Corporate board pulls plug on dialysis for poor patients

More than 100 patients, their family members, doctors, other health workers and community activists packed into the board room at Grady Hospital on Sept. 14 to press for the continued operation of the outpatient dialysis clinic, a function of the once-public hospital for 62 years.

Ignoring the appeals of the crowd, many of whom held signs reading “How Many Will Die?” and “Keep the Clinic Open,” the corporate-dominated privatized board voted unanimously to close the life-sustaining treatment facility on Sept. 20.

Protesters demand treatment for poor people at Grady Hospital’s clinic. Photo: Jonathan Springston, Atlanta Progressive News

Despite boasting of raising more than $280 million for the financially stressed hospital, Board Chairman Pete Correll, former head of Georgia-Pacific, justified the decision by stating that the dialysis clinic was “a big money loser.”

About 100 patients suffering from renal failure and kidney disease currently receive dialysis at Grady. Some of them must go three times a week to rid their bodies of the deadly toxins that build up. Many of them are long-time immigrant residents who have lived in the Atlanta area for decades but under Georgia law are ineligible for Medicaid coverage.

Others who are U.S. citizens or have a green card have not yet been approved for Medicaid. Georgia has one of the highest rates of application rejection in the country, requiring sick people to apply multiple times or wait extraordinarily long times for acceptance into the program.

In August, social workers began to tell these critically ill people that the clinic was closing. People were given a seven-page list of for-profit dialysis centers to call to see if the centers would accept them as patients.

Their other options were to return to their home country, move to another state where Medicaid is available to undocumented immigrants, or go to an emergency room when the poison build-up brings them dangerously close to death. Federal law mandates emergency dialysis treatment if death is likely.

As a gesture of “care and compassion” for these patients, Grady officials offered to pay for plane tickets to Mexico, Thailand, Honduras and Ethiopia as well as transportation to the 11 states identified as providing immigrant care. Inexplicably, when contacted by reporters from the Atlanta Journal-Constitution, health officials in at least three of those states—North Carolina, Virginia and New Jersey—said they also do not pay for outpatient dialysis treatment for undocumented sick people. Florida, another state on the list, requires a six-month residency, an impossible wait for a dialysis patient.

The patients who testified at news conferences, rallies and at the board meeting repeatedly said they had nowhere to go. Many are unable to work. All have family and children in the Atlanta area who care for them, take them to their doctor appointments and dialysis treatments.

One woman said through her tears: “I have no one in Mexico. Who will look after me?” Her three young granddaughters carried a carefully printed sign that read, “Don’t send our grandmother away.”

Opponents of the closure won a temporary restraining order on Sept. 16 that mandated the hospital continue serving dialysis patients and prohibited it from pressuring patients to leave the state. On Sept. 23, there will be a hearing to determine if the injunction will stay in effect.

In his initial ruling, Judge Ural Glanville stated that before he would allow the clinic to close, Grady would have to provide all patients with a “plan that does not jeopardize their lives or medical needs.”

The Grady Coalition, which has been an activist voice for quality patient care and for workers’ rights at the hospital for 10 years, is being joined in the struggle to save the dialysis clinic by Grady Advocates for Responsible Care, a group of doctors, clinicians and patients.