Grady Memorial Hospital's plan to send kidney dialysis patients to several other states, where the hospital said they would qualify for care, could leave some patients stranded without adequate treatment.
At least three states on the list --- Virginia, North Carolina and New Jersey --- have requirements that could shut out these new residents from routine dialysis care, The Atlanta Journal-Constitution has found.
Late Thursday Grady officials could not explain the discrepancy between their plan and the states' response. They said the list of 11 states named in the relocation plan came from an outside consultant. They would not name the consultant.
"I am investigating the source of the list to make sure we had verified that these claims are true," said Grady spokesman Matt Gove.
He said none of the patients who've left Georgia have moved to New Jersey, North Carolina or Virginia.
The hospital had said the dialysis unit would close Sunday and the hospital hoped to send about 90 patients --- some of whom are illegal immigrants --- out of state, back to their home countries or to local clinics. As many as 10 patients have already moved out of state. For many, Grady had been their last resort for dialysis care.
Late Wednesday, Fulton County Superior Court Judge Ural Glanville issued a temporary restraining order that stopped Grady Memorial Hospital from closing its outpatient dialysis unit --- at least for a few days.
The restraining order also compels the hospital to stop the hospital's controversial plan to pay the relocation costs of some patients to move to another state or back to their home country.
The judge's action came as a relief to Ignacio Godinez Lopez, an illegal immigrant from Mexico, who is a laid-off home remodeler.
"I don't know anyone anywhere else," he said.
Patients --- some who need dialysis three times a week --- said they worried that their health would deteriorate as they moved to another state or country. Advocates said some patients were not informed that if they chose not to relocate, Grady would help them find care and take care of their bill.
"People are talking about death panels. The real death panels occurred here at Grady, when people were told to go and die," said state Sen. Vincent Fort (D-Atlanta), a leader of the Grady Coalition advocacy group.
Controversy has built since Grady first announced in July plans to close the outpatient dialysis clinic. This week, reaction to the plan erupted.
Grady officials have repeatedly assured patients and the public that no patient would be left without care. They said they found states that provide Medicaid assistance for illegal immigrants for outpatient dialysis treatment. Georgia does not.
But officials of three of those states --- North Carolina, New Jersey and Virginia --- told The Atlanta Journal-Constitution Thursday that they do not offer Medicaid assistance for illegal immigrants for outpatient dialysis treatment.
They only provide Medicaid assistance for illegal immigrants for emergency services provided through an emergency room. None of the three states has a special program for illegal immigrants needing ongoing outpatient dialysis.
Mark Van Sciver, spokesman for the North Carolina Department of Health and Human Services, said every state in the country is required by federal law to offer such Medicaid assistance for emergency situations.
"Why is Grady telling people to go to another state? I don't know," said the spokesman.
The Atlanta Journal-Constitution is still trying to contact the other states on the list.
The restraining order, sought by patient advocates, said the plaintiffs showed "the likelihood that plaintiffs will suffer irrevocable injury unless this court intervenes."
The judge said Grady must provide the patients with notice in their primary language of their right to receive continued dialysis treatment at Grady. And before he will allow the dialysis clinic to close, Grady must provide the judge with a "suitable alternative dialysis treatment plan that does not jeopardize their lives or medical needs."
The judge set a hearing for Wednesday.
Grady spokesman Gove declined to comment on the court's action. But Grady officials have said none of the dialysis patients will be left without care. About 30 of them --- all U.S. citizens --- will be transferred to local clinics, he said.
Several of the remaining 60 have already committed to moving to other states or back to their home country.
The advocates' success in temporarily stopping the closure reflects the emergence of a new patient advocacy group --- the Grady Advocates for Responsible Care. The group played a key role in getting the temporary restraining order.
Co-founder Dorothy Leone-Glasser, a DeKalb County-based nurse and wellness counselor, said people came together about two months ago when word spread that Grady was closing its outpatient dialysis unit. Several conference calls later, the group was born.
The group worked with an existing patient advocacy group, the Grady Coalition, in the push to file the legal challenge that led to the temporary restraining order.
The group is described as an alliance of physicians, medical care providers, patients, human rights organizations and patients advocates.
The group was galvanized because "this was a life and death issue," Leone-Glasser said. "There was no time to waste in trying to get these patients help. These patients didn't have a voice."
Staff writer Rachel Tobin Ramos contributed.
Copyright 2009 The Atlanta Journal-Constitution