Hello and happy summer! For many, July holds holiday and vacation fun amidst the heat of summer in the South. At DBHDD, July is a time of transition, with the closeout of one fiscal year (FY 2018) and the start of the next one (FY 2019), while planning for the following year (FY 2020). We kick off FY 2019 with grateful acknowledgment of Governor Deal’s Commission on Children’s Mental Health, and the support from the General Assembly, which invested more than $20 million dollars in priority services and supports to address the behavioral health needs of Georgia’s youth and families.
Our system-wide work continues with great momentum, but there is one area of concern that I would like to highlight: DBHDD’s role in Georgia’s response to the opioid epidemic. Recurring headlines and your own family and community experiences may have you wondering how our state is responding. First, the facts: In 2014, the Substance Abuse and Mental Health Services Administration (SAMHSA) estimated that more than 2.5 million Americans struggled with addiction to prescription pain medication or heroin. The Centers for Disease Control and Prevention (CDC) cited a four-fold increase in opioid-related overdose deaths since 1999, and in Georgia, the rate more-than-tripled between 2006 and 2015.
I want to assure you that Georgia is tackling the epidemic head-on, and DBHDD is on the front line. As the state opioid authority, DBHDD is responsible for the prevention, treatment, and recovery elements of Georgia’s statewide response. In 2017, we received SAMHSA’s two-year State Targeted Response (STR) to the Opioid Crisis grant ($11.8 million per year). At the end of the first year, we have made important enhancements in each area of responsibility.
DBHDD’s Office of Behavioral Health Prevention has focused on three initiatives:
The Office of Addictive Diseases contracted with nine providers for treatment – including Medication-Assisted Treatment (MAT) – of uninsured and underinsured Georgians who have opioid use disorders. Through this initiative, 450 individuals have received treatment.
Three recovery initiatives have been added through the grant:
In the second year of the grant, which began May 1, 2018, the Prevention Office will double naloxone distribution to first responders and will release two additional PSAs that promote self-advocacy and safe storage and disposal of prescription drugs. It will also continue to fund SPF providers. The Office of Addictive Diseases will continue funding programs for MAT services and add new providers in regions 1, 3, and 6 to address the treatment need. Recovery initiatives will continue with the addition of recovery coaches in two additional hospital emergency departments and funding of three recovery community organizations in regions 2, 4, and 6 to provide support to those seeking recovery.
The opioid epidemic is multi-faceted and requires extensive collaboration. DBHDD has many great partners in this venture. We are working closely with the Georgia Department of Public Health to develop Georgia’s Opioid Response Strategic Plan.
We also participated in the launch of a Statewide Opioid Taskforce, convened by Attorney General Carr in October 2017 to bring together key stakeholders. Following the initial meeting, the Attorney General’s Office, DBHDD, the Georgia Department of Community Health (DCH), and DPH met to discuss strategies for addressing the growing opioid crisis. To date, over 200 people from more than 50 organizations have participated in a series of meetings to inform the strategic plan by identifying key goals, objectives, and outcomes in the following areas:
This work will result in the publication of a statewide plan that ensures accountability and transparency in the work ahead. As an essential enhancement to our efforts to address the opioid epidemic, DBHDD received $4 million in new state funding to support statewide implementation of Addiction Recovery Support Centers. Led by peers, the centers offer non-clinical activities that engage, educate, and support individuals and families to make the life changes necessary for to experience recovery. There is growing evidence of the need for a continuum of care that offers support and assistance well beyond the bounds of treatment.
There is hardly a family in Georgia that is not touched by addiction. Even as we battle at the cutting edge of treatment and services in the opioid crisis, we know that the bottom line is that addiction is the fundamental issue to be addressed. Abuse of alcohol, cocaine, and methamphetamines still represent significant challenges in our state. DBHDD – along with our providers and our state, federal, and community partners – is committed to education, prevention, early intervention, and evidence-based treatment. We engage in this work grounded in the belief that recovery is possible for each and every Georgian.
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This is that wonderful time of year when many are honored for graduating. For some, this is the culmination of years of hard work, dedication, and achievement; and for others, a stop along the way on a continuum of formal education and training. In either case, many do so with the realization that learning does not end with the earning of a diploma or degree. It is a lifetime journey in which we accept responsibility for improvement of self and the world around us.
