Deal Would Provide Dialysis to Illegal Immigrants in Atlanta

By KEVIN SACK and CATRIN EINHORN
ATLANTA — Thirty-eight end-stage renal patients, most of them illegal immigrants, would receive the dialysis they need to stay alive at no cost under a rough agreement brokered Tuesday among local dialysis providers and Atlanta’s safety-net hospital, Grady Memorial.

The deal, if completed, would end a yearlong impasse that has come to symbolize the health care plight of the country’s uninsured immigrants and the taxpayer-supported hospitals that end up caring for them. The problem remains unaddressed by the new health care law, which maintains the federal ban on government health insurance for illegal immigrants.

Grady, which receives direct appropriations from Fulton and DeKalb Counties, ultimately agreed on Tuesday to help pay for continuing dialysis for most of the immigrants. Others would be distributed among local dialysis providers as charity cases.

Last fall, Grady’s new management closed its money-losing outpatient dialysis clinic in a move intended to demonstrate fiscal toughness to the city’s philanthropic community. The closing displaced about 60 uninsured illegal immigrants who depended on free thrice-weekly treatments at the clinic to survive.

Illegal immigrants, and legal immigrants newly in the country, are not eligible for Medicare, the federal program that covers most dialysis costs for American citizens with end-stage renal disease.

Grady volunteered to transport the patients to other states or their home countries and pay for three months of treatment. Thirteen accepted the offer. But in response to a patient lawsuit and news media scrutiny, the hospital eventually contracted with a commercial dialysis provider to treat the others in Atlanta for one transitional year.

That contract, with Fresenius Medical Services, expired on Tuesday.

Vital details of the agreement remain to be negotiated, including precisely how the patients will be distributed, how much Grady will pay and whether the arrangement will extend for patients’ lifetimes. But all parties said after meeting Tuesday morning that they were optimistic that they would reach an understanding and that patients would see no lapse in treatment.

“That would make me feel real happy because continuing with my dialysis, I need it to live,â€