The Fuqua Center values its partnerships with numerous organizations throughout Georgia with whom we have worked closely throughout the years to improve the quality of life for older adults by keeping them involved in their communities and by providing them and their families with resources, support and information to improve health and wellbeing. Some of the projects and partnerships include:
Improving Access to Care…..
Since 2009. generous support from the Jesse Parker Williams Foundation and Fuqua Foundation has allowed the Fuqua Center to provide in-home psychiatric services to low-income senior public housing apartments throughout metro Atlanta. The goal of this program is to help older residents with mental illness remain independent by improving access to appropriate evaluation, medication, and support services. The Fuqua Center’s advanced practice nurses, social worker, and area partners in healthcare and social services collaborate to provide a continuum of care to this population. Housing staff receive mental health education and support services. Through this work, a strong partnership has been formed with Atlanta Housing Authority (AHA), which operates 11 senior and disabled high rises where approximately 2,000 low-income seniors and disabled adults live. LeadingAge is another strong partner and community clinic services are provided in several member sites that provide affordable housing to older adults. By 2012, the program expanded to include 18 low-income senior apartment buildings. In 2013 the Fuqua Center provided services in 22 residential communities including nursing homes, assisted living facilities, and independent living facilities.
Funding: Jesse Parker Williams Foundation and Fuqua Foundation
Partners: Jesse Parker Williams Foundation, Fuqua Foundation, Atlanta Housing Authority, LeadingAge
TELEMEDICINE-The Georgia Partnership for TeleHealth connects patients in rural communities with specialty physicians throughout the state via videoconferencing “telemedicine” equipment. Emory University Fuqua Center/Division of Geriatric Psychiatry is one of the Georgia Telemedicine Program specialty providers providing psychiatry services to individuals fifty-five and older via telemedicine. This service is covered by Medicare, Medicaid and many other insurances. Patients attend their appointment at their local telemedicine site and an Emory clinician will see the patient using the telemedicine equipment. The clinician will work closely with the patient and the patient’s primary care physician to implement the recommended treatment. Emory clinicians will continue to consult with the patient via telemedicine as long as deemed necessary. The majority of the patients seen from rural areas by the Division of Geriatric Psychiatry are residents of nursing homes.
Funding: Start up Fuqua Foundation and Private donor. The service is now supported by Emory Healthcare
Partners: Emory Healthcare; Georgia Partnership for TeleHealth. Mr. Maynard Bates
TRAINING AND IMPLEMENTATION OF EVIDENCE BASED CLINICAL MODELS– The following models of care known to improve the recognition of depression in older adults have been implemented in settings with Partners including Emma Darnell Geriatric Clinic at Grady, Affordable Housing in collaboration with LeadingAge Georgia, the Georgia Community Care Services Program (CCSP), Atlanta Regional Geriatric Education Center (ARGEC), Georgia Department of Human Services, Division of Aging (DOA); Department of Behavioral Health and Developmental Disabilities (DBHDD), and the Atlanta Regional Commission (ARC).
Funding: Fuqua Foundation, Kaiser Permanente/Mental Health America, Georgia Gerontology Society via a Lilly Grant
IMPACT – (Improving Mood-Promoting Access to Collaborative Treatment) is a program for older adults who have major depression or dysthymic disorder. The intervention is a stepped, collaborative care approach in which a nurse, social worker, or psychologist works with the participants’ regular primary care provider to develop a course of treatment. Potential participants are either referred by the primary care provider or identified via routine screening of all clients. During the initial visit, the depression care manager (DCM) completes an assessment, provides education about depression and available treatments, and asks the participant about his or her depression treatment preferences. All participants are encouraged to engage in some form of behavioral activation, such as engaging in physical activity or scheduling pleasant events. IMPACT was found to be more than twice as effective as usual care for depression and also improves physical and social functioning and patients’ quality of life while reducing overall health care costs over a four-year follow-up. Currently in its fourth year of working with the Grady Health System’s geriatric primary care clinic to implement IMPACT, the Fuqua Center has trained a clinic-based nurse practitioner to provide Problem Solving Therapy and worked with staff to embed depression screening practices in everyday clinic operations. In 2012, 450 patients were screened for depression, 21% screened positive, and over 50% of those that screened positive accepted treatment. As the program expanded its reach in 2013, 484 patients were screened for depression and 65 screened positive. The Fuqua Center continues to consult with the Darnell Clinic to provide process evaluation and technical assistance services.