Peter Senge carried this message to organizations in his book, The Fifth Discipline: The Art and Practice of the Learning Organization, stating, “The organizations that will truly excel in the future will be those that discover how to tap people’s commitment and capacity to learn at all levels of the organization.” At DBHDD, we believe in this philosophy and are truly committed to becoming a Learning Organization—one in which we continue to grow and develop through awareness of self and others, education, training, collaboration, and commitment to excellence in all we do.
DBHDD’s Office of Human Resources and Learning plays an integral part in supporting our evolution as a Learning Organization. Aligned with DBHDD’s mission and vision, HR and Learning is at the forefront of ensuring that we have a skilled, engaged, and high-performing workforce to meet the needs of the people we serve.
Our Learning Team (formerly the Office of Learning and Organizational Development, or “OLOD”), comprises an important part of our integrated Office of HR and Learning. Led by Mark Green, director of HR and Learning, and Theodore Carter, Jr., senior director of Learning, the team is responsible for the development, acquisition, and delivery of high-quality, evidence-based learning solutions to DBHDD staff, community providers, and the people we serve.
Learning is comprised of three major sections:
The efforts of each of these groups is augmented through our partnership with the University of Georgia’s Carl Vinson Institute of Government (CVIOG). A prime example of the value of this collaboration is shown in DBHDD’s Management Academy, a certification program helping to equip selected team members with the skills and tools necessary to position the department as an “Employer of Choice” and achieve our mission and vision. To date, some 200 emerging leaders have participated in the program, with many of the graduates advancing to fill critical roles and/or assume increased responsibilities within DBHDD.
Within our hospitals, training program administration teams coordinate with local leadership and subject matter experts to ensure that new staff are enthusiastically and effectively introduced to the organization. This is accomplished through our redesigned/refreshed new staff orientation (NSO). Implemented in 2017, NSO provides a meaningful and engaging onboarding experience for all staff, and prepares them for further training and learning on the job. Mundane classroom-based lecture and reading was replaced by streamlined content, group discussion and activities, and a totally refreshed look and feel to the orientation experience. Staff can sense the learning culture of DBHDD and are encouraged to carry their energy and passion into their work.
The work of Hospital Training Administration doesn’t end there! The team supports delivery of approximately 175,000 hours of annual recertification training to hospital staff. These trainings are critical to ensuring that staff acquire and sustain knowledge, skills, and competency necessary in performing their roles, and are a critical component in achieving/maintaining facility accreditation.
Training Programs for Divisional, Office, and Community Team members provide learning solutions which greatly enhance DBHDD and the provider network’s ability to meet the needs of the people we serve; and ensure their quality of care, health, and safety within the healthcare continuum. This is done through comprehensive project development, management, and coordination, and the presentation and/or facilitation of a multitude of offerings. Often behind the scenes, yet instrumental to the success of our largest events, the team coordinates with speakers, vendors, and venues to ensure that all aspects of program delivery are excellent, and desired outcomes achieved. Did you know that our diverse training programs are attended by more than 6,000 participants annually?
Learning must assist in ensuring that staff and stakeholders are informed, connected, and accountable. Achieving this requires content and delivery of learning solutions which meet the needs and style of the learner. Learning Systems and Content Development create and adapt curricula, incorporating technology, and leveraging cutting-edge training modalities to bring learning to the places where we are and work. The DBHDD University website provides direct 24-7 access to a library of more than 2,500 offerings and online certification courses and trainings to build a broad spectrum of skills and competencies.
We are proud that DBHDD’s Learning Team is viewed among the elite within the learning community of state government. This team continues to seek ways to support and advance the skills, abilities, passion, and contributions of our staff, providers, and partners. We believe that an engaged and informed workforce in Georgia is the best path to achieve our shared goal of improved outcomes for the people we serve.
Greetings! It seems that Spring is finally here and we can look forward to the celebration of Mental Health Month throughout May. Today, I want to celebrate mental health and more through an important story. It is the story of a decade of transformation at DBHDD. Since becoming a standalone agency in 2009, we have gone through a remarkable transformation, and it is time for us to honor our achievements.
