Georgia Department of Human Resources Blueprint for a New Mental Health System
Jan 15, 2016
Georgia Department of Human Resources
Blueprint for a New Mental Health System
Georgia Department of Human Resources Slide 2
Why Change Our Mental Health System?
By 2012, Georgia will spend millions of taxpayer dollars to maintain 7 aging psychiatric hospitals that were never designed for today’s mental health consumer…
…even then, Georgia will continue to lack:
Comprehensive community-based services Modern hospitals designed to treat today’s consumer Options for overburdened law enforcement
Georgia Department of Human Resources Slide 3
Here’s the problem Georgia faces …
State hospitals have been a primary treatment option for mental health consumers.
Most consumers need community services; a smaller number need state-of-the-art hospitals.
The hospitals are between 40 and 150 years old and will require $30 million in upkeep by 2012.
Fixing these hospitals provides no additional services for consumers.
No new state funds are available to build new hospitals.
Georgia Department of Human Resources Slide 4
Georgia needs a system that …
Creates new mental health services and facilities at current budget level
Provides community-based treatment options to avoid hospitalization
Offers opportunities for a skilled healthcare labor force Eases the burden on law enforcement and jails
Here’s how it can be done …
What Will It Take to Build a New Mental Health System?
Georgia Department of Human Resources Slide 5
Georgia Department of Human Resources Slide 6
The Right Services Versus ‘a Hospital Bed’
For the first time, Georgia will provide a range of community-based mental health services to replace hospitalization when appropriate.
Here’s how we are increasing our service capacity:
Increasing crisis stabilization beds for short term care Expanding mobile crisis programs to respond to immediate mental
health emergencies Adding ACT teams for those with severe mental illness Adding social detox programs to include ambulatory detox services Adding intensive treatment residences equipped to treat long-term
consumers who otherwise would be hospitalized
Georgia Department of Human Resources Slide 7
Georgians with serious mental illness can go from …this to this
HospitalBeds
Previous Capacity
Some Community
Services
Georgia Department of Human Resources Slide 8
It’s already happening …
Average Client Load in State Hospitals, FY2002 - FY2008 (July 2001 - June 2008)
2,000
2,100
2,200
2,300
2,400
2,500
2,600
2,700
2,800
2,900
3,000
Jul-0
1
Oct-01
Jan-
02
Apr-0
2
Jul-0
2
Oct-02
Jan-
03
Apr-0
3
Jul-0
3
Oct-03
Jan-
04
Apr-0
4
Jul-0
4
Oct-04
Jan-
05
Apr-0
5
Jul-0
5
Oct-05
Jan-
06
Apr-0
6
Jul-0
6
Oct-06
Jan-
07
Apr-0
7
Jul-0
7
Oct-07
Jan-
08
Apr-0
8
Average Client Load
Since 2001, Georgia’s hospital census has declined as more consumers are treated in the community. By expanding community services even further, existing hospitals will be converted into behavioral health hubs that provide more targeted treatment.
Georgia Department of Human Resources Slide 9
Savannah and Columbus:Model Communities in a New System
$6.5 million and $11.2 million (annually) in seed funds to expand community services for first time ever in Savannah and Columbus.
Replacing Savannah hospital with behavioral health hub creates savings to be reinvested into new services for other communities.
After Savannah and Columbus, other hospital regions will have their mental health service capacity transformed as well.
Georgia Department of Human Resources Slide 10
2,713 2,742
5,215
4,561
0
1,000
2,000
3,000
4,000
5,000
6,000
Savannah Area Columbus Area
Co
nsu
mer
s S
erve
d
2008
2010
Savannah and Columbus:Model Communities in a New System
Pre
vio
us
Cap
aci
ty
New
Cap
acit
y
Pre
vio
us
Cap
aci
ty
New
Cap
acit
y
Serving More Georgians
Georgia Department of Human Resources Slide 11
2013 – A New Mental Health System
New Services for Consumers
Every region will have a comprehensive package of community-based services.
