450M5 1 96970 4 V s fc M s 4F f i 4 c w 4r cf 4 o C K 4 9 vv J department of public health central state hospital ANNUAL REPORT UNIVERSITY OF GEORGIA JUL 13 1971 LIBRARIES AND YEAR BOOK milledgeville 1970 mm A 9 v t V p b o i3 5 c o in c o E 3 2 u 22 O o O 5 S I I CD t s i 3 o i s THE COVER PHOTO Governor Lester Maddox and Georgia Health Department Director Doctor John Venable show little Mary Ann and Frankie some of the Christmas gifts provided by generous Georgia citizens for the patients at CSH The program is sponsored annually by members of the Georgia Municipal Association Q Z O LIBRARIES OF GEORGIA DIRECTORY Honorable Lester Maddox Governor State of Georgia MEMBERS OF THE GEORGIA STATE BOARD OF HEALTH B W Forester MD Chairman John M Martin MD ViceChairman J T Mercer DVM Secretary Harrison Bray Wesley A Carr DDS Lee Roy Claxton RPh William M Dickson MD P K Dixon MD John E Garner Jr Roy L Gibson MD L H Griffin MD John D Marshall RPh Earl T McGhee MD W Frank McKemie MD Lamar B Peacock MD Carl E Pruett Richard H Smoot MD A C Tuck DDS n John H Venable MD Director State Department of Public Health Addison M Duval MD Director Division of Mental Health Charles K Bush MD Director Hospital Services Branch James B Craig MD Superintendent Central State Hospital TABLE OF CONTENTS GENERAL INFORMATION OFFICE OF THE SUPERINTENDENT Staff Housing Public Information Patient Affairs Medical Staff Secretary Hospital Receptionist ADMINISTRATION Institutional Business Administration Personnel Engineering Manpower Hospital Information Systems Industrial Engineering Horticulture CLINICAL SERVICES General Psychiatric Units Special Psychiatric Units Veterans Maximum Security Children Mental Retardation Yarbrough Vocational Rehabilitation Center Psychology Nursing Social Work Chaplaincy Services Special Education School PHYSICAL HEALTH Jones Hospital General Medicine and Surgery Rivers Hospital Tubercular Drugs and Alcohol Medicare Pharmacy Dentistry Occupational Therapy Music Therapy Recreation Volunteer Services Remotivation EDUCATION TRAINING AND RESEARCH Neurology AudioVisual Services Psychiatric Residency Research Medical Records Medical Library APPENDIX PAGE 19 1217 2036 4080 4048 50 51 52 54 57 61 72 75 76 78 8199 82 84 86 88 90 92 94 95 98 101111 102 103 104 106 108 108 111 s July 1 1970 Doctor Charles K Bush Director Hospital Services Branch Division of Mental Health Georgia Department of Public Health 47 Trinity Avenue SW Atlanta Georgia 30334 i Dear Doctor Bush We present herewith the Annual Report of Central State Hospital covering the fiscal yearending June 30 1970 You will notice that the format which received wide acclaim last year has been retained with such modifications which progress inevitably makes necessary We are happy that our hope expressed last year that the report in its present form would be widely used as a source book seems to have been realized T Since for the first time in our history we have our full complement of Assistant Superintendents we have sectionalized the material under four headings Administrative Education Training and Research Clinical and Physical Health corresponding to the responsibilities of the four Assis tant Superintendents There is much in the report which presents cause for satisfaction as well as a feeling of confidence for the future A steadily declining resident population in the face of increasing admissions and an On Book population which hovers just under 19 000 can only be attributed to a more effective treatment program backed up by increasingly potent community mental health facilities We wish to express our thanks for continued sympathetic understanding of our problems as well as a willingness on the part of Health Department staff to go the second mile in getting things done for the benefit of our patients Your helpfulness and effective support has been a strengthening factor throughout the year Respectfully submitted D James B Craig M Superintendent HIGHLIGHTS OF 1970 Resident patient population decreased by 957 in spite of increased number of admissions and patients treated Patient Affairs Division relocated for increased efficiency in operation National Recognition given Medical Records Division for work in filing pro tective applications for patients Social Security Central Occupational Therapy building staffed and clinics operating New Fire Station completed and partially staffed Old Colony Recreation Area and Rehabilitation Garden for patients completed Tenth Ward completely renovated including air conditioning of patient areas Air Conditioning installed in sick wards in nine patient buildings Ten dining rooms renovated with new cafeteria lines and serving equipment Hospital Authority project for new sewage treatment plant to serve CSH Milledgeville and Baldwin County completed Plans completed and bids about to be let for new GM S Hospital CSH patients participated in State and National Olympics for handicapped winning a number of medals in each Jones Medical and Surgical Hospital west wing renovated to provide modern facilities for OBGYN and EKG Hospital income not provided by state increased 327863 due to additional collections from medicare patient pay plan and veterans services Neurological diagnoses improved by addition of Electromyograph and Ultra sonic Analyzer Complete renovation of the Central Dental Clinic completed New AudioVisual Division set up with closed circuit TV system for hospital in operation with studios in the Yarbrough Building r Computer assisted menu planning resulted in the serving of 10897889 meals including 2158335 special diets at a raw food cost of 02719 per mealHHHHiH mmm ft v i VINSON PSYCHATRIC OP CU MIC ffc NORTH Central State HosplTBL BALDWIN COUNTY GEORGIA GEORGIA PEPARTMENT OF PUBLIC HEALTH 8 A THE VARBROUGH REHABILITATION CENTER 1 A BRIEF HISTORY OF CENTRAL STATE HOSPITAL One hundred and twentyeight years ago the doors of Georgias first state psychiatric hospital were opened on December 15 1842 At that time the onebuilding institution was known as Georgia State Lunatic Asylum For the following 125 years the hospital continued to be the only state psy chiatric hospital The patient population steadily increased until in 1965 it reached a peak of almost 13000 Three name changes have taken place since the hospital opened Some years later it became the Georgia State Sanitarium then the Milledgeville State Hospital and finally in accor dance with Georgias new regional hospital concept it acquired its pre sent name n During the last four years the resident population decreased to 9408 at the end of fiscal 1969 mainly due to improved treatment programs as well as transfer of 3200 geriatric patients to nursing home care and to the new regional hospitals in Thomasville in Bainbridge and in Atlanta Central State Hospital is situated on a 1000 acre campus dotted by some 135 buildings 24 of which are resident quarters for the patients Until 1968 the hospital also operated a 9000 acre farm and dairy pro gram however this is now liquidated although the hospital retains the land which is now used for treatment and recreation The massive institution is like a small city It has fire and police departments general hospital services five chapels for the spiritual in spiration of the patients complete recreation facilities such as picnic areas a large gymnasium and auditorium a baseball field and water sports of all kinds available at a nearby lake warehouses and maintenance shops lumber yard patient operated stores laundry and steam plant sewage control cemetaries and bus service Also in the Central Kitchen more than 33000 meals are prepared daily in an area the size of two foot ball fields The budgeted employee work force numbers 4023 and includes these categories Physicians 108 dentists 9 nurses 117 semiprofessional and technical 2205 psychologists 12 MSW social workers 20 also clinical chaplains music therapists recreation therapists occupational therapists teachers vocational rehabilitation personnel and business engineering maintenance construction and administrative personnel A complete list of employee classifications will be found elsewhere in this report As an educational and training facility the hospital has accredited programs in psychiatry medicine psychology social work occupational therapy music therapy recreation therapy pharmacy vocational rehabil itation hospital administration clinical chaplaincy mental health infor mation and a rotating residency in ophthalmology for senior residents from the Mayo Clinic at Rochester N Y As a treatment facility Central State Hospital serves residents of Georgia who are mentally ill mentally retarded or suffering from an addic tion problem The institution is divided into five psychiatric units ad mission to a particular unit being determined by county of residence Other units include a vocational rehabilitation center and school a childrens unit and special education school a veterans home a unit for the men tally retarded a unit for patients who are tubercular a medicare unit and a general medicalsurgical hospital of some 250 beds Approximately 700 childrenunder the age of 18 reside at Central State Hospital and of these 222 are in the special education school which is divided into two sections classes for children who are emotionally dis turbed and for those who are mentally retarded At the present time there are 62 students in the EM section 2 7 are in high school 2 7 are in inter mediate classes and 8 in primary classes The classes for educable MR students have 55 enrolled and the number attending trainable MR classes is 43 The school is staffed by a principal and 24 teachers Underage admissions to Central State Hospital are increasing ma terially every year at the rate of approximately 33 per cent At the pre sent time there are a number of children who should be admitted to school but there is not sufficient classroom space nor an adequate number of teachers It is estimated that the school will need at the very minimum 39 teachers to meet the need during the coming yearSUPERINTENDENT ADMINISTRATIVE AIDE ASST SUPT ADMINISTRATIVE INST BUS ADM PERSONNEL ENGINEERING MANPOWER ADM HOSP INFO SYSTEM DATA PROCESSING IND ENGINEERING HORTICULTURE ASST SUPT EDUCATION TRAINING RESEARCH MEDICAL LIBRARY RESEARCH NEUROLOGY PSY RESIDENCY TNG AUDIO VISUAL SVS MEDICAL RECORDS ADMINISTRATIVE OFFICER ASST SUPT CLINICAL CLIN D1R PSY GEN UNITS IV PSY OP CLINIC CLIN DIR PSY SPEC UNITS VIX SPECIAL EDUCATION PSYCHOLOGY SOCIOLOGY SOCIAL WORK NURSING SERVICE CHAPLAINCY SVS EXECUTIVE ASSISTANT HOUSING PUBLIC INFO PATIENT AFFAIRS MED STAFF SECY ASST SUPT PHYSICAL HEALTH JONES HOSP RIVERS HOSP PHARMACY SVS DENTAL PROGRAM SANITATION COORDINATOR SPEC THERAPIES OCCUPATIONAL THPY RECREATIONAL THPY MUSIC THPY VOLUNTEER SVS REMOTIVATION SVS CENTRAL STATE HOSPITAL Revised 1 Apr 70 kS Vo tifaEXECUTIVE ASSISTANT SUPERVISOR MEDICAL STAFF SECRETARIAT HOUSING MANAGER SECRETARY DIRECTOR PUBLIC INFORMATION SECRETARY HOSPITAL RECEPTIONIST COORDINATOR PATIENT SERVICES SECRETARY SECRETARY PUBLIC INFORMATION OFFICER ASSISTANT PUBLIC INFORMATION OFFICER PHOTOGRAPHER EXECUTIVE ASSISTANT REVISED 1 AUG 69mm mmmmm 12 OFFICE OF THE SUPERINTENDENT James B Craig MD Superintendent John J Schuyler LLB Executive Assistant John R Cline Administrative Officer Mildred Riner Coordinator Patient Affairs Raymond D Brown Director Public Information James R Emerson Director Staff Housing Barbara Farmer Supervisor Medical Staff Secretariat Jean Niblett Hospital Receptionist Superintendents Secretarial Staff Katherine Batchelor Administrative Aide Mary McCrary Secretary ADMINISTRATIVE STAFF ASSISTANT SUPERINTENDENT ADMINISTRATIVE ASSISTANT SUPERINTENDENT EDUCATION TRAINING AND RESEARCH Rod Clelland BA MA John W Kemble MD ASSISTANT SUPERINTENDENT PHYSICAL HEALTH ASSISTANT SUPERINTENDENT CLINICAL William R Howard MD Michael L Sheppeck MD lr CLINICAL DIRECTORPSYCHIATRY GENERAL PSYCHIATRIC UNITS W T Smith MD CLINICAL DIRECTORPSYCHIATRY SPECIAL PSYCHIATRIC UNITS Hollis C Miles MD13 THE SUPERINTENDENT JAMES B CRAIG MDwmmmm mm 14 OFFICE OF THE SUPERINTENDENT The Office of the Superintendent includes those departments reporting directly to him through his Executive Assistant and which are funded through the Superintendents budget They include Staff Housing Pub lic Information and Education the Medical Staff Secretariat Hospital Re ceptionist and the Patient Affairs Division STAFF HOUSING The division is responsible for the general oversight of staff quarters including renovations and renting of 97 houses 50 apartments and 102 dormitory rooms During fiscal 1970 387 maintenance work orders were referred to the Engineering Division for service from the plumbing elec trical and carpenter sections A large number of these orders were for repairs to vacated houses and apartments and were initiated by the Hous ing Division Others were initiated by the occupants themselves During the year 21 requests were received for private residences and due to personnel turnover 14 vacancies occurred with 13 assignments completed The exterior of 14 private residences were painted during this period Requests for apartments totaled 2 2 with 15 vacancies occurring during the year in addition to two which were carried over from the prior year All 17 were assigned For the same period 46 rooms in the dormi tory were assigned to males and 37 to females PUBLIC INFORMATION AND EDUCATION This department is charged by the Superintendent with the responsibility of collecting editing and effectively presenting factual information about Central State Hospital its programs and its staff in verbal written and visual form to the hospital community and to the general public utilizing whatever communications media will most adequately accomplish this result MASS MEDIA COVERAGE The department initiated 108 news releases which went to 31 daily and 200 weekly newspapers 150 radio and TV news out lets and a selected list of organizations and individuals Sponsored and programmed 41 TV and radio interviews and educational programs dealing with various hospital activities Release on computerization of hospital menus appeared in newspapers of 42 states 3 foreign countries and re sulted in 9 articles in professional magazines PHOTOGRAPHIC COVERAGE Since July 1 19 69 the department photographer has taken more than 3050 individual black and white photographs 3006 15 color slides and has provided more than 12000 enlargements from 4 x 5 to 11 x 14 for the use of hospital departments and the mass media SLIDE SHOWS All permanent shows were updated Additional shows were provided for six hospital departments as well as for the Houston County Mental Health Clinic Courts of Ordinary from Southeastern Georgia sev eral garden clubs and the Macon Social Security office A special show was set up for Mercer University for a TV presentation DISPLAYS Included continuous color slide show on Volunteer Services for Mental Health Week in Macon display on Milledgevilles Largest Em ployer for the Baldwin County Fair photo display of Public Information Services for Ten Years of Progress conference photo display on Men tally Retarded Children at CSH for the Tuesdays Child Fair in Bruns wick and displays in all units of photos of patient activities for patient viewing PUBLIC EDUCATION Department personnel directly sponsored and arrang ed seminar programs for 126 visiting groups totalling 5220 individuals These included high school and college students nursing students var ious civic groups Department personnel also provided orientation tours for new employees various groups of professionals from other state in stitutions and a number of individual visitors from other states and coun tries These groups are not included in the above total The Director visited 83 colleges high schools vocational schools and schools of nursing with color slide shows on various hospital programs as well as with recruitment material covering the mental health career field A total of 4843 individual contacts were made through this program PUBLICATIONS The department published the Annual Report and Year Book for 1969 the Weekly Bulletin and a number of brochures including A History of the Whittle Building Job Openings Stipends for Graduate Study in Psychology revised Job Openings for Psychologists and Clin ical Interns A Rewarding Career in Social Work revised Christmas Around the World Central State Hospital map revised and a series of Central State Hospital folders for use at conferences PATIENT AFFAIRS The Patient Affairs Division set up by the Superintendent in 1969 was faced with a number of problems related to the implementation of the new Mental Health Law which went into effect on January 1 1970 The division was charged with the responsibility of processing some 15000 petitions to1 16 Ordinaries relating to patient admissions convalescent leave and other matters affecting the hospitalcounty relationships Petitions affecting more than 2500 patients on convalescent leave were handled during the year Relocation of the division with added space equipment and facil ities has materially aided in efficiently and promptly processing the nec essary paper work MEDICAL STAFF SECRETARIAT The work load of the division has materially increased during the year due to the new law which permits noncitizens to take the Georgia State Med ical Examination as well as increased work relating to Medicare which requires periodic review of physicians working in the unit The secretary continues to maintain all minute books records and agenda of medical staff departments the Clinical Review Committees the Executive Com mittee meetings and the handling of all records affecting the medical staff as required HOSPITAL RECEPTIONIST The work of the Hospital Receptionist has also increased during the year due to an increased number of admissions as well as visits by families of residents Since the receptionist is the original contact person for visi tors to the institution she is often responsible for the attitude with which the individual views the institution A number of favorable comments from visitors regarding treatment by the receptionist were received during the year Hoiputal viAitosn oi many typu o umApoifavtlot 17 GEORGIANS SERVED On Books July 1 1970 18677 Resident in hospital 8451 On Convalescent Leave 10226 Admissions Total Admissions 6 625 First Admissions 4 603 Readmissions CSH 2022 Average daily resident population 9 0 60 Decrease over 1969 585 Discharged direct from hospital 2020 Patients placed on convalescent leave 9155 Transferred out 513 Deaths 771 BUDGET ACTUALS State Appropriations 2977939900 Agency Funds 340053430 3317993330 EXPENDITURES Personal Services 2430965739 Operating Expense 837841221 Capital Outlay 29990812 Total Expenditures 3298797772 Balance at close of year 19195558uhbhhmHI 18 Them U a place on everything In eautk on ky on iea blhene aX may Ind it pnopen me And o advantage be Benjamin WanfiieZd 19 ADMINISTRATION ASSISTANT SUPERINTENDENT ADMINISTRATIVE Rod ClelZand BA MA INSTITUTIONAL BUSINESS ADMINISTRATION PERSONNEL ENGINEERING MANPOWER ADMINISTRATION HOSPITAL INFORMATION SYSTEM INDUSTRIAL ENGINEERING HORTICULTUREma l 20 ADMINISTRATION Following are the summaries of the seven major departments that are within the jurisdiction of the assistant superintendent responsible for administration Each of them will speak for itself In addition to the intensification of administrative functions in each of these seven departments Administration has been responsible for major changes in the institutions policies budget and a considerable realignment of the general organization Finally Administration has originated a project management procedure in which existing sources are utilized to plan improvements in approximately 40 areas of the hospital INSTITUTIONAL BUSINESS ADMINISTRATION The appropriation for fiscal year 1970 for Central State Hospital was 33049026 divided into the following major categories Personnel Services Operating Expense Capital Outlay 24314776 8434460 300000 33049236 n The Legislature approved an additional 143 positions but due to limited funds we were unable to fill these for the full fiscal year The capital outlay funds were budgeted to the following projects Tenth Ward Renovation Boone and Boland Bathrooms Powell and Green Lighting Patient Dining RoomsFloor Covering Outside Lighting Dishwashing RoomsRenovation 49300 213600 9500 12300 7900 7400 300000 The total amount of agency income received during the fiscal year was 3298060 an increase of 327 863 over fiscal year 1969 This increase in agency income was the result of increases in medicare collections patient pay and veterans service A new budget and cost control system has been developed and will be operable July 1 1970 This system will give better control of the expendi ture of funds and will ensure that funds are expended as approved The system requires that all documents affecting the purchase of property be processed through the computer for verification of funds 21 Much progress has been made in upgrading housekeeping services in the various patient areas Housekeeping studies and routine cleaning programs have been implemented in the following units 1 Unit VIII Childrens Building Boland Wards 7 and 8 and the Special Education School Facility 2 Unit IX Boone and Boland Buildings 3 Central Housekeeping Staff Dormitory and Apartments Cen ter Section Powell Building and Nurses Home Housekeeping studies have been completed and manuals prepared for Units II V and Rivers Hospital A housekeeping program for these units will be implemented in the first and second quarters of fiscal year 1971 Concrete floors have been sealed in the Whittle Building and are 75 completed in the Rivers Building The sealing of these floors has resulted in a noticeable reduction in odors and gives the housekeeping department a better surface to clean A wellbalanced training program for housekeeping personnel has been developed This program has slides and scripts which were taken on the hospital grounds and they are used in the training program for all house keeping personnel The new fire station will be completely manned in July 1971 Funds and positions were approved to staff the third shift and with these additional positions we should have adequate coverage Training programs are conducted for the new employees and continuing programs are held for all employees An accurate physical inventory of all warehouse and drug items was taken in June 1970 and this inventory has been placed in the computer All receipts and issues for fiscal year 1971 will be processed into the computer and we will have better control of the physical inventory New labor saving equipment electric fork lifts dock levelers conveyors have been purchased and installed A physical inventory of all capital equip ment is being taken and is scheduled for completion in September 1971 The transfer of all food service personnel from the units to food service has been completed This places the responsibility for all dining room operations under food service however due to inadequate staffing it is still necessary to utilize attendants and other patient care personnel in some areas When additional positions are approved for food service it will no longer be necessary to utilize patient care personnel in these areas The number of