As Gov. Jerry Brown takes steps to downsize or close developmental centers, including California’s largest near Sonoma, concerns linger over whether community-based programs will be able to serve the needs of perhaps the state’s most vulnerable residents.
Some patients advocates say efforts to find care for the severely disabled outside an institutional setting often have proved disastrous.
“They end up in jail