Georgia Agrees To Move Patients Out Of Mental Hospitals

Partner content from Kaiser Health News

ATLANTA – A sweeping agreement this week between the Justice Department and the state of Georgia highlights an aggressive new campaign by the Obama administration to ensure that people with mental illness and developmental disabilities can get services in their communities — and not be forced to live in institutions.

As part of the accord, Georgia agreed to specific targets for creating housing aid and community treatment for people with disabilities. Those with disabilities have often cycled in and out of the state's long-troubled psychiatric hospitals in the past. The state said it will set aside $15 million in the current fiscal year and $62 million next year to make the improvements.

The settlement, announced Tuesday, will be used "as a template for our enforcement efforts across the country," said Thomas Perez, assistant attorney general for the Civil Rights Division at Justice, in a statement announcing the accord.

National consumer advocacy organizations called the Georgia settlement unprecedented, with Curt Decker, executive director of the National Disability Rights Network saying in an interview that the agreement "sends a message to the rest of the country."

Enforcing A Previous Ruling

The Justice Department action demonstrates broader enforcement of the Supreme Court's landmark Olmstead decision from 1999. In the case, which originated in Georgia, the court ruled that unnecessary institutionalization of people with disabilities is a form of discrimination under the Americans With Disabilities Act.

Lewis Bossing, a senior staff attorney at the Bazelon Center for Mental Health Law, a Washington, D.C.-based advocacy organization for people with mental illness, said the "ground-breaking" settlement in Georgia capped a flurry of federal legal activity in disability cases during the past 18 months.

Indeed, Justice has filed briefs and joined Olmstead-related lawsuits in several states, including New York, North Carolina, Arkansas, California and Illinois. Over the past year and a half, Department of Justice attorneys:

— Filed a brief in support of North Carolina litigation seeking to keep two individuals with developmental disabilities in community settings. A proposed cutoff of funds jeopardized the housing for the two. Perez said in an April statement about the case, "We will not allow people with disabilities to be a casualty of the difficult economy."

— Filed a motion to intervene in a lawsuit in New York, seeking supported housing units for thousands of residents of "adult homes."

— Filed briefs in existing lawsuits in Florida, Illinois and New Jersey against what the agency called "unnecessary institutionalization" of people with disabilities.

"We will continue to aggressively enforce the law, and we hope other states will follow Georgia's example," Perez said.

Bossing said the Justice Department, by spelling out an array of community services required to meet Olmstead criteria, "will make it more likely that states will change the way they do business with people with disabilities."

Change For Georgia

Georgia said it would improve its state hospitals in a January 2009 agreement with the Justice Department during the final days of the Bush administration. But a coalition of consumer groups filed a brief in opposition to that settlement, saying it failed to improve hospital discharge planning and services in the community.

The Justice Department later backed away from the original terms of the deal and eventually added the Olmstead issues in a separate complaint in January. Last month, the federal judge in the case ratified the original hospital agreement, but let the Olmstead portion proceed, which culminated in the second agreement.

The Georgia settlement ends three years of legal wrangling that began after an Atlanta Journal-Constitution series found dozens of patients died under suspicious circumstances in the state-run facilities. Other provisions the state agreed to include:

— Ending all admissions of people with developmental disabilities to the state hospitals by July 2011.

— Moving people with developmental disabilities out of hospitals to community settings by July 2015.

— Establishing community services, including supported housing, for about 9,000 people with mental illness. These individuals, Perez said, "currently receive services in the state hospitals, are frequently readmitted to state hospitals, are frequently seen in emergency rooms, are chronically homeless or are being released from jails or prisons."

— Creating community support teams and crisis intervention teams to help people with developmental disabilities and mental illness avoid hospitalization.

Georgia Gov. Sonny Perdue said the agreement "moves us towards our common goals of recovery and independence for people with mental illness and developmental disabilities."

Change can't happen soon enough for Rhonda Davidson. She was discharged from a Milledgeville, Ga., mental hospital when the state closed her unit earlier this year. While Davidson, who has schizophrenia, has found a group home in metro Atlanta to live in, she has not received the treatment program and employment help she needs, says her attorney, Sue Jamieson of the Atlanta Legal Aid Society. This agreement should help accelerate that help for Davidson and others, Jamieson said.

This story was produced through collaboration between NPR and Kaiser Health News (KHN), an editorially independent news service and a program of the Kaiser Family Foundation, a nonpartisan health care policy organization that isn’t affiliated with Kaiser Permanente.

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