ATLANTA - Hoping to generate a critical infusion of cash, the board that oversees Grady Memorial Hospital gave preliminary approval Monday to turning over day-to-day operation of the financially struggling facility to a nonprofit corporation.
Members of the Fulton-DeKalb Hospital Authority voted unanimously for the change, despite an outcry from local activists worried that the move will lead Georgia's largest public hospital to abandon its commitment to the poor and uninsured.
During the raucous meeting that preceded the vote, a long list of speakers called the restructuring unnecessary and accused board members of giving in to threats by state and local political leaders, business groups and the two medical colleges that supply Grady with physicians.
"What we are experiencing today is nothing short of extortion," said the Rev. Timothy McDonald, co-chairman of the Grady Coalition, a group of citizens opposed to the change.
Grady, which has the largest number of nonpaying patients in the state by far, lost money in 10 of the last 11 years, including a projected shortfall of $55 million this year. Without a massive bailout, the hospital could close by the end of the year, flooding other hospital emergency rooms across metro Atlanta with poor and uninsured patients.
The state, Fulton and DeKalb counties and the Metro Atlanta Chamber of Commerce all have expressed interest in helping, but not without strings attached.
Gov. Sonny Perdue, legislative leaders, county commissioners and chamber officials all have endorsed a chamber task force recommendation that Grady bring on a nonprofit to run the hospital.
In addition, officials from Morehouse and Emory University medical schools, which use Grady as a teaching hospital, have threatened to send some of their doctors to other hospitals unless the Grady board approves the restructuring.
Supporters say converting to a nonprofit would make state lawmakers, banks and private foundations more willing to come to the hospital's aid.
Indeed, the resolution adopted by the board on Monday makes the change contingent upon financial commitments from the state, the two counties and the business and philanthropic communities amounting to hundreds of millions of dollars.
"It's an important step to give us the opportunity and the time to get all of the various forces and people who want to be a part of Grady to not just show us the money, but give us the money," said board member Michael Hollis, who was born at Grady. "This resolution permits Grady to not only survive, but thrive."
The resolution also requires the hospital to maintain its commitment to serving the poor.
But Monday's speakers said those commitments are worthless because they don't trust those who are giving them.
"The mission is supposed to remain the same. I'm skeptical of that," said Sen. Vincent Fort, D-Atlanta, the Grady Coalition's other co-chairman. "I don't believe the promises."
Fort and activist Derrick Boazman were involved in a scuffle with Grady Hospital security outside of the hospital board room while board members were meeting behind closed doors.
After the executive session, the board moved the public portion of the meeting to an auditorium across the street to accommodate the crowd.
Many of the speakers praised the board for doing a good job managing Grady, blaming its financial woes instead on chronic under-funding.
Rep. Pam Stephenson, D-Lithonia, the board's chairman, agreed that Grady's financial plight is not the board's fault.
"We have served the least of these despite a decline in reimbursements and lack of direct support from the state," she said.
Before board members can give the agreement final approval, the resolution requires two public hearings. The first will take place on Dec. 27, followed in short order by a second hearing no later than Dec. 31.