DOJ pact shows results, but challenges remain

A man who lived for years in a crude shelter in the woods is now housed in an apartment.

A young woman who was institutionalized for a dozen years now lives in her own home, and is using the bathroom by herself for the first time in her life.

The two individuals’ transitions are among the success stories of Georgia’s 2010 agreement with the U.S. Justice Department to revamp the state’s system to care for people with mental illness and developmental disabilities.

On Friday, state officials described these two people’s new situations in an update on the settlement agreement at the Rosalynn Carter Georgia Mental Health Forum, held at the Carter Center in Atlanta.

Officials with the state Department of Behavioral Health and Developmental Disabilities (DBHDD) also detailed the hurdles and problems in remaking the public system of care, in the wake of the Justice Department settlement.

The agreement includes providing supported housing and employment for people with mental illness, and moving individuals with developmental disabilities from state hospitals into residential settings.

“It is not an easy task,’’ said Frank Berry, commissioner of the DBHDD. “It’s about providing better care to people who had lived in institutions [and are] now out in the community.”

The number of people with developmental disabilities in state hospitals has shrunk from roughly 1,000 at the beginning of the agreement to 342 now.

But Berry said he is imposing a 45-day delay in moving people with disabilities out of the hospitals. He cited concerns about quality of care.

“We can’t mess up on quality,’’ he said.

He also spoke of the difficulty of telling parents when disabled people are to be moved into the community, with support services, after living for decades in a hospital. Parents often want their disabled offspring to remain in the institution they’ve known for so long, he said.

Georgia also 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 illnesses to avoid hospitalization.

More than 800 people with mental illness now are using housing vouchers, with a goal of more than 1,400 by next July, said Chris Gault, assistant commissioner for Behavioral Health. Hundreds of individuals are receiving supportive employment, Gault added.

The new array of services includes 22 Assertive Community Treatment (ACT) teams in place across the state, with about 1,100 people enrolled. Mobile crisis teams will cover 128 of Georgia’s 159 counties by July, Gault said.

Berry acknowledged that there have been high turnover rates on those ACT teams and among other state-contracted providers. Maintaining a high-quality workforce through recruitment and retention of good workers “is one of our biggest challenges,’’ he said.

He noted that state employees have gone several years without a pay raise.

Berry said it’s not easy to tell employees of state-operated hospitals that they may be losing their jobs due to the changes, but that the state needs them to stay on until that happens.

Another forum panelist, Josh Norris, legal director of the Georgia Advocacy Office, noted that “there are some fantastic stories of people finally getting the support they needed’’ in the wake of the settlement agreement.

The reduction in the number of institutionalized people with developmental disabilities, Norris said, “is monumental.’’

Still, Norris said, problems remain, including a need to have more people using housing vouchers rather than living in group homes.