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Dems, GOP clash over Grady funds
Lawmakers dispute tying state aid to management changes

ATLANTA - The state must step up immediately and commit to funding a major share of Grady Memorial Hospital's growing deficit, several Atlanta Democrats in the General Assembly said Wednesday.

But Republicans continued to insist that any state bailout of Georgia's largest public hospital be tied to an overhaul of Grady's management structure.

Democrats in the Atlanta-Fulton County House and Senate delegations called on GOP Gov. Sonny Perdue and Republican legislative leaders to fully fund the trauma care services Grady provides to indigent patients throughout metro Atlanta.

Grady, which has the region's only Level 1 trauma center, spent $38.8 million on trauma services for the indigent in 2005, according to the Georgia Hospital Association.

The General Assembly's Fiscal Affairs Committee has the authority to make spending decisions between legislative sessions.

Once that's done, the Democrats also asked that the governor and legislative leaders earmark at least $50 million for Grady in the 2008 midyear budget and each subsequent year.

"Changing the managerial structure without support from the state is not a short-term or long-term solution," said Rep. Bob Holmes, D-Atlanta, the Atlanta-Fulton delegation's chairman.

Grady has been losing money since 2000, the year after then-Gov. Roy Barnes, a Democrat, steered $100 million from Georgia's share of the national tobacco settlement to Grady and 45 other hospitals that treat a high percentage of poor and uninsured patients.

A task force assembled by the Metro Atlanta Chamber of Commerce reported last June that Grady's cash-flow problems were getting worse and that the hospital could be forced to close by the end of the year without an infusion of about $120 million.

On Wednesday, a member of that task force warned a Senate committee of dire consequences if Grady shuts down.

Tom Bell, CEO and chairman of Cousins Properties, said many trauma patients currently are being diverted there during busy weekend nights from other hospitals throughout the metro region.

"If Grady were to close, you'd literally be in an emergency vehicle wandering the streets of Atlanta," he said. "You're going to have a bunch of dead people."

The task force has recommended turning the management of Grady over to a nonprofit board.

The hospital currently is run by the Fulton-DeKalb Hospital Authority, a 10-member board appointed by commissioners from the two counties.

Bell told members of the Senate Urban Affairs Committee that model creates an inherent conflict because it makes the authority's members directly answerable to the politicians who control Grady's funding.

Picking up where the chamber left off, Sen. David Shafer, R-Duluth, said last month that he would introduce a bill mandating the management overhaul.

But Sen. Vincent Fort, D-Atlanta, said debating who's in charge at Grady takes the focus away from the hospital's financial woes.

"The problem at Grady is a resource problem," he said. "Privatizing Grady will not bring one more dollar to that institution."

Republicans said they're not ignoring the hospital's money crunch.

Rep. Ben Harbin, R-Evans, chairman of the House Appropriations Committee and a member of a special House committee created to study Grady's situation, said the state likely will step in with some funding.

But he said it would be irresponsible to act now when his committee is still trying to determine how Grady got into financial trouble so quickly after the 1999 bailout and what steps the hospital could take to improve its bottom line.

"If we're going to put taxpayer money in there, it needs to be a proper investment," he said.

Added Shafer: "The last thing we should do is simply write a check without making changes."