Its like Deja Vu all over again...and again...and again...and again...and again...and again...and again

The Rome News-Tribune is reporting that Northwest Georgia Regional Hospital will stop admitting mental health consumers April 1 and close its doors sometime around June 30.

Northwest Georgia Regional Hospital will not close until all necessary services are in place to absorb the patients into the community.

That's the promise made to the legislature's joint appropriations committee this morning by Dr. Frank Shelp, commissioner of the Department of Behavioral Health and Developmental Disabilities.

He was noncommittal when asked if that means the proposed June 30 closing date of the hospital might be pushed back, reiterating that it's important to set deadlines.

"We have dates as targets," he said. "But we're not under any compulsion to close the Rome hospital prior to having those other services up and running," he said.

Just like in Milledgeville, the announcement came early in the legislative session and the community's legislative delegation can do little more than pepper the Commissioner of Behavioral Health and Developmental Disabilities with questions during budget hearings at the Capitol.

The announcement of the closing of NGRH is the latest news about the fundamental changes taking place in Georgia's mental health system as a result of the settlement agreement between the State of Georgia and the US Department of Justice concerning the care of people with mental illness and developmental disabilities in the state's network of regional mental health facilities and the state's failure to meet the standards for serving consumers in the most integrated community setting possible, per the Olmstead v. L.C. decision, which originated in Georgia.

This Justice Department press release is a pretty succinct summary of what's going to happen in the next several years.

Under today’s agreement, over the next five years, Georgia will increase its assertive community treatment, intensive case management, case management, supported housing and supported employment programs to serve 9,000 individuals with mental illness in community settings. The agreement will also increase community crisis services to respond to and serve individuals in a mental health crisis without admission to a state hospital, including crisis services centers, crisis stabilization programs, mobile crisis and crisis apartments; create at least 1,000 Medicaid waivers to transition all individuals with developmental disabilities from the state hospitals to community settings; and increase crisis, respite, family and housing support services to serve individuals with developmental disabilities in community settings.

Central State Hospital was the first, and Northwest Georgia Regional Hospital won't be the last. But in a strange note that spooked me when I first read it, the News-Tribune writes:

[Department of Behavioral Health and Developmental Disabilities Spokesman Tom] Wilson said 54 of the current patients have been admitted to the mental health ward, and 73 patients admitted by a court. They will have to be moved to state hospitals in Milledgeville or Atlanta.

Then I remember that the Payton Cook Building just opened a few years ago.

But Rome will not have a new forensics unit to save any state jobs as Georgia moves non-criminals living with mental illness and developmental disabilities into non-profit and for-profit private mental healthcare providers. Again, from the News-Tribune:

The state-run mental health hospital has about 180 patients and 764 employees, according to Tom Wilson, spokesman for the state Department of Behavioral Health and Developmental Disabilities.

Though it should be noted that DBHDD will be creating a lot of these community care settings, and that will create job opportunities for some of the employees who will be affected by the closings.

I share all this because it should be a warning the entire State of Georgia, especially those in the mental health system, those with family in the system and employees of the system: Don't think this is just something happening at some other hospital, in some other part of the state. The Federal Government and the State of Georgia are revolutionizing the delivery of mental health services--for better or for worse. We simply don't know yet.

And residents of Augusta, Columbus, Decatur, Savannah and Thomasville should heed these words state Rep. Rusty Kidd uttered roughly nine months ago:

Kidd said it is clear from legislators’ reactions that people from different parts of the state outside of the Middle Georgia region are not hearing about the closing of Central State and the fate of employees there.

“I hope [legislators and DBHDD officials] hear this and take it to heart, so that they will be more sensitive to employees — all employees not just new or long-time employees — now and in the future,” he said. “Everyone needs to be aware that these are people who have had jobs there for a long time, and to lose a job is very serious. [The legislature and state government] need to help them transition into new jobs.”

Georgia House Committee Assignments Posted

The Post Title is a link to the committee assignments by legislator.
State Rep. Rusty Kidd is assigned to Governmental Affairs, Health and Human Services, Science and Technology and State Institutions and Property.

State of the State

Click the post title to link to Georgia Public Broadcasting coverage of today's address.
You can see the proposed budgets(AFY2011 and FY2012) at the Governor's Office of Planning and Budget.

In other legislative news:
Political Insider has your list of Senate Committee Assignments. State Senator Johnny Grant is now chairing Public Safety and Vice Chair in Higher Education. As of this writing, it does not appear that the House has named, or the webmasters have updated, the House committee assignments.

Newsflash: Georgians must assume responsibility for themselves and their families.

