1. Georgia Department of Human Resources Blueprint for a New Mental Health System

2. Georgia Department of Human Resources Slide 2 Why Change Our Mental Health System? By 2012, Georgia will spend millions of taxpayer dollars to maintain 7 aging psychiatric hospitals that were never designed for today’s mental health consumer… …even then, Georgia will continue to lack:  Comprehensive community-based services  Modern hospitals designed to treat today’s consumer  Options for overburdened law enforcement

3. Georgia Department of Human Resources Slide 3 Here’s the problem Georgia faces …  State hospitals have been a primary treatment option for mental health consumers.  Most consumers need community services; a smaller number need state-of-the-art hospitals.  The hospitals are between 40 and 150 years old and will require $30 million in upkeep by 2012.  Fixing these hospitals provides no additional services for consumers.  No new state funds are available to build new hospitals.

4. Georgia Department of Human Resources Slide 4 Georgia needs a system that …  Creates new mental health services and facilities at current budget level  Provides community-based treatment options to avoid hospitalization  Offers opportunities for a skilled healthcare labor force  Eases the burden on law enforcement and jails Here’s how it can be done …

5. What Will It Take to Build a New Mental Health System? Georgia Department of Human Resources Slide 5

6. Georgia Department of Human Resources Slide 6 The Right Services Versus ‘a Hospital Bed’ For the first time, Georgia will provide a range of community-based mental health services to replace hospitalization when appropriate. Here’s how we are increasing our service capacity:  Increasing crisis stabilization beds for short term care  Expanding mobile crisis programs to respond to immediate mental health emergencies  Adding ACT teams for those with severe mental illness  Adding social detox programs to include ambulatory detox services  Adding intensive treatment residences equipped to treat long-term consumers who otherwise would be hospitalized

7. Georgia Department of Human Resources Slide 7 Georgians with serious mental illness can go from … this to this New Capacity Expanded Crisis Stabilization Beds Expanded Intensive Residential Beds Expanded Mobile Crisis Services Expanded Detoxification Beds Hospital Beds ACT Teams Hospital Beds Previous Capacity Some Community Services

8. Georgia Department of Human Resources Slide 8 It’s already happening … Since 2001, Georgia’s hospital census has declined as more consumers are treated in the community. By expanding community services even further, existing hospitals will be converted into behavioral health hubs that provide more targeted treatment.

9. Georgia Department of Human Resources Slide 9 Savannah and Columbus: Model Communities in a New System  $6.5 million and $11.2 million (annually) in seed funds to expand community services for first time ever in Savannah and Columbus.  Replacing Savannah hospital with behavioral health hub creates savings to be reinvested into new services for other communities.  After Savannah and Columbus, other hospital regions will have their mental health service capacity transformed as well.

10. Georgia Department of Human Resources Slide 10 Savannah and Columbus: Model Communities in a New System Previous Capacity New Capacity Previous Capacity New Capacity Serving More Georgians

11. Georgia Department of Human Resources Slide 11 2013 – A New Mental Health System New Services for Consumers  Every region will have a comprehensive package of community-based services.  Community services – not psychiatric hospitals – will be the first choice for consumers.  Service capacity will nearly double without additional budget funds.  Two new hospitals and one new forensics facility to provide state-of-the-art care for today's mental health needs.  Consumers will receive treatment tailored to their mental health needs.  Children and adolescents to be treated in community.

12. Georgia Department of Human Resources Slide 12 2013 – A New Mental Health System New Healthcare Employment Opportunities  New privatized facilities will provide employment for existing hospital staff wherever possible.  Employment opportunities will be available with new behavioral health centers and expanded community service providers.

13. Georgia Department of Human Resources Slide 13 2013 – A New Mental Health System Options for Law Enforcement  Statewide, 90% of forensic evaluations will be completed in jails.  Crisis stabilization, mobile crisis services and ACT teams will reduce burden on law enforcement officers.  Transportation issues minimized.  Increased use of local crisis stabilization programs for civil evaluations. * * * * * * * * * * * * * * * * * * * * * * *Evaluation locations for law enforcement

14. Georgia Department of Human Resources Slide 14 2013 – A New Mental Health System More Effective Use of Taxpayer Dollars  Service capacity will nearly double with no additional funds spent. - Crisis stabilization to increase by 48% - Mobile crisis services to increase by 154% - ACT teams to increase by 114% - Transportation capacity to increase by 21% - New social detoxification services will be available  Three state-of-the-art facilities to be built and operated with no additional budget funds spent.  Nearly $30 million that would have gone to maintaining aging hospitals is now invested in new facilities.

15. Georgia Department of Human Resources Slide 15 2009 – 2013: An Overview 2009201020112012 Expand community services in Savannah and Columbus Convert Savannah hospital to behavioral health hub All savings reinvested Expand community services in Fulton, Clayton and Rome area Privatize Atlanta hospital Privatize forensics $29.3 million saved to be reinvested in additional community services Begin building forensics facility in Milledgeville Begin building two new hospitals Replace hospitals with behavioral health hubs Expand services statewide $27.2 million saved in 2011 and 2012 to be reinvested in community services statewide 2013

16. Georgia Department of Human Resources Slide 16 Phase One (2009) and Phase Two (2010) Phase One: Actions – $6.5 million expands community services in Savannah and Columbus. Seek proposals (RFPs) for privatizing forensics and Atlanta Regional Hospital (long-term treatment) Move Savannah forensics to Rome and Augusta. Results – Service capacity nearly doubled without increasing budget. In-jail evaluations ease burden on law enforcement. Phase Two: Actions – Invest savings from Phase One into expanded community services for Fulton, Clayton and Rome area. Increase in-jail evaluations. Privatize forensic services to Milledgeville. Privatize Atlanta Regional Hospital. Results – Service capacity nearly doubled in Fulton, Clayton and Rome area at no additional cost to state budget. In-jail evaluations ease burden on law enforcement in Fulton, Clayton and Rome area.

17. Georgia Department of Human Resources Slide 17 Phase Three (2011) and Phase Four (2012-2013) Phase Three: Actions – Build forensics facility in Milledgeville, and two new hospitals in Atlanta and South Georgia Consolidate forensic patients from Rome, Augusta, Thomasville, Columbus and Decatur to privatized facility in Milledgeville (late 2011). Reconfigure West Central Georgia Regional Hospital in Columbus into behavioral health hub (late 2011). Results – Forensic consolidation complete. Phase Four: Actions – Northwest Regional (Rome), Southwest Regional (Thomasville), East Central Regional (Augusta) and Central State (Milledgeville) convert into behavioral health hubs. Use $27.2 million saved from transforming hospitals to expand community mental health services in Augusta, Athens, Thomasville, Warner Robins and Macon areas. Open new state-of-the-art hospitals in metro Atlanta and south Georgia. Results – Georgia has three new hospitals providing state-of-the-art care. State now has expanded community-based mental health services.