Earlier this year, I shared the story of DBHDD’s transformation from a system that was inconsistent and fragmented to an accountable and transparent continuum of care for all people we serve. While this dramatic transformation has unfolded over the last decade, the past year has been marked by an intensification of progress. As 2018 comes to a close, I would like to thank all of you for the passion and partnership that characterize the following highlights of Georgia’s achievements.
Children’s Mental Health
Last year, I had the honor of serving as co-chair of Governor Deal’s Commission on Children’s Mental Health. We made eight recommendations to the Governor and General Assembly, including strategies for enhancing school-based mental health services, crisis services, suicide prevention, education and prevention of opioid use, telemedicine infrastructure, and training on evidence-based practices. In March, Governor Deal and the General Assembly invested more than $20 million to accomplish goals in each of these critical areas.
Recovery, Wellness, and Independence
For DBHDD and our hospital and provider community, our mission is to facilitate recovery, wellness, and independence. These three tenets drive our purpose, and this year, we codified our commitment in policy to deliver a clear message about who we are and what we do. The policy articulates our belief in the principles of self-determination, freedom, and personal responsibility as
Intellectual and Developmental Disability Planning Lists
In 2016, we began reviewing our approach to the I/DD Planning list to ensure that individuals with the greatest level of need were prioritized, regardless of their location in the state. Since then, we have adjusted outdated staffing patterns and adopted new tools and technology to support more consistent and sophisticated analysis of changing needs and to improve access and communication. For more information, please see our Multiyear Planning Lists Strategic Plan.
Center for Wellness, Hope, and Learning
In March, we opened the new Center for Wellness, Hope, and Learning at Central State Hospital. The center consolidated the hospital’s treatment mall services into one innovative, state-of-the-art facility designed to support recovery in an education-like environment. 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. Each of our hospitals
DBHDD as a Learning Organization
One of the things that set’s DBHDD apart is our commitment to embody the principles of a learning organization. We believe that team members should have opportunities to grow and develop through awareness of self and others.
Our Office of Human Resources and Learning supports our evolution as a learning organization by working to ensure that we have a skilled, trained, engaged, and high-performing workforce to meet the needs of the people we serve. Our suite of development opportunities includes a new model for hospital staff orientation, training programs for our staff and community providers, learning systems and content development, and a Management Academy for emerging leaders. We are also training our team members in the Strengths Deployment Inventory (SDI) to enhance our effectiveness through improved communication. As we strive for excellence in all we do, we want DBHDD to be a place where meaningful and
Fighting on the Front Lines of the Opioid Epidemic
As Georgia’s opioid authority, DBHDD is responsible for the prevention, treatment, and recovery elements of our statewide response to the opioid epidemic. In 2017, we received SAMHSA’s two-year State Targeted Response (STR) to the Opioid Crisis grant ($11.8 million per year), which we have put to work providing naloxone training and kits, public services announcements, expanded medication-assisted treatment (MAT) programs, a peer warm line, recovery coaches for emergency departments, and education for providers.
In September of this year, we were awarded SAMHA’s State Opioid Response (SOR) to replace the STR funds which end in April 2019. The SOR grant provides $19.9 million per year for two years and will allow DBHDD to expand and sustain the work set in motion through the STR grant.
In addition, we received $4 million in new state funding (FY 2019) to support statewide implementation of Addiction Recovery Support Centers, an essential, peer-led element of the recovery continuum. We also engaged with the Georgia Department of Public Health to develop Georgia’s Opioid Response Strategic Plan, and we serve on Attorney General Chris Carr’s Statewide Opioid Taskforce.
Information Technology Transformation
In the last five years, our information technology (IT) system has profoundly transformed. DBHDD’s IT improvements are not just about new software and gadgets. We have enhanced security, provider data, technology supporting clinical oversight for high-risk individuals, forensic evaluation tools, employee support, application development
With the alarming statistic that suicide is the second leading cause of death among individuals between ages 10 and 34, suicide prevention is one of DBHDD’s top priorities. We use a data-driven approach to facilitate suicide prevention coalitions that work with faith, business, and civic leaders, and community service boards and other local providers to train and educate. This year, we supported training of approximately 600 providers and community members in two proven gatekeeper suicide programs: Question, Persuade, and Refer (QPR) and Mental Health First Aid (MHFA). Each of us has a role to play in suicide prevention.
