~~:rhe umanSfttle 2002 GEORGIA DEPARTMENT OF HuMAN REsouRcEs 0 SUMMER The mission of the Georgia Department of Human Resources is to assist Georgians in achieving healthy, independent and self-sufficient lives. Breaking the cycle Treatment courts for people mwith mental disabilities n a tiny white concrete roo~ that serves as a courtroom m the DeKalb County jail, a young man with mental illness and addictive disease decides his fate. He stands in front of a judge, who talks to him about treatment court for people who have been charged with a misdemeanor. A person from the DeKalb Community Service Board recognized his symptoms and said he would be a good candidate for the program. He knows that going into treatment is voluntary, that it means going back to school, improving his living situation and making peace with his family. It also means getting treatment for his crack habit, which he knows is going to be tough. He'll have to keep appointments with counselors, people from the community service board will be in his face, and he'll have to stick to the conditions of his bond. His charges carry a maximum sentence of 12 months on each count, and he's already spent a month in jail. Treatment takes two to three months. If he chooses treatment, gets clean, stays on medica- The Division of Mental Health, Mental Retardation and Substance Abuse changed its name to the Division of Mental Health, Developmental Disabilities and Addiction Diseases, effective July 1, 2002. tions for his mental illness, attends school regularly and becomes a solid citizen, there will be no prosecution of his case. Otherwise, he may end up with a conviction on his record and a jail sentence. Which will it be? Luckily, in DeKalb County's pretrial treatment program, many people with mental illness and addictive diseases who have committed minor offenses such as loitering, disorderly conduct or shoplifting choose treatment court. They get a chance to keep their record clean and a new lease on life. None of this would be possible without the strong commitment and partnership among the county's magistrate judges, particularly Chief Magistrate Winston Bethel; Sheriff Thomas Brown; jail personnel; police; the solicitor's office; the public defender's office; the DeKalb Regional Board; the DeKalb Community Service Board (CSB); families; and advocate/volunteer Flo Giltman. In 1999, Giltman saw the need for treatment instead of jail for people with mental illness who commit misdemeanors. She convinced the right people to serve on a task force and to visit one of the first diversion courts , in Broward County, Florida. Judge Bethel was sold enough on the concept to obtain federal funding and work things out with key jail, court and CSB personnel. The treatment court opened its doors in May 2001. The four judges who preside rotate every month. They also attend each other's court sessions to learn and coach each other. Judge Bethel is committed to seeing that other counties adopt a mental health jail diversion program. He is training in other regions, such as Gwinnett/Rockdale/Newton, to convince them to continued on page 7 In this issue Commssioner's corner ........pg. 2 Learning cultural skills ........pg. 3 Preventing suicide .............. pg. 4 Managing stress .................. pg. 5 Who's news ........................ pg. 6 Write it right ...................... pg. 7 What's news .......................pg. 8 The Human Side Spring 2002 I Commissioner's corner W hen I became Commissioner of Human Resources in September one of my first tasks was to explain the department's budget and legislative recommendations to the Governor and the Georgia General Assembly. Now that the session is over I can report that the results were positive. It is true that we suffered budget cuts that affected our programs, but the department with the help of the Governor and the General Assembly was able to make the reductions in a way that minimized the impact on services. It could have been worse. Other states have experienced more serious shortfalls, and many of them are convening special sessions to address budget problems. Governor Barnes exempted many of our vital programs from reductions. We did not have to implement reductions in force or layoffs, and we received the full funding we requested to improve child welfare services. I am very sympathetic with the stress many of you are feeling as you struggle to provide other vitally needed services with reduced funds. I appreciate your dedication and support. New legislation will improve our ability to do our jobs. House Bill 498 gives DHR more control over the quality and consistency of services offered people with mental illness, developmental disabilities and addictive disease, while preserving a strong role for local boards and for consumers and their families. As a result we will be more accountable both to consumers and to the public. HB 498 also shifts back to DHR administrative functions such as selecting providers and contracting for community services, while leaving planning responsibilities with the regional planning boards. The com- munity service boards, who provide many services under contract with DHR, will have new business powers and flexibility, and the opportunity to either become a private, nonprofit agency or become part of county government or a hospital authority. Another new law clarifies existing regulations that help us to protect the public from a dangerous outbreak of infectious disease, including the ability to mandate vaccinations and quarantines. The governor now will have the power to declare a public health emergency in the event of a bioterrorism attack. DHR will coordinate the state's response to such an emergency. We are already working with other state and federal emergency management agencies to prepare a response plan and rules and regulations that would go into effect. Among these rules , there will be