Governor Nathan Deal sat the state down and gave it a talking to during his inaugural address today.
Whether it was the subject of crime, education, transportation, the water crisis or healthcare reform, Deal pushed a paternal tone that conveyed a message of 'I've been a longtime gone, and look what you've done to my great state' in his first message to Georgia as its 82nd Governor.

One of the other core responsibilities of State government is the education of our children. This is an undertaking that has been the primary focus of several of my predecessors in this office. Despite their best efforts and that of dedicated teachers and educators all across our state, our public education system in grades K through 12 has failed to make the progress we need...

This failure is a stain on our efforts to recruit businesses to our State and is a contributing factor in the frightening crime statistics previously mentioned. High dropout rates and low graduation percentages are incompatible with the future I envision for Georgia.

Betraying little about the way he intends to tackle some of the large problems he identified in his almost 20-minute speech, Deal said enough to sketch a vision of limited government and personal responsibility helping Georgia find a way out of the hard times it faces today.
As some pointed out earlier, Deal outlined a somewhat progressive direction in handling the state's overcrowded corrections system, advocating for day reporting centers, drug-, DUI- and Mental Health-courts. But don't think the new Governor's going to be soft on crime, he's asking the entire state to get his back as he works to break the cycle of crime that threatens the security of all Georgians.
Education was next on deck, and even though Deal said Georgia's education system is failing the state's economic development efforts, he said the entire state has got to get his back in making learning a top priority under his administration. HOPE will be passed on to future generations, but there are going to be hard decisions about who is going to get cut out of lottery-funded goodness.
Add to the list of things that are ruining Georgia's opportunities for economic development--Transportation. Driving a car anywhere in Atlanta sucks--especially today. So we need to cast aside our petty regional divisions and get behind the effort to find solutions to successfully meeting the state's challenges. Deepening the Port of Savannah may be a way to do that and bring more jobs to Georgia, so Deal says he's all about it.
And while we're talking about water, the Governor wants you to know that he's going to continue talking about it too--with Alabama and Florida. And whether that works or not, we're going to start building reservoirs and begin implementing plans for water conservation.
And even though that might be something that requires federal oversight or assistance, the former Congressman wants you to know that he does not welcome the federal government's assistance in delivering healthcare to its people.

As Governor, I will resist the efforts of the Federal Government to mandate its solutions on our people, our businesses and our State government.

You can hear the many people in the state Capitol who have the Governor's back on this in the audio of Monday's address.
Despite all the things mentioned above, Deal used the final portion of his inaugural address to say that his administration will be measuring success by job creation. And as with many of these challenges, the best way to move forward is through limited government and personal responsibility.

Audio of Governor Deal's Inaugural Address

Listen to the future of Georgia Politics with me, via WMUM Macon and my RTR 280 DRs. Total blogger fail on on the inability to host audio files (see my sister blog @ exploremilledgeville.org).

Portion of Text from Governor's Inaugural Address

These highlights come from the We Are Politics website, click on the post title to follow the link.


Highlights of the Inaugural Address of Governor Nathan Deal:

Throughout this "Experiment in Democracy," there has been a healthy skepticism by "We the People" about the role of government which we have "ordained and established." The lingering pain of this "Great Recession" in which we are still engulfed has underscored the urgency of re-examining the role of government in our lives.

Presently, one out of every thirteen Georgia residents is under some form of correctional control. It cost about Three Million Dollars per day to operate our Department of Corrections. And yet, every day criminals continue to inflict violence on our citizens and an alarming number of perpetrators are juveniles.

Our dedicated law enforcement officers must not be targets for criminals. Anyone who harms one of them harms us all.

Breaking the culture of crime and violence is not a task for law enforcement officials alone. Parents must assume more responsibility for their children. Communities must marshal their collective wills; civic and religious organizations must use their influence to set the tone for expected behavior.

One of the other core responsibilities of State government is the education of our children. This is an undertaking that has been the primary focus of several of my predecessors in this office. Despite their best efforts and that of dedicated teachers and educators all across our state, our public education system in grades K through 12 has failed to make the progress we need.

This failure is a stain on our efforts to recruit businesses to our State and is a contributing factor in the frightening crime statistics previously mentioned. High dropout rates and low graduation percentages are incompatible with the future I envision for Georgia.

I ask the members of the General Assembly and our State School Board to work with me to restore discipline in our schools, eliminate bureaucratic nonsense, adopt fair funding mechanisms and reward quality and excellence. If we do these things, we will convey the magic of learning to our children and restore the joy of teaching to our educators.