This is our story.
In 2009, our system was inconsistent and fragmented. We were underfunded; many of the people we served were “stuck” in the wrong places in our system; we over-relied on our hospitals and lacked community services; we had outdated systems, and our compliance and quality improvement mechanisms were inadequate. The public safety net was broken.
The department we are today has completely transformed from this broken and fragmented system to one that embraces the hope of recovery and independence for Georgia’s most vulnerable citizens.
This transformation was not accidental. It did not happen overnight. We did not do this alone. Our transformation is the result of leadership, dedication, partnerships, and a commitment to doing better.
The first essential step was an acknowledgment of our deficiencies. Throughout this decade, we have successfully navigated a settlement agreement under the Civil Rights of Institutionalized Persons Act (CRIPA) with substantial and sustained hospital improvements. We have also made dramatic progress toward fulfilling our obligations under the Americans with Disabilities Act (ADA) Settlement Agreement.
Our transformation has at times been messy, but it is meaningful, authentic, and measurable, leading us to demonstrated outcomes that impact the lives of those we serve. It is important to tell our story to remind all of us of what we have undertaken and what we have accomplished.
After acknowledgment of the things that challenged us, our next step was commitment. We made a commitment that we were going to improve. We made investments in our system. We executed adjustments to our infrastructure and the way we do business. Under the leadership of Commissioner Frank Berry, we prioritized engagement of key partners. These changes fostered the development of updated strategies and enabled noteworthy enhancements to our service delivery system. Through all of these reforms, we have been able to make measurable improvements in the experience of interacting with DBHDD and our community service providers.
Since 2011, our system has had an infusion of $256 million dollars—more than any other state in the country. Through the generosity of Governor Nathan Deal and the Georgia General Assembly, we have used this funding to make significant improvements across our system.
In behavioral health, we transformed our safety net into an accountable, community-based, recovery-oriented system of care. We tiered our provider network, clarified standards, implemented key performance indicators, and reformed our funding structure to incentivize productivity. In 2009, we didn’t have assertive community treatment, behavioral health crisis centers, mobile crisis, supported housing vouchers, or supported employment. We have also expanded peer support to include youth, parent, and forensic services. Today, we have built a broad statewide behavioral health service continuum. We have more work to do, and we believe we have the vision, the support, the skills and partnerships to keep growing.
In intellectual and developmental disabilities, we have developed a system that is more individualized and responsive, and promotes independence. We have redesigned our waiver program to serve people in the most flexible and integrated manner possible. We’ve added intensive case management, and enhanced support coordination, supported employment, and community and family support. We have also expanded self-directed services, transformed nursing services, added nutritional services, and created high-risk surveillance to monitor people’s health and wellness in the community. In both behavioral health and intellectual and developmental disabilities, we have engaged with providers, advocates, families, and stakeholders, and the people we serve throughout our transformation so that our work truly reflects what is needed.
At the enterprise level, we implemented a reorganization to modernize our internal structure. We have centralized and functionally aligned our field offices and central office, and we increased oversight of our hospitals through governing body. We have maintained experienced, capable, and passionate leadership teams across our hospital system. We contracted an administrative services organization to streamline administrative functions with better tools to manage system use and performance. We continue to improve these elements. Our internal offices of Information Technology, Learning, Legal Services, Budget and Finance, and Facilities Management have made significant shifts in their focus on serving their customers within the department; and our Office of Public Affairs led a brand refresh to update our logo and branding in a way that truly reflects DBHDD’s professionalism and values. We have a smart, engaged board that provides support, guidance, and perspective on our mission and plans.
Finally, we have focused on staff development to make DBHDD an exciting place that people want to work by offering a number of great opportunities like the Strengths Deployment Inventory (SDI) and the Management Academy. We did this because our employees matter. You matter. Your experiences in your jobs and with each other influences your work and your heart for service. I am so proud to represent what we have achieved and our commitment to continuous improvement.
This is who we are. This is what we do. This is our story.
I hope you will join me in telling it and celebrating all the work you have done to transform our system for the people we serve.
