ABOUT THE JUSTICE DEPARTMENT SETTLEMENT AGREEMENT
The state has created new services for people with development disabilities under the agreement, including:
- Case management
- Crisis respite homes
- Mobile crisis teams
- Family support resources
Source: Georgia Department of Behavioral Health and Development Disabilities
Georgia's years-long efforts to improve services for people with developmental disabilities continue to draw fire from federal attorneys, who now say in court documents that 79 of the 503 individuals released since 2010 have died.
Reports show many of the patients who died had poor care and oversight, federal attorneys said in their Jan. 19 court filing. The majority of those discharged also had complex medical needs associated with higher rates of death, the attorneys said.
The federal filing details problem areas that remain with a 2010 settlement agreement between Georgia and the U.S. Department of Justice over care for people with serious mental illnesses, such as schizophrenia, and those with developmental disabilities, such as cerebral palsy.
The federal filing asks for court intervention to, among other things, find the state in contempt, direct the state to show cause why it shouldn’t be found in contempt, order a corrective action plan, and hold an evidentiary hearing.
Georgia's five-year agreement with the DOJ stemmed from an investigation into the deaths and abuse of dozens of patients in state-run mental hospitals, some of which have since been shut down.
Georgia, under the landmark pact, agreed to end all state psychiatric hospital admissions of people with physical and mental disabilities that impede normal development. It also promised that patients with developmental disabilities already in those hospitals would be moved to more appropriate settings by July 2015.
The agreement 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.
An Atlanta Journal-Constitution series in 2007, called “A Hidden Shame,” about deaths of patients in state hospitals helped lead to the settlement.
Both the state and the DOJ agree that Georgia has made tremendous progress in delivering new services to people with serious mental illness. But care for people with developmental disabilities remains a source of conflict and disagreement, despite U.S. District Court Judge Charles Pannell's recent push for quicker action to resolve those differences.
“The available records indicated many unaddressed medical needs,” said DOJ attorneys in their arguments for improved community services for people who are developmentally disabled and have been discharged from state hospitals.
MARCH 28 COURT HEARING
The most common health care concerns were related to medication problems, including people not receiving their prescribed drugs, said DOJ consultant Nancy Ray. Staff also failed to adequately track important measures of health, including a person’s weight, food and fluid intake, bowel movements, or blood pressure, Ray said.
Of people who died after a hospital discharge, the state conducted investigations in only 38, or roughly half, of those cases, Ray said. The cause of death is listed as unknown for 29 of the 79 individuals, and 22 deaths were not investigated at all.
“People with complex needs can be served in the community with adequate supports and services. … The state has failed to assemble professionals with expertise who can assess an individual’s needs and connect the individual to services in a timely manner, and the failure to do so has placed persons at risk of serious and preventable harm,’’ DOJ attorneys argue.
A spokeswoman for the state Department of Behavioral Health and Developmental Disabilities said Monday that the agency will appear at a court hearing on the matter on March 28.
“We remain steadfast in our commitment to fulfill the settlement obligations and to support recovery and independence for the people we serve,’’ spokeswoman Angelyn Dionysatus said.
IMPROVEMENTS AND A GAP
Previously, Jaime Theriot, an attorney representing Georgia, has argued that the state has fundamental disagreements with the Department of Justice over what is required under the settlement.
Theriot has said the state does not dispute the numerical targets on hospital discharges. But she said Georgia does object to what she called a federal “attempt to enforce terms that don’t exist in the settlement agreement.”
Georgia “cannot and will not accept any of (the DOJ’s) proposals that are subjective, prescriptive, and divorced from any consideration of available resources — not only financial but also human resources,” Theriot said in a recent court filing.
“While (the DOJ) may now complain about the ‘quality’ of services in the community or wish for (the state) to operate mini-hospitals throughout the state, that certainly was not contemplated or expressed in the parties’ 2010 settlement agreement and therefore not subject to enforcement in these proceedings,” Theriot said.
While services for people with serious mental illnesses have improved, the federal attorneys note that there’s still a major gap in supported housing for these people.
More than 250 of these people with developmental disabilities, meanwhile, remain in state hospitals, according to the DOJ court filing.
Federal attorneys, and those representing consumer groups, point out that 14 states have closed state-run facilities for people with developmental disabilities.
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