Report finds improvements under Justice pact

Georgia has made considerable progress in improving services for people with mental illness and developmental disabilities, a new report says.

The report by an independent reviewer, which was released last week, tracks the steps the state has taken since it agreed to revamp its services in an agreement with the U.S. Department of Justice.

Georgia has actually exceeded second-year targets of providing supported housing and employment for people with mental illness. It also surpassed its required number of placements of individuals with developmental disabilities from state hospitals into residential settings, according to the report by independent reviewer Elizabeth Jones.

But, like Jones’ report a year ago, this review also cites some significant problems.

A review of services for 48 individuals with developmental disabilities placed in community settings found rights violations, unsanitary environments, inadequate staffing, unsatisfactory day programs, and psychotropic drug use without informed consent. “Needed supports were found to be lacking,’’ Jones says in the report.

Frank Berry, who recently became commissioner of the state Department of Behavioral Health and Developmental Disabilities (DBHDD), said that while the report is largely positive, “we’re most concerned that some individuals with developmental disabilities didn’t receive adequate support from our contracted service providers.”

Department spokesman Tom Wilson said Monday that the state is still building its network of service providers for people with developmental disabilities. “Providers needed more training and oversight’’ than some of them received, Wilson said.

In the 2010 settlement with the Justice Department, Georgia agreed to establish community services for about 9,000 people with mental illness, and to create community support and crisis intervention teams to help people with developmental disabilities and mental illness avoid hospitalization.

Georgia pledged to end all admissions of people with developmental disabilities to the state psychiatric hospitals. It also promised that patients with developmental disabilities already in those hospitals would be moved to more appropriate settings by July 2015.

The DBHDD “has demonstrated very good faith in meeting its obligations,’’ the report says. It credits the leadership of Dr. Frank Shelp, who preceded Berry as commissioner of the department, as well as Berry.

In the report, Jones also notes that the state Legislature has continued to fund the improvements called for under the settlement. During the period since the agreement was reached, Georgia has grappled with budgetary problems.

Listing the improvements

Berry said that “people all around the country are watching Georgia’s progress, and we want to ensure that we’re open with all of our stakeholders about our progress and areas of concern.”

He noted that Georgia has created 12 mobile crisis teams for people with developmental disabilities –- twice as many as it promised –- and that the teams have responded to more than 800 calls across the state. The state also established 11 “crisis respite” homes to give those individuals support during behavioral crises.

The report by Jones says that among its accomplishments, the state:

*Ceased hospital admissions for people whose primary diagnosis was a developmental disability.

* Placed 164 individuals with developmental disabilities into community residential settings during the past year, exceeding the target of 150.

* Awarded housing vouchers for 648 people with mental illness.

* Helped 181 people with mental illness get supported employment, exceeding a target of 170.

* Established peer support for 3,000 individuals with mental illness.

The report, though, also notes the trouble the state has had maintaining assertive community treatment teams to help people with mental illness. In late August, the state requested and received a delay of a scheduled review, explaining that the ACT teams were either disbanded or inadequate.

Forty of the 48 people with developmental disabilities whose services were reviewed were placed in group homes, Jones’ report says. She recommends more use of “host homes,’’ where individuals live with families that are not related to them.

“The failures to provide meaningful and adequate day programming, to fully monitor health care, and to obtain informed consent for psychotropic medications and behavioral support plans again were noted for some of the individuals placed from the state hospitals into community settings,’’ the report says.

Pat Nobbie, deputy director of the Georgia Council on Developmental Disabilities, noted that very few of these patients have ended up living in their own homes or the homes of their families.

The people who plan community transitions for individuals with developmental disabilities ‘‘are being very thoughtful,’’ Nobbie said. But once individuals are placed in community settings, she said, they don’t have enough options for meaningful activities during the day.

Nobbie also said she would like to see supported housing and employment for people with developmental disabilities.

An attorney with Atlanta Legal Aid, which along with other advocacy organizations helped develop the settlement agreement, said not enough information is available on the problems in the disabilities system and the steps being taken to address them.

“Overall, the state has made substantial progress,’’ said Talley Wells, director of the Disability Rights Project of Atlanta Legal Aid. “But it’s like climbing a giant mountain, with the steepest parts to come.’’

Housing for thousands of people with mental illness still must be provided, and the ACT team problems still must be fixed, Wells said. “There’s a long way to go.’’