State’s Public-Private Partnership Provides Immediate Care to Georgians During COVID-19 Crisis

Staff Report From Georgia CEO

Wednesday, October 28th, 2020

It was Tuesday morning, March 24. While most Georgians were still learning about a deadly new virus that just landed on American shores, the South Georgia town of Albany had suddenly become the world’s fourth largest epicenter of Covid-19 patients.

About 183 Covid-19 patients were at Phoebe Putney Hospital and more were coming in by the hour. 

“It was completely stressing the system,” said Scott Steiner, President and Chief Executive Officer of Phoebe Putney Health System. “We thought we would be like most rural areas and get just a little bit of it. But people were coming in super sick. 

“This was more death than most people ever imagine,” Steiner said. “Healthcare workers are trained to save lives. There were some days we thought we weren’t going to make it four more hours.”

But four more hours they did make it. Hospitals like Phoebe Putney and other hotspots around the state say it was because Gov. Brian Kemp, the Department of Community Health (DCH) and other state agencies stepped forward with a coordinated, public-private partnership that may have kept Georgia facilities from experiencing a disaster.

It was perhaps a textbook model of a public-private partnership the likes the state has never seen as Georgia officials mobilized private providers to offer much-needed supplies, staffing and medications to the frontline battle against Covid-19 at a moment’s notice.

Here, state government served as a clearinghouse while hospitals and long-term care facilities were able to concentrate on treating and caring for desperately ill patients.

“If there was ever a demonstration of a public-private partnership that has gone unbelievably well, this is it,” said Frank Berry, Commissioner of the Department of Community Health. “We had one purpose: to save people’s lives, and this has been a model for how we do it.”

Just days before, the Georgia Legislature granted the governor emergency powers to suspend procedures that would delay managing an urgent situation like this pandemic. 

With emergency powers, the state did not have to undergo a lengthy procurement process for products or services to save lives. Hospital executives, nursing home administrators and state officials say the expedient nature in which the state acted likely saved many lives.

“The last thing we wanted was for frontline workers to have expected the cavalry to come and the cavalry never came,” Berry said.

Those who saw very sick patients – and still see COVID patients today – said it was an approach that paid off.

“We value the heck out of our partners who got this for us, particularly Gov. Kemp and his team,” Albany’s Steiner said.

DCH took on the role as a liaison with a private company to find healthcare workers and support staff for hospitals, new medical units and nursing homes. The Georgia Emergency Management Agency (GEMA) reached out to companies to find personal protective equipment (PPE) such as gloves, masks and gowns while the Georgia Department of Public Health sent a team of epidemiologists to work with hospitals and long-term care facilities on infection prevention and control, and to facilitate COVID-19 testing and contact tracing in local communities. 

State officials asked Georgia-based Jackson Healthcare for staffing support on a Sunday and the first nurses arrived to Albany by Thursday – something that was made possible by state officials working together under emergency powers to quickly identify the right partner to serve Georgians in one of their greatest hours of need.

“Our home state was in the midst of the biggest healthcare crisis it has ever seen, and we did everything possible to put Georgia patients first and get support staff to the front lines in record time,” said Shane Jackson, President of Jackson Healthcare. “We send doctors and nurses all over the country every day, but the state’s rapid decision-making was the most organized and thorough we saw anywhere.”

DCH actually contracted with a subsidiary of Jackson Healthcare – the Southeast’s largest healthcare staffing company –– to place physicians, nurses, respiratory therapists, pharmacists and a host of other medical staff to temporarily fill in for COVID-infected personnel at community hospitals and nursing homes. 

As of today, there have been more than 3,000 support staff placed in 53 Georgia hospitals and 83 skilled nursing facilities to treat Covid-19 patients. Many were also used to man testing centers to determine how much of the population had been exposed.

At Northeast Georgia Medical Center in Gainesville, CEO Carol Burrell said that by April her hospital looked like a MASH unit with 90 to 100 negative pressurized rooms for COVID patients. Staff physicians, nurses and respiratory therapists too were extremely fatigued – some becoming infected with COVID themselves – and in need of additional personnel and PPE.

“There were many sleepless nights with concern about your staff – what they had to endure plus so many patients who were in the last hours of their life as their family couldn’t be with them,” she said. “Doctors and nurses can handle crises but there was no light at the end of the tunnel.”

To prepare for a number of patients expected in the city of Atlanta, the state contracted with PAE Holding Corp., a Virginia infrastructure company that converted the Georgia World Congress Center into a temporary hospital and staffed it.

With the state coordinating the effort to search for supplies and personnel, facilities could then focus on taking care of sick patients.

“The state was so supportive, and it had the ability to pool all these resources together where the needs were greatest – and we are very thankful for that,” Burrell said. “Without the state leading the way, we (hospitals) would have all been competing with each other trying to do the same thing.”

In some nursing homes, COVID was sweeping through the staff leaving few options to care for residents until the state provided temporary staff through the partnership.

“You felt so helpless as this thing came here like a thief in the night,” said James Andrews, CEO of Wellington Healthcare, which operates Legacy Nursing home off Auburn Avenue in Atlanta and 11 others throughout the state. “We were at a point where we had to have some help because we were going to run out of people.”

At one point in the spring, 40 percent of Legacy’s staff was infected with COVID. About 112 of 160 residents came down with the virus and they would have sadly lost more than 20 residents if the state did not promptly send managers and nurses.

“We greatly appreciate the state being there to help in our time of need,” he said. “Today at Legacy we are COVID-free.”

In Gainesville at Northeast Georgia Medical Center, Dr. Clifton Hastings, chief of medical staff, said physicians and staff were not only concerned about COVID exposure, but some doctors were about to be put in a position of deciding who would get treatment and who would only get palliative care.

“It was a life changing moment to tell our staff that we may not be able to take care of everyone that came in as we might have to begin scoring patients based on their ability to survive,” he said. “We were almost at a point where would have to decide who we could take care of on a fair and ethical basis.”

But that never happened as additional personnel and supplies showed up just in time as numbers were peaking in late spring, Dr. Hastings said, adding that a mobile hospital unit was erected by the state adjacent to Northeast Georgia Medical Center for additional COVID patients. 

Public policy experts say the state’s model is one to be commended for its efficiency and cost-effectiveness.

“Hospitals around the country that had to reach out and find doctors and nurses and supplies on their own are having to pay as much as double in certain other places,” said John Goodman, President of the Goodman Institute for Public Policy Research, a public policy think tank. “Georgia’s public-private partnerships allowed the state to act decisively and responsibly with respect to taxpayer dollars and allowed medical providers to focus on what they do best – take care of sick patients.” 

If there is another significant wave of COVID-19 this fall, state officials say they will continue to rely on this state clearinghouse model that partners with the business community.

“The state is grateful to all of our providers and so proud of our front-line workers, who really have been the true heroes throughout the pandemic. We are only as strong as our network of providers and the state needed to help shore up the healthcare infrastructure of our state during this time of crisis,” Berry said. “We figured things out efficiently and effectively and delivered it well. This was one of the greatest experiences I have had in state government in 36 years.”