Developmentally disabled patients in Georgia still dangerously at risk

Seven years after the state of Georgia agreed to a settlement with the U.S. Department of Justice over the conditions under which some developmentally disabled patients were being cared for in state hospitals, many of those vulnerable patients are still very much at risk. In too many cases, lethal risk.

According to a weekend story by Tom Corwin of the Augusta Chronicle, a federal court-appointed observer reported that 160 developmentally disabled patients died under state care in the last fiscal year.

The grimiest statistic might be that this was actually an improvement over just a couple of years earlier, when a Chronicle investigation found nearly 1,000 such deaths over the previous two years.

As noted in the Corwin story, the Georgia Department of Behavioral Health and Developmental Disabilities reached an agreement with Washington in 2010 that involved moving patients from state facilities to “the most appropriate integrated setting” in community-based environments. But observer Elizabeth Jones, who reports to a federal court in Atlanta, notes that the change in environment has not necessarily resulted in an improvement in patient outcomes.

In some situations, Jones reported, the problem involves caregivers who are not adequately trained and/or supervised for the kind of specialized care these patients need, as in the case of one woman who had to be hospitalized and then sent to recuperate in a nursing home after she refused to eat.

Other circumstances are more troubling, the Chronicle report noted, such as when the state “overlooks potential neglect or mistreatment uncovered by its own investigators” — as in the case of a woman who drowned in a bathtub even though her care instructions specified that she be kept in “line of sight at all times.” The court-appointed observer noted that the staff had more than once left to go out for food, and had offered “conflicting statements” about what they were doing the day she died; yet there was no official finding of neglect in the circumstances of her death.

A site visit to another residential provider by a nurse consultant found a male patient, with a black eye nobody on the staff seemed able to explain, “slouched down in the chair with his head hanging down,” apparently under heavy sedation.

The situation doesn’t look to get appreciably better any time soon. Jones, the court observer, wrote that 68 of the 160 FY 2017 deaths were officially investigated, but “the findings and recommendations in certain investigations raise concerns about thoroughness, and, even more importantly, the legitimacy of the conclusions drawn from the investigation.”

Meanwhile, after moving 26 patients to community care in 2016 and 29 in 2017, the Chronicle reports, the state has 366 developmentally disabled patients still awaiting placement in community facilities.

That’s assuming Georgia finds more community-based care providers for these high-risk, high-maintenance patients. Since the original deadline in the settlement was extended to June of next year, the Chronicle reports, the state has yet to recruit a single one.

This story was originally published October 9, 2017 at 4:54 PM with the headline "Developmentally disabled patients in Georgia still dangerously at risk."