Georgia 2003 | advancingstates.org

<H3>Georgia</H3> <H4> Task Force</H4> In April 2000, the Governor named the Department of Human Resources (DHR) as the lead state agency to apply for, and then carry out the activities of, a grant from the Center for Health Care Strategies. Upon receipt of the grant, Georgia established the Olmstead Planning Committee, which included consumers of services, consumer advocates, providers of services to people with disabilities, and leaders of the Department of Community Health (Medicaid) and DHR, including the Division of Mental Health, Mental Retardation and Substance Abuse; the Division of Aging Services; the Division of Family and Children Services; the Office of Regulatory Services; and the Governor's Council on Developmental Disabilities. The committee finalized its report and recommendations in November 2001 and presented the report to the commissioners of DHR and DCH on Jan. 30, 2002. The Governor issued an Executive Order in June 2002 and charged the Council on Aging, the Governor's Council on Developmental Disabilities, the Long-Term Care Advisory Committee for the Department of Community Health (DCH), and the Governor's Advisory Council on Mental Health, Mental Retardation and Substance Abuse with ongoing review and reporting responsibilities on the state's compliance with Olmstead requirements. The Executive Order instructed state agencies to work together in ensuring the state's Olmstead compliance and designated the Governor's Office of Planning and Budget to oversee Georgia's efforts to address Olmstead. While an official Olmstead plan has not been released for distribution, individual state agencies are continually and actively involved in working together for compliance. In light of the state of the economy, Georgia has chosen to confront the issue on an annual basis rather than through a multi-year plan. <H4> Implementation </H4> The following initiatives, corresponding to several of the Olmstead Planning Committee's recommendations were funded in the fiscal year 2003 budget, with implementation beginning July 1, 2002: <UL> <LI>Move all consumers under age 21 from state mental retardation institutions into community residential services (65 consumers; $4.1 million). </LI> <LI>Provide intensive family intervention services for severely emotionally disturbed youth and their families at risk of institutionalization (600 families; $3 million). </LI> <LI>Continue reduction of the community-based waiting list for the Community Care Services Program (CCSP) (822 consumers; $4.1 million) and mental retardation waiver services (507 consumers; $8 million). </LI> <LI>Use grant funds to explore the state's ability to restructure existing long-term care delivery systems.</LI></UL>   Successes During fiscal years 2000 through 2002, Georgia has done a variety of things to move people from state institutions or nursing homes and has delayed or prevented the need for institutional care. Redirecting resources from hospital to community services - Georgia has moved over $25.5 million from the state hospital system into community mental health, developmental disabilities, and addictive diseases (MHDDAD) services. State hospital closures - Bainbridge State Hospital (BSH) closed in 2001, making it possible for over 100 people with mental retardation to move from BSH and other state institutions into comprehensive community-based services. Overall, the state has closed 4 hospitals since 1996: Rivers' Crossing (37 bed facility for children with mental retardation); Brook Run (326 bed MR facility); Georgia Mental Health Institute (141 bed psychiatric hospital); and Bainbridge. Community-based services - Over 4 years, Georgia has increased the number of consumers served by home and community-based waivers, which has helped to provide services to consumers in the least restrictive settings <UL> <LI>1,670 individuals with mental retardation have been placed from waiting lists into a variety of community-based services, including 800 consumers who were moved into comprehensive residential services. Funding to serve these individuals has increased by 65 percent.</LI> <LI>180 adults with physical disabilities have moved from a waiting list to the Independent Care Waiver Program</LI> <LI>The number of consumers served by the Community Care Services Program (CCSP) has increased by 15 percent and funding has increased by 28 percent. In FY2001, nearly 17,000 consumers received CCSP services.</LI></UL> New family support and natural supports initiatives - Providing the supports a family or other caretaker needs to continue caring for an individual with mental retardation, autism or other developmental disability in the community. Increased length of stay in community services - Overall, the length of time individuals receive CCSP services has increased from 34 months to 39 months. Those who eventually move into nursing homes (38 percent of CCSP recipients) are able to stay at home and on average delay moving from their own home for five additional months. Revamped community mental health services - Georgia implemented the Medicaid Rehabilitation Option to have more flexible services that better meet the needs of consumers with mental illness. Mental health services for children and adolescents with severe emotional disturbance - Georgia continues to build a network of crisis and other community-based services across the state. Recent service expansions have focused on children with the most severe emotional disturbance. In FY 2002, the state allocated $2.8 million in state funds to support crisis residential services for children who needed out-of-home placement. Also, $2.3 million was received in additional block grant funds for mobile crisis and crisis residential services. Challenges As Georgia continues the efforts to comply with the Olmstead decision, the primary challenges include expanding capacity to serve people in the community and improving safety and quality in community services. Georgia has begun statewide initiatives to expand community services, especially for those with the most severe disabilities, behavior problems, and/or complex medical needs. The state is also working to develop an improved quality assurance, monitoring and a standardized evaluation process to increase consistency in decisions about individuals' ability to live in the community. Lawsuits Other than the Olmstead decision itself, no other suits have been filed in Georgia. The department is currently working with the federal Office of Civil Rights on several complaints. Next Steps The Olmstead Planning Committee's recommendations spurred the state to plan for the next series of initiatives addressing Olmstead compliance during remainder of state Fiscal Year 2003, including: <UL> <LI>Create four state-run community homes for 40 hard-to-place, severely emotionally disturbed adolescents that currently are in state hospitals. </LI> <LI>Transfer 13 eligible children in private nursing homes to community placements </LI> <LI>Provide transitional funding to move all consumers under age 21 from state mental retardation institutions into community residential services. </LI> <LI>Develop criteria to prioritize the need for those waiting for community-based services, regardless of existing placement (institution or community). </LI> <LI>Improve the infrastructure and system capacity in order to meet the community-based needs of individuals with disabilities and older adults. </LI> <LI>Ensure that the state can monitor and provide oversight of all community-based providers. Consumers served in the community should be safe and receive services appropriate to meet their needs. </LI></UL> In addition, Georgia received two grants totaling $627,211 from the federal Centers for Medicare and Medicaid Services (CMS) and preliminary notice of a third grant to overcome barriers to community living for individuals with disabilities and older adults. Projects will include the transition of individuals from nursing homes, housing and workforce development, enhancing peer support to help people make the transition from institutions to community services, and improving communications to consumers and their families and across agencies. For FY 2004, the Governor has recommended $6.3 million in DHR's budget and $3.3 million in the Department of Community Health (DCH) budget for service expansions to support persons moving from institutions to community-based settings.