Timothy Jefferson brings more than 25 years of experience in health care to his position overseeing the legal department at Grady Health System and Grady Memorial Hospital in Atlanta, a busy trauma center and one of the largest public hospitals in the United States.

Jefferson is Grady’s chief legal officer and executive vice president, and also has served stints as the hospital’s chief operating officer, president and CEO.

Prior to joining Grady in 1998, Jefferson served as senior vice president and general counsel at D.C. Health and Hospitals Public Benefit Corp., senior associate general counsel at Howard University and senior attorney for the Department of Health and Human Services and National Institutes of Health.

He earned a J.D. from Columbia University and a B.A. in political science from Hofstra University.

His wife, Walda Jefferson, is an Atlanta public school teacher and they have three children, including a U.S. Air Force Academy graduate, lawyer and social worker. When his knees permit, he said, he enjoys tennis and basketball.

Jefferson recently talked about his role as Grady’s GC with Mary Welch.

Tell us about your department and your role in it.

I serve as executive vice president and general counsel for Grady. As chief counsel for the health system, I am responsible for all legal and risk management services rendered on behalf of the health system. We have a small in-house team of four lawyers who handle day-to-day legal issues, with several area law firms that handle major litigation or complex business matters. I serve as a member of executive leadership and assist with all corporate or business concerns of the organization.

What is the toughest part of the job?

In prior years the most difficult part was managing an underfunded health care organization with a public health mission to serve the local Atlanta community. Grady’s legal issues were always compounded by funding shortfalls that impacted the ability to perform that charitable mission. Recently Grady’s financial position has improved, particularly with the assistance of the local business and philanthropic community.

What impact have your experiences as CEO and COO at Grady had on your current role as general counsel?

These experiences provide a keen insight into the mindset of key leaders of the organization. I fully appreciate the impact that legal advice and counsel has on the operations of the health system, but more importantly, my role as an enabler for leaders to better perform their functions.

What effects will the Affordable Care Act have on your department?

My department is tasked with providing legal advice and counsel regarding the different aspects of the Affordable Care Act and their effect on the Grady Health System. Obviously, the ACA could have huge ramifications on public hospitals like Grady and we are carefully monitoring developments related to its implementation.

What is the one change that would make your job easier?

We are currently implementing a paperless legal office which will increase the efficiency of the entire law department.

How are you handling Recovery Audit Contractors?

We are devoting significant resources to meeting the demands of the RAC vendors. The health system recent hired a RAC coordinator who works closely with compliance, finance and legal staff in meeting and defending Grady’s interests in connection with these audits. These audits have the potential to significantly impact Grady’s finances. Accordingly, we are aggressively challenging RAC findings when appropriate.

What will be the top legal issues for hospitals over the next five years?

Affordable Care Act and Medicaid expansion, electronic data breaches and security; malpractice, quality of care and re-admissions.

What is you legal philosophy when handling large layoffs?

Unfortunately we have had several experiences with large layoffs at Grady over the years. It has a devastating effect on the organization each time it occurs.

My legal advice in each case is that the layoff be conducted in the fairest and least destructive manner possible. The process and manner of determining positions to be impacted should be well documented and available to those impacted. The organization should be careful to scrutinize each decision to assure that employees are not terminated for unlawful reasons.