dining rooms has been reduced from 68 to 63 and will be further reduced in fiscal year 1971mmm 22 Computer Assisted Menu Planning was inaugurated in July 1969 with October November and December 1969 menus This capability enabled the serving of 10 897 889 meals including 2158335 special and modified diet meals during FY70 at a raw food cost of 02719 per meal an in crease of 5 over FY69 This was in the face of an 118 increase in the cost of meat fish and poultry in the Atlanta area as reported by the USDA during FY70 Surplus Commodity foods available for use dropped approximately 100000 during 1970 Ten dining rooms were rehabilitated with new cafeteria lines refrig eratorfreezers dishwashing machines coffee urns tables chairs and other serving equipment This included dining rooms in the Walker Binion Freeman Boone and Allen Buildings Georgia State Department of Health Food Service Permits were received for the Boone Building dining room Green Building dining room five Arnall Building dining rooms Vinson Building dining room four Yarbrough Building dining rooms and Childrens Building A preventive maintenance program for all motor vehicles has been initiated All motor vehicles are scheduled for service and maintenance and all drivers are required to maintain daily logs A complete record of the operating and maintenance cost of each vehicle will be maintained A complete study of our warehousing and procurement procedures has been made by a committee appointed for this purpose The findings of this committee resulted in a recommendation for the creation of three major sections procurement inventory and property control under the direction of a materials manager These recommendations have been approved by the Plans and Operations Committee and will be implemented early in FY71 PERSONNEL DIVISION On June 30 1970 there were 4023 regular employees on our staff an increase of 190 over the end of the previous fiscal year The largest gain was in the subprofessional nursing category Increases were also made in the clerical and services categories During the fiscal year approximately 900 employees received salary adjustments as a result of class reassignments by the State Personnel Board Included in these reassignments were physicians dentists and nurses and positions within the clerical trades managerial subprofes sional and manual labor categories Incompliance with provisions of the Fair Labor Standards Act the lowest entrance salaries were elevated from 231 per month to 255 per month during the year Ccntsial State Hospital opexata it6 own watex treatment plant which annually phoceAieA 676 million galloni o watex Shown above ii the fiecentty completed iewage txeatment plant with a capacity p 7 mil Lion gallon peji day and which will olio iexve the needk o the ci ty ol IhilledgevWLe and Baldwin County 23 Let The new fixe Station Above A numb ex oi wand a neaA wexe nenovotedv aflH 24 The 1970 session of the Georgia legislature appropriated funds for a 400 per yearsalary adjustment for all state employees Accordingly the Personnel Board at its April meeting approved anew compensation sche dule to be effective July 1 1970 which increased each step of the pay plan 3350 per month All of our regular employees were assured of an increase in this amount A night salary differential for licensed nursing personnel was initiated on July 1 1969 The following is a tabulation of personnel actions during the year Appointments 1218 Transfers 426 Promotions 552 Demotions 23 Leaves of absence 227 Return from leaves 168 of absence Miscellaneous 778 Separations 952 including 734 Resignations 117 Dismissals 18 Deaths 23 Transfers to other agencies 60 Retirements Rate of turnover 23 6 The number of appointments listed above is based on regular employees in pay status and does not include those on various types of leave without pay or employees on stipends Consequently a figure obtained by sub tracting separations from appointments will not balance with the change in total employment A tabulation of personnel of the hospital by type is shown on a sepa rate page25 A WINNING COMBINATION BEAUTY AND COMPETENCE MliA CSH fan 7970 aj Mm Ruanda Underwood who id SucAttaty to Food SwoldL VixzcXoft McuwLce McNabbmimmt am Hv 26 PERSONNEL BY TYPE AS OF JUNE 30 1969 AND JUNE 30 1970 n 1969 1970 1 Physicians 2 Dentists 3 Nurses 4 Therapists 5 Engineers 6 Sanitarians 7 Physical Scientists 8 Nutritionists 9 Education Information Specialists 10 Psychologists 11 Social Workers 12 Other Professions 13 SemiProfessional Technical 14 Managerial 15 Clerical 16 Agricultural 17 Trades Crafts Mechanical 18 Services 19 Manual Labor Total 101 108 5 9 110 117 22 25 7 7 1 3 8 9 3 3 8 8 6 12 17 20 23 21 2117 2205 35 39 302 322 12 22 306 312 407 427 343 354 3833 4023 mmmm 27 ENGINEERING The mission of the Engineering Division is to maintain adequate patient housing and related facilities in a safe and sanitary condition and to up grade the facilities to comply with the standards of the Joint Commission on Accreditation The Engineering Division is comprised of 278 employees including administrative and supervisory personnel This division is responsible for the maintenance of seventy major buildings housing approximately 9060 patients administrative offices and other related functions In addition to building maintenance this division also maintains 103 personnel dwellings that are assigned to staff members approximately 20 miles of roads and streets operates its own water treatment plant which processes 676000000 gallons of water annually and operates its own steam plant to provide power for heating and air conditioning of buildings and operation of two laundries The following is a brief summary of the major Engineering Projects for 1970 1 State Highway Department Program installed concrete curbs and gutters underground culverts and paved the roads around the Bostick Building 2 Hospital Authority project for new sewage treatment plant with a capacity of 7000000 gallons per day to serve Cen tral State Hospital Milledgeville and Baldwin County was completed Contracts were let and work begun on a system of lift stations and interceptor sewers to serve the hospital and surrounding areas 3 Short term air conditioning units were installed in sick wards of nine patient buildings 4 Three passenger elevators in the Powell Building were reno vated with modern controls The Dental Clinic was completely renovated to include floor covering improved lighting repiping hot and cold water systems new fixtures and new vacuum evacuation system New floor covering was installed in the dining areas of the Ingram Whittle Walker and Green Buildings Contract was let and work begun to renovate eleven bath rooms in the Boone Building and one bathroom in the BolandV 28 Building renovation to include new fixtures with all interiors to have structural glazed tile 75 complete 8 Contract was let and work begun to renovate Tenth Ward to include new roof exterior brick veneer new aluminum win dows acoustical ceiling increased electrical service air conditioning of patient areas and installation of fire sprink ler system 90 complete 9 All windows were removed from the interior of patio in Boland Building Windows were replaced with brick and structural glass block 10 Improved lighting was installed in patient areas of the Powell Green Binion and Whittle Buildings 11 The Pharmacy area in the Lawrence Building was expanded to provide additional facilities for storage and work areas 12 Renovated Jones West wing to provide modern facilities for OBGYN and EKG Departments 13 Constructed TV studio in Yarbrough Building for use by Audio visual Services 14 Constructed Patient Information Office in Powell Building 15 Installed improved electrical service in Holly Building Old Laundry and Powell Building 16 Installed outside lighting for Chapels 2 and 5 and on Law rence Road and Yarbrough Drive The Engineering Division actively participates in the Patient Rehabili tation Program We are presently working with 45 patients who are being trained in the various fields of construction and maintenance This program enables individuals to return to the outside prepared for useful employ ment through their experience and training in this program The capital outlay program for this division plans for all patient buildings to be air conditioned within the next ten years This program will include construction of a new steam plant as the present plant is gradually becoming obsolete and will not meet the increased demand for steam that will be needed for our air conditioning program SITE OF THE FUTURE GENERAL MEDICAL t SURGICAL BUILDING CENTRAL STATE HOSPITAL STATE OF GEORGIA DEPARTMENT OF PUBLIC HEALTH BRADBURY ASSOCIATES ARCHITECTS PLANNERS ATLANTA II 1 I L 1 Plan ion the New Genznal Mzdical and Sanglcal Hospital one almost complete 29 The iie Wonting on the Vinton Highway give ample Apace ion deveZopment30 i Long range goals of this division are to establish a planned program of preventive maintenance and capital outlay projects to provide a pleasant environment for patients and employees with an ultimate goal of providing adequate buildings and utilities to enable the hospital to meet its objec tives of proper treatment and rehabilitation of patients DIVISION OF MANPOWER ADMINISTRATION The Division of Manpower Administration is concerned with the de termination of requirements for and allocation of personnel resources and optimum utilization of these resources This is accomplished through the development of staffing standards employee training organization policy and procedure formulation and management auditing Other programs are grants management forms control printing and various staff services as required The following are some of the significant events of the year 1 The division assumed responsibility for the secretariat of the Plans and Operations Committee and for the direction of the Print Shop 2 Developed policies and procedures for and initiated a forms control program 3 Initiated manpower audits in hospital units and prepared staffpatient ratios on a regular basis 4 Prepared staffed and published 54 amendments to the Policy Manual including 24 new policies 12 new procedures 12 revised policies and six revised procedures 5 Initiated preparation of a Staffing Guide for the entire hos pital 6 Processed 210 training applications prepared and submitted 602 Employee Training Records and coordinated preparation of and forwarded 3950 Training Record Questionnaires 7 Planned and coordinated presentation of three management training courses and coordinated the hospitals participation in a supervisory development course presented by the State Department of Education Completed preparations for train ing in Planning Programming and Budgeting Systems to be conducted during FY71 8 Prepared staffed and published 69 discrete amendments to the organization chart 31 9 Processed approximately 2000 jobs at the Print Shop pro ducing approximately 800000 printed cards and 4000000 printed sheets HOSPITAL INFORMATION SYSTEM Duringthe fiscal year 1970 the Hospital Information System designed programmed and implemented a number of new systems a summary of which follows A public release on the menu planning system for the central kitchen resulted in national and international interest and requests for additional information were received from more than 48 states and five foreign coun tries 1 Pharmacy Inventory System This system provides and maintains a perpetual accounting for all drugs and pharmaceutical supplies stored at Central State Hospital 2 General Inventory System This system much like the Pharmacy maintains a perpetual record of all food clothing engineering and supply items stored at Central State Hospital 3 Patients Payroll System This accounting system produces auditable records of our payments to working patients 4 Patient Recidivism Analysis This system calculates the rate of return of patients released from various units within the hospital It provides a super ficial method of evaluating our patient treatment program Annual Statistics Reporting System This system calculates and maintains statistics on a yearly basis for use in printing the annual reports Some of the information contained in this system is as follows Admis sions of patients by class Patients within the Hospital by diagnosis Transfers out of the Hospitals Transfers into the Hospitals Separations and Discharges32 6 File Maintenance System This system was created for the purpose of retrieving from the patient information files information in an expedient manner We are called on to utilize this system almost daily 7 Patient Clinic Scheduling System This system produces reports of appointments which the patients have with the ancillary functions in the Jones Hos pital These reports are made available to the wards and buildings so that they may prepare patients for appointments This system also provides a reminder to wards and buildings regarding specific medication that patients must have 8 Movable Capital Equipment Inventory System This system maintains a perpetual inventory of all items which have a value of 25 or more and an expected life of one year or better It provides the hospital with the ability to maintain inventories by department or unit and capture transfers both interdepartment and intradepartment 9 Personnel Action Transmittal System This system provides a means of transmitting to the Depart ment of Public Health all personnel transactions These transactions such as promotions and increases to salaries update the payroll files at the Department of Public Health and provide an expedient means of obtaining an accurate payroll 10 Budget Planning System This system provides the hospital with the facilities of cap turing and printing the annual budget in advance by depart ment and unit and consolidating into a hospital budget for the fiscal year It also provides the facilities to alter and revise the budget as required Major maintenance and enhancements were applied to the following systems in fiscal 1970 The Centnat Kitchen dibpenheh 30000 balanced meal6 pen day Computerized menuA have con siderably reduced ood cohtb Small iteaki are accumulated and provide a welcome change In diet The bakery tutvnb out pie cake and 1000 loavei ol bread pen day 3334 Patients Information System This system was enhanced to provide more pertinent infor mation regarding the patients history and background The facilities were also provided to send via a telecommunica tions device to Atlanta the entire patient information files and to update these files with relevant information periodi cally This will give the Department of Public Health the facility of a central patient census file 2 Patients Deposit Fund This system was enhanced to provide daily updating of pa tients deposits and withdrawals allowing the patient to more regularly utilize his checking account here at the hospital 3 Menu Planning Menu Planning has been maintained and enhanced to provide the Food Service Director more and better control over the raw food costs 4 Personnel System This system has been enhanced to provide management with more adequate reports regarding vacancies and personnel transactions Systems which were designed in 1970 and scheduled for implementation in early 1971 are as follows 1 Budget and Cost Control System This system will provide the management of Central State Hospital with accurate and expedient information regarding the budgets and encumbrances to these budgets of each and every department and unit within the hospital ultimately capsuling this report to a hospitalwide budget and encum brance report Cost Findings Cost findings is in the process of being designed and will provide the hospital with the facility of acquiring more agen cy income from federal and industrial insurance programs This system will also provide management of the hospital with better cost information thus giving them the facilities to better manage our scarce resources 3 Credit Union 35 The Credit Union has asked that the Hospital Information System design program and implement an accounting system for the accounts which they maintain for the personnel at the hospital This system is being reviewed by the hospital management and should begin the design phase no later than September 1970 In addition to the above the Hospital Information System has been called on at the rate of approximately thirty 30 times per month to provide to hospital management special statistical reports regarding patients the budget and personnel The computer utilization has steadily increased over the past fiscal year from 90 central processing unit hours in June 1969 to 170 central processing unit hours in June 1970 The staff of Hospital Information System consists of a Data Processing Manager a Systems Analyst a Programmer II three Programmer Trainees three Computer Operators five Key Punch Operators and a Secretary The staff continues to further its capabilities through the educational facilities provided by the IBM Corporation through its General Education and Medical Offices in Atlanta The Hospital Information System continues to aid the hospital in meet ing its objectives by providing management with expedient information in areas concerning resources and patient care INDUSTRIAL ENGINEERING Industrial Engineering has become the locus of information for the Medicare Medicaid and National Health Insurance programs at Central State Hospital by gathering all available information into their office Detailed reference manuals are being completed which correlate Federal and Georgia laws list conditions of participation show guidelines for gaining participation in all phases of Medicare and Medicaid should they become available describe existing procedures in detail and make re commendations for additional participation in Medicare and Medicaid 36 Industrial Engineering also has the continuing responsibility of sur veying new decisions rulings and laws to maintain a current knowledge of Medicare Medicaid and National Health Insurance programs In this manner Central State Hospital can be more alert to and take advantage of additional sources of revenue with which the quantity and quality of patient care can be improved Income derived from implemented recommendations during the first six months of 1970 fiscal year will far exceed the cost of conducting the project Projects upon which Industrial Engineering was working when the MedicareMedicaid Project assignment was received were delayed until completion of the MedicareMedicaid Project The Budget Simulation the Total Linen Systems Study and the Industrial Engineering Manual will first be reinitiated Upon completion of one or more of these projects studies in Nursing Time and Motion Printing Costs Comparison and Communica tions TWX are being planned and scheduled An advanced course for Data Technicians who have completed one of the basic courses conducted by the Industrial Engineering Division is being tentatively planned for this fall or winter HORTICULTURE Three new projects begun during fiscal year 1970 included the recon struction of the old Colony pond orchard for a recreation area for patients the renovation of the grounds of the old cemetery and anew rehabilitation garden between the Rivers Building and the Vinson Highway The old Colony pond area will be one of the most important recreational areas for hospital residents and is now approximately 20 completed It will be divided into several sections so that many functions can be carried on simultaneously Scuppernongs and muscadines have been rooted and will be ready for planting in the fall This part of the new orchard will cover 10 acres and will also include apples pears and blackberries Renovation of the old cemetery is about 40 complete and has been planted with Bermuda grass and made much more attractive Garden Clubs of Georgia Inc furnished 2000 narcissus bulbs which were planted in the western section of the cemetery under loblolly and short leaf pines and beside the walks that are being established throughout the cemetery aza leas camellias and flowering shrubs will be planted Dogwoods and flowering cherries have already been planted The rehabilitation garden project was started three years ago and includes an eight acre area which will function both as a picnic grounds and a flower garden The building was finished this year and zoysia grass The greenhouse is producing as many flowers as can be adequately arranged The arrangements go to the hospital wards and various other patient areas Forty thousand cut chrysanthemums were produced as well as 3 6000 snapdragons however this only allows about 20 arrangements for each ward per year In addition floral arrangements are furnished for each funeral that is held in the hospital chapels Floral arrangements are supplemented by pot plants of geraniums coleus begonias gloxinias and ageratum Bedding plants are furnished for the garden clubs of the hospital for planting in the various hospital areas by patient members All patients assigned to the department are on the Patient Pay Program and most come from the Yarbrough Building through the Vocational Reha bilitation Division 37 will be planted on the bank on the north side of the building as soon as possible More than 1200 ft of walks are to be planted with various grasses and flowering perennials in the north area and with azaleas and camellias to the south In addition to this a garden for the blind is con templated which will include various types of scented plants as well as those with different leaf textures EJOgBBSPBieipa 38 Camt thou not mlnlbteA to a mind dacud Pluck ftom the memory a tooted iowiovo Raze out the MhJXten tAoubleA oh the bitaln And with home meet obtivloui antidote Cleanse the Atud boom ofi the pexitoui Atu Which welglu upon the heantl Macbeth39 CLINICAL ASSISTANT SUPERINTENDENT CLINICAL Michael L Sheppeck MP GENERAL PSYCHIATRY SPECIAL PSYCHIATRY NURSING SERVICE PSYCHOLOGY SOCIAL WORK SOCIOLOGY CHAPLAINCY SERVICE SPECIAL EDUCATION 40 UNIT 1 BUILDINGS Powell Const 1858 remodeled 1955 Walker Const 1883 Green Const 1947 10th Ward Const 1938 NUMBER OF WARDS 13 PATIENT CENSUS June 30 1970 1100 ADMISSIONS 973 DIRECTOR Santiago Aguilar M D ADMINISTRATOR James Tate DIRECTOR OF NURSING Mrs Ouida Couch Registered Nurse COUNTIES SERVED 3 Fulton DeKalb and Clayton This Unit includes admissions coming from the Metropolitan Atlanta area the number of patients from Fulton County being the largest The two ad mission wards are located in the Powell Building which includes four other wards The main domiciliary buildings are Green and Walker which house females and the 10th Ward which houses males The Unit includes a com plete roster of treatment services including psychology social service occupational therapy music therapy recreation therapy and chaplaincy services During the past year patient involvement in various hospital activities increased considerably A close working relationship and liaison has been maintained with state mental health resources such as the Georgian Clinic the Georgia Mental Health Institute the Atlanta Regional Hospital and comprehen sive mental health centers in Fulton DeKalb and Clayton Counties These aftercare programs are proving increasingly effective in helping the patient remain out of the