I am dedicated to honoring the promise that has been made to our students through HOPE and will work with the General Assembly to tailor the program to the financial realities we face today. I was not elected to make easy decisions, but difficult ones. In this legislative session we will save the HOPE for future generations.

We will do our part to deepen the Savannah port in order to accommodate the larger vessels that will soon pass through the Panama Canal. But we must do more. Our rail capacity and cargo routes must be improved and expanded. We must not miss this opportunity to provide jobs for Georgians.

Highway congestion, especially in the Greater Atlanta area is a deterrent to job growth in the region. If we do not solve this problem soon, we will lose the businesses who want to expand or locate in our State.

I am dedicated to working with all elements of government to improve our transportation system and I call on all Georgians to join us. We must put aside some of the regional differences of the past and work for the common good of our State.

As Governor, I will continue to pursue negotiations with Alabama and Florida to reach a resolution of the long standing dispute over the use of water in our Federal reservoirs and our major rivers.

We will develop regional reservoirs and continue our conservation efforts. We have been blessed with abundant water resources and we must use them wisely.

As Governor, I will resist the efforts of the Federal Government to mandate its solutions on our people, our businesses and our State government.

We will do our part to provide healthcare to our most vulnerable citizens, but government cannot make or keep us healthy. The primary responsibility for good health rests with individuals and families. We can help cultivate a culture of wellness in our educational programs and offer incentives in Medicaid and the State Health Insurance Program, but it is only individuals and families that can make healthy lifestyle choices.

So today as we embark on this journey to lead our State forward, I call on all Georgians to assume responsibility for themselves and their family. I call on communities and civic and religious organizations to continue and expand their efforts to serve the needs of people in their area. State government cannot and should not be expected to provide for us what we can provide for ourselves.

Snowed Over

With everything else that has happened this weekend, it was easy to miss this late Friday docu drop of the much anticipated report from the 2010 Council for Tax Reform and Fairness for Georgians.
Via Political Insider:

If you have experience with the Georgia tax system, we need your help to put this document through some quick scrutiny. What would these changes mean? What are the unintended consequences?

Post your observations below – or mail them to cjoyner@ajc.com.

Many thanks. And stay warm this weekend.

Elections of the Future

Will probably continue to look like this.

Continuing with the news I have neglected to link to in this interim period, I want to draw attention to the Elections Advisory Council convened by Secretary of State Brian Kemp.
Baldwin County is lucky to have two representatives, state Representative Rusty Kidd (I-Milledgeville) and Baldwin County Probate Court Judge Todd Blackwell, on this council that is charged with creating cost efficiencies in the state's elections system and improving the system overall.
Georgia's elections system is a mixed bag of efforts to open the ballot box to as many people as possible and throwbacks to the partisan warfare of Georgia's one-party past and present. The Athens Banner Herald editorial board has this to say about some of the opportunities for improvement that they hope the council will consider.

In terms of guaranteeing ballot access, Georgians should watch how much time and effort Kemp and the panel spend in considering current state law for third-party candidates to get on the ballot.
Georgia is widely acknowledged to have one of the most strict ballot access laws in the country. Independent candidates - that is, candidates not running under a major party banner - must obtain the signatures of 5 percent of registered voters in their respective electoral district to get on the ballot when running for local offices, including seats in the state legislature and Congress. Independent candidates seeking statewide offices must obtain the signatures of 1 percent of the state's registered voters.
In some of the state's metropolitan areas, and, obviously, in any statewide race, the signature requirements mean that prospective independent candidates must get thousands of people to sign their petitions to seek office. In those cases, it's fair to see the ballot access laws as a de facto means of keeping third-party candidates off of ballots.

I'm sure Rep. Kidd, who has used that ballot petition in the last two years to send a message to opponents about the number of voters who will be showing up to support him, will have plenty of ideas to share about how we can open the statehouse to Georgians who don't necessarily fit the Republican/Democratic dynamic.
Judge Blackwell's inclusion is a welcome surprise as I've spent much time in his office talking about the ins and outs of election law. He is a great logical thinker, who can objectively explore the many facets of an issue. And most importantly, he knows what he doesn't know and retains the curiosity to explore it.
The image above comes from a photo story I submitted after shadowing Blackwell on Election Day 2008.
To put myself out on a limb, I'd recommend that the council look into the amount of time allocated to early voting. The 45 days of early voting put a significant cost on county governments to employ poll workers for dubious results in bringing people to the polls. I'm not saying that the state should walk away from early voting altogether, but I doubt that the overall turnout numbers would be affected much if early voting was confined to the two weeks before the election.
Despite the obvious opportunities for fraud in the absentee ballot system, it remains as a release valve for engaged voters to cast their ballot despite their scheduling conflicts.
So I look forward to reading the findings of this group and, as others before me, commend Secretary of State Kemp for convening an inclusive commission to consider the future of Democracy's most solemn responsibilities.

