Letter from Lieutenant Governor Casey Cagle

July 23, 2007

Hon. John Eaves   
Commission Chairman  
Fulton County    
141 Pryor Street   
Atlanta, GA 30303  

Hon. Vernon Jones
Chief Executive Officer
DeKalb County
1300 Commerce Drive
Decatur, GA 30030

Re:  Grady Hospital

Dear Chairman Eaves and CEO Jones:

I am contacting you regarding a financial problem that has clearly reached crisis proportions for the Fulton-DeKalb Hospital Authority.

As I am sure you are all too aware, Grady Hospital’s financial deficit has reached an unmanageable level.  In turn, the ability of the hospital to survive – at least at its current level of service – has been called into question.

Public officials often use the word “crisis” to describe a situation that needs attention; however, this is clearly a case where that word is entirely appropriate.  There can be no doubt that a Grady failure would have disastrous results for the entire metro Atlanta region.  At stake are the area’s only level one trauma center, the training center for one in four Georgia medical students, and the care of almost one million patients annually.  Losing even one of these critical components would be a disaster, but losing all three of them would cause serious damage to our entire state.

I hope that this is a time when we can put politics aside and act in the best interests of the constituents we serve.  At the outset, I want to acknowledge that the state clearly has a role to play in rescuing Grady financially.  It is essential that we begin taking steps in this direction as we move to build a stronger trauma care network for our entire state. Since the publication of the Metro Chamber Task Force report, I have discussed Grady with several key legislative leaders on both sides of the aisle.  More than anything else, I have been impressed by the uniform belief that restructuring daily management operations under a non-profit 501(c)(3) board that is insulated from the political process represents a critical foundation upon which any successful effort must be built.  Simply put, I believe the support is there for a significant state role in saving Grady, but that such a restructuring effort absolutely must precede any discussion of that role.

As you know, this has become the model for most successful urban non-profit hospitals, because it enhances funding, improves efficiency, and protects the hospital’s governance structure from political influence.  This is a transition that Grady must undertake with all due speed if it is to continue offering a high level of service to metro residents.  The State Senate is looking to the Fulton and DeKalb commissions to move rapidly toward this transition, and I urge you to complete it in time for us to move forward on a broader effort to save Grady in the next legislative session.  It is my hope that you will take this opportunity to move forward quickly.

In the event progress does not occur on this front, I want to advise you the Senate intends to consider legislation to reform state requirements for the management of large urban hospital authorities.  While it is our hope to see a local solution, given the importance of this issue and the limited time available, we simply cannot stand by and do nothing if immediate steps are not taken.  I realize this is a difficult issue, and I want you to know I stand ready to work with you in any way possible to resolve it.  Thank you for your careful consideration of this critical alternative.


Casey Cagle
Lt. Governor of Georgia

cc: DeKalb County Commission
Fulton County Commission
Governor Sonny Perdue
Speaker Glenn Richardson
Sen. David Adelman
Sen. David Shafer

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