Probably fewer still are aware Dr. Shelp recently dropped the second shoe, announcing the closing of the facility caring for the developmentally disabled at Central State Hospital in Milledgeville, laying off 280 workers atop the 60 who had already left knowing this was coming. That’s far less than the 750 terminated at the now-empty Rome campus with its 70 buildings. Even so, Central State, once the main “mental hospital” in Georgia, is now down to a nursing home and “forensics unit” — that means those put there by the court after committing crimes. Rome had one of those, too, but they even shut that one down and relocated the population.
All this, of course, is part of the Shelp-directed strategy to move most mental-health treatment from institutional to “community-based” care — sometimes privately operated — in the wake of a U.S. Justice Department investigation, and subsequent settlement, that found Georgia’s hospital system had large amounts of unreported and uninvestigated and unprosecuted homicides, sexual assaults and so forth occurring inside them.
IN THEORY, community-based treatment for the developmentally disabled as well as the mentally disturbed should work better — or be more humane — than “caging” even with doctors and nurses in attendance. Most who toil in this area do so for all the right reasons and have great concern about protecting and defending those, who by the very definition of their illness, are unable to do so for themselves. This, alas, is also an area where not even a single exception to that rule of caring can be tolerated no matter who the provider is.
In the end, it all depends on whether the public, and/or the state bureaucracy, is paying close and constant attention. Plainly, when it takes the FBI poking around to discover problems right under the state’s nose the current scattering of this population to hundreds of locations/homes instead of their being treated in a handful does little but hamper any federal investigators, journalists, advocacy groups who seem to have been the only ones watching a problem not unique to Georgia.
Thus, whether the changes have or have not been working well can only be judged by Shelp and his employees bragging upon themselves. He recently reported that Northwest Georgia now had half as many new mental patients appearing than before and treatment costs had been sharply lowered. That need not mean better; it could mean reduced access. As to whether the transferred patients are dead or alive, or now homeless instead of in home-like settings, is unknown.
THAT’S NOT to say anything is amiss. It is only to repeat the observation made by this writer and others since the changeover began: Where’s the system for keeping a close and constant eye on how all the individuals being helped/treated/housed at state/federal taxpayer expense are doing?
There frankly should be something akin to the juvenile-justice system’s guardian ad litem, except not limited to legal matters: one-on-one constant oversight and ability to act on behalf of the client.
Unfortunately, what the public doesn’t know can hurt it or at least warp its understanding of what is going on.
There may be no better example than Dr. Shelp himself. For example, did he quit after three years of great success or was he pushed? Information about his time in office is not well known and, like specifics regarding the developmentally disabled and mentally disturbed, has been largely kept out of public sight — in one instance it required reading a newspaper in California to find out!
There certainly are questions worth pursing about the switch to community-based care itself, including the policy of limiting group homes to four patients thus avoiding the “institution” category ... and most local zoning laws and “not in my backyard” protests. However, here are a few things most readers, and even those former NWGRH employees still looking for work, may not know about Shelp’s tenure that could cast a different light on what’s going on — as also might be the case if there were more information about how the relocated clients themselves are doing.
CURRENTLY in Illinois there is an uproar because it has been discovered by Belleville News-Democrat journalists that the state agency charged with preventing neglect and abuse of disabled adults living at home turns away hundreds of hotline calls each year and doesn’t investigate when such persons die after severe mistreatment because — seriously! — its legislative authority is limited to living persons.
It appears there have been 53 such uninvestigated deaths in Illinois since 2003 just of those taken to hospital emergency rooms even though the Office of the Inspector General for the Illinois Department of Human Services has 53 employees and an annual budget of $5 million.
As for what’s possible to uncover in stray corners of the media/internet regarding Shelp, a geriatric (old folks) psychiatrist from Virginia: He was hired for $225,000 a year, plus a $22,500 signing bonus, plus $2,000 a month for rent. He’s been running up about $12,000 a year in travel expenses and flying home on weekends to keep oversight of the Methodist retirement center where he is a paid consultant. He openly ignored Gov. Nathan Deal’s policy banning state officials from being wined and dined by those they were doing business with ... such as giving out those “community-based” contracts.
State Rep. Keith Heard, D-Athens, has been all over Shelp for more than a year — to this lonely watchdog’s considerable credit. Among his discoveries were the payment of 46 bonuses ranging from $1,034 to $22,000 to employees for taking jobs from filing clerk on up, all paid outside normal procedures, and the suspension and later demotion of an employee who blew the whistle about other goings-on including improper use of department funds, excessive billing practices, violations of state policies resulting in waste and fraud — all of which resulted in no corrective action taken.
HOWEVER, MOST interesting due the timing of the resignation was that California newspaper report. The Los Angeles Times story began: “A consultant who led the troubled effort to overhaul California’s public psychiatric hospitals has played a lead role in federal reforms in at least five other states, where critics have raised similar concerns about cronyism and the quality of his work.
“Nirbhay Singh, a psychologist from Virginia, abruptly resigned from his California post last year after The Times asked state officials about rising violence in the hospitals and the state’s hiring of Singh’s family members.”
One of those states was Georgia, where the paper reported:
“In 2010, officials in Georgia awarded Singh a no-bid, $3.5-million contract to reform seven mental hospitals and allowed him to hire staff through American Health and Wellness Institute, a company owned by Singh and his son and run by his daughter-in-law.
“Two former employees of the firm said they were told by higher-ups not to provide guidance to hospital caregivers but simply to fill out checklists gauging their performance.”
That story appeared out West on June 17. On June 22 Dr. Shelp announced his pending departure, saying it was time because he had successfully completed his mission.
That there is smoke rising in the vicinity of state bureaucrats or operations is hardly a novelty. Much of the public has grown to believe that some portion of the government is always burning.
The true concern should be, and always must be, in regard to what is happening to the patients/clients who are possibly even unaware if they are being mistreated/abused, certainly incapable of objecting or telling their stories without outside assistance.
WHEN GOVERNMENT fails to operate as it should, taxpayers are always the victims. The innocent/helpless in our society never should be.
And, most disturbing of all given how hard to find and near-invisible such disturbing information tends to be, is this question all of us need to ask ourselves: Is it that we can’t afford to properly help this always-there part of our society or ... don’t we care?