Trouble with Community Residences in Georgia
On June 24, Georgia Health News reported (h/t EB):
Nearly 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, said 44 occurred from mid-2010 to early May.
On Sunday, Alan Judd, in an Atlanta Journal-Constitution article, described horrific incidents of abuse or neglect following the transfers 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 officials documented 76 reports of physical or psychological abuse, 48 instances 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.
AP provides background:
In the June 22, 1999, decision in Olmstead v. L.C., the justices ruled that unnecessarily segregating people with disabilities in institutions amounts to discrimination under the Americans with Disabilities Act if they can be cared for in more home-like settings. Advocates for the mentally ill, older people and the physically disabled regularly cite the ruling, but it has limitations. It says individuals should be "reasonably accommodated," specifically noting "the resources available to the state," caveats that have made it difficult to assess compliance and that have fueled widely different outcomes around the country.
Nationally, the share of Medicaid long-term care spending that went to home and community services was 28 percent at the time of the ruling, according to a Department of Health and Human Services report. By 2012, the latest year for which data were tallied, the figure had risen to 50 percent, according to the Centers for Medicare and Medicaid Services. Every state has increased its allocation to non-institutional services, but the allocations range from 78.3 percent of Medicaid spending in Oregon down to 27.4 percent in Mississippi and New Jersey.
The ruling offers no guidance on the allotment of funds. Many advocates argue that states could allow all individuals to be treated at home or in community-based settings such as group homes. The industry says there will always be some people who require or prefer institutional care.
