KiTrT 3 o Qij 7 f Vi w IT MtittlHHBHMHuHHnnMaHSUHH 4 V ft sG department of public health central state hospital ANNUAL REPORT AND YEAR BOOK milledgeville1971 ii kr K IS lrJCOVER PHOTO The new General Medical and Surgical Hospital is closer to reality with the comple tion of plans Bids will be let early next year and the actual construction will be started shortly thereafter V V 4 DIRECTORY Honorable Jimmy Carter Governor State of Georgia MEMBERS OF THE GEORGIA STATE BOARD OF HEALTH B W Forester MD Chairman Earl T McGhee MD ViceChairman J T Mercer DVM Secretary Harrison Bray W A Carr DDS Lee Roy Claxton RPh William A Dickson MD P K Dixon MD John E Garner Jr John D Marshall RPh J K McDonald MD W F McKemie MD Lamar B Peacock MD Carl E Pruett J H Sullivan MD J K Train MD A C Tuck DDS 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 4 jTABLE OF CONTENTS GENERAL INFORMATION PAGE 111 OFFICE OF THE SUPERINTENDENT 1218 Staff Housing Public Information Patient Affairs Medical Staff Secretary Hospital Receptionist ADMINISTRATION 1936 Institutional Business Administration Personnel Engineering Manpower Hospital Information Systems Industrial Engineering Horticulture CLINICAL SERVICES 378 General Psychiatric Units 398 Special Psychiatric Units Veterans 9 Maximum Security 53 Children 5 Mental Retardation 57 Yarbrough Vocational Rehabilitation Center 60 Social Work 62 Chaplaincy Services 6k Special Education School 66 Nursing 68 Psychology 72 EDUCATION TRAINING AND RESEARCH 8592 Neurology 86 AudioVisual Services 86 Medical Library 87 Psychiatric Residency 88 Research 90 PHYSICAL HEALTH 9311 Jones HospitalGeneral Medicine and Surgery 9 Rivers HospitalTubercular Drugs and Alcohol Medicare 98 Pharmacy 100 Dentistry 101 Recreation 102 Occupational Therapy 10f Music Therapy 106 Volunteer Services 111 Remotivation 11 APPENDIX 11 5 fc IHHMHMBiliHHHHSHHHH it 7 July 1 1971 Doctor Charles K Bush Director Hospital Services Branch Division of Mental Health Georgia Department of Public Health 47 Trinity Avenue SW Atlanta Georgia 30334 Dear Doctor Bush IT I We present herewith the Annual Report and Year Book of Central State Hospital covering the fiscal year ending June 30 1971 While progress toward accreditation has not been as rapid as we would have liked there has been a steady improvement in the efficacy of the treatment programs as well as in the improvement of physical facilities thereby creating better environment for the patients Admissions reached an alltime high of 7521 patients but the residential population continued to decline the decrease this year being 964 which brought the average daily resident population to 8041 individuals The re duction in residents has somewhat relieved overcrowding and made much needed ward space available for therapeutic and recreational purposes Also we are pleased to report that much of the hospitals outpatient load is now being assumed by community aftercare facilities The reduction in patient population has also resulted in better coverage of the remaining patients with standard treatment programs as well as by paramedical technics Although we are still understaffed particularly in nursing and psychiatric aide personnel our accredited training programs are all healthy and continue to graduate a supply of professionals many of whom we are glad to say con tinue at the hospital We wish to express our thanks for continued support of our treatment goals both by the members of the Board of Health and by the Health Department staff Your keen awareness of our problems and ready recognition of our progress is a source of much strength and gratification to all of us Respectfully submitted James B Craig MD V SuperintendentGEORGIANS SERVED On Books July 1 1971 16706 Resident in hospital 7487 On Convalescent Leave 9219 Admissions Total Admissions 7521 First Admissions tfl 766 Readmissions CSH 2755 Average daily resident population 8041 Decrease over 1970 964 Discharged direct from hospital 2287 Patients placed on convalescent leave 9 343 Transferred out 661 Deaths 700 BUDGET ACTUALS State Appropriations 3487555100 Agency Funds 328390000 3815945100 EXPENDITURES Personal Services 2799432000 Operating Expense 878945500 Capital Outlay 180000000 Total Expenditures 3858377500 V l V r p NORTH Central State Hospitrl BALDWIN COUNTY GEORGIA GEORGIA PEPARTMENT OF PUBLIC HEALTH IT 0 JTZZZZ Si l ty s rtt I J y szyf y zzzc sr A BRIEF HISTORY OF CENTRAL STATE HOSPITAL One hundred and twentynine 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 12 5 years the hospital continued to be the only state psychiatric 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 accordance with Georgias new regional hospital concept it acquired its present name During the last four years the resident population decreased to 8041 at the end of fiscal 1970 mainly due to improved treatment programs as well as transfer of 3 680 geriatric patients to nursing home care and an additional 1600 patients sent to the new regional hospitals in Thomasville in Bain bridge in Atlanta and in Augusta 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 19 68 the hospital also operated a 9000 acre farm and dairy program however this is now liquidated although the hospital retains the land which is now used for treatment and recreationThe massive institution is like a small city It has fire and police de partments general hospital services five chapels for the spiritual inspira tion 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 and cemeteries and bus service The Central Kitchen prepares more than 33000 meals daily in an area the size of two football fields The budgeted employee work force numbers 4099 and includes these cate gories Physicians 105 dentists 7 nurses 115 semiprofessional and technical 2234 psychologists 15 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 rehabilitation clini cal chaplaincy and a rotating residency in ophthalmology for senior residents from the Mayo Clinic at Rochester Minnesota As atreatment facility Central State Hospital serves residents of Georgia who are mentally ill mentally retarded or suffering from an addiction pro blem The institution is divided into five psychiatric units admission 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 mentally retarded a unit for patients who are tubercular a medicare unit and a general medicalsurgical hospital of some 250 beds Approximately 800 children under the age of 18 reside at Central State Hospital and of these 199 are in the special education school which is di vided into two sections classes for children who are emotionally disturbed and for those who are mentally retarded At the present time there are 67 students in the ED section 35 are in high school 23 are in intermediate classes and 9 in primary classes The classes for educable MR students have 83 enrolled and the number attending trainable MR classes is 49 The school is staffed by a principal 24 teachers and four teachers aides Underage admissions to Central State Hospital are increasing materially every year at the rate of approximately 33 per cent At the present 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 ASST SUPT ADMINISTRATIVE INST BUS ADM PERSONNEL ENGINEERING MANPOWER ADM HOSP INFO SYSTEM DATA PROCESSING BUDGET OFFICER HORTICULTURE ASST SUPT EDUCATION TRAINING RESEARCH MEDICAL LIBRARY RESEARCH NEUROLOGY PSY RESIDENCY TNG AUDIO VISUAL SVS ASST SUPT ASST SUPT CLINICAL PHYSICAL HEALTH CLIN DIR PSY GEN JONES HOSP UNITS IV RIVERS HOSP PSY OP CLINIC PHARMACY SVS CLIN DIR PSY SPEC DENTAL PROGRAM UNITS VIX ENVIRONMENTAL SPECIAL EDUCATION SANITATION PSYCHOLOGY COORDINATOR SPEC SOCIOLOGY THERAPIES SOCIAL WORK OCCUPATIONAL THPY NURSING SERVICE RECREATION THPY CHAPLAINCY SVS MUSIC THPY MEDICAL RECORDS VOLUNTEER SVS REMOTIVATION SVS EXECUTIVE ASSISTANT HOUSING PUBLIC INFO MED STAFF SECY CENTRAL STATE HOSPITAL Revised 1 August 1971EXECUTIVE ASSISTANT MEDICAL STAFF SECRETARIAT HOUSING MANAGER SECRETARY DIRECTOR PUBLIC INFORMATION SECRETARY PUBLIC INFORMATION OFFICERS SECRETARY PHOTOGRAPHER HOSPITAL RECEPTIONIST EXECUTIVE ASSISTANT Revised 1 May 19713 12 P OFFICE OF THE SUPERINTENDENT James B Craig MD Superintendent John J Schuyler LLB Executive Assistant John R Cline Administrative Officer Raymond D Brown Director Public Information James R Emerson Director Staff Housing Barbara Farmer Supervisor Medical Staff Secretariat 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 ASSISTANT SUPERINTENDENT PHYSICAL HEALTH John W Kemble MD ASSISTANT SUPERINTENDENT CLINICAL William R Howard MD CLINICAL DIRECTORPSYCHIATRY GENERAL PSYCHIATRIC UNITS W T Smith MD Michael L Sheppeck MD CLINICAL DIRECTORPSYCHIATRY SPECIAL PSYCHIATRIC UNITS E F Stincer MD P13 THE SUPERINTENDENT JAMES B CRAIG MD PBHHHBHHHHHHHHHI 14 IT OFFICE OF THE SUPERINTENDENT The Office of the Superintendent includes the Superintendent the clerical staff and staff assistants directly responsible to him through the Executive Assistant They include Staff Housing Public Information and Education the Medical Staff Secretariat and the Hospital Receptionist The Patient Affairs Division which last year was located in the Superintendents office completed its projects and has since been transferred to the Medical Records Depart ment under the Assistant Superintendent Clinical STAFF HOUSING The division is responsible for the renovations and renting of 97 houses 39 apartments and 102 dormitory rooms During the fiscal year 381 main tenance work orders were referred to the Engineering Division for service from the plumbing electrical and carpenter sections A large number of these were placed by the Housing Office for repairs to vacated houses and apart ments Other requests were initiated by the occupants themselves The ex terior of 17 private residences were painted During the year 17 requests were received for private residences and as a result of personnel turnover 18 vacancies occurred with 17 assignments completed Fifteen requests were received for apartments with 12 vacancies occurring Nine of the vacancies were assigned as well as 43 rooms in the dormitory to males and 24 to females PUBLIC INFORMATION AND EDUCATION This department is charged by the Superintendent with the responsibility of collecting editing and presenting factual information in both written and visual form about Central State Hospital its programs and its staff All communications media are utilized to accomplish this result MASS MEDIA COVERAGE The department initiated 40 news releases which went to general news media sources including daily and weekly newspapers radio and television outlets and a select list of organizations and indivi duals Six releases were sent to specialized outlets Television coverage of the hospital programs during the year was quite effective The institutions programs were included in several TV documentaries on alcohol and drugs as well as in the areas of mental retardation special education and mental illness PHOTOGRAPHIC COVERAGE The department photographer took more than 3000 individual black and white photographs and a similar number of color slides Some of these accompanied news releases Others were utilized for patient therapy programs and placed on exhibit illustrating various phases of15 the treatment program Color slide programs were updated and additional shows were provided for the Superintendent the Special Education School Unit 9 Work Evaluation Center Music Therapy Recreation Volunteer Ser vices and various other hospital departments upon request PUBLIC EDUCATION The department personnel directed sponsored and arranged seminar programs for 103 visiting groups totaling 2 700 individuals These included high school and college students members of civic organi zations and various groups of professionals from other state institutions The director visited 92 colleges high schools vocational schools and schools of nursing for lectures illustrated by color slides on the various hospital programs A number of prospective employees were also inter viewed on these trips A total of 5021 individual contacts were made through this program PUBLICATIONS The department published the Annual Report and Yearbook for 1970 the Weekly Bulletin and a number of brochures including theYarbrough Rehabilitation Center Handbook for Central State Hospital Vocational Rehabili tation Clients Specialized Music Therapy Training with Retarded and Emo tionally Disturbed Children Chaplaincy Service Opportunities in Psychology for Psychologists and Opportunities in Psychology for Psychology Techni cians MEDICAL STAFF SECRETARIAT The Medical Staff Secretariat is responsible for the care and maintenance of all minute books records and agenda of the medical staff departments the clinical review committees the Executive Committee meetings and the handling of all records affecting the medical staff as required HOSPITAL RECEPTIONIST The work of the Hospital Receptionist has increased during the year primarily because of the number of admissions which reached the highest in the history of the hospital The receptionist is the original contact person for many visitors coming into the hospital and is therefore extremely im portant in influencing the attitudes of relatives of patients and other visitors V 16 HIGHLIGHTS OF THE YEAR Plans completed for the new General Medical Surgical Hospital Construction to start early next year New Physical Therapy Department now operating in Jones Hospital Training program for 20 L P N students from Bibb County Board of Education underway in Jones Hospital New therapy program for drug addicts and alcoholics functioning well and will be expanded to include 30 beds for females Renovations including air conditioning in Howell building Powell 2 East and West and Binion admission ward Future Missions Project for utilization of CSH for next ten years completed and approved Budget and cost control system completed CSH psychologists now treating 700 patients in 10 behavior modification programs Complete master plan for development of recreational facilities developed Pharmacy moved into new quarters and now supplies drug needs of 45 aftercare clinics throughout the state Separate budget division set up and warehouse and inventory control transferred to Institutional Business Manager Also first hospitalwide inventory of moveable capital equipment completed Added equipment in laundries is providing patients with better linen and wearing apparel Eleven dining rooms were equipped with new serving lines and dishwashing equipment A modern Police Station was provided through the renovation of an old building Patient trainees are now working with the engineering department in drafting maintenance and construction Special and modified diets were added to the computerassisted menu planning and the service is now being provided to the regional hospitals Much of the CSH outpatient load has been transferred to the community facilities m 17 GOVERNOR AND MRS JIMMY CARTER ARE VISITORS TO CENTRAL STATE HOSPITAL 18 L Work is love made visible And if you oannot work with love but only with distaste it is better that you should leave your work and sit at the gate of the temple and take alms of those who work for joy Kahlil Gibran r19 ADMINISTRATION ASSISTANT SUPERINTENDENT ADMINISTRATIVE Rod Clelland BFA MBA INSTITUTIONAL BUSINESS ADMINISTRATION DIVISION OF THE BUDGET ENGINEERING MANPOWER ADMINISTRATION HOSPITAL INFORMATION SYSTEM HORTICULTURE ikHHIHHHHHHiHHHHHHHi 20 ADMINISTRATION SN Fiscal 1971 was a year of planning for change Most of the planning was done for establishing a Central Regional Hospital within Central States complex to serve a region composed of 26 Middle Georgia counties At the same time other patient groupings were planned Geriatric patients to be placed in one unit for their special treatment needs Mentally retarded patients all to be under treatment in one unit Veterans entirely in one unit Three other units were organized to back up the several regional hospitals through out the state These plans which would later move over 4000 patients and 350 employees to new buildings new programs and new relationships were administrative functions professionally performed It involved logistics plans manning tables and new staffing standards Consultation with Andrew G Robinson Second from right3 Chief Deputy Director of the California Department of Mental Hygiene21 BUDGET DIVISION A separate Budget Division was established in early March 1971 This office now reports directly to the Assistant Superintendent Administrative and is responsible for the formulation and control of the budgeting system and for the direction of the fiscal and planning functions at Central State Hospital In April 1970 the fiscal 1971 internal budget for Central State Hospital was submitted to the Georgia Department of Public Health and included funds as appropriated in the following amounts and categories Personal Services Operating Expense Capital Outlay TOTAL 27721130 8638321 1800000 38159451 The original State Appropriation for FY 1971 was 34875551 A summary of our anticipated income follows Veterans Service Patient Payment Maintenance ReimbursementPBF Medicare Miscellaneous Medicaid Total Agency Income Add Federal Grants State Appropriation TOTAL AVAILABLE FUNDS 1209900 800000 90000 41000 773000 170000 100000 3183900 100000 3283900 34875551 38159451 Due to Medicaid expansion and other program changes during the fiscal year the amount of the amended Hospital budget as of June 30 1971 was as follows Personal Services Operating Expense Capital Outlay 27994320 8789455 1800000 TOTAL 38583775Hr 22 L During the spring the entire hospital was heavily engaged in the new zerobase budgeting effort for FY 1973 Approximately 520 decision packages were compiled and submitted to Dr Bush for his review in May 1971 The FY 1972 internal budget was being prepared simultaneously and was also submitted in May 1971 INSTITUTIONAL BUSINESS ADMINISTRATION During the year two significant changes were made in this division The budget unit was transferred from the office of Business Management and made a separate division responsible to the Assistant Superintendent Administrative The responsibility for Pest Control was removed from the Housekeeping section and made a part of the Environmental Sanitation section under the Assistant Superintendent Physical Health One major change was made internally in this division The responsibility for Warehouse and Inventory Control was transferred to the Business Manager Formerly this was a responsibility of the Procurement and Property Officer f Increased efforts have been made toward the improvement of the warehouse and inventory control system A consultant has been engaged to develop a program for a practical and efficient materials handling system for warehousing Recommendations will be made for more efficient space utilization operating procedures and improved material handling equipment Information from the annual inventory which was taken in June has been utilized to better plan and control inventory operation From this information surplus stock can be identified and proper utilization or disposition can be made stock levels and reorder points can be assigned and other necessary inventory control procedures can be installed Two cold storage rooms are being renovated and converted into one large room with a higher ceiling which will increase our cold storage capacity and provide adequate space for storage The Medicaid Program was inaugurated in July 1970 Billing procedures were established and by the end of fiscal year 1971 we were billing for 264 medicaid eligible patients Total income for the hospital in fiscal year 1971 was 299000 and it is expected that this figure will more than double in fiscal year 1972 In an effort to improve our cost finding system for Medicare purposes a relative value system was instituted in the Jones Hospital Rivers Medicare and Electroencephalography Relative value units provide a means of weighing the value of any service within a department in terms of all other services performed In this manner an appropriate value may be established for each service Periodically the cost for each department will be determined and23 a Relative Value Unit will be established for each department The cost per Relative Value Unit varies among ancillary services The Relative Value Unit of any procedure is only comparative in terms of value and cost toother values within the same department This will result in a more accurate allocation of costs to Medicare patients and is expected to increase our income from Medicare eligible patients in future years A Relative Value book was prepared and is being distributed to the various organizations involved The Procurement office processed a total of 11602 lineitem transactions for this year as opposed to 13280 for the previous year The drop in num ber is a direct result of the increased use of annual contracts which also has produced better prices and more timely delivery We expect a further improvement this year with the selective use of buying from the General Services Administration which we are authorized to do beginning July 1 1971 The first hospitalwide inventory of movable capital equipment was completed during this fiscal year and will be maintained on a perpetual basis with verifications required on all losses gains andor transfers During fiscal year 1971 the Central Housekeeping section with the help of Service Engineering Associates and Unit personnel implemented house keeping programs in an additional three Units Data collection and drafting of manuals was completed on five other Units leaving only one Unit to be studied Housekeeping programs in Units V X and the Rivers Hospital were implemented and are very effective relieving nursing personnel of much of this responsibility Units I II III IV and VI were studied and manuals were written They are now ready to implement but due to lack of personnel and equipment no further progress was made The Jones Hospital manual should be completed by December 1 1971 This will complete a house keeping manual for each Unit The Central Housekeeping section will con tinue to provide training classes for all Units even after the programs are in effect Concrete floors in the Rivers Hospital Ingram building and Walker building were sealed during fiscal year 1971 with polyurethane concrete sealer This has helped to control odors and provide a smoother surface for easier cleaning In the Central Laundry a new washerextractor a flatwork ironer and two automatic pants pressing units were installed With this modern equip ment the laundry is providing neater linen and wearing apparel for our patients 24 s tr at an increased volume The laundry has instituted a mop exchange system which serves the entire Hospital An additional 32 refuse containers of three yards capacity were purchased and located to provide better service for trash collection Training programs on fire safety and evacuation procedures are being developed in all areas of the hospital with primary emphasis being given to the Jones and Rivers Hospitals and the Unit for Mental Retardation because these areas receive Federal reimbursement from Medicare and Medicaid and are subject to an annual licensure review Schedules for these programs have been established and will be carried out on a regular basis Programs have been developed for other areas of the hospital which will be expanded in the next fiscal year Routine inspections are made regularly by fire inspectors who report deficiencies to the proper officials through the Fire Chiefs office Training programs continue to be held for all fire fighting personnel Improved computer technology and management procedures employed in 1970 enabled the Food Service Section to make further accomplishments in nutrition dietetics and menu planning This program has been so success ful that plans have been made to extend it to other institutions in the Depart ment of Public Health and we have presented it to other State institutions upon request During calendar year 1970 10034225 meals were served of which 2061123 were special and modified diets and 114711 were for patient special parties and cookouts at a raw food cost of 02687 per meal a decrease of 4 cost over 1969 in spite of an increase of 6 in food prices Surplus commodities available and used decreased by more than 7 5000 Eleven dining rooms were remodeled with new serving lines andor dishwashing equipment and ten dining rooms were closed and consolidated into serving areas Thirtythree new electrically heated and cooled meal tray carts were received and put into use Georgia State Department of Health Food Service Permits were received for the Boland Binion and Boone dining rooms The Police Department responded to 2760 requests for assistance apprehended 1353 patients who had left without consent issued 563 cita tions for traffic violations investigated 64 traffic accidents arrested 95 individuals for violation of State laws conducted 198 investigations and traveled a total of 166000 miles on security patrols The highlight of the year was the renovation of an old building to provide a modern police station for the institution The Ambulance Service is responsible for the movement of emergency and nonambulatory patients During fiscal year 1971 this section provided services for the movement of 2406 emergency cases and 14406 non ambulatory cases for a total mileage of 45000 miles for the year25 The Motor Transport Service is responsible for providing quality preventive maintenance on all motorized vehicles and for providing vehicles for the movement of equipment supplies and personnel This service includes per forming scheduled preventive maintenance inspections on all vehicles dis bursement of all petroleum oil and lubricants shuttle bus operation on campus and the dispatching of general purpose vehicles and drivers in sup port of hospital Units and Departments This section handled 18384 trans portation requests shuttled 92579 passengers returned 2 66 escaped patients