If you are concerned about someone who may be considering suicide, remember these four action steps: ASK-LISTEN-STAY-HELP. Ask openly and compassionately, ‘Are you thinking about suicide?’ Listen to the person without judgment; avoid trying to ‘fix it.’ Stay with the person if he or she is suicidal; keep him or her safe until help arrives. Help him or her find the right kind of help. Call the Georgia Crisis Access Line (GCAL) anytime at (800) 715-4225.
Speaking of our GCAL line, we await the implementation of an “app” that will extend outreach through texting.
As you can see, we have had a busy year! All of these accomplishments are possible because of our great team, our provider network, and the generous support of Governor Deal and the Georgia General Assembly. Expect this progress to continue at warp speed as Georgia’s needs are pressing, and our perseverance is relentless.
If you would like to learn more about any of the highlights above, please visit our blog.
Commissioner Judy Fitzgerald
This Veterans Day, as we pause to pay tribute to the men and women who bear the burden of safeguarding our freedom, we must ensure that our gratitude is extended to all veterans, including those who struggle to cope right here at home. Georgia is home to more than 700,000 veterans. Many of these men and women are strengthened by their service and are vital members of our communities. But we also know that some have difficulty adjusting. It is estimated that one in five post-9/11 veterans struggle with post-traumatic stress disorder or major depression, and one in six has a substance use disorder. In 2014, the Veterans Health Administration reported that 20 percent of suicide deaths in the U.S. occur by veterans, and approximately 22 veterans die by suicide every day. These numbers are both alarming and tragic.
As your Commissioner, I would first like to acknowledge the veterans who serve on the DBHDD team and in our provider network, including our Medical Director, Dr. Emile Risby, who retired after 31 years of service as a Colonel in the U.S. Army Reserves Medical Corps. We are so proud of our veteran service members. Second, I am pleased to share some of the work that has occurred over the last ten years to help provide Georgia’s service members, veterans, and their families with the support they need and deserve to begin their process of recovery.
In 2008, DBHDD spearheaded the Georgia Operation Enduring Freedom/Operation Iraqi Freedom Veterans State Action Plan. This brought vital stakeholders within the Armed Forces, treatment providers, and suicide prevention and recovery communities together to address the behavioral health needs of Georgia veterans. That same year, Georgia was one of six states to receive SAMHSA funding for a grant entitled “Jail Diversion and Trauma Recovery – Priority to Veterans.” Through this work, DBHDD implemented jail diversion programs for veterans with post-traumatic stress disorder and other trauma-related disorders. This pivotal work was instrumental to the now 13 Veteran Treatment Courts throughout the state. These are specialty courts created specifically for veterans who struggle with behavioral health challenges and are involved in the criminal justice system. We collaborated with various other criminal justice agencies to ensure that professionals around the state received invaluable training on the unique needs and challenges of this population.
In 2012, we partnered with the Georgia Army National Guard and scaled the STAR Behavioral Health Program to train approximately 1,800 providers throughout the state to specialize in understanding and treating military service members and their families. We continued our work with the Georgia Army National Guard and developed the Substance Abuse Treatment Initiative (SATI). SATI provided a continuum of substance abuse services which included prevention, assessment, counseling, and other treatment services to soldiers who needed assistance during challenging times. As the state behavioral health authority, we continue to lend our expertise as part of the Georgia Department of Veterans Service’s Returning Veterans Task Force and countless other statewide initiatives focusing on veterans in the criminal justice system and trauma-informed care for veterans.
