Time for Grady to Take Its Medicine

February 13, 2008

Grady Hospital is the only Level 1 trauma center in North Georgia.  If seriously injured in a severe automobile accident, Grady is where you’d likely be treated.  It is the top medical facility for treating indigent patients in Metro Atlanta, and thus relieves a burden that otherwise would be fully borne by the emergency rooms of local hospitals such as Northside, St. Joseph’s, and Piedmont.  Grady also is a teaching hospital that trains one out of every four doctors in Georgia.

From all of this, one thing is clear:  We cannot afford for Grady Hospital to close.  Its major role in the health of our region would be impossible to replace.  Yet, Grady faces an alarming and deepening financial shortfall amounting to hundreds of millions of dollars.  The hospital is on life support, and major decisions will need to be made during this year’s legislative session to help save Grady from its financial coma.

The hospital is operated by the Fulton-DeKalb Hospital Authority, which has a governing board comprised of political appointees of the Fulton and DeKalb County governments.  Given that a substantial proportion of Grady’s patients are uninsured or on Medicaid, it is true that Grady’s current financial situation isn’t entirely the fault of its governing board.  However, it’s also true this political board has a history of gross mismanagement and poor fiscal oversight, and now is giving off erratic signals about whether it will take the steps necessary to save Grady.

What’s the most important step needed to save Grady?  A task force composed of representatives of Atlanta’s business community and sponsored by the Metro Atlanta Chamber of Commerce hit that nail squarely on the head:  “Like every other urban hospital authority in Georgia has done, Grady must restructure to take advantage of money-generating services and to remove the politics from the day to day management and operations of the hospital.”

This change in the management of Grady would be accomplished by creating a non-profit 501(c)(3) board comprised primarily of business leaders and medical professionals.  Of course, in order for that to happen, the current political board of the Fulton-DeKalb Hospital Authority would have to approve the new board and hand over control of the hospital.

Fulton and DeKalb political types rarely recede quietly into the night.  Thus far, the political Grady board has only been willing to approve a new professional governance structure with caveats and strings attached.  To date, a new non-profit board has not been appointed.

If the Grady board and its political bosses in Fulton and DeKalb Counties fail to get the job done by the end of February, it will become imperative that the General Assembly take action to force the necessary and overdue governance changes before our 40-day legislative session draws to a close.

I have resolved to be a part of that effort.  I also will be working with State Senator David Shafer on his two initiatives to create a legislative oversight committee to review Grady’s finances on an ongoing basis, and to prohibit those with a financial interest in Grady from serving on the political Grady board, or on the new non-profit board, once it is created.

A couple of weeks ago, the CEO of Grady Hospital was abruptly booted from that position and replaced with DeKalb State Rep. Pam Stephenson — who also serves as chair of the Grady board — as interim CEO.  Stephenson became Grady’s fifth CEO since 2005.

I know how difficult it is for me to maintain my law practice while the General Assembly is in session, so I do question how a state legislator can serve as CEO and board chair of an ailing public hospital while the legislature is in session, and be effective in all three positions.  More importantly, however, there is an extraordinary conflict of interest between serving in an executive position in a public hospital and serving on the board that oversees the hospital.  When managing taxpayer funds, you cannot be both the overseer and the overseen.

It is time to inject the stability into Grady Hospital that a new, non-profit, professional governing board would provide.  The state of our health system in Metro Atlanta truly does depend on it.

A version of this column was published in the February 6 edition of the Dunwoody Crier.

Vote Tuesday!

February 4, 2008

This Tuesday, February 5, is Georgia’s Presidential Preference Primary.  A whopping 24 states coast-to-coast will hold primaries and caucuses to help select each party’s presidential nominee.  Georgia is one of these “Super Tuesday” states.

Your regular voting location will be open from 7:00 a.m. to 7:00 p.m.  I hope to see you at the polls!


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