from outlying counties transported 387 patients to otherinstitutions conducted 827 preventive maintenance inspections 200 State vehicle safety inspections and traveled a total of 250000 miles Three new computerized programs were designed programmed and implemented to provide manage ment with statistical data showing operating cost per vehicle to include repair parts labor fuel and lubricants plus an additional program showing utilization of all vehicles by Units and Departments Approximately eighty acres of land owned by Central State Hospital has been transferred to the Board of Corrections for the construction of a new prison for women This facility will be constructed and administered by the Board of Corrections and when completed will house all female prisoners now domiciled in the Kemper building PERSONNEL DIVISION On June 30 1971 there were 4099 regular employees on our staff an increase of 77 over the end of the previous fiscal year The largest gain was in the subprofessional nursing category Personnel activity at Central State Hospital during 1971 was influenced by statewide fiscal problems It was necessary to initiate several employ ment restrictions to remain within the Hospitals Personal Services budget for the year These included hiring only at the beginning of a pay period pro hibition of overlapment on positions and periodic unfunding of vacancies Our turnover rate was lower during fiscal 1971 than it has been since 1963 Figure 1 on the following page is a tabulation of personnel actions during the year The number of total employees shown in the first paragraph 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 subtracting 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 separate page 26 PERSONNEL BY TYPE AS OF JUNE 30 1970 AND JUNE 30 1971 V kH 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 1970 1971 108 105 9 7 117 115 25 24 7 7 3 3 9 11 3 3 8 8 12 15 20 20 21 27 2205 2234 39 43 322 332 22 22 312 316 427 441 354 366 4023 4099 fgggggggSBmm gggff0B Mrs Laura Williamson Accounting Services 27 28 Figure 1 Personnel Actions FY 1971 Appointments 913 Transfers 350 Promotions 374 Demotions 20 Leaves of absence 238 Returns from leave of absence 191 Miscellaneous 811 Separations 825 including 608 Resignations 41 Dismissals 54 Separations during Workinc Test 15 Deaths 29 Transfers to other agencies 78 Retirements Rate of turnover 202 ENGINEERING DIVISION The Engineering Division is comprised of 2 74 employees including administrative and supervisory personnel This Division has a responsibility to the Hospital to provide centralized services in the field of engineering The objectives of this Division are 2 To render professional engineering services and advice to the Superintendent Assistant Superintendents Admini strative Staff and Department Heads To provide efficient engineering and maintenance services related to the physical properties equipment and utilities owned by the Hospital To design plan prepare specifications estimate costs and provide the necessary workmanship to construct and maintain facilities This Division operates and maintains the Hospitals water treatment plant waste treatment plant waste and water pumping stations water dis tribution system waste collection system steam plant and steam distribu tion system overhead electrical distribution system and the system of streets and roads This Division also prepares and maintains updated reports on hospital facilities for the self insurance program IHHHIiHwil 29 The following is a brief summary of the major engineering projects for 1971 1 Construction of three lift stations and a system of inter ceptor sewers to serve the Hospital and surrounding areas was completed 2 Renovation of Tenth Ward to include new roof exterior brick veneer new aluminum windows acoustical ceiling increased electrical service air conditioning of patient areas and installation of sprinkler systems was completed 3 Renovation of the old firehouse was completed for a cen tralized police headquarters which included installation of air conditioning a communications system new floor tile and a new ceiling 4 Construction of the Rivers administrative suite was com pleted providing a modern uptodate complex for office personnel 5 Construction of two additional bedrooms for personnel dwelling 27 was completed 6 Renovation and reworking of controls in freezer room at Cold Storage was completed 7 Howell building north passenger elevator was renovated to include selectivecollective controls 8 Contract was let and work begun to air condition and renovate the Howell building wards 2 East and 2 West in the Powell building and the admission ward in the Binion building 9 Renovation of Jones XRay to provide space for additional equipment was completed 10 Renovation of Personnel office to provide additional office space and conference area was completed 11 Sprinkler systems were installed in all storage closets in the Bostick and Washington buildings 12 Bathrooms in the Green building were renovatedQgfigaadBBigfltt 30 13 Renovation of a portion of the Lawrence building ware house area for a centralized Procurement Property and Receiving section was begun This area will receive masonry walls new ceiling floor covering and air con ditioning 14 Construction of one brick veneer four bedroom residence was completed 15 Rivers 5 East was renovated to provide space for the male Alcohol and Drug Unit 16 Twenty year bonded roofs were installed on the Lawrence building Print Shop and Engineering warehouse Abattoir Boland building and Binion building 17 Sidewalks were constructed in the patios of the Washing ton building 18 New light fixtures were installed in the Bostick and Wash ington buildings 19 Paving of eight driveways and two parking lots was com pleted 20 Detention screens were installed on Binion 1 North M 21 Steam and return lines at the auditorium were replaced The Division continues to participate in the Patient Rehabilitation Program We are presently working with patients in the fields of drafting maintenance and construction This program provides training to prepare the individuals for employment upon their release from the Hospital The Capital Outlay Program is designed to provide for the air conditioning and renovation of all patient buildings to upgrade the facilities to meet standards of the Joint Commission for Accreditation DIVISION OF MANPOWER ADMINISTRATION The Division of Manpower Administration is concerned with the determi nation of requirements for and allocation of personnel resources and optimum utilization of these resources This is accomplished through the develop ment of staffing standards employee training organization policy and procedure formulation and management auditing The Division also provides professional Industrial Engineering services to the management and thejgBggggHmmmmtKmmmtK LITTLE MISTER AND LITTLE MISS CENTRAL STATE HOSPITAL 31 H Mitchell Scott son of Mr and Mrs Paul Scott and Gina Mills daughter of Mr and Mrs J W MillsI 1 32 various segments of the Hospital and directs the operation of the Hospital switchboard Other programs are grants management forms control printing and various staff services as required The following are some of the sig nificant events of the year l The Division assumed responsibility for Industrial Engi neering services and operation of the telephone switch board Developed staffing standards applicable to the majority of employees of the Hospital including standards for patient care services Prepared a plan for the redistribution of employees inci dent to a proposal to reorganize the Hospital in accor dance with Future Missions plans Initiated a project to add functional statements to the Organization Chart Manual for each separately organized segment of the Hospital Planned and coordinated presentation of nine management training sessions including three on Planning Programm ing and Budgeting with 55 trainees and six on the Princi ples and Techniques of Management and Supervision with 149 trainees In cooperation with the Hospitals Audio Visual services arranged for the presentation of a super visory training course by closed circuit television which was broadcast twice during the year Processed 121 training applications prepared and sub mitted 655 Employee Training Records and coordinated preparation of and forwarded 795 Training Record Ques tionnaires Prepared staffed and published 23 amendments to the CSH Policy and Procedures Manual Completed all planning and obtained approval for a Man agementSupervisory Training Program to be initiated during the next fiscal year and operated on a continuing basis to provide formal instruction to all personnel in management or supervisory positions Prepared staffed and published 22 discrete amendments to the Organization Chart of the Hospital qHmHHHHHBM lgjHHHHIHHIMBiBi 33 10 Produced approximately 4439000 printed sheets and 417000 printed cards at the Print Shop 11 Industrial Engineering projects included completion of a comprlfriensive reference manual on federallysponsored health insurance programs with an attendant system for providing current information on Medicare Medicaid and related matters Other projects were a comprehensive study for a complete laundry linen and clothing service for the Hospital and studies on drug costs cost of wound dressings and income potential of an extended care facility HOSPITAL INFORMATION SYSTEMS During the fiscal year 1971 Hospital Information System personnel participated in several projects of considerable benefit to Central State Hospital In addition to continuing its regular production jobs such as patients movement patients deposit fund clinical appointments ward census menu planning warehouse inventory personnel data meal labels industrial therapy system motor vehicle transportation system Hospital Information System filled some 200 special requests expanded and improved existing systems and added new systems to its operations A substantial expansion and improvement of menu planning for Central State Hospital resulted from the addition of special and modified diets to the computer assisted operation Preparation instructions were also incorporated into the system so that now not only can menus be planned but cooking and preparation instructions can be issued At the request of the State Health Department Hospital Information System personnel offered leadership and assistance in menu planning to the regional hospitals As a result Computer Assisted Menu Planning is being installed at these facilities Personnel also participated in the completion of the Future Missions Project which called for some 10 programs and included a time series analy sis of admissions to Central State Hospital over the past 10 years The primary purpose of the project was to determine the feasibility of converting the institution to a regional hospital The study also considered the possi bility of converting the Powell building to a central admitting and dismissing facility the objective was to ascertain whether or not such a facility could operate at least five years before becoming spacially inadequate During the year the Budget and Cost Control System for Central State Hospital was implemented The major function of this system is to report an accurate and uptodate account of expenditures for each budgeted organiza tion The system also processes warehouse receipts and issues in order to t 34 maintain a perpetual warehouse inventory Assembling projected budget data has become much easier through utilization of this system The Inventory of Movable Capital Equipment was added to the data processing equipment With the completion of the initial inventory and the continuous updating of property disposition some 70000 ilfems of equipment have been brought under a more organized framework of control The Behavior Modification System which began during this year is of particular significance because of its direct relation with patient rehabilita tion This program is an ideal application for computer utilization because of the large volumes of evaluation data which must be gathered on each resi dent to retrieve the information they require at the speed necessary for timely decision making Initially the system will involve only the residents of Unit 9 Hospital Information System has made continuous progress during fiscal year 1971 and now makes its presence felt throughout Central State Hospital HORTICULTURE During fiscal year 1971 a neworchard for patient use was begun to replace trees and vines lost to the hospital by the transfer of farm property to other state agencies Planting included apples peaches grapes and strawberries to which pears blackberries and scuppernong grapes will be added during autumn The orchard will be used exclusively for patient therapy activities and not to supplement the food supply for dining rooms Assistance was given to the regional hospitals at Atlanta and at Augusta in beginning a garden therapy program This included consultative service and the transfer of seven thousand bedding plants from our greenhouses The new picnic area the Rehabilitation Garden below the Rivers building was planted with zoysia grass The ravine between the building and the parking lot area has been filled in for the convenience of the patients The outstanding feature of the Horticulture Department remains in the area of garden therapy This program is sponsored by the Garden Clubs of Georgia Inc and has been in operation since 1959 The Garden Clubs of Georgia have received the national award for garden therapy twice because of their sponsorship of this very effective program With the aid of Garden Club volunteers flower borders are planted and maintained on a continuing basis which provides not only therapeutic activity for the patients but also enhances the beauty of the grounds Another feature of garden therapy is a number of vegetable gardens cultivated by patients with the assistance of employees and volunteers The Horticulture Department provides support for these programs by breaking ground and supplying bedding plantsoiBnnm iBIBMMBB 35 The Horticulture Department cooperated with the Vocational Rehabilitation program by providing practical experience in greenhouse work under the guidance of counselors Approximately 80000 bedding plants were planted by patients participating in this program Assistance was also given to Remotivation activities by demonstrating flower arranging and corsage making and by other usage of flowers to obtain patient interest The department continued the intensive maintenance of 60Q acres in the main campus of the hospital in addition to minimum maintenance on two thousand acres to the extent necessary to reduce fire hazards and maintain a pleasant landscape Limited manpower in the department makes it difficult to maintain adequately such a large area and makes the contribution of volun teers to the appearance of the grounds of especial benefit to the hospital and its patients t William W Curl receives plaque as President of Employees Associationvi iftiTniffmwwittrom s 36 W m People say I let myself get too involved3 that Im a perfectionist I suppose I am In fact I know I am I have to be I am dealing with lives3 you know If people think I can do that without becoming per sonally involved with the patients3 they are wrong Dr Michael BeBakey M HHBBMMBMHiMil 37 CLINICAL ASSISTANT SUPERINTENDENT CLINICAL MLchaeJt L Sieppecfe MP L GENERAL PSYCHIATRY SPECIAL PSYCHIATRY NURSING SERVICE PSYCHOLOGY SOCIAL WORK SOCIOLOGY CHAPLAINCY SERVICE SPECIAL EDUCATION MEDICAL RECORDS f38 FOREWORD TO THE SUPERINTENDENT I bring to your attention a few of the highlights during the past fiscal year Each Director andor Department Head relates his activities and rec ommendations as noted in the following reports One of the developing trends is the increased number of admissions This is accompanied by shorter average stay increased turnover and a grad ual reduction in occupancy days These developments are worthwhile trends Comparative occupancy days Fiscal 1970 3307669 days Fiscal 1971 2939688 Comparative admissions Fiscal 1970 11502 Fiscal 1971 12027 The capital improvement and modernization program applied to the better structured buildings is a definite asset to the safety care and comfort of patients This has been so well demonstrated in the North half of the Howell building Many of the Unit Directors are aware of this improvement and desire the same for their facilities Also minor improvements are underway in the Powell Holly and Binion buildings The planning for the Future Missions program and its eventual realization should provide a higher degree of specialized care based on the approved yardstick of minimum man hours of nursing service per patient per day Coordination with community health agencies continues to provide referral information to support their aftercare program This should stimulate a spirited mental health maintenance and rehabilitation program at the community level At present so many are lost to aftercare with failure in maintenance resulting in readmissions The specially funded programs in Alcohol and Drugs and Behavior Modification of the mentally retarded should further promote return and ad justment to family and community living Several of the reports are exciting depicting a venture forward in the care of those admitted to our hospital BHHmhhhhh MM 39 GENERAL PSYCHIATRY UNIT I BUILDINGS Powell Const 1858 remodeled 1955 Walker Const 1883 Green Const 1947 10th Ward Const 1938 NUMBER OF WARDS 13 PATIENT CENSUS June 30 1971 962 ADMISSIONS 1179 DIRECTOR Santiago Aguilar MD ADMINISTRATOR James Tate DIRECTOR OF NURSING Mrs Ouida Couch RN COUNTIES SERVED 3 Fulton DeKalb and Clayton This Unit serves the Metropolitan Atlanta area including the counties of Fulton DeKalb and Clayton The majority of new admissions come from Fulton County The receiving wards are located in the Powell building where initial diagnosis and evaluation takes place If the patient has an acute problem he is usually released from the admission wards If he requires hospitalization longer than thirty to sixty days he is usually transferred to continuing treatment wards Treatment is given by a team of professionals including psychiatrists psychologists dentists social workers clinical chaplains occupational music and recreation therapists and vocational rehabilitation counselors Two major treatment programs were initiated in 1971 These include a behavior therapy program conducted by Unit psychologists and a special treatment program for chronically ill patients who have remained in the Unit for a number of years This is being supervised by the Unit social workers A close working relationship with community mental health resources has been maintained as these facilities have continued to expand At present the patient followup is done in the majority of cases in the Fulton DeKalb and Clayton County Community Health Clinics This has resulted in a decreased demand for hospital outpatient services Unit I is the center for the training of psychiatrists through the Psychiatric Residency Training Program and a majority of student nurses who affiliate with Central State Hospital receive much of their professional training here Basic thrust of the treatment program is to get the patient back to his home community as rapidly as possible by utilization of community resources where these are available f r 40 A numberof improvements in physical facilities have occurred during the year The Walker building was painted throughout and complete renovation of the bathrooms in the Green building has provided adequate facilities for all patients Kardex files and assessments have been completed on all patients in the Powell building and are almost complete for the Walker building Nine attendants have successfully completed three months of psychiatric aide training and 16 attendants having attended workshops on remotivation are now conducting their own groups Several of the registered nurses have taken special training in group therapy and are working with groups of patients under supervision Basic needs include additional housing for male patients air conditioning of the Green and Walker buildings and additional nursing staff Georgia Junior Chamber of Commerce members sponsor watermelon cutting17 V m 41 GENERAL PSYCHIATRY UNIT 2 BUILDINGS Bostick Const 1951 Washington Const 1950 NUMBER OF WARDS 20 PATIENT CENSUS June 30 1971 1193 ADMISSIONS 2373 DIRECTOR Eduardo Guernica MD ADMINISTRATOR Benny C Daniel DIRECTOR OF NURSING Mrs Fay H Fidler RN 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 Seminole Clay Tift Grady Thomas Brooks Muscogee Lowndes Lanier Echols Decatur Harris This Unit serves 45 counties in southwest Georgia Admissions for fiscal year 1971 showed an increase of 1159 over fiscal year 1970 while the patient population for the same period was reduced by 169 for a total of 1 193 This reduction was achieved through transfer of patients to the re gional hospital at Thomasville and placement of candidates into nursing homes in the geographical area served Expansion and improvement of treatment programs nursing care physical plant and equipment and reduction of patient population has resulted in better patient care The Unit includes a complete roster of treatment services including dental service social service occupational therapy musictherapy recreation therapy remotivation vocational rehabilitation and chaplaincy services Patient participation in the various unit activities has shown con siderable increase during the past year Nursing Service while continuing to improve nursing care has given special attention to continuing education During the year registered nurses licensed practical nurses and attendant service supervisors have attended courses on Development and Leadership Techniques Staff Development Pro gram for Professional Nurses and Chronic Obstructive Pulmonary Disease Most Nursing Service employees completed a course in Cardiopulmonary Re suscitation Techniques Inservice education programs an effective method of increasing the efficiency and knowledge of nursing service personnel are fVi 42 seriously hampered by the shortage of qualified personnel to teach and supervise them Other accomplishments by Nursing Service include the completion of Kardex cards on all patients organization of a Wheelchair Club in the Bos tick building and the organization of a Home Economics Class in the Wash ington building through Vocational Rehabilitation This Unit received 15 new attendant positions during the year but continues to have insufficient personnel to adequately staff the 311 and 117 shifts Personnel shortages in the medical and nursing staff seriously limit the professional care available to patients Seven doctors and five registered nurses are assigned to this Unit Renovation and beautification of patient areas continue at a satisfactory level Fluorescent lights were installed in both the Bostick and Washington buildings central linen supply and drug rooms were completed and newly renovated space was provided for Music Therapy and Vocational Rehabilita tion Many items of new equipment were purchased during the year Georgia Allstars gospel singers entertain patients in Unit 2HIHHHHH iBBMRMMMiflHH 43 GENERAL PSYCHIATRY UNIT 3 BUILDINGS Holly Const 1949 Ingram Const 1928 Howell Const 1939 NUMBER OF WARDS 20 reduced to 16 April 1 1971 PATIENT CENSUS June 30 1971 884 ADMISSIONS 1332 DIRECTOR Jose A G Mendoza MD ADMINISTRATOR R O Pennepacker DIRECTOR OF NURSING Mrs Frances Osborne RN COUNTIES SERVED 3 8 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 Ware Liberty Brantley Dodge Telfair Bacon Wayne Appling Pierce Mclntosh Bryan Glynn Clinch Admissions continue to increase Thirteen hundred thirty two patients were admitted as compared with 1227 last year The Unit census however decreased 3 50 patients due for the most part to accelerated nursing home placements and several large transfers to Southwestern State Hospital Another factor was increased emphasis on accelerating returns to the com munities through convalescent leave and discharge Average monthly admis sions rose from 102 to 111 and average monthly returns from convalescent leave decreased from 66 to 62 The Social Work Division again sponsored a volunteer group from local schools during the summer vacation Volunteers consisted of teachers and students who assisted in individualized services for residents as well as helping regressed patients become active in ward programs This is the second successful program and plans are for continuance during the coming year The Dental Clinic operatory was closed for the major portion of the year due to lack of professional staff We miss this valuable service and hope for an early reopening Onthejob training of ward nursing personnel as well as formal classes in administration of medications was conducted by the registered nurse in structor This resulted in an upgrading in the quality of ward nursing staff The contract forrenovation of the Howell building necessitated emptying f V 44 the four wards on the north side of the building in early April This was accomplished by moving the sick ward 70 patients to the Ingram building along with necessary staff to operate the ward Ingram patients were con solidated into five wards Transfers to Southwestern State Hospital assisted in reducing the Howell census and the remaining patients were crowded into the southwards with an increase of census on all wards The contractor appears to be progressing satisfactorily The target date for completion is projected for June 1972 Budget limitations permitted the purchase of only a small amount of needed equipment New programs initiated in the Holly building during the year include a treatment program for female alcoholics a multiimpact therapy program and intensive treatment for chronic female schizophrenics Anew program was also started for male alcoholics in the Howell building The multiimpact program is maturing rapidly This