Washington Ethics Group Names Deal to Top 10

Blake Aued of the Athens Banner-Herald would like to remind everyone that there was some shady stuff going on before Governor-elect Nathan Deal resigned his seat in Congress.
Why He Do That?
Read the Citizens for Responsibility and Ethics in Washington's Top 10 Ethics Scandals 2010 report here.

"If they want to get paid, they shouldn't commit crimes."

It seems like common sense. But somehow, state Senator Johnny Grant (R-Milledgeville) has created a stir over statements he made concerning a strike by inmates in several state prisons over conditions in the state prisons and the state's practice of not paying prisoners for their labor.

Commenting in his role as Senate State Institutions and Properties Chair, Grant told the Chattanooga Times Free Press that he's not about to change the state's practice of not paying the majority of prisoners who provide labor to Georgia counties and municipalities and who toil away in the Correctional Industries program.

"If they want to get paid, they shouldn't commit crimes," said state Sen. Johnny Grant, R-Milledgeville, chairman of the Senate Institutions and Property Committee, which oversees prisons.

Besides, he said, "If we started paying inmates, we'd also start charging them for room and board, as well. They ought to be careful what they ask for."

Georgia is no stranger to trouble in its penal system. Prison Historian Larry R. Findlay Sr. writes in "History of the Georgia Prison System" that Georgia's Department of Corrections has often been a venue for moral questions about the treatment of prisoners.

Governor John Milledge first lobbied the General Assembly to establish a penitentiary system "to soften the penal code in use at that time,"which drew heavily form the English system of penal law wherein "branding, pillory, and stocks, in addition to imprisonment and execution were used."

By 1820, the state's penitentiary system was in debt. The General Assembly abolished the system eleven years later in 1831, re-instating the punitive practices of the past and returning many prisoners to the counties they where they were convicted. But the state couldn't abdicate its responsibilities for long and the legislature re-established it the penitentiary system by the next year.

In 1866 the General Assembly laid the infrastructure to take its prison system from a money pit to a money maker.

In December 1866, the legislature passed an Act to regulate the management of the penitentiary and to provide for the inferior courts of each county to hire out offenders to contractors engaged in such repair work [for the penitentiary, itself, at the time]. No lease was to be made which did not relive the state of all expenses during the term of the lease, and no lease was to be made longer than five years. This is the Act that led to the Georgia chain gang.

By operating the Convict Lease System,in which male and female prisoners were leased to individuals or companies for hard labor details such as railroad construction, Georgia's Penitentiary emptied its prison buildings and began turning a profit.

As you can imagine, its hard to keep the state government from going hog wild with any program that it is making money on. Findlay writes that by 1870, there were no more convicts in the penitentiaries and the state discharged all corrections employees the next year. Six years later, the program had become so engrained into the system that the state was able to lease all its prisoners "to three companies for twenty years for a total of $500,000."

Now this is a privatization plan that many legislators will wish they had access to as budget negotiations begin this session.

But public opinion was turning against the Convict Lease System, and Findlay describes 1890 as the beginning of a decade marked by "public outcries over brutalities suffered by the convicts under the lease program." Newspapers including the Macon Telegraph, Atlanta Georgian and the Columbus Enquirer-Sun rallied the people against the system of leasing convicts to private companies.

The legislature ended the Convict Lease System in 1908 by passing an act "to provide that misdemeanor convicts could work on public roads under state or county supervision. In no case, were they to be placed under the control of private parties. Female convicts were sentenced to the female prison instead of the chain gang."

More than 100 years later, the Atlanta Journal Constitution and New York Times are reporting a complex network of prisoner groups that are "not known to cooperate," organized via contraband cell phones, word-of-mouth and the help of family members and prisoner advocates.

These prisoners' story is an interesting study in networking and promotion. No one can doubt that they undertook this large task of organizing these disparate factions because they are upset about the conditions in the prisons. Those same kind of conditions that led the federal government to intervene in the administration of Georgia State Prison in Reidsville in the 1970s and '80s when 52 prisoners at filed a class action lawsuit over the issues of overcrowding, racial segregation, violence and intimidation on behalf of the guards

No one can doubt that the effects of the economic recession have been particularly harsh on those Georgians who have been shoe-horned into a smaller and smaller DOC footprint.

The Times reports that these strikes began in earnest when the department banned cigarettes earlier this year. And the organizers say they will be ready to unleash another wave of protests, which may not be as peaceful, if their demands are not met.