hospital All physicians in the first and second year of the Psychiatric Residency Training Program remain in the Unit thus providing the patients with con siderably more medical supervision than they would otherwise receive The Units population also increased last year when it was assigned responsibility for mentally ill individuals housed in the Georgia Rehabili tation Center for Women The major need of the Unit for the coming year is air conditioning of41 two large buildings Green and Walker The 10th Ward building is being completely renovated The outside is bricked and a new roof installed Interior renovation includes new windows new walls a new sprinkler sy stem new bathrooms a special clothing room and other facilities The air conditioning of the building was completed this past year Also during the year the Green Building was painted Walker 1 sick ward was air conditioned and the dining areas in both Walker and Green were com pletely remodeled ALL WORK AND NO PLAY HOW DOES IT GO An elective IntxamuxaL ipoKtt program provide yearround recreation in mot major sports Competition U keen and trophies are awarded at the end oh each league schedule Recreation Like alt other patient activities at CSH lt in cluded in the patient6 therapeutic ph0QKam Recreation Therapist Supervise KHIIBBBHBBnHHaHaHlHBBHflMnMlm 42 UNIT 2 BUILDINGS Bostick Const 1951 and Washington Const 1950 NUMBER OF WARDS 20 PATIENT CENSUS June 30 1970 1362 ADMISSIONS 1214 DIRECTOR Eduardo Guernica MD ADMINISTRATOR Paul W Mitchell DIRECTOR OF NURSING Mrs Fay Fidler Registered Nurse COUNTIES SERVED 45 Bibb Crawford Peach Houston Taylor Macon Dooly Pulaski Chattahoochee Marion Schley Sumter Crisp Wilcox Stewart Webster Cook Quitman Randolph Terrell Lee Worth Irwin Turner Calhoun Ben Hill Dougherty Berrien Early Miller Baker Mitchell Colquitt Sem inole Clay Tift Grady Thomas Brooks Mus cogee Lowndes Lanier Echols Decatur Harris The overall objective of the Unit is to improve patient care through improved treatment programs better nursing care improved physical plant and equip ment and reduction of patient load In regard to the latter the patient census at the end of the year was 1362 compared to 1428 at the end of the previous year despite a full years experience of the addition of Muscogee County to this Unit Psychiatric treatment follows basically an eclectic approach with all disciplines occupational therapy music therapy recreation therapy so cial service psychology and chaplaincy participating directly with the psychiatrist in a coordinated therapeutic effort through an active milieu program By this the patient is kept active most of the day This program operates in the intensive treatment wards and progress is being made in order to provide a similar program in Washington 1 Unfortunately inad equacy of personnel and overcrowding are hindering further progress The results seem encouraging and it is hoped that somehow in the future the program can be extended to other wards In regard to physical illness each building has its own sick ward where minor illnesses are treated Patients with major illnesses are transferred to the Medical and Surgical Unit in the Jones Hospital for their treatment While improved patient care is the basic objective of Nursing Service nursing education has received special attention during the past year Registered nurses have attended management development courses a course on mass casualties held at the Medical College of Georgia in Augusta a course on alcoholism presented by the Georgian Clinic in Atlanta and a course on staff development for professional nurses held at Central State Hospital Although social service has remained primarily related to routine ser vices because of the lack of staff there has been considerable work with patient groups A major emphasis has been on nursing home placements as a significant means of reducing patient population thus increasing the staffpatient ratios Building and eguipment improvements continue at a satisfactory level Highlights of construction were the completion of the Bostick road and circle complete with sidewalks curbs and drains The badly needed linen rooms on all the wards in the Bostick and Washington Buildings were completed A new drug room has been constructed and will be in operation early next year The contract using current year funds has been let to tile the remaining six wards in the Bostick Building Modernization and re placement of eguipment continued There were no personnel increases during the fiscal year 43 iBliiHiHHi 44 UNIT 3 K BUILDINGS Holly Const 1949 Ingram Const 1928 Howell Const 1939 NUMBER OF WARDS 20 PATIENT CENSUS June 30 1970 1232 ADMISSIONS 1227 DIRECTOR Jose A G Mendoza MD ADMINISTRATOR R O Pennepacker DIRECTOR OF NURSING Mrs Frances Osborne Registered Nurse COUNTIES SERVED 38 Richmond Jefferson Burke Johnson Treutlen Emanuel Jenkins Screven Laurens Charlton Effingham Wheeler Toombs Candler Bleckley Montgomery Tattnall Bulloch Coffee Chatham Atkinson Long Camden Evans Jeff Davis Lib erty Brantley Dodge Telfair Bacon Wayne Appling Pierce Mclntosh Bryan Ware Glynn Clinch Admissions during the last year increased by 151 to a total of 1227 how ever the census decreased by 82 to a total of 1232 due in a large mea sure to patients being successfully placed in nursing homes Monthly admissions averaged 102 this year as against 92 last year Monthly re turns from furlough averaged 66 for both years During June of the year the Social Work Division recruited 128 vol unteers from two local high schools The students assisted Unit person nel in individualized services for the residents The volunteers spent their time writing letters involving the patients in the cosmetology par ties helping regressed patients become active in ward programs and just talking to patients The project has been so successful it will be con tinued during the coming year The dental clinic operatory completed the screening of all patients performed extensive dental repair and generally improved oral hygiene in the Unit Inservice education was enhanced by the full time assignment of a45 registered nurse as an instructor which permits continuous onthejob training for ward personnel in improved nursing techniques however re gistered nurse staffing in other areas is critical Housekeeping was expanded with the assignment of a supervisor for the male service in the Howell Building A number of patient areas were improved the square footage per patient was increased and continuing improvement in these two areas will be a major project of the new year A considerable amount of new equipment was added during the year permitting much better recording of patient records New beds have been added in several areas and Ingram 1 North and Howell 2 North both sick wards have been air conditioned Some adjustment in ward alighment was made making physician and nurse coverage more available to the patients Computer listing of pa tients going to the Eye Clinic and other clinic appointments has been of great assistance The affiliation of the nursing students from Georgia College at Milledgeville has been helpful in providing better patient care Twentysix students completed their affiliation in Unit 3 this past year Thz old iukin hole ptioidzi donvwdatlon tieZaxation and iomeXlmu lih46 p UNIT 4 BUILDINGS Freeman Const 1962 1939 Arnall Const 1939 new addition NUMBER OF WARDS 17 PATIENT CENSUS June 30 1970 1414 ADMISSIONS 1292 DIRECTOR Charles A Rich MD ADMINISTRATOR William W Curl DIRECTOR OF NURSING Mrs Ruth Mullis Registered Nurse COUNTIES SERVED 28 Catoosa Walker Whitfield Murray Dade Gil mer Chattooga Floyd Gordon Bartow Pickens Cherokee Haralson Paulding Cobb Polk Car roll Douglas Heard Coweta Fayette Talbot Spalding Meriwether Troup Up son Pike La mar Admissions to this Unit come from 2 8 counties in the northwest corner of Georgia The Unit census shows a net reduction of 129 patients during the past year The reduction was brought about by the transfer of patients to the regional hospital at Thomasville as well as by the placing of nurs ing home candidates from the Unit into geographical areas served Admis sions have been averaging over 100 per month The Unit operates three admission wards one male and two female Unit 4 continues to operate a sick ward that could be classified as a skilled nursing home This ward has qualified personnel and adequate coverage for any given 24 hour period Ward areas have been improved and the reduction of patient census has allowed more space per patient on each of the wards A new dental operatory was installed in the Arnall Building A full time dentist a hygienist and two aides staff this department Expansion of services by the special therapies has helped considerably with the con tinued treatment of patients confined to Unit 4 Ward programs have been started by occupational and recreation therapy The treatment programs in the Unit have changed slightly during the year due to a turnover of the medical staff however they continue to be hhmmnp 47 more than adequate and chemotherapy is utilized as one of the major treatment programs During the year the staff to patient ratio has slightly improved with the addition of several new attendants to the afternoon shift The social work program has also improved with the adding of personnel to the staff The medical staff with the assistance of social service continues to encourage community contacts with the patients so that treatment may be continued after the patient is discharged or sent home on convalescent leave The continuation of equipment modernization programs constant im provement of patient residential areas and the establishment of a closer working relationship within the Unit as well as with the local communi ties is providing better patient care and treatment and the development and utilization of new and tested methods of psychiatric care within the Unit Careful evaluation and analysis of existing programs based on collected data is providing factual information for the improvement of all Unit operations A planned capital outlay program for next year will in clude the complete air conditioning of Arnall East which was built in 1939 New and modern lighting will also be installed The new nnoJizoJtion centeA opened laut yzoji ti much appftecioXed by the paLentigj texts fe8ft ivs tfc i gg 48 UNIT 5 BUILDINGS Allen Const 1939 Whittle Const 1901 remodeled 1953 NUMBER OF WARDS 18 PATIENT CENSUS June 30 1970 843 ADMISSIONS 1373 DIRECTOR Lorenzo del Portillo M D ADMINISTRATOR Thomas A Simmons DIRECTOR OF NURSING Mrs Mildred H Daniel Registered Nurse COUNTIES SERVED 45 Fannin Union Towns Rabun Dawson Hall Elbert Lumpkin White Habersham Banks Hen ry Forsyth Stephens Franklin Gwinnett Bar row Jackson Madison Hart Rockdale Walton Newton Oconee Clarke Oglethorpe Wilkes Glascock Lincoln Taliaferro Greene Butts McDuffie Jasper Putnam Hancock Warren Washington Monroe Jones Baldwin Wilkinson Columbia Twiggs Morgan Unit 5 continues to progress although turnover of professional personnel has been a problem during the past year In spite of this effective pro grams in activity milieu behavior modification resocialization attitude techniques drug addiction problems and work with chronic patients have all progressed Also effective have been home and family management classes adult education for both male and female patients and an orien tation program for new admissions Weekly rounds in the General Medi cal and Surgical Hospital have been continued so that patients from the Unit maintain contact with Unit personnel Wellplanned program activi ties have been conducted by the recreation therapy occupational therapy music therapy and remotivation departments as well as by the volunteer workers from the garden clubs The Unit now has two nursing home wards one in each building A toilettraining program was initiated in the Whittle Building and a closer supervision of storage rooms as well as the repair and dispersal of fur niture has resulted in dressing up the wards An interdisciplinary executive committee was organized to provide better communication interdisciplinary cooperation and more unified de 49 cisions on policy and procedure Each patient in the Unit was completely reevaluated for mental status and physical problems A medication review and progress note on general treatment was initiated with the advent of the 1970 Mental Health Law All court cases have been reviewed and disposition made according to the patients mental condition Unit personnel have continued visiting various health departments aftercare clinics nursing homes and other treatment facilities within the geographical area covered by the Unit This has improved communication and resulted in better treatment techniques A total of 43 6 patients were transferred to nursing homes during the past fiscal year The Unit census last year was 1191 and this year was 843 giving a total decrease of 348 patients Physical changes in the Unit have been extensive Fluorescent lights were installed in the Whittle Building new recreation and occupational therapy areas were constructed air conditioners were installed in both sick wards commercial washers and dryers were installed for the patients personal clothing the Whittle Building was painted and necessary repairs were made to windows and doors Dining areas in the Allen Building were renovated and a lounge was setup in each building for women employees During the coming year an orientation program for chronic and senile patients will be initiated the toilettraining program for chronic patients will be expanded a preparation ward for vocational rehabilitation candi dates will be set up and hopefully a ward for attendant job orientation which will function under the direction of a clinical instructor registered nurse will be organized Ml6 Van UonAsL cut the cake Geongia BeutlcianA Annual JliiX50 UNIT 6 BUILDINGS Cabiness Const 1901 remodeled 1953 Carl Vinson Georgia War Veterans Home Const 19 69 NUMBER OF WARDS 13 PATIENT CENSUS June 30 1970 467 ADMISSIONS 84 DIRECTOR Carl L Smith MD ADMINISTRATOR Vacant DIRECTOR OF NURSING Mrs Edna Ross Registered Nurse COUNTIES SERVED The State of Georgia The new Carl Vinson Georgia War Veterans Home has given the institution treatment space for 150 additional veterans including a 10bed ward for females Treatment programs include all standard therapies as well as effective inservice treatment programs Some physical ward changes were made to better accommodate the type of patients assigned to the wards An increased number of personnel and the above mentioned changes in the physical facilities have materially contributed to an improved treat ment program The assignment of an additional recreation therapist and a fulltime attendant to work with him has resulted in a much better program for the aged residents In the Cabiness Building some additional equipment renovation of physical facilities and reassignment of ward functions has resulted in a more effective utilization of personnel as well as an improved treatment program The medicine rooms were removed from the wards and each pa tient in the Cabiness Building now has a private room Monthly inservice programs have been effective in raising the efficiency of nursing personnel thereby resulting in better patient care The new building is a modern threestory air conditioned facility in corporating the latest techniques in utilizing the patients environment as a therapeutic toolUNIT 7 MAXIMUM SECURITY 51 BUILDINGS Binion Const 1946 NUMBER OF WARDS 4 PATIENT CENSUS June 30 1970 266 ADMISSIONS 309 DIRECTOR E L Stincer MD ADMINISTRATOR Calhoun Berry DIRECTOR OF NURSING Vacant COUNTIES SERVED State of Georgia The Unit has responsibility for the psychiatric treatment of court cases male inmates of the state penitentiary system and hospital patients who require treatment in a maximum security setting Admissions during the year totaled 309 288 patients were discharged as improved or restored The treatment program now includes chemotherapy individual psy chotherapy group psychotherapy milieu therapy recreation therapy work therapy and music therapy The completion of a new laundry has provided additional opportunity for patients in job training and the work therapy program has expanded as a result The addition of another phy sician to the staff has materially increased the effectiveness of the treat ment program A new roof on the building has made possible better security measures The ward environment has been improved with the addition of upholstered furniture in the recreation rooms instead of the wooden benches formerly used The Unit director is required to do considerable traveling in testifying in court cases as well as in other matters affecting the forensic psychia try program A total of 20 visits were made last year in carrying out this responsibilityI I I III I I III 52 UNIT 8 BUILDINGS Childrens Rehabilitation Center Const 1964 Adolescent Wards 7 and 8 Boland Building Const 1969 NUMBER OF WARDS 4 PATIENT CENSUS June 30 1970 105 ADMISSIONS 88 DIRECTOR Juan Portuondo MD ADMINISTRATOR Jerry Bush DIRECTOR OF NURSING Mrs Mary Ann Bell Registered Nurse COUNTIES SERVED The State of Georgia The Unit provides psychiatric treatment and care for 122 mentally disturbed children and adolescents It includes the Childrens Building with a capa city of 56 patients and two adolescent wards in the Boland Building with a capacity of 40 beds on each Adolescent Ward 7 is occupied by males and Adolescent Ward 8 by females The Unit provides a complete treatment program individual and group psychotherapy child psychiatry psychology and social work services chaplaincy services special education classes provided by the Special Education Department State Department of Education music recreation and occupational therapy a behavior modification token system on the adolescent wards a merit and demerit system in the Childrens Building and ward government on the Adolescent Wards Special programs include growth and development and speech therapy sessions in cooperation with the University of Georgia Speech and Hearing Clinic During the year the policy was established that children and adoles cents with an IQ above 70 would be admitted to the Unit Several innovations have added to the efficiency of the treatment pro gram including the establishment of a Kardex nursing care plan with pic tures throughout the Unit the completion of a course in cardiopulmonary resuscitation procedure by all nursing personnel the selection and certi fication of a team of attendants for intravenous medications andnasogas trictube feeding the modification of the adolescent wards to provide quiet rooms with seclusion doors Quiet rooms were also constructed in the B I R T H D A Y S A R E F 0 R R E M E M B E R I N G 53 Childrens Building A background music and intercom system was in stalled in the Adolescent Wards and the Childrens Building Some of the Units problems include the lack of an adequate recrea tion area for adolescents the shortage of teachers and classrooms in the School of Special Education Twentyfive per cent of the boys and girls are unable to attend school because of insufficient classroom space and teachers54 UNIT 9 BUILDINGS Boland Const 1951 Boone Const 1952 NUMBER OF WARDS 16 PATIENT CENSUS June 30 1970 823 ADMISSIONS 101 DIRECTOR Evelio F Diaz MD ADMINISTRATOR Bobby Sheppard DIRECTOR OF NURSING Mrs Virginia Smith Registered Nurse COUNTIES SERVED The State of Georgia The function of this Unit is the care treatment and education of those persons whose primary impairment is mental retardation The goal is to provide an interim experience to enable the residents to develop their fullest potential at physical emotional spiritual and social levels regard less of the degree of handicap Approximately 298 staff members serve the 825 residents of the Unit Possibly the most significant development during the year was the organization of interdisciplinary teams working in the four areas of mild retardation moderate retardation severe retardation and profound retar dation Development of these teams around the interdisciplinary concepts has resulted in implementing training programs in three areas in the Unit The wards are grouped so that residents are similar in terms of level of retardation and behavior Each team examines the needs of the residents on the teams three wards and designs a program that makes best use of staff in the treatment program The team working with mildly retarded residents has developed an effective training program for adolescents Token economy systems pro vide the ward structure for two of the three wards The Special Education Program and vocational rehabilitation facilities are utilized to provide off ward training for the residents All other disciplines provide services for residents with special needs as well as those not involved in school or work training The result of this approach is seen in an increased num ber of furloughs and an increased number of residents transferred to the Yarbrough Building for vocational training The teams tor the mildly retarded severely retarded and profoundly HHretarded are in the process of developing their programs to include both structured ward programs and offward activities as well as providing training in selfhelf activities which will enable the residents to better cope with an institutional life 55 GENERAL PROGRAM ACTIVITIES Medical services are offered to the residents by six physicians who provide for the total health care of the residents including pediatric and psychiatric services Also available are the services of the Department of Physical Medicine The Nursing Service profited by the addition of new ward programs and the expansion of the Housekeeping Department thereby allowing the Nursing Department to participate more actively indirect care of the resi dents The psychologists implemented several behavior modification programs during the year The two token economy wards have been maintained and the level of functioning has risen considerably due to refinements in the programs The training program on Boone 8 has been extended to include a nursery school designed to prepare the children for entrance into the Special Education Program Psychologists also provided psychological evaluations on both residents and outpatients and served in several lead ership capacities The music therapy staff has conducted two training programs in toilet training and selffeeding with severely retarded residents The staff has alsocontinued the Unit choirof 40 mildly retarded residents and has begun preschool training for selected residents of Boland 3 Recreational activities are arranged to suit the weather available resources and needs of the residents and include both large and small activities Several programs are carried out in conjunction with other disciplines Remotivation personnel have worked with 200 residents during the year in small group sessions which utilize the five basic steps of remo tivation therapy and practice Social service has had major responsibility for coordinating pre admission evaluation services expanding and upgrading the collection of background and social history information on all new admissions and in providing counseling services for individual residents and their families Vocational rehabilitation has increased