Transfers of disabled out of state-run hospitals into community homes still a problem

Tuesday, June 24, 2014 11:08 AM
Last updated 8:23 PM
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ATLANTA -- Almost 10 percent of the 480 people with developmental disabilities who have moved out of state hospitals since July 2010 have died after their placement in community residences.

Chris Bailey, a spokesman with the Georgia Department of Behavioral Health and Developmental Disabilities, when asked about deaths after hospital transfers, told GHN that 44 occurred from mid-2010 to early May of this year.

On Sunday, Alan Judd, in an Atlanta Journal Constitution article, described horrific incidents of abuse or neglect following the transfer of these patients into group homes. Forty patients placed in group homes have died, Judd reported, with 30 of those deaths classified as unexpected.

Many of the deaths appeared to be from natural causes, Judd reported.

The article also said that officials documented 76 reports of physical or psychological abuse; 48 of neglect; and 60 accidental injuries.

In March, an independent reviewer reported that Georgia was failing to provide adequate supervision of individuals with developmental disabilities who had been moved from state hospitals to community group homes.

That report, by Elizabeth Jones, came as an update to a groundbreaking 2010 settlement between the state of Georgia and the U.S. Justice Department. Under the terms of that deal, Georgia agreed to establish community services 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.

As part of the settlement, Georgia pledged to end all admissions of people with developmental disabilities to state psychiatric hospitals. It also promised that patients with developmental disabilities already in those hospitals would be moved to more appropriate settings by July 2015.

Talley Wells, the director of the Disability Integration Project at Atlanta Legal Aid, said Monday that the way the state has carried out the agreement has worked better for people with mental illness than for those with developmental disabilities.

“It has provided new services to thousands of people with mental illness,” Wells said, citing housing vouchers that he called “the most innovative in the country.”

Wells said of the AJC report, “It’s critical to shine this light on these problems, because they absolutely have to be fixed.”

Frank Berry, the commissioner of the state Department of Behavioral Health and Developmental Disabilities, said in April that “we have not accomplished what we need to accomplish’’ in community placements of people with developmental disabilities.

“I am very concerned about it,” he told GHN.

The state has twice halted such placements over concerns about the quality of life provided in the new settings, and more than 300 people with developmental disabilities remain in the state’s institutions in Augusta, Milledgeville and Atlanta.

The agency has also changed its executive leadership of developmental disabilities services, but said that change had nothing to do with the report by reviewer Jones.

The reviewer’s report pointed out that state officials had terminated three providers of services for poor quality of care.

DBHDD said Monday that it has contracted with an independent organization for external review of all deaths of developmentally disabled individuals transferring from hospital to community.

DBHDD’s Berry said in April that the state had met nearly all the goals on the mental health side of the agreement — providing support for people with housing and employment, and deploying treatment teams, case management, crisis stabilization units and other services.

Berry also said that this year, the state achieved compliance with Department of Justice requirements on improving conditions and care in psychiatric hospitals.

Jones also referred to a report done by Georgia State University for the state government. That report, dated December 2013, found that many residences were not clean, had safety issues or didn’t have adequate food supplies. Many individuals lacked access to dental services, it added.

Most people in the Georgia State study received psychotropic medications, but many of them did not have a confirmed psychiatric diagnosis.

Eric Jacobson, the executive director of the Georgia Council on Developmental Disabilities, said in April that the individuals being moved out of hospitals now “are the most medically fragile. They will be the most difficult individuals for the state to transition into the community.”

Georgia’s service providers currently “don’t have the capacity to support these individuals,’’ Jacobson told GHN.

He nevertheless reiterated his support of the settlement goal to move all people with developmental disabilities into community settings. “We believe no one should be living in an institution.”

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Little Lamb
44973
Points
Little Lamb 06/24/14 - 11:45 am
1
0
Perspective

You have to look beyond the lobbyists’ attempt to shock:

ATLANTA -- Almost 10 percent of the 480 people with developmental disabilities who have moved out of state hospitals since July 2010 have died after their placement in community residences.

You can't make any pronouncements until you have the ‘rest of the story.’ Ten percent of people with problems over four years does not seem high or unusual. The reporter should have dug up the statistics showing the death rates in mental hospitals from July 2006 to July 2010. It very well could have been higher than 10 percent in four years.

Little Lamb
44973
Points
Little Lamb 06/24/14 - 11:55 am
1
0
Distinction

I am just a layman, so I don't understand or appreciate the demarcation line separating "mental" disability and "developmental" disability. I looked it up on Google and got this definition from the Developmental Disabilities Resource Center:

Definition of Developmental Disability
Developmental Disability means a disability that is manifested before the person reaches twenty-two (22) years of age, which constitutes a substantial disability to the affected individual, and is attributable to mental retardation or related conditions which include cerebral palsy, epilepsy, autism or other neurological conditions when such conditions result in impairment of general intellectual functioning or adaptive behavior similar to that of a person with mental retardation. Unless otherwise specifically stated, the federal definition of "Developmental Disability" found in 42 U.S.C. 6000, et seq., shall not apply.

A. Impairment of general intellectual functioning means that the person has been determined to have an intellectual quotient equivalent which is two or more standard deviations below the mean (70 or less assuming a scale with a mean of 100 and a standard deviation of 15), as measured by an instrument which is standardized, appropriate to the nature of the person's disability, and administered by a qualified professional. The standard error of measurement of the instrument should be considered when determining the intellectual quotient equivalent. When an individual's general intellectual functioning cannot be measured by a standardized instrument, then the assessment of a qualified professional shall be used.

B. "Adaptive behavior similar to that of a person with mental retardation" means that the person has overall adaptive behavior which is two or more standard deviations below the mean in two or more skill areas (communication, self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure, and work), as measured by an instrument which is standardized, appropriate to the person's living environment, and administered and clinically determined by a qualified professional. These adaptive behavior limitations are a direct result of, or are significantly influenced by, the person's substantial intellectual deficits and may not be attributable to only a physical or sensory impairment or mental illness.

"Substantial intellectual deficits" means an intellectual quotient that is between 71 and 75 assuming a scale with a mean of 100 and a standard deviation of 15, as measured by an instrument which is standardized, appropriate to the nature of the person's disability, and administered by a qualified professional. The standard error of measurement of the instrument should be considered when determining the intellectual quotient equivalent. - See more at: http://www.ddrcco.com/resources-and-training/definition-of-developmental...

whyme
1623
Points
whyme 06/24/14 - 11:30 pm
0
0
it is indeed complicated

The entire realm of mental health and developmental disabilities is one that has never received proper intention, involving men and women who are still isolated, misunderstood, neglected, or overlooked by the mere nature of their conditions. All other areas of medicine and the social aspects of them are met with sympathy and support, yet mental health/mental retardation is so far down the road still. God bless the fellow citizens and their families, as well as those who work with them.

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