I hope that prison and state officials will work diligently to find some kind of compromise with the men and women in their charge. Georgia's prison guards' jobs are hard enough, we don't need to be putting them directly into a hostile situation after we've asked them to sacrifice so much already. Access to better healthcare and more educational opportunities are something that can expand jobs for Georgians who don't need to go to jail to find a job. But I don't believe there are many Georgians who are going to get behind a plan to begin paying inmates.

We've come a long way since the beginning of the penitentiary system in Milledgeville, but we haven't come that far yet.

Need for Improvement: Mental Health Ombudsman's Year One Report

Former AJC writer and current Georgia Health News CEOAndy Miller brings us the story that's being missed amidst all the press coverage of the settlement agreement between the US Department of Justice and the State of Georgia concerning the treatment of persons in its mental health system. An interim report summarizing Georgia's Disability Services Ombudsman Jewel Norman's first year on the job cites the need to improve clients' access to timely care and concern over the continually growing role of Law Enforcement in the lives of many Georgians who are living with mental illness. Miller writes that despite the high profile of the settlement between Georgia and the Feds, there are many issues that need addressing in the state's network of mental health service providers:

A little-noticed state report says an independent review team found poor medical care in the deaths of 23 patients at Georgia’s mental hospitals during the past fiscal year.

The report, from Georgia’s disabilities services ombudsman, also shows that the state’s mental health system remains plagued by other major problems, despite more than a year of scrutiny by the U.S. Department of Justice. Many patients still sit for hours in general hospitals’ emergency rooms, waiting for mental health treatment. And jails across the state still house a high percentage of people with psychiatric illnesses, the report adds.

Still, the state ombudsman who produced the report, Jewel Norman, said she sees improvement in the seven state-run psychiatric hospitals.

The report, itself, addresses the critical issue that there are not adequate resources throughout the state to assist people when they are experiencing a mental health emergency:

Georgia law requires the sheriff’s department of each county to transport mentally ill persons who are a danger to themselves or others to an emergency receiving facility. State policy requires medical clearance before any state hospital or Community Services Board Crisis Stabilization Program (CSP) can accept such a transfer. Most of the time the closest destination to achieve the required medical clearance is a general hospital emergency room (ER)...

In a late spring meeting of the Psychiatric Council of the Georgia Hospital Association, the Ombudsman discovered that many people with mental illness were experiencing excessive periods of waiting in the emergency rooms after medical clearance...

The average wait time for these patients, many of whom were experiencing an acute episode of their illness, was 36 hours... The average time for those persons exceeding the 36-hour mean time was 64 hours or 2.67 days.

These long wait times do more than put Georgians living with mental illness at risk, they have a multiplier effect on society as they tie up vital law enforcement, emergency medical services and hospital resources while these placements are being made. And then there is the worst-case scenario--an unfortunate societal situation that happens far too often in Georgia and elsewhere around the world--in which mental health consumers are adjudicated and incarcerated until a suitable placement can be made in a state forensic unit .

Preliminary data suggests that the corrections system, both local jails and our state prisons have become major providers of mental health services. For example, the Chatham County Sheriff provides data that, on any given day, he has between 200 and 250 people with mental illness in his jail. The Augusta Chronicle, in a July 11, 2010 article reported by Sandy Hodson, stated, “184 men and women who have been deemed mentally incapable of standing trial are locked in jails for weeks and months because there isn’t enough room in the state’s seven mental health hospitals [Forensic Units].” "That's what jails have turned into -- mental hospitals," said Richmond County Sheriff's Maj. Gene Johnson, who oversees the county's overcrowded jail. The Georgia Department of Corrections reports that 15.6 percent of the inmate population is receiving mental health services.

The settlement agreement with the federal government is forcing Georgia to make revolutionary changes to the way people receive treatment in the state's mental health system. In order to realize those anticipated outcomes, Georgia will have to conquer some of the most challenging sets of circumstances seen in the history of the treatment of mental illness. The Justice Department is requiring Georgia to allot the resources necessary to meet the federal government's benchmark of providing care in the most integrated setting appropriate to an individuals’ needs, but it will take the dedication of the Governor-elect, the entire General Assembly, many departments of state government and the people of the State of Georgia to decisively bring an end to this sad chapter in the state's history.

House Party Jumpers Already Moving Up the Ladder

AJC's Election's Central is reporting that Governor-elect Nathan Deal's House Floor leaders will include newly-minted Valdosta Republican Amy Carter.

**It looks like the General Assembly's Webmasters have been hard at work updating the legislature's website as Carter's bio reflects her recent decision to caucus with the Republican Party.