I am proud of DBHDD and our providers for the work done in the past, present, and future to support our service members, veterans, and their families. As we prepare to host the 2019 Unspoken Wounds Conference: One Team. One Battle. Many Victories!, the focus will be on evidence-based practices and innovative strategies to continue our work serving the needs of this population. This conference is scheduled for March 17-19, 2019, in Columbus. This powerful three-day event brings together hundreds of stakeholders from the public and private sectors to share their expertise and their experiences working with service members, veterans, and their families. Check our website in the coming months for additional details.
To the many veterans and service members across Georgia, I offer my humble gratitude for your sacrifices and contributions to our nation. On this and every day, we support you.
Help for all Georgians is just a call away through the Georgia Crisis and Access Line (GCAL) at 1 (800) 715-4225.
Walker Tisdale, Director of Suicide Prevention, was interviewed on WJZA 101.1 FM’s show “Sunday Conversations” to bring awareness to the epidemic of suicide currently happening in Georgia and beyond. Tisdale also led the 8th Annual Georgia College and University Suicide Prevention Conference (pictured below) on September 24 and 25.
Region 4 Recovery Workshop
Highland River’s Women’s Outreach Program 20th Anniversary
OIT receives the Technology Innovation Showcase Award from GTA
Greetings! It’s finally Fall, even if it doesn’t feel like it outside. While it may still be a while before we have sweater weather, this is the season when we start reflecting on the past year and drawing closer to our family and friends. It’s also the time when we think more about giving. And it’s time once again for Georgia’s annual State Charitable Contributions Program (SCCP). This year’s theme is, Shaping Our Future Through Giving.
In addition to the honor of serving as your Commissioner, I am privileged to serve as Chair of the 2018 campaign. I have embraced this role with enthusiasm because of one known truth: our team at DBHDD is generous. Every day, I see you serving people and demonstrating kindness in both large and small ways. I am proud to work alongside you, and I want to extend my heartfelt appreciation for your tireless service to our state and the people who live here, our neighbors.
In my role, I am able to connect with thousands of public servants across Georgia and witness the difference each person makes. The work of DBHDD touches thousands of lives, and yet so many more in Georgia have unmet needs that can be supported by local and statewide charities.
As SCCP Chair, I am counting on our team. For DBHDD employees, who already do so much for the people we serve, this is an opportunity to extend our goodwill further throughout Georgia and the world. We know that Georgians count on us each day to deliver essential services in all corners of the state. Our work is challenging, and also rewarding, and it is easier to make progress when our economy is strong, and people are optimistic about the future.
So I ask you, please. Please consider contributing. Even a dollar per pay period can make a real difference to someone who needs it. Please join me in setting a goal of 100% participation by DBHDD employees. No amount is too small for you to be a part of this important effort.
If you are ready to make the commitment, simply click this link through October 31, and follow the prompts. You will see how easy it is to select organizations or causes of your choice, and let them know that you value their work with your giving. Your contribution matters.
Inspired by Robert T. Bennett, a small act of kindness can light a candle in the darkest moments of someone else’s life. Thank you for your support. I look forward to joining you as together we kindle the flame of generosity.
Commissioner of DBHDD and Chair of the 2018 State Charitable Contributions Program
Greetings, DBHDD supporters! September is Suicide Prevention Awareness Month, and this is an especially important issue to discuss right now. In fact, talking about suicide out loud—regularly, repeatedly, and thoughtfully—is part of the solution. I’ll say more about what YOU can do regardless of your age, skill level or background. But first, let’s remember what we ALL can do, and that is to offer a message of hope. Each life matters, and we know that help is available. We also know that treatment for issues related to mental health and addiction can save lives. Hope comes in the form of the Georgia Crisis and Access Line (GCAL). In every way possible, please share the number: 1-800-715-4225 to increase awareness of the support that is available 24/7 statewide.
