Report criticizes state’s overdue patient transfers

Georgia continues to show a lack of progress in moving people with developmental disabilities out of state-run hospitals, an independent monitor says.

The report by independent reviewer Elizabeth Jones, filed in federal court, said just four individuals with developmental disabilities have moved to community settings in the past year. “This is especially troubling because 266 individuals are still confined to state hospitals,” Jones said in her report, dated Sept. 17.


Georgia, under a five-year settlement agreement with the U.S. Department of Justice, agreed to end all admissions of people with developmental disabilities to state psychiatric hospitals. It also promised in the 2010 pact that patients with developmental disabilities already in those hospitals would be moved to more appropriate settings by July of this year — the deadline for the agreement’s provisions to be met.

But problems in the care delivered in the community living situations led a state agency last year to stop transferring people with developmental disabilities from hospitals to community residences.

Media outlets reported that almost 10 percent of the Georgians with developmental disabilities who had moved out of state hospitals since July 2010 had died after being placed in community situations.

The settlement agreement with the Justice Department also sought to improve care for Georgians with mental illness. Georgia agreed to establish community services and housing 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.

Jones, the court-appointed monitor, cited progress by Georgia in meeting goals for people with serious mental illness, including in areas such as supported employment.

Still, the AJC reported Sunday that Georgia’s spending on mental illness ranks near the bottom among states. The state also has a shortage of mental health professionals. And Georgia’s acute-care hospitals since 2010 have lost more than $150 million in delivering care for uninsured patients with psychiatric disorders, the AJC article added.

Meanwhile, Georgia has declined to expand its Medicaid program, which could help tens of thousands of low-income adults with mental illness obtain services.


The state Department of Behavioral Health and Developmental Disabilities (DBHDD) issued a statement Monday that said the independent reviewer’s report “reflects the significant improvements made to Georgia’s behavioral health and developmental disability service system in the last five years.”

“As with all previous reports, we highly value and take into consideration the recommendations of the reviewer and her team of experts,’’ the statement said. “While the end date of the settlement agreement has passed, we are constantly working to ensure that the services we deliver provide the best opportunity for the people we serve to live a life of recovery and independence.”

Consumer advocates Monday echoed many of the Jones report’s criticisms of the state’s handling of people with developmental disabilities.

Eric Jacobson
Eric Jacobson

Eric Jacobson of the Georgia Council on Developmental Disabilities told GHN that while the state DBHDD has a good basic plan to help these patients, the lack of execution is both disappointing and frustrating.

“Do we have the will power and leadership to move folks to the community?’’ Jacobson asked.

“The overall numbers [of patients moved to community placements] are poor,” he said.

Talley Wells, director of the Disability Integration Project at Atlanta Legal Aid, told GHN on Monday that “it’s unacceptable to have moved only four people out [of hospitals] in the last year.”

Wells said the state has made progress in five years on mental health services “after 150 years of little progress.”

Georgia also has closed state-run psychiatric hospitals “where there was overcrowding and incidents of real harm and death,” he added.

But Wells said the state is at best just halfway to meeting the goal of housing for 9,000 individuals with mental illness.

The Jones report indicated that many people with developmental disabilities and mental illness have received good services. She cited a 28-year-old woman in the Augusta area who “spent most of the last fifteen years in a state hospital with only brief periods in community-based residential programs. She has both a serious mental illness and a developmental disability.”


But after much work by state officials, Jones said, the woman “since November 2014 has lived in her own (spotlessly maintained) apartment funded with a Home and Community-Based Services waiver.”

But Jones also noted that a DBHDD report “described in very unsettling detail the lack of trained staff currently responsible for individuals with a developmental disability in twenty-seven provider agencies.”

And the report said “crisis respite homes’’ have been used for long-term residential placements of people with developmental disabilities instead of their intended purpose of providing seven to 10 days of care. “S.G.’s stay in the Crisis Respite Home has exceeded 2.5 years,’’ the report said. “There are no plans for an alternative placement.”

Jones urged that the state be given additional time to fix problems. “However, there also must be a series of stringent timelines, specific outcome measures and a frank assessment of available resources if the systemic reform is to move forward in a reasonable manner without unnecessary delay and risk,” she said.