According to DHR, “Georgia has the capacity, ability and responsibility to develop a public mental health system that is recovery-focused and provides both community-based and hospital-based services established on best and evidence-based practices.”
Although I recognize that DHR faces budget cuts of almost $150 million, I am confused at the reasoning behind the total elimination of State funding to Supported Employment programs.

Representatives of DMHDDAD admit that:

• SE is an evidence-based best practice, proven to be effective.
• Most providers follow SAMHSA Best Practice guidelines.
• SE is Cost Effective.
• SE has Worked for Many People and Changed Lives.
• 1000 or more people could lose their jobs.
• SE represents a very small percentage of the budget.
• SE Service elimination will have very little effect on the Budget problem.
• SE produces taxpayers who eventually pay more than the initial cost of the service.

Other funding approaches, such as Ticket to Work have not worked well in the past. DHR is investigating making Supported Employment Medicaid billable. Maybe this will open some opportunities, keeping in mind that Supported Employment is not a clinical service, and does not fit well into the medical model.

Although Governor Perdue’s Mental Health Service Delivery Commission Final Report noted that “if all available funding sources are not used for  maximum impact, individuals with mental illness will have a devastating impact on the State’s basic infrastructure”, and recommended that supported employment programs be developed Statewide, the Division of Mental Health, Developmental Disabilities and Addictive Diseases decided to cut 100% of state appropriated dollars to mental health supported employment programs. This commission recognized that “Supported Employment is generally seen as an important social service that enhances the overall quality of life for those who require the structure, support and training necessary to maintain a place in the workforce. Supported employment offers individuals with mental illness or addictive diseases more independence and hope, as well as a daily motivation to continue toward recovery. Supported employment provides an exciting opportunity for private industry to partner with consumers, family members, community supports and treatment providers to promote inclusion of people with mental illness into mainstream society… With unemployment in Georgia (6.2 percent) running higher than the national average (5.7 percent) the difficulty for any citizen to find gainful employment is daunting. This is especially true for the disabled population who request assistance in acquiring and maintaining employment through supported employment services. A comprehensive service and support program will enhance services provided by DHR, DOC, county jails and DOL to individuals with mental illness... Supported employment services and activities have been described as one of the most important strategies to engender empowerment in persons with psychiatric disabilities. Supported employment programs should be developed statewide to work jointly with case management services, housing and treatment services.”

Programs like Psychiatric Rehabilitation, peer support services and supported employment increase the likelihood of keeping consumers out of the hospitals (a priority of the Olmstead Commission and DOJ agreements). These programs all reduce costs to the state and directly benefit the citizens of Georgia.

At a recent meeting I attended, I heard that the State expenditure towards supported employment was about ½ of 1% of the total DHR budget.  Instead of reducing funding (as they did with child protective services, food stamp and Medicaid eligibility positions, substance abuse and addictive disease services, the Mental Retardation Waiver Program, Meals on Wheels, Alzheimer’s services, Home Supports and Public Health Grants to Counties), Supported Employment (a recognized evidence-based best practice) shares the distinction of total funding elimination along with family violence and sexual assault shelters. All of these cuts together “saved” the State less than $30 million and will negatively impact thousands of lives. This is less than the proposed (HB212 and HB116) $31 million tax break to airlines and private airplane owners which the Ways and Means Committee just approved. If it is reasonable to consider these bills, isn’t there room to reconsider at least some State funding for evidence-based programs like Supported Employment?"
The Pipeline, p.2 – Winter 2009 (Newsletter of the Georgia Mental Health Consumer Network)