State settlements called into question

As covered extensively in this blog, Georgia's mental health system has been under scrutiny and finally reached an agreement with the federal government to overhaul patient care (see "Georgia reaches agreement with feds.")
According to an NPR report today, however, the Justice Department's agreement with Georgia and five other states, including Hawaii, Washington, South Carolina, Tennessee and Connecticut, are on ice. According to the NPR report, "Advocacy groups say the terms of these last-minute settlements are inexcusably weak and that the agreements don't do enough to make sure the states fix their problems."Sphere: Related Content
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Georgia reaches agreement with feds

Georgia Governor Sonny Perdue announced yesterday that his state has reached an agreement with the Justice Department to overhaul patient care seven state psychiatric hospitals.
The agreement, which still needs judicial approval, covers almost every area of patient care:

• Incident reviews and investigations
• Treatment planning
• Seclusion and restraint protocols
• Medical and nursing care
• Discharge planning

The tentative agreement also calls for the state to develop new suicide risk assessment tools to prevent patient suicides. They are also to examine approaches to deter assaultive behavior.
As discussed on this blog, Georgia has been under intense scrutiny after an Atlanta Journal-Constitution investigation uncovered 136 deaths and nearly 200 cases of patient abuse since 2002. Recently, the state has been exploring privatizing its crumbling public psychiatric hospital system.Sphere: Related Content
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Update on Georgia's Mental Health Makeover

As discussed previously on this blog, Georgia officials are considering turning their state's mental health system over to the private sector (see "Georgia Edges Toward Eliminating Public Psychiatric Hospitals," Dec. 11, 2008). Since then, Gwen Skinner, director of the state's Division of Mental Health, Developmental Disabilities and Addictive Diseases, announced she will be leaving the troubled agency come this fall.
Today's Atlanta Journal-Constitution featured a thought-provoking opinion piece authored by Dr. Branko Radulovacki, a clinical psychiatrist and Program Director of the Adult Psychiatric Partial Hospitalization Program at the Ridgeview Institute. He rightly proposes that instead of looking to for-profit companies to run Georgia's psychiatric hospitals, the state's mentally ill would be far better served if non-profit hospitals took them over instead.Sphere: Related Content
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Georgia Edges Toward Eliminating Public Psychiatric Hospitals

Their mental health infrastructure in shambles, their services under investigation by the US Justice Department and their money pool evaporating, Georgia's Department of Human Resources may just go for broke. They are considering a plan which would privatize the state's entire mental health network. Such a move would put Georgia boldly where no state has gone before. Florida and North Carolina made overtures to the private sector in their recent pasts, parceling off pieces of their psychiatric system to for-profit entities who then delivered grim results in the form of substandard services and stagnant outcomes.
As recently as September, Human Resources Commisioner B.J. Walker was publicly floating proposals allowing a measured amount of privatization. But when the Department quietly met in November, Walker laid out plans for a total surrender of the state system. When word got out to the media, considerable consternation ensued. Ellyn Jeager of the advocacy group Mental Health America politely expressed "serious reservations" about the strategy, telling the Atlanta Journal-Constitution, "Private companies are in the business to make money. I’m not sure it will improve the system.”
Then again, maybe they will. Georgia's state-run system has been faulted for negligent care resulting in a dizzying 136 patient deaths between 2002 and 2007. It's hard to imagine any privately held corporation would tolerate that many risks to its bottom line.

PHOTO: NED HORTONSphere: Related Content
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