the number of residents ad mitted to the Yarbrough Center during the past year and has also developed56 a more comprehensive vocational training program for the retarded College students hired as summer workers during the summers of 1969 and 1970 have brought youthful enthusiasm to the Unit and provided much needed assistance They have worked effectively in the toilettraining and feeding programs established on Boone 5 and in an additional feeding program on Boone 3 Students from Mercer University in Macon have driven the 60 miles each week to work with retarded children and students from Georgia College at Milledgeville have also been active in the volunteer programs An increased number of worship services clinical pastoral services clinical pastoral education sessions and conferences on the aspects of religious interpretation have been conducted in Unit 9 during the year by chaplaincy service Inservice training programs have been considerably expanded includ ing six programs in general orientation in retardation a retardation work shop psychiatric aide training program a continuing education program for nursing personnel special training activities for the Housekeeping Department and classes in physical therapy training participated in by several members of the nursing service Several staff members of the Unit were honored during the year One member served as president of the Georgia Association for Retarded Child ren another served as president of the Baldwin County Area Association for Retarded Children and Mrs Alma Digby Charge Attendant was recog nized by the Georgia Association for Retarded Children with an award as Outstanding Residential Service Worker for Central State Hospital CSH athlztnA won ouA madaJU and eight ribbon cut Ckicago Olympics UNIT 10 57 BUILDINGS Yarbrough Const 1962 Various Work Centers around the hospital NUMBER OF WARDS 8 PATIENT CENSUS June 30 1970 283 ADMISSIONS No direct admissions DIRECTOR Salvador Mendez M D ADMINISTRATOR Levi Swinger DIRECTOR OF NURSING Mrs Janet Smith Registered Nurse DIRECTOR OF VOCATIONAL REHABILITATION SERVICES W C Petty AB COUNTIES SERVED The State of Georgia This Unit is operated jointly by Central State Hospital staff who provide the psychiatric treatment services and the staff of the Office of Rehabili tation Services who supervise a treatment milieu in which the emotionally disturbed patient can acquire sound work habits and vocational skills in preparation for employment in his home community The Unit contains eight psychiatric treatment wards a specialized treatment program for patients with multiple handicaps such as sight speech and hearing defects the testing laboratories for Neurology and Electroencephalography the research laboratories in Medical Genetics and the hospitals closedcircuit television studios and transmission equipment In addition there is a Work Evaluation Training Center a VocationalTechnical School and an Adult Basic Education Training Pro gram in cooperation with the Baldwin County Board of Education Patients enter the Unit from referral by the vocational rehabilitation counselor on the ward and come from all over the hospital They suffer from a variety of psychiatric and workrelated problems Many of them have long histories of poor work adjustment inadequate vocational and educational skills and a number have never worked There is also the patient who cannot return to his previous employment because of his hand icap and must seek job retraining The counselor works closely with the psychiatric team from referral until the patient leaves the hospital thus he is better able to understand the patients problem and to help him arriveIHHIHflgBBMEflNflflHOBHflHiHHIHHflwBMi 58 at agood vocational adjustment Last year 2446 patients received voca tional rehabilitation services The counselor uses the evaluation unit to assess the patients adjust ment to work and his vocational aptitudes and skills Work samples work performance tests psychometric tests including specific and general aptitude tests are used in measuring the patients specific abilities work aptitudes work habits and behavior and his tolerances to work con ditions A total of 539 clients received vocational evaluation Many patients receiving an evaluation are found to have serious pro blems in adjusting to work The counselor has a wide range of services available to him in helping the client overcome his problems More than 325 clients receive services through the program of the Work Evaluation Training Center This number represents many patients who could not even have been properly evaluated for vocational rehabilitation services due to their severely impaired condition Through this program an improved level of adjustment and function was achieved and the client thus became eli gible to receive the full range of vocational rehabilitation services Some 50 clients have been placed in competitive employment outside the hospi tal directly from the Work Evaluation Training Center Many more showed significant progress and were moved to the vocational training classes The work training program is made as realistic as possible incorpo rating within real work settings many of the demands made upon employees of industry Clients are working on contracts that have been made with private industry A total supportive therapy approach is undertaken in the work training center to encourage the long term chronic patient enrolled in this program The work adjustment unit extends the range of work settings available for adjustment training to include almost any conceivable occupational area of interest to a VR client Over 500 patients received services through the work adjustment program which emphasizes behavioral development of work habits and interpersonal skills with the ultimate goal being the resocialization or rehabilitation of the patient Two approaches are used in achieving this units objectives One is treatment through work therapy The philosophy of work therapy suggests that in making a good vocational adjustment the patient will also solve many of his nonvocational problems The second is using work adjust ment as an evaluation technique permitting the early identification of a patients assets and potential which can be developed through a voca tional rehabilitation program The emphasis of the program is on the dy namic element of the worker on the patients abilities as a productive person rather than concentrating on his disabilities In this milieu the 59 patient is an active rather than a passive being Work therapy differs from related programs such as occupational therapy in that the work setting is realistic Numerous specialized training programs in the adjustment area have been developed One of the most popular and largest has been the Unit Home and Family Management classes which provide basic adjustment training for the chronic female patient Through homemaking activities familiar to these women the course provides a medium with which they can identify and provides instruction in practices in which they will be engaged upon release It is also beneficial in helping them to learn skills and reduce anxiety which may be created by a feeling of inadequacy The classes are held in each psychiatric Unit have been supplied with furniture and equipment that closely resembles that found in therhomes of most patients and the classroom has been turned into a little home Instruction is geared to individual needs and abilities Specific areas of instruction are home management food and nutrition home nursing basic education child care personal and social adjustment clothing and crafts During the past year 447 women participated in these classes Many of the clients worked with by vocational rehabilitation are found to be unable to locate employment upon release To meet this need the adjustment services unit has recreated a class called The Job Hunting Class designed to teach the VR client how to go about applying for jobs in an appropriate way Sixtyeight clients were served in this program Adjustment services are provided on the multiple handicap ward of the Yarbrough Rehabilitation Center for clients with sensory losses Two classes are taught daily in sign language for the client with impaired hear ing and mobility training is provided three times a week through a coop erative agreement with the Georgia Academy for the Blind for the visually impaired client Educational handicaps are one of the most common to the population served by vocational rehabilitation In order to teach many vocational skills educational skills must be acquired in advance The most logical method of approach is in the form of the program of education aimed at taking the individual at his present level and upgrading him to the greatest extent possible This may be from the rudiments of basic reading and writing skills to enable a client to obtain a general educational develop ment equivalency diploma required by many employers today During this past fiscal year the adult basic education program in cooperation with the Baldwin County Board of Education worked with 252 patients Once the VR client has made a more satisfactory adjustment to work and overcome basic academic deficiencies a formal program of vocational60 training may be undertaken The vocational training program at the Yar brough Rehabilitation Center provides training similar to the states voca tionaltechnical school program The program is tailored to fit the needs of the individual patient but is designed to train students on a level equal to that of the vocational training schools in the community When a client is ready for release he may continue his training in the public and private school systems in his home community without loss of credits earned at the Yarbrough Rehabilitation Center These arrange ments were made with the Georgia State Department of Education and with private institutions at the inception of the program Over 900 clients re ceived training through the program in the following areas automotive service repair barbering cabinet making business education cosmetol ogy drafting metal trades nurses aide and shoe repair The Office of Rehabilitation Services operates a program of community rehabilitation residences This program has been an effective instrument in helping the discharged patients make a satisfactory adjustment to com munity living A new residence was opened in Macon this year bringing the total to six Residences are also operated in Augusta Albany Colum bus Savannah and two in Atlanta Approximately half of the patients completing a rehabilitation program at the Yarbrough Center are now pass ing through the rehabilitation residences when released from the hospital A total of 370 clients after receiving the followup services by the field counselor made a satisfactory adjustment to employment Adult BaAlc Education Lcasining Lahofiatofiy In VaAbnouQh BaiZcLing WWIWPW 61 PSYCHOLOGY DIVISION The Psychology Division has adopted an approach toward the evaluation and treatment of mental patients based on application of the results of scientific research to the problem of emotional disorders There is a con stant evaluation of the effectiveness of these techniques which leads to old procedures being replaced by more effective techniques This is also true of administrative activities and much systematization of these func tions has been achieved during the past year The Psychology Division is not only doing more but doing it better RESEARCH EDUCATION AND TRAINING The Research Education and Training Section coordinates activities in these three areas making their work more efficient Psychologists at Central State Hospital are among the most productive in conducting and publishing scientific research Members of the Division published in scientific journals or read at professional meetings eight re search articles Ten other research projects conducted at CSH are com pleted and the results are in preparation for publication Seven research studies now in progress are concerned with both treatment and evaluation and have as their principal aim the improvement of services to the patients of CSH The Division cooperates with the Public Information Office in providing seminar programs for visiting high school and college students The goal of this program is to dispell erroneous ideas about the hospital and emo tional disorders Psychologists are active in the inservice training pro grams of other disciplines and are frequently called upon to present lectures which illustrate the role of the clinical psychologist in the evaluation and treatment of patients Psychologists spoke to a total of 3822 individuals as part of the above programs INTERNSHIP PROGRAM The Psychology Division was approved for the eighth consecutive year of its internship training program in clinical psychology subsequent to the visit of an American Psychological Association Evaluation Committee In 1963 CSH became the fifth state hospital in the entire United States to have an accredited internship program in clinical psychology and today it is one of only nine approved departments in the southeast The Division is very selective in accepting intern applicants con sidering only those students who rank in the upper 10 percent of theirgigmgnmu 62 graduate classes This year two interns have received training in clinical psychology The number is kept small to permit each intern to receive close personal supervision by PhD psychologists Interns are taught treatment and evaluation skills which center around an understanding and appreciation of research findings Interns are encouraged to do research while at the hospital TECHNICIAN PROGRAM During the past decade the Division has been involved in a highly innovative program utilizing subdoctoral personnel The Psychology Di vision at Central State Hospital was one of the first to utilize Bachelor and Masterlevel assistants or psychology technicians for psychological testing interviewing patients and writing psychological evaluations They have begun to play large roles in treatment programs Their work is closely supervised by doctorallevel psychologists The technician program has resulted in a great increase in psycholo gical services and a financial savings to the State of Georgia It allows psychology majors graduating from college to obtain experience prior to entering graduate school EVALUATION Each psychological evaluation contains a summary of the patients history and of the stresses and events which led to the hospitalization Each patient is given a complete battery of psychological tests which mea sure the individuals abilities limitations and aid in the determination of a specific diagnosis Finally a diagnosis and recommendations are offered Each evaluation represents the product of six to eight hours of work by staff members More than 2300 evaluations were produced during fiscal 1970 Attempts are constantly made to improve the validity and usefulness of the evaluations Research in evaluation procedures is being conducted and an improved structured interview has been developed by the staff TREATMENT As a result of constant scientific evaluation of procedures the Divi sion has primarily committed itself to a treatment technique called behavior modification This technique is based upon discoveries from psychological laboratories which indicate that much of what a person does is the result of the types of behavior which his environment has rewarded in the past It therefore becomes the task of the therapist to so order the environment in which the patient is placed at this hospital that normal appropriate be haviors are rewarded and abnormal inappropriate behaviors are discourag ed This is what is done on a behavior modification or token economy 63 ward Patients are allowed to earn tokens roughly equivalent to money in the outside world for behaving in a socially desirable way They are fined tokens for behaving in a mentally ill manner Patients are allowed to spend tokens in a ward store and can pay for special privileges such as going to dances and movies with tokens Patients on token economy wards have a greater opportunity for living a life similar to that of a nor mal person than do patients on traditionally operated wards This approach greatly increases the furlough rate of patients from the hospital and cuts the return rate to the hospital by a factor of about 75 percent The behavior modification programs have contributed to the improve ment of many patients at the hospital and have resulted in substantial financial savings for the taxpayers of Georgia Six behavior modification wards are currently in operation At any given time approximately 500 patients are being treated Below are presented some examples of data obtained from behavior modification programs to illustrate the effectiveness of this technique and show the benefit which patients have derived from its application Treatment of the Mentally Retarded During the past year the supervisor of psychological services in the Mental Retardation Unit has served as program coordinator therefore psy chologists have been involved in the treatment of all of the patients of that Unit The Division has also operated three behavior modification wards in the Unit Boone 8 is a ward for severely and profoundly retarded children The last annual report indicated a great increase in the patients ability to care for themselves which was brought about by a behavior modification program These gains have been maintained Boland 6 is a ward for mildly retarded young male patients Prior to the institution of a behavior modification program acting out antisocial behaviors were a major problem Institution of a token economy enabled the disruptive behaviors to be controlled and allowed the patients to par ticipate in educational and social advantages previously closed to them Boone 1 has had a token economy in operation for a year and a half The behavior of these young mildly retarded females continues to progress in a socially desirable direction Cursing is an inappropriate behavior in most wards of the hospital On Boone 1 the token economy is structured in such a way as to eliminate cursing a behavior which could get the patient into trouble outside the hospital upon release Figure 2 shows the decline in number of fines form msmmumjmum 64 cursing for one patient during a five week period during which this pro blem was treated Stealing is another problem with which ward personnel are frequently confronted Sometimes patients stole tokens which could disrupt the be havior modification program One way psychologists stop an individual from stealing tokens is to put him on what are called special tokens distinguished in one manner or another usually by color from those used by other patients on the ward A person placed on special tokens can spend only these tokens The data presented on the left of the dotted line in Figure 2 indicate the additional numberof tokens that two patients spent over and above the number they earned To the right of the dotted line we see that this condition has been rectified in that the patients are required to live within their income They will find this ability to spend no more than they earn of great adaptive value when they leave the hospital Psychologists also directed a special project on a ward for severely and profoundly retarded adult females Prior to the beginning of this pro gram most of these patients ate with their hands sometimes grabbing food from the plates of other patients These behaviors led to a great deal of waste of food and some of the residents not receiving a proper diet Also ward personnel were required to devote a great deal of their time to cleaning up after meals The behavior modification program involved among other things a patient being temporarily delayed from receiving more food following an instance of inappropriate eating behavior This progress has been maintained by staff members An operant conditioning laboratory in Unit 9 is used in treating patients and in researching new treatment techniques Treatment of Children and Adolescents Some form of behavior modification is in operation on all wards in Unit 8 In the Childrens Building the patients under 11 years of age are too young to keep up with the tokens used on other behavior modifica tion wards On these wards a merit system has replaced the token econ omy Patients are verbally given good points for acceptable desirable behaviors and are given bad points for inappropriate deviant behaviors A patient who maintains a specified number of good points after the bad points are subtracted is placed on the merit list which entitles the pa tient to many privileges such as swimming additional candy and special attention from staff members Figure 4 shows how a patient in the Child rens Building learned over a period of time to be consistently on the merit list This was one improvement in the appropriateness and desira bility of her behavior A behavior modification program has been in operation on the Adoles cent Wards since November 1968 A recent report indicated that the per65 66 centage of patients successfully rehabilitated has more than doubled as a result of the token economy and other work supervised by psychology per sonnel Psychology is continually making efforts to improve the effectiveness of its behavior modification programs On the Adolescent Wards patients were paid tokens for taking showers and brushing their teeth The tokens were paid to them at payoff time at the end of the day This resulted in about 30 or 40 percent participation In an attempt to improve on this record patients were paid immediately after performing the desirable ac tions Figure 5 shows that the percentage of patients taking a shower and brushing their teeth at least once per day jumped from 30 percent to be tween 70 and 80 percent per day Individual or special behavior modification programs are frequently used in addition to the overall token economy on the Adolescent Wards These special programs are usually instituted to modify specific behaviors of an individual patient Figure 6 is an illustration of the kind of special programs which are employed Inspection of the base line of this graph indicates that the fines and the regular token economy were not effectively controlling the inappropriate behavior of either Patient No 1 or 2 There fore both were placed on a special program in which walk out privileges were made contingent on the appropriateness of their behavior If the patient received fines of 50 tokens or more per day for three consecutive days his walk out privileges were removed In order to obtain his walk out privileges again the patient had to go for three consecutive days with fines of 15 tokens per day or less The data presented to the right of the dotted line illustrates the effectiveness of this treatment program Figure 7 illustrates the treatment of a patient who has been in Central State Hospital since 1966 Due to her constant misbehavior and irritating interpersonal relationships with therapists the patient was in the past shuffled from therapist to therapist while on the Adolescent Wards An individual behavior modification program was designed to decrease the number of times she was put in seclusion per month for misbehavior This consisted first of making all available reinforcers