Time for an Update: A Slice of our Work

Hello friends, colleagues and supporters. We seem to have turned the page to fall with the emergence of pumpkins, football and changing leaves. These are reminders that despite the uncertainty that has characterized 2020, elements of our existence roll forward, albeit with new practices and precautions, and new opportunities as well. Conversations with friends, partners and stakeholders that rely on DBHDD and our provider network have challenged me to acknowledge the exhaustion and unpredictability we have experienced, and at the same time embrace the joy of small pleasures and reinvigorate our safety net mission.

In recent months, I have used the term “customized co-existence” to describe our approach of continuing to serve in the face of COVID-19. It doesn’t quite feel like a “new normal” and I am not sure that “post pandemic” is the right sentiment for the months ahead either. What I am most proud of is the way that DBHDD, our hospitals and our provider network have worked so diligently to fulfill our mission to serve some of Georgia’s most vulnerable citizens with mental illness, substance use disorder and intellectual and developmental disabilities. As you all are well aware, needs have not remained dormant in the pandemic, but rather there are numerous reports of increased mental health needs, skyrocketing substance misuse, and deep concerns regarding social isolation for people with disabilities.  Each of these issues is important to me, and I want Georgians to be aware of the ways in which DBHDD’s “customized co-existence” enables us to ensure that the safety net is operational, and we can answer the call to serve.

It is important to acknowledge that our progress is the result of support from Governor Kemp and his team who recognized some of the unique challenges we have faced and provided targeted support to assist us, especially in our hospitals. We have also benefitted greatly from the support of several key legislative champions who helped us to preserve vital services even in the face of necessary budget reductions. I know very well that my Commissioner colleagues across the country do not have this level of support. Given the challenges we face, I wanted to share some tangible examples of what “co-existence” looks like in our core areas of business: our state hospitals, community behavioral health, and services and supports for people with intellectual and developmental disabilities.

Under the leadership of our Medical Director, Dr. Emile Risby, our five state hospitals have fought a valiant battle to understand the detailed protocols, practices and vigilance that COVID-19 requires. Protecting our patients and our staff are the highest priority, and so we have made massive changes to our daily operations, including the following:

  • Conducting COVID-19 screening of all employees upon arrival and mid-shift
  • Adding eye protection to face covering as required wear in patient care areas
  • Achieving PPE compliance over 95% across our hospital system
  • Adapting quarantine and isolation procedures unique to each hospital
  • Revising discharge planning and visitation rules and protocols
  • Aligning to comply with new CMS policies for frequency of testing at our Skilled Nursing Facilities in Atlanta and Augusta
  • Preparing for availability of Point of Care testing for both patients and staff
  • Mandating flu vaccine
  • Posting our daily COVID numbers on our DBHDD website to ensure transparency and accountability

I want to name our hospital leaders who have been relentless in their pursuit of quality care. Dr. Charles Li in Atlanta, Paul Brock in Augusta, Marsha Capshaw in Columbus, Gilbert Sullivan in Milledgeville, and Andy Mannich in Savannah, along with the devoted teams they manage, are to be commended for their competent and flexible leadership. Of course, the true heroes of our hospitals are the front-line staff, who don PPE and each day answer the call to serve. I am proud to call them colleagues and remind them how much we rely on their care and competence.

In Behavioral Health, Director Monica Johnson leads a strong and capable team that knows our work is never done. When we say the safety net is open for business, we mean the following things are occurring:   

  • Supporting flexible and ongoing telehealth utilization
  • Prioritizing crisis services and the role of Georgia Crisis and Access Line (GCAL) and our Community Service Board partners who run crisis units across the state  
  • Joining First Lady Marty Kemp to celebrate cross agency collaboration to serve sex trafficked youth at the Wellspring Center, highlighting our CSB partner Highland Rivers Health delivery of vital clinical care
  • Sustaining our COVID Emotional support line for individuals that are not in crisis, but need a place to turn for conversation and support
  • Remaining in active dialogue with Apex schools to maximize the ability to address behavioral health issues whether the environment is virtual, in person, or hybrid
  • Conducting a virtual System of Care Academy, promoting evidence based practices and offering CEUs for youth-serving professionals across the state
  • Partnering with Georgia Public Safety Training Center to train law enforcement personnel on Opioid response strategies
  • Partnering with Georgia Public Broadcasting system to develop the State Opioid Response documentary 
  • Participating in the Opening of the River Edge Recovery Center, the newest and most innovative Behavioral health Crisis Center in our state 
  • In partnership with Carl Vinson Institute of Government, seeking feedback from providers and clients to assess telehealth experiences
  • Pursuing and receiving several federal grants to address Opioid Use, Suicide Prevention, and Crisis Response

In our service delivery system for people with Intellectual and Developmental Disabilities, we have been challenged as all states have. Under the leadership of Division Director Ron Wakefield, the team has walked hand in hand with providers, family members and people we serve. Even when budget cuts have been heartbreaking and personal, they have kept the dialogue open. Progress includes the following:

  • In partnership with CMS (Centers for Medicaid and Medicare Services), facilitating Appendix K of the NOW/COMP waiver that allows flexibility in service delivery
  • Working with community providers to review re-opening plans for Day services
  • Conducting active surveillance of COVID infections and outbreaks to assist providers with response and to address health and safety needs
  • Partnering with our Support Coordination agency partners to enable resumption of in-person visitation of complex and vulnerable individuals
  • Continuing to manage Crisis Homes for individuals with I/DD
  • Returning to web-based trainings for providers
  • Prioritizing uninterrupted provision of clinical assessments and authorization of supports
  • Continuing annual and initial assessment to initiate or continue vital services
  • Meeting with providers, individual and families around the state to mitigate the impact of budget reductions.

Across the enterprise, we are resuming Quality reviews, enabling virtual provider enrollment and continue to monitor incidents that occur in community and hospital settings so that we have effective Corrective Action Plans that prioritize the health and wellbeing of the people we serve. Melissa Sperbeck and Robert Dorr lead this work very capably for our Department and our network. Our website is such a vital tool for communication at this time, and I want to also acknowledge our Public Affairs team, led by David Sofferin, and Doug Reineke, our Director of Legislative Affairs, who responds to questions and concerns, and serves as a vital link to elected officials around the state.

These updates are just a slice of our work. I share them and the names of some of our team members to let you know that we are here to serve. I can never claim that we are perfect, or that we get it right every time and can meet each and every need that exists. What I can assure you is that we remain more committed than ever to be present, to answer the call, to listen, and to partner in service our vision of a life of recovery and independence for the people we serve. Thank you for walking with us on this important journey.