program involves the team approach with each patient having a primary nurse attendant level and a primary therapist drawn from the team consisting of chaplains occupa tional recreational and music therapists social workers etc A treatment program is designed for each patient in team committee meetings and modi fied as necessary The Occupational Therapy Clinic in the Ingram building was discontinued as being marginally productive for the chronic residents One occupational therapy aide was detailed to the Recreation Department expanding that ther apys activities considerably M New emphasis is being placed on the Adult Foster Care program with several placements being made during the year and 310 residents were placed in nursing homes during the year Everyone thoroughly enjoyed this Easter party for the residents of Unit 3 HJHHMMMMMiM1 45 GENERAL PSYCHIATRY UNIT 4 BUILDINGS Freeman Const 1939 Arnall Const 1939 new addition 1962 NUMBER OF WARDS 17 PATIENT CENSUS June 30 1971 1272 ADMISSIONS 1592 DIRECTOR Charles A Rich MD ADMINISTRATOR William W Curl DIRECTOR OF NURSING Mrs Ruth Mullis RN COUNTIES SERVED 2 8 Catoosa Walker Whitfield Murray Chattooga Dade Gilmer Floyd Gordon Bartow Pickens Cherokee Haralson Paulding Cobb Spalding Polk Carroll Douglas Heard Coweta Fayette Talbot Meriwether Troup Upson Pike Lamar Admissions from the 28 counties served by Unit 4 have continued to show some increase Total admissions have been averaging 200 patients permonth The Unit operates two female receiving wards and one male as well as two sick wards one male and one female The census of the sick wards includes 170 chronic cribbed patients who require a great deal of close supervision and nursing care These wards could well be classified as skilled nursing homes During the year a behavior therapy ward was begun on Freeman 4 West and is being conducted by a full staff including all professional disciplines within the hospital Treatment programs in general have shown considerable improvement during the year as a result of the reduction in patient population especially in the female section which has allowed more square footage per patient on the otherwise overcrowded wards One entire ward in the male building has been closed because of this reduction thus permitting much needed additional attendant coverage on the other wards The therapy teams including occupational recreation and music thera pists have begun individual ward programs on all wards within the Unit and are achieving excellent results and reaching more patients particularly chronic patients not heretofore participating in these activities Social Ser vice has had some success in its foster home program in placing patients in local community settings Continuation of the nursing home placement pro gram has resulted in 146 patients being transferred to nursing homes during the year fHHHH Vi s 15 46 The dental department of the Unit has started an oral hygiene program using electric brushes for the male patients This program along with the routine services offered by the dental staff have contributed materially to the overall dental hygiene of the patients New beds were obtained for one of the wards which has allowed modern ization of some equipment however budget limitations would not permit the updating of needed equipment during the year Personnel shortages particu larly in the nursing care areas still impede totally adequate patient care jLn 2ML HP BR M TOP Country and Western Show sponsored by the CSH Employees Association BOTTOM An autograph signing session by guess who i GENERAL PSYCHIATRY UNIT 5 BUILDINGS Allen Const 1939 Whittle Const 1901 remodeled 1953 NUMBER OF WARDS 18 PATIENT CENSUS June 30 1971 813 ADMISSIONS 1629 DIRECTOR Lorenzo del Portillo MD ADMINISTRATOR Thomas A Simmons DIRECTOR OF NURSING Mrs Mildred H Daniel RN Admissions have again increased over last year with a total of 1026 females and 1644 males being admitted In spite of the increase the Unit capacity was reduced from 93 6 to 904 During the past year the Unit has continued to progress slowly in its treatment programs which now include active milieu therapy behavior ther apy nursing home placement resocialization attitude techniques therapy programs for alcoholics and drug addicts a specialized program for chronic patients home and family management orientation programs for new admis sions and an intensive treatment program A few patients are returning to the Unit for outpatient psychotherapy both individual and family Also some patients are now being treated on a daycare and nightcare basis which is working out very well for these particular patients and seems to be short ening their length of stay in the hospital Weekly rounds in the Jones Hos pital to see patients from this Unit have continued A weekly interdisciplinary meeting is providing excellent cooperation and wellplanned program activities from the various professional staff mem bers Some expansion in program activities has occurred in recreation occupational and music therapy and remotivation as well as by volunteers working with patients in the garden clubs The Unit director supervises a bimonthly meeting with registered nurses and physicians to discuss problems 47 COUNTIES SERVED 45 Fannin Union Towns Rabun Dawson Elbert Hall Lumpkin White Habersham Banks Henry Forsyth Stephens Franklin Gwinnett Barrow Jackson Madison Hart Rockdale Walton Butts Newton Oconee Clarke Oglethorpe Wilkes Glascock Lincoln Taliaferro Greene McDuffie Jasper Putnam Hancock Warren Washington Monroe Jones Baldwin Wilkinson Columbia Twiggs Morgan f V 48 on new rules and regulations There is also a monthly meeting of personnel and a treatment team meeting twice monthly in each building The Unit Ex ecutive Committee meets weekly to deal with various matters affecting the Unit as a whole to decide upon policies and procedures and to set goals and objectives The Unit Drug Committee meets regularly to discuss better methods of drug control and to decide upon new developments in drug therapy and their possible use and benefit to the patients Each patient is completely reevaluated as needed and at least every six months as required by law The Unit now has a registered nurse who is a full time therapist and is involved with inpatients nightcare patients daycare patients and family and individual therapy on an outpatient basis The program has been so successful that additional registered nurses are showing interest in this area and work as cotherapists in addition to their assigned duties A full time clinical instructor works with ward personnel in orientation and followup of the psychiatric aide training class Staff coverage has been improved by a better utilization of personnel It has been possible to purchase much needed medical equipment as well as equipment to improve housekeeping techniques Improvement in physical facilities has included installation of flourescent lights in the Whittle build ing recreation room retiling of some areas installation of electric wiring for three washers and three dryers in the laundry room the painting of a number of areas in the Whittle building and the addition of a color television set obtained through the Monroe County Mental Health Association for the inten sive treatment area A special pilot project in cooperation with the Clarke County Alcohol Program will permit more intensive work with alcoholics and drug addicts and with the possible success of the Clarke County program this will be ex panded to include other counties served by the Unit m BUILDINGS GENERAL PSYCHIATRY UNIT 6 Cabiness Const 1901 remodeled 1953 Carl Vinson Georgia War Veterans Home Const 1969 49 NUMBER OF WARDS 13 PATIENT CENSUS June 30 1971 475 ADMISSIONS 85 DIRECTOR Carl L Smith M D ADMINISTRATOR Joe Rooks DIRECTOR OF NURSING Mrs Gaydelle Johnson RN COUNTIES SERVED The State of Georgia The Veterans Service office is located within the Unit and much time is spent in consultation with that office regarding present status of patients eligibility for Veterans Administration benefits on the basis of service pre sent or past serviceconnected or nonservice connected disabilities and requests for transfer to other Veterans Administration facilities The Unit is setup as a treatment and domiciliary care facility foreligible veterans from the State of Georgia During the year there were 85 direct admissions with 359 being transferred into the Unit from other Units at the hospital There were 107 patients discharged and 1048 released on conva lescent leave status Some of those were transferred to other VA hospitals VA nursing homes HalfWay House Georgian Clinic and other rehabilitation centers Due to the better than average mental condition of the veteran members 14 92 were granted temporary passes home for therapeutic reasons Of the present number on convalescent leave status 861 returned to the hospital A high percentage of our patients have a problem with alcohol thus accounting for many of our frequent readmissions A service that is most beneficial to the patients released from the Unit is the outpatient followup Those who require aftercare can return and see one of the physicians or psychologist for therapy andor medication All furlough charts and an uptodate doctors card are kept in the Unit and are readily available In addition any correspondence concerning furloughed and discharged patients is handled in the Unit This Unit is responsible for making arrangements for transporting veterans to the OutPatient Clinic at the VA Hospital in Atlanta for scheduled appoint ments for examination followup and special treatment when indicated by I v V 50 s r i the attending physician or when requested by that facility There is participation in the Industrial Therapy program with patients working in dining rooms maintenance shops offices as mail carriers cleaning offices and other areas One particular patient worked with building beautification in beautifying the grounds around the Vinson and Cabaniss buildings and this proved to be very therapeutic for him PROGRAM HIGHLIGHTS The Occupational Therapy program has been most successful There was an average daily patient participation of 30 in the two daily programs The patients were involved in more than 12 different projects The goal for 1972 is to add two or three more O T Aides to the present staff Under the Vocational Rehabilitation program two barbers work in the Vin son building barber shop A special highlight was having a female barber from the Kemper building placed in the barber shop under the barber training program This proved to be most effective The vocational rehabilitation counselor assists the veteran members by making arrangements for transfers to other treatment facilities such as HalfWay House Georgian Clinic and other rehabilitation facilities for continued treatment and supervision and job placement In addition some were referred to the VR counselor in their home town for continued counseling guidance job placement and supervision The Social Service Department works in coordination with the medical staff nursing staff psychologist and Veterans Service office concerning the needs of the patients There are also frequent contacts with ward attendants vocational rehabilitation counselor chaplain occupational therapy workers recreation therapist and others who may be working with the patients The social worker also has conferences with families of patients concerning their general welfare Several veterans were referred to Volunteer Services who has assigned them a sponsor Our Nursing Service program included inservice education programs in the Unit each month for all attendants with special speakers from other dis ciplines within the hospital Attendants also participated in the psychiatric aide classes each month Monthly meetings were held by Nursing Service for the charge attendants to discuss ward improvements for the better care of patients Each week the social worker meets with the receiving ward atten dants and nurses to discuss better ways of meeting the patients needs Morning devotional services are held weekly on the receiving ward with ap proximately 40 patients participating On the geriatric wards snacks are provided morning and afternoon from the hospital store Some of the elderly patients are taken to the patio with supervision by ward attendants A day is scheduled for our female patients to go to the beauty salon in theYarbrough building Also a day is scheduled for the elderly men to be sent to the bar ber shop in the Vinson buildingmmaaUi BHBoHBBHBSBBHBa HBBBIiHMiMiMi FRATERNAL AND VETERANS ORGANIZATIONS The Benevolent and Protective Order of Elks contributes monthly cash donations to be used for the veteran recreation and occupational therapy pro grams One night each month is designated as Elks Night at which time special activities take place with prizes and refreshments Meetings are attended by some of the members in the Unit when some of the organizations hold their meeting in the building The Ladies Auxiliary Post 237 from Hardwick Georgia has been holding their monthly meetings in theVinson building and the female veteran patients attend The Tenth Dis trict American Legion held their district meeting here this being the first time for this type meeting There was an increased participation of veterans organizations in the way of social activities and donations of cigarettes personal effects television sets and recreation equipment Entertainment activities were presented by the American Legion Daughters of American Confederacy Veterans of Foreign Wars Jewish War Veterans Am Vets and such related auxiliaries for the benefit of the patients The VFW and Legionnaire monthly newspaper is received and distri buted to the veteran members BUILDING EQUIPMENT New equipment procured includes ward chairs wall urns lounge chairs 51 Under the Recreation program activities were provided on a full time basis The recreation building is equipped with a pool table ping pong table table games television area library weight room and an abundance of com fortable seats Bingo parties are held at various times during the year Re freshments are served frequently at the dances or during movies which are held in the recreation hall During the year we acquired a new movie screen Patients also attend movies at the auditorium on Monday and Friday after noons The veterans have participated in the hospitalwide intramural pro gram again We have fielded teams in volleyball and softball this year Special activities included bus rides outoftown trips to ballgames and wrestling matches cookouts and dances Three new grills were acquired for the Recreation Department for the cookouts held during the year The fis cal year showed a total participation of 25361 patients with an average daily participation of 10517 During the coming year we plan to add a weight club exercise class and golf This year we added a pool table ping pong table and boxing equipment to the third floor Cabaniss building nursing station area We hope to initiate a patient interview program soon to find out in what activities the patients would like to participate thereby having even greater participation s I Vs 52 s 15 ward beds coffee urns patio furniture fans janitorial medical recreation and administrative equipment Special purchases for handicapped patients included hearing aids artificial limbs braces crutches and wheelchairs BUILDING IMPROVEMENTS Outstanding building improvements included repairing and painting of Cabaniss building roof installation of new windows and window screens replacement of individual room doors to patients rooms paving of parking areas between both buildings and around recreation hall and landscaping of grounds in certain areas MISCELLANEOUS 3 U P II Plans have been completed for construction of the Richard B Russell building This will be a 132bed skilled nursing care facility for veterans with occupancy anticipated for January 1973 Former Governor and Mrs Ernest Vandiver view progress of new nursing home fgHMMMM 53 MAXIMUM SECURITY UNIT 7 I BUILDINGS Binion Const 1946 NUMBER OF WARDS 4 PATIENT CENSUS June 30 1971 275 ADMISSIONS 411 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 re quire treatment in a maximum security setting The total number of 411 patients admitted included 289 charged with felony six charged with misde meanor and eight other admissions Transfers from the Department of Cor rections totaled 79 Transfers from other hospital Units was 31 During the year 360 patients were released Of these 296 were discharged five were returned to their communities on convalescent leave two were transferred to other institutions and five were transferred to other hospital Units The current treatment programs include group therapy drug therapy recreation therapy milieu therapy music therapy and work therapy Are cent addition to the Unit was a clinical chaplain who is now working with a number of men in individual therapeutic situations The completion of the new laundry area has made possible the setting up of standards for patients clothing and linens which are now being met All patients are now clothed in washandwear material Airconditioning is being installed on the receiving ward Binion 2 South A full time physician specialist has been added to the medical staff which has resulted in patients receiving more intensive care and better diagnostic and evaluation procedures Each patient is given a complete physical exam ination every six months Inservice training programs on a monthly basis have been instituted for all employees The Unit director and physician specialist are required to do considerable traveling for the purpose of testifying in court cases as well as in other mat ters affecting the forensic psychiatry program A total of 25 visits were made last year in fulfilling this responsibility fB 54 l I CHILDREN AND ADOLESCENTS 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 1971 117 ADMISSIONS 89 DIRECTOR Juan Portuondo MD DIRECTOR OF NURSING Mrs Mary Ann Bell RN COUNTIES SERVED The State of Georgia The Unit gives appropriate support to mentally disturbed children and adolescents and their families Treatment programs include individual and group therapy for both individuals and family groups behavior therapy in cluding a token economy system operating in the adolescent wards a card token system behavior therapy program in the Childrens building judo ther apy speech therapy outpatient evaluation and consultation A child psychiatrist consultant visits once a month and the sessions are video taped and shared with the entire hospital The Unit also serves as a rotating experience for residents in the Psychiatric Residency Training Pro gram Volunteers are used extensively and a majority of these come from the local colleges Boys and girls in the Unit who are able to function on job assignments are participating in the Industrial Therapy program The Unit also serves as a field placement facility for the University of Georgia Gradu ate School of Social Work with two students completing their first year place ment this year Eightysix per cent of the boys and girls in the Unit attend the Special Education School as part of their treatment program Close communication is maintained between the treatment staff and the teachers in order that both programs may adequately compliment each other The Kardex system recently installed has been a factor in improved patient care as has the inservice education programs for nursing personnel in which all employees are encouraged to participate These programs are aimed at continuous personal growth and development on the job and have been a vital factor in improving personnel competence in the Unit Attendant nursing personnel had an opportunity to chaperone a group ofTSBmr 55 boys and girls who attended a day and overnight camp sponsored by the Milledgeville Recreation Department The group adapted exceptionally well to the situation in which they found themselves and made such a positive impression that they were invited to attend next year The Music Therapy Department uses music as a tool for teaching appro priate behavior Individual lessons small group and large group activities and special musical events are all geared to pinpointing defining and eliminating behavior problems The therapists are also concerned with teaching basic facts within the structure of music as well as improving the residents pronunciation and reading skills increasing their attention spans and developing basic music abilities and interests which can be carried over into the community and school activities upon their return home Clinical chaplains participate in treatment team and staff meetings as primary therapists in treatment programs and in pastoral counseling respon sibilities They provide written evaluations and reports as needed Worship services are conducted in Chapel 5 and pastoral visitation in the Unit is a regular part of the therapy program Recreation therapists provide a variety of activities including both male and female basketball and softball teams a wrestling group for boys a judo therapy team for both boys and girls A referral system has been developed for individual recreation therapy for the adolescent ward which is proving successful in working more closely with the primary therapies in solving in dividual problem areas The Smoke Canada Room was a new idea initiated in order to fill a void in evening activities This is a coed free time activity hour which includes badminton pool tetherball table games and a dancing area A weekly door prize has been an incentive to good attendance The younger patient population participates in Cub Scouts and have their own basketball and softball teams Young patients who need perceptual motor training received much benefit from these sessions which were begun this year The regular activities such as tennis swimming bicycle riding table games and art sessions provide a wellrounded recreation program Unit psychologists functioned in a variety of therapy programs which included the evaluation of patients on admission to assess intellectual academic and behavioral status and to ascertain behavioral deficits and ex cesses which should be considered in determining individual therapeutic goals Patients who will be furloughed from the hospital are also evaluated to determine progress and current status and to make recommendations for followup treatment after the child leaves the hospital Psychologists also carry individual therapy caseloads counsel families of patients consult with special education teachers on dealing with behavioral problems in the classroom develop individual behavior schedules for patients as requested by other therapists coordinate the volunteer program for college I 56 J students coordinate the ward wide behavior therapy program in the Unit and participate in interdisciplinary endeavors A number of research projects are also in progress Unit social workers are responsible for a onetoone relationship as therapists for approximately onethird of the patient population They also serve as cotherapists with other disciplines for groups The social workers are responsible for preparing prerelease summaries for community agencies patients who are being discharged or sent home on convalescent leave and for preparing material on patients who are presented for consultation and in service training sessions They secure social history information on each patient admitted to the Unit handle all correspondence with community agencies and patient families and handle the correspondence concerning the Junior Olympics for mentally retarded children Easter Seal camp and patient immunization records N During the year there have been many contacts with community agencies over the state resulting in a number of groups visiting the Unit In February a large meeting with the title The Hospital is Not a Home was coordinated by the Social Work Department The purpose was to identify problems of the Atlanta area and resources available to meet them At the conclusion of the meeting the Unit staff participated in a television documentary aired by WQXI Channel 11 in Atlanta which emphasized the need for developing foster homes and boarding facilities for children and adolescents who are residing in the Unit MggglHHHMHBMMlBMMMB 57 MENTAL RETARDATION UNIT 9 BUILDINGS Boland Const 1951 Boone Const 1952 NUMBER OF WARDS 14 PATIENT CENSUS June 30 1971 775 ADMISSIONS 25 DIRECTOR Evelio F Diaz MD ADMINISTRATOR Bobby Sheppard DIRECTOR OF NURSING Mrs Virginia Smith RN COUNTIES SERVED The State of Georgia This Unit is responsible for the care treatment training 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 436 staff members serve the 775 residents of the Unit The outstanding characteristics of the functioning of the Mental Retarda tion Unit are the interdisciplinary spirit of cooperation coordination and esprit de corps The four interdisciplinary treatment teams organized last year were divided this year into 14 teams one for each ward It was felt that this would allow each team to better focus attention on problems spe cific to one ward and its individual residents Team leaders include staff from nursing music therapy psychology recreation therapy and social work and all disciplines participate as team members Activities of the various disciplines are coordinated by the program coordinator Inservice education in retardation is provided for all Unit 9 personnel through inter disciplinary efforts During July 1970 Unit 9 began to convert the Mental Retardation Unit to Skilled Nursing Homes Nursing Home Center No 1 initially began operat ing on July 9 1970 with a bed capacity of 184 This area was filled imme diately with residents already occupying the beds Of the 184 beds 138 residents or 75 were found eligible for Medicaid under Title XLX The Baldwin County Department of Family and Children Services gave assistance to the Unit in establishing the eligibility of its patients On January 1 1971 Nursing Home Center