Mental health services in Georgia focus of state commission

The sight of the woman lying on the floor of a windowless jail cell is a something Henry County Judge Brian Amero will never forget.

Pregnant, unresponsive, off her medication and “draped in a paper robe,” the woman had been kept there for several months with scant help for her mental health issues, waiting for a probation hearing. Jail staff tried transferring her to a psychiatric facility but “no one would take her,” Amero said.

“So this is where she sits, this is where she lays, twenty-four hours a day in the dark basement of the jail, in this condition,” said Amero, one of many judges in Georgia hoping to curb how often people with mental health issues wind up in jail rather than treatment settings.

Amero is among dozens of advocates, experts and officials on a state commission studying how to improve Georgia’s mental health system, an underfunded web of agencies and local boards that serve tens of thousands of people with mental illnesses, developmental disabilities and substance addiction.

The Behavioral Health Reform and Innovation Commission held its second meeting last week after forming in 2019 to draw up solutions to the funding, workforce, care access and insurance issues that hamper the state’s mental health services.

Reversing the trend of jails and prisons acting as revolving doors for those with mental health issues is a top challenge facing Georgia’s service providers and law enforcement, both of which often lack enough resources to help people before they experience a preventable crisis that leads to arrest.

Nearly one-fourth of the roughly 53,700 people in state prisons as of January of this year needed treatment for a mental illness, said Georgia Supreme Court Justice Michael Boggs, who serves on the commission and has worked for years on criminal justice reform.

The situation is more dire at county jails such as in South Georgia’s Dougherty County, where Boggs said 209 out of 597 people housed in the jail last January needed mental health services. Those persons tend to stay incarcerated longer than other inmates, depriving them of treatment and increasing jail costs.

“Our jails become the de facto mental health institutions in a lot of our communities,” Boggs said. “It is not only morally unacceptable; it’s financially and otherwise not sustainable.

“We’ve got to do a better job of getting these individuals the treatment they need and not putting them in the county jails.”

Children also face major mental-health challenges in Georgia. Youth admissions to emergency rooms have increased 116% since 2015 with more than half of those children transferring to psychiatric facilities, said Dr. Dan Salinas, chief of community clinical integration at Children’s Healthcare of Atlanta.

Insurance red tape blocks many of those children from receiving help. Children covered under Medicaid in Georgia are often delayed or outright denied admission to residential treatment facilities after hospital stays, said Emily Acker, president and CEO of the nonprofit care provider Hillside.

Acker told commission members last week about a 13-year-old girl named “Rose” who was sex-trafficked by a parent and hospitalized 19 times between two stays at residential treatment facilities, where she was initially denied admission by a Medicaid care management organization.

“In Georgia today, it should not be so difficult to provide a child like Rose the care that she needs and deserves,” Acker said.

Collecting key data on mental health services in Georgia is also an uphill battle. Spotty data on Medicaid claims and local providers participating in state-funded programs make it tough to address care gaps, said Nicoleta Serban, a professor of industrial and systems engineering at Georgia Tech.

“Once we have a good understanding of the supply of services, we can really have a good understanding also of what is the demand that we can cover with the current supply,” Serban said. “I don’t think we have an answer to this question, and it’s a quite challenging question to address.”

Experts and commission members offered up several recommendations to bolster Georgia’s mental health system including more specialized probation supervision, alternative court programs with more treatment-focused sentencing and single-provider Medicaid management through the state.

State Rep. Kevin Tanner, R-Dawsonville, who chairs the commission, said he’ll convene members soon to draft and approve an annual report on recommendations. The commission is set to continue meeting through June of 2023.

Right to Farm debate likely to return to General Assembly

ATLANTA – A recent court ruling awarding monetary damages to neighbors of a North Carolina industrial hog farm is stirring interest among Georgia agribusiness organizations in renewing a push to update the state’s Right to Farm Act.

But the Nov. 20 judgement a federal appeals court handed down against giant pork producer Smithfield Foods also served notice to environmental groups that defeated the legislation during this year’s General Assembly session to gear up for another round in 2021.

“I think it amps up the stakes,” said Gordon Rogers, executive director of Albany-based Flint Riverkeeper, one of the groups that joined forces to oppose changes to the Right to Farm Act this year.

The bill would make it more difficult for property owners living in areas zoned for agricultural use to file nuisance suits against nearby farms generating offensive noise, dust, smells or sludge runoff.

Under an amendment to the original bill approved on the Senate floor, lawsuits would have to be filed within two years after a nuisance occurs. More restrictive language in the original legislation would have required lawsuits to be brought within two years of an applicant obtaining a permit to start or change a farm operation.

The Republican-controlled Georgia Senate passed the bill in June in a vote along party lines, but it failed to reach the floor of the state House of Representatives.

