State of Georgia ADA Settlement Agreement Update
The following is a guest article from the Summer 2013 Making a Difference magazine, offering an update on the ADA Settlement Agreement in the State of Georgia. Click here to read the entire magazine.
State of Georgia ADA Settlement Agreement Update
By Dr. Charles Li
Since 2010, the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) has committed extensive time, energy and resources to compliance with a settlement agreement between the agency and the United States Department of Justice (DOJ).
The agreement requires DBHDD to transition all individuals with developmental disabilities (DD) from state institutions into community-based settings with the goal of allowing people with DD to live in their own homes and communities. This provides individuals with care plans custom-fit to their needs, as well as supports and services that afford them the opportunity to live the life of independence they deserve.
Now in year three of the settlement's implementation, changes to the model of healthcare delivery have significantly impacted both the individuals who receive services and the service delivery system.
Since the inception of the settlement agreement, 437 individuals have transitioned from state institutions into community-based settings. Seventy-nine of these transitions occurred in FY 2013. For the first time since the Civil War, there are now fewer than 300 individuals with DD in state institutions. Further, DBHDD plans to close the Craig Skilled Nursing facility at Central State Hospital in Milledgeville and the Rose Haven DD facility at Southwestern State Hospital in Thomasville by December 31, 2013.
As clients are transitioned out of institutionalized care, community-based service options are rapidly expanding. In FY 2013, 1,380 individuals received DD services, including 895 who were granted DD Medicaid waivers and 485 who obtained state-funded services.
The quality of community-based DD placements and services has become a key focus of the settlement agreement. DBHDD is working closely with providers, advocates, the DOJ and other stakeholders to ensure a safe and high quality placement and living experience for each consumer.
Recently, DBHDD deployed six special quality review teams to assess the 79 transitions made in FY 2013. A comprehensive audit tool, the Monitoring Questionnaire, has been employed for the review. The results of the evaluation will be used to identify deficiencies in the service delivery system and to develop an action plan for improving quality. The current improvement projects include provider education and training, developing an enhanced transition plan, improving support coordination and providing training to regional quality review team members. Metrics for quality implementation will consider environmental safety, health and medical services, individual rights and choice, behavior support and community integration.
Service settings and programs are shifting toward community integration. New congregate housing projects are no longer being developed, and community-based placements are increasingly interspersed within residential settings. More individualized day programs and supportive employment opportunities are being created
to replace the sheltered workshop model. Some innovative programs, such as individual career path and customized employment, have already been introduced into the system.
There are still many challenges as DBHDD works to meet the goals and mandates of the settlement agreement. The agency is confident that with the partnership and support of all stakeholders, the goals set forth will be achieved, bringing a new future to all consumers who utilize and benefit from DBHDD services.
Dr. Charles Li's Bio:
Dr. Charles Li is the Assistant Commissioner at DBHDD – Division of Developmental Disabilities
