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For Rhonda, it's an even bigger battle to leave an institution, because the state gives preference to de-institutionalizing the physically disabled over the mentally ill.
"There's very little planning to help people with mental impairments return to the community," says Anna McCrary, a disability attorney with Georgia Legal Services in Macon. "But the community services set up for mental health don't provide enough care for the mentally disabled."
Even when an institutionalized person is approved for transfer to a community home, the wait isn't over. Most homes have long waiting lists that move at a slow pace. Part of the waiting list problem lies in the lack of community-based facilities; the homes are a relatively new concept, and few state buildings are designed to foster such living conditions. To re-outfit them would be a pricey endeavor.
Yet Michael Allen, a senior staff attorney for the Bazelon Center for Mental Health Law in Washington D.C., says once the state builds such settings, waiting lists would shorten, transitions would be smoother and the cost per patient would wane.
Skinner, the state mental health director, says Georgia is currently redirecting some resources from hospitals to community-based services, but that a major shift will take time.
"We're planning for and expanding with every opportunity we get," Skinner says.
However, not all the blame for slow de-institutionalization falls on Georgia. The feds are putting little pressure on the states to follow the Olmstead ruling. In June 2001, George Bush signed an executive order calling for the "swift implementation of Olmstead" and announced that fulfilling the Olmstead mandate was a key component of his "New Freedom Initiative."
But little in the way of "swift implementation" has occurred in the past three years.
A month before Bush signed the initiative, a handful of Georgia legal groups filed a complaint with the U.S. Office of Civil Rights to fully enforce the Olmstead law. An Office of Civil Rights staff member working on the case says the investigation is ongoing, but the Georgia legal groups say they've been hearing that response for the past three years.
"The state has to think about these consumers differently and incorporate them into our community," Skinner says. "It's not different from any other social service. It just takes time."
The double doors of the brick, ranch-style home with white columns and black shutters are unlocked. A couple of miles from the home's manicured lawn sits the main strip of Jeffersonville, a small Middle Georgia town. On its outskirts, a sign at the side of a small pond warns, "Fish at your own risk." The town's hubs are the Dollar General and Piggly Wiggly.
Inside the home, plush leather couches give a cozy feel to the living room. Only 20 patients live here.
Sitting in the kitchen, Floyd Bryant cuts a striking image in his pressed blue Oxford and navy blue vest. His new black sneakers shine, and his hair is neatly parted.
It's lunchtime at Brittany's Place, a personal care home, and the residents chow down on chicken and dumplings, turnip greens and cornbread. Floyd isn't that hungry. He takes a few bites of his lunch, his hand quivering as he tries to steady his fork. He wears two watches on his right wrist. His sleeve gets caught in the turnip greens, but he's quick to clean it with his napkin. He gulps down his full glass of milk and then pushes his plate away. He looks nervous, eating in front of a bunch of people in the home where he's lived for just two weeks.
Sometimes, the 72-year-old speaks about his nephews and growing up on a farm, about how he likes Diet Coke, Reba McEntire and bingo. But today, he doesn't say much.
Floyd is diagnosed with epilepsy, schizophrenia and chronic obstructive pulmonary disease. His piercing blue eyes wander around the room and his mouth trembles as he tries to speak. Floyd glances at the TV, where Bob Barker is asking "The Price Is Right" contestants to place their bids, then he settles on staring out the window.
At Brittany's, Floyd gets his own room. He's on the right wing, a couple of doors down a short hallway. A white sheet of paper taped to the door says "Floyd Bryant" in aqua-colored marker. Inside, there's a twin-sized bed with a plaid comforter, a green velour chair and two wooden dressers. There's also a large window. Floyd likes it because he can look out at the vast front lawn.
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