to relocate about 60 outpatient dialysis patients to other states or send them back to their home countries as the hospital prepares to close its dialysis unit.

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But some patients are scared and panicking. They say they cannot move to another state or back to their home country. Many are poor, uninsured and undocumented immigrants. Grady has been their last resort. They’re afraid when the clinic closes, they’ll have nowhere to go and their health will spiral.

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Grady officials say they understand that some patients will not take the relocation offer, and the officials said these people will not be left out in the cold.

If the patient resides in Fulton or DeKalb–the two counties which provide direct subsidies to Grady–then Grady will find a private dialysis provider and pay their bill, Gove said.

If they reside outside those two counties, the hospital will work to find a care provider in their home county to help care for the person, he said. But Grady won’t pay that bill.

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Grady Memorial Hospital officials on Monday offered up to a six-month reprieve to patients concerned their health would spiral after the closing of the outpatient dialysis clinic.

The Grady board, acting on a motion by board member Michael Hollis, voted to extend the license on the clinic for up to six months. The license was set to expire Sept. 30.

That doesn’t mean the clinic will stay open another six months, officials said. It means the clinic will stay open until each of the patients has a viable plan for receiving care elsewhere, said hospital CEO Michael Young.

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Grady officials said they plan to close the outpatient dialysis unit because the clinic is old, uses outdated equipment and has lost between $2 million and $4 million a year in recent years.

The problem is that about 60 of the clinic’s 90 patients are undocumented immigrants who cannot collect government aid such as Medicaid. That makes it difficult to transfer them to a private provider.

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Grady loses about $75,000 a year providing care to each of these nonpaying patients.

Grady plans to shift about 30 of the outpatient dialysis patients to private providers in metro Atlanta. These patients are U.S. citizens and almost all either have Medicaid or Medicare or are soon to receive it.

Gove, the hospital spokesman, said hospital officials expect as many as 20 of the patients who are undocumented immigrants will relocate to another state. He said Grady has found about 11 states in the country that provide Medicaid assistance for undocumented immigrants for outpatient dialysis treatment. Georgia does not. The states include New York, North Carolina, Florida, New Jersey, Washington, Virginia, Massachusetts, Connecticut, Ohio, Illinois and Wisconsin.

Gove said these patients will receive some guidance from Grady on setting up their health care in the new state, but will be largely left on their own in negotiating the system.

Officials say that eight patients have committed to locate back to their home country, and more may follow. Many come from Mexico but others are from Togo, Ethiopia, Honduras, El Salvador, the Philippines and Guyana. The hospital is working with the Mexican Consulate in Atlanta and a private group that specializes in relocating people to Latin America and helping them obtain health care there.

After the center closes, patients in transition would receive care at a local provider and Grady would foot the bill, Gove said.

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