The Dialysis Crisis

Letter to Commissioner Larry Johnson

Advocates for Responsible Care
1434 Brook Valley Lane NE Atlanta, GA 30324 404-633-5843
July 7, 2010
Via First Class Mail and Fax

Commissioner Larry Johnson
DeKalb County Board of Commissioners
Commission District 3
Manuel Maloof Center
1300 Commerce Drive, 5th Floor
Decatur, GA 30030

Dear Commissioner Johnson:
Thank you again for electing to bring together private dialysis providers in our community in an effort to allocate the responsibility of supplying hemodialysis to the 33 Grady patients end-stage-renal disease patients of ARxC. However, seeing that we, the volunteers and patients of the Advocates for Responsible Care remain in the dark as to the progress being made on this front, we feel it is appropriate that we take this opportunity to update you on our current situation.

This past week all ARxC patients received letters from Grady notifying them that their hemodialysis treatment, of which they have been receiving over the past years, most recently from Fresenius, will be cut on August 31, 2010. As you know hemodialysis is required to sustain the lives of all end-stage-renal disease patients and therefore, this threatening deadline has instilled in us severe trepidation in what the future may hold.

It is becoming a realization that the ARxC patients may be forced to seek treatment through the emergency department of hospitals in DeKalb, Fulton, Gwinnett, and neighboring counties. We fear that this method of treatment is the worst possible solution to our situation for the following reasons:

1. The patients seeking care through the emergency room will have to meet specific toxicity levels in order for doctors to admit the patients and supply them with dialysis treatment. This means if a patient’s blood level does not meet the requirement to be admitted, they will be turned away. This will result in crashes that will require the employment of advanced emergency services and in-hospital treatment.

2. The end-stage-renal disease patients will be forced to use emergency care services two or three times per week and therefore flood the emergency room, putting stress on an already over-worked emergency care department.

3. Ultimately admission through the emergency room will cost the hospital 4 to 5 times more money than if the patients were provided care via an outpatient dialysis service.

The most cost-effective way to proceed is to screen our existing patients for peritoneal dialysis, in-home dialysis treatment. We ask that you please let us know about your progress and how we may participate to find a solution before August 31, 2010 as a means to preserve their human right to life.

Thank you for your time and consideration.

Volunteers of the Advocates for Responsible Care
Haley Stolp
Director of Volunteers
Board of Directors of ARxC
ARxC Patients

G.A.R.C. 9/5/2009


Grady Advocates for Responsible Care                                                             September 5, 2009


Grady Memorial Hospital Corporation Board of Directors

A.D. "Pete" Corell, Chair

Grady Health System

80 Jesse Hill Jr Dr, SE

Atlanta, Georgia 30303



Dear Mr. Corell and Grady Memorial Hospital Corporation Board of Directors:

The Grady Advocates for Responsible Care is an alliance of physicians, medical care providers, medical/ patient organizations, human rights organizations, and patient advocates that was formed out of concern for the patient’s lives at the Grady Health System. We are most alarmed by the urgent crisis at the Grady Hospital Dialysis Clinic. This clinic is scheduled to close September 20, 2009. We have received pleas from several patients that receive care at the Grady Dialysis Clinic and who have not been provided realistic resources to assure the continuity of dialysis treatment after the closing date. We understand Grady is making some provisions for some of the patients to receive dialysis treatment. However, the details of assured care for all the patients of this clinic have not been disclosed despite our many attempts to retrieve this information. We are foremost asking Grady to delay this closing until all the patients have transitional care. As advocates and medical caretakers we have a professional and ethical desire to help the patients for without our interest, they have no voice. We understand Grady’s economic constraints; however, we ask for a viable life-sustaining plan for the clinic patients. As citizens of Atlanta, we are eager to support any efforts by Grady to appeal to the private dialysis centers to care for these most vulnerable patients.


The closing of the Grady Dialysis Clinic puts the patients and the medical community of Grady in jeopardy unless we can assure that there will be a comprehensive and unveiled plan of continuity of care for all patients. We are in jeopardy of sustaining our mission of care if all the details of this plan are not shared with the patients and concerned volunteers of this community. 


We specifically ask the Grady Administration and Board of Directors to:

  • Delay the closing of The Grady Dialysis Clinic.
  • Meet with Representatives of Grady Advocates for Responsible Care before September 14 to share their plan for transitional care for each individual patient of the clinic including the terms of treatment and its duration.
  • Collaborate with The Grady Advocates for Responsible Care, the Grady community and the Atlanta community to provide viable solutions to any obstacles of care for any patient Grady will not cover.   


The Grady Health System mission is to improve the health of the community by providing quality, comprehensive healthcare in a compassionate, culturally competent, ethical and fiscally responsible manner. Grady maintains its commitment to the underserved of Fulton and Dekalb counties, while also providing care for residents of metro Atlanta and Georgia. As the Chairman of the Board of Grady Health System so aptly said, “We need to change the environment within the institution, but not the mission or dedication to service.”


We ask that you uphold that promise by putting these patients first through sustaining their treatment and saving their lives.




The Grady Advocates for Responsible Care:


Neil Shulman, MD

Dorothy Leone-Glasser, RN, HHC

Cristina Drenkard, MD, PhD

Elbert Tuttle, MD

Doyt Conn, MD

S. Sam Lim, MD, MPH

Daniel S. Blumenthal, MD, MPH

Ines Colmegna, MD

Kim Schofield

Sam Newcom, M.D.

Isabel Sance

Olga Jimenez

Sandy McMath


Community Supporters:


Health Action Network

The Wisdom of Wellness Project, LLC.

Grady Coalition

Metro Atlanta Task Force for the Homeless

Georgia Council of Nephrology Social Workers

Georgia Society of Rheumatology

S.T.A.R.S. for Patients

Hispanic Health Coalition of Georgia

Racial and Ethnic Concerns Working Group

Atlantans Building Leadership for Empowerment

Lupus Foundation of America, Inc., Georgia Chapter

Diabetes Foundation of Georgia

Universal Abundance

Students and Volunteers for Grady Advocates for Responsible Care


Please contact:

Grady Advocates for Responsible Care

Dorothy Leone-Glasser,

404-633-5843, 678-778-3614

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