PEARLS – (Program to Encourage Active Rewarding Lives for Seniors) is a brief, time-limited, and participant-driven program that teaches depression management techniques to older adults with depression. It is offered to people who are receiving home-based services from community services agencies. The program consists of in-home counseling sessions followed by a series of maintenance session contacts conducted over the telephone utilizing problem solving treatment (PST), behavioral activation, and pleasant activities scheduling. PEARLS Program counselors empower individuals to take action and make lasting changes so that they can lead more active and rewarding lives. In partnership with LeadingAge and thanks to a grant from the Fuqua Foundation, PEARLS will be offered in several affordable housing sites throughout the METRO area in 2014.
Healthy IDEAS (Identifying Depression, Empowering Activities for Seniors) is an evidence-based program that integrates depression awareness and management into existing case management services provided to older adults. Healthy IDEAS is a structured depression program that prepares case managers and care coordinators to identify depression in at-risk elders and to facilitate access to treatment. It targets underserved, chronically ill, older adults in the community and addresses commonly recognized barriers to mental health care: detecting depression, helping clients understand depression as treatable assisting them to gain knowledge and skills to self-manage it; and linking primary care, mental health care and social-service providers. Healthy IDEAS empowers clients to manage their depression through a behavioral-activation (BA) approach that encourages involvement in meaningful, positive activities.
SBIRT (Screening, Brief Intervention, and Referral to Treatment). SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with substance use disorders, as well as those who are at risk of developing these disorders. SBIRT provides opportunities for early intervention with at-risk substance users before more severe consequences occur through a quick screening to assesses the severity of substance use and identify the appropriate level of treatment. Brief intervention focuses on increasing insight and awareness regarding substance use and motivation toward behavioral change; referral to treatment provides those identified as needing more extensive treatment with access to specialty care. All of the Fuqua Center Advanced Practice Nurses (APRNs) and social work staff have received SBIRT training.
PHQ-9 PERFORMANCE IMPROVEMENT PROJECT (PIP) The Fuqua Center has a long history of collaboration with Georgia’s Medicaid-Waiver CCSP Program which assists seniors and/or functionally disabled adults througout the state in providing staff training and education focused on late-life mental illness. Following a $2 million grant award from the Centers for Medicare and Medicaid Services (CMS) to the CCSP Program in 2013, the Fuqua Center has been engaged to help develop trainings and processes for screening for clinical depression and management of antidepressant medication for the elderly and disabled. These processes will be used by all Area Agencies on Aging (AAAs) and care coordination providers in the State of Georgia to improve care to CCSP’s thousands of elderly and disabled clients.
CERTIFIED PEER SPECIALIST (CPS)/ WHOLE HEALTH/WRAP – PePersons with the lived experience of mental illness are trained to work with a person seeking treatment for mental illness. Peers assist with health education and the setting of health related goals. During 2013, the Fuqua Center initiated a weekly CPS facilitated Wellness Recovery Action Plan (WRAP) Group for older adults in which participants develop a self-designed plan for staying well, feeling better when they are not feeling well, increasing personal responsibility, and improving their quality of life. The group is open to the public.
Funding: Thanks Mom and Dad Fund/ Atlanta Regional Commission
Community Education and Outreach……
SPARC: (Sickness Prevention Achieved through Regional Collaboration) The SPARC program, facilitated by the Atlanta Regional Commission for the senior population, was designed to increase the utilization of preventative health care services including immunizations and health screenings by providing these services in the community at locations that are easily accessible to older adults and not typically places someone would go for healthcare. The Fuqua Center for Late-Life Depression in partnership with other health care providers in DeKalb and Fulton counties participates in an average of 10 SPARC events during the Fall and Spring months providing depression screens and information on community based mental health resources. Over 1,000 screens have been completed to date with a number of them resulting in referral for further evaluation.
