The Sonoma Developmental Center faces the loss of millions in federal funds and revocation of its license to treat 290 seriously disabled patients after California public health officials said they uncovered major problems at the troubled institution, including instances of patient abuse.

The problems earlier forced the ouster of the center's executive director and clinical director, and led to several staff members being disciplined or fired.

On Wednesday, the California Department of Public Health announced it is seeking to decertify the center's intermediate care unit -- which treats more than half of the center's total population of 517 -- by Jan. 4 if immediate actions aren't taken to address the problems.

The state rarely takes such action, which in other cases has resulted in health care facilities shutting down.

Terri Delgadillo, director of the state Department of Developmental Services, said in a written statement Wednesday that addressing problems at the Sonoma Developmental Center is her "top priority."

She said she will appeal the health department's actions, a move that could keep the intermediate care unit open and operating for at least a year.

Delgadillo also announced Wednesday that in addition to the personnel changes she made at the Sonoma center earlier this year, CHP Assistant Chief Frank Parrish will assume control of the center's police force until a new commander is hired.

Kathleen Miller of Santa Rosa, whose autistic son has lived at the developmental center's intermediate care facility for more than a decade, said she was "confused" by Wednesday's developments.

"I thought we were all working as part of a team, and now they (the state public health department) are doing this," she said. "I worry that they are worried about their public image rather than the well-being of the clientele."

Miller, who is president of the center's Parent Hospital Association, said families are "obviously concerned" that the intermediate care facility could close and that their loved ones could lose access to that care.

"It's going to ruin some holidays for sure," she said.

Public health officials insisted Wednesday that their actions were not prompted by media reports detailing graphic examples of abuse at the state's developmental centers and the failure of law enforcement to properly investigate the crimes.

Instead, they said problems at the Sonoma Developmental Center came to light during an annual recertification survey and licensing review.

State officials visited the sprawling Eldridge campus Wednesday to inform interim director Patricia Flannery that they are planning to terminate the facility's federal Medicaid funding after their investigation revealed 57 deficiencies, including four cases of "immediate jeopardy" to patient health and safety.

The immediate threats included instances of patients being abused by staff or one another, a staff member exposing himself and allowing a patient to ingest food against medical advice, according to Pam Dickfoss, assistant deputy director of the state's Center for Healthcare Quality.

The people who reside in the intermediate care facility where the problems were uncovered have ailments ranging from traumatic brain injuries to disorders that cause them to eat inappropriate things. The center also has a skilled nursing facility for more seriously disabled patients.

Flannery was informed on July 20 that the state was planning to discontinue the facility's Medi-Cal funding. Flannery asked for a reconsideration of the findings on Aug. 3, but a follow-up review found "dozens more deficiencies," including "serious threats to the physical safety of female clients in certain units," according to the Medicaid termination letter given to Flannery on Wednesday.

The public health agency has given the center 10 days to correct the most serious violations that place clients in immediate jeopardy or face termination of Medicaid funding on Jan. 4, regardless of any appeal.

Losing that money would represent a devastating blow for the center, which previously lost its certification in 2000 and spent $21 million in taxpayer money to get it back.

The average annual cost of treating a patient at the center is $300,000, according to Nancy Lungren, a spokeswoman for the Department of Developmental Services. She said the federal Medicaid program, which is administered in California through Medi-Cal, covers as much as 50 percent of the cost for patients who qualify.

In total, the Sonoma Developmental Center stands to lose an estimated $117,000 in federal funding every day should the facility lose its Medicaid eligibility.

The state also is threatening to revoke the license that allows the developmental center to operate the intermediate care facility.

Asked what would happen to the nearly 300 people who reside in that unit should that happen, Dickfoss said she is "very confident" the problems can be corrected and the facility can be brought back into compliance.

"We're starting that process today," she said Wednesday.

You can reach Staff Writer Derek Moore at 521-5336 or derek.moore@pressdemocrat.com. On Twitter @deadlinederek.