�The only option is to count the days until he dies.�

By John Ballard

Atlanta's Grady Memorial Hospital is closing its money-losing dialysis unit.

Judge clears way for Grady dialysis to close

A Fulton County judge on Friday cleared the way for Grady Memorial Hospital to close its outpatient dialysis clinic within days.

Grady spokesman Matt Gove said the outpatient dialysis clinic would close in about a week, once plans are in place to find other care for its patients.

But even as Grady prepares to close the clinic, the legal and political challenges carry on. Superior Court Judge Ural Glanville had issued a temporary restraining order last week to keep the clinic open pending a hearing. Patient advocates had filed a lawsuit asserting that patients desperately needed the Grady service and would suffer without.

Glanville said he will continue to hear arguments on the case, said Grady attorney Bernard Taylor. So the hospital is expected to face off in about a month against the patient advocates who filed the legal challenge.

In addition, the Fulton DeKalb Hospital Authority is expected to discuss the closure at its meeting Monday. The authority contracts with the Grady corporate board to run the hospital. Some authority members question whether the closure violates the contract between the two, which demands that Grady continue its mission to provide for the needy.

�We want to make sure the decision was made not only about dollars and cents,� but for what�s best for people, said authority board member Thomas Dortch.

The closing of the Grady clinic would essentially leave metro Atlanta without a major hospital that provides nearly free outpatient dialysis care for the poor, uninsured and illegal immigrants.

Lindsay Jones, an attorney for the patients, said they he planned to file legal actions on Monday to keep the clinic open.

Some patients are frightened that they will not find alternative care and the ruling will become a death sentence.

Abebech Tadesse is worried for her father. �We have no options,� Tadesse said, her voice breaking. �The only option is to count the days until he dies.� Her father, Tadesse A. Amdago, 69, is a green card holder from Ethiopia. They are not giving up hope. �I will pray and see what�s going to happen.�

The closing of Grady�s outpatient dialysis clinic reflects many of the issues that are hurting safety net hospitals across the country. Their communities often expect them to provide all the care that other hospitals don�t, but many of these medical facilities are sinking financially under the weight of providing uncompensated care to uninsured people.

Grady officials say the outpatient dialysis clinic has outdated equipment and loses between $2 million to $4 million a year. Grady officials say they will help find care elsewhere for patients. Some 51 patients, all illegal immigrants, remain without plans for treatment. Grady has offered to finance their moves back to their home countries or to another state that pays for such care for illegal immigrants. Grady spokesman Gove said Grady would pay for their care at private clinics for three months, as other options are explored.

Grady will also set up a hotline to provide guidance to patients for the next 120 days.

Ignacio Godinez Lopez, an illegal immigrant from Mexico and a laid-off home remodeler, is worried that he may end up in the emergency room.
He knows he doesn�t want to go back to Mexico. "I know a man who moved to Mexico about a week ago and he cannot get his dialysis,� he said.

Judge Glanville had initially granted the temporary restraining order Sept. 16, pending a hearing on the issue. In his decision Friday, Glanville said that at this time the patients and advocates had not presented enough evidence to prove that the patient�s needed the court�s intervention.

The judge made it clear that �the court is unpersuaded at this time that plaintiffs will succeed on the merits of their claims.�  He added that the court is unconvinced that the patients have a constitutional right to the court�s relief.

Patients, their relatives and patient advocates were stunned by the action.

State Sen. Vincent Fort (D-Atlanta), a member of the Grady Coalition, feared closing the clinic is just the first step in more service cuts.

Dorothy Leone-Glasser, co-founder of the Grady Advocates for Responsible Care, which worked with the coalition, called the order �very cruel.�

�Patients will then flood the emergency rooms (to get treatment) and I don�t see how that is a healthy medical solution to that problem,� she said.

I report. You decide.