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Community Action Care Plan (CACP)

In 2009 Grady Hospital closed their out-patient dialysis clinic, leaving 96 uninsured and immigrant ESRD patients without their life-sustaining dialysis treatments. Not having any other means to sustain the care for their patients, the physicians at Grady reached out to a group of community advocates, to intercede and find a solution. That group of advocates became the Advocates for Responsible Care.


To sustain the care of the patients, ARxC mobilized the patients into what we now call the ARxC family. We designed an innovative strategic plan to motivate community leaders and health care providers to understand the economic, social, and public-spirited advantages of contributing to the wellness of their community. We call this plan the Community Action Care Plan (CACP).

Community Action Care Plan (CACP)


Our implementation of the CACP led to the development of 3 contracts between Grady Hospital and Fresenius Inc. that successfully secured continuous and regularly scheduled dialysis treatments for our patients over a span of 5 years (with the current contract expiring in 2014). We also secured indefinite “in kind” dialysis treatment for 13 patients from Fresenius Inc., DaVita, and Emory Healthcare. 


We continue to work with the dialysis patients and immigrant health subject matter experts from across the country to derive a means to get the patients the care they require. With the need for immigration reform, we remain hopeful this group of immigrant patients will eventually receive the right to quality health care.


ARxC designed an innovative strategic plan to sustain the care of uninsured and under-insured immigrant patients with end stage renal disease (ESRD). This approach, which we call the Community Action Care Plan (CACP), has become a best practice model that we have shared with other communities facing the challenge of finding care for marginalized populations.


The Plan:

  • Helps stakeholders understand the community-based options for finding alternative sources of care

  • Ensures no details regarding the patients’ care are overlooked.

  • Promotes accountability of all stakeholders

  • Develops a professional, competent, organized, and dedicated publically-facing coalition 


A critical component of this plan is facilitating continuous cooperation and communication among stakeholders and generating widespread public support through the voice of the patients.


This best-practice template can be adopted by other community leaders to sustain specialty services for marginalized populations who have fallen through the cracks of our country’s safety net health care system.

Download the CACP Factsheet


Listen to WRFG's August 23, 2010 interview with Dorothy Leone-Glasser for an overview of the dialysis crisis in Georgia and how ARxC implemented the CACP to find a resolution.

WRFG Interview with Dorothy Leone-Glasser
00:00 / 12:12

We are currently looking for funding to publish and disseminate the CACP so other advocates may learn and adopt the approach and strategies we used to secure care for the immigrant patients in our community. This cause is especially pertinent given that public funding for uncompensated care is expected to sunset as more Americans receive affordable health insurance through the Affordable Care Act, a benefit that is not afforded to undocumented immigrants.


If you are interested in supporting this effort or know of others who may be interested in working with us on this project please contact us.

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