No 1 was expanded by 178 beds By March 1 1971 80 residents were found eligible out of those occupying the 178 beds This with the 138originally found eligible gave a total of 205 residents or 566 IScheduled for October 1 1971 is the remainder of Boone building wards 4 8 and 9 to be added to the nursing home program In April 1971 Boland building was officially opened as Nursing Home Center No 2 with a bed capacity of 138 Of the 138 49 or 355 have been found eligible as of June 30 Expansion of Nursing Home Center No 2 is scheduled for September 1 1971 when 66 additional beds will be added This will bring the nursing home program in the Boland building up to a total bed capacity of 204 Through the nursing home program in Unit 9 98 new positions have been added to meet the requirement This has resulted in better care to the resi dents more activities and residents found eligible are provided a small amount of money for incidental expenses by the Department of Family and Children Services as they have no income GENERAL PROGRAM ACTIVITIES w Chaplaincy Service has been providing worship services for an increased number of residents in the Unit In addition to one staff chaplain supervisor serving in the Unit there have been seven chaplain trainees who have served in the Unit as part of their clinical pastoral education experience offering both pastoral services and clinical services for the residents klpMl1 Medical services are offered to the residents by six physicians who provide for the total health care of the residents including pediatric and psy chiatric services Also available are the services of the Department of Phy sical Medicine Music therapy staff has conducted several training programs in the areas of toilet training selffeeding Boland 4 preschool training Boland 3 and command training Boone 5 In addition to the Unit 9 adolescent choir for mildly retarded residents Music Therapy has begun a boy choir Nursing Service has been able to markedly upgrade nursing care in Unit 9 especially with the nonambulatory physically handicapped residents due to additional personnel employed to meet skilled nursing home requirements The expanded staff has enabled Nursing Service to participate more actively in ward treatment teams and training programs Occupational therapy staff worked daily with approximately 75 residents in the occupational therapy clinics Occupational therapy personnel are also involved in four ward programs and assist other disciplines in providing su pervision for activities for residents of Unit 9 Psychology staff maintained previous behavior modification programs during the year Several new programs have been initiated by other staff members in consultation with psychology personnel Psychologists also pro B 59 vide psychological evaluations for residents and outpatients and serve as treatment team members and leaders The 1971 session of the Georgia General Assembly included in the fiscal year 1972 Appropriations Bill a special provision sponsored by Senator Bobby Rowan and Senator Culver Kidd which will provide 342000 for behavior modification projects to be implemented by mental retardation psychology staff The special appropriation will provide 31 new psychology positions and renovation of Boone 10 into office space Additionally the driveways around the Boone Boland and Childrens buildings are now scheduled to be paved It is anticipated that this special appropriation will make possible be havior modification programs on all wards in the Unit by the middle of fiscal year 1972 Recreation Therapy profited by the addition of new staff enabling them to provide more than just diversional activities Recreation has implemented or is planning many smallgroup and specialized activities of a highly thera peutic nature Remotivation personnel have worked with residents from all wards uti lizing the five basic steps of remotivation therapy Social Work has major responsibilities for coordination of outpatient evaluation services screening of new admissions obtaining social histories and background information on all residents and coordinating release and aftercare plans for residents Each member of the social work staff has spe cific responsibilities on at least one of the ward teams and two staff mem bers serve as team leaders Vocational Rehabilitation has assigned expanded space for Unit 9 resi dents Residents are being successfully included in programs with emotion ally disturbed patients from other Units Unit 9 residents have entered rehabilitation residences in cities throughout the state and into community placements Utilization of community resources has included summer student workers and volunteers from nearby colleges These individuals have been primarily involved in training programs for residents of Unit 94 YARBROUGH REHABILITATION CENTER UNIT 10 BUILDINGS Yarbrough Const 1962 Various Work Centers around the hos pital NUMBER OF WARDS 8 PATIENT CENSUS June 30 1971 298 ADMISSIONS No direct admissions DIRECTOR Salvador Mendez MD ADMINISTRATOR Levi Swinger DIRECTOR OF NURSING Mrs Tanet Smith RN DIRECTOR OF VOCATIONAL REHABILITATION SERVICES W C Petty AB COUNTIES SERVED The State of Georgia The Unit is operated jointly by Central State Hospital staff who provide the psychiatric treatment services and the staff of the office of Rehabilitation 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 includes eight psychiatric treatment wards a specialized treat ment program for patients with multiple handicaps such as sight speech and hearing defects the testing laboratories for Neurology and Electroencephalo graphy 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 Program 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 The psychiatric treatment program includes the standard therapeutic techniques in which the team approach is used with interdisciplinary services available from psy chology social work music recreation and occupational therapy and voca tional rehabilitation Because of the lack of a qualified recreation therapist nursing service personnel have responsibility for recreation and three evenings a week ap proximately 3 00 patients meet in the large recreation area on the ground floor for various recreation activities Outside activities are also planned Nurs ing service is also responsible for orientation of new patients coming into61 the center as well as promoting full patient participation in all scheduled activities The Unit has two physicians who make daily ward rounds and conduct diagnoses and evaluation of treatment programs both when the patient enters the Center and later to determine his progress in the treatment program Additional programs are being planned covering prerelease evaluations addictive illnesses basic resocialization programs for maladjusted adol escents and expanded individual and group therapy sessions Unit social workers include diagnostic and treatment program development provision of therapy through casework and group work referrals in the hospital and the community to meet the patients needs as well as working with patients families Programs of casework and group work were mainly oriented toward problems involving the patients vocational training programs interpersonal relationships and preparation for his return to the community Unit social workers also have been involved in the training and supervision of graduate and undergraduate students in field placement positions from state schools of social work Jim Grover receives citation for meritorious service from Bud Van Orden presented for the CSH work rehabilitation program Looking on are Dr Michael Sheppeck and Wallace Petty iV 62 SOCIAL WORK DIVISION Social workers are involved in all aspects of patient care at the hospital The staff consists of clerical help and fortyeight positions of which twenty require the Masters degree The staff throughout the hospital is responsible to the medical directors of their respective units Professionally members of the division are responsible to the Director of Social Work Release and Release Planning 3 Will II Innumerable hours are spent by the staff in meeting with patients families hospital personnel and community agency personnel facilitating the release of individual patients or groups of patients Working with the pa tients family toward release may include such services as securing the familys support for the course of the patients care and treatment insuring that a suitable aftercare plan has been developed securing transportation funds and helping the family to alter established behavior patterns For many of our patients return to their natural families is not feasible Social workers are very active in finding other sources of placement The staff was involved in making 1564 referrals to the Department of Family and Children Services DFCS for nursing home placement Within the past year 1044 individuals have been placed in nursing homes from the hospital on the DFCS Vendor Program In addition 64 private placements have been ar ranged The nursing home program has had a sharp effect on the patient census and it provides continued supervised care for individuals that are not in need of psychiatric hospitalization During the latter half of the fiscal year the Adult Foster Home and Work Placement Programs were developed Approximately fifty patients were successfully placed as a result of these programs by the Social Work staff Transfers to other treatment facilities are frequently initiated by Social Work staff Social workers assisted in placing Central State Hospital pa tients in outofstate institutions as well as in transfers to Georgia public facilities such as Gracewood Southwestern State Hospital Georgia Mental Health Institute and regional hospitals Transfer to other facilities such as veterans hospitals private residential centers and private alcoholic pro grams were arranged through social work efforts Referrals to many types of community resources such as vocational rehabilitation programs mental health clinics and aftercare programs and the public school system were routinely made by Social Work staff Direct Patient Services Many social work hours are spent in direct contact with patients on an individual or group basis Social work treatment is usually geared to helping the patient deal with the interpersonal problems which necessitated his63 hospitalization current interpersonal difficulties the patient may be having which hinder him in fully benefitting from available hospital programs or those problems which may prevent successful release Social work provides group services in almost all the Units of the hospital Ward Programs The Social Work staff is moving more into this area of hospital life They are becoming more involved in the development maintenance manage ment and assessment of ward programs Some examples of current ward programs are alcohol and drug dependency resocialization wards for re gressed patients admission ward intensive treatment and the development of social work volunteer programs among others Community The staff has increased its involvement in the communities served by the hospital Some specific activities are the development of a referral system between one populous county and the hospital area serving that county con ferences for state wide workers of the Department of Family and Children Services conferences for state wide court services workers and judges etc Some efforts have also been made through some communities in the prevention of hospitalization One example of this is that two members of the staff give time to a mental health center where they have scheduled appointments Another example is the acceptance of speaking engagements which focus on proper utilization of the hospital f Research This is a relatively new area of interest among the staff One study has resulted in publication and three studies are presently in preparation Staff Development and Education The staff has engaged in numerous educational endeavors at the ward unit and hospital level as well as state and national meetings Some of these have been the annual conference of the National Association of Mental De ficiency a Group Procedure Symposium at the University of Georgia etc Meetings were also held with the staff of other state facilities In addition to eleven members of the staff being on education stipends three members of the staff are pursuing additional academic degrees During the year three graduate social work students were placed in the department for supervised field training Future Goals Future goals include expansion of current programs of service with special emphasis on resocialization programs to reach the long term patient along with increased efforts in release planning servicesV 64 CHAPLAINCY DIVISION Chaplaincy Division continued earlier trends as fiscal year 1971 brought further staff changes By the end of this period more than half of the permanent staff had less than two year employment at this institution A competitive basis on which to maintain or attract experienced chaplains whose training and certification were completed was hindered by a lack of action of the proposed reclassification to differentiate between actual levels of training and functioning in the chaplaincy staff I HI1 But for all its relative newness the current chaplaincy staff possesses characteristics which render it effective in its tasks In employing new per sonnel an attempt was made to create a varied staff in terms of experience and interests Consequently there are chaplains who in addition to basic clinical pastoral training either have or are getting doctorates in religion or some related field Certification of staff chaplains ranges from such ac crediting agencies as The Association of Mental Health Chaplains College of the Chaplains American Protestant Hospital Association to The Associa tion for Clinical Pastoral Education Inc In keeping with the organizational chart one of the staff chaplains was promoted to the position of Chief Clin ical ChaplainChildrens Division In addition a chaplain whose specialty is in alcohol and drug addiction treatment was employed for the new treatment unit for these disorders The varied background the increase in middle management positions within the department and continuing use of such inservice education methods as a monthly staff seminar make it possible to train and mold the staff into an effective arm of the hospitals treatment process which is the primary purpose of chaplaincy service Patient care took first place within the concerns and objectives of this department This priority is evidenced in such statistics as an annual total of 43772 pastoral visits to patients almost double from the year before a total of 3 182 services of worship in the chapels and on the wards and a totalof 79 69 pastoral counseling therapy sessions either individual or group Chaplaincy service capitalized on its pastoral tradition and heritage to contribute to the therapeutic milieu of the hospital in the form of special festive and dramatic services of worship on All Saints Day Christmas Brotherhood Week and Easter Also throughout the hospital evaluation and treatment teams were alerted to diagnostic significance in religious ideation and behavior in patients A major function of the Division which directly and indirectly contributes to patient care is the program of clinical pastoral education for clergymen During this fiscal year there were fourteen clergymen in fulltime training for a quarter or more These individuals came from as far away as California and Iowa to get training in pastoral care of the mentally ill Of those who finished the intern or resident programs four took positions as clinicalHIHHHHH 65 1 chaplains in state health and welfare agencies two remained for a second year of advanced training These clergymen not only render a direct ministry to patients while in training but use their skills in the mental health field after completing training There were workshops of short duration for parish clergymen A total of twentyone individuals participated in this program which is designed to acquaint community clergymen with mental health re sources Also Candler School of Theology Emory University began an affil iation with this hospital which results in parttime training in ministry to disturbed persons for seminarians whose later ministry in communities can be effective in promoting mental health Further this Division maintains its status as an accredited clinical pastoral education center through the Association for Clinical Pastoral Education Inc Finally chaplaincy service has enlarged its concerns to extend to other Divisions and to the community During this fiscal year it has participated with Social Work Psychology and Psychiatry in an interdisciplinary effort to understand and to improve the healthproducing structure of the hospital In a wider span the chaplains of this department image the resources and significance of this hospital through their contacts with community churches Last year there were 642 addresses or sermons given by this staff in adjoin ing communities This appears to be one means of generating and maintain ing that indispensable public support for this health agency i I I I I A I CSH closed circuit television system provides complete ward coverage of chaplains activities V 66 SCHOOL OF SPECIAL EDUCATION The School of Special Education trains and educates the mentally retarded and emotionally disturbed children who reside at Central State Hospital The school a part of the Baldwin County school system is administered and financed through the Department of Education and the State Department of Public Health This unique arrangement enables the school to benefit from the extensive resources of both these departments The school is divided into five academic sections Three of these are the primary intermediate and high school sections for the emotionally dis turbed The other two sections are for the educable and the trainable mentally retarded Children are placed in classes according to their intellectual level academic achievement level chronological age and their social functioning level s The school stresses the regular academic courses and remedial education in the academic areas as well as providing instruction in physical education home economics music and art Because the curriculum must be designed to meet the particular needs of each child classes are kept small These small classes allow for the necessary emphasis on individual instruction and training The teachers work together with the psychiatrists psychologists social workers and other members of the hospital staff in this tailoring of the childs education or training This interdisciplinary approach to educa tion is perhaps the schools most salutary feature While the school is basically educationally oriented nevertheless it is recognized that the learning deficiencies of each child are inextricably involved with his social and cultural shortcomings It is significant in the respect that most of the students come from a severely deprived home schoolsocial environment Many of them have a history of failure in other public schools The School of Special Education attempts to compensate for the underpriviledged background of such children by complementing class room instruction with enriching experiences Some of these experiences are strictly educational in nature Others which are designed for social enhancement include extended camping trips and excursions to amusement and recreational areas These activities to a large extent have been financed by federal grants under authority of Title I Public Law 89313 For the average student it is the first time in his life he has been exposed to such a beneficial environment These valuable cul tural and social experiences also serve as powerful incentives in behavior management These activities are possible only because the teachers give their afterhour time to accompany the students These teachers receive jto monetary compensation for the afterhour time they so generously devote to the students At present the school serves only 215 of the 765 children under 18 yearsIIBM HHBHHH 67 old who are patients at the hospital Of the 215 presently enrolled 89 are classified as educable retarded 68 as trainable retarded and 58 as emotion ally disturbed However this figure of 215 is misleading because during 1971 367 students did attend the school at some time and many have since departed from the hospital This turnover is a strong indication of the school s remedial effect At present there are 33 teachers administrative assistants and teacher aides Emphasis is given to the continuing education of the staff who visit model educational centers and attend state and national conferences Also consultants who are expert in special education and allied fields are brought to the school These consultants hold seminars with the teachers advise on specific problems and conduct other inservice education This ongoing education enables the teachers to keep abreast of current curricular trends and innovative procedures for the education of exceptional children As with the cultural enrichment program much of this continuing education has been made possible through federal grants under Title I of PL 89313 The enrollment has been increasing through the years as the schools reputation has become established with educational welfare judicial and medical personnel The enrollment now is at a point where the three reno vated wards in the Boland building can accommodate approximately onethird of those who need to be in school Nor is this shortage in accommodation likely to be alleviated in the foreseeable future Recent laws emphasize the necessity for providing education for all who can benefit from it For instance the 1969 Georgia General Assembly passed a law which states The rights of any child under treatment in a facility to an education within the limits of his capability shall be fully respected Georgia Code Annotated Charter 3235 requires that by 1976 education be provided for all exceptional child ren in Georgia The newly enacted Tuvenile Court Code of Georgia for the first time enables judges themselves to initiate proceedings for retarded and disturbed children and to order commitments for extended periods It is possible that this latter law will be implemented so as to cause an influx of students Hopefully in the future a new school facility will be constructed one that is large enough to accommodate all the children at the hospital who are capable of benefitting from training and education V 68 NURSING SERVICE As the fiscal year ended nursing personnel included 119 registered nurses 1882 attendants 96 licensed practical nurses 8 medical aides and 12 beauticians This staff directs the nursing care of more than 7500 in patients in service areas of psychiatry medicine and surgery mental retar dation emotionally disturbed children and adolescents alcohol and drug addiction geriatrics and vocational rehabilitation The program is directed through a Nursing Service Administrator respon sible to the Assistant Superintendent Clinical An Assistant Nursing Ser vice Administrator functions as coordinator to the Unit Directors of Nursing Liaison is maintained by semimonthly meetings with Unit Nursing Directors and other administrative nursing personnel as well as by individual and group conferences and by periodic nursing rounds in patient areas 3 Steady progress was made during the year in the improvement of patient care resulting from better physical environment from the purchase of addi tional equipment and from staff additions Nursing care has noticeably im proved where Medicare Medicaid and alcohol and drug programs have been implemented A definite degree of success has been achieved through patient care planning The plans put into effect have resulted in improved patient care and more efficient utilization of nursing personnel ikM11 In service education programs included all levels of nursing personnel Fire safety programs have been emphasized and audiovisual programs on closed circuit television have been helpful Concerted efforts have been made to train all nursing service personnel in cardiopulmonary resuscitation techniques In service programs have been vastly improved by the services of nursing instructors in some of the Units who are able to devote time and energy in implementing these programs and in assessing employee performance A token economy program was begun in one Unit on a male ward housing some 80 regressed schizophrenic patients with an average hospital stay of 20 years each From this program 16 patients have gone on convalescent leave four have been transferred to vocational rehabilitation and 63 have been home on trial visits In the spring open house was held in the Jones Hospital for a physio therapy department While budget funds did not permit fulltime staffing a parttime consultant physiotherapist spent time in training personnel untit he left the program A registered nurse with neuro post graduate training in physical rehabilitation at Warm Springs Foundation has been employed and is now working this area training nursing personnel in techniques and follow up care wBUHmMBKmUmKmlm HflBBHHHIH B 69 Recruitment of nursing personnel continues to be a major problem For several years now we have been unable to increase our staffpatient ratio Licensed practical nurse applicants have not been sufficient to permit either filling positions of this classification or to allow for careful screening During the year an agreement was made for the operation of a MDTA Manpower Development Training Act school for practical nurses in the Jones Hospital The program began in March with 24 enrollees It is hoped that when they have completed the course and have successfully completed the State Board Examination some of them will remain on the hospital staff The MDTA training program for psychiatric aides trained 75 aides in four classes of 12 weeks each We benefitted very