contingent upon her not being placed in seclusion for the day The number of days that she stayed out of seclusion was gradually extended to a week Concurrently posi tive reinforcers were given for other appropriate behavior As evidenced by this figure this program has had a definite effect upon the number of times this patient has been secluded for deviant behavior The Supervisor of the Psychology Divisions program in the Childrens and Adolescents Unit has in the past year been experimenting with a modi fication of a treatment technique known as psychotherapy by reciprocal inhibition His technique involves the pairing of anxiety with the patients imagining the performance of undesirable behaviors and the pairing of re laxation with the patients imagery of his performing acceptable socially 67 68 desirable actions All six homosexual males who have gone through this treatment program have abstained from engaging in homosexual activity for extended periods of time Also this technique has been quite suc cessful in dealing with a girl who exhibited selfdestructive behavior ie slashing her wrists Treatment of Adult Patients During the past year psychologists worked with a 21yearold boy who manifested a very high frequency of hand mannerisms Prior to treat ment he had never been able to keep his hands still for any appreciable amount of time He was treated by requiring him to hold his hands still for one minute When he successfully did this he was given a token When he earned 20 tokens he was allowed to exchange them for a candy bar The reader will observe in Figure 8 the great decrease in the number of hand mannerisms during the treatment sessions Beginning at session 25 indicated by the dotted line the patient was required to earn two to kens at a time by holding still for two minutes This is an attempt to teach the patient to behave appropriately for a longer period of time so that when he leaves the hospital he will be able to adjust to an environment in which rewards are rarely immediate This patients rate of hand mannerisms was particularly high at meal time This would have been predicted from a learning theory framework A treatment procedure was therefore employed at this time The therapist sat next to the patient during his meals and whenever he engaged in man neristic behavior his hand was held up from the plate for a tensecond period Then the hand was released and he could begin eating again This procedure had the effect of teaching the patient that any manneristic eating behavior would result in a delay in his next intake of food a mildly punishing situation Figure 9 shows the average number of inappropriate responses during mealtime before and after training The baron the left indicates that the patient averaged 955 hand mannerisms during mealtime before the treatment procedure was instituted After treatment this rate was down to 105 The multiple handicapped ward in the Yarbrough Vocational Rehabili tation Building is supervised by a psychologist who works with blind deaf and other physically handicapped individuals Using individual and group therapy and specialized treatment by consulting therapists the needs and problems of the handicapped individual are dealt with while he is attending vocational rehabilitation classes and learning the skills that will enable him to become a successful member of the community Pre sently eighty patients are treated weekly Assisting the psychology staff are sign language interpreters who help conduct group therapy with the deaf speech therapists audiologists and remotivation therapists who work with the blind The blind patients have the opportunity to listen to a talking book machine and are taught how to walk with a cane These 311 X j S JL T t l i i h X I I Si t t X 7 3C Ll 1 i J X i i r f Zx L S f s t 1 J If it IT j3 if m JL i P 51 5 a fc I c 5 3JL fJ i i X 1 it1 j US1 H2 It IK fll j 1 fTjm 5 icrfin Trr KrrceTrxfrsclsrrn 3ai k a airisetJiri iyiiEiiL rfrr 8ttr ai I6 3S1 OltrpcrnJ IL 5a q inf jcfiajirwjqt j i 9 T r f r 4 IL X i 11irt i 1 Z 1 J f ft 1 tJ J J 1 aj f r 1 J i Q L L S I J 53JI 7 Z X S1 lie i t l 1 C H 1 e 1 1 X I uXS 5 1 1 1 a 1 t izp i lKKS Fnjne 3 Fedibt1 oi ir nunlm itjnLJ apLSujELXi ell intriv nidi ot 11a 1 v Tiyu 1 1 1 l 1 1 l 11 n ui 1 1111 L J JL 6970 m services enable the handicapped individuals to learn to function outside the hospital at a level compatible with his ability and physical limitations The Psychology Division also provides the Georgia Veterans Home with a fulltime psychologist and staff This psychologist in association with the Unit director directs a twentybed ward with emphasis on indivi dual treatment Extensive outpatient care is offered to those veterans who are released from the Georgia Veterans Home The psychologist in this Unit is also involved in writing psychological evaluations which play a large role in certain administrative and financial decisions which the Veterans Administration makes in regard to the patient FUTURE PLANS The Psychology Division at Central State Hospital intends to broaden and expand its services to patients in two main areas First by setting up a behavior modification ward for adult females and by organizing an interdisciplinary team to institute a similar program for chronic adult males Secondly by applying the principles of empirical psychology to more complex and abstract problems such as neuroses and problems which center around basic attitudes and beliefs of patients 71 AMnV 72 NURSING SERVICE The nursing staff at the end of the fiscal year included 117 registered nurses 84 licensed practical nurses 1824 attendants and 7 medical aides A special concern was recruitment in the attendant classification It is becoming increasingly difficult to secure desirable and qualified appli cants The improvement of patient environment has enabled Nursing Service to utilize personnel more efficiently and made possible better patient care in more attractive surroundings A primary project has been the coordina tion of nursing throughout the ten psychiatric Units Better communication has been maintained through regular bimonthly meetings and staff devel opment training programs for professional nurses have been effective in upgrading personnel The Department of Public Health nursing staff taught seminars on nursing assessment patient care plans and evaluation Thirtysix regis tered nurses attended the three seminars and 49 of the nursing staff at tended management courses A summer project initiated by the consultant in the Division of Mental Health of the Georgia Department of Public Health provided five college students who surveyed all patients in Units 2 and 5 and set up individual Kardex files including the patients photograph Patient characteristic information obtained in the survey has been computerized and data will be utilized as a basis for determining an adequate nursing staff The Nurse Consultant of the Division of Mental Health has been especially coopera tive and helpful in hospital training programs during the year The inservice training program for psychiatric aides funded by a four year grant from the National Institute of Mental Health was terminated this year and salaries for personnel were provided thereafter by the hospital During the past two years 145 students were admitted to the class with 102 completing the course A feature of the program was a wellplanned course on cardiopulmonary resuscitation An orientation program for Unit clinical instructors was begun during the year to provide them with a more comprehensive understanding of the principles practices and involvement of the attendant in the program of psychiatric nursing After completing the 12week period the instructors will be assigned to individual Units to conduct any further development of inservice education in that Unit The number of enrollees in the Neighborhood Youth Corps Nursing Aide Class has been considerably curtailed this year The class met for two hours each Friday for four months for a total of 32 hours The content in cluded minimal essentials and basic techniques Fifteen students were enrolled 73 Inservice education in the Units has continued with the Unit Directors of Nursing and their committees planning programs for a six month period Each Unit gears the topics towards its particular needs The programs con tribute to improving patient care and serve as a means for interunit com munication The staff development program for registered nurses is a threeyear federal project terminating in June 1972 Its purpose is to initiate the re duction of the gap between previous education of registered nurses and the newer theories and practices which provide more therapeutic nursing care of psychiatric patients The program includes a series of ten workshops of two oneweek sessions led by consultants in specific content areas Consultants in various fields pertinent to nursing have been brought in from different parts of the country thereby broadening the experience and knowledge of the nurses The program has also afforded funds for much needed equipment and educational media not otherwise available Staff meetings are held periodically to improve communication and as a medium for exchange of ideas in current and future planning NURSING EDUCATION During the past fiscal year 165 students successfully completed the twelveweek course in psychiatric nursing The affiliates came from the following schools of nursing Georgia Baptist Hospital School of Nursing 93 Hall County Hospital School of Nursing 10 the MaconGeneral Hospi tal School of Nursing 2 8 and the Atlanta Piedmont Hospital School of Nursing 34 A more limited experience was provided for nursing students from the junior colleges and Grady Memorial Hospital which does not affiliate here These included oneday visits by 44 students and two instructors from DeKalb Junior College 44 students and two instructors from Floyd County Hospital and 80 students and four instructors from Grady Memorial Hospi tal in Atlanta A twoday visit was provided 16 students and three instruc tors from Dalton Junior College a threeday visit was arranged for 19 students and two instructors from Albany Junior College and a fiveday visit for 19 students and one instructor from Albany Junior College Four of these groups were housed in the Nurses Residence and ate in the Cen tral Kitchen cafeteria Program schedules were set up by Nursing Educa tion in cooperation with staff members of the various disciplines and va rious patient areas concerned Faculty members participated as consultants and liaison persons74 Faculty representatives of the various schools visited the schools during the year for conferences and Nursing Education personnel and re presentatives from the various disciplines who were involved in the student program attended one faculty meeting each quarter and also participated in the annual faculty meeting with representatives from the affiliating schools All Central State Hospital faculty members belong to and are active in the 14th District Georgia State Nurses Association and one is a member of the National League for Nursing Conference Group on Psychiatric Nursing The faculty members also participated in 32 workshops seminars and conferences and prepared a number of opinion papers on fact finding nurs ing care plans and task force reports The Nursing Education library was consolidated with that of the in service department in March and moved to the Myra S Bonner nursing library located in the Brantley Building and placed under the direction of a fulltime qualified librarian Faculty members have also reviewed handbook rules for students living in the Nurses Residence and are working on a project to shorten the twelveweek affiliation course in psychiatric nursing which requires re vision of the curriculum plan and course outline SOCIAL WORK DIVISION 75 Release planning and the placement of patients in nursing homes throughout the state continued to be a high priority program in the Social Work Division A total of 1360 patients were referred to the CSH Unit of the Baldwin County Department of Family and Children Services and 802 patients were placed by that department Counting private placements utilizing patients personal resources nearly 1000 patients were placed in nursing homes During this fiscal year an adult foster home placement program was initiated by the Social Work Division on a demonstration basis in Macon Bibb County Later in the year the program was adopted by the Georgia Department of Public Health Division of Mental Health and funded for expansion on a state wide basis A number of creative service programs developed this year They in clude the recruitment and utilization of local high school volunteer workers who devote many hours of time serving the needs of patients in Unit 3 Unit 5 developed a program in which patients from other areas of the hos pital as well as from within the Unit are used to provide concrete social work services to patients Services to patients include the writing of 13745 letters to the rela tives of patients to community agencies and toother interested individu als The staff held 20518 interviews with inpatients their families and their representatives and 3240 interviews with families of patients on leave from the hospital At least in part as a result of this activity 2558 patients were sent back to their home communities during the year These included placements with relatives independent living arrangements transfers to a nursing home and transfers out of state At the conclusion of this fiscal year the staff consisted of the Director an Assistant Director eleven Social Worker IIs five Social Worker Is twentyseven Social Work Technicians one Social Work Aide and twelve secretaries for a total of fiftyseven This represents an increase of one staff member during the past fiscal year In addition the Division spon sored eleven staff members on educational leave in various stages of com pleting their masters degree in social work supported by stipends from the hospital The schools attended include Smith College Tulane Uni versity Florida State University and the University of Georgia Finally more than thirty undergraduate students from Mercer University and Georgia College were supervised in social work field placements at the hospitalBOBKSliHHaBHaMMMiiiiBHaiMMMGMBnnMni 76 CHAPLAINCY DIVISION Fiscal year 1970 was a period of consolidation and maintenance on one hand and change and instability on the other On the whole it was a successful year particularly as measured by services rendered The staff displayed a commendable evidence of devotion to the work of minis tering to the religious needs of patients A total of 23923 pastoral visits were made to patients during the year a significant increase over last year In this function the clergy symbol ized the presence of concern and care which has traditionally been a part of their heritage More than 3000 worship services provided the patients a socially acceptable opportunity to experience a structured and caring fellowship in an atmosphere of challenge and comfort The philosophy and methodology of religious worship at Central State was spelled out in a paper published by the Journal of Hospital and Community Psychiatry Also the chaplaincy staff conducted more than 6500 pastoral counseling sessions for patients in group and individual therapy There were almost 500 patients involved in these therapeutic relationships during the year In the area of clinical pastoral education the division continued to provide various levels of training for seminarians and clergymen Again this year men were attracted from many different areas of the United States An orientation workshop for community clergymen involved several parish ministers from different parts of the state An orientation program for seminary students involved six seminarians from the Columbia Theological Seminary in Decatur Seven students participated in an initial quarter of clinical pastoral education representing schools of theology in Tennessee Georgia Illinois and North Carolina Twelve clergymen were participants in our yearlong internship in clinical pastoral education These men represented a variety of denominations Finally there were four clergy men involved in the clinical chaplain residency Two of these were in advanced pastoral care two were in training to become chaplain super visors This was the first major move into the field of training men to be chaplain supervisors Several significant research projects are in progress A project de signed to facilitate religious diagnosis was continued with refinements and improvements A project to assess the nature and effect of programs in clinical pastoral education was begun as a part of graduate study being carried on at Emory University The means by which these services were maintained and improved may be described in various ways First there was a continuation of the policy and provision for advanced study in related fields for persons in the de partment During this year two people were involved at the graduate 3Si 77 level in the fields of Pastoral Theology and Sociology of Religion This provided the necessary training and tools for an increase in both services and research in the division Second the staff was involved in a retreat designed to promote communication within the division and give attention to longrange goals for chaplaincy service as a part of the total treatment program within the hospital This proved to be effective in increasing the level of communication and competence within the division Finally a major resource within the hospital that of the data processing facility has been utilized to process information concerning the patients who are involved in therapy with the chaplaincy staff This provides not only a means of assessing their work but of gathering information for longterm research projects in the area of religion and mental health Thus far attention has been given to the aspect of consolidation and maintenance For the areas of instability and change two aspects need to be pointed out First during the year this division felt the increased competition from other institutions and hospitals both within the state and outside the state Three major staff members took positions elsewhere during this year During the first part of the year it was comparatively easy to find competent personnel to replace these individuals however toward the end of the year the market for competent clinically trained cler gymen and chaplain supervisors diminished considerably and the end of the fiscal year found the division facing a severe test in remaining com petitive in securing the kind of chaplaincy personnel needed A proposed upgrading of the chaplaincy series should provide some help A second aspect of this change is the addition of another perspective within the profession itself This is the perspective of sociology and re ligion For some time it has been felt that this dimension was neglected in the traditional training and performance of the clinical chaplain There fore the Health Department underwrote and supported graduate study which would bring this perspective into the division The major part of the train ing has been completed and already this professional perspective is being infused through the presentation of papers onthejob training and the use of consultants in order to widen the base on which the division per forms its task within Central State Hospital uHHIHflif 78 SCHOOL OF SPECIAL EDUCATION The School of Special Education located in three renovated wards of the Boland Building provides remediation in academic needs as well as in social skills and cultural enrichment to emotionally disturbed or men tally retarded patients 18 years of age or under Of the underaged pa tients in the hospital that are classified educable or trainable less than 50 can be accommodated within the school at any given time due to an inadequate educational facility not specifically designed to handle spe cial education needs A complete school complex designed for a total educational program has been planned and requested in order to reach a larger percentage of these patients The administrative and teaching staff work in conjunction with the State Health Department and Central State Hospital to provide a total therapeutic program for the students enrolled in the school The school also cooperates with the Baldwin County School System the State Depart ment of Education and its Division of Exceptional Children the Department of Education at the University of Georgia Georgia State University and Georgia College at Milledgeville as well as the National Council of Ex ceptional Children and other suborganizations of related interests to keep abreast of teacher certification requirements current trends innovative ideas and new approaches to reaching and teaching exceptional children The school is divided into five academic sections This includes three general age groups for the emotionally disturbed primary interme diate and high school There are two groupings for the mentally retarded divided by diagnostic testing to indicate I Q levels and academic achieve ment potentials There are 703 patients 18 years of age or under at the hospital 412 of which are classified educable or trainable and 170 in school The remaining 242 could be served by the school if a larger edu cational facility were available Even though 170 students are enrolled approximately 373 students were given educational services at the school during the past twelve months a more realistic figure The present teaching staff totals 24 an increase of five over last year The school also has seven administrative assistants and aides All available space provided in the renovated wards in the Boland Building is now being used No additional faculty or staff can be hired until a larger complex is provided The curricula of the school are geared to the individual needs of each child by providing remediation in academic needs as well as in social skills and cultural enrichment Most of the students have been in severe conflict with the original homeschoolsocial environment and have failed HffPWOTiVMimw 79 in public school classes regular or special The school provides in struction in order to supplement their many educational andor social handicaps and to assist them in becoming more wellrounded and socially acceptable individuals The school is basically an educationtreatment oriented project In addition to the basic academic studies the school provides the services of physical education home economics remedial reading speech music and art Each teacher develops guidelines structured on individual bases paces tasks to individual tempos and structures the environment either in the classroom or on cultural enrichment trips for behavior management and modification More involvement with the original homeschool environment of each child is being initiated for the 197071 school year in order to provide better communication understanding and help between this schools work with the student and the childs origin It has been proven that the carefully structured educational program paralleling the hospitals therapeutic treatment program shortens the length of time the patients are required to stay in the hospital Credits earned by the student may be transferred