Now let’s talk about what DBHDD is doing in response to the fact that suicide rates have increased at a disturbing rate across the country. Suicide is the second leading cause of death among individuals between ages of 10 and 34. Our alarm and concern must be grounded in an evidence-based, multi-tiered approach that reaches individuals, families, caregivers and communities, and uses public policy, education, prevention and intervention strategies, and community planning to confront this problem. Using research data to drive priority target populations and geographic areas, we facilitate suicide prevention coalitions that work with faith, business, and civic leaders alongside community service boards and other local providers to disseminate education and training and to promote access to GCAL and community-based services. If the tragedy of suicide occurs, our partners work to mitigate the risk of contagion by providing grief support, making physical contact for emotional respite, and most importantly, helping reduce the stigma of mourning the loss of a loved one by suicide.
Through a network of suicide prevention experts, DBHDD supports training and technical assistance to grow professional and organizational capacity building, so that providers can offer 21st century suicide prevention support; address the most complex cases of mental health and substance abuse disorders; and ensure that more Georgians who are at-risk for suicide behaviors are screened and connected to care.
So far in 2018, through our collective internal and partner efforts, approximately 600 providers and community members have been trained in two proven gatekeeper suicide trainings: Question, Persuade, and Refer (QPR) and Mental Health First Aid (MHFA). Additionally, DBHDD supports evidence-based and best practices to target suicide screening and interventions for vulnerable individuals, such as youth and young adults; people with specific mental health diagnoses, substance use disorder history, chronic health conditions; and those with prior documented attempts. A focused statewide effort includes collaborating on multiple levels in all six regions of the state, working with community service boards, the Georgia Department of Education, colleges/universities, civic organizations, law enforcement, public and private clinicians, community groups, suicide survivors, and many, many other stakeholders.
It’s important to understand that when it comes to suicide prevention – there is something YOU can do. If you are concerned about someone who may be considering suicide, remember these four action steps: ASK-LISTEN-STAY-HELP.
Ask openly and compassionately, ‘Are you thinking about suicide?’ Listen to the person without judgment; avoid trying to ‘fix it.’ Stay with the person if he or she is suicidal; keep him or her safe until help arrives. Help him or her find the right kind of help. Call the Georgia Crisis Access Line (GCAL) anytime at 1-800-715-4225. Together, we have the power to decrease the prevalence of suicide and reduce its devastating impact on families and communities in Georgia.
By now, you’ve probably heard me talking about our remarkable transformation story. You’ve heard me brag on our talented and dedicated team at 2 Peachtree, in our regional field offices, and our state hospitals, as well as in our network of community-based providers. If you were part of our system in 2009, you remember that Georgia’s public safety net was inconsistent, fragmented, underfunded, outdated, over-reliant on hospitals, and lacking capacity to serve people in the community. In a word, it was broken.
Today, after a decade of transformation, DBHDD is a consumer-focused, innovative, and responsive leader in behavioral health and intellectual and developmental disabilities, both in Georgia and across the nation. In my May column, I highlighted many changes to our community service delivery system, managed by our Divisions of Behavioral Health and Developmental Disabilities. Today, I want to talk about a less visible but no less significant piece of our transformation: our information technology system.
The health care environment of the future demands modern technology and a nimble workforce that can adopt new and evolving digital skills. Under the leadership of our Chief Information Officer Doug Engle, DBHDD has embraced a state-of-the-art approach to information technology. DBHDD’s Office of Information Technology (OIT) supports our 5,000 employees working in the state office, our six regional field offices, and our five hospitals. While you may not think about IT unless you have a problem with your computer, their work undergirds everything that we do.
In the last five years, our IT system has profoundly transformed. IT improvements are not just about new software for staff. They are directly leading to efficiencies and better care for the people we serve. You don’t need a technology background to understand how DBHDD’s many IT advancements are making it easier for us to do our jobs and to support easy access to high-quality care for everyone who is touched by our department.
Below are just a few of the advancements that are in progress or will be launched soon.
- An enhanced cybersecurity policy protects the confidentiality, integrity, and availability of our systems, networks and data, and helps staff recover their business processes after computer or network security incidents.New cyber incident response teams provide a quick, effective, and orderly response to computer-related incidents, such as viruses, hackers, or the improper disclosure of confidential information.