Funding: Fuqua Foundation
Partners: ARC, Fulton and DeKalb Senior Services; Fulton Behavioral Health, Visiting Nurse Heath System (VNHS)
Mental Health First Aid (MHFA) – Mental Health First Aid is a public education program that introduces participants to risk factors and warning signs of mental health concerns, builds understanding of their impact, and overviews common treatments. The course uses role-playing and simulations to demonstrate how to assess a mental health crisis; select interventions and provide initial help; and connect persons to professional, peer and social supports as well as self-help resources. Mental Health First Aid is an 8-hour course taught by certified instructors. The training allows for early detection and intervention by teaching participants about the signs and symptoms of specific illnesses like anxiety, depression, schizophrenia, bipolar disorder, and addictions. Like CPR, Mental Health First Aid prepares participants to interact with a person in crisis and connect the person with help. Mental Health First Aiders learn a single 5-step strategy that includes assessing risk, respectfully listening to and supporting the individual in crisis, and identifying appropriate professional help and other supports. Certified Mental Health First Aid instructors provide a list of community healthcare providers and national resources, support groups, and online tools for mental health and addictions treatment and support. The Fuqua Center has trained housing providers including Atlanta Housing Authority (AHA) staff, DeKalb Housing Authority staff and staff from other affordable housing sites; senior services providers; residents of AHA and other affordable housing sites; clergy; home health providers; in-home caregiver; DBHDD staff including staff from the Regional Hospital; Aging Services staff including Adult Protective Services (APS) workers and Ombudsman; CSB staff and CSB Board Members; as well as older adults living independently in the community
Funding: National Council for Behavioral Health (NCBH), Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD), Fuqua Foundation, ARC for Lifelong Mableton, Fulton County Behavioral Health, Georgia Gerontology Society (GGS)/ Lilly Foundation Grant, Atlanta Housing Authority, Senior Citizens Services/Atlanta Women’s Foundation
Georgia systems change and geriatric mental health policy……
Georgia Coalition on Older Adults and Mental Health (GCOAMH) – The Fuqua Center chairs and is heavily involved in the facilitation and implementation of cross education between the Division of Aging (DOA) and the Department of Behavioral Health and Developmental Disabilites (DBHDD). Part of the focus is the placement of leadership from each division on decision making councils of the other division with the purpose of creating infrastructure that begins to support public geriatric mental health services.
Atlanta Area Coalition on Aging and Mental Health (AACOAMH) –The Fuqua Center chairs the Coalition which focuses on developing workforce expertise in recognizing and addressing behavioral health issues in the older adult population. In partnership with the Atlanta Regional Geriatric Education Center (ARGEC), the Coalition hosted a workforce development symposium on the care of older adults with mental illness for social workers (2011) and for nurses (2012), and in 2013, the Coalition hosted a workforce development symposium for all disciplines on issues related to substance use/misuse by older adults. Fred Blow, Ph.D., a nationally known researcher and presenter from the University of Michigan was the featured speaker.
US Substance Abuse and Mental Health (SAMHSA) Policy Academy on Older Adult Mental Health – The purpose of the Policy Academy was to convene a meeting of key stakeholders which have the authority and expertise to begin to develop a plan for the state which would improve the recognition and treatment of older adults with mental illness. Georgia leadership included persons from the Georgia Department of Behavioral Health and Substance Abuse, Division of Aging and the Medicaid Authority as well as the Fuqua Center. The Fuqua Center wrote a paper documenting the recommendations and action steps decided on at the Georgia Academy.
Behavioral Health Services Coalition (BHSC) – The Fuqua Center chairs the statewide Coalition of behavioral health services and advocates which functions for the purpose of improved communication with the state and regional offices and advocates for the needs of Georgia’s citizens with behavioral health challenges. The Coalition coordinates the annual MH Day at the Capital Rally which helps to highlight attention to the principles of Recovery and advocates for behavioral services priorities.
Systems Change –
- Facilitating work between NW Area Agency on Aging and Highland Rivers Community Services Board to expand services within public mental health system to include older adult services.
Developed recommendation paper and action steps in coordination with the Georgia Alzheimer’s Association towards system of care for older adults with mental illness and dementia. Click here to read
Provided consultation for the Money Follows the Person (MFP) Initiative through a contract with ARC, working with Area Agencies on Aging (AAA) and their local CSB to help facilitate a smooth transition and identify needed policy and system changes to better serve persons with behavioral health challenges who choose to move from long term nursing home placement into living independently in the community.