Piedmont Geriatric Hospital

Piedmont Geriatric Hospital (phone: [phone]; [http://www.pgh.dmhmrsas.virginia.gov] )Virginia's only state facility solely dedicated to the evaluation and treatment of persons over the age of 65 [http://www.oig.state.va.us/Facility_Reports/Piedmont%20Geriatric%20Hospital%20Snapshot%20Inspection%20Feb%202003.htm] . The 135-bed geriatric hospital is located in Burkeville, Virginia on the 300 acre (1.2 km²) site of the former Piedmont Sanatorium. Founded in 1967, the facility employs 320 staff members and is a training site for major universities, colleges, and vocational schools in geropsychiatry and other clinical specialties.

Residents

PGH treats elderly persons (65+ years of age) who:
*Are in need of inpatient treatment for mental illness,
*Meet the requirements for voluntary or involuntary admission as determined by their mental health center, and
*Do not have a medical condition that requires priority treatment in an acute care hospital.

According to PGH's facility profile, "80-90% of PGH's admissions come from a complex combination of psychiatric and physical impairments whose needs are not met in traditional medical or psychiatric settings" [http://www.pgh.state.va.us/facility_profile.htm] . Many Hospital residents are transferred there because of complex behavior that nursing homes are not equipped to manage [http://www.oig.state.va.us/Facility_Reports/Piedmont%20Geriatric%20Hospital%20Snapshot%20Inspection%20Feb%202003.htm] . Under Virginia law, patients must be transferred out of nursing homes if they [http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+63.2-1805] :
* Present an imminent physical threat or danger to self or others,
* Require continuous licensed nursing care (seven-days-a-week, 24-hours-a-day), or
* Have other medical and functional care needs of residents that cannot properly be met in an assisted living facility.

ervices

Music therapy

Music therapy part of the Psychosocial-Rehabilitation Department and is staffed by the following personnel:

*Amanda R. Schleef, MT-BC

Definition:

Music therapy is the prescribed use of music and musical interventions in order to restore, maintain, and improve emotional, physical, physiological, and spiritual health and well-being.

Purpose:

Music therapy works towards specific therapeutic goals and objectives. Goal area include communicative, academic, motor, emotional, and social skills. It is important to be aware that while clients may develop their musical skills during treatment, these skills are not the primary concern of the therapist. Rather it is the affect such musical development might have on the client's physical, psychological and socio-economical functioning.

MT-BC Information:

The credential Music Therapist - Board Certified (MT-BC) is granted by the Certification Board for Music Therapists (CBMT) to identify music therapists who have demonstrated the knowledge, skills and abilities necessary to practice music therapy at the current level of the profession. The purpose of board certification in music therapy is to provide an objective national standard that can be used as a measure of professionalism by interested agencies, groups, and individuals.For more information on this topic visit: [http://www.cbmt.org/]

Other References: [http://members.aol.com/kathysl/def.html]

Psychology

Purpose:

The PGH Psychology Department provides evaluations and nonpharmacological interventions for all PGH patients. Evaluations provided vary widely and include neurocognitive, emotional, personality, decision-making capacity, and forensic evaluations. Interventions include, among others, individual psychotherapy, group therapy, psychoeducational sessions, and behavior planning. PGH Psychologists are also active in hospital administration, program evaluation, performance improvement, and risk management activities. Hospital research efforts are also overseen by the Psychology Department.

The Psychology Department utilizes the most current techniques available in current research literature. Department staff serve as leaders within and outside of the hospital regarding current knowledge in mental health and behavioral research, and have developed many innovative protocols and methods to optimally serve their clientele. Psychology is also heavily involved in clinical teaching, serving as a practicum site for Virginia Commonwealth University graduate students (Clinical and Counseling Psychology) and offering frequent seminars for community eldercare providers through Piedmont Geriatric Institute.