little from employment of these aides Nursing Service must depend largely on semiskilled personnel most of whom find themselves on deadend jobs if they remain here a few years therefore it is imperative that an incentive career ladder be implemented which will offer a chance for promotion as well as adequate pay and benefits necessary for basic survival and security NURSING EDUCATION An Assistant Nursing Service Administrator who returned in September following a three year educational leave of absence for the doctorate degree in nursing science is delegated the responsibility for nursing education and nursing research The psychiatric nursing affiliation course for student nursing is changing as some diploma schools of nursing have been able to provide this experience for their students elsewhere During the year 172 students were enrolled and successfully completed the twelveweek basic course in psychiatric nursing from the following schools Georgia Baptist Hospital 111 the Macon Hos pital 22 Piedmont Hospital 38 and one graduate nurse from New Delhi India Programs for a more limited psychiatric experience of from one to six days are provided for other diploma school students associate degree pro gram students and nursing groups who come at prescheduled times Housing and meals are furnished at nominal fees Liaison is maintained by faculty participation between the schools during the year and by an annual meeting in September for faculty representatives from all participating agencies As the end result of discussions at annual meetings relative to reducing the length of the affiliation program through the efforts of the Principal Nurse Consultant Division of Mental Health we were afforded the services of a dynamic and gifted consultant who worked with educational staff to accomplish this mission Beginning with the Fall Quarter of 1971 the pro gram will be cut from twelve to eight weeksFaculty members have actively participated in available workshops seminars conference groups and in service and staff development programs In preparation for the changes necessitated by the reduction in the affiliation course the faculty is busy with revision of tests and examinations study guides nursing assessments and lectures The psychiatric aide program continues as a twelveweek concentrated course with major emphasis on the principles and techniques for better psy chiatric nursing practice Clinical experience has been effective with the use of patient studies informal discussions and conferences to correlate theory and nursing practice One hundred three attendants successfully completed the course this year Clinical nursing instructors are oriented by attendance and active participation in the Aide Course after which they go into assigned Units to conduct and implement further development of in ser vice education Staff Development Program for Professional Nurses made possible by a federal grant for three years ending June 30 1972 has added considerably to the professional enrichment of 53 nurses who have attended two oneweek workshops Participants agree that they have experienced personal growth broadened their knowledge gained a better understanding of patient behavior and how to cope with this and learned how administrative principles could in one way or another be applied in their daily work area Some nurses are functioning in a broader role as cotherapists in patient groups and in inter personal interaction with patients on a onetoone basis The grant program made possible the participation of a number of nationally recognized nursing consultants to deal with specific content areas whose expertise could never have been shared with nursing staff otherwise Worth while contributions to these workshops were made from hospital heads of departments in nursing and administration The midprogram seminar following completion of the first five workshops was held in February Two consultants professors at the nursing school of Medical College of Georgia critiqued the program Their recommendations have been most helpful and evaluations are gratifying Nursing education has benefitted greatly by the acquisition of films other audiovisual aids equipment work tables chairs books and resource materials purchased with grant funds The Myra Bonner Nursing Library has a total collection of books numbering some 1900 During the year 237 new books were added most of which were purchased through grant funds The cumulative index to nursing literature which provides a listing of articles in periodicals pertaining to the nursing field was purchased and has proven an asset to staff members throughout the institution All nursing personnel are encouraged to use the library As we move into fiscal year 1972 we are faced with the need to structure M1 a nursing program which will be effective in an institution which is chancing as a result of emphasis on community mental health services and various other aspects which will alter the future mission of this institution How ever we will meet the problems and challenges with the confidence that patient care will improve as a result of our continued efforts 71 I 1 TOP Frequent staff development programs keep nursing staff up to date BOTTOM Student nurses double as entertainers for patients 72 PSYCHOLOGY DIVISION The Psychology Division has adopted an approach toward the evaluation and treatment of mental patients based on the application of the results of scientific research to the problem of emotional disorders During the past fiscal year the Division has continued its constant reevaluation and im provement of its programs throughout the hospital RESEARCH EDUCATION AND TRAINING The Research Education Training and Special Assignments Section coordinates activities in these important areas Psychologists at Central State Hospital are productive in conducting and publishing scientific research During fiscal 1971 members of the Division published in scientific journals or read at professional meetings 17 research articles Nine other research projects conducted at Central State are com pleted and the results are in preparation for publication Six research studies are currently in progress The psychology research conducted has as its principal aim the improvement of services to the patients of the hospi tal 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 dispel erroneous ideas about the hospital and emotional disorders Psychologists are also active in the inservice training programs of other disciplines and are frequently called upon to present lectures which illustrate the role of the clinical psychologist Psychologists spoke to a total of over 3000 individuals as part of the above programs INTERNSHIP PROGRAM The Divisions internship training program in clinical psychology was approved for the ninth consecutive year by the American Psychological Asso ciation In 1963 Central State became the fifth state hospital in the entire United States to have an accredited internship program and today is one of only nine approved departments in the southeast The Division is very selective in accepting intern applicants considering only those students who rank in the upper 10 percent of their graduate classes This year one intern received training in clinical psychology The number is kept small to permit each intern to receive close personal supervision by doctorallevel psychologists The internship program will be expanded to provide for the training of three psychology interns during the coming fiscal year Interns are taught treatment and evaluation skills which center around an understanding and appreciation of research findings Interns are encouragedHHHhHmmHMM 73 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 Divi sion of Central State Hospital was one of the first to utilize Bachelor and Masterlevel assistants psychology technicians for psychological testing interviewing patients and writing psychological evaluations They also have begun to play extensive roles in treatment programs The work of psychology technicians is closely supervised by doctorallevel clinical psychologists The psychology technician program has resulted in a great increase in psychological services and a financial savings to the State of Georgia Also this program 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 his hospitalization Each patient is given a complete battery of psychological tests which measures his abili ties and limitations and aids in the determination of a diagnosis Finally a clinical interview is conducted and a diagnosis and recommendations for treatment are offered Each psychological evaluation represents eight hours of work by staff members More than 2500 evaluations were produced during fiscal 1971 Attempts are constantly made to improve the validity and usefulness of the evaluations Research in evaluation procedures is being conducted by the staff of the Central Psychological Evaluation Section TREATMENT As a result of constant scientific evaluation of procedures the Division has committed itself primarily to a treatment approach called behavior therapy This approach which includes a wide variety of treatment techniques such as behavior modification systematic desensitization and implosive therapy 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 order the environment in which the patient is placed at this hos pital so that normal appropriate behaviors are rewarded and abnormal in appropriate behaviors are discouraged This is what is done on a behavior modification or token economy 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 H 74 tokens for behaving in a mentally ill manner Patients are allowed to spend tokens at 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 normal 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 Additional techniques within the behavior therapy framework are continually being contributed by psychologi cal laboratories throughout the world The behavior therapy programs have contributed to the improvement of many patients Ten such ward programs are currently in operation At any given time approximately 700 patients are being treated It should be pointed out that members of other disciplines particularly the attendant staff play important roles in carrying out the behavior therapy programs designed by the Psychology Division Below are presented some examples of data obtained from behavior therapy programs to illustrate the effectiveness of this approach and to 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 unit program coordinator Therefore psychologists have been involved in the treatment of all of the patients of that Unit Also the Division has directly operated three behavior modifica tion wards in the Mental Retardation Unit klfcul1 Boone 8 is a ward for severely and profoundly retarded children The 1969 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 Additionally and because these basic problems have been taken care of the staff has been able togo on and teach the residents of Boone 8 higherlevel skills Figure 1 illustrates how these patients have been taught concepts such as number and color This training took place in the nursery school which is operated as a part of the psycholo gy treatment program on this ward One girl in the school exhibited manner istic behavior excessive and bizarre movements As shown in Figure 2 these mannerisms were substantially reduced through the application of be havior modification techniques Boland 6 is a ward for mildly retarded teenage male patients Prior to the institution of a behavior modification program acting out antisocial behaviors were a major problem Institution of a token economy two years ago has enabled the disruptive behaviors to be brought under control and has allowed the patients to participate in educational and social advantages previously closed to them HHHHHMMMHMM1 A i J I 7l PHHHiHHHHH 76 Boone 1 has had a token economy in operation for two and a half years The behavior of these young mildly retarded females continues to progress in a socially desirable direction M During 1970 a group of summer employees college students under the direction of Psychology Division personnel carried out a special toilet training project on a ward for severely and profoundly retarded adult females Figure 3 illustrates the progress that was made during the eight weeks of this program The dotted line shows how the number of inappropriate urinations and defecations decreased during the project This means that the number of accidents on the ward decreased steadily throughout this time period The solid line shows how the number of appropriate responses increased This improvement was initially brought about by periodically bringing the resi dents into the bathroom sitting them on the toilet until they relieved them selves and then rewarding them with candy or soft drinks However as time progressed the residents more and more frequently came voluntarily to the bathroom to make the appropriate responses Treatment of Children and Adolescents Some form of behavior modification program is in operation on all wards in Unit 8 In the Childrens building the behavior treatment program which has been developed is called the cardtoken system CTS While the use of an individual rating card is not original with us the psychology staff has greatly expanded and increased the utility of these cards over other similar programs The CTS has the same therapeutic objective inherent in all such systems to strengthen appropriate behaviors and weaken or eliminate in appropriate behaviors but the system elaborates on the two basic services which must be supplied First it provides a stable structured consistent environment requiring each child to learn to take responsibility for reason able everyday behavior expected of all children Second it provides a system which is flexible and versatile enough to specify individual therapeutic goals while at the same time allowing all ward personnel to work on the same indi vidual treatment plan for any given child Basically the CTS works like this Every week each child is given two cards on which are printed the behaviors under consideration Next to each behavior are seven blocks one for each day of the week A token consists of having a staff member write his initials in one of these blocks indicating that the behavior has been performed according to the criteria established for each child The general ward behavior card is designed to reinforce the patient for assuming responsibility for the basic behaviors of daily life and includes behavioron the ward and in school In addition spaces are provided in which the therapist from whatever discipline can write in specific target behaviors which he wishes to be reinforced on the wardIHMHM iHV 78 V 4 s The second card is the individual behavior card On this card are speci fied the treatment goals in individual music and recreation therapy By having the therapists specify these goals in behavioral terms the system provides a common language which facilitates communication but still allows any theoretical orientation to prevail in individual therapy sessions It is felt that this is a major achievement and has moved us from the common multidisciplinary approach to a truly interdisciplinary approach which allows all staff from ward attendants to the unit director to work coopera tively toward common goals for each child Figure 4 presents data showing how over a period of three months the behavior of an emotionally disturbed boy in the Childrens building became more and more acceptable so that at the end of this period he was earning as many tokens as the group average Prior to July 1 1968 adolescent patients at Central State were distributed through the geographic units At the beginning of fiscal 1969 two wards were set aside for adolescents on the north wing of the Boland building These two wards were combined administratively with the Childrens building to form the present Childrens and Adolescents Unit During the first four andahalf months the Adolescent Wards operated without a token economy However during midNovember 1968 a token economy was installed on both the boys and girls Adolescent Wards Under this system patients are paid tokens for acceptable desirable behaviors and are fined tokens for maladaptive or undesirable behavior The patients can spend these tokens at a special ward store and they pay for special privileges such as going to dances and movies with tokens Also there is a token charge for breakfast and supper Figure 5 shows a comparison between the pretoken economy period of the Adolescents Wards functioning and the first fourandahalf months with a token economy in operation It will be noted that during the pretoken economy period 38 percent of those patients admitted were furloughed with in six months After six more months 32 percent of those admitted were still out of the hospital after 12 months 2 9 percent and after 18 months 2 8 per cent For the first token economy period the figures were 64 percent fur loughed within six months 55 percent still out after six postfurlough months 50 percent still out after 12 months and the percentage remained the same for 18 months or longer Since these data were collected a number of improvements particularly on the boys ward have been made in the psychology treatment program for adolescents The first of these improvements is a system whereby patients are assigned to a dayroom according to their behavior The dayroom for the behavior problem boys provides very few opportunities for entertainment The wellbehaved boys have it much better In this dayroom a television games and other sources of entertainment are available gggggggggBggmtmmtttmmmKBmt gggjjgPBHHHHNHI 80 The staff is beginning to experiment with a steplevel token economy in which more and more is expected of a patient as he improves The parti cular level a boy has achieved is indicated by the color of the badge he wears Another project is a program for sociopathic males Under this regimen boys are given very specific instructions Their performances of these assign ments are carefully checked on and only exact compliance with instructions results in reinforcement For example if a boy is told to make up 10 beds only by his actually making up 10 beds will he be rewarded If he makes up 9 or 11 beds he is fined for failure to follow instructions 5 A final new development in the adolescent program is a behavioristic form of group therapy In these groups an attempt is made to teach patients appropriate patterns of social interaction MMs and tokens are used as immediate reinforcers during group meetings Also reallife situations on the ward are rehearsed in the group One of the initial problems that was encountered with the group therapy procedure was that some of the boys monopolized the conversations while some boys hardly said anything at all The psychology staff is experimenting with a procedure to correct this The less talkative boys are being seen in a separate group and are being taught among themselves to carry on group discussions The hope is that when they are reintroduced into the larger group they will be more assertive and take a more active role These new procedures have been in effect for too short a time for any data to have been collected yet as to their effectiveness but the results appear encouraging ii Figure 6 shows the results of two behavior therapy treatment series on the number of suicidal attempts made by a 14 yearold girl The reader will note that this patient has made no suicide attempts during the past six months The technique employed in treatment of this patient was developed by a doc toral member of the Psychology Division A presentation of the psychology program for children and adolescents was made at the 1971 annual meeting of the Georgia Psychological Associa tion Treatment of Adult Patients During the fall of 1970 the Psychology Division directed an interdisci plinary team in opening a behavior modification ward for chronic male patients The disciplines of chaplaincy medicine music therapy nursing and social work were represented in this program The patients involved in the program on an average had been hospitalized for 20 years A token economy system was set up wherein patients are fined for maladaptive behaviors and are re warded for adaptive behaviors As on other token economy wards the patientsV 82 can exchange the tokens for commodities at the wards token store The open bars in Figure 7 show the average frequency of the maladaptive behaviors listed prior to the beginning of the project After just eight weeks of the token economy system being in operation these undesirable behaviors had decreased to the levels indicated by the hatched bars Adaptive behaviors on the other hand have increased from the average indicated by the clear bars in Figure 8 to that indicated by the hatched areas Figure 9 demonstrates that the frequency of psychotic behavior among the residents has been sharply reduced since the institution of this program These gains have also been reflected in an increase in the number of residents working off the ward attending vocational rehabilitation and being furloughed The Psychology Division operates another behavioristic treatment program for adult patients this one a highlevel project for acutely disturbed females On this ward individual and group therapy are conducted within a behavior therapy framework JM1 The multiple handicapped ward in the Yarbrough Vocational Rehabilitation 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 re habilitation classes and learning the skills that will enable him to become a successful member of the community Presently 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 services enable the handicapped individuals to learn to function outside the hospital at a level compatible with his ability and phy sical 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 individual 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 an important role in certain administrative and financial decisions which the Veterans Administration makes in regard to the patient FUTURE PLANS During the coming year the Psychology Division will expand its services to the mentally retarded residents of the hospital This will be made possi ble by a special appropriation of the Georgia General Assembly which provides for the addition of 3 1 psychology personnel Plans are currently being made to computerize data from psychology treatment programs in order to make theirmamsmm 83 assessment and improvement more efficient Great effort will be made to fur ther improve the efficiency of all the Divisions activities so the taxpayers of Georgia will receive the maximum service for their tax dollar Also the Division will continue its program of applying the techniques of behavior therapy to increasingly complex mental problems K 7 I84 PSYCHIATRIC OUTPATIENT CLINIC The Psychiatric Outpatient Clinic has continued to operate to afford aftercare for patients on convalescent leave and a few that have been recently discharged However the aftercare services in the communities in which the patients live have served so well that the volume has been reduced by more than 50 of the peak level in 19661967 The total number of appoint ments for 19701971 were 4495 In addition Fulton County and others have recently added aftercare services During the past year we have been arranging patient appointments more on an even load basis for five days per week with only part coordination as to which unit treated the patient in the hospital The current plan is to have all aftercare patients seen in the area connected with the admission office as soon as suitable renovation is completed so that the admission dismissal and aftercare can be arranged centrally and orderly We are still trying to expedite full use of the community facilities where present to carry on aftercare i M1 MEDICAL RECORD DIVISION The Medical Record Division has established an organized system which provides continuity of information to those who are responsible for the care and treatment of the patient The accelerated public demand for comprehen sive health services has fostered the development of the community mental health program and Central State Hospital Record Division accepts its role as the focal point or hub of biocommunications A variety of information furthering patient care teaching research and management is channeled through the Medical Record Division to the public the medical staff and administration This Division which is also respon sible for admissions and implementation of the Mental Health Law seeks bilateral communication with all Central State Hospital catchment areas Interacting with the various service systems affecting continuum of care there is no interruption in the flow of reliable and detailed reports from all treatment sources Improved quality of record documentation has accompanied the greater growth of the Medical Record Division In depth programs of ongoing peer review as monitored by the Medical Record Committee and the Utilization Review Committee assure a high quality of care and efficiency of servicesmMMMUH SSSJVijfeaiiKstwioecses 85 ASSISTANT SUPERINTENDENT EDUCATION TRAINING RESEARCH v t John W Kmblz MP PSYCHITRIC RESIDENCY TRAINING MEDICAL LIBRARY RESEARCH NEUROLOGY AUDIO VISUAL SERVICES a86 EDUCATION TRAINING AND RESEARCH The Division has continued with accredited training in psychiatry The programmed texts which have been obtained have been of variable interest to the physicians some finding that this is a useful way of teaching and learn ing others preferring not to use the programmed material An additional training facet was obtained for several months in the area of computer assisted diagnosis in Pediatrics and Internal Medicine This is not only a method of obtaining diagnostic assistance but also of training in obtaining elaborate bibliographies It has been our observation that there has been little interest generated among staff physicians in