I would say we are not talking about corruption -how our politics and the bureacrocies have blinded the public with not meeting fundimental human rights of dignity.
I would say also -the public is corrupted without saying -in that they are a the root cause(s) with creating the inviroment of human rights violations.
What we got to do is make the public responcible for the poor results we are seing all around us!!!!
Crimes against Humanity in Georgia
http://www.ajc.com/opinion/content/opinion/0405/10edmental.html
No rescuers catch state's mentally ill
> Reforms will be costly and complex, but the level of suffering demands that Georgia get to work
> Published on: 04/10/05
If mental illness were a communicable disease, like influenza or tuberculosis, Georgia could be experiencing an epidemic and never know it. The safety net supposedly created to protect the state's most vulnerable residents from lives of mental anguish is so ripped apart that no one is certain how big the holes are and where the holes might be found.
It may take millions of dollars just to find out how bad the system is failing before it can be fixed.
In the latest stop-gap measure, Gov. Sonny Perdue has created a task force to study how well the state provides mental health services through its 25 regional community service boards. The move is a hasty response to yet another state audit that reported very little accounting of the $500 million a year that the state spends on an estimated 180,000 Georgians who depend on community-based care to stay well.
The Department of Human Resources, which is supposed to oversee the regional boards, often has no idea of their financial condition or how they are dealing with patients, many of whom are on Social Security disability and covered by the state's Medicaid program. Similarly, the boards seem to have no systematic way of monitoring the effectiveness of services they provide their patients, short of finding out they have been re-hospitalized for their illness.
Moreover, the auditors showed that when patient-care problems were uncovered by accrediting agencies, the DHR did not have policies in place to see that the problems were corrected. It relied mainly on the boards to police themselves.
Some of the boards keep adequate financial records; others are in constant financial and administrative turmoil. The audit showed seven boards were owed a total of $55 million by clients who were able to pay for the services or had private insurance. Two of the boards had not sent statements to clients and insurance providers for more than two years. A similar audit two years ago prompted the state to demand $1 million in repayments to Medicaid from nine of the service boards due to mismanagement, substandard services and poor record-keeping.
The fractured system, which has remained this way for more than a decade, doesn't merely waste money, it wastes lives. A coordinated, community-based approach to mental health care — regular monitoring of medications, routine counseling and casework management of the complicated lives of mentally ill and recovering patients — can make the difference between a productive life and living on the streets or in and out of jail for nuisance crimes.
Georgia is not alone in facing the problem of how best to provide community-based services to people with schizophrenia, bipolar disorders, acute depression and organic brain diseases brought on by alcoholism and substance abuse. It is a national problem that has its roots in the closing of hundreds of public mental hospitals over the last four decades.
The presumption then, as now, is that the mentally ill will be best-served in the least restrictive environment appropriate to their condition. For many, that means seeking treatment on an outpatient basis in their own community instead of confinement in a state hospital miles from home and their support system.
As hospital wards were shuttered and patients encouraged to seek help closer to home, it became infinitely harder to keep track of the services patients needed and whether they were even getting them. Many patients were simply lost in the system. In Georgia, they remain mostly invisible because patient information is rarely shared between the boards, and too often the missing patients aren't found until they are committed to a psychiatric hospital or sent to jail. Many wind up homeless and on the streets.
Fixing the problem will not be easy or inexpensive. Those states that have the best success have decentralized mental health services down to the county level — the way most counties now operate health departments that provide immunizations and basic health services. In many of these states, counties also provide local taxes to match some of the dollars the state passes on to them from Medicaid to provide mental health services.
With 159 counties, Georgia is unlikely to be able to create such a localized system, especially in rural areas where small counties couldn't afford to go it alone. Multi-county districts will need to be retained, but the state could exert much more influence over the quality of services rendered. That's the easy part — reorganizing the structure.
The difficult and expensive part will be monitoring the intensity of services that mentally ill patients demand. The most effective models utilize psychiatric social workers or case managers assigned to individual patients to make sure they get the medications they need, keep their appointments, and receive adequate housing and access to jobs and job training. These patients have to be followed for years.
That will mean establishing a patient information system that works. The state's troubled $300 million computerized payment system for physicians and other providers handling Medicaid patients has so far failed in that role. The state is rushing to provide an audit of 2004 Department of Community Health spending by June, which might provide some of the information it needs to get started.
Georgia has never put a high priority on public health. Its track record on spending for mental health services is even poorer, and as the audits show, much of that is being wasted. We should be getting more services for the limited dollars we are spending.
The disgrace is that it has taken this long to even acknowledge how abjectly we have failed. The task force — to be headed by a former chairman of the DHR board, Bruce Cook — needs to be empaneled quickly and get to work reforming the system. Too many productive lives have already been lost.
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