- The Office of Provider Certification and Service Integrity under the Division of Accountability and Compliance now uses an integrated platform for collecting, tracking, and reporting provider assessments, as well as resolving any issues identified in the assessments. This platform makes the provider review process more efficient by automating reporting and consolidating data. It significantly reduces the amount of time spent on almost every step in the process. It also provides easy access to reports and analytics, helping us meet our goal of ensuring high-quality care across our entire provider network.
Clinical Oversight for High-Risk Individuals
- The Office of Health and Wellness’ Statewide Clinical Oversight Application is a web-based tool used to document and track events/incidents for high-risk individuals with intellectual and developmental disabilities (IDD) receiving Waiver services. It supports the timely, systematic, and comprehensive attention necessary to adequately resolve or address identified events/incidents with the goal of reducing morbidity and mortality risks. The tool enables:
- Increased visibility and accountability on all oversight processes statewide;
- Improved collaboration and communication among; and
- Data-driven decision making through centralized and standardized data collection.
IDD Service Review Technical Application (SRTA)
- The SRTA applications helps 30 evaluators track more than 200 health, wellness, and safety data elements of more than 400 high-risk individuals with intellectual and developmental disabilities who have been transferred from our hospitals to a community residential setting.
Forensic Evaluation Logistix
- The Office of Forensic Services has been working closely with OIT to develop a new web-based tool to document and manage court-ordered competency evaluations and the assignment of the evaluations. The Forensic Evaluation Logistix (FELIX) application will facilitate collaborative and timely management of competency evaluations. This is being achieved through increased visibility of all court-ordered competency evaluations and annual evaluations within a single application. Through the consolidation of forensic evaluation data collection, there will be improved dashboards, reporting, and oversight. In return, the Office of Forensic Services will have an application that enables data-driven decision making and accountability. The FELIX application is planned to be released this month.
- The new work request management tool uses a ticketing system to track and monitor computer- and technology-related issues for employees, so that they can be resolved in an organized and timely manner. It also provides metrics to allow OIT to see where and how frequently various issues occur. DBHDD staff can submit work requests through the OIT homepage in SharePoint.
- OIT developed an application to identify and track DBHDD hardware assets and locate them quickly if lost or stolen. This helps ensure that protected health information and other confidential material is secure. The application also enables more efficient updates. The use of this application has reduced monthly billing costs by $10,000, and led to a 17 percent decrease in assets not in use and a 65 percent decrease in reserve assets.
While the benefits of DBHDD’s IT enhancements are felt across our department, many efforts been targeted around helping our hospitals improve patient care.
- A new fiber network and other enhancements, including the addition of campus-wide wireless Internet, have been piloted at Georgia Regional Hospital-Atlanta with future expansion planned for other hospitals.
- OIT continues to work with our business partners to provide refreshed and up-to-date laptops, tablets, and desktop computers across our agency.
Application Development and Support
- OIT has developed, and continues to develop or enhance, several hospital-based applications, including Avatar, our electronic health records system. Future Avatar modules will be able to quickly and securely exchange referrals with external provider organizations; send and receive clinical data, lab results, and treatment plans; and incorporate external data directly into individuals’ medical charts.
Patient Care Enablement Project
- This initiative improves care by fostering an environment in which staff are informed, connected, and accountable by creating standardized workflows and training modules; communication and on-the-job skill development; and the ability to measure the adoption rate of these new features by staff.
Hospital and Enterprise Reporting
- An enhanced data reporting system provides reliable reports via a simple tool that allows fast and easy access to information, as well as the ability to monitor individuals (including those at high risk), pinpoint data input and timeliness issues, and collect relevant information for decision making. The system also standardizes required data collection across our hospitals.
I am so proud of our OIT staff and the many technological enhancements they have brought across our system. While these efforts certainly make it easier for staff to accomplish daily work, the real impact is on our ability to provide more efficient and responsive care to the people we serve.