to the home school Ml6 Glznda Young o CSH tecexvea TtacheJt o the Vnah owoJid faom Baldwin County kiit School SupoJilntdndznt Van SpuaAA Principal RauiLLnA lookb on ihbhHHBIMHHHIHBH HBHHHHBflKi 80 blhtn onea oJUL nlgkt heA pnone to Apite The doctoiA peaceful mliiion Bat when he htck ttA load and qalck He bawti ok a phytclan Eaaem TleJLdimmamiwt J 81 Pfaftiort eatt6 ASSISTANT SUPERINTENDENT PHYSICAL HEALTH blilLLam R HowoJid MP JONES RIVERS HOSPITALS PHARMACY DENTISTRY SANITATION COORDINATOR SPECIAL THERAPIES OCCUPATIONAL THERAPY RECREATIONAL THERAPY MUSIC THERAPY VOLUNTEER SERVICES REMOTIVATION SERVICES HHHBSSr 82 JONES HOSPITAL GENERAL MEDICINE AND SURGERY BUILDINGS Jones Const 1930 RESIDENT PATIENTS June 30 1970 122 ADMISSIONS 3685 DIRECTOR Joseph G Bohorfoush MD ADMINISTRATOR Norman E Wood Jr DIRECTOR OF NURSING Mrs Irene Wood Registered Nurse The Jones General Medical and Surgical Hospital is a223bed facility that provides inpatient and outpatient hospital care to the residents of Central State Hospital the Georgia Rehabilitation Center for Women and the Youth Development Center at Milledgeville Continual modernization of equipment and renovation of the physical plant has vastly improved the deliverance of patient care and enhanced environmental conditions during the past year Some of the developments include complete renovation of the outpatient department installation of additional air conditioning and of several items of major equipment The OBGYN department was moved to a remodeled area which includes a newly equipped and air conditioned delivery room nursery and labor room Cardiology was relocated in a redecorated and air conditioned area providing more space The addition of two electrocardiograph machines enabled better treatment of an increasing patient load The administra tive department moved into the area vacated by the cardiology department which provided needed space for the centralization of clerical staff and the installation of a central dictating system A marked improvement in the work flow has resulted Physicians offices were redecorated a central waiting room and refreshment area was added for visitors to the Jones Hospital all patient dormitories were air conditioned and most received new drapes and furniture The installation of a central paging system provided all departments with a paging station The addition of new positions in the housekeeping department improved services to the extent that a marked reduction of infections resulted This also enabled nursing personnel to be relieved of housekeeping duties and devote their full attention to patient care83 The Jones Hospital continues to carry on work in preventive medicine including survey and treatment of blindness uterine and breast cancer diabetics and unknown diabetics anemias and blood dyscrasias kidney diseases and lung cancer Every assistance was given in determining the infectious agents of epidemics During the past year the hospital treated a total of 3685 individuals with a total of 53707 days of patient care The outpatient department reported 33481 visits to the clinic the laboratory completed 354602 procedures the surgery division completed 1239 procedures and the ophthalmology section reported 370 operative procedures ABOVE LETT KHD RIGHT Vynaplx Scanner and Uagna Scanner assist the radiolo gist In determining presence oh path ology In various organs including the brain lungs thyroid and liver using various radioIsotopes as diagnostic agents The Vynaplx Is specially use hul since the Information can be pre served on tape hon latex review This new equipment makes it unnecessary to take CSH patient elsewhere ion diag nosis oh this nature BELOW The EKG ward represents an example oh the ex tensive renovation oh physical jacxi Itles which took place during 1970 HMHMIBlHHH 5 84 RIVERS HOSPITAL TUBERCULAR DIABETIC AND MEDICARE BUILDINGS Rivers Const 1939 RESIDENT PATIENTS June 30 1970 43 6 ADMISSIONS 485 DIRECTOR Mahmud Majanovic MD ADMINISTRATOR George Hart DIRECTOR OF NURSING Mrs Valeria Atchison Registered Nurse The total admissions to this Unit during the past year was 485 Of this number 314 were transferred 114 were placed on convalescent leave 15 were discharged and there were 36 deaths The program of planned equipment renewal continued throughout the year with the purchase and installation of new Xray equipment including a new film processor which facilitates better and faster service to the medical staff The purchase of three electric typewriters to replace worn out manual models has increased efficiency and the amount of work done by secretarial employees Medicare is functioning well New beds and bedside tables dining room furniture and charts were added this year and new chart desks were installed in all nursing stations Rivers 5 was renovated and now houses a pilot program for alcoholic and drug treatment with a capacity of 30 patients Many improvements were made during the year that have contributed to the patients welfare These included the addition of a full time social worker a new housekeep ing supervisor who has instituted a more intensive housekeeping program the consolidation of two occupational therapy shops into one thus providing more day room space for patients on Rivers 7 and the establishment of two dining areas on Rivers 3 Additional improvements included the sealing of all concrete floors which has kept the wards in a more sanitary condition and eliminated many obnoxious odors The property and supply area was enclosed with an ex panded metal wire guard and now provides better security for supplies A chainlink fence was installed between the buildings to provide the patients with a more accessible recreation area and eight new concrete tables were added for the convenience of patients when having picnics and cookouts Ramps for the transportation of wheelchair and stretcher patients were installed at the entrances to all three buildings Rivers IB has been p 85 completely remodeled and now houses an administrative suite of offices thus consolidating all administrative employees and physicians in one area The electrical system of the complex was upgraded and updated to provide adequate electrical power A survey was made to determine the exact square footage in the patient area which will provide a certified bed capacity of 510 beds The assignment of a registered nurse as a clinical instructor for the inservice education program has improved charting techniques on the ward provided better orientation programs and added to the amount ofonthejob training received by psychiatric aides Hospital AdmiyiLtnatoi Gcotigz Want tkt Unit VincctoK Vfi Uahmud Uajanovlc and Vlfinctofi o Naulng SeJiviceA Mm Valvvua Atcklon RN puchldc at open kou6c in ZiveAA Hospital maAklng the completion o nw Admini Auxtivc Suite oh oUicd ion physician and pfiolte bional itaii mmbem The Apace wo6 made available by a declining residential population at Central State 86 PHARMACY DIVISION The past year has been marked by continued improvement particularly in the expansion and remodeling of physical facilities and the addition of much needed shelving and equipment The expansion program has more than doubled the floor space and provided a modern office area It has been possible to more efficiently arrange and organize storage areas Also included in the new facilities is a separate explosive proof storage area for inflammables an additional space for dispensing drugs for patients leaving the hospital on convalescent leave and a new waiting room and reception area The present staff consist of eight pharmacists two pharmacy interns five drug technicians a secretary a typist and a truck driver The staff operates in three main areas the Central Pharmacy satellite pharmacies and the Jones Hospital Pharmacy New equipment includes a large walk in cooler for storage of items needing refrigeration a bottle washing apparatus new desks and chairs an additional highspeed electronic tabletcapsule counting machine and a new delivery truck The Pharmacy Division has recently reorganized with regard to basic purpose and intent Efforts have been directed toward improving patient care by better utilization of new resources The Central Pharmacy staff is involved with continual refinement of systems pertaining to purchasing repackaging record keeping and general information The area of greatest improvement lies in the utilization of electronic data processing services to maintain a perpetual inventory sys tem The staff in this area is also responsible for the dispensing of drugs used in the Mental Health Aftercare Program which is active throughout the state The Central Pharmacy dispenses a 30day supply of medication to each patient leaving the hospital The Jones Hospital Pharmacy staff is dedicated toward improved patient care in our general medical and surgical hospital This includes direct daily contact with all ward personnel with the end result being better and safer handling procedures Satellite Pharmacies are manned by two full time pharmacists who continually move through each patient building in the hospital and inspect ward drug rooms for old drugs and excess inventories They are also active in conducting inservice education programs as well as training ward per sonnel in correct drug procedures This staff is responsible for the dis tribution and inventory of all narcotics and dangerous drugs in the hospital87 as well as the operation of Satellite Pharmacies in the Veterans Building and the Bostick Building The Central State Hospital Pharmacy purchased drugs and supplies during the last year to the amount of 100456156 Prescriptions num bering 21826 were filled for patients leaving the hospital on convalescent leave Also 5427 prescriptions were filled for hospital employees The Division has been moving steadily forward for the past two years toward a goal of more efficient service to patients and an improved con cept of patient care as pertaining to drugs Vn William R HovoaJid AAitant SupoAAntmd2wt Physical HzaUh axpnaAtM approval ai Eanl Wand Executive Vinocton Kmcnican Boand oi diplomats in Phanmacy pncicntA ccntiiicatoj to Vn VuAwand Poland CSH Vinccton o Phan macy and to A6ittant Vinzcton Clanznce E Gibbcndanncn ion dutinguikLng thcmAclvzA ah hpccialUti In PhaAmacy and ion mcoXing pnoicAional qualiii catiom and Acquirement oi the Kmcnlcan Boand oi ViplomatZA In PhaAmacyiflHr HtygSBgSBBHBBHIIBHBHMBHMnBHaHHHIBHaBHMlUHBB HH srrsff 88 DENTAL DIVISION Achievements during the past year have made it apparent that a com prehensive program of dental care for patients at Central State Hospital is nearing reality The dental program now includes most phases of dental care for adequate institutional dental service The installation of five twochair and three onechair satellite facil ities now make possible treatment for patients who otherwise may not have received it These facilities serve tubercular and diabetic patients crim inally insane patients mentally retarded patients and those remotely lo cated from the Central Dental Clinic Completely mobile equipment is available which can easily be moved to any ward of the hospital for bedside dental treatment Larger facilities are equipped with moveable dental chairs so that ambulance stretchers can be readily placed beside dental units thus allowing bed patients to receive treatment The Central Dental Clinic was completely remodeled and now includes administrative offices conference areas waiting rooms a laboratory library and storage areas The six operatories were modernized with new equipment A public address system and telephone intercommunication system was installed and new furniture was purchased for all waiting rooms The Central Dental Clinic serves an overflow of patients from other areas of the hospital and also provides consultation for referred cases Staff training programs are located in the central clinic and all case pre sentations are made here The initiation and operation of a comprehensive oral hygiene program is a paramount objective in preventive dentistry the dental hygienists devoting a relatively large amount of their time in this area Periodic den tal examinations are provided for all patients throughout the hospital in cluding weekly examinations of all new patients Those needing treatment are seen in the various dental clinics During the year 53492 operations and treatments were completed and 16 725 oral examinations were performed The dental laboratory processed 563 appliances and repaired 186 The Division has maintained a full staff of nine dentists In addition five licensed dental hygienists are employed Six dental assistants are currently enrolled in the preceptor program for training hygienists The Divisions consulting maxilloprosthodontist successfully per formed facial restorations for three patients These included the restoration of a nose the replacing of an ear and the restoration of a nose and lip WVWi m 89 and adjacent facial structure At the present time an operating room is being constructed in the Central Dental Clinic for accommodating patients requiring general anesthesia for dental extractions During the past year numerous scientific films and case presentations were shown at regularly scheduled staff meetings Representatives of leading drug companies as well as outstanding professionals in the dental field were guest lecturers The hospital Dental Service Director is currently the First Vice Presi dent of the Central District Dental Society and a staff dental hygienist is President of the Central District Dental Assistants Society Stafi Vzntut Raymond Johvuon VVS and AAjtant Bttty Joe Gordon pswvtde dewtaZ tAeatment fion paZiznt vaulting Centxat Ventat CtintcitSBSBmmi wmmmm IM fccraneajJWX AjA4JWUhhVjrfAI 90 OCCUPATIONAL THERAPY DIVISION The new central occupational therapy building was formally opened in February and provides a modern gift shop store rooms clinic and offices PROGRAMS Thirtytwo individual programs were carried on during the year with 3295 patients participating Several clinics have been combined providing more space air conditioning has been installed and physical settings have been upgraded in all Units Variety was added to the programs by the addition of new crafts such as oriental rug weaving novelty afghans colorful yarn pictures and others Two new programs were started for mentally retarded patients and emphasis here continues to be placed on personal appearance as a vital element in treatment Makeup and mens grooming products are made available to all clinics Socializing experiences were stressed in regular programs as well as those planned and carried out cooperatively with other disciplines Patients attended parties cookouts ballgames watermelon cuttings luncheons and other similar events A total of 1302 items with a value of 894 were made and issued to the hospital These included upholstery picture framing ceramics and miscellaneous supplies EDUCATION Members of the Division filled lecture requirements for student nurses new physicians psychiatric residents psychiatric aides music therapy staff and interns pharmacy workers and new employees with a total of 218 individuals participating in 742 training hours On a voluntary basis the Director taught conversational English once each week for fourmonths to Cuban doctors and their wives Ten staff meetings were held during the year Training classes in which employees participated included movies and lectures a twoday workshop in mental retardation a course in cardiopulmonary resuscita tion and demonstrations on emergency first aid and data processing Field trips were made to a ceramic studio the Happy Hour School a gen eral craft workshop and an adult education training program in rug making sewing and upholstery Division personnel hosted the annual meeting of the Georgia Occupa tional Therapy Associationmm 91 Projects made by patients as part of the treatment program were ex hibited at meetings of the Crawford Long Medical Auxiliary in Athens the Happy Hour Club in Macon and the Athens Fair A total of 2504 patients were enrolled in occupational therapy programs during the year and with 791 on the enrollment at the beginning of the year the Division served a total of 3295 patients Of this number 1207 were placed on convalescent leave 205 were discharged 347 were transferred to physical or psychia tric treatment programs 65 were transferred to vocational rehabilitation or industry 657 were transferred to other state institution programs VlltoiA to the CcntAal Occupational Thexapy Building Vlbplay Room admlne the comptichcnlvc exhibit o handlchxxit done by patients iarMiJiJMmersrauHM 92 MUSIC THERAPY DIVISION Continued growth in personnel and quality of programming has been the outstanding feature of the past year The staff increased from 24 full time employees to 29 The clinical training program provided instruction for five interns who completed their requirements for becoming registered music therapists The interns came from Florida State University the University of Wisconsin and East Carolina University Three of them remained as permanent employees following the completion of their training The Division recently added a threemonth internship for individuals de siring to specialize in music therapy for emotionally disturbed children The first trainee was recently graduated and joined the Central State Hos pital staff Increasing demands for music groups such as the CountryWe stern group and a dance combo will require expansion in the near future The patients ensemble is another popular music organization much in demand Since decentralization of music therapy programs into the Units it has been possible for the therapists to structure these programs to more closely meet the needs of the patients For instance Boland 4 ward has been assigned to music therapy as a work and research project in toilet training for severely retarded children The result of this program was videotaped and the project was presented to the Southeastern Conference of the National Association of Music Therapists It has received con siderable acclaim and requests are being received from educational in stitutions around the country for use of the tape and color slide program A total push program has been established in Unit 5 emphasizing the release of chronic mentally ill patients The work involves remotiva tion of the patients through the use of simple square dances exercises singing and playing rhythm instruments The Divisions approach to treatment includes dynamic traditional programs and the use of behavioral modification In the behavioral modi fication program the music therapists serve as members of the team ap proach The Music Therapy Division of Central State Hospital has initiated one of the few music therapy research programs in the country Utilizing the assumption that music does indeed influence behavior and is there fore a useful therapeutic tool certain goals have been developed to es tablish new treatment techniques This provides an empirical basis for current treatment methodology by applying recent experimental technology in the clinical setting as well as provide research facilities and informa tion which will enlighten the music therapy staff and improve treatment skills Findings and conclusions will be published inappropriate profes sional journals Three research projects are now in process two of which93 will be presented at the National Association for Music Therapy Conven tion this year The Music Therapy Division serves each of the chapels in the hospital by providing music for all services The patient choir this year obtained much needed new choir vestments which were worn at the annual perfor mance of The Messiah This traditional music work was one of the many fine musical offerings several concert artists and choir groups have given performances for the patients throughout the year The Music Therapy Division while functioning without the services of a permanent department head continues to make advancements which are serving Central State Hospital its patient population and the field of music therapy M SaAaZyn Latkam dlneaU MoiXc TkeJuxpyt ChnJjtmaA pageant tMkch pneJentzd the Aacntd and tdculoA oJpeoX o the ChtuAtmu Atony beone a lull kouie The Atlanta Community OnckeAtyia In theJJi annual vUU pnovcded the accompayumentHBMHUHMHHHHHMHlHHMlHMnHHHHHBHiHflMlH 94 RECREATION THERAPY DIVISION The highlight of last year was the participation by 64 Central State Hospital patients in the Georgia Special Olympics held in Atlanta Parti cipants were from Units 9 3 and 2 They won 76 medals Decentralization to the Units has enabled the recreation therapists to better evaluate the needs of the patients and plan programs to meet these needs The program is now structured to the requirements of the individual Unit rather than the hospital as a whole Two students from the University of Georgia did a study recommending the development of a recreation area on Lake Sinclair for the use of hospi tal patients A graduate student from the University of Georgia is working on a master plan which is nearing completion for recreational areas and facilities for the hospital This will be utilized in future planning in the recreation program at Central State The Division continues to provide clinical experience for recreation students and interns came from Florida State University and Indiana State University Members of the Division participated in lecture programs for other disciplines in the hospital as needed Participation in community recreation by patients enrolled in hospital recreation activities has shown a marked increase Some of these events included wrestling Braves baseball Harlem Globetrotters the Roller Derby ice hockey championship high school basketball games and trips to points of interest such as Rock Eagle Indian Mounds and kaolin mines The Recreation Therapy Division assisted in getting patients to the annual show of the Hoxie Brothers Circus The structuring of programs to meet the needs of individual Units has added several new activities One Unit has started a square dance club and two Golden Age groups for senior citizens have been formed A new art program was initiated in another Unit One Unit has a program which includes sponsoring a different fine arts program each month One Unit has an exercise program for overweight women Creative dramatics is emphasized in another Unit and other programs include dances fish fries bus trips movies and various intramural sports activities and games The addition of four recreation therapists to the staff has helped materially in providing better programs VOLUNTEER SERVICES 95 During the year the Central Patients Library became a reality with the employment of a librarian The first six months were spent in processing over 2100 books which had been received through a federal grant These represent a model collection of books for a mental institution Good used shelving was given by the Library for the Blind in Atlanta Tables chairs and other essential furnishings were purchased with federal grant money Donated chairs and sofas were reupholstered by the occupational therapy upholstery department and magazine and paper racks were made in the hospital carpentry shop In addition to the excellent selection of books 14 newspapers and 47 periodicals have been donated