Transcript Department of Human Resources Division of Mental Health

DRAFT
Department of Human Resources
Division of Mental Health, Developmental
Disabilities and Addictive Diseases
BEHAVIORAL HEALTH
GAME PLAN
December 9, 2008
GEORGIA’S REALITY
• No resources for state to build new hospital
infrastructure
– 7 hospitals ranging from 40 to 150 years in age
– $70M has been spent in the last 6 years to maintain the
facilities (projected an additional $30M in next 3 years---$100M
in 9 years)
– Buildings were not designed for today’s active treatment
requirements
• Community system requires new resources that are not
available in current budget environment
• Front door for MHDDAD is the hospital system and
should be the community system
2
STRATEGIES
1. Consolidation of hospital populations
2. Shift the front door from the hospitals
to the community
3. Privatization to construct new facilities
4. Closure of some hospitals and open
community crisis stabilization programs
in those areas
3
WHY THIS GAME PLAN?
• Provides new hospital infrastructure to replace
outdated and inefficient facilities
• Expands and enhances treatment alternatives
in the community
• Positions state hospitals to be used only after
community options have been exhausted
4
GAME PLAN: SFY 2009
Establish community as front door
• Use SFY 2009 new fund to add community services (CSP’s, social
detox, mobile crisis, transportation and ACT teams) in Columbus
and Savannah areas
• Increase capacity for outpatient (in jail) forensic evaluators
Consolidate
• Savannah forensics consolidated to West Central and Southwest
• Savannah and West Central long-term adult MH clients into
other hospitals or the community (IRTFs)
Privatize
• Cook building for Central State forensics-close deteriorating
Freeman and Binion buildings
• Begin refurbishment/expansion of Kidd building to house
forensics
5
GAME PLAN: SFY 2009
Privatize (continued)
• Issue RFP to privatize, design and construct new Atlanta
Regional Hospital to replace hospitals in Atlanta and Rome
• Issue RFP to privatize, design and construct a new hospital in
south-central Georgia to replace hospitals in Milledgeville,
Augusta and Thomasville
Close
•
•
•
Open
•
•
C&A units at Atlanta and Central State hospitals (56 beds)
263 DD beds
Savannah hospital and convert facility to adult CSP program
Adult enhanced CSP program at Savannah
Private Sector beds for C& A
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GAME PLAN: SFY 2010
Establish community as front door
• Use funds from Savannah hospital conversion to add community
services (enhanced CSP’s, social detox, mobile crisis,
transportation and ACT teams) in Fulton, Clayton and Rome
areas
Privatize
•
•
•
•
Atlanta Regional Hospital
Continue construction of new hospital for metro Atlanta
Finish refurbishment/expansion of Kidd building
Finalize RFP and begin construction of new hospital in southcentral Georgia
• Initiate RFP for Skilled Nursing Facility at Milledgeville
Close
• 150 DD beds
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GAME PLAN: SFY2011
Consolidate
• Forensic clients from Rome, Augusta, Southwest, West
Central and Atlanta at Milledgeville in privatized Kidd
building
Close
• West Central hospital
• 117 DD beds
POTENTIAL NEED FOR APPROXIMATELY $5M IN STATE FUNDS
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GAME PLAN: SFY2012
Establish community as front door
• Use funds from closing of Rome, Southwest, East Central and
Central State to add community services (i.e. enhanced CSP’s,
social detox, mobile crisis, transportation and ACT teams) in
Augusta, Athens, Thomasville, Warner Robins and Macon areas
Privatize
• Skilled Nursing Facility at Milledgeville
Close
• Rome, Southwest, East Central (with exception of 250 DD
consumers) and Central State hospitals and open adult CSP
programs
• 149 DD beds
Open
• Metro Atlanta new hospital (early SFY 2012)
• South-Central new hospital (mid SFY 2012)
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GEORGIA’S PUBLIC BEHAVIORAL
HEALTH SYSTEM IN 2012
• Privatized inpatient forensic services consolidated in
Milledgeville
• Significantly increased number and timeliness of
outpatient (in jail) evaluations
• Inpatient child and adolescent (C&A) programs
operated by community providers
• SNF (nursing home) operated by private provider
• Privatized inpatient adult mental health services in two
new, state-of-the-art hospitals (Atlanta and South
Central Georgia)
• All regions have enhanced community mental health
and addictive disease services serving as alternates to
hospitalization using private providers, CSBs or MHDDAD
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Projected Hospital Bed
Capacity in 2012
Bed Type
2008
2009
2010
2011
2012
AMH
573
464
464
450
450
Forensic
590
590
590
600
600
DD
929
650
516
364
250
C&A
56
0
0
0
0
SNF
205
205
205
205
180 **
Total
2,353
1,909
1,775
1,619
1,480*
* 679 beds replaced by DD waivers (Olmstead)
** Current utilization of Craig Nursing Home (SNF)
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Projected New Community Capacity
in 2012
2009
2010
2011-2012
TOTAL
% increase
from 2008
44 beds
($6.6M)
40 beds
($6.9M)
88 beds
($11.9M)
172 beds
($25.4M)
48%
Social Detox
2 programs
($1.0M)
2 programs
($1.0M)
2 programs
($1.0M)
6 programs
($3M)
New Program
Mobile Crisis
16 counties
($1.5M)
20 counties
($2.3M)
32 counties
($2.3M)
68 counties
($6M)
154%
2 teams
($1.7M)
4 teams
($3.5M)
2 teams
($1.7M)
8 teams
($6.9M)
114%
Transportation
$200K
$200K
$300K
$700K
21%
Total Community
Investment
$11.0M
$13.8M
$17.2M
$42.0M
15%
Columbus,
Savannah
Fulton,
Clayton,
Rome
Augusta,
Athens,
Thomasville,
Warner
Robbins, Macon
FY09 Approp
Savannah
closure
Rome, SWSH,
ECRH and
CSH closure
Enhanced CSP
ACT
(team caseload = 70)
Communities Served
Source of Revenue
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Projected Hospitals in Service at Beginning of
Each Fiscal Year
2009
2010
2011
2012
Savannah
Closed
Closed
Closed
West Central
West Central
Closed (1/1/2011)
Closed
Atlanta
Privatized
Privatized
New Hospital*
Rome
Rome
Rome
Closed
Southwest
Southwest
Southwest
Closed
Central State
Central State
Central State
New Hospital**
East Central
East Central
East Central
Closed
* 250 adult mental health beds – metro Atlanta
** 200 adult mental health beds – south central Georgia
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