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NAMI president sends letter to Georgia DHR commissioner

The Columbus chapter of the National Alliance on Mental Illness is taking aim at the Georgia Department of Human Resources, which oversees the state's mental health hospitals.

An open letter from local President Sue Marlowe to DHR Commissioner was sent out recently. The letter comes as the state is considering closing or privatizing some of the state's mental facilities, including West Central Georgia Regional Hospital in Columbus.

The following is Marlowe's letter to NAMI members and the commissioner:

Dear NAMI Friends:

This is an “open letter” to you and to DHR Commissioner B. J. Walker from Sue Marlowe (aka SueNAMI):

Attached with this newsletter is a document which gives the results of a performance audit on the Department of Human Resources Child & Adolescent (C&A) Mental Health Program. This limited audit was requested by the Georgia House and Senate Appropriations Committees after they learned that Commissioner Walker had transferred MHDDAD money (over $8 million) to DFCS and advocates were calling this move into question. They asked the Georgia Department of Audits and Accounts to find answers to the following questions:

1) What is the impact of the April, 2007 fee-for service policy that Commissioner Walker forced on public providers;

2) What is the effectiveness of DHR’s needs assessment process and changes to the availability of children’s mental health services;

3) How are appropriated funds used?

Background:

In 2007, Commissioner Walker “forced” public providers to close most of the C&A substance abuse residential programs (despite their effectiveness); mental health after school programs; day treatment and day support programs. Ms. Walker “forced” public providers to adopt her “fee for service,” policies better known as managed care, (despite a lot of pleas to wait because the changes that she had already ordered had further de-stabilized a fragile mental health system). Legislators were receiving a lot of complaints and thus the audit was ordered.

Commissioner Walker’s DHR has been found lacking once again. This is what we end up with when we have non-treatment professionals making treatment decisions for a medical illness. The DHR C&A program was found to:

· lack a systematic process for determining what were the most critical needs of the C&A population;

· lack transparency for prioitizing the services to be offered (despite legislation that requires the DHR to report such information to legislators);

· underserve Georgia’s population (approximately 6,000 children are not able to access mental health services),

· use outdated and inconsistent information in their planning process;

· report expenditures which do not include all costs incurred in providing services (for example, providers are forced to use Adult MH funds to pay for the Medicaid costs for uninsured children) – further exacerbating the mental health system in Georgia;

· have multiple manual journal entries transferring funds from one program to another (20.8% of the C&A funds were transferred to other DHR programs).

When advocates and public providers warn Commissioner Walker (and previous Commissioners before her) of harm that will happen if DHR policies and plans are carried out, they have been ignored. Now Commissioner Walker is forcing the closure of Georgia’s state psychiatric hospital system. Commissioner Walker continues to not call it “closing” the hospitals – she calls it “repurposing”. Ms. Walker is intent upon privatization despite almost 100% advocate and professional opinions. The sole bidder came up short and Commissioner Walker issued a press release stating that the DHR will rewrite the bid so that the sole bidder can win the contract.

The DHR is using The Olmstead Decision (which orders that persons with mental retardation not live in hospitals, but rather the community) to also apply to persons with a mental illness. The DHR is preparing to close Savannah Regional’s last 19 adult mental health beds and next on the list will be Columbus. The DHR “reduces its budget” by dooming people to jails and prisons, sitting for days in emergency rooms; too many children receiving mental health treatment from youth detention centers; and so on. So what if it costs more? Ms. Walker appears to think THAT is a Department of Corrections and Department of Juvenile Justice problem that THEY must solve.

We need to call a halt to ALL changes in the mental health, substance abuse and developmental disabilities system until decisions can be made by a department that cares more about outcomes than it does budget spreadsheets. And by the way let’s all tell Ms. Walker that Georgia taxpayers will SAVE if mental health and substance abuse recovery services are offered instead of cut. Her priority is the foster care situation. What she doesn’t seem to understand is that the foster care situation will not improve until mental health and substance abuse services improve.

Commissioner Walker is advocating for the Division of Developmental Disabilities (DD) stay with DHR instead of moving with mental health and substance abuse to the new department that hopefully legislators will vote into existence. House Bill 228 has been introduced to make this a reality. I believe (and so do many others) that DD needs to stay with MH and SA. The system is already set up to handle DD, along with MH and SA services and all 3 depend on each other for shared expenses. The recent survey of families and consumers have revealed that most want out of DHR. We need to have HB 228 withdrawn or defeated.

We need the crisis stabilization beds, ACT teams, detox units that the Commissioner has ordered added – but they should have always been present and NOT in lieu of hospital beds. We need the hospital beds as a part of the full continuum of care. If Ms. Walker wants to close the hospitals – she always has had that power. But instead of privatization, it would have been a reduction of beds because more people were getting better in community care. Right now in Georgia, we are mainly delivering crisis care. Someone has to fail 4 times in one year in order to receive accelerated services. The Catch-22 is that doesn’t count the people who have committed suicide and ended up homeless or in prison.

I personally have learned too much during 6 years of mental health advocacy. Sometimes I just want to take a bath after learning more unpleasant truths. Until behavioral services ceases to be run by politics and uneducated appointed officials, and is guided instead by results and people in recovery, we will continue down the path of misery that DHR has created.

Sincerely,

Sue Marlowe

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