for the patients The Librarian conducted a bibliotherapy workshop to acquaint an in vited group of staff members with this form of therapy The audiovisual department made a videotape of this session for future reference The garden therapy program has now been in operation for ten years and is continuing to provide a most beneficial service to the patients and personnel The patient garden club groups meet regularly the yearround providing a variety of services to the patients The volunteers have not relinquished their efforts in promoting financial sponsorship of the program through attendance at district meetings state conventions and providing programs and materials for individual garden club meetings throughout the state A twoday orientation was held for the new State District Directors and Therapy Chairmen so that they could be better informed about the total program Individual garden clubs are continuing to visit the hospital to see the garden therapy program in action The completion of the 30000 pavilion is the first step toward the development of the eightacre park on Vinson Highway near the Rivers Hos pital The fund drive was undertaken by the treasurer of the Garden Club of Georgia Inc This most appropriate and attractive facility is being used by a variety of interested groups throughout the institution The Horticulture Division continues to play an important role in the garden therapy activities ana projects Members of the Georgia Hairdressers and Cosmetologists Association from 15 affiliates provided services for 303 patients These included 107 cold waves 300 shampoos 186 haircuts 290 hair sets and many other services usually provided in beauty salons Recreation therapy has cooperated in arranging for and supervising school groups church groups civic service and fraternal organizations which have provided a variety of programs picnics and activities for patient groups Individual volunteers including high school and collegeriii 111 1it 1 jAfiififfr of tti 11 rrMtifjirtf AWft fjniyjffQ 96 students have contributed much to the program The Hoxie Brothers Circus gave their scheduled performances in April for the third consecutive year Funds were already on hand as a result of the successful fund drive conducted by Radio Station WSB in 1969 The circus acts patient participation and personnel cooperation made this one of the most outstanding and successful activities to date Among off campus trips for which complimentary tickets were obtained were Atlanta Braves games Atlanta Hawks Shrine Circus and Six Flags Over Georgia Art therapy remains a regular activity for several patient groups In addition to the large annual art show depicting the works of the patients pictures are displayed in the Central Patient Library on a rotating basis The Apparel Shop continues to operate from its temporary location Pavilion E The volume of donated new and used clothing is almost unbe lievable In addition to tons of clothing being sent directly to the build ings 3089 patient customers visited the shop Since the death of their Day Room Chairman the Church Women United in Georgia has decided not to continue the Day Room project on a state wide basis but encouragement will be given individual church organizations to work directly with Volunteer Services on providing funds for furnishings In April 1970 the state organization furnished a Day Room on Allen 1 West in memory of Mrs L L Austin who was Day Room Chairman for many years and on April 27 1970 a beautiful and appropriate special dedica tion service was held Three additional day rooms have been furnished with funds given by other groups and individuals The Music Therapy Department has utilized the services of high school and college students who were interested in and talented in music The staff has also cooperated in managing and arranging for patients to attend special programs presented by visiting musical groups The excellent patient referrals to the weekly Alcoholics Anonymous meetings by the medical staff is indicative of their realization that these sessions are therapeutic to those who have alcohol and drug problems The six sponsoring groups are to be commended for serving so faithfully over the past ten years The interest of individuals and groups participating in the Forgotten Patient program regularly befriending approximately 300 patients is most gratifying Patients have been encouraged to write personal notes of ac knowledgement to accompany the official reply There has been a marked increase in the number of patient notes received which points out the per sonal interest and assistance given by the nursing personnel A special playground project for Boone 4 which was begun three years 97 ago was completed The area has been fenced in a concrete pad has been built a corrulux covering has been erected over the pad and essen tial playground equipment has been purchased This provides a suitable place for the infants and small children to be taken off the ward and put in the fresh air and sunshine A group of interested citizens of Smyrna Decatur Marietta and the Glenwood Jaycettes of Decatur are responsible for this endeavor Another project of the Glenwood Jaycettes is the total sponsorship of the bowling league from the Childrens Unit This involved paying the bowling fees purchase of uniforms providing awards for each child who participated team trophies and the special awards dinner given at a local restaurant which was also attended by a committee from the sponsoring group Volunteer Services has been the recipient of large quantities of toilet articles cosmetics shoe dye and fabric dye which have proved invalu able to the patients During the year funds totaling 6560 have been donated for the purchase of special equipment and sponsorship of projects The 1969 MDay Christmas program was held at Gracewood State School and Hospital as scheduled on the rotating basis The patients had a wonderful Christmas with the denominational church parties adequate Christmas cards to send to their friends and relatives special ward pro grams cake parties and activities throughout the hospital which are usually associated with the Christmas season The second Annual Volunteer Awards Dinner was held at the Central Cafeteria on March 2 1970 In addition to the individual volunteers being recognized a special certificate was given to representatives of the Church Women United in Georgia Macon Jaycees Georgia Jaycettes Women of the Presbyterian Church in Louisville Georgia Hairdressers and Cosme tologists Association and Garden Club of Georgia as an additional feature The Volunteer Services staff is grateful for the excellent assistance from the hospital personnel who have demonstrated their desire to coope rate fully by their efforts to supplement staff and programs with volunteers to suggest appropriate special projects utilizing available supplies and materials and keeping the department informed of their needs The Public Information Department has provided invaluable coverage of special acti vities through news releases and professional photographers Slides have been an asset in presenting programs to interested community groups inservice education and student nurse classes and orientation for psy chiatric residents HI mmimmmmmm 98 REMOTIVATION DIVISION Remotivation in its fifth year of operation as a departmental discipline continues to make significant progress as a therapeutic modality The development of the program continues on three levels the unstructured nonformal activities relating to the basic functions inherent to human beings the formal group structured type of simple conversational activity relating to features of everyday living free from emotional difficulties and the advanced group type concentrating on indepth conversation about current living with its accompanying problems Within the hospital 558 patient activity groups held 20 088 sessions with 4 608 patient participants The average number of patients hospital wide participating in nonformal unstructured types of remotivation in any given month numbered 2000 The active aide remotivators in any given month decreased to 60 Remotivation activities which have produced good responses from patient participants are birthday parties cookouts picnics ice cream socials dining room projects personal care grooming walks cycling swimming community singing musical band shopping trips field trips tours to the Governors Mansion to town Fairs and to Rock Eagle gar dening fishing Girl Scouts ward improvement ward cleaning and beau tification projects flower making flower arranging window washing poster and calendar making sewing dressmaking dress revue quilting 24hour project in Medicare knitting Halloween Thanksgiving dinners Christmas play and pageant nightclub activity photography and T groups The motivational program in the Mental Retardation Unit has pursued the goal of elevating the functional level of the residents to their fullest capabilities through exposure experience and participation in coordinated efforts with recreation and occupational therapies A geriatric project in Unit 4 was directed by the recreation therapist and assisted by the remotivation instructor In the beginning stages of the Over Sixty Club it was found that the Unit had more than 250 pa tients 60 years of age and over Through careful screening 75100 pa tients were selected for weekly group meetings Successful activities included community oldfashion sings cookouts picnics walks bus tours bingo parties and tea parties During the training institutes some 200 patients were involved with trainees who came from the southeastern region As the Regional Training Center forthe southeastern area four training institutes and one workshop were held with 120 participants from hospitals and community agenciesWWfwmmmmm Rzmotlvation U a AucceAAiul theAapeivUc tzchYilc at Central State Hopital 99 within the area Of the total number of participants 55 were involved in the latter activity a three day workshop at the Veterans Administration Center in Dublin A total of 1530 patients participated in the clinical laboratory settings manned by selected experienced Aide Remotivators in selected wards throughout the hospital A total of 875 persons have been oriented to the hospitalsremotivation program during the fiscal year January 1970 marked the cessation of financial support for remotivation programs throughout the country by the Smith Kline and French Laboratories Each Training Center however was provided with three copies of the film Remotivation A Technique for the Psychiatric Aide available on loan to any interested institution or agency in the southeastern region Some 750 persons have viewed the film since the donations were effectedV 100 Education u the tntAuction ofi the lnteZlect In the law o na ture undex uiklck name 7 tncZude not meAety thing and theJji faoti cej but mzn and theln way ThomaA HuxZty 101 ASSISTANT SUPERINTENDENT EDUCATION TRAINING RESEARCH Jokn W Kembe MP PSYCHIATRIC RESIDENCY TRAINING MEDICAL RECORDS MEDICAL LIBRARY RESEARCH NEUROLOGY AUDIO VISUAL 102 EDUCATION TRAINING AND RESEARCH The Division has continued with accreditation in the training of psy chiatrists pharmacists psychologists social workers clinical chap lains music therapists occupational therapists and recreation therapists Descriptions of the training programs are included in individual reports Programmed texts have been introduced to the professional staff and are being used as a meansof instruction An increasing number of requests for stipends find all budgeted positions filled to capacity Stipends are offered in social work psychology business administration religion sociology and medicine in public health A senior resident in ophthal mology from Mayo Clinic in Rochester Minnesota continues to rotate through the hospitals Ophthalmology Department every three months This program was started in 1964 and has continued with satisfactory results The new Audiovisual Division has helped to broaden training programs in all areas of the hospital These services will be utilized more as tele vision distribution spreads throughout the hospital A three months training program in psychiatric nursing procedures and techniques was conducted for 165 students from various affiliated nursing schools Inservice training classes continue for aides and similar per sonnel Considerable attention by all the professional departments has been given to the development of effective inservice training and orienta tion programs Plans are being made for all attendants hired at the hospi tal to attend basic training inpsychiatric nursing before ward assignments are made NEUROLOGY During the past year diagnostic facilities inthis Division have greatly increased An electromyograph has been purchased and put into use Also a new ultrosonic analyzer was added now making it possible for more accu rate diagnosis to be reached In 1970 there were 543 neurologic consultations 246 echoencephalo grams and 1410 electroencephalograms plus the studies mentioned above A total of five psychiatric residents rotated for a three month period through this service in 1970 A neuropathologist consultant Hans Peters MD makes a monthly visit for teaching purposes A neurologist consultant Charles Rowley MD from Macon Georgia is available on a nonscheduled basis n 103 AUDIOVISUAL SERVICES A director of AudioVisual Services was hired during August and initial steps taken to install a closed circuit television system and provide audio visual support for all types of training in the institution A dining area in the Yarbrough Center was converted to a television studio master control repair and office space Distribution cable was installed to 20 of the hospital buildings Priority was assigned to those buildings housing training areas During the year nearly all disciplines utilized the system to some extent A total of 193 programs were produced locally and 254 programs played back The primary effort is the support of training for attendants nurses and resident physicians However continuing medical education for phy sicians in practice intern training sessions for the departments of psy chology music therapy and recreation therapy has demanded many hours of television time Evaluation sessions for psychiatrists vocational rehabilitation counselors and social workers have also been undertaken Increased patient TV entertainment and education were also made a vailable as a fringe benefit to the distribution system Macon NBC and Georgia ETV were taken off the air and transmitted over the same cable as locally produced material m 104 PSYCHIATRIC RESIDENCY TRAINING PROGRAM GOALS OF THE RESIDENCY PROGRAM The Psychiatric Residency Training Program at Central State Hospital provides appropriate training to prepare qualified physicians for the prac tice of psychiatry as a medical specialty in private practice in commu nity mental health or in an institutional setting Emphasis is placed on developing sound understanding of the dynamics of human personality and behavior and the role of emotions therein These teachings combined with administrative experience in both institutional and community settings and consultation experience prepare a resident to obtain certification by the American Board of Psychiatry and Neurology Since the programs initiation in 1964 the training faculty and con sulting staff have consistently evaluated and improved the program Su pervision and direction of residents are provided by experienced profes sionals adequately trained and capable of assuming the responsibilities for teaching psychiatric residents Although the program relies heavily on the individual residents personal experiences as a learning device the residency faculty is constantly scrutinizing residents techniques and procedures to correct faulty methods and interpretations and guide resi dents toward sound psychiatric practice Each physician in the Psychiatric Residency Training Program is as signed a faculty member as his advisor for the three years of training The close relationship between student and teacher lends itself to a more suitable and harmonious adjustment of the resident and for a more rapid airing of feelings which might otherwise block the learning process The first year of the training program is designed to acquaint residents with the basic principles of psychiatry and the care and treatment of psy chiatric patients The second year involves more specific areas of psy chiatry and patient treatment on an intensive basis The final year of the program includes a series of three month rotations to various psychiatric specialty areas These placements are in child psy chiatry community psychiatry geriatrics and mental retardation forensic psychiatry neurology psychosomatic medicine and possibly research Since its inception in January 19 64 until the present day 31 residents have completed their training in this program Initially the program was approved for 10 residents at each year level There are presently 12 resi dents enrolled Though there is no obligated service following the com pletion of this training our record of physicians remaining in the state BBBn nB 105 after completion of their training is excellent Of the 31 that have com pleted their training here in our program 23 continue to work at Central State Hospital three remain elsewhere in the State of Georgia and only five have left the State of Georgia APPOINTMENT OF RESIDENTS Residents are appointed to the Psychiatric Residency Training Program on a yearly basis with reasonable assurance of annual reappointment until completion of the three year program unless individual considerations warrant other recommendations on the part of the faculty Applications are accepted for training beginning July 1 and January 1 of every year Candidates must have graduated from an approved medical school in the United States or if a graduate of a foreign medical facility the applicant must have passed the ECFMG examination An internship is no longer required therefore candidates may apply directly from medi cal school Through appropriate references candidates must show evidence of good character and reputation An interview with the Admissions Committee is desirable and an acceptable impression is an important criterion for approval Every effort will be made to determine the motives qualifications and aptitudes of the candidate Applicants may be accepted by transfer from an accredited psychiatric residency program if they meet all other require ments Residents do not have to be licensed in Georgia if they are granted an institutional permit but they are encouraged to obtain a medical license if qualified by examination or reciprocity Vh EveLio VLolz VlftzcXon oh Utntal ReXaAdcvUon Unit In conheAenet with ReJideni In iychlaJJiy Vn Maxtka McCsianie oh the Mtdical Coltege oh Geongla tt one oh many lecXahexi knaxd duUng the yean106 RESEARCH DIVISION The Research Division conducts basic scientific investigations oriented toward problems of Central State Hospital patients At present the coop erating disciplines represented are Genetics Neurophysiology and Bio Chemistry Genetic studies probe the hereditary factors involved in syndromes and mental disorders aiding diagnosis by means of chromosome culture and histological techniques Genetic consultation is offered Studies on genetic factors in fearfulness and retinal degeneration have continued Neurophysiological studies are centered about the phenomena of nerve conduction and the function of the eye Visual defects are corrected to permit better learning among the hospitals mentally retarded children with a view toward therapy The Research Division has recently installed equipment for recording clinical and experimental electroretinography and will soon have facili ties for recording visually evoked cortical potentials Studies of visual function in mental retardates are nearing completion and a new test for visual acuity has been developed The figure shows the visual testing of a nonverbal mental retardate by matching the screen symbol with a panel symbol A correct choice is rewarded with a tiny chocolate candy Because all biochemical reactions are due to enzymes and a number of mental diseases and syndromes in volve absence or distortion of enzymes particular attention is being fo cused upon enzyme abnormalities among Central State Hospital patients A Negro Klinefelter syndrome case was karyotyped and found to pos sess an XXXYXXXXY constitution Our study of dehydrogenase due to a gene on the Xchromosome showed that substance not to be increased by the xchromosomes thus confirming the Lyon hypothesis that functionally all but one xchromosome is discarded A study employing radioactive technetium and radioactive mercury showed that the bloodbrain barrier is functional in excluding these sub stances as early as one day of age whereas it is believed that some toxic substances are admitted early and later excluded This year the hospitals Research Bulletin carried a report on seven teen research projects During the year a number of papers have been in preparation and two papers have been published in Volume 61 of the Journal of Heredity These were on Melanin Adrenalin and the Legacy of Fear 107 pages 8188 and A New Hereditary Degeneration of the Mouse Retina Volume 61 pp 6Z63 Education continues to be an important part of the Divisions total program During the year staff members gave 40 lectures The Division also received 82 requests for reprints of scientific research publications The requests came from 31 states and 14 foreign countries WHEW SPECIAL PROCEDURES ARE NECESSARY THE CSH STAFF VEVELOP THEM Many mentally netanded chUidnen one unable to nead the nonmal chant when being tested ion glasses so Vn Rex Comntney ok CSH ReAeanch staii dev eloped a special chant using the thnee symbol shown hene Teaching this little glnl to necognlze the symbols Is Technician Vonell JeJinlgan This pnocedune lnsunej adequate conAectlve measunes ion bight deficiencies108 ADMISSION MEDICAL RECORD SERVICES Admission procedure innovation and implementation of the new Mental Health Law placed tremendous demands on the Medical Record Department during the last year however efficient operation was maintained and varied services were provided 24 hours a day 7 days a week Central State Hospital is unique in the experience of the majority of mental or general hospitals in that the medical staff is prompt in the completion of patient charts within the time limit specified by the Joint Commission on Accreditation of Hospitals Delinquent charting is not a problem at Central State An onthejob training program for inpatients and female prisoners in medical record procedures has resulted in motivating many trainees to en roll in formal programs of medical record library science or secure jobs in the medical record field upon release Success in this project conducted with the cooperation of Vocational Rehabilitation has been gratifying Cooperative efforts of the Business Office Social Service Department and Medical Record Department in filing protective applications for Social Security benefits for the entire patient population of Central State Hospital received national recognition by Health Education and Welfare Mr Robert Bynum regional commissioner of the Social Security Ad ministration