provisions for due process for anyone objecting to a mandated vaccination or quarantine. The legislature passed two new laws that will benefit children. Now, noncustodial parents who pay child support must provide health insurance for their children if it is offered by their employer. Also , the juvenile courts are now required to plan permanent placements for children in DFCS custody, either through adoption or by reuniting them with their birth family, to comply with the requirements of the federal Adoption and Safe Families Act. Legislation was also passed to allow us to contract with religious organizations to provide services funded by federal dollars, if they are qualified as nonprofit organizations under section 501 (c)3 of the Internal Revenue Services' rules ; do not discriminate on the basis of religious beliefs or practices; and agree to open their books for state audits. Finally, the legislature expanded the Board of Human Resources from 15 to 17 members, so there will be one member for each congressional district plus four at-large members. This follows the addition of two more congressional districts in our state. 21--~z~.~ Senior Day Nearly 600 seniors shared in games, dancing, food , and music at the 11th 1 Annual Senior Day Pi.cnic in Soperton - on May 10th . The event was sponsored by the Georgia Altamaha Area Agency on Aging, to celebrate Older Americans Month. This years national them e, "America: A Community for All Ages," pays tribute to the nation and the elders who represent th e strength of the nation. 2 The Human Side Summer 2002 Learning cultural skills improves customer service G eorgians speak many languages these days. Spanish, Korean , Chinese, Vietnamese , Somali , Swahili, Cambodian, Farsi , Bosnian, Arabic and Russian, and their various dialects , are just a few. Many people who speak these languages also speak English very well, but many do not. Title VI of the federal Civil Rights Act of 1964 mandates state and county agencies that serve people with limited English to provide vital documents , such as forms , applications and brochures, in the languages spoken by their clients. In addition, clinics must provide those customers with a qualified interpreter free of charge. In addition to overcoming language barriers, understanding cultural differences is key to improving our services to refugees and immigrants. To comply with Title VI, the Division of Public Health's Refugee Health Program has conducted nine cultural competency training sessions so far. About 450 people attended from eight areas: DeKalb County, Augusta, Rome, Gainesville , Macon, Athens and the East Metro district. Kitty Kelley, an anthropologist from Georgia State University, led the workshop. She gave examples from her own experience of cultural differences and also of both blatant and subtle racism that healthcare providers and their patients encounter. Susan M. Pavlin, an attorney, explained the federal requirements in ways everyone could understand. Tony Flores, outreach program director with DHR's Office of Communications, attended the Macon workshop to describe corrective actions that are taking place in Georgia to help Latino and Asian groups have better access to public services. The feedback from people who attended the workshop was very positive. One participant said, "This training will help me to better understand the cultural differences among the new consumers we are serving. " Plans are underway to provide more workshops in the current fiscal year. - Barbara Joye and Tony Flores Karl H. Schwarzkopf named director of state mental health division K arl H. Schwarzkopf, Ph.D. , has been named director of the Division of Mental Health, Developmental Disabilities and Addiction Diseases (MHDDAD). Schwarzkopf joined MHDDAD (then MHMRSA) as deputy director for community services in March 2001. "I am delighted that Dr. Schwarzkopf will be heading the division ," says Commissioner Jim Martin. "He brings great strengths and experience to MHDDAD , and I look forward to working closely with him. " Schwarzkopf has over 25 years experience managing both institutional and community-based healthcare and human services programs. He came to Georgia from New York State, where he was program director for RehabCare Group, Inc., a major provider of physical medicine and rehabilitation program management for hospitals , long-term-care units and outpatient facilities throughout the U.S. Prior to that he managed sub-acute and brain injury rehabilitation programs in a variety of settings in New York and Ohio. He also served as chief operating officer for Cambridge Regional Human Services Center in Cambridge, Minnesota, which provides intermediate care and community-based group homes for people with mental retardation. He has experience in private practice and in working with children and adolescents with severe emotional disturbances. "I am excited about the opportunity to work with Commissioner Martin and to help implement the changes to the mental health, mental retardation and substance abuse system recently adopted by the state legislature," says Schwarzkopf. The Human Side Summer 2002 3 Preventing suicide G eorgia now has a state plan for preventing suicide. The plan was developed by the Georgia Suicide Prevention Advocacy Network (SPAN USA), written by Julie Chambliss and funded by a grant from DHR, using $250,000 allocated by the Georgia Legislature at the request of Governor Roy Barnes. It was released in May at the Rosalynn Carter Georgia Mental Health Forum. Suicide is the state's ninth leading cause of death, claiming some 850 lives each year - greater than the average number of homicides. It is also the third leading cause of death among Georgians 15 to 24 years of age. "Suicide is a very serious, yet very preventable, public health problem," says Kathleen E. Toomey, M.D., M.P.H. , director of DHR's Division of Public Health. "With greater