this respect and so it has been recommended that this program be discontinued The Audiovisual Division has continued to play a very important part in broadening training in all areas of the hospital as it has previously The increased availability of the services of this Division will be described in detail separately hil NEUROLOGY In 1971 there were 587 neurologic consultations 203 echoencephalo grams and 1553 electroencephalograms Didactic and practical teaching efforts have continued in the field of neuroanatomy and neuropathology the latter under the guidance of Dr Hans Peters Clinical neurology teaching is provided through a series of lectures as well as by clinical demonstrations Each psychiatric resident rotates through the program for one quarter JM The addition of Dr Marshall Allens efforts in neurosurgical consultation have been of immeasurable value to the teaching of clinical neurology AUDIOVISUAL DIVISION Expansion of closed circuit television cable to include 50 of institutional buildings resulted in far better viewing for patients In addition local patient programming in the form of a daily news program weekly variety show and biweekly church services were initiated Training for attendants medical and paramedical personnel continued All vocational rehabilitation counselors evaluators and instructors have been videotaped for self review or review by peer group Similar programs are being undertaken by social work and music therapy personnel A total of 314 programs were produced locally and 747 programs were played back in addition to continual programming on commercial and educa tional channels Audiovisual support in areas other than television included 22 audiotapes V BHHHMMliMl 87 18 slide shows 38 16millimeter and 8millimeter movies and 18 repairs to audiovisual equipment owned by various departments I MEDICAL LIBRARY The Medical Library at Central State Hospital now includes 4500 books and 200 journals covering the areas of medicine psychology and psychiatry and other fields represented in Central State Hospitals treatment program Library services have been thoroughly utilized by members of the hospital staff both in studying pertinent material in the library itself and by collecting bibliographic information resulting in 574 interlibrary loan requests The use of subscriptions to AudioDigest in internal medicine and surgery has been consistent A number of physicians listen to every bimonthly issue Others utilize the service according to individual problems which arise in their daily treatment programs A file folder with content copies of the tapes provides a speedy orientation to topics available Frequently the library staff calls to the attention of doctors individual topics in which they might be interested The library now has eight bookstacks and two cabinets in the conference room which have helped to relieve congested conditions The shipment of 94 packages of outdated and duplicated journals to members of the Medical Library Association has also helped to alleviate overcrowding Clinical chaplains have a reserved section in the library for material pertinent to their teaching programs and staff members working on degrees use the library extensively Georgia College students also avail themselves of the library services As in former years a twohour English course has been taught regularly in the library and participation has been requested by more persons than could be accommodated Because cataloging procedures have undergone considerable change through the acceptance and installation of AngloAmerican cataloging participation in an institute on AngloAmerican cataloging in November has been profitable Attendance at the Medical Library Association meeting in June provided the library staff with new information regarding li brary materials and procedures I 88 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 practice of psychiatry as a medical specialty in private practice in community men tal 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 s Since the programs initiation in 19 64 the training faculty and consulting staff have consistently evaluated and improved the program Supervision and direction of residents are provided by experienced professionals adequate ly trained and capable of assuming the responsibilities for teaching psy chiatric 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 residents toward sound psy chiatric practice Each physician in the Psychiatric Residency Training Program is assigned 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 JM1 The first year of the training program is designed to acquaint residents with the basic principles of psychiatry and the care and treatment of psychia tric patients The second year involves more specific areas of psychiatry 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 1964 until the present day 38 residents have completed their training in this program Initially the program was approved for 10 residents at each year level There are presently 13 resi dents enrolled Though there is no obligated service following the completion of this training our record of physicians remaining in the state after comple tion of their training is excellent Of the 38 that have completed their training here in our program 24 continue to work at Central State Hospital three re main elsewhere in the State of Georgia and only 11 have left the State of Georgia HHHHHiHWB 89 APPOINTMENT OF RESIDENTS Residents are appointed to the Psychiatric Residency Training Program on a yearly basis with reasonable assurance of annual reappointment until com pletion 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 appli cant must have passed the ECFMG examination An internship is no longer required therefore candidates may apply directly from medical 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 requirements Residents do not have to be licensed in Georgia if they are granted an insti tutional permit but they are encouraged to obtain a medical license if quali fied by examination or reciprocity Dr James B Craig CSH Superintendent presents Certificates of Graduation to Psychiatric Residents 90 RESEARCH DIVISION Genetics Neurophysiology and Biochemistry are the cooperative units composing the Research Division These disciplines focus upon basic scien tific problems of Central State Hospital patients Genetic studies diagnose and investigate the hereditary factors determin ing inherited syndromes and disorders of mental function Chromosome cul tures are used to reveal cytogenetic abnormalities causing certain types of mental retardation Genetic counseling is offered Genetic factors in fear are being studied it Neurophysiological investigations probe the normal characteristics of the nerve impulse and abnormal variations from this norm These researches deal particularly with transmission in the sensory nerve of the eye and the peripheral neuromuscular system of the extremities Equipment of the Research Division is capable of recording visually evoked cortical potentials as well as clinical and experimental electroretino graphy Computerized mass data will provide a normal retinographic curve with which to compare the abnormal deviations of individual hospital patients suffering from visual handicaps The left figure shows our experimental light stimulator sphere designed in such a fashion as to provide the most satisfactory retinal excitation for eliciting multiple potentials in sequence These are recorded and treated on the oscilloscope assembly and computer averager in the figure at right iM1 A further study of the rare XXXXY XXXY mosaic Klinefelter male syndrome at Central State is being made In general the greater the number of X chro mosomes the greater the number of skeletal abnormalities as well as the greater the degree of mental retardation In comparison the normal male has simply XY sex chromosomes in each of his body cells A curious constellation of chromosomal karyotypes is being investigated in a trainable mongoloid patient These multiple constitutions of cells in this individual include normal XX cells GG mongoloid translocations XO Turners syndrome cells triple X cells and missing G chromosome karyo types A survey of mental retardates at Central State has been made to search for the Australian antigen frequently associated with liver hepatitis to learn if hepatitis is a causal factor in retardation The current Research Bulletin reported ten research projects of the Re search Division and a total of seventeen researches for the hospital J JHHHHHHMHHHHHBHHIIBHHHi 92 Publications of the Division for the year include Courtney GR Color Vision Deficiency in the Mentally Retarded Am J Mental Deficiency In Press Courtney GR Refractive Errors in Institutionalized Mentally Retarded and Emotionally Disturbed Children Am J of Optometry 48 492496 1971 Keeler CE Reoccurrence of fourrow rodlessmice A hereditary syn drome that parallels night blindness in man Arch Oph thal 84 499504 1970 Keeler CE Cuna MoonChild Albinism 19501970 J Hered 61 273277 1970 Study of a hereditary handicap affecting behavior Keeler CE M M Rehabilitation in San Bias J Rehab MarchApril 1971 Preparing the visually handicapped for new type employ ment Governor Jimmy Carter visits with CSH children on field trip to Capitol iB 93 PttWical eat ASSISTANT SUPERINTENDENT PHYSICAL HEALTH WMJUcun R HoivaAd Mfl JONES RIVERS HOSPITALS PHARMACY DENTISTRY COORDINATOR SPECIAL THERAPIES OCCUPATIONAL THERAPY RECREATIONAL THERAPY MUSIC THERAPY VOLUNTEER SERVICES REMOTIVATION SERVICES ENVIRONMENTAL SANITATION94 JONES HOSPITAL GENERAL MEDICINE AND SURGERY M Ail BUILDINGS Jones Const 1930 RESIDENT PATIENTS June 30 1971 123 ADMISSIONS 23 67 DIRECTOR Joseph G Bohorfoush MD ADMINISTRATOR Norman E Wood Jr DIRECTOR OF NURSING Mrs Irene Wood RN The Jones Hospital is a 200bed medical and surgical facility providing total hospital care both inpatient and outpatient to the residents of Central State Hospital the Georgia Rehabilitation Center for Women the Youth Development Center in Milledgeville and all other authorized persons A summary of hospital activities for the fiscal year 1971 in each major depart ment follows MEDICAL DEPARTMENT The Medical Department which furnishes medical care for all patients eligible for treatment in the Jones Hospital added six physicians to the medi cal staff however eight physicians left the institution resulting in a net loss of two doctors New clinics inaugurated were Metabolic and Diabetic The Medical Service admitted 2367 patients for 29937 days of patient care Also served were 40 retired employees 5 student nurses 217 inmates of the Georgia Rehabilitation Center for Women and 44 inmates from the Youth Development Center RADIOLOGY DEPARTMENT The Radiology Department was fortunate to obtain several new equipment additions for the fiscal year including an automatic film changer an S S Console Illuminator an emergency case a step wedge and spin top a M6A Kodak XOmat Processor a CE CMX110 cordless portable Xray unit and a Hope resuscitator This much needed equipment will contribute considera bly toward the efficient operation of the department MEDICALSURGICAL CLINIC The MedicalSurgical Clinic provides the best possible emergency and medical treatment to all authorized persons on an outpatient basis The clinic provided a total of 45803 services during the year Of this number 31337 were for patients 2469 for employees 72 for dependents of employees ggHIBHHIIMMHi jgjmHHHBiBiW PATHOLOGY AND LABORATORY DEPARTMENTS The primary objectives of these departments include providing clinical laboratory services to Central State Hospital to provide diagnostic services in Surgical Pathology Cytology and autopsy to support the education and training programs of this institution and the medical colleges of Georgia as well as dental nursing embalming and physical therapy schools The de partment also provides medical legal services to the entire hospital including the investigation of unnatural deaths identification of bodies and cooperat ing with law enforcement authorities The department last year generated 354000 tests which is almost twice that of a normal 200bed hospital The laboratory has passed all proficiency checkups satisfactorily It has provided surgical diagnostic services to 845 patients and considerably increased its activity in the teaching field During the year six clinical pathology conferences were conducted for the medical staff in addition to participating in neuropathology conferences for psychiatric residents Neuropathology review classes have been conducted for specialty Board candidates in addition to the general pathology reviews for State Board candidates Also some physicians have been certified in order to take Board examinations During the past year the autopsy percentage has been 24 both for Central State and the Jones Hospital This more than meets the requirement for accreditation Many lecturedemonstrations to various visiting groups of college students and hospital personnel were provided For the fiscal year a total of 716 bodies were processed 3 63 of which were embalmed Funeral services were provided by the hospital for a number of these The training program for technologists as well as that for professional personnel should be maintained and expanded if possible Funds should be secured to send trainees and personnel to refresher courses This is of considerable importance in main taining the accreditation of the laboratory and because of the laboratory li censure law which makes annual inspection of all laboratories compulsory 95 67 for student nurses 8582 for inmates of the Georgia Rehabilitation Center for Women and 989 for the Youth Development Center SURGERY DEPARTMENT The Surgery Department is now fairly well staffed with competent personnel and during last year served 464 major surgical cases 342 minor surgical cases and performed 296 other procedures for a total of 1102 surgical operations Dr K M Sreeramaiah is now performing the insertion of pacemakers where necessary 96 EYE CLINIC The Eye Clinic served a total of 9395 patients 257 major surgical cases were performed as well as 46 minor cases and nine items of much needed equipment were added to the department during the year The Hospital IBM System has helped the department update and keep accurate and uptodate records for every patient seen Use of the computer has greatly increased the efficiency of the department and expanded services to patients particu larly in the followup records of surgery and glaucoma patients A number of patients have been greatly benefitted by the use of microsurgery made possible by the addition of the operating microscope NURSING SERVICE w Nursing Service has cooperated with the Pharmacy in converting a new procedure for filling individual patient prescriptions The system is now working on two wards and will be extended throughout the hospital as soon as possible Relocation of orthopedic equipment has provided better services and the environment has been improved by redecorating some of the television rooms and by the addition of furniture and pictures Personnel participated in staff development programs for professional nurses a management and leadership course a physical therapy class and fire drill training during the year The number of registered nurses is still not adequate for a hospital of this size and the addition of an escort service assigned to wards to take patients to EKG EEG and Xray would relieve nursing service of this duty and allow the nurses to remain on the ward for better patient care JM PHYSICAL THERAPY The Jones Hospital opened a fully operational physical therapy depart ment in the west wing of the building during the past year The program not only provided orthopedic services for patients but contributed to the training of selected personnel in physical therapy techniques ADMINISTRATION The capacity of the hospital was reduced from 223 beds to 200 beds and all rooms patient rooms and offices have been numbered to meet locator needs The Property Control office and the storage area were relocated from the basement to Jones 1 West thus increasing the storage area and providing better security of supplies and a more pleasant working environment The physical inventory of all Jones Hospital property was also completed during the year purchase orders were originated for approximately 160 pieces of new and replacement equipment costing 63000 Delivery of housekeeping services were improved by the elimination of HHHHHHHiHi HW ih 97 the night shift and the assignment of those personnel to the day shift Fire regulations and evacuation plans were developed The elevators have continued to be a problem but necessary corrective measures are now being taken A new program in cooperation with the Bibb County Board of Education is providing training for 20 licensed practical nurses The hospital lost five budget positions during the employment freeze which resulted inconsiderable hardship on those employees who had to absorb additional work The central steno pool lost one position and while covering for all absences in all departments of the hospital an average of three typists including the supervisor averaged 90 typewritten pages of medical material per working day In addition to this work they also typed for the Assistant Administrator and processed all incoming mail for the building Plans for the General Medical and Surgical Hospital are now almost complete and beds will be let early in January 1972 I Rivers Hospital medicare ward98 RIVERS HOSPITAL TUBERCULAR DIABETIC AND MEDICARE l M BUILDINGS Rivers Const 1939 RESIDENT PATIENTS June 30 1971 283 ADMISSIONS 772 DIRECTOR Mahmud Majanovic MD ADMINISTRATOR George Hart DIRECTOR OF NURSING Mrs Valeria Atchison RN Total admissions to this Unit during the year were 772 Of the total population 461 were transferred to the communities from which they came 300 were placed on convalescent leave and 112 were discharged The Alcohol and Drug Program was opened on October 1 and is functioning well During the coming year it will be expanded to include 3 0 beds for fe males The assignment of an additional social worker to the Unit has provided a much better social work program for this activity Medicare is functioning well and airconditioning is being installed for the entire ward which will make the summer more comfortable for the patients The dining room on Rivers 1 East is being renovated and airconditioned for the Music Therapy Department A new therapist has been assigned and the new area will provide a much improved recreation music therapy and occu pational therapy program Additional improvements include a new administrative suite a new employee parking area replacement of all old hospital beds the installation of fluorescent lights in all nurses stations and treatment rooms and the addi tion of other much needed equipment A central drug room was established and stocked in cooperation with the hospital Pharmacy All medicine rooms were checked and excess drugs removed New procedures for ordering and issuing drugs were begun This has resulted in improvements in economy efficiency and safety The advent of a clinical instructor in Nursing has permitted the initiation of several new programs All new nursing service personnel participated in an orientation program upon employment Medication classes are being con ducted and employees are given individual supervision in preparation admini stration and charting of medications Classes are being conducted in special areas of need and every Nursing Service employee participated in a courseHHHhwhbi 99 in cardiopulmonary resuscitation during the year The installation of Kardex files on all wards has added greatly to the efficiency of the patient record system Plans for the future include the renovation of two rooms on Rivers 2 and 3 East to provide an observation area for patients who are being diagnosed and evaluated Nursing Service personnel will continue to strive for im proved patient care through the development and use of nursing assessment and nursing care plans I Rivers Hospital the recreation room in the medicare section100 PHARMACY DIVISION The 1971 fiscal year has been one of continued growth and expansion for the Pharmacy The staff consists of eight pharmacists two pharmacy interns five technicians a truck driver secretary and typist The usual duties related to the Division were carried out during the year with a view toward increased uses of personnel resources culminating in greater service for patients The pharmacy staff operates in three main areas The Central Pharmacy Satellite Pharmacies and the Jones Hospital Pharmacy The Central Pharmacy has directed its activities toward a practical system of inventory control through the use of electronic data processing equipment and the establishment of automatic reorder points The purchasing and in ventory system is now complete and is a great improvement Also the filling of ward orders has been streamlined through the use of preprinted issue tickets to the extent that one person may now perform the work normally done by two persons Central Pharmacy staff members have developed methods of service to the various hospital wards which have been approved as extensive care facil ities The Boone and Boland buildings now operate under an individual patient drug dispensing system in order to meet state and federal guidelines Since October this has resulted in the filling of over 3 000 individual prescriptions Mill1 The Central Pharmacy also supplies the drug needs of 45 Mental Health Aftercare Clinics which are scattered throughout the state The close of this fiscal year saw the introduction of a new Pharmacy Newsletter which is a monthly publication designed to efficiently disseminate news and policies to the Central State Hospital professional personnel The Jones Hospital Pharmacy is rapidly moving toward the desirable goal of receiving carbon copies of all doctors drug orders The Jones Pharmacy is initiating a complete patient dispensing system with a pharmacist review of all drug orders A seven day weekly pharmacy service for the Jones Hos pital has been established The Satellite Pharmacy staff has improved distribution and control of drugs throughout the hospital During this past year a new system for ordering drugs from individual wards has been developed to facilitate control functions and eliminate past errors This section of the pharmacy provides monthly inspections to all hospital wards as well as direct service to the Childrens building and the Adolescent Wards During the past year the Pharmacy purchased drugs and medical supplies totaling 112972000 supplied 21924 prescriptions for patients going on convalescent leave and filled 6556 prescriptions for hospital employeesBOOHMiMHHHMM iBi DENTAL DIVISION 101 Dr Robert C Watson Dental Service Director was granted educational leave to obtain his Masters Degree in Public Health Administration and is now at the University of North Carolina Dr William K Willoughby Staff Dentist assumed the direction of the dental program in his absence During the past year 47 286 operations and treatments were accomplished and an additional 13287 oral examinations were rendered The dental labora tory processed 677 appliances and repaired 178 All members of the dental staff successfully completed a course in cardiopulmonary resuscitation techniques Mrs Betty Pierce a dental hygienist on the staff is past president of the Central District Dental Assistants Society and also served as a Board member for the Georgia Dental Assistants Association during the past year Mrs Mary Sharpe dental hygienist is currently Chairman of Education for Central District Dental Assistants Society Besides the five licensed dental hygienists on the staff four dental assistants are now in training so that they will become eligible to take the dental hygienist examination The hospital cooperated with the Central District Dental Assistants Society in sponsoring an approved course in dental radiology The course was conducted for dental assistants and dental hy gienists by Dr William H Wege Chairman of the Department of Radiology of the Medical College of Georgia School of Dentistry The program provided a method for the dental assistants and dental hygienists to improve status by devoting some time to an organized course of study The Division sponsored a poster contest during National Childrens Dental Health Week and a large number of students enrolled in the Special Education School participated in producing a display of colorful posters which was viewed in the hospital auditorium by patients employees and the public An operating room was completed within the Central Dental Clinic within the past year for use by consultants in oral surgery in rendering oral surgical procedures to selected uncooperative patients This operating room has greatly improved services to patients The Division continues to cooperate with neighboring universities and colleges During the past year 71 dental students from Macon Junior College were allowed to render routine dental prophylaxes to patients thereby gaining valuable practical experience I102 RECREATION THERAPY DIVISION The acceptance of recreation therapists as members of the Unit treatment teams has contributed greatly to the success of the recreation program this past year In some of the Units the recreation therapist serves as cotherapist in group therapy sessions and in other Units he has been designated as a primary therapist for a particular group of patients ll Several innovative activities have resulted in an expanded recreation program which has involved additional patients during the past year In August six patients were sent from Unit 9 to compete in the International Special Olympics in Chicago It was not only an enlightening and exciting trip for them but provided an opportunity to gain public recognition for their ability to compete effectively at their own level The Special Olympics are sponsored by the