Personnel:

PGH Psychology consists of four full-time doctoral level clinicians and two graduate students. They are listed below:

*Andrew L. Heck, Psy.D., ABPP - Psychology Director
*Lindsey K. Slaughter, Psy.D. - Staff Psychologist
*Patricia L. Hooker, Ph.D. - Staff Psychologist and Forensic Coordinator
*Vacant fourth staff psychologist position

*Cassie Brode - VCU Counseling Psychology practicum student (2008-09)
*Lillian Flores Stevens, MS - VCU Clinical Psychology practicum student (2008-09)

Psychology Pre-Doctoral Internship: The JFS Collaborative

The JFS Collaborative of Richmond, VA is a Greater Richmond Consortium of three member agencies. For the 2008/09 training year, we have three vacancies for pre-doctoral psychology interns.

The JFS Collaborative provides a comprehensive training program that follows the standards set by APPIC. This includes at least 2 hours per week of individual supervision by licensed clinical psychologists, a comprehensive didactics program, participation in monthly case conferences, multiple opportunities for training and collaboration with fellow students, and myriad clinical experiences. In addition, all three membership agencies place a strong emphasis on interdisciplinary team work.

Vision Statement

The JFS Collaborative seeks to provide high-quality intensive pre-doctoral internship training for the practice of professional psychology. Although the participating sites are diverse in their service missions and populations served, across all sites the internship strives to promote a generalist perspective on psychological evaluations, interventions, and related professional activities. Training is provided via direct clinical work with patients, regular supervisory contact, and scheduled didactic and discussion-based educational forums.We are planning to apply for APPIC membership within the next 6-8 months.

Member Agencies

(1) JFS of Richmond is now entering its third year of pre-doctoral training. JFS is a non-profit social service agency that has provided a wide variety of services to the greater Richmond community since 1849. In addition to a very active and diverse counseling department, JFS provides home health care, telephone reassurance, bill paying and guardianship services, a Wee-care program for new mothers, an adoption program, and Independence for Seniors programming.

JFS has a highly experienced multi-disciplinary counseling department that includes 2 licensed psychologists, a psychiatric consultant, social workers, and licensed professional counselors. JFS serves a wide variety of clients in individual, group, family, and couple’s therapy. In addition, the counseling program is known for its involvement in a wide range of projects, services, and consultation, including school consultation and planning and community outreach. JFS has a reputation for providing excellent training in both intensive psychotherapy and therapy as a creative and dynamic process. Interns will be provided with a wide range of experiences including opportunities to participate in family therapy with experienced co-therapists, short-term and long-term treatment of outpatients, child and adolescent therapy, psycho-diagnostic assessment, dream analysis, sand-tray therapy, school consultation and counseling, and outreach. Interns emerge from our training program with a strong understanding of the client as a whole person. In addition, interns learn the value of team work and work within a community. They learn skills in community outreach, preventive mental health, and marketing of psychological services, in addition to training in dynamic process, and strong family therapy experiences.

For additional information about the agency, please access our website at [http://www.jfsrichmond.org]

(2) Piedmont Geriatric Hospital is a 135-bed inpatient geropsychiatric hospital, operated by the Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services (DMHMRSAS). It is the only Virginia state facility that exclusively treats elderly persons (65+ years of age) who are in need of inpatient treatment for mental illness; meet the requirements for voluntary or involuntary admission as determined by their mental health center (Community Services Board, or CSB) and do not have a medical condition that requires priority treatment in an acute care hospital. Piedmont’s clientele present with a wide array of psychiatric and behavioral disturbances, including severe and persistent mental illness, dementia syndromes, adjustment and other emotional disorders, and personality disorders. The hospital operates with an interdisciplinary model of care, and treatment teams include psychologists, nurses, social workers, and rehabilitation services professionals (e.g., music, activity, recreational, and occupational therapists). The Piedmont Psychology Department has four licensed doctoral-level psychologists on staff; doctoral-level practicum students are also on site and provide interns the opportunity to gain experience as clinical supervisors.