public awareness and support for prevention resources we can save hundreds of lives. This plan shows us how. " The Georgia Suicide Prevention Plan outlines ways to prevent suicide deaths and suicidal behavior and the traumatic impact of suicide on loved Help for kids with asthma P arents and caregivers of children with asthma, older children, and medical professionals had an opportunity to learn how to control childhood asthma at an "Asthma Awareness Symposium" at the Medical Center of Central Georgia in Macon on May 4th, sponsored by DHR's Division of Public Health. World Asthma Day was May 7. At the symposium, parents and caregivers participated in a free "Asthma 101" workshop where they practiced using tools to manage asthma. Special activities were provided for children over age 4. In a separate workshop, health care providers focussed on "Becoming an asthma educator" so they could understand the condition better and develop plans for the care of each asthma patient. One of every six Georgia households includes a child with asthma. Parents miss nearly 400,000 work days and children miss over a halfmillion school days each year in order to deal with asthma attacks, which may require visiting a hospital emergency room. Yet with better education, families can reduce the number of asthma attacks their children suffer. Asthma is one of the most common chronic health conditions in the world, affecting over 15 million people in the United States. An estimated 11 percent of children in Georgia have asthma. In the United States, rates of asthma deaths, hospitalizations and emergency room visits have been increasing for the past two decades, especially among African Americans and children. "World Asthma Day 2002 emphasized 'communities working for life and breath,"' says Kathleen E. Toomey, M.D., M.P.H., director of DHR's Division of Public Health. "We hope that by bringing together people from communities throughout Georgia at this symposium we will significantly reduce the stress and suffering caused by this major public health problem." - Barbara Joye ones, following guidelines provided by the United States Surgeon General's Call to Action to Prevent Suicide. Using a systematic public health model, the plan defines suicide, identifies risk and protective factors , and outlines and evaluates intervention methods. Action steps aim to develop support for suicide prevention; reduce stigma for people who seek help; and involve communities, helping agencies, professionals, families and individuals in planning and implementing prevention efforts. Other steps would strengthen prevention and treatment resources and improve systems for studying the problem and evaluating the success of prevention programs. The prevention network, SPAN , a national grassroots organization, was launched in Marietta, Georgia in 1996. Georgians from many fields and backgrounds helped develop the plan. DHR and the National Mental Health Association of Georgia were key organizational partners. For a copy of The Georgia Suicide Prevention Plan , visit the SPAN USA website at www.spanusa. org, or contact Laurell Reussow of the Georgia Suicide Prevention Plan Management Team at gspp@spanusa.org or 770740-0632. Additional information on suicide in Georgia, including suicide rates by county for the years 1994 1998, is provided by the Division of Public Health's report Suicide in Georgia: 2000, which can be obtained from Karen Flemister, Epidemiology, 14th floor, Two Peachtree Street NW, Atlanta, Georgia 30303 or 404-657-3103 or on the web at http://health. state. ga. us/programs/ injurypreventionl pdfsl suicidemanual. pdf. - Barbara Joye 4 The Human Side Summer 2002 Managing stress with peer support E very county DFCS office has at least one horror story to tell - a time when a child died after returning to his parents, or an enraged client making threats. And every DFCS staff member knows the feeling of being overwhelmed by the volume and the grief of the work. The question is, where do you turn when the job becomes too much to handle? For Glynn County Director Tony Kreimborg, the answer is peer support. "Peer support is needed in all stressful work. Everybody in DFCS is dealing with troubled families. All of the staff members see a lot of grief, and even eligibility clients often come in and unload their problems on the worker." Peer support has two key elements, according to Kreimborg. First is one-on-one intervention offering support to other staff members who are having a difficult time due to work-related or personal issues. This may mean a 10-minute chat or a series of contacts where the peer supporter listens or if necessary helps the worker find professional help. "For example, a staff member may have had an accumulation of difficult cases," Kreimborg said. "A peer supporter is trained to help people identify signs of stress and ways to lessen it. " The second element of the program is "critical incident stress managemeni.. " A critical incident is one that affects a group of people, such as the death of a child known to the agency. When this happens, a trained debriefer, usually a staff member, leads the affected group through a process that helps individuals express and share their feelings of loss. Glynn APS case manager Tanya Poillucci found such a debriefing Tanya Poillucci with another peer supporte1; Social Services supervisor Greg Jaudon. particularly helpful when a child who had been in foster care drowned after being returned to a neglectful parent. "I had worked with that family for a year and a half when I was in Placement so it was very hard to lose the child," she said. "I questioned the decisions I had made, and I think my co-workers did, too. We asked peer supporters from the federal law enforcement training center here in Brunswick to meet with us for what was a very emotional two hour session." With Kreimborg's enthusiastic backing, Glynn County now