280 jobs cut as patients leave Milledgeville hospital

A state agency announced Friday that the remaining patients with developmental disabilities will be moved out of the state psychiatric hospital in Milledgeville into community residences by July.

That move will lead to layoffs for 280 Central State Hospital employees, said Tom Wilson, a spokesman for the Department of Behavioral Health and Developmental Disabilities (DBHDD). Those employees have received a 30-day notice of their positions being cut.

The discharges of the final 16 patients with developmental disabilities follows the placement of 100 others from the sprawling Milledgeville campus into group homes and other community settings since October.

The state is pursuing the goal of having all developmentally disabled patients out of state mental hospitals by 2015, as is required under the landmark 2010 settlement between Georgia and the Department of Justice.

While consumer advocates have praised the transition of patients out of institutional care, DBHDD has drawn sharp criticism over its limitations on the housing situations for people with disabilities.

And a state lawmaker who represents Milledgeville questions whether the developmentally disabled patients will have the same variety of activities in group homes that they received at Central State Hospital.

Wilson said Friday that the agency will have job fairs for the laid-off employees. Some job opportunities are available at Central State, he said.

But the hospital campus that once housed thousands of patients – and in past decades, had poor conditions  and major care problems – is now operating just a nursing home and a forensic facility for people who are judged incompetent to stand trial or not guilty by reason of insanity.

The job cut announcement “is not a surprise,’’ Wilson said, adding that some employees have already left the facility.

Wilson said the move from hospitals to community services will save the state money over time “because services can be more tailored to the needs of the individual, and we won’t have the sunk costs of brick and mortar and other overhead.’’

But over the short term, he said, the moving of patients costs  money “because the overhead is roughly the same but there’s fewer Medicaid dollars coming in.’’

The agency has been criticized over its rule of allowing just four people with developmental disabilities to live in any group home. Wilson cited the Justice Department settlement for that requirement. “The feeling among advocates nationally is that if you have more than four people, it’s looking more like an institution,’’ he said.

But Robyn Garrett-Gunnoe, director of the Georgia Association of Community Service Boards, said that some people with developmental disabilities want to go to group homes that already have four residents. She said one Tattnall County woman who prefers to stay close to home is having to move to the Savannah area.

The CSB association welcomes moving people from institutions, she said. But she added, “They’re not allowing them to have a choice.’’

In addition, Garrett-Gunnoe said local nonprofits have HUD loans that are designed for residences with five people.  Without the fifth person, she said, full mortgage payments are difficult to make, and the loans are in jeopardy of being defaulted on.

Wilson of DBHDD acknowledged that the rule ‘’has been troublesome for some providers.’’

Meanwhile, state Rep. Rusty Kidd, an Independent from Milledgeville, told Georgia Health News on Friday that he questions whether the developmentally disabled patients will receive the same level of recreational and educational activities in community settings.

“I have a hard time thinking all these homes are going to provide all these activities,’’ Kidd said.

Wilson said the patients may get even more activities than they had at Central State. Some will be going home to their families, and others going to ‘’host homes’’ for one or two patients.

Pat Puckett, executive director of the Statewide Independent Living Council of Georgia, said Friday that community residences for people with disabilities ‘’increase  the chances they will get quality care.’’

Neighbors, friends and churchgoers are more apt to look after these people, she said. “If you’re behind the walls of an institution, people won’t drop in and visit,’’ Puckett said. “It’s a natural quality-assurance mechanism.’’

Yet Puckett added that DBHDD can be ‘’very bureaucratic at times.’’

Garrett-Gunnoe also cited a Brunswick News story that reported that the state agency wants 22 residents to move from a Brunswick assisted living facility for the mentally disabled.

Gateway Behavioral Services officials said in the article that the state wants residents in the facility to live as independently as possible, and that they should not live in a building where more than 49 percent of residents have a mental disability.

Over the past year, the state has been reducing its patient census in its psychiatric hospitals. In the northwest region of Georgia, where a state psychiatric hospital has been closed, more people at risk of hospitalization have received mental health services for a lesser amount of money, the DBHDD commissioner, Dr. Frank Shelp, said recently.