Piedmont is a progressively-minded and highly dynamic organization that places a high priority on student training and professional development. Although the PGH population is somewhat specialized, many students with interests outside of geriatric psychology have gained knowledge and skills that are relevant and readily applicable to many other patient populations. PGH also operates a teaching arm of the hospital called Piedmont Geriatric Institute (PGI), which provides both geriatric-specific and general mental health training to community health care professionals, caregivers, and mental health consumers. Interns have the opportunity to create and present workshops through PGI. More information about PGH can be found at [http://www.pgh.dmhmrsas.virginia.gov] .

(3) Cumberland Hospital for Children and Adolescents is a 94-bed hospital in New Kent, Virginia, which provides treatment for young persons with complex medical, behavioral and social profiles who have failed to get better repeatedly in other more traditional settings. By offering integrated medical, rehabilitative, and behavioral and educational services, Cumberland is able to stabilize and treat medical problems, help the family cope with their child’s illness and injury, address severe behavior management problems, and reduce the likelihood of repeated hospitalizations. The hospital opened in 1983, to serve children with chronic medical conditions and accompanying emotional and behavioral disturbances. Over the last 25 years Cumberland built its reputation on treatment programs for brain injury, chronic illness, and neurobehavioral rehabilitation. For information about our facility please access our website at [http://www.cumberlandhospital.com] .

Cumberland’s dynamic multi-disciplinary psychology department is comprised of 4 licensed clinical psychologists, a psychology technician, and several licensed clinical social workers and licensed professional counselors for a total of 15 positions. Therapists have an individual caseload of patients for whom they facilitate individual and family therapy. Because of the broad spectrum of diagnoses and psychological issues represented by our patients, therapists are constantly challenged to find creative ways of engaging patients who have often been in several other placements prior to coming to Cumberland. Therapists also facilitate same sex adolescent process and chronic illness groups for patients in the chronic illness program. In addition, the psychologists complete social/emotional psychological evaluations with all of the patients in the chronic illness program. Educational evaluations are completed as needed. Therapists collaborate with the members of their patients’ multi-disciplinary treatment teams comprised of the physician, physical, occupational, and speech therapists as applicable, dieticians, teachers, nurses, behavior specialists and behavior counselors.

The JFS Collaborative Psychology Staff

The Director of Training, Dr. Robin B. Zeiger, Ph.D., received her Ph.D. in 1985 from the University of Illinois at Chicago and has worked at JFS of Richmond since 1991. Dr. Zeiger has a wide variety of clinical and training experiences with outpatient, inpatient, and residential treatment. Her interests include Jungian psychotherapy, the interface of spirituality and psychology, women’s issues, sand-tray work, dream analysis, and family work. She has a strong background in Object Relations Theory and incorporates an interpersonal approach to her clinical work. Dr. Zeiger has a love of supervision and training.

Additional Psychologists Include:

Dr. Andrew Heck (Psy.D., ABPP), Director of Psychology, Piedmont Geriatric Hospital, PGH site supervisor for JFS Collaborative. Dr. Heck received his undergraduate degree at Wabash College in Crawfordsville, Indiana, and his graduate degree from the University of Indianapolis. He has been awarded diplomate status in Clinical Psychology from the American Board of Professional Psychology and serves as a Fellow in the American Academy of Clinical Psychology. Dr. Heck works primarily with older adults, and holds clinical faculty appointments in the Psychiatry, Psychology, and Gerontology departments at Virginia Commonwealth University. His areas of clinical interest include decision-making capacity evaluations, neurocognitive screening, differential diagnosis of dementia and related disorders, depression in the elderly and behavioral treatment.

Dr. Deborah Hill-Barlow (Ph.D.), Director of Psychology, Cumberland Hospital; CH site supervisor for JFS Collaborative. Dr. Hill-Barlow received her Ph.D. in 1997 from George Mason University in Fairfax, Virginia. She has worked at Cumberland Hospital since 1999 and has experience in working with children, adolescents, adults and families in both outpatient and inpatient settings. She thoroughly enjoys the collaboration involved in supervision and training. Various clinical interests include working with patients with significant trauma histories, eating disorders, and other significant emotional issues that impact an adolescent’s ability to cope effectively with a chronic illness.