The 2018 Legislative Session adjourned at the end of March, and I am pleased to report that it was a successful Session for DBHDD. We are very grateful to Governor Nathan Deal and the Georgia General Assembly for their generous support of our mission through the FY 2019 budget. I invite you to read DBHDD’s Gold Dome Report, which highlights key funding and legislation affecting our department and the people we serve.
During the Session, DBHDD’s essential work continues. As you know, we have led a dramatic transformation in the last decade, shifting from a system that is over-reliant on hospital-based care to a community-based and recovery-oriented system of care. The evidence of this transformation can be seen in many communities around the state. That said, our five state hospitals still play a critical role in our service continuum. As our community service system expands, our hospitals will be reserved for two populations: First, individuals with long-term chronic mental illness who cannot be adequately treated in a community-based setting; and second, the growing population of individuals with mental health needs who have forensic status, meaning that they are involved with the judicial system. These individuals may have a short- or long-term stay with us as the court determines their ability to return to a community setting. DBHDD embraces the dual responsibilities of protecting public safety and creating an environment that fosters recovery for each individual in our care.
Given our commitment to wellness, I am proud to announce the March 16, 2018 opening of the new Center for Wellness, Hope and Learning at Central State Hospital in Milledgeville, Georgia. The center consolidates the hospital’s treatment mall services into one innovative, state-of-the-art facility designed to support recovery in an education-like environment.
The new center demonstrates the considerable strides Georgia has made in forensic services, signifying a shift from an institutional model to one that is based on recovery. In February, I announced DBHDD’s new policy on Recovery, Wellness, and Independence as a cornerstone in our commitment to the people we serve. The Center for Wellness, Hope, and Learning embodies the goals and values articulated in this policy.
The center follows a recovery model focused on hope, wellness, respect, and self-responsibility while helping people learn practical skills that prepare them for a life beyond the hospital. The space is serene and inviting, featuring large windows, open hallways, and an emphasis on natural lighting. The décor is comfortable, visually appealing, and creates a pleasant atmosphere in which individuals can learn and grow. Retractable walls allow for a large common space to be divided into two, three, or four classrooms for multi-functional use. An apartment-style classroom creates a real-life environment where people can learn the skills of independent living.
We envision that recovery is possible for every person who comes through our door. The center’s thoughtful and detailed design is modeled after a community setting. Here, individuals can develop independence while learning how to be safe and how to interact with others, so that they can thrive in the community. This is a place where hope begins.
Quick Facts about the Center:
Many of our DBHDD colleagues played a part in the realization of this remarkable facility. I want to specifically acknowledge Dr. Karen Bailey, Statewide Forensic Director; Susan Trueblood, Central State Hospital Administrator, and the CSH team; and Greg Hoyt, Director of Hospital Operations. None of this would have been possible without the generous support of Governor Deal and the General Assembly, who are deeply committed to the people we serve, as well as local public officials who support DBHDD’s vision and mission.
Check out the photos from the center’s ribbon cutting!
Judy Fitzgerald, Commissioner
Cassandra Price speaking at Attorney General Chris Carr’s Statewide Opioid Taskforce meeting, held at Atlanta Technical College
Customer love fuels Slalom’s day to day and speaks to a two-way relationship that can impact all involved on both a professional and personal level. Because of customer love, Slalom consultants are excited to go to work and their clients like working with them. Slalom had a long history of celebrating their internal accomplishment and their people, and the time came for them to celebrate those clients that bring out the best in Slalom. So they thought it was only fitting to recognize their clients that best support them in creating a culture of customer love.
With great pleasure Slalom announced the inaugural annual Atlanta Slalom Customer Love Award that will be presented to an individual that has served as a model client in terms of their engagement of Slalom and their people. This award recognizes a client with a proven track record of working with Slalom and creates an engagement environment that allows Slalom to fully showcase their core values.
This year Slalom had a very strong list of finalists from their clients throughout Atlanta that were reviewed by their selection committee and with great pleasure Slalom Atlanta announced their 2017 Customer Love Inaugural Award winner, Doug Engle of the Georgia Department of Behavioral Health & Developmental Disabilities.
Congratulations Doug on being selected for this prestigious honor by Slalom as you are most deserving of the award and recognition!
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