Category Archives: mental health

Judge hears objections to closing Greene Valley Developmental Center

In a federal court hearing at Nashville Wednesday, there were impassioned objections to the state’s plan to close Greene Valley Developmental Center from relatives with disabled loved ones still living there, reports The Tennessean.

Four guardians of residents living in Greene Valley have hired an attorney, who on Wednesday asked that the court allow them to intervene in the case.

U.S. District Judge Kevin Sharp said he will rule next week on whether the guardians can legally intervene. He will also rule on whether to approve an “exit plan” from the lawsuit that includes the plan to close Greene Valley as well as institute other changes in the way the state cares for people with intellectual disabilities.

But lawyers for the state told the judge that while his approval is needed to end the long-running court case, the decision to close Greene Valley ultimately lies with the state.

… The plan to close Greene Valley is part of an overall agreement to end nearly 20 years of federal court oversight over two large institutions operated by the Department of Intellectual and Developmental Disabilities. A second institution, Clover Bottom Developmental Center in Nashville, is scheduled to close in June.

A federal court has been overseeing the facilities since the Department of Justice first filed suit in 1996 over deplorable conditions inside the state’s institutions for people with intellectual disabilities, defined as possessing an IQ of 70 or less.

The plan to shut down Greene Valley emerged unexpectedly earlier this month, taking many guardians by surprise.

But it comes many years into a national movement to end the practice of caring for people in large asylum-style facilities and integrating them into neighborhood homes. For decades, Tennessee officials have slowly transitioned residents form large institutions into small group homes or four- or eight-person medical facilities.

“This should come as no real surprise to anyone because in many respects that institution has been closing since the 1970s,” said Jonathan Lakey, an attorney for the state.

At its peak, 3,200 people lived in state institutions, but today just 96 remain at Greene Valley and 20 at Clover Bottom. The cost of providing care to so few in institutions built to serve hundreds has become “economically prohibitive,” Lakey said.

State plans closing of Greene Valley Developmental Center

GREENEVILLE, Tenn. (AP) — State officials have agreed to close a large facility in East Tennessee that houses mentally disabled people, but local officials say they will argue to keep it open.

The Department of Intellectual and Developmental Disabilities has submitted a plan to shut down Greene Valley Developmental Center by next June and move its nearly 100 residents into more home-like settings. According to media, the move would end a lawsuit filed against the state in 1995 over its care of mentally disabled people.

Tennessee Disability Coalition assistant director Donna DeStefano said the organization has pushed for more than two decades for people with intellectual disabilities to be moved into more community-like settings.

“People with all types of disabilities belong in the community with family and friends,” she said. “In institutions, staff are paid to be there. What happens is that everybody the person with disabilities knows is paid to be there. That’s an unequal relationship. In the community, it can be more equalized.”

Some in Greene County object to the proposal because they say the facility cares well for its residents, and it would put 600 people out of work.

“The concern of Greene Valley and Greene County communities is about the welfare of the residents currently living in Greene Valley,” said Rep. David Hawk, a Republican from Greeneville. “These residents are the most medically and mentally fragile Tennesseans. It’s going to be difficult to find care for those individuals outside the setting of Greene Valley.”

Family members “do not want their loved ones to leave,” he said.

A federal judge must decide whether to approve the plan. A hearing in the case is set for Jan. 21 in Nashville.

State gets $5M in federal suicide prevention grants

News release from state Department of Mental Health and Substance Abuse Services
NASHVILLE – Tennessee Department of Mental Health and Substance Abuse Services has been awarded two federal grants totaling nearly $5 million dollars, to reduce the rate of suicides in the state. The funds, from the United States Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA), will be focused on preventing suicides statewide.

“The rate of suicides in Tennessee has been steadily increasing since the late 1980s,” said E. Douglas Varney, Commissioner, Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS). “Suicide is a serious public health problem and a subject people are still very hesitant to talk about. These grant awards will allow us to address this threat and save lives.”


Adults 25 to 34 year olds: Suicide is the 2nd leading cause of death

Youth 10 to 24 years old: Suicide is the 3rd leading cause of death

Adults 35 to 64 years old: Represent 70% of all suicides in 2010

“For every death, there are 8 to 10 suicide attempts,” said Melissa Sparks, Director of Crisis Services at TDMHSAS. “Our goal is zero suicides in Tennessee with a focus on reducing suicide attempts.”

Educating mental health providers statewide is key to preventing suicides in Tennessee. By training more professionals to identify people who may be in crisis and potentially suicidal, there is more opportunity to intervene and save lives.

“Many people contemplating suicide are dealing with a lot of untreated depression,” said Sparks. “We look to collaborate with medical professionals across the state, to connect those in crisis with behavioral health services and get them the help they need.”

Tennessee, New York, New Mexico and Oklahoma are the only four states to receive a federal grant for adult suicide prevention.

For help in Tennessee, call the 24/7 REDLINE at 1-800-889-9789.