Kennedy Foundation for the mentally retarded Central State Hospital residents also participated in the State Olympics in Atlanta in May and altogether 40 residents were involved Another unusual experience was the opportunity for some residents to spend two weeks at the Easter Seal Camp located at Winder Georgia Six of the 15 residents who participated were confined to wheelchairs The camping program included fishing archery horseback riding and various other outdoor activities iM Four patients from the Childrens Unit attended a twoweek session of daycamping sponsored by the Baldwin County Recreation Department They adjusted exceptionally well and made such a positive impression that Central State Hospital has been invited to participate again next year Each twoweek session involved 60 boys and girls between the ages of seven and twelve from Milledgeville and the Central State Hospital group was an integral part of this program In two of the Units hobby groups have been started for regressed patients not involved in any other therapy and who were referred by the ward physi cians Projects included simplified crafts not being done by other departments in the hospital Unit 9 recreation therapists have started a store group on Boone 7 and once a week patients from this ward are taken to the store to purchase items of their choice The primary purpose of this activity is to teach the patients how to budget their money and to obtain value received for what is spent A wrestling group organized in the Adolescent Unit is providing an acceptable means for release of aggression and hostility Also continued in this Unit was the junior bowling league which was expanded to include more patients Several Units formed additional Golden Agers clubs and the members of one of these made a trip to Lithonia to visit with the sponsoring volunteer group The trip proved very helpful to this group of Golden Agers103 Art groups are operating in two Units and one of these had an art show the past year which was so successful it is planned to sponsor a similar event on an annual basis The recreation therapist assigned to the new Alcohol and Drug Unit has also been able to assist in the Rivers building programs which has aided considerably in providing more effective supervision A oneday workshop in simplified crafts was sponsored by the Division with a series of demonstrations by representatives of craft companies A large number of patients participated in trips off campus during the year These included visits to Atlanta Braves baseball games Grant Park Stone Mountain and Six Flags and a trip was also made to Macon to visit the Indian Mounds and to ride the Nancy Hanks railroad train Patients also visited basketball games wrestling programs Holiday on Ice and the roller derby Other activities included visits to Eatonton to the Uncle Remus Museum and Rock Eagle to Lake Sinclair for picnics cookouts and swimming and down town on sightseeing trips shopping trips and to attend activities sponsored by local schools colleges and other groups Volunteers from the local community including students from Georgia Military College and Georgia College at Milledgeville added a great deal to the success of the recreation program Volunteers from Macon Atlanta and Lithonia were also active in the recreation therapy program at Central State Hospital The Master Plan for the location and development of future recreation facilities was completed during the past year It was set up by a graduate student at the University of Georgia and includes the development of the Colony Pond area so that full use can be made of this facility Funds are included in the budget of fiscal year 1972 to start implementation of part of the Colony Pond plan the completion of which should add greatly to the effectiveness of the recreation program The Division has continued to provide a clinical training program for students majoring in recreation from Florida State University and Georgia Southern College as well as from the Georgia College at Milledgeville Cooperative programs with the Volunteer Services Remotivation Occu pational Therapy and Music Therapy Divisions involved a large number of patients and were therapeutically successful Several new employees were added to the staff this year and members of the department participated in local regional and national conferences and institutes on recreation The Division members also provided lectures and presentations to students in nursing remotivators hospital staff members and community groups visiting the hospital 104 OCCUPATIONAL THERAPY DIVISION The objectives of this Division are to conduct a therapeutic program of manual and creative arts as part of the total patient treatment plan to provide opportunities for professional growth to support the efforts of other hospital disciplines and to promote community relations THERAPEUTIC PROGRAMS Thirtyfour programs were carried on with 3742 individual patients participating reflecting an increased patient load of 135 Clinic programs were deemphasized and more ward programs were initiated thus providing a built in screening method for promotion to clinics for more advanced acti vities andor attention to special goals Of the total patient load 134 were discharged or transferred to industry and 32 were furloughed Several clinics have moved to better physical settings and two have been combined for more efficient utilization of personnel and for program continuitv The clinic in the OT Center has been opened clients being drawn selectively from the entire hospital through the concerted efforts of occupa tional therapy with vocational rehabilitation social service and the medical staff iM Patients in all programs were involved in some phase of the special Project Footstool which had as its goals the making of 64 footstools for geriatric patients in Unit 3 New crafts including foil and fringe craft aluminum tooling phenolic plastics ceramic staining and tincan craft were initiated for program enrichment Emphasis continues to be placed on good grooming as a treatment modality with makeup grooming products and dress fabrics available for patient use Also stressed were socializing experiences both in regular programs and in those involving other disciplines Our planned special activities included fishing trips cookouts parties nature walks bus rides watermelon cuttings and other similar events with 16595 patient attendances noted EDUCATION AND PROFESSIONAL GROWTH The OT staff continues to further its capabilities and effectiveness by utilization of inhospital community and other opportunities These included craft workshops sewing modern math and the GED preparatory course as well as staff meetings courses in Modern Supervisory Tech niques and a Supervisory Development Seminar Five personnel are mem bers of the Georgia OT Association and one of the American OT Associa tion BQBBHMHH 105 Members of the Division filled lecture requirements for student nurses physicians psychiatric aides remotivation trainees and others for a total of 549 training hours I INTERDEPARTMENTAL COOPERATION In addition to the educational functions the Division assisted other departments with their activities such as movies dances recitals parties ballgames etc thus making possible 21842 more attendances than would have been the case Members were deeply involved in all phases of the Christmas Pageant from costumemaking through dressing and making up patients for the performance Patients in the Center clinic made giant three dimensional sunbursts to decorate the auditorium and the central dining room at Christmas A total of 1508 items at a cost of 2 14600 were made and issued to the hospital These included upholstery picture frames ceramics and functional equipment COMMUNITY RELATIONS Exhibits of patient work were held at the Athens Fair at a Medical Auxiliary meeting in Athens and at the Macon Friendship Club Our Gift Shop has been visited by people from as far away as Seattle Washington and Toronto Canada Staff members continue active in local organizations including Eastern Star American Legion Auxiliary Shrine and their various churches Services performed for the community included framing 167 pictures upholstering 44 pieces of furniture and a number of small repair and touchup jobs The hospital participated in the local Christmas parade the float being designed and constructed by occupational therapy personnel Visitors to our programs included college and high school students garden clubs etc for a total of 1048 in 46 groups Relatives and friends of patients also visited with frequency and were very responsive to and appreciative of the therapy given I106 MUSIC THERAPY DIVISION The fiscal year 1971 has shown a personnel force of twentyeight full time employees fourteen of which are music therapists eleven music thera py aides two interns and one secretary Program emphasis has been centered about quality of programming and increases in resident coverage Eight units a total of seventeen buildings are now being furnished with regular music therapy services and intermittent service is being furnished to the remainder of the hospital ADULT PSYCHIATRIC UNITS Each of the programs in the adult psychiatric Units which includes Units 1 through V has shown considerable emphasis developing in the area of ward programming The need for the therapists attention on the wardlevel has been pointed up clearly through a decline in the number of literate pa tients who need to learn selfhelp skills This is due to the hospital admini strations changing emphasis to therapy rather than mere custodial care N1 A portion of these ward programs are conducted by the music therapy staff members who work primarily with the patients in a given Unit while the remainder of the programs are led by a music therapist centrally assigned whose entire time is devoted to carrying out ward programs in all the Units ifc In addition to ward programs specialized music therapy activities consist of patient choir hand bell choir folk dance music appreciation rhythm groups social dancing and individual therapy offered through piano and voice lessons The music therapist prefers receiving referrals for these patients from the medical staff However the therapist at times finds it necessary to utilize patients introduced to them through ward rounds One of the outstanding problems of music therapy personnel in these Units is the coordination of the specialized music activities with the activities of other disciplines and the regular scheduling of participating residents Both of these problems are being studied by this department at the present time EMOTIONALLY DISTURBED CHILDREN AND ADOLESCENTS This departments program in the Childrens building offers each child a planned program of music therapy Activities include drum corp basic rhythms guitar choir and piano The therapist assigns music activities on an individual basis and according to individual needs Development of social and academic skills rank high on our list of goals The adolescent section of this Unit is receiving special programming which includes Teen Club adolescent band guitar and individual music in therapy In addition to the regularly scheduled music activities the music therapist acts as a member of the therapeutic team and assists in planning and carrying out largescale activities involving all the disciplines in Unit VIII These acti vities during the past year have included an adolescent basketball tournament107 January 1971 June 1971 CountryWestern Band January June 1971 1971 Instrumental Ccrrbo January 1971 June 1971 Ward Program Specialist Figure 2 Increases in Number of Patients served weekly by Centralized Programs108 St Patricks Day dance and all day excursions for swimming at Lake Sinclair Further emphasis for these young people is being planned for the future RETARDATION A severe staff shortage exists in this program One registered music therapist and one parttime aide are providing an outstanding program employ ing behavior modification in their music sessions The residents are being taught selfhelp skills intelligible and conversational speech response to verbal commands along with preacademic and academic skills The resi dents behavioral deficits determine the therapists goals for each individual involved in the Music Therapy program Therefore the teaching of adaptive behavior is our goal The role of the music therapist here has been expanded to not only include furnishing the Unit with goal directed music activities but also to act as a contributing member of the treatment team in improving channels of coordina tion and communication S M INSTRUMENTAL THERAPY The centrally controlled instrumental department has been organized to furnish much needed support to the Unit Music Therapy programs Five em ployees constitute two music groups One performs CountryWestern music the other popular dance music They respectively present over thirtyfive programs weekly and play for residents in six Units of the hospital A total of more than 1100 patients are entertained during this period of time In addition to this service each employee instructs patients in band orchestra and nonband instruments individually Both beginning and advanced bands are conducted for patients referred by Unit music therapists Twentyseven patients performed in this high level music activity in the course of the last year RESEARCH Structured attempts to explore the various uses of music in dealing with mental illness has produced several studies during the last year Of special note is the study which has been completed and submitted to the National Tournalof Music Therapy for publication entitled Operant Use of Guitar Rental to Decelerate Head and Face Touching in an Adult Male Psychiatric Patient by Dennis Carroccio Saralyn Latham and Beth Carroccio Five other studies for which data has been collected are currently being written for possible publication These studies use the severely and profoundly retarded males on award with training programs supervised by music therapy staff members They emphasize using music to teach a nonmusic skill or reward for learning such a skill109 20 15 10 I 1 Wards without ward programs U Wards given ward programs each week as of June 1971 I Wards given ward programs each week as of January 1971 7 Lfl 2 3 4 ADULT UNITS 5 Rivers Figure 1 Increases in Number of Wards Receiving Ward Programsno INTERNSHIP PROGRAM During the past year seven students successfully completed their six months internship in this department and became registered music therapists They represented Florida State University East Carolina University and the University of Wisconsin The Music Therapy Divisions clinical training program is the only one in the southeast approved by the National Associa tion for Music Therapy for a specialized internship with the retarded and emotionally disturbed children NEW PROGRAMS M 1 Effective June 16 1971 a new music therapist was assigned to the Rivers Hospital Along with the responsibility for all activities dealing with music in therapy this therapist will also serve as organist and choir director for religious services in the Unit Many plans are being developed to service these medicare diabetic and tubercular patients 2 A system of data collection has been developed by the Division of Music Therapy and is at present being used as a method of evaluation It is graphically showing such information as total number of hours spent with patient groups time spent in individual therapy time necessary for prepara tion and travel etc Another system is further examining the possibility of correlation between patients involved in music therapy activities and their furlough and discharge rates as compared to the overall hospital rate FUTURE PROGRAMS M Plans for an additional centrally operated program are now being formu lated Residents from all hospital Units will be eligible on a referral basis The initial plan includes teaching a class of illiterate patients to read utiliz ing music Many avenues will be examined to find new and more effective ways of raising the functioning level of longterm patients as well as means of aiding in the quick return of patients to their communities HIHIHH ui VOLUNTEER SERVICES 111 The Department of Volunteer Services has continued to serve the patients through programs and projects provided by volunteers and materials donated for their comfort and pleasure In looking back over the ten years that the department has been in existence it can be determined that many lasting friendships have been formed and at the same time it is interesting to recog nize annually the growth of the program through the establishment of new friends Such growth is indicative of the good relationship that has been established between the personnel and the communities and the effective utilization of the services recruited and offered Garden Therapy continues to be a major service to the patients There are currently thirteen garden clubs being sponsored by the Garden Club of Georgia Inc Fiftyfive volunteers from Milledgeville are directly involved with the program Tours arranged for the Garden Clubs to see the program in action activity slides and corresponding material for programs and displays at district and state meetings are used to keep the garden club members in formed throughout the state of the service they have made possible The new pavilion given to the hospital through the Garden Club of Georgia Inc has provided many hours of recreation for a variety of groups It has been in daily use throughout the seasons suitable for outdoor activities The workdays for the Georgia Hairdressers and Cosmetologists Associa tion were perhaps the most exciting to date For the first time black hair dressers were included in the group During the three organized workdays 144 volunteers served 42 0 patients gave 109 cold waves 410 shampoos and 220 haircuts along with other related services In addition five black senior barbering students from an Atlanta barber college gave haircuts through out one mens building The hairdressers organization contributed 350 to be used for purchase of additional equipment for beauty shops The highlight of the art therapy program was the art show in clothesline fashion which depicted the years work The volunteers have exhibited much enthusiasm in their work with the patients who in turn have responded well to this type therapy The Apparel Shop has continued to provide an invaluable service throughout the hospital to those patients who remain in the hospital as well as those who are transferred to nursing homes to rehabilitation houses and to other facilities The shop has been well supplied through donations of many tons of new and used clothing During the year 3690 individual patients were served in 8534 visits to the shop In addition to the services rendered this facility has proved to be an invaluable training area under the Vocational Rehabilitation program for sales persons The Apparel Shop is currently operating from a building which is most inadequate and one that is in a de plorable condition If adequate facilities were available additional and 112 M improved services could be provided Plans have been completed for a Volunteer Services complex which includes an excellent Apparel Shop area Such a building is needed so that all Volunteer Services activities can be under one roof which will provide for more adequate supervision and for im proved services to the participating volunteer groups and individuals and to the patients The Alcoholics Anonymous group functions as strong as ever under the leadership of AA Groups from Milledgeville Dublin Monticello Macon Warner Robins Sandersville and Louisville In addition to serving as a program to aid the hospitalized alcoholics and drug addicts these weekly meetings are used as a training aid or laboratory setting for student nurses and special classes conducted for teachers under the direction of a college professor The Central Patients Library was officially opened to the patients on March 31 1970 During this time 3 152 patients have visited the library and 1940 books have been checked out The number of books available to the patients has increased to 2808 There are also 500 paperbacks which the patients have access toon a bring one take one basis Fortyfive period icals and 15 newspapers have been donated to the library As an added service a reading club was organized during the summer of 1971 The mem bership has grown to 54 and has served to generate much interest This is indeed an outstanding service to those who enjoy this form of therapy kM One patient assists the librarian under the Vocational Rehabilitation program A severely handicapped young man from the local community works onehalf day each day in the library He did this totally on a volunteer basis until February 1971 when the Tenth District of the Georgia Federation of Womens Clubs began contributing 20 per month so he could have spending money His services have proved most beneficial and at the same time has made this young man feel that he can make a contribution to society The Social Service departments in Units III and V have most effectively used high school students and adult volunteers in carrying out special projects and programs Their goals have been geared toward helping the patients to develop areas of basic competence necessary for independence and self respect learning to interact with each other in an informal manner providing them with opportunities to practice basic social skills and group decision making Students from Georgia College have been an asset to the staff of the Childrens Unit by providing manpower for additional activities to operate the token store as apart of the behavior modification program to interact with the patients in playground activities and as tutors for those attending the School of Special Education who need assistance Christmas 1970 was another memorable occasion for the patients TheBBS H 113 Georgia Municipal Association sponsored MDay with the event being staged at Central State An adequate quantity of good quality gifts was received from MDay participants school and church groups mental health associa tions individuals and service civic and fraternal organizations Seasonal denominational parties sponsored by the local churches with statewide financial support and other special group parties helped the patients to enter the spirit of Christmas Christmas cards for the patients to send to their friends and relatives were furnished through Miss Laura Watson who for 30 years served as Christmas Card Lady She has now retired due to ill health and the phase of her work involved with making tray favors for the bed patients has been assumed by a new Christmas Card Lady Mrs Carolyn Seivers also of Atlanta Plans have already been completed for cards to be made available to the patients in 1971 from other voluntary contributions There are currently 300 Forgotten Patients who are being sponsored by individuals and organizations who send gifts andor spending money once a month This has meant a great deal to these indigent patients who are en tirely dependent on the kindness and generosity of others The Hoxie Brothers Circus performed for the patients for the fourth straight year and each years performance seemed to surpass the one of the previous year The last of the funds raised through the campaign waged by WSB Radio Station in Atlanta were utilized in 1971 Mr Elmo Ellis General Manager of WSB has advised that they will again sponsor the campaign to raise funds for the circus This is to be conducted either in the fall or winter of 1971 Donations and special projects play a major role in a variety of programs and projects throughout the institution Some outstanding examples are a fraternity from the University of Georgia that gave the entire proceeds from their annual fundraising project for the purchase of rocking chairs for the Jones Hospital the C S Bank employees from Athens raised funds to pur chase some playground equipment for a small playground area in the Mental Retardation Unit stage curtains and lighting equipment for the Unit III recrea tion room and day room furniture for Rivers Hospital given by the Chatham Savannah Mental Health Association day room furnishings for Walker building by Columbus United Church Women two washing machines and one dryer by the Georgia Jaycettes heavyduty fans for Unit V donated by Region 18 Jay cettes numerous nursing home kits filled with toilet articles to be given to patients transferring to nursing homes A total of 7385 was donated through Volunteer Services Department to aid in supplementing services and materials for the patients added comfort pleasure and therapy An additional amount of 8641 was expanded by the Garden Therapy Treasurer in the support of the Garden Therapy programs I s I114 LT 5 I REMOTIVATION DIVISION The Remotivation program continues the structured approach on three levels of treatment The first level emphasizes therapy to the regressed aged untidy noncommunicative mentally retarded individual on a oneto one basis or in a small group activity The approaches used concentrate on basic functions inherent to human beings such as personal cleanliness neat ness in dress habit training grooming acceptable eating habits communi cating with others and physical fitness Parties hobbies etc are employed as treatment techniques on improvement trips The worth dignity and indi viduality of each resident is recognized and increased in this program The second level includes formal remotivation group discussions held at least once a week with a group of eight to twelve residents Groups are evaluated after twelve weeks progress is noted and weak points are rein forced The third level includes advanced remotivation groups who are involved in learning experiences and many phases of outside living As these resi dents progress they are involved in other therapies and all phases of hospital life The Remotivator in each area