Supporters say the original Right to Farm Act the legislature enacted during the 1980s contains ambiguities that expose farmers to costly lawsuits that could be avoided by a clearer statute.

“Agriculture is our No.-1 industry,” said state Sen. Larry Walker III, R-Perry, a member of the Senate Agriculture Committee. “If companies are nervous to invest in rural Georgia because they feel our law is not strong enough to protect against frivolous lawsuits, we need to address it.”

The legislation’s opponents say it is intended to shield large industrial farms not only against lawsuits from an influx of  suburban homeowners who find farm operations offensive but even from other farmers who don’t want giant livestock operations in their midst polluting their air and water.

“Major industrial row crop farmers as well as the organic types who opposed this bill showed this mantra [the bill’s supporters] were pushing that this was good for all Georgia famers was not true,” Rogers said.

Rogers said there’s no need to update the Right to Farm Act because the original law already contains sufficient protections for farmers when neighbors who object to the sights, smells and sounds of farming move into their vicinity.

“I cannot and you cannot move next to a farming operation now and bring a complaint,” he said. “If [the farm is] already there, you have no right. … That problem was solved in the 1980s.”

But Mike Giles, president of the Gainesville-based Georgia Poultry Federation, said the law needs updating.

“It has to do with the determination of what is a changed condition,” he said.

As an example, Giles explained, a farm located in an agricultural zone near a cluster of houses might be left alone until a new homeowner moves in who objects to the farm and files a nuisance suit.

“Is that a changed condition or not?” Giles asked. “I would argue it is, but a court may rule it’s not.”

Walker said the legislation is not an effort to gut existing laws prohibiting large farms from polluting streams and other waterways. Those protections already are in effect in the form of the federal Clean Water Act, he said.

“We were not trying to circumvent the Clean Water Act,” he said. “This was noise, odor, dust, light, that sort of thing.”

But Senate Democrats argued during the June floor debate on the bill that the state and federal environmental agencies in charge of enforcing the Clean Water Act typically offer little protection from violations.

Rogers said the bill fizzled at the end of this year’s legislative session because the level of grassroots opposition scared off lawmakers in an election year.

“They didn’t want to get on the bad side of their constituents,” he said.

Walker said supporters hope to overcome that opposition during the upcoming General Assembly session by stepping up their efforts to educate the legislators they will need to pass it.

“It ended up being a rural-urban fight,” he said of last year’s debate on the bill. “We just have to educate our urban and suburban legislators of the need for it.”

COVID-19 cases rising in Georgia, Kemp urges vigilance for Thanksgiving

Coronavirus has sickened hundreds of thousands people and killed thousands more in Georgia. (Image: Centers for Disease Control and Prevention)

Gov. Brian Kemp is urging Georgians to keep distanced and consider outdoor or virtual gatherings this Thanksgiving with COVID-19 cases, hospitalizations and deaths on the rise in recent weeks.

Positive cases have increased substantially in recent weeks from a daily average of just under 1,200 cases on Oct. 1 to an average of more than 2,600 daily cases as of Monday, according to state Department of Public Health data.

Kemp and other state officials are hoping to stave off an even steeper spike during the holidays, when the temptation for more Georgians to abandon distancing precautions may be high after eight months of isolation away from loved ones.

The governor asked people to consider holding virtual or outdoor gatherings and to tightly limit group sizes in Georgia homes for the Thanksgiving feast.

“I know that people are frustrated and ready to return to normal,” Kemp said at a news conference Tuesday. “But we cannot grow weary. We have to keep our foot on the gas in this fight.”

As of Monday, more than 406,000 people had tested positive for COVID-19 in Georgia. The virus had killed 8,644 Georgians.

Public-health officials across the U.S. are warning of a possible bleak winter season for COVID-19 transmissions with emergency-use authorization for several vaccines just around the corner – but not ready yet.

Georgia’s top public-health official, Dr. Katheen Toomey, said Tuesday that while Georgia has not seen the virus spread as rapidly recently as in other states, positive cases, hospitalizations and deaths are still on the rise.

She cautioned people hopeful of spending time with family and friends to not rely on any recent negative COVID-19 tests they may have taken, since that’s no guarantee against catching the virus after receiving results.

“It’s particularly important that we don’t use a [COVID-19] test as a justification to go and not follow the guidelines,” Toomey said.

As they have in the past, Kemp and Toomey stressed the importance of wearing masks, maintaining distance and washing hands to lower chances for catching the virus. The governor also said officials have up to two months-worth of protective gear to send local hospitals and elderly care facilities.

“We are prepared to handle whatever comes our way,” Kemp said. “We want this to be a bump, not a spike.”

Despite the case climb and holiday risks, Kemp has declined so far to change any mandatory COVID-19 rules beyond sanitation guidelines in restaurants and bars, a ban on gatherings of more than 50 people and a shelter-in-place order for Georgia’s elderly and chronically ill populations.

