ATLANTA (AP) Grady Memorial Hospital's board of trustees on Monday unanimously approved a resolution that would establish a nonprofit governing board intended to attract $300 million in immediate and long-term funding from the city's business, philanthropic and government communities as well as from the state.

Dozens of activists, doctors, clergy, lawmakers and citizens packed an auditorium across from Grady and demanded to be heard before the board made its decision. Several gave impassioned comments, many tinged with accusations of racism.

``It's not what we think you're going to do,'' said John Evans, an activist who was the first person to speak during the public comment section of the meeting. ``The point is that citizens always feel that they're bringing up the rear. We ain't got no money, we understand that.''

Grady is looking at a deficit of as much as $55 million by the end of the year, and is scrambling to find a solution before 2008. The hospital also estimates it needs as much as $300 million in improvements to its infrastructure and modernization of its equipment and technology.

``It's an important step to give us the opportunity and the time to get all of the various forces and people who want to be a part of Grady to not just show us the money, but give us the money,'' said board member Michael Hollis, who was born at Grady. ``This resolution permits Grady to not only survive, but thrive.''

The Metro Atlanta Chamber of Commerce in July proposed that Grady change its governing structure to create a nonprofit board to control daily operations, though the current board would retain ownership of the health system. The plan has been met with skepticism from activists and citizens who fear the change would threaten the hospital's mission as a safety net hospital that cares primarily for the city's poor.

Under the resolution adopted Monday night by the Fulton Dekalb Hospital Authority Grady's current 10-member board the Grady Memorial Hospital Corporation would be created as a 501(c)(3) and composed of 17 members, four of whom would be members of the current board.

The nonprofit board would have a lease agreement with the current board. Several conditions of the proposal hinge on that agreement, including a $200 million, four-year commitment from the business, charitable and philanthropic communities including $50 million in cash or in escrow before the lease agreement is executed;

A commitment to raise $100 million in private donations over three years by the same groups;

An additional $30 million from the state of Georgia, to which the governor, lieutenant governor and speaker of the house would commit in writing.

State Sen. Vincent Fort and activist Derrick Boazman were involved in a scuffle with Grady Hospital security outside of the hospital board room shortly before the meeting was moved across the street. Fort told the board members that he was skeptical about the proposal.

``Y'all ought to be ready to stay here all night,'' Fort said when board members asked him to conclude his speech. ``The fight ain't over. If some of us have to go to jail, so be it.''

(Copyright 2007 by The Associated Press. All Rights Reserved.)