By the Progressive States Network
Georgia's Department of Human Resources (DHR) is considering privatizing much or all of its public mental health hospital network and closing its mental health facilities in cities like Savannah and Augusta. State officials say that no final decisions have been made, but DHR is considering privatization as a solution to problems that have plagued state-run hospitals and that led to a U.S. Department of Justice investigation of the quality of care provided. DHR provided advocates and providers with an outline of its plan to consolidate the seven mental health hospitals into two and to rely more heavily on community-based services.
The only concrete step the state has taken toward enacting this plan has been to issue a request for proposals (RFP) to potential contractors to take over a unit at the mental hospital currently located in Savannah. Dena Smith, a spokesperson for the DHR, said, "If through that RFP process, it's found that it's not the best way to move forward, then it won't happen." However, the outline of the agency's plan indicates that the state is moving rapidly to close down its institutions and to switch to private providers. By the end of June 2009, the state intends to issue RFPs for new hospitals in Atlanta and South Georgia, both scheduled to open by the end of 2011, and will close the Savannah hospital. The mental health hospital in Columbus would close by July 2011, and by the end of the following fiscal year, public facilities in five other cities would likely close down.
Doubts about Cost Savings
Mental health advocates, state legislators, and members of Gov. Sonny Perdue's mental health commission have expressed concerns over the possibility of privatization, emphasizing that there is little evidence that having private companies take over state hospitals will save taxpayers money or improve the quality of patient care. They believe that more public participation in the DHR's privatization plans is necessary. Furthermore, they question the viability of turning state mental health hospitals over to for-profit companies. Most patients who end up in state institutions have exhausted all private insurance coverage, and there is no way to cost-shift the burden of caring for uninsured patients by treating insured patients. Given these limitations, private companies may resort to reducing staff and services in order to make a profit.
Problems in Other States from Partial Mental Health Privatization
No other state has privatized its entire psychiatric hospital network, and states that have privatized some of their mental health services have not realized their intended results. In Florida, private facilities operate at only a slightly less expensive rate than state institutions, and they have not been able to demonstrate improvements in patient outcomes. In North Carolina, auditors found that the state wasted $400 million by allowing unqualified private companies to provide many mental health services. In a Texas private mental health clinic, poor staffing led to patients violently assaulting others, inadequate cleaning, and incorrect doses of medicine dispensed to patients.
This report originally appeared in the Progressive State Network's Privatization Update: Schools, Prisons, Mental Health -- and What States are Doing to Hold Contractors Accountable.
The Centers for Medicaid and Medicare Services (CMS), this being the federal funding that even GA will have to pay attention to----has the matter of the IMD exclusion rule which means that you cannot have more than 14% Medicaid beds in a private, psychiatric, for-profit, free standing hospital. And that is what the GA psychiatric hospitals will be if they are privatized. So, HOW does the GA State legislature think that they are going to get around the IMD exclusion rule?
For more info on the IMD exclusion rule:
"One major factor leading the states to close their psychiatric hospitals is an aspect of Federal Medicaid reimbursement policy known as the IMD Exclusion. (See What is the IMD Exclusion, infra.) In a nutshell, this exclusion prevents a state psychiatric hospital from receiving federal Medicaid funds for its patients, whereas patients hospitalized on the psychiatric ward of a general hospital or treated in a community setting are eligible for such funds. Without federal funds, state hospitals close. The result of discharging patients and then closing the state hospital beds is that states save state money. If a patient then needs rehospitalization, it is to a general hospital that is not usually properly equipped to handle long-term psychiatric care. And the quality of care is generally poorer than in private or state psychiatric hospitals.[23]"
http://www.psychlaws.org/HospitalClosure/Repeal.htm
Marsha V. Hammond, PhD: clinical lic psychologist, NC:
NC mental health reform blogspot: http://madame-defarge.blogspot.com/
see: Monday, March 30, 2009
GA Depart Hum. Resources taking bids on privatizing mental health hospitals: WE'RE GONNA TELL YOU, 'WE TOLD YOU SO'
March 30, 2009 7:37 PM | Reply
I am not sure where the privatization issue now stands in light of the Governor signing HB 228 separating the Human Resources Dept. into three separate agencies, but if it is still being considered, I would like to add the following.
While privatization might be the easy way to go, it is not the right way. We have the opportunity to make our mental health system one of the best in the country if we would look beyond the same old way of doing things.
I am only familiar with the grounds at Georgia Regional in Decatur where acres and acres of lawn are mowed each day. With the current interest in gardening (families as well as Mrs. Obama's garden on the White House grounds) why not, instead of mowing, till the grounds and plant vegetables, herbs, fruit trees, etc., giving the patients the chance to work in the gardens and do something worthwhile, something they would feel good about. The savings generated by growing their own food as well as healthier eating would be added benefits. With all of the gardeners in the Atlanta area, I believe help in getting this project started would be in abundance.
My daughter is currently in the forensic unit at Georgia Regional in Decatur, and it seems for most of the day she constantly walks, having "walked" through a pair of tennis shoes in less than 6 months. She needs something constructive to do, which along with medication and counseling would help her get well faster. Which should be the whole point of her being there.
I know it is hard to be sympathetic to those with mental illness (especially if you don't have any personal experience with someone who is sick). But I believe if we could all live inside the head of a mentally ill person for 24 hours and see what they have to go through each day just to get by, we would want to do all we could to help them get well.
My daughter did nothing to deserve this illness. She didn't smoke, drink or take drugs. She worked hard, bought a house, got a dog and cat, donated to every cause that asked. She deserves the best treatment, and I believe we have the opportunity to do that for her and all of the others institutionalized in Georgia's facilities.
May 8, 2009 6:46 AM | Reply