TN has more people abusing prescription drugs than alcohol

News release from state Department of Mental Health and Substance Abuse Services:
NAsHVILLE – Abuse of prescription opioids, ie: pain medications, is the number one drug problem for Tennesseans receiving publicly funded assistance for treatment services. Over the past decade, substance abuse admissions for prescription drugs like: hydrocodone, oxycodone, morphine, and methadone have increased 500%.

The situation has dramatically driven admissions to treatment facilities way up, from 764 in 2001 to 3,828 admissions in 2011.

“As of July 1, 2012, the number of admissions in our state for prescription drug abuse exceeded admissions for alcohol abuse for the first time in history,” said E. Douglas Varney, Commissioner of the Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS).

According to a 2010 National Survey on Drug Use and Health, more than 4% of Tennessean’s over the age of 18 and approximately 12% of 18 to 25 year olds reported using pain relievers recreationally in the past year.

“Many people needing substance abuse treatment are not getting the help they need,” said Commissioner Varney. “And of the number of Tennesseans who could benefit from treatment, only about one person in eight actually received it.”

treatment is effective and saves money

Substance abuse treatment offers both a benefit to those who receive it and a savings to communities.

“The greatest savings is a reduction in the cost of crime for law enforcement, general healthcare costs, court and victimization costs and increased employer earnings,” said Commissioner Varney. “And the gain can also be measured in lives saved from a premature death.”

In 2010, Tennessee’s 1,059 recorded drug-overdose deaths add up to an estimated 7,000 years of life lost, and a loss of earnings of approximately $238 million.

“We all pay a price when someone needing substance abuse treatment doesn’t get the help they need,” said Commissioner Varney.

Mental health facility pays $800K to settle false billing claims

News release from attorney general’s office:
The A.I.M. Center, Inc. (AIM), which operates a community mental health facility located in Chattanooga, Tenn., has agreed to pay $800,000 to settle allegations that it violated the federal False Claims Act (FCA) and the Tennessee Medicaid False Claims Act (TNMFCA). This settlement resolves an investigation into AIM’s billing practices which began with the filing of an action by a former member of the facility on behalf of the United States and the State of Tennessee under the qui tam, also known as whistle-blower, provisions of both the FCA and the TNMFCA. The United States and the State of Tennessee subsequently filed a joint intervention complaint.

As a result of a joint federal and state investigation, the government alleged in the joint complaint that, from 2009 through 2012, the AIM Center knowingly submitted numerous false claims to the TennCare/Medicaid program by overcharging for psychosocial rehabilitation (PSR) services provided to TennCare/Medicaid facility members. Specifically, the government alleged that the AIM Center engaged in a practice commonly known as “upcoding” by submitting claims for services that were more lengthy and more expensive than the services actually provided. For example, the AIM Center submitted claims for a full day (per diem) of PSR services for TennCare/Medicaid members even when the members spent as little as 5 minutes to an hour at the facility.

In addition, the government alleged that the AIM Center knowingly concealed its obligation to return funds to the TennCare/Medicaid program that were improperly paid and retained as a result of “double billing” (submitting distinct and separate claims for services that were already included in the scope of the per diem services).
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Top officials at Clover Bottom Developmental Center fired

The two top officials at Clover Bottom Developmental Center were fired Thursday and a third person contracted to provide behavioral services also was dismissed, reports The Tennessean.

The terminations follow a Tennessean story on Sunday that chronicled ongoing health and safety problems faced by the remaining 40 residents at Tennessee’s oldest institution for people with intellectual disabilities — more than four years after state officials pledged to shut it down. The Tennessean also reported on the high cost borne by taxpayers as a result of the delay in closing the institution. Tennessee taxpayers next year will foot the bill for what could be the nation’s costliest institutional care — more than half a million dollars per person living at Clover Bottom — to care for a small number of residents who have waited for years to be relocated into residential homes from a sprawling campus built to house 1,500.

Those affected by Thursday’s terminations were Chief Officer Stacey Dixon, who oversaw operations at the 90-year-old Donelson facility; Darla Goad, director of residential and case management services; and Jennifer Bruzek, who state officials said was a contract employee through Columbus, a behavioral services agency. The Department of Intellectual and Developmental Disabilities has asked Columbus for a different behavioral analyst, spokeswoman Cara Kumari said.

DIDD officials did not comment on the reasons behind the dismissals beyond a statement that read: “This restructuring will align our staffing with those in the other regions, dedicating one person to oversight of Clover Bottom and the new Middle Tennessee Homes while also dedicating an administrator specific to the Harold Jordan Center.

Audit: DIDD deputy overturned findings of misconduct in two deaths

News release from state comptroller’s office:
The Department of Intellectual and Developmental Disabilities (DIDD) must remedy serious problems in its service recipient safety practices, service delivery system, and information system implementation efforts, according to a report released today by the Comptroller’s office.

The department provides services directly to recipients or indirectly through contracts with community providers in a variety of settings, ranging from institutional care to individual supported living in the community. DIDD was serving 8,096 individuals as of May 31 of this year.