That steadiness comes despite a recent White House COVID-19 task force warning Georgia to boost safety rules for the holidays. Kemp said Tuesday he did not “see any reasons” for more safety measures since the state is seeing a “bump” and not a “spike” in viral transmissions and illnesses.

Kemp has long sought to weigh health risks with potential economic damages when imposing mandatory COVID-19 rules since March, most contentiously by declining to order a statewide mask mandate as other states as well as cities within Georgia chose to do so.

State officials also gave a first glimpse into preparations for rolling out COVID-19 vaccine doses once the U.S. Food and Drug Administration gives the green light likely next month for distributing a handful of vaccines that have passed clinical trials with flying colors.

Insurance Commissioner John King, who is heading up Georgia’s vaccine plans, said officials are currently “fine-tuning” how best to locate the state’s most vulnerable elderly and chronically ill community members to prioritize them for distribution, due to a limited number of doses initially set to arrive.

With many public-health experts anticipating vaccines will not be available widespread to the general public until at least summer 2021, King heeded Georgians not to lean on any vaccine’s near-readiness as an excuse to ignore distancing, hand-washing and wearing masks.

“When you’re waiting for the cavalry to arrive, you double down,” King said. “We know that the vaccine is coming [and] you can’t let your guard down.”

The Home Depot settles data breach case with Georgia, 45 other states

ATLANTA – Atlanta-based The Home Depot has agreed to pay a $17.5 million settlement with 46 states including Georgia over a 2014 data breach

The settlement, announced Tuesday, resolves a multistate investigation of a data breach involving the payment card information of about 40 million Home Depot customers nationwide. Georgia’s share of the agreement will total more than $356,000.

“Our office will continue to do all we can to protect consumers and their personally identifiable information,” Georgia Attorney General Chris Carr said. “It is important to remember that in a world where cybersecurity threats are evolving, so too must our efforts to combat them. That means we must all remain vigilant.”

The breach occurred when hackers gained access to The Home Depot’s network and deployed malware on the retailer’s self-checkout point-of-sale system. The malware let the hackers obtain the payment card information of customers who used self-checkout lanes at The Home Depot stores across the country between April 10 and Sept. 13 of 2014.

Carr said The Home Depot has taken steps to correct the situation. In addition to the $17.5 million settlement payment, the company has agreed to strengthen its information security program to better protect the personal information of consumers.

Specific steps include hiring a chief information security officer who will report directly to senior executives and members of The Home Depot’s board, providing security awareness and privacy training to all personnel who have access to the company’s network and employing security safeguards for log-ins, password management, firewalls, encryption and intrusion detection.

State medical cannabis commission looking for growers, manufacturers

ATLANTA – The state panel in charge of Georgia’s medical marijuana program is opening the search for businesses interested in growing the leaf crop and converting it into cannabis oil.

The Georgia Access to Medical Cannabis Commission voted Monday to release a Request for Proposals (RFP) that will lead to the granting of two “Class 1” licenses and four “Class 2” licenses to grow marijuana indoors and manufacture the oil derived from the plants.

The RFP is based on input from the state attorney general’s office and the Georgia Department of Administrative Services (DOAS).

Starting the licensing process is a major step forward for a program that has been slow to get off the ground since the General Assembly passed legislation in April of last year legalizing the cultivation of marijuana in Georgia, conversion of the leaf into cannabis oil and the sale of the drug to eligible patients.

Although the law took effect in July 2019, the seven members of the commission given the task of overseeing the program weren’t appointed until last November.

The process of developing the RFP has been “tedious,” Dr. Christopher Edwards, principal surgeon at the Atlanta Neurological & Spine Institute and the commission’s chairman, said Monday.

“We just want to keep the patients in the forefront,” Edwards said. “The longer this process goes on, the longer it takes patients to get help.”

Under the medical cannabis legislation, businesses granted Class 1 licenses will be able to grow marijuana in up to 100,000 square feet of space. Class 2 licensees will be limited to no more than 50,000 square feet.

The 2019 bill was a follow-up to legislation the General Assembly passed in 2015 that  legalized possession of low-THC cannabis oil in Georgia by patients suffering from certain diseases enrolled in a registry overseen by the state Department of Public Health.

Lawmakers acted after it became apparent that the first law left Georgians with no legal way of obtaining cannabis oil even though they were allowed to possess the drug.

Patients eligible to receive cannabis oil with a doctor’s prescription include those suffering from a wide range of diseases, including seizure disorders and Parkinson’s. 

Commission Executive Director Andrew Turnage, appointed by Gov. Brian Kemp last May, said the DOAS is expected to post the RFP on the Georgia Procurement Registry by Wednesday.