Department
County Manager
Requested Action (Identify appropriate Action or Motion, purpose, cost, timeframe, etc.)
title
Request approval of an Agreement between Fulton County, DeKalb County, Grady Memorial Hospital Corporation (“GMHC”) and the Fulton-DeKalb Hospital Authority (the “Authority”) for the provision of support payments and other funding from the counties to GMHC for use by GMHC and the Authority to ensure the provision of medical care and adequate facilities at Grady Hospital and in other Neighborhood Health Centers in the counties for residents of the counties regardless of their ability to pay, and for other purposes, for an initial term of six (6) years, commencing January 1, 2024 and ending December 31, 2029, with the Agreement terminating and automatically renewing on December 31 of each year; and with two (2) additional, successive renewal terms of two (2) years each thereafter for a final termination date of December 31, 2033, with the amount for Fulton County’s share of support set at $43,297,870.00 for the term of January 1, 2024 through December 31, 2024, and increasing automatically thereafter by an amount equal to the percentage change in the Consumer Price Index, Medical Care for the preceding calendar. The County Attorney is authorized to approve the Agreement as to form and to make modifications thereto prior to execution by the Chairman. (APPROVED)
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Requirement for Board Action (Cite specific Board policy, statute or code requirement)
Pursuant to Fulton County Code § 1-117, the Board of Commissioners has exclusive jurisdiction and control over directing and controlling all property of the County. General funds may be used to finance care for the county’s indigent sick. O.C.G.A. § 48-5-220. The County may contract with a hospital authority for the purpose of using the services and facilities of the hospital authority. O.C.G.A. § 31-7-85. See also, O.C.G.A. § 36-60-13 regarding multi-year agreements.
Strategic Priority Area related to this item (If yes, note strategic priority area below)
Health and Human Services
Commission Districts Affected
All Districts ☒
District 1 ☐
District 2 ☐
District 3 ☐
District 4 ☐
District 5 ☐
District 6 ☐
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Summary & Background (First sentence includes Agency recommendation. Provide an executive summary of the action that gives an overview of the relevant details for the item.)
The County Manager recommends approval of this Agreement. Since 1984, Fulton and DeKalb Counties (“Counties”) have provided support to Grady Hospital through the Fulton-DeKalb Hospital Authority and GMHC. This Agreement will replace the original agreement among the parties which has been extended several times and expires on December 31, 2023. Over time, the needs of the Counties have changed as have the models for the provision of health care. This Agreement is designed to support the placement and operation of Neighborhood Health Centers in the Counties along with the operation of Grady Memorial Hospital, and to provide both a reliable expectation of income for GMHC and the Authority and an equitable distribution of those costs between the Counties.
Scope of Work: The main components of the agreement are as follows: Coordination of lobbying and related efforts to encourage the expansion of Medicaid in Georgia. Provision of monthly support payments in 2024 from Fulton County in the amount of $3,608,155.83 ($43,297,870.00 total for 2024) and from DeKalb County in the amount of $2,047,260.83 ($24,567,130.00 total for 2024), which would cease in the year following full Medicaid expansion if that were to occur. Calculation of monthly support payments for future years where no Medicaid expansion has occurred based upon the percentage change in the Consumer Price Index, Medical Care for the preceding calendar year as reported by the U.S. Bureau of Labor Statistics. Establishment of two new neighborhood health centers in Fulton County and three new neighborhood health centers in DeKalb County to include, among other things, mental health, social services, navigation services, nutritional support, and pharmacy services; expanded hours where possible; and specialty care based upon local needs. Assurance of emergency and trauma care locations within each county. Provision of care for employees of the Counties workforce injuries and for individuals in the custody of law enforcement. Issuance of revenue obligations by the Authority when needed for certain long-term capital and operational needs. Payment by the Counties of debt service on bond contracts. Establishment of quarterly meetings of the parties through their representatives to discuss operational, financial, and other needs and progress. Establishment of semi-annual meetings for Grady and Authority executives to provide presentations to the counties’ Boards of Commissioners.
Community Impact: The community will benefit from the continued and expanded health care facilities and resources provided through this Agreement.
Department Recommendation: Approve.
Project Implications: The community will benefit from the continued and expanded health care facilities and resources provided through this Agreement
Community Issues/Concerns: None
Department Issues/Concerns: None
Exhibits Attached (Provide copies of originals, number exhibits consecutively, and label all exhibits in the upper right corner.)
Contact Information (Type Name, Title, Agency and Phone)
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Pamela Roshell, Chief Operating Officer, Office of the County Manager,404-612-1243
Fiscal Impact / Funding Source
Funding Line 1:
100-730-7300-1080
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Key Contract Terms |
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Start Date: 1/1/2024 |
End Date: 12/31/2029 |
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Cost Adjustment: |
Renewal/Extension Terms: Two automatic renewals of two years each. Furthermore, during each of these multi-year terms, the Agreement will terminate on December 31 of each year and automatically renew. |
Overall Contractor Performance Rating:
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Report Period Start: |
Report Period End: |
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1/2/2024 |
12/31/2029 |