Georgia stalls as disabled endure

By Sue Jamieson and Talley Wells


Last week, a federal judge withheld approval of the state of Georgia’s settlement proposal to remedy dangerous and unsafe conditions at state psychiatric hospitals.

Paradoxically, the key work that must take place to fix Georgia’s hospitals must take place outside of the hospitals. The state must dramatically build up its supports, services and residential options in the community. Many of the incidents of violence, neglect and abuse in the state hospitals directly relate to overcrowding. Building a community infrastructure will reduce overcrowding and will have the added benefit of bringing Georgia into compliance with the Americans with Disabilities Act.

This is the 10-year anniversary of the landmark U.S. Supreme Court decision in Olmstead. The Supreme Court interpreted the Americans with Disabilities Act to require the state of Georgia to provide necessary services to individuals with disabilities in the community rather than in state hospitals when individuals are able to live in the community. It noted Congress explicitly found that unjustified isolation in hospitals is both segregation and discrimination.

Ten years after Olmstead, Georgia is woefully out of compliance with the Supreme Court’s mandate. Georgia has commissioned several committees, reports and studies as to how it will provide services in the community rather than in state hospitals. Although it has deliberated a lot, it has done very little.

In July 2008, the state settled complaints based on Olmstead with a federal Office for Civil Rights. The state promised to marshal necessary resources to move all individuals with developmental and mental health disabilities, who could live in the community with supports, out of state hospitals over a five-year period. The governor was required to appoint an Olmstead coordinator and planning committee, which was to create an Olmstead plan by February 2009.

As of today, an Olmstead plan has not been adopted. For several months, the Olmstead coordinator position was essentially vacant and committee meetings were canceled. Just in the past week, there is a new Olmstead coordinator and a draft of a plan, but we are deeply concerned there will be no action. This has happened over and over again.

Our concern is magnified by Georgia’s refusal to consider expansion of community services in implementing its settlement agreement with the Department of Justice. In a joint report to the court, both the Justice Department and mental health advocates wrote that expansion of community services is necessary for the state to fulfill its obligations under the agreement.

In the long run, community supports and services are much cheaper than hospitals. State psychiatric hospitals receive no money from the federal government and the per diem cost is $362, which is $132,130 per year. In the community, the state can provide flexible services, which can have Medicaid and HUD matches and the annual cost per individual is much less.

The most important benefit of community services is that they are better at helping individuals recover. In the community, individuals live much more meaningful lives. We represent many individuals who are ready to live in the community but simply need the cheaper community supports and residential options.

Sue Jamieson and Talley Wells are attorneys with the Atlanta Legal Aid Society Inc. Jamieson and Atlanta Legal Aid initiated the Olmstead case.