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Changes to mental health services
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Mental health and developmental disability service provisions have transformed over the last few years due in large part to two settlement agreements with the Department of Justice (DOJ).  On July 1, the Department of Behavioral Health and Developmental Disabilities (DBHDD) will have completed the third year in a five-year plan established to dramatically increase community services for citizens with developmental disabilities and mental illness.

In this and subsequent columns, we will try to understand the context of the agreements and the measures Georgia is taking to ensure compliance.

DOJ settlement overview
In 2010, the Department of Justice filed a lawsuit in federal court against the Georgia Department of Behavioral Health and Developmental Disabilities citing violations of the Americans with Disabilities Act (ADA). On Oct. 29, 2010, DBHDD entered into a five-year settlement agreement complete with plans to increase access to community-based services for individuals with mental illness and developmental disabilities.

One aspect of the agreement provides community supports and crisis services for two populations: people with developmental disabilities (DD) and citizens with serious and persistent mental illness (SPMI), who would be served in state hospitals without community services. The second aspect of the agreement requires the state to implement quality management systems such as communication plans and create interstate comparisons on performance measures.

The terms of the agreement focus on specific provisions that differ depending on whether the individual is developmentally disabled or has mental illness.  Before the agreement, individuals with SPMI were served in hospital settings because community supports were unavailable. By the end of the five-year term, 9,000 individuals with SPMI will be provided community services. The population served includes individuals who meet a range of circumstances such as those who are currently being treated in state hospitals or are being released from incarceration.

For the developmentally disabled population, the agreement required Georgia to no longer admit individuals with developmental disabilities into state-run hospitals by July 1, 2011. Instead of staying in the hospital, individuals access community services through a waiver system. The agreement also includes additional family support funds, mobile crisis teams, and respite services. Family support funds helps individuals remain with their families instead of transitioning to a new setting.

In every case, the individuals are able to make informed choices about where they would prefer to live. Ranging from highly integrated to least integrated, options include receiving services in their own home, homes of their families, host homes, congregate living settings, skilled nursing facilities, intermediate care facilities, or assisted living facilities.

Settlement agreement services
Georgia collaborated with the federal Department of Justice to establish an agreement that specifies a multitude of services ranging from crisis stabilization to education. Depending upon the location of the individual, different services are offered. For example, assertive community treatment (ACT) teams might not be available in certain rural areas, but other comparable services such as community support teams will be offered instead. Often, individuals lack the necessary resources to manage their disability and are unsure of how to take advantage of the numerous services available.

As you can see below, many of the services are aimed at linking people with the resources and supports that are the best fit:
Crisis Line
ACT (Assertive Community Treatment) teams
Intensive case management teams
Supported employment
Community support teams
Crisis stabilization units
Peer support services
Crisis service centers
Family supports
Community waivers
Crisis respite homes

The services listed above highlight a mere snapshot of the many changes DBHDD has implemented in response to the settlement. For more information on these services or additional services provided, visit the Department’s Web site:

Next week: We flesh out these services and how they will impact disabled and mentally ill citizens.

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