Dr. Diane Harris (Psy.D) – Cumberland

Dr. Patricia Hooker (Ph.D.) - Piedmont

Dr. Jordan Kilgour (Ph.D.) – JFS of Richmond

Dr. Tammy Redman (Psy.D.) – Cumberland

Dr. Lindsey Slaughter (Psy.D.) - Piedmont

Stipends

Students are accepted for three separate positions.

Two students are jointly assigned to JFS/Piedmont – Students are expected to spend 16 hours per week at JFS and 16 hours per week at Piedmont. They will spend one day of training at JFS.

Stipends are approximately $15,000

One student is assigned to Cumberland Hospital for 32 hours per week. The additional day is spent in training at JFS with the other interns.

Stipend will be $18,000 with Cumberland Health Benefits

The training year runs from the first week of September until the last week of August.

The JFS Collaborative is looking for students with a wide variety of clinical interests who are flexible, insightful about self, and eager to work in a team setting. We do not select students based on theoretical orientation. However, we encourage students to develop an openness and self-awareness through supervision and training. We support a therapist as a model who uses her/his own self as a change agent. Thus, we place an emphasis on process and interpersonal issues in the therapy interaction, while attempting to tie theory to practice. Students interested in assessment should bring a strong academic background in psychometric theory and practice, as well as exposure to a variety of assessment instruments and techniques.

Please e-mail your interest to [e-mail] and to [e-mail] with your resume, APPIC application reference letters, and a letter of introduction. In the letter or introduction, we would like to see a paragraph on your clinical goals for internship and why you are attracted to our site. We will also require proof of your readiness for internship from your training site.

Organization

Units

PGH's 123 residents are divided into four units of approximately 30 residents each. The staff for each unit consists of Registered Nurses, Licensed Practical Nurses, and Direct Service Assistants.

hifts

The staff are organized into day, evening, and night shifts. During the day shift, members of the physical, recreational, occupational, Psychology, and Music Therapy staff, as well as social workers, visit each unit. During the evening and night shifts, unit nursing coordinators and the house-nursing supervisor make rounds.

Administrators

Hospital administration, as of 2007, consisted of [http://www.dmhmrsas.state.va.us/SVC-SFAddressDetails.asp?facname=Piedmont%20Geriatric%20Hospital] :
*Director - Stephen Herrick, Ph.D.,M.S.H.A.
*Facility Admin - James Ayers, M.A.
*Dir., Human Resources - Michael C. Wimsatt, Ph.D.
*Fiscal Officer - Lynne Inge
*Psychology Director - Andrew L. Heck, Psy.D., ABPP
*Medical Director - Hugo Falcon, M.D.
*Chief Nurse Executive - Maxcine Maxfield, Ph.D.
*Social Work Director - Brinda Fowlkes, MSW, LCSW
*Rehabilitation Services Director - Nellie Coleman, M.Ed.

Inspectors

The facility is inspected routinely by the [http://www.oig.state.va.us/ Office of the Inspector General] . Unannounced reviews conducted between 1999 and 2004 consistently reported clean, comfortable, and well-maintained surroundings.

History

The 300 acre (1.2 km²) site of PGH was originally Piedmont Sanatorium, a rest home for blacks with tuberculosis. The Sanatorium was closed in 1965 and converted into a geriatric hospital in 1967. In 1985, PGH was accredited by the Joint Commission on Accreditation of Healthcare Organizations.

In 1999, word leaked out that PGH was slated to be closed under the 1999-2000 budget of Governor George Allen [http://www.afscme.org/publications/steward/stew99w3.htm] . The Legislature voted to keep PGH open with funding allocated through 2000.