Among other findings, state auditors reported that:

· DIDD’s former deputy commissioner of the Office of Policy and Innovation improperly assumed authority to overturn two substantiated allegations of misconduct against provider employees and therefore did not intend to hold the provider accountable for service recipient deaths;

· The department did not establish appropriate safeguards to govern the background checks of DIDD employees, volunteers, or provider employees. That deficiency resulted in employees beginning work before background checks were completed, volunteers who had no background checks performed, and provider employees with disqualifying drug convictions that went undetected;

· DIDD was not providing adequate services for individuals with developmental disabilities in violation of statutory requirements and its own mission statement;

· Until top state officials find a sufficient funding solution, the high number of individuals with intellectual disabilities on the waiting list for Medicaid services will continue to plague the department; and

· Since 1994, DIDD has spent at least $4.3 million to replace its outdated information system with little to show for the expense. DIDD has estimated that it will spend another $11.8 million to complete the project.

“DIDD serves some of the state’s most vulnerable citizens,” said Comptroller Justin P. Wilson. “Therefore, the department must do its utmost to ensure the safety of each individual served and to enhance the quality of life of all Tennesseans with intellectual and developmental disabilities.”

Auditors will present their findings at a meeting of the General Assembly’s Government Operations Joint Subcommittee on Education, Health and General Welfare on October 23. The meeting is scheduled to begin at 9 a.m. in Hearing Room 16 at Legislative Plaza in downtown Nashville.

Note: The full audit — 155 pages with multiple findings — is HERE.

State Opens First ‘Recovery Court’ for Prisoners

Next month, in the quiet Morgan County city of Wartburg, the state Department of Mental Health and Substance Abuse Services, along with the Tennessee Department of Correction, will open what the state says is the nation’s first statewide residential Recovery Court, reports the News Sentinel.
The 24-hour, 100-bed facility, which opens its doors Aug. 1, will allow the state to divert people with substance abuse or mental health issues from prison beds, with the hope of halting the cycle of hospitalization, incarceration and homelessness that plagues many.
In a November budget hearing meeting with Gov. Bill Haslam, Mental Health Commissioner Doug Varney laid out such a plan as being a humane and cost-effective way to deal with what he sees as one of the state’s biggest problems. In 2011, he told Haslam, for the first time ever, the state saw more people seeking treatment for narcotics addiction than for alcoholism — and the state’s system was sorely taxed.
“A large number of people in jails … their core problem is really drug abuse,” he said. Such an intensive program could “change their (lives) before they ever get that far.”
TDOC estimates the average daily cost to house a prison inmate at just more than $67. The Recovery Court residential program, even being more service-intensive than existing programs, will cost an average of $35 per person per day, the state said. But it also will, in theory, save money by reducing recidivism — “repeat offenders” — by using “evidence-based” programs “proven to have a larger impact on reducing recidivism.”
The state said studies have shown the recidivism rate for people who participate in such programs is one-third that of those who don’t.
However, it should not been taken as the state going “soft on crime,” TDOC Commissioner Derek Schofield said.
“What it says is that we’re going to place people in the best option to ensure they don’t re-offend. But also, we’re going to make sure we have a prison bed available for people who commit violent offenses that harm our communities,” he said.

Five Mental Health Institute Workers Fired Amid Patient Abuse Allegations

Five former state employees have been accused of abusing patients at Middle Tennessee Mental Health Institute and the TBI is investigating, according to WSMV-TV.
“If those vulnerable patients are being mistreated by state employees, harmed or injured, we need action,” said State Rep. Gary Odom, D-Nashville.
…The five former employees (not named in the report) are accused of abusing two patients, one of them confirmed by the I-Team to be Matthew McDougal of Brentwood.
The termination records read that in two separate instances, once in April, and another in May, employees inflicted bodily injuries on McDougal and the other patient.
The reported abuse occurred in the forensic services program, where some of the most at-risk patients are located.
“If a patient is abused in that situation, there’s a failure of the system,” said Jeff Fladen, with the National Alliance on Mental Illness.
A spokeswoman for the TBI confirms on May 23, some 22 days after the last reported abuse, the Tennessee Department of Mental Health, which oversees the institute, asked the TBI to investigate.
The five employees were then fired the next month.

Bill Lets Mental Health Professionals Report Violence Prone People

The state Senate approved a bill Thursday that would require mental health professionals to report potential threats to law enforcement, reports The Tennessean. Supporters say the move could head off mass shootings.
Senate Bill 789 passed unanimously as lawmakers found little reason to debate a measure that tightens reporting requirements for mental health workers and the courts. The bill is part of a push — backed by gun-rights proponents and gun-control advocates alike — to change mental health laws in response to the Sandy Hook Elementary School shooting in Newtown, Conn., in December.
“Mass violence of any sort is a tragic occurrence. But the worst tragedy results when the state overreacts to a mass shooting by restricting the Second Amendment rights of the law-abiding,” Lt. Gov. Ron Ramsey said in a prepared statement praising the measure. “This bill focuses not on inanimate objects but on the very real issue of mental health. …
“By focusing on the mentally ill, we will focus on those who should not have weapons while leaving the law-abiding gun owner free to exercise his God-given constitutional right.”
The Tennessee Psychological Association supports the bill. Mark Greene, a lobbyist for the group, said it clarifies that when clients make threats to harm or kill, the police must be told, in addition to potential victims.