coordinates his program with each of the special therapies as much as possible thereby giving a greater emphasis to more residents through coordinated efforts u Bulletin board prints posters etc orient residents to holidays and current events Clocks and handmade calendars assist patients in orientation in time Remotivators are constantly searching for new interests and innovative programs for the residents For instance the use of cake icing was employed to make Christmas decorations panorama Easter eggs and decorations for other events thereby providing the residents with a simple technique for everyday living In the Mental Retardation Unit Nursing Service has assigned a third aide as a full time remotivator As part of the personal care project regressed and physically handicapped residents are taken to the beauty shop for pro fessional hair care and styling One remotivator has organized a dance band including himself and mentally retarded patients They furnish music for ward parties and regular dances The wheelchair residents join in the fun and rhythm of these events Three training institutes were held during the year providing remotivation technique training for hospital employees as well as personnel from other hospitals and institutions in the southeastern area These institutes created particular interest among nursing home delegates who hoped to use remotiva tion techniques with their patients 115 APPENDIX ADMISSION RATES PER 100000 ESTIMATED CIVILIAN POPULATION ONBOOK POPULATION RESIDENT PATIENTS ADMISSIONS AND CONVALESCENT LEAVE FOR TENYEAR PERIOD 9621971 RESIDENT POPULATION BY MENTAL DISORDER TYPES OF MENTAL RETARDATION ADMISSIONS DISCHARGES AND DEATHS BY AGE DEATHS AND DISCHARGES BY TIME ON BOOKS RESIDENT POPULATION BY COUNTY FOURYEAR COMPARISON OF COUNTY ADMISSIONS COMMUNITY MENTAL HEALTH PROGRAMS COMMUNITY MENTAL RETARDATION DAY CARE AMD TRAINING COMMUNITY ALCOHOLISM PROGRAMS RESIDENT PATIENT BREAKDOWN AS OF APRIL 301971 SERVICE AREAS FOR STATE HOSPITALS ROSTER OF PROFESSIONAL STAFF 116 117 118 119 120 121 122 1236 127 128 129 130 131 132 116 ADMISSION RATES PER 100000 ESTIMATED CIVILIAN POPULATION BY COUNTY OF ADMISSION FISCAL YEAR ENDING JUNE 30 1971 13 ill kM Legend 0 1000 1001 1500 J 1501 2000 2001 and Over 1 X I WORTH O uH A DOUGHERTY f 4 I A R L Y IBAKEH JCkiil yMl T C HE L L t j J ggggHgggttUnUmmUK 10 11 12 13 14 15 16 17 18118 M M ri D J 1 c l l fk Iks l kv l lFJ l OOOO It 1 7ooO f V JJ X Xi 11 X l 6000 HH it V U 4X X XiX j O rrs h H11 j 15 I sOOO cr 41 h X h v X XI X X X i X X la it X 1 X x4 41 1 r r j C3 j 1 H h X H j r 551 Si iN it X X S P5T VOOO f X if n ft X r If 5 X 4X i T3 it X K r S IN TO ffi jo nq m 5 tr 1 X 1 S M f Cv 3 0 X X Ji H 00O X 1 X P3i C2I vw 1 g oX s y 0 0 isq TC ft 12 F4 Jt I TrT t x x 6 3 yi H ix Xr 3 n cs tcj t3 1H ET O T Ph tt IB 0 T iOOO S 1 I it Xi XX Wy p vt b jj IX X X X n Cri 1 11 11 1 H r rn Hr iii ru 1 ff iJ jf tu tj fiL T IH Jl f xr 5 x XEf X r St X xt ar isg 2C Sf St Tl S5X in Innn 0 x xi x ir St tr 1 iisr bt 2t XX 1 f1 3 fr pt h C CD tr r r ftttttt Bim 119 SOS H WFF m EE Ifc 0 mil B EKE iiSl JJJE 172 tal ecebshlrb OT ft 2j IfeMemiIjEfeiHS fflB lELEESO 20 CGI W pa rm mnm ttAGE l52f 253 35M if55 556 657 7581 85 and un51rf1V14Vol1er 1500 No of Patients 100 IH Al DEATHS AND DISCHARGES BY TIME ON BOOKS 121 I TIME ON BOOKS 011 Months 1 Year 2 Years 3 Years 4 Years 59 Years 1014 Years 1519 Years 2024 Years 2529 Years 3 0 Years and Over DEATHS 9 64 33 44 29 85 37 31 19 20 329 DISCHARGES 43 1929 686 375 265 593 205 164 154 121 3789 TOTAL 700 8324M 122 RESIDENT POPULATION BY COUNTY M r APPLING 2k ATKINSON 12 BACON 19 BAKER 9 BALDWIN 135 BANKS 0 BARROW 33 BARTOW 59 BEN HILL 35 BERRIEN lit BIBB 385 BLECKLEY 2h BRANTLEY 9 BROOKS 32 BRYAN if BULLOCH it8 BURKE 37 BUTTS 17 CALHOUN 12 CAMDEN 13 CANDLER 17 CARROLL 75 CATOOSA 27 CHARLTON 13 CHATHAM 292 CHATTAHOOCHEE 5 CHATOOGA 30 CHEROKEE 16 CLARKE 87 CLAY 10 CLAYTON 9 CLINCH 7 COBB I2lf COFFEE 31 COLQUTTT 66 COLUMBIA 19 COOK 3 COWETA 71 CRAWFORD i2 CRISP 38 DADE 13 DAWSON DECATUR 39 DEKALB 300 DODGE 5 DOOLY 22 DOUGHERTY 1Q0 DOUGLAS 9 EARLY 2 ECHOLS 0 EFFINGHAM 5 ELBERT 37 EMANUEL 18 EVANS 9 FANNIN 30 FAYETTE 17 FLOYD 122 FORSYTHE 26 FRANKLIN 16 FULTON 1227 GILMER 23 GLASCOCK 9 GLYNN 75 GORDON he GRADY 25 GREENE 22 GWINNETT 77 HABERSHAM lf6 HALL 101 HANCOCK 32 HARALSON 3 HARRIS 22 HART 2i HEARD 5 HENRY 25 HOUSTON 69 IRWIN lit JACKSON 33 JASPER 20 JEFF DAVIS 18 JEFFERSON 31 JENKINS 25 JOHNSON 20 JONES 19 LAMAR 30 LANIER 7 LAURENS 78 LEE 6 LIBERTY 21 Lincoln 10 LONG If LOWNDES 78 LUMPKIN 16 MACON 29 MADISON 37 MARION 7 McDUFFIE 18 McINTOSH 10 MERI WETHER lf6 MILLER 10 MITCHELL 30 MONROE 28 MONTGOMERY 9 MORGAN 10 MURRAY 16 MUSCOGEE 26 NEWTON l8 OCONEE 10 OGLETHORPE 21 PAULDING 29 PEACH 37 PICKENS 19 PIERCE 9 PIKE 28 POLK 67 PULASKI 31 PUTNAM 20 QUITMAN 2 RABUN 15 RANDOLPH 29 RICHMOND 181 ROCKDALE 26 SCHLEY 5 SCREVEN 25 SEMINOLE 7 SPALDING 10 STEVENS 27 STEWART 27 SUMTER 18 TALBOT 15 TALIAFERRO 5 TATNALL 30 TAYLOR 18 TELFAIR 29 TERRELL 29 THOMAS 59 TIFT 3 TOOMBS h9 TOWNS 5 TREUTLEN 8 TROOP 91 TURNER 22 TWIGGS A7 UNION 12 UPSON 56 WALKER V WALTON h5 WARE 9 WARREN 11 WASHINGTON 33 WAYNE 27 WEBSTER 6 WHEELER 8 WHITE 12 WHITFIELD 102 WILCOX 11 WILKES 23 WILKINSON 27 WORTH 28 TOTAL 7W7FOURYEAR COMPARISON OF COUNTY ADMISSIONS l 123 COUNTY YEAR OF ADMISSION 1968 1969 1970 1971 TOTAL Appling 17 15 24 19 75 Atkinson 1 9 8 5 23 Bacon 26 33 31 35 125 Baker 1 1 2 2 6 Baldwin 144 127 176 229 676 Banks 7 9 6 9 31 Barrow 52 39 40 52 183 Bartow 73 46 69 95 283 Ben Hill 37 37 41 32 147 Berrien 19 23 34 37 113 Bibb 273 279 333 562 1447 Bleckley 23 14 19 25 81 Brantley 13 20 12 13 58 Brooks 16 18 15 17 66 Bryan 16 13 11 13 53 Bulloch 32 36 32 39 139 Burke 19 20 24 20 83 Butts 27 17 24 25 93 Calhoun 4 11 12 11 38 Camden 12 13 14 8 47 Candler 17 5 8 10 40 Carroll 66 58 67 68 259 Catoosa 34 40 39 32 145 Charlton 5 8 12 7 32 Chatham 161 167 184 189 701 Chattahoochee 4 0 1 2 7 Chattooga 24 23 36 36 119 Cherokee 58 45 40 53 196 Clarke 118 112 116 124 470 Clay 7 10 4 6 27 Clayton 88 82 76 72 318 Clinch 15 12 11 11 49 Cobb 237 194 211 213 855 Coffee 29 35 43 48 155 Colquitt 54 49 46 42 171 Columbia 32 24 34 22 112 Cook 16 17 14 18 65 Coweta 70 63 56 66 255 Crawford 10 8 7 10 35 Crisp 32 36 28 29 125 Dade 17 15 11 5 48 Dawson 9 8 12 9 38 124 N COUNTY OF ADMISSION YEAR 1968 1969 1970 1971 TOTAL Decatur 47 32 27 31 137 DeKalb 300 274 231 251 1056 Dodge 24 31 60 56 168 Dooly 26 20 18 13 77 Dougherty 106 96 84 96 382 Douglas 29 38 56 41 164 Early 26 20 18 14 78 Echols 5 0 0 1 6 Effingham 19 7 7 7 40 Elbert 28 41 38 23 130 Emanuel 52 56 51 60 219 Evans 12 11 17 14 54 Fannin 18 21 24 33 96 Fayette 10 13 6 8 37 Floyd 101 103 76 97 377 Forsyth 25 23 29 25 102 Franklin 23 31 24 16 94 Fulton 873 800 771 856 3300 Gilmer 21 24 19 32 99 Glascock 6 9 6 6 27 Glynn 82 91 89 108 370 Gordon 41 40 32 43 156 Grady 33 23 35 13 104 Greene 15 17 20 20 72 Gwinnett 92 85 99 119 395 Habersham 32 36 30 33 131 Hall 107 135 154 162 558 Hancock 24 17 27 40 108 Haralson 29 29 28 50 136 Harri s 11 18 9 12 50 Hart 24 24 24 24 96 Heard 5 8 2 8 23 Henry 24 28 27 19 98 Houston 71 55 73 94 293 Irwin 12 7 13 9 41 Jackson 31 22 38 50 141 jasper 15 13 19 14 61 eff Davis 20 24 31 47 122 Jefferson 29 20 14 28 91 Jenkins 17 17 14 15 63 Johnson 26 21 19 35 101 Jones 21 19 24 25 89 La mar 20 19 2 5 40 104 125 COUNTY OF ADMISSION Lanier Laurens Lee Liberty Lincoln Long Lowndes Lumpkin Macon Madison Marion McDuffie Mclntosh Meriwether Miller Mitchell Monroe Montgomery Morgan Murray Muscogee Newton Oconee Oglethorpe Paulding Peach Pickens Pierce Pike Polk Pulaski Putnam Quitman Rabun Randolph Richmond Rockdale Schley Screven Seminole Spalding Stephens Stewart YEAR 1968 73 3 19 13 7 52 16 31 22 8 56 5 30 10 37 28 13 11 12 166 58 13 14 45 39 16 9 14 58 24 16 2 21 21 24 29 4 19 6 105 24 14 1969 9 59 3 24 6 1 38 14 15 21 5 61 7 31 9 16 23 9 9 8 187 55 14 8 46 32 13 10 9 52 14 15 1 17 12 160 24 4 17 10 97 30 1970 5 80 3 18 5 2 48 17 14 17 12 53 13 27 6 23 25 13 11 12 172 57 49 27 19 8 9 61 21 32 2 25 16 181 29 3 13 4 95 33 7 1971 123 6 23 4 6 54 17 11 31 11 43 6 44 7 18 33 13 19 8 227 63 8 13 41 41 16 7 10 40 31 24 3 17 14 172 32 4 6 10 125 26 11 TOTAL 30 335 15 74 28 16 192 64 71 91 36 213 31 132 32 94 109 48 50 40 752 233 43 43 181 139 64 34 42 211 90 87 8 80 63 761 114 15 55 30 422 113 40 I126 3 M ton1 COUNTY OF ADMISSION YEAR 1968 1969 1970 1971 TOTAL Sumter 34 30 27 32 123 Talbot 13 10 10 9 42 Taliaferro 4 2 5 5 16 Tattnall 20 18 20 19 77 Taylor 6 7 4 13 30 Telfair 29 28 29 33 119 Terrell 15 17 10 15 57 Thomas 76 44 65 35 220 Tift 31 29 32 41 133 Toombs 55 51 62 73 241 Towns 6 6 2 7 21 Treutlen 14 16 22 21 73 Troup 67 76 66 83 292 Turner 16 12 11 18 57 Twiggs 18 13 11 8 50 Union 12 19 13 15 59 Upson 32 37 58 66 193 Walker 95 77 66 97 335 Walton 66 57 62 81 266 Ware 64 99 65 80 308 Warren 17 6 8 5 36 Washington 42 27 46 47 162 Wayne 32 28 49 28 137 Webster 1 3 5 0 9 Wheeler 11 12 5 7 35 White 7 4 2 13 26 Whitfield 81 91 123 166 461 Wilcox 9 9 10 14 42 Wilkes 27 14 23 13 77 Wilkinson 24 21 21 26 92 Worth 22 15 19 17 73 TOTAL 6802 6290 6625 7521 27238 127 COMMUNITY MENTAL HEALTH PROGRAMS LEGEND Program Location Counties Participating in Mental Health Programs As of 3171 31271128 COMMUNITY MENTAL RETARDATION DAY CARE AND TRAINING PROGRAMS April l 1971 ht M j CATOOSA C FANNIN S TOWNS Li JM s K i I I r I MURRAY UNION A I ly WHITFIELO 1 L WALKER J J k GILMER rl HABERSHAM WALKER I S Aa A LnKr i LUMPKIN 1 DN L pitkfuk A sILKrJ i LUMPKIN I f GORDON Xn CHATTOOGA I pCKENS I y ji j oawson I u t A J HALL 1 FLOYD j BARTOW CHEROKEE FORSYTH J A I j rj v V A A CHEROKEE FORSYTH I N Y JACKSON MADISON ELBERT 7TI M v i S ca GwNNETT c ULOING K Wk CObo PAULDING 1 l OEKALB 7 U A VS ALT0N X RALSON 1 jll OEKALB 7 j T a a v AlT0N I DOUGLAS FULTON i 4k N CARROLL i A i rVA V NWfl T ik ICLAVTON V MOWAN GREENE taLIAFERRO mcOUFFIeV COLUMBIA HEARO A A TROUP COWETA x dll ii A TVA 1C A CLAYTON V S J A NEWTON jr P A Jx 1 FETTEV J HENRY SJ Li r Y PUTNAM AREN C RCHMDND BI Vf jasper j s ly SPaTSnG BUTTS I J HANC0C VA V A GLASCOCK PIKF I AUAR M JEFFERSON i PIKE LAMAR MERIWETHER J MONROE STEPHENS BANKS FRANKLIN HART LEGEND Health Department Operated Private Purchase of Service Programs A Private Programs Kl Cii CI rnvuie rrograms No State Funds OCONEE y OGLETHORPE r1 7 WILKES LINC0L BURKE jkon hana ABIBA Y HARRIS v t TALBOT J V J CRAWFOR fiV TWIGGS V JENKINS SCREVEN T JOHNSON s EMANJEi r I AM J I r TAYLOR VX PEACH i mgnmf r v A l I1 HOUSTON fBLECKLEY LAURENS y N j BULLOCH f f I ri y TREUTLEN CANOLER EFFINGH QhaTTAHOOCHEe mabion I LI MACON j T i Xx L schley 1 J x 1 r x JLASKI f I x OOOGE Vj I TODMBS EVANS i sWHEELER if 1 v 1 OOOLY EBSTERr SUMTER L CRISP JTx v X BRYAN Nj CHATHAM X i TATTNALL T B S V I i j LEE j TERRELL ii 4 RANDOLPH LsJ CLAY 1 I CALHOUN DOUGHERTY JA X J LIBERTY 11 w sf I ir BEN HILL TURNER j I 1 TS mWN J COFFEE 1 r t 1 t i a lL 1 pierce tvr r U k 3 ATKINSON J GLYNN T BRANTLEY 7i i I BERRIEN COLOUITT y COOK 1 j I I WARE L LLTLANIER LOWNDES j I0MAS BROOKS j J 1 r 1 A 7 7 HHHHllflHHBBBHHHlHHHBHIIBHHHHBiHHIHBMI 129 COMMUNITY SERVICES BRANCH DIVISION OF MENTAL HEALTH GEORGIA DEPARTMENT OF PUBLIC HEALTH LEGEND Community Alcoholism Programs Location Proposed or in Planning Stages 31571foil 130 RESIDENT PATIENT BREAKDOWN AS OF APRIL 301971 INSTITUTION Central State Hospital Gracewood State School and Hospital Southwestern State Hospital Georgia Mental Health Institute Georgia Retardation Center Atlanta Regional Hospital Augusta Regional Hospital Savannah Regional Hospital Battey State Hospital MENTAL RETARDATION 1625 1586 517 349 120 39 49 MENTAL ILLNESS 6017 524 142 279 257 45 TOTAL 4285 7264 JUNE 1971 Division of Mental Health131 fANNM f 1 mum w NORVMEsTj CMTVo f CHJ I UN W J JJ WWTI f HMIH1N4M r I i LUMPKIN I V j V Tt J I L06 ftHrow HlL V y T FMMUJN MAUT i coti rftfoifXJKffrEfaf tOU X l PAUlOlNC orturt Ai lUVu MADISON V itST CtAAMC OCONCI OOLCTHOItPC WALTON J V STATE OF GEORGIA Service Areas for State Hospitals NEW TON MOaUN OJtltNC WILJ LINCOLN r I MCDOffH COLUMBIA tNt rcintii r w V lt f7 UTT1 1 r HaNCOC OLASCOCM 1 V RKMUONO 7 r T f IK I MAN TROUP MrIWITHIM fcALOWIW y GRfi LfJ a rWeTCEJ4TRAL f frK2tNTRAL TALiOT J WILKINSON V L ca wrong TWi0M V V3S RHAUCUSTA ICM K r tuTTMOKMU UiJIlON I H HOUSTON STCwir J1Tr UUTO L VJ tucntir UtAKI I DODOC WILCOX V TCLfm iULLOCK CAHOLIW 7 V tPFINOMAM CV4HS I L KHIU I woTM V clhoun ooucMtnTYMr M corrtt s n rLTT v LONO T CrSjJBTrfWESJ J J MlTCHtLL I HHMIC1 MliLM COLQUTT I I i COOK r rr rtjLAJ AILING r N X ACON WAYMC w J AT HI H JON J V 1 MC INTOSM i X z I J t anact V r ANTLIT LStMINOLl A r i THOMAJ oOKJ r S r CLINCH S 1L j 7 i 132 MEDICAL DEPARTMENT James B Craig MD Superintendent M L Sheppeck MD Assistant Superintendent Clinical JohnW Kemble MD Assistant Superintendent Education Training Research W T Smith MD Clinical Director Psychiatric Service E F Stincer MD Clinical Director Psychiatric Service UNIT I h1 n Santiago Aguilar MD Director Jose de la Torre MD Psychiatric Resident Maria Dourron MD Staff Physician Nestor Dourron MD Psychiatric Resident Jose Delgado MD Psychiatric Resident Hugo Galletti MD Deceased Staff Physician Muhammed Karatela MDPhysician Specialist I Jesus Llobet MD Psychiatric Resident Ricardo Mesa MD Staff Physician B E Orosdy MD Staff Physician Zelma Ozolins MD Staff Physician Jacinto Regalado MD Psychiatric Resident Raul Rivero MD Staff Physician Olando Rojas MD Psychiatric Resident Adolph Sarma MD Staff Physician UNIT II Eduardo Guernica MD Director M Aslam Sandvi MD Physician Specialist I Marta Bosch MD Physician Specialist I Tomas GarciaMontesinos MD StaffPhysician Humberto Ravelo MD Physician Specialist I Roberto Rey MD Physician Specialist I Vilis J Zakitis MD Chief PhysicianHH UNIT III 133 Jose Mendoza MD Director Eugene Christian MD Physician Specialist II Francisco Huerta MD Staff Physician Moises Jacobs MD Staff Physician JuanLlambes MD Staff Physician Rafael Pascual MD Staff Physician R S Planas MD Staff Physician Hector Sotolongo MD Staff Physician UNIT rv Charles A Rich MD Director John Azzi MD Staff Physician Ramon Berenguer MD Senior Staff Physician Thomas Bullock MD Physician Specialist I Marta Dzirkalis MD Senior Staff Physician Clifford Harden M D Physician Specialist I Mario de Laosa MD Chief Physician N T Soorya MD Physician Specialist I John J Word MD Physician Specialist II UNIT V Lorenzo del Portillo MD Director Jose Bernardo Garcia MD Staff Physician George Grant MD Physician Specialist I Isidro Insua MD Staff Physician Manuel Pena MD Senior Staff Physician Carlos PerezAbreu MD Senior Staff Physician Roberto Perdomo MD Chief Physician Carlos GarciaRivera M D Senior Staff Physician Jose Rouco MD Physician Specialist I UNIT VI Carl Smith MD Director Ernesto Giro MD Physician Specialist I Victor Ubieta MD Senior Staff Physician 134 UNIT VII E F Stincer MD s Miguel Bosch MD Physician Specialist I Diego Sans MD Psychiatric Resident UNIT VIII Juan Portuondo M D Director Francisco Borges MD Psychiatric Resident Jose Gonzales MD Physician Specialist I Oscar Medina MD Psychiatric Resident Juan Perez MD Psychiatric Resident Odelia Zapatero MD Physician Specialist I UNIT rx E F Diaz MD Director Manuel Estrada MD Chief Physician Rene Montero MD Physician Specialist II Luis Samper MD Physician Specialist II Juan Trejo MD Staff Physician Emilio Yero MD Deceased Staff Physician UNITX S A Mendez MD Director Armando Gutierrez MDPhysician Specialist I NEUROLOGY John W Kemble M D Director Guida Graciaa MD Psychiatric Resident Olga Medina MD Psychiatric Resident RESEARCH Clyde Keeler ScD PhD Director G R Courtney ODNeurophysiologist Jerry Curtis PhD Biochemist PSYCHIATRIC RESIDENCY TRAINING Louis Jacobs MDDirector E F Stincer MD Supervisor Jose Rubio MD Deceased SupervisorNURSING SERVICE Bernice H King RNActing Nursing Service Administrator Vera W Knowles RN Assistant Nursing Service Administrator 135 DIRECTORS OF NURSING Ouida Couch RN Unit I Mary A Bell RN Unit VIII Fay Fidler RN Unit II Virginia Smith RN Unit IX Ruth Mullis RN Unit IV Janet Smith RN Unit X Mildred Daniel RN Unit V Irene Wood RN Jones Hospital Edna Ross RN Unit VI Valeria Atchison RN Rivers Hospital PSYCHIATRIC OUTPATIENT CLINIC Ellen Moncrief GN NURSING EDUCATION AND RESEARCH Maidana K Nunn RN DNSc Assistant Nursing Service Administrator PSYCHIATRIC AFFILIATION PROGRAM Beatrice Tribble RN ABNurse Supervisor Pauline Anderson RN Senior Staff Nurse Gertrude Thigpen RN Senior Staff Nurse Gloria A Williams RN Senior Staff Nurse Alice K 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 Margaret E Tanner RN Senior Staff Nurse Clinical Instructor Unit I Gladys Moore RN BS Senior Staff Nurse Clinical Instructor Unit III Lucille Brannan GN Staff Nurse Clinical Instructor Unit V Mary H Thomas RN Senior Staff Nurse Clinical Instructor Unit VIII Ruth Leverette RNSenior Staff Nurse Clinical Instructor Unit IX Lee Bell RN Senior Staff Nurse Clinical Instructor Rivers Hospital Faye Wilson RN Senior Staff Nurse Classroom Instructor Georgene Eakes RN Staff Nurse Classroom Instructorr 136 CLINICAL PSYCHOLOGY b Robert W Wildman Ph D John 7 Gates PhD Thomas W Lucik Ph D Thomas N Elliott Ph D i Robert D Smith PhD 0 Lawrence F Quattlebaum MS G F Biessel MS F L Madison MA r INTERNS G F Biessel MS Carolyn Widmer AB William Peel MS SENIOR TECHNICIANS Tedd Brown AB Carlton L Lanier MA P J Alice Lee Canipe MS G R Dixon AB Kenneth Varnadoe MA Douglas Watson MA l Carolyn Erickson MA Robert W Wildman II MS Ivor Groves MA B F Williams MEd Wayne Hodges BS y TECHNICIANS Edward Amos BA Raymond C Olivier BA Roger Bell BA Polly Paul MA Michael Brush BA James Resseger BA kP 11 Pete Christian BA Joanne Rogers BA r Lane Dennard BA Larry Sheppard AB h Larry Dresdale BA Jackie Shivers BA Marilyn Edmiston MA Lesley Slone MA Donald W Harris BA Deborah Smith BA 7 Steve Hollomon MA Tom Wilkinson BA E 0 SCHOLARSHIPS Edward Amos BA Carlton L Lanier MA Carolyn Erickson MA Raymond C Olivier BA Y James D Foulks BS Dennis Pilgrim MA Alice Lee Groves MS Jerry Sloan BA Ivor Groves MA Robert D Smith PhD Wayne Hodges BS HMIilMHIWMMMiHH SOCIAL WORK Kenneth F Jasnau MSS ACSW Director E O Melton MSW A CSW Assistant Director Martha C Tomlin MSW Social Worker III Pat Allen MSW Social Worker II Carol Andrews MSW Social Worker II Nancy J Autry MSW Social Worker II Roy H Brown MSW Social Worker II Sandra E Evans MSW Social Worker II Lynne Feagin MSW Social Worker II Carolyn Grant MSW Social Worker II Joseph T Hodge MSW Social Worker II Patricia R Karatela M SW Social Worker II Allie Kilpatrick MSW Social Worker II Jimmy D Lanier MSW Social Worker II Walker McKnight MSW Social Worker II Rosa C Mendoza MSW Social Worker II Kirk C Minor MSW Social Worker II Robert M Rhymes MSW Social Worker II Janet E Scott MSW Social Worker II Doris T Sutton MSW Social Worker II Gwendolyn G Turner MSW Social Worker II C Paul Wright MSW A CSW Social Worker II Suzanne R Wright MSW Social Worker II E Alton Gregory MSW Social Worker I Louise H Powell BA Social Worker I John W Prather MSW Social Worker I TECHNICIANS 137 Truett Abbott AB Annette Acree AB Nan W Baird AB Renwick F Bradley AB Susan R Brooker BA Rosemary Brown BA Ludwina Bull B S Janet E Clark BA Elizabeth Collins AB Charles C Connor BA Holley Cowan AB Yvonne Everett BA James F Hamlin BA Darryl Herren AB Will a Hertwig BS Gayle Hooks AB Horace P Horton BS Sarah F Ivey BS Kaye Lanier AB Jeannette Lewis AB Charles C Lowery BA Wilbur Manson BA M Andres McCollum BA J Michael McCroskey BA Wanda McKnight AB Martha McLaurin BA June Moore BA Eloise B Myles BA R Michael Owens BA Frances B Rogers BA Alton Scott BS Mary Ann Simmons BA Madelyn C Spivey BS Joan Venable Thompson BS Herbert Turk BA Jewell J Turner AB Harry C Weathers BA Patricia Weerts BS Rubye M Wright BA138 SOCIAL WORK AIDE Carrie Smith SOCIAL WORK SCHOLARSHIPS Nancy J Autry Yvonne Everett E Alton Gregory Jeannette Lewis M Andrew McCollum John W Prather Robert Rhymes Doris T Sutton Gwendolyn G Turner Jewell Turner Harry Weathers CLINICAL CHAPLAINCY G I u James L Travis ThM Director Milton P Snyder ThM Chief Clinical ChaplainChildrens Division Ronald A Wilkins ThM Chief Clinical ChaplainTraining Charles Alston BDClinical Chaplain James E Carter BD Clinical Chaplain Payton B Cook BD Clinical Chaplain Oliver Benton Curtis BD Clinical Chaplain Russell H Davis Th M Clinical Chaplain Joseph S Dukes III BD Clinical Chaplain James F Hardie MA Clinical Chaplain William M Hearn BD Clinical Chaplain Robert Z Powell ThD Clinical Chaplain Joseph G Cassidy ABCatholic Chaplain Harold L Gelfman D DRabbi Ervin R Oermann BDChaplain to the Deaf Charles B Fanshaw MREChaplain to the Deaf RESIDENTS H Dean Duke BD L Leneal Fortner BD James C Polich MDiv INTERNS John D Call BD James G Davenport MDiv James E Davis MDiv Benjamin B Fore BD William W Goins ThM Robert F Gray BD Edward B Nelson BD Kirby L Pickus M Div Frank J Powers MDiv MMMHHllflMMMI 139 RECREATION THERAPY Bruce R Prosser BS MSDirector Helen M Callaway BS Recreation Therapist II Wayne Gay BS Recreation Therapist II Janice L Landry BS MS Recreation Therapist II Lyndoll U Moore AB Recreation Therapist II Ronald R Smith BS Recreation Therapist II Charles M Vandiver BSRecreation Therapist II Anna G Warnock BS Recreation Therapist II Betty J Welch AB Recreation Therapist II Ronald Farmer BS Recreation Therapist I Charles Parramore B S Recreation Therapist I MUSIC THERAPY Saralyn Latham MADirector THERAPISTS Judy Baron RMT Mary M Medingfield RMT Ann B Caldwell BM Solomon Cunio BM Cynthia R Curtis MM Sandra Graham BME Sarah Frances Ivey BS Suzanne Pipp RMT Carol Prickett RMT Pamela Roberson BM Carolyn Sanders RMT Jeannette Warren RMT OCCUPATIONAL THERAPY Dorothy M Clarke OTRDirector INTERNS Karen Davis Bette A Goldenstar VOLUNTEER SERVICES Jane M Haddock BS CVC Director STAFF Susan Coursey AB C Earnest Yearwood AB140 SPECIALIZED MEDICAL SERVICES GENERAL MEDICINE SURGERY I tf Jhi J G Bohorfoush MD Director E G Allende MD Physician Specialist II Sergio AlvarezMena MD Physician Specialist II Antonio Ballagas MD Senior Staff Physician David Cardoso MD Physician Specialist II Orestes Fernandez Caral MD Staff Physician Harold Carson MD Staff Physician Osvaldo Casas MD Senior Staff Physician E C Clayton MD Physician Specialist I Andres Fernandez MD Physician Specialist II G Garmendia MD Chief Physician Francisco Gomez MDSenior Staff Physician Samuel Goodrich MD Physician Specialist II Pilar Goicoechea MD Physician Specialist II Raymond Jordan MD Chief Physician Leon Koen MD Physician Specialist II Lloyd Laine MD Senior Staff Physician Joseph Leyva MD Physician Specialist II Carlos Montalvo MD Senior Staff Physician Perry Moore MD Physician Specialist II John Moody MD Chief Physician Helena PessinoMarshall MDPhysician Specialist IF Dionisio Pinero MDPhysician Specialist III Luis Rodriguez MD Physician Specialist II K Sreeramaiah MD Physician Specialist II Julio San Martin MD Chief Physician Erlinda Valdecanas MD Staff Physician Virgilio Valdecanas MDPhysician Specialist I Raul Veiga MD Physician Specialist I Teofilo Tomas MD Physician Specialist II Pedro Tomayo MD Physician Specialist II S H Dillard Optometrist RIVERS HOSPITAL Mahmud Majanovic MD Director Jose Sanchez MD Senior Staff Physician A Steinhards MD Senior Staff Physician Bernardo Utset MD Staff Physician nHHHHH 141 RIVERS ALCOHOL DRUG Jose Rubio M DDirector Hortensia Alvarez MD Psychiatric Resident MEDICARE E W Allen Sr MD Director Luis Carrodeguas MDChief Physician Rafael Alvarez MD Psychiatric Resident DENTAL SERVICE Robert Watson DDS Director Ray M Camp DDS Dentist I Stephen S Fennell DDS Dentist I Jack W Groover DDS Dentist I Raymond G Johnson DDS Dentist I Charles C Jones DDS Dentist I Joe Lister DDS Dentist I Richard D Rogers DDS Dentist I Cecil Roundtree DDS Dentist I Phillip Spence DDS Dentist II James L Vaden DDS Dentist I William Willoughby DDS Dentist II Thomas B Wylie DDS Dentist I PHARMACY Durward Poland Pharm D Director Clarence Gissendanner BSAssistant Director Ken Autry BS Pharmacist I Raymond Covey BS Pharmacist I W R Kendricks BS Pharmacist I Thomas Reese BSPharmacist II Rymer Rivers BSPharmacist II Glenn Veal BSPharmacist II Phyllis Parks BSIntern Woody Proveaux BSIntern REMOTIVATION Mattie L Pennington RN Supervisor Diplomate American Board of Psychiatry Neurology 142 VOCATIONAL REHABILITATION W C Petty AB Director Marvin Denton Jr BS MEd Supervisor of Services Jesse P Collette BS Ed Supervisor Counseling Service James C Grover AB Supervisor Job Development Edwin Ray Freeman BS MEd Supervisor VR Evaluation John W White BA Supervisor Vocational Instructor REHABILITATION COUNSELORS Harry D Bates BS MRC Charles H Boland Jr AB BD Alvin K Dixon III BS Marsha S Fields AB MCE Joseph J Fulbright AB LLB Irwin P Gates Jr BA BD James D Helton AB William M Moore Jr AB BD Robert Wiley BS MEd Dennis OConner AB MDiv Robert E Pickett BA MEd Peter Shenkman BA MRC Helen P Simpson BS Joe Frank Stevens BA BD Algie E Thomas AB Frances Torrance BS MHE Mary Janis Weathers BS E VALUATORS il Ronald Barnard BA MEd Lanier Browning BS Julian F Council BA Joseph W Davall Jr BS Robert D Gillian BBA Henry M Hopkins Jr BA Jane Rhodes BA Grady Pennington BBA William Allen Werts BA WORK ADJUSTMENT INSTRUCTORS Pat Collins Faye P Day Miles A Jones Jr Virginia Mullis Robert L Strickland VOCATIONAL INSTRUCTORS James Adcock A L Booth E M Bradford Charlene Carpenter K E Donaszewski Arthur Jones Marianne Thompson BS Anne Hamilton Ruth Marshall BS Jeraldine E Pearson RN Ken Ryals Jacquelyn Shell Gloria Smith BS143 SCHOOL OF SPECIAL EDUCATION John H Rawlins MEd Eleanor Sikking PhD Director Assistant Director TEACHERS Suelle Austin MA Larry Callaway BS Elaine Cowan BS Bertha Eakins BS Mary Edwards BS Antoinette Ennis AB Colleen Farmer BME Gertrude Higgins MEd John Home AB Lois Irvin AB Collins Lee BS E J Lundy Jr BS John Martin BS Zenaida Mesa BA Gwen Peacock BS Becky Smith BS Sybil Smith BS Martha Stevenson BS Dorothy Trawick BS Ruby Werts BS Glenda Young MEdNW n m b UWVERSfTY OF GEOoGA FEB 1 1973 LIBRARIESVI ol 5 9HHBUBHiHUUHanB o ft LI1