Community services – not psychiatric hospitals – will be the first choice for consumers.
Service capacity will nearly double without additional budget funds.
Two new hospitals and one new forensics facility to provide state-of-the-art care for today's mental health needs.
Consumers will receive treatment tailored to their mental health needs.
Children and adolescents to be treated in community.
Georgia Department of Human Resources Slide 12
2013 – A New Mental Health System
New Healthcare Employment Opportunities
New privatized facilities will provide employment for existing hospital staff wherever possible.
Employment opportunities will be available with new behavioral health centers and expanded community service providers.
Georgia Department of Human Resources Slide 13
2013 – A New Mental Health System
Options for Law Enforcement
Statewide, 90% of forensic evaluations will be completed in jails.
Crisis stabilization, mobile crisis services and ACT teams will reduce burden on law enforcement officers.
Transportation issues minimized.
Increased use of local crisis stabilization programs for civil evaluations.
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*Evaluation locations for law enforcement
Georgia Department of Human Resources Slide 14
2013 – A New Mental Health System
More Effective Use of Taxpayer Dollars
Service capacity will nearly double with no additional funds spent. - Crisis stabilization to increase by 48%- Mobile crisis services to increase by 154%- ACT teams to increase by 114%- Transportation capacity to increase by 21%- New social detoxification services will be available
Three state-of-the-art facilities to be built and operated with no additional budget funds spent.
Nearly $30 million that would have gone to maintaining aging hospitals is now invested in new facilities.
Georgia Department of Human Resources Slide 15
2009 – 2013: An Overview
2009 2010 2011 2012
•Expand community services in Savannah and Columbus
•Convert Savannah hospital to behavioral health hub
•All savings reinvested
•Expand community services in Fulton, Clayton and Rome area
•Privatize Atlanta hospital•Privatize forensics•$29.3 million saved to be reinvested
in additional community services
• Begin building forensics facility in Milledgeville•Begin building two new hospitals
• Replace hospitals with behavioral health hubs• Expand services statewide
• $27.2 million saved in 2011 and 2012 to be reinvested in community services statewide
2013
Georgia Department of Human Resources Slide 16
Phase One (2009) and Phase Two (2010)
Phase One: Actions –• $6.5 million expands community services in Savannah and Columbus.• Seek proposals (RFPs) for privatizing forensics and Atlanta Regional Hospital (long-term treatment)• Move Savannah forensics to Rome and Augusta.Results – • Service capacity nearly doubled without increasing budget.• In-jail evaluations ease burden on law enforcement.
Phase Two: Actions –• Invest savings from Phase One into expanded community services for Fulton, Clayton and Rome area.• Increase in-jail evaluations. Privatize forensic services to Milledgeville. • Privatize Atlanta Regional Hospital. Results – • Service capacity nearly doubled in Fulton, Clayton and Rome area at no additional cost to state budget.• In-jail evaluations ease burden on law enforcement in Fulton, Clayton and Rome area.
Georgia Department of Human Resources Slide 17
Phase Three (2011) and Phase Four (2012-2013)
Phase Three: Actions –• Build forensics facility in Milledgeville, and two new hospitals in Atlanta and South Georgia• Consolidate forensic patients from Rome, Augusta, Thomasville, Columbus and Decatur to privatized facility in Milledgeville (late 2011).• Reconfigure West Central Georgia Regional Hospital in Columbus into behavioral health hub (late 2011).Results – • Forensic consolidation complete.
Phase Four: Actions –• Northwest Regional (Rome), Southwest Regional (Thomasville), East Central Regional (Augusta) and Central State (Milledgeville) convert into behavioral health hubs. • Use $27.2 million saved from transforming hospitals to expand community mental health services in Augusta, Athens, Thomasville, Warner Robins and Macon areas.• Open new state-of-the-art hospitals in metro Atlanta and south Georgia.Results – • Georgia has three new hospitals providing state-of-the-art care.• State now has expanded community-based mental health services.