complimented hospital personnel for performance beyond the call of duty MEDICAL LIBRARY The Medical Library is now well supplied with the newest and best textbooks in the preclinical sciences and in all fields of medicine and medical education as well as in the other various fields that this library serves Suggested medical library book lists appearing in professional library publications and requests from our professional staff are screened by the library to determine new acquisitions All additions are announced in the Weekly Bulletin The extensive holdings of the Medical Library are actively used to improve patient care and by staff members who are participating in college courses Students from colleges in Milledgeville not connected with the hospital are also making use of the library service Residents in ophthal mology from Mayo Clinic and students from the University of Georgia working at Central State have all necessary reading material available 109 The Medical Library shares resources with Georgia College at Mill edgeville and has active interlibrary loan relations with the Southeastern Regional Library Program as well as with other libraries The audiodigest tapes in internal medicine and surgery to which the Medical Library subscribes are regularly utilized by physicians working in the General Medical and Surgical Hospital The Medical Library is a member of the Medical Library Association and the library participates in meetings such as the recent Medical Library Association Convention held in New Orleans and the various workshops designed to keep the staff abreast of the newest information in the field ALL MEPICAL RECORDS AT CENTRAL STATE HOSPITAL ARE U TO VATE APPNDtX in ADMISSION RATES PER 100000 ESTIMATED CIVILIAN POPULATION 112 ONBOOK POPULATION RESIDENT PATIENTS ADMISSIONS AND CONVALESCENT LEAVE FOR TENYEAR PERIOD 19611970 RESIDENT POPULATION BY MENTAL DISORDER TYPES OF MENTAL RETARDATION ADMISSIONS DISCHARGES AND DEATHS BY AGE PATIENT ADMISSIONS BY DAY OF THE WEEK POPULATION PROJECTIONS BY UNITS FOR 19701975 DEATHS AND DISCHARGES BY TIME ON BOOKS RESIDENT POPULATION BY COUNTY FOURYEAR COMPARISON OF COUNTY ADMISSIONS ROSTER OF PROFESSIONAL STAFF 113 114 115 116 117 118 119 120 121 125112 ADMISSION RATES PER 100000 ESTIMATED CIVILIAN POPULATION BY COUNTY OF ADMISSION FISCAL YEAR ENDING JUNE 30 1970 L 1 inoleV C R A D Y lVvt i ocCATVui 1 113 1970 9000 8000 7000 6000 5000 4000 3000 2000 1000 I M 1 Ih IS 1 Jl IP II 1 i f V h N 1 II 1 1 SI II 1 h H c d f J 1 1 u J 2 V 1 l 3 o t c 7 i V u J j 2 i i cl rt Ct c 2 ti 1 2 r p P 1 K H tl C U r L J X Lt rf c f i t H CV 5 j 1 2 i z c a l V r ll I g c c 5 i i 1 r r Q i 7 t Q C r i H CL c T H CO 1 t S J tititrri Q 4 14 UU i 1 th c ok u T uu uj 3i c s c i Qt t tju u r o J 3 H4 u u a o n if p c3 F n or lllllllllllllllllllll 1 500 400 300 200 100 an b FWt MER RE te H jm IKS 3HS BEHDtt fOW MrffCF H urn REmmzum REBtfflEU Efi Ws IffiD Jm U4 E 23 SitNHCSPFF HE 4 All JOftfIR rHtt OfUnKnot nvmnmnvw 40 117 30 20 10 0 H U M P C 0 H P n H a Ml o a Si 0 en 0 5 Sunday Monday Tuesday Wednesday Thursday Friday Saturday Days of the Week This chart shows the average number of patients admitted and returned to Central State Hospital for each day of the week This chart is derived from a project performed by Industrial Engineering which utilized data furnished by the Medical Records Department for the first six months of 1969Table 1 Population Projections by Unit 19701975 Versus Present Available Beds and Occupancy Unit Population Projections Number of Persons Population Change 1970 to 1975 Beds available As Of March 1969 Patients in Unit As Of Occupancy March 1969 Rate 1970 1975 1247735 1497771 20 1299 1236 95 II 1107579 1210137 9 1591 1411 89 III IV 928205 980118 859518 931339 658193 681485 6 8 4 1463 1700 1344 1328 91 1553 915 1250 93 Source Population PH0j2ction6 Ion GzoHqIo CounLM 19701975 University of GeorgiaDEATHS AND DISCHARGES BY TIME ON BOOKS 119 TIME ON BOOKS Under 3 Months 35 Months 611 Months 1 Year 2 Years 3 Years 4 Years 59 Years 1014 Years 1519 Years 2024 Years 2529 Years 30 Years and Over DEATHS 88 51 82 79 56 38 37 78 49 30 18 28 137 DISCHARGES 745 201 159 2248 551 251 118 225 48 27 19 8 875 TOTAL 771 5479120 RESIDENT POPULATION BY COUNTY APPLING 25 FANNIN 26 ATKINSON 8 FAYETTE 20 BACON 22 FLOYD 133 BAKER 6 FORSYTHE 24 BALDWIN 133 FRANKLIN 18 BANKS 14 FULTON 1300 BARROW 35 GILMER 20 BARTOW 65 GLASSCOCK 10 BEN HILL 41 GLYNN 79 BERRIEN 14 GORDON 49 BIBB 376 GRADY 26 BLECKLEY 32 GREENE 25 BRANTLEY 7 GWINNETT 67 BROOKS 30 HABERSHAM 47 BRYAN 8 HALL 108 BULLOCH 46 HANCOCK 29 BURKE 43 HARALSON 38 BUTTS 16 HARRIS 25 CALHOUN 13 HART 21 CAMDEN 14 HEARD 17 CANDLER 15 HENRY 25 CARROLL 77 HOUSTON 56 CATOOSA 33 IRWIN 12 CHARLTON 11 JACKSON 40 CHATHAM 329 JASPER 22 CHATTAHOOCHEE 5 JEFF DAVIS 19 CHATOOGA 37 JEFFERSON 41 CHEROKEE 52 JENKINS 30 CLARKE 95 JOHNSON 24 CLAY 8 JONES 13 CLAYTON 56 LAMAR 30 CLINCH 4 LANIER 8 COBB 187 LAURENS 94 COFFEE 32 LEE 7 COLQUITT 64 LIBERTY 20 COLUMBIA 22 LINCOLN 8 COOK 12 LONG 7 COWETA 80 LOWNDES 76 CRAWFORD 16 LUMPKIN 19 CRISP 42 MACON 25 DADE 14 MADISON 32 DAWSON 7 MARION 19 DECATUR 41 McDUFFIE 22 DEKALB 307 McINTOSH 8 DODGE 47 MERIWETHER 47 DOOLY 26 MILLER 10 DOUGHERTY 114 MITCHELL 32 DOUGLAS 49 MONROE 28 EARLY 26 MONTGOMERY 10 ECHOLS 2 MORGAN 17 EFFINGHAM 17 MURRAY 19 ELBERT 44 MUSKOGEE 243 EMANUEL 51 NEWTON 59 EVANS 12 OCONEE 16 OGLETHORPE 23 PAULDING 39 PEACH 38 PICKENS 20 PIERCE 10 PIKE 30 POLK 81 PULASKI 27 PUTNAM 17 QUITMAN 2 RABUN 14 RANDOLPH 25 RICHMOND 204 ROCKDALE 29 SCHLEY 6 SCREVEN 34 SEMINOLE 5 SPALDING 108 STEVENS 26 STEWART 31 SUMTER 52 TALBOT 15 TALIAFERRO 9 TATNALL 32 TAYLOR 17 TELFAIR 36 TERRELL 27 THOMAS 63 TIFT 39 TOOMBS 54 TOWNS 5 TREUTLEN 8 TROOP 87 TURNER 24 TWIGGS 16 UNION 11 UPSON 63 WALKER 76 WALTON 43 WARE 71 WARREN 11 WASHINGTON 31 WAYNE 30 WEBSTER 7 WHEELER 6 WHITE 11 WHITFIELD 106 WILCOX 17 WILKES 25 WILKINSON 25 WORTH 32 TOTAL 7921 FOURYEAR COMPARISON OF COUNTY ADMISSIONS 121 COUNTY OF ADMISSION Appling Atkinson Bacon Baker Baldwin Banks Barrow Bartow Ben Hill Berrien Bibb Bleckley Brantley Brooks Bryan Bulloch Burke Butts Calhoun Camden Candler Carroll Catoosa Charlton Chatham Chattahoochee Chattooga Cherokee Clarke Clay Clayton Clinch Cobb Coffee Colquitt Columbia Cook Coweta Crawford Crisp Dade Dawson YEAR 1967 19 7 15 5 119 5 45 61 37 19 256 23 15 24 15 28 25 27 8 17 6 79 35 7 154 1 30 47 100 3 81 11 196 51 71 22 17 65 5 33 17 7 1968 17 1 26 1 144 7 52 73 37 19 273 23 13 16 16 32 19 27 4 12 17 66 34 5 161 4 24 58 118 7 88 15 237 29 54 32 16 70 10 32 17 9 1969 15 9 33 1 127 9 39 46 37 23 279 14 20 18 13 36 20 17 11 13 5 58 40 8 167 0 23 45 112 10 82 12 194 35 49 24 17 63 8 36 15 1970 TOTAL 24 75 8 25 31 105 2 9 176 566 6 27 40 176 69 249 41 152 34 95 333 1141 19 79 12 60 15 73 11 55 32 128 24 88 24 95 12 35 14 56 8 36 67 270 39 148 12 32 184 666 1 6 36 113 40 190 116 446 4 24 76 327 11 49 211 838 43 158 46 220 34 112 14 64 56 254 7 30 28 129 11 60 12 36 122 COUNTY OF ADMISSION YEAR 1967 1968 1969 1970 TOTAL Decatur 39 47 32 27 145 DeKalb 278 300 274 231 1083 Dodge 43 24 31 60 158 Dooly 11 26 20 18 75 Dougherty 95 106 96 84 381 Douglas 40 29 38 56 163 Early 21 26 20 18 85 Echols 2 5 0 0 7 Effingham 13 19 7 7 46 Elbert 27 28 41 38 134 Emanuel 50 52 56 51 209 Evans 18 12 11 17 58 Fannin 24 18 21 24 87 Fayette 7 10 13 6 36 Floyd 106 101 103 76 386 Forsyth 28 25 23 29 106 Franklin 23 23 31 24 101 Fulton 987 873 800 771 3431 Gilmer 14 21 24 19 78 Glascock 5 6 9 6 26 Glynn 70 82 91 89 332 Gordon 48 41 40 32 161 Grady 26 33 23 35 117 Greene 17 15 17 20 69 Gwinnett 78 92 85 99 354 Habersham 35 32 36 30 133 Hall 102 107 135 154 498 Hancock 22 24 17 27 90 Haralson 31 29 29 28 117 Harris 15 11 18 9 53 Hart 22 24 24 24 94 Heard 16 5 8 2 31 Henry 19 24 28 27 98 Houston 66 71 55 73 265 Irwin 16 12 7 13 48 Jackson 32 31 22 38 123 Jasper 6 15 13 19 53 Jeff Davis 36 20 24 31 111 Jefferson 21 29 20 14 84 Jenkins 17 17 17 14 65 Johnson 20 26 21 19 86 Jones 20 21 19 24 84 Lamar 21 20 19 25 85 123 COUNTY OF ADMISSION YEAR 1967 1968 1969 1970 TOTAL Lanier 9 8 9 5 31 Laurens 54 73 59 80 266 Lee 4 3 3 3 13 Liberty 20 19 24 18 81 Lincoln 11 13 6 5 35 Long 5 7 1 2 15 Lowndes 62 52 38 48 200 Lumpkin 12 16 14 17 59 Macon 14 31 15 14 74 Madison 23 22 21 17 83 Marion 8 8 5 12 33 McDuffie 21 56 61 53 191 Mclntosh 11 5 7 13 36 Meriwether 21 30 31 27 109 Miller 12 10 9 6 37 Mitchell 29 37 16 23 105 Monroe 25 28 23 25 101 Montgomery 7 13 9 13 42 Morgan 18 11 9 11 49 Murray 12 12 8 12 44 Muscogee 196 166 187 172 721 Newton 67 58 55 57 237 Oconee 11 13 14 8 46 Oglethorpe 7 14 8 8 37 Paulding 42 45 46 49 182 Peach 36 39 32 27 134 Pickens 14 16 13 19 62 Pierce 13 9 10 8 40 Pike 18 14 9 9 50 Polk 64 58 52 61 235 Pulaski 17 24 14 21 76 Putnam 21 16 15 32 84 Quitman 2 2 1 2 7 Rabun 13 21 17 25 76 Randolph 14 21 12 16 63 Richmond 241 248 160 181 830 Rockdale 26 29 24 29 108 Schley 2 4 4 3 13 Screven 28 19 17 13 77 Seminole 10 6 10 4 30 Spalding 93 105 97 95 390 Stephens 35 24 30 33 122 Stewart 10 14 8 7 39 124 COUNTY OF ADMISSION YEAR 1967 1968 1969 1970 TOTAL Sumter 32 34 30 27 123 Talbot 8 13 10 10 41 Taliaferro 5 4 2 5 16 Tattnall 24 20 18 20 82 Taylor 10 6 7 4 27 Telfair 26 29 28 29 112 Terrell 7 15 17 10 49 Thomas 55 76 44 65 240 Tift 28 31 29 32 120 Toombs 53 55 51 62 221 Towns 11 6 6 2 25 Treutlen 20 14 16 22 72 Troup 74 67 76 66 283 Turner 13 16 12 11 52 Twiggs 11 18 13 11 53 Union 16 12 19 13 60 Upson 44 32 37 58 171 Walker 92 95 77 66 330 Walton 56 66 57 62 241 Ware 70 64 99 65 298 Warren 9 17 6 8 40 Washington 49 42 27 46 164 Wayne 30 32 28 49 139 Webster 6 1 3 5 15 Wheeler 9 11 12 5 37 White 5 7 4 2 18 Whitfield 96 81 91 123 391 Wilcox 11 9 9 10 39 Wilkes 25 27 14 23 89 Wilkinson 24 24 21 21 90 Worth 20 22 15 19 76 TOTAL 6691 6802 6290 6625 26420 125 MEDICAL DEPARTMENT James B Craig MD Superintendent John W Kemble MD Assistant Superintendent Education Training Research William R Howard MD Assistant Superintendent Physical Health W T Smith MD Clinical Director Psychiatric Service H C Miles MD Clinical Director Psychiatric Service UNIT I Santiago Aguilar MD Director Francisco Borges MD Psychiatric Resident Jose Delgado MD Psychiatric Resident Maria Dourron MD Staff Physician Mohammed Karatela MD Physician Specialist I Stephen E Kramer MD Staff Physician Jesus Llobet MD Psychiatric Resident Ricardo Mesa MD Staff Physician B E Orosdy MD Staff Physician Zelma Ozolins MD Senior Staff Physician Raul Rivero MD Senior Staff Physician Orlando Rojas MD Psychiatric Resident Diego Sans MD Psychiatric Resident UNIT II Eduardo Guernica MD Director Marta Bosch MD Physician Specialist I Tomas GarciaMontesinos MD Staff Physician Humberto Ravelo MD Physician Specialist I Roberto Rey MD Physician Specialist I Muhammed AslamSandvi MD Physician Specialist I Adolph Sarma MD Chief Physician Vilis J Zakitis MD Chief Physician126 UNIT III Jose Mendoza MD Di rector Eugene Christian MD Physician Specialist I Moises Jacobs MD Staff Physician Juan Llambes MD Staff Physician Rafael Pascual MD Senior Staff Physician Francisco Huerta MD Senior Staff Physician R S Planas MD Staff Physician Jacinto Regal ado MD Staff Physician Hector Sotolongo MD Staff Physician UNIT IV Charles Rich MD Director John Azzi MD Senior Staff Physician Ramon Berenguer MD Senior Staff Physician Thomas Bullock MD Physician Specialist I Marta L Dzirkalis MD Senior Staff Physician Clifford Harden MD Physician Specialist I Mario de Laosa MD Chief Physician N T Soorya MD Physician Specialist I John J Word MD Physician Specialist 2 UNIT V Lorenzo del Portillo MD Director Orestes FernandezCaral MD Staff Physician Jose Bernardo Garcia MD Staff Physician George Grant MD Physician Specialist I Isidro Insua MD Staff Physician Manuel J Pena MD Staff Physician Carlos PerezAbreu MD Staff Physician Roberto Perdomo MD Chief Physician Carlos Garcia Rivera MD Staff Physician UNIT VI Carl Smi th MD Di rector Ernesto Giro MD Physician Specialist I Victor Ubieta MD Senior Staff Physician UNIT VII E F Stincer MD Director Miguel Bosch MD Physician Specialist I Gudio Graciaa MDPsychiatric Resident 127 UNIT VIII Juan Portuondo MD Director Hortensia Alvarez MD Psychiatric Resident Mary Elliott MD Physician Specialist 2 Jose Gonzales MD Physician Specialist 1 Juan Perez MD Psychiatric Resident Jose Rouco MD Psychiatric Resident Odelia Zapatero MD Physician Specialist 1 UNIT IX E F Diaz MD Director Manuel Diaz Estrada MD Senior Staff Physician Ana Marrero MD Psychiatric Resident Teofilio Milian MD Staff Physician III Rene Montero MD Physician Specialist 2 Juna Trejo MD Staff Physician Luis Samper MD Physician Specialist 2 Emilio Yero MD Staff Physician UNIT X S A Mendez MD Director Armando Gutierrez MD Physician Specialist 1 Henry F Yost MD Senior Physician Medical Specialty NEUROLOGY John W Kemble MD Director Rafael Alvarez MD Psychiatric Resident Jose Rubio MD Psychiatric Resident RESEARCH Clyde Keeler ScD PhD Director G R Courtney OD Neurophysiologist Jerry Curtis PhD Biochemist PSYCHIATRIC RESIDENCY TRAINING Louis Jacobs MD Director E F Stincer MD Supervisor 128 SPECIALIZED MEDICAL SERVICES GENERAL MEDICINE SURGERY J G Bohorfoush MD Director E G Allende MD Physician Specialist 2 Sergio AlvarezMena MD Physician Specialist 2 Antonio Ballagas MD Senior Staff Physician David Cardoso MD Physician Specialist 3 Harold Carson MD Staff Physician Osvaldo Casas MD Senior Staff Physician S H Dillard Optometrist Andres Fernandez MD Physician Specialist 2 Samuel Goodrich MD Physician Specialist I Pilar Goicoechea MD Physician Specialist 2 Francisco Gomez MD Senior Staff Physician Jose Jimenez MD Chief Physician Medical Specialty Raymond Jordan MD Senior Staff Physician Leon Koen MD Physician Specialist 2 Joseph Leyva MD Physician Specialist 1 Carlos Montalvo MD Senior Staff Physician John Moody MD Chief Physician Perry Moore MD Physician Specialist 2 Helena P Marshall MD Physician Specialist 2 Dionisio Pinero MD Physician Specialist 3 Luis Rodriquez MD Physician Specialist 2 Julio San Martin MD Chief Physician K Sreeramaiah MD Physician Specialist 2 Erlinda Valdecanas MD Staff Physician Virgilio Valdecanas MD Physician Specialist 1 Raul Veiga MD Physician Specialist 1 ChiehCheng Wu MD Physician Specialist 2 Pedro L Tamayo MD Physician Specialist 2 Teofilo Tomas MD Physician Specialist 2 Paolo Zerbi MD Physician Specialist 3 RIVERS HOSPITAL Mahmud Majanovic MD Director Francisco Madrid MD Senior Staff Physician Jose R Sanchez MD Staff Physician A Steinhards MD Staff Physician MEDICARE Edwin W Allen Sr MD Chief of Service Luis Carrodeguas MD Senior Staff Physician Geraldine Pilcher MD Psychiatric Resident Bernardo Utset MD Staff Physician COORDINATOR HOSPITAL CONSTRUCTION Michael L Sheppeck MD Dipi ornate American Board of Psychiatry and Neurology m mmm 129 DENTAL SERVICE Robert Watson DDS Director Ray Camp DDS Jack Groover DDS Raymond Johnson DDS Joe Lister DDS Richard Rogers DDS Phillip Spence DDS James Vaden DDS William Willoughby DDS Thomas Wylie DDS PHARMACY Durward Poland PharD Director Ken Autry BS Clarence Gissendanner BS Edgar Height BS Thomas Reese BS Rymer Rivers BS Glenn Veal BS William F Kendricks Raymond Covey Intern BS 130 NURSING SERVICE Bernice H King RN Acting Nursing Service Administrator Vera W Knowles RN Assistant Nursing Service Administrator DIRECTORS OF NURSING Ouida Couch RN Unit I Edna Ross RN Unit VI Fay H Fidler RN Unit II Mary A Bell RN Unit VIII Frances Osborne RN Unit III Virginia Smith RN Unit IX Ruth D Mull is RN Unit IV Janet Smith RN Unit X Mildred Daniel RN Unit V Irene Wood RN Jones Hospital Valeria Atchison RN Rivers Hospital PSYCHIATRIC OUTPATIENT CLINIC Mary W Billue RN Nurse Supervisor PSYCHIATRIC AFFILIATION PROGRAM Maidana Nunn RN MS Assistant Director of Nursing Beatrice Tribble RN AB Nurse Supervisor Pauline Anderson RN Senior Staff Nurse Gertrude Thigpen RN Senior Staff Nurse Gloria A Williams RN Senior Staff Nurse Alice Paschal RN Senior Staff Nurse PSYCHIATRIC AIDE PROGRAM AND INSERVICE EDUCATION Vivetta Kramer RN MS Assistant Director of Nursing Christine Brookins RN Nurse Supervisor Grant Program Glenda Ridley RN BS Nurse Supervisor Ellen Carr RN Senior Staff Nurse Clinical Instructor Unit II Gladys Moore RN BS Senior Staff Nurse Clinical Instructor Unit III Vivian Knight RN BS Senior Staff Nurse Clinical Instructor Unit V Mary H Thomas RN Senior Staff Nurse Clinical Instructor Unit VIII Ruth Leverette RN Senior Staff Nurse Clinical Instructor Unit IX Lee Bell RN Senior Staff Nurse Clinical Instructor Rivers Hospital REMOTIVATION Lolita Rutland RN PhD Director Mattie L Pennington RN Supervisor TECHNICIANS Truett Abbott AB Annette Acree AB Renwick F Bradley AB Ludwina G Bull BS Nancy J Carter BA Janet E Clark BA Elizabeth Collins AB K Holley Cowan AB Anita Cruz BA Yvonne J Everett BA Edwin A Gregory BS Emmett L Griswold BS R Darryl Herren AB Gayle Hooks AB Sarah F Ivey BS Kaye W Lanier AB Jeannette M Lewis AB Charles C Lowery BA M Andrew McCollum BS Wanda Dykes McKnight AB Martha McLaurin BA Wilbur Manson BA Byron 0 Merritt BA June Moore BA Eloise B Myles BA John W Prather AB Lena M Price BA Frances B Rogers BA Virginia L Shealy BA Mary Ann Simmons BA Doris T Sutton AB TeCoah Tucker AB Gwendolyn G Turner BA Jewell J Turner AB Joan S Venable BS Harry C Weathers BA Patricia Weerts BS Nedra M Williams BA SOCIAL WORK AIDES 131 SOCIAL WORK Kenneth F Jasnau MSS ACSW Director E 0 Melton MSW ACSW Assistant Director Nancy E Barnes MSW Social Worker I E Wayne Bland MSW Social Worker I Brenda M Jones MSW ACSW Social Worker I Martha C Tomin MSW Social Worker I Roy H Brown MSW Social Worker Lynne N Feagin MSW Social Worker Carolyn B Grant MSW Social Worker Jim D Lanier MSW Social Worker Walker McKnight MSW Social Worker Rosa C Mendoza MSW Social Worker Kirk C Minor MSW Social Worker Janet E Scott MSW Social Worker Caleb Paul Wright MSW Social Worker Suzanne R Wright MSW Social Worker Carol Andrews MSW Social Worker David R Burgest MSW Social Worker Joseph T Hodge MSW Social Worker Patricia R Karatela MSW Social Worker Allie C Kilpatrick MSW Social Worker Louise H Powell BA Social Worker Lamar H Watkins MSW Social Worker Carrie L Smith Wanda WhitakerF 132 SOCIAL WORK SCHOLARSHIPS Roy H Brown Nancy J Carter Edwin A Gregory Joseph T Hodge Jim D Lanier Walker McKnight John W Prather Robert M Rhymes Doris T Sutton Gwendolyn G Turner Richard D Zellner CLINICAL PSYCHOLOGY Robert W Wildman PhD Director Thomas W Lucik PhD Senior Clinical Psychologist John J Gates PhD Clinical Psychologist Robert F Heap PhD Clinical Psychologist Thomas N Elliott MS Staff Psychologist F L Madison MA Staff Psychologist L F Quattlebaum MS Psychologist INTERNS G F Beissel MS Thomas N Elliott MS Harry G Karras MA William C Peel Jr MS Martin F Rosenman MA Allen E Shealy MA SENIOR TECHNICIANS Alice Lee Canipe MS G Robert Dixon AB Carolyn C Erickson MA Ivor D Groves III MA Wayne Hodges BS Carlton L Lanier MA Kenneth W Varnadoe MA P Douglas Watson BA Robert W Wildman II BS B Frank Williams MEd TECHNICIANS Edward H Amos Jr BA Tedd B Brown AB Faye Butler AB William A Carruso BA H Lane Dennard AB Lawrence E Dresdale BA Drena S Lanier AB Ray C Olivier BA Vincent L Parrish BA James G Ressenger AB Alexander G Riddle AB Joanne D Rogers AB Deborah S Smith BA James T Wilkinson AB SCHOLARSHIPS Tedd B Brown BA G Robert Dixon AB James D Foulks BS Wayne Hodges BS Dean Kilpatrick AB Dennis L Pilgrim MA Jerry L Sloan BA R Douglas Smith BA P Douglas Watson BA Claude L Andrews BD C Paul Bennett BD L Leneal Fortner BD William W Goins ThM William M Hearn BD Ralph T Milligan BD Robert W Addiss BD William Counsel man BD J Mark Gaines BD Robert Gray BD Andrew L Miles BD G Guy Walton ThM RECREATION THERAPY Bruce R Prosser BS MS Director Helen Callaway BS Recreation Therapist II Lyndoll U Moore AB Recreation Therapist II Ronald R Smith BS Recreation Therapist II Charles M Vandiver BS Recreation Therapist II Anna G Warnock BS Recreation Therapist II Betty J Welch AB Recreation Therapist II Ronald Farmer BS Recreation Therapist I Wayne Gay BS Recreation Therapist I Charles Parramore BS Recreation Therapist I INTERNS Philip Ackerman Susan Bingham Richard Lewman 133 CLINICAL CHAPLAINCY James L Travis ThM Chief Clinical Chaplain Ronald A Wilkins ThM Asst Chief Clinical Chaplain Charles Alston BD Clinical Chaplain Baxter P Cochran BD Clinical Chaplain Payton B Cook BD Clinical Chaplain John J Gleason ThM Clinical Chaplain James F Hardie MA Clinical Chaplain Robert Z Powell ThD Clinical Chaplain Milton P Snyder ThM Clinical Chaplain 0 Chappell Wilson M Div Clinical Chaplain Joseph G Cassidy AB Catholic Chaplain Harold L Gelfman DD Rabbi Ervin R Oermann BD Chaplain to the Deaf Charles B Fanshaw MRE Chaplain to the Deaf RESIDENTS Robert E Ballard ThM C Jack Caudill Joseph S Dukes III BD Raymond J Lawrence ThM INTERNS L134 MUSIC THERAPY Herbert P Goldsmith RMT Director Music Therapists Judy A Baron RMT Beth B Carroccio RMT Dennis F Carroccio RMT Elizabeth Caudill BA Solomon Cunio BM Sandra Graham BME Saralyn Latham MA Jayne Marsh MA RMT Mary Mattos RMT Suzanne Pipp RMT Carol Prickett RMT Pamela Roberson BA Carolyn Sanders RMT Jeannette Warren RMT OCCUPATIONAL THERAPY Dorothy M Clarke OTR Karen A Harms OTR Occupational Director Therapist VOLUNTEER SERVICES Jane M Haddock BS CVC Director STAFF Susan Coursey AB Earnest Yearwood AB I 135 VOCATIONAL REHABILITATION W C Petty AB Director Marvin Denton Jr BS MEd Supervisor of Services Jesse P Collette BS EdSupervisor Counseling Service Thomas Gannaway BS MA Supervisor Evaluation Adjustment Services James C Grover AB Supervisor Job Development REHABILITATION COUNSELORS Harry D Bates BS MRC Dennis M OConner AB BD Charles H Boland Jr AB BD Robert E Pickett BA MEd Alvin D Dixon III BS Peter Shenkman BA MRC Marsha S Fields AB MCE Helen P Simpson BS Joseph J Fulbright AB LLB Joe Frank Stevens BA BD Irwin P Gates Jr BA BD Algie E Thomas AB James D Helton AB Frances W Torrance BS MHt William M Moore Jr AB BD Mary Jams Weathers BS L I EVALUATORS Ronald Barnard BA MEd Tom W Brown BS Lanier Browning BS Julian F Council BA Edwin R Freeman BS Henry M Hopkins Jr BA Jane Rhodes BA John W White BA Robert Wiley BS MEd WORK ADJUSTMENT INSTRUCTORS Pat Collins Faye P Day Miles A Jones Jr Virginia Mull is Robert L Strickland VOCATIONAL INSTRUCTORS James Adcock Wynelle Armstrong RN A L Booth E M Bradford Charlene Carpenter K E Donaszewski Arthur Jones Anne Hamilton Ruth Marshall BS Ken Ryals Jacquelyn Shell Gloria Smith BS Marianne Thompson BS136 SCHOOL OF SPECIAL EDUCATION John H Rawlins BS MEd Principal TEACHERS Suelle Austin BS MEd Pamela Bryant BS Bessie Burton BS Pam Bush BS Larry Call away BS Karen Caruso BS Cathy Chapman BS Elaine Cowan BS Roberta Crittenden BS Bertha Eakins BS Mary Edwards BS Antoinette Ennis AB Colleen Farmer BS Robert Floyd BS Gertrude Higgins BS MEd Lois Irvin AB Walter Kirkland BS MEd Collins Lee BS E J Lundy BS John Martin BS James Nelson AB Fe Pinero BS Georgia Prosser BS Sibyl Smith BS Dorothy Trawick BS Larry Waldrep BS Ruby Werts BS Glenda Young BS MEd 9B 137 AND SO ONCE MORE THE TALE IS TOLD WHAT WILL THE FUTURE YEAR UNFOLD BRIGHT HOPE NEW PROGRESS OR A COLD UNFEELING APATHY YOU HAVE THE ANSWERYOU MY FRIEND CAN HELP THESE LONELY ONES TO MEND THEIR SHATTERED MINDS IF YOU EXTEND A LOVING SYMPATHY Ray Brown bssr R lot UNIVERSITY OF GEORGIA JUL 13 1971 LIBRARIESwmmmmmm v av cav77v A A S 1 9 A