has nine trained peer supporters. With a grant from the division, Glynn has also sponsored two week-long training events for DFCS staff from other counties. Kreimborg says his dream is to develop a statewide network of peer supporters and critical incident managers in DFCS. "I hope we can have peers in each area who have also been trained in managing critical incidents so they can intervene in situations that warrant a more immediate, comprehensive response," he commented. For more information about peer support, contact Tony Kriemborg at 912-262-3200 or akreimborg@yahoo.com - Renee Huie Rosa D. Waymon new director DHR Human Resources Managment C ommissioner Jim Martin appointed Rosa D. Waymon director of the department's Office of Human Resource Management (OHRM) , effective May 1, 2002. "I am very pleased that Rosa Waymon will be joining us," says Martin. "She brings to DHR a strong background in personnel administration, with leadership experience in major nonprofit and private organizations." Waymon most recently directed the Human Resources division of Atria Assisted Living. Earlier, she was a regional training manager and human resources generalist for the American Association of Retired Persons; manger of employee relations for the PYA Monarch Division of Sara Lee; human resources development manager for RJR Nabisco; and a regional training and personnel manager for General Cinema Beverages, Inc, a division of Pepsi-Cola Bottlers of Atlanta. A graduate of Clark Atlanta University, Waymon earned an M.S. degree in human resource development from Clayton University in St. Louis, Missouri. She lives in Stone Mountain. The Human Side Summer 2002 5 Who's news Our stars win awards Governor Barnes proclaimed May 8, 2002 State Employee Recognition Day in Georgia, during National Public Employee Recognition Week May 5 - 11. At a reception hosted by Commissioner Martin, several DHR employees received "employee of the year" awards: Community Service (s tate winner) - Judy Clark, R.N. , nurse executive, Georgia Regional Hospital at Savannah, was honored for her work establishing "Harsin' Around," a nonprofit riding therapy program for children with disabilities. Customer Service - Margaret Dawe, social services case manager, DeKalb County DFCS, is dedicated to her caseload of medically fragile children and older teens who need specialized treatment in foster care. She is accessible at all hours to the children's parents, volunteers to help train foster parents and CASA volunteers, advocates vigorously for her kids, and has gone out of her way to help them many times. Heroism - Judy Allen, Patsy Bass, Beverly Farmer, Linda Ogburn, Brenda Sewell and Stephanie Wallace of the Covington Child Support Enforcement Office saved the life of a neighbor who suffered a heart attack while cutting his grass (see Human Side , fall 2001) . Innovations/Suggestions - Gary Child care licensing director receives award Jo Cato, director of the Child Care Licensing Section (CCLS) for the Office of Regulato~y Services ORS) , received an award at the 2002 Nat10nal Fam- ily Child Care Convention in March "for her many years of unwavering commitment and dedication to the field of family child care in Georgia." Cato has been with DHR for almost 34 years, including 30 in CCLS, where she became director in 1982. Before that she worked for DFCS' Child Pro- tective Services. She will retire December 1, 2002. "It is great to see Jo receive the public recognition she definitely deserves," said Marty Rotter, ORS director. "Her tireless dedication to improving care for children in out-of- home settings, whether in daily child care or in residential care, is hard to match. Her leaving will be a loss felt by the state, providers and advo- cates alike. The challenge and ultimate tribute to Jo will be in continuing on the journey to quality care for children throughout Georgia. " Cato said that improvements in family child care quality have result- ed from the work of many dedicated staff and others. In 1996, CCLS implemented a routine inspection system for family homes for the first time. Funded by the federal child care block grant, this system estab- lishP.d the foundation for other child care quality initiatives that followed. In 2001 , as part of the Georgia Early Learning Initiative, a new Homes of Quality program began and many family providers are now working toward national accreditation. _Edna Jackson Milton, clinical pharmacist, computerized medication administration records, installed them on nursing unit computers, and trained nursing staff to use them at Southwestern State Hospital and Georgia Regional Hospital at Savannah. He has also developed other reporting systems in use at state hospitals. These reports improve patient safety and save nursing staff time, and helped the hospitals win accreditation. Leadership - Billy Nicholson, Jr. , maintenance director, Northwest Georgia Regional Hospital, has renovated many buildings and implemented energy conservation measures that saved the state millions of dollars. He restored heat and power to the patient buildings during the blizzard of 1993, and installed emergency generators to prevent service interruptions in the future. Team - Georgia Thomas , Carol Hartman, Andrea Harrison, Gloria Washington, and Kenya Bassett, with the Georgia Early Learning Initiative (GELi), CAPS team, improved the quality of childcare statewide through improvements in policies and procedures, incentives, training, technical assistance, scholarships, and a new system that grants higher reimbursement to higher quality childcare providers. ~~~ii'iti' The Columbus Health Department received the 2002 Joy Maxey Lead Agency Award at the annual Safe Kids of Georgia awards luncheon in February, recognizing their "energetic and enthusiastic" support of Safe Kids of Georgia in continued next page 6 The Human Side Summer 2002 Write it right - ill = 11 ll --