On November 25, 2000, the Richmond Times-Dispatch cited an administration leak that PGH would be closed by 2006. State Senator Frank Ruff speculated that the information was leaked on purpose in order to gauge the public's reaction [http://www.blackstoneva.com/courier/121400.shtml] . Local officials and the Piedmont Geriatric Association organized to oppose the closure, and the Legislature funded PGH for 2000.

In 2002, Governor Mark R. Warner proposed budget amendments to shut down PGH and Delegate Robert McDonnell introduced House Bill 995 to close Piedmont by 2007 [http://www.blackstoneva.com/courier/012402a.shtml] . Nottoway Supervisor Jack Green called it the facility's most serious closure threat to date. He noted the state's desire to save money and the attractiveness of the hospital's 300 acre (1.2 km²) estate for other building projects. The bill passed after it was amended to eliminate the provision to "close Piedmont Geriatric Hospital, opened in 1967 and located in Burkeville, no earlier than July 1, 2007" [http://leg1.state.va.us/cgi-bin/legp504.exe?ses=021&typ=bil&val=hb995] .

In 2004, the state Department of Mental Health, Mental Retardation and Substance Abuse proposed building a facility to house 150 of Virginia's most dangerous sex offenders on PGH grounds. The facility would be self-contained and not occupy the same buildings as PGH. Reasons for selecting the Burkeville site included its proximity to Nottoway Correctional Center, which could provide backup security help, and the nearby temporary sex offenders unit in Dinwiddie, whose workers could easily transition to the new facility. [http://home.hamptonroads.com/stories/print.cfm?story=64674&ran=48466]

The offenders in question fall under the control of the DMHMRS, rather than the prison system, because they have completed their prison sentences but still meet the criteria for civil commitment as sexually violent predators [http://www.oig.state.va.us/Annual_Reports/oigfinal.pdf] .

References

* [http://www.pgh.state.va.us/facility_profile.htm PGH Facility Profile]
* [http://www.oig.state.va.us/Facility_Reports/Piedmont%20Geriatric%20Hospital%20Snapshot%20Inspection%20Feb%202003.htm OIG Report #75-03] , Anita S. Everett, MD, Office of the Inspector General, Feb. 4-5, 2003.
* [http://www.oig.state.va.us/Facility_Reports/Piedmont%20Geriatric%20Hospital%20Snapshot%20Inspection%20March%202004.doc OIG Report #96-04] , James W. Stewart, III, Office of the Inspector General, Mar. 9, 2004.
* [http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+63.2-1805 § 63.2-1805. Admissions and discharge] , Code of Virginia, 1993, cc. 957, 993, § 63.1-174.001; 1995, cc. 649, 844; 2000, c. 176; 2002, c. 747; 2004, c. 49.
* [http://www.dmhmrsas.state.va.us/SVC-SFAddressDetails.asp?facname=Piedmont%20Geriatric%20Hospital DMHMRSAS State Facilities Information]
* [http://www.afscme.org/publications/steward/stew99w3.htm Savvy Steward Helps Save Hospital] , American Federation of State and County Municipal Employees, Winter 1999.
* [http://www.blackstoneva.com/courier/121400.shtml County Rallies Troops for Piedmont] , Billy Coleburn, Courier Record, Dec. 14, 2000.
* [http://www.blackstoneva.com/courier/012402a.shtml Hospital's Condition Critical, Says Nottoway Co. Supervisor] , Bille Coleburn, Courier Record, Jan. 24, 2002.
* [http://leg1.state.va.us/cgi-bin/legp504.exe?ses=021&typ=bil&val=hb995 Legislative Information System] , Bill Tracking, HB 995, 2002 session.
* [http://home.hamptonroads.com/stories/print.cfm?story=64674&ran=48466 State Department Wants Facility for Worst Sex Offenders] , Associated Press, Jan. 14, 2004.
* [http://www.oig.state.va.us/Annual_Reports/oigfinal.pdf Office of the Inspector General for the Department of Mental Health, Mental Retardation, and Substance Abuse Services] , Semiannual Report, Oct. 1, 2003 - Mar. 31, 2004.