ANOTHER SHOE has dropped in the State of Georgia’s rush to get out of the business of caring about those of its citizens facing the greatest difficulties in just staying alive. Few heard it go “Thud!” One of the consequences of citizens increasingly getting their news from electronic media that feature pregnant princesses is that few dig down deep enough to learn the state is closing its only nursing home in Milledgeville where acutely disabled Georgians without means are cared for.

So, by Dec. 31, joining the 750 employees who lost their jobs when Northwest Georgia Regional Hospital in Rome was closed last year will be the 350 employed by the James B. Craig Nursing Center at Central State Hospital in Milledgeville.

There are some notable differences involved worth noting regarding this as the state continues to apparently take the position that Christian principles are only binding on citizens and churches, not governments and taxpayers.

If that’s the case, why don’t many politicians just shut up about other religiously-tinged matters?

First among interesting differences, those patients now in the Craig Center are not developmentally or mentally disabled. They are acutely physically limited. Yet the state is using the same blanket excuse — the federal mandate that Georgia quit killing/raping mental-hospital patients and instead place them in community-based care — to close its only nursing home in order to save money.

As with those with severe developmental/mental problems, the idea in this case is to shift those with acute physical limitations to “community-based” care as well — either back home with families plus tax-paid assistance or in other nursing-home operations with Medicaid support. It is pretty difficult to find nursing homes willing to take only Medicaid, by the way, particularly for clients apparently this limited and likely in need of intensive services.



SOME MAY recall this particular trend actually began with closing down a wing of the state veterans home (also in Milledgeville) a few years back and this year passing legislation whereby any disabled veterans dwelling there and getting a federal allowance of $682 a month from the U.S. Department of Veterans Affairs would henceforth have to pay the state $682 a month to be there.

This is apparently an otherwise unannounced expansion of the state “bailing” on previous support for those in need even as it takes a position against adding similar functions, as with the proposed Medicaid expansion to those of low income in the Obamacare package. That seems part of a growing pattern that also shows up elsewhere, such as cutting the number of weeks of eligibility for unemployment benefits.

It also uses — in seeming total contradiction to the political stance being taken — the notion of increasing federal responsibility and funding in order to replace state outlays. In this case, the cover of a federal mandate is being used to shift who pays the bills.

As Dan Howell, the regional hospital administrator for the Milledgeville operations put it, there are three reasons the Department of Behavioral Health and Developmental Disabilities is closing the nursing home: First, “the state is choosing not to be in the nursing-home business any longer.” Second, a “belief that the individuals who currently reside at the Craig Center can be supported within existing community-care providers.” And third, a suspicion that the nursing home would fail to meet the standards of the settlement with the U.S. Department of Justice ... that didn’t even include such clients.

Perhaps this was just taking note of federal inspection rankings for the Craig Center that were decidedly so-so. Oddly enough, it was top-rated (five stars) for quality of services while getting only two stars for sufficiency of skilled staffing — nowhere near enough registered/practical nurses. Obviously the staff about to be let go must consist of really caring folks to still do so well on quality. Let’s also grant that if the feds started poking around in some Medicaid-supported nursing-home operations they might get very disturbed, as a recent federal case involving a Rome provider certainly indicated.



AND IF ALL this reads like a confusing muddle, that is because it is. For those interested in this area of human concern finding out what is news involves going on scavenger hunts using search engines. The results are episodic and the state doesn’t even seem to bother to explain itself about very much any longer, perhaps because it can’t think of logical excuses for what it does. As with mothballing the State Archives, it is just walking away from doing a lot of stuff in hopes the public won’t notice, won’t care and won’t compare/contrast the functions abandoned to those being continued or even increased.

And, just to further muddy the waters, the proposed state budget for fiscal 2014 is reported to cut $9.4 million from what is being paid to those “community-based” providers now serving clients with mental illness and developmental disabilities. That is in addition to a cut of $27.8 million made in the budget of behavioral health for the 2013 year, although funding to meet the federal settlement won’t be cut because the deal promises more will be spent to dismantle the old problem. For those who do not understand such matters, spending more on tearing stuff down and then creating new emergency shelters is not necessarily the same thing as paying providers what the services are worth.

There simply shouldn’t be such either/or, push/pull going on. Everybody knows most governments — federal, state in particular — are overweight, but is dieting by cutting off helping hands and other appendages really the only answer ... or just the easiest one?

Oh well, perhaps nobody much among the citizenry does know or does care about such concerns. Or perhaps Christian instruction about caring for and protecting those least fortunate or most defenseless really does not belong in the realm of Caesar, to whom entirely different things belong.



PERHAPS the governor or someone of similar policy control will someday explain all this far better than is now the case. And, at the same time and in another old refrain in this column, let the public know just how all those already placed in “community-based” care are actually doing. Certainly the recent report on community-based involving a security guard sexually assaulting three female clients in Austell can’t be norm. But that is what becomes “news” and the image created.

Somebody please start telling the public, and proving, that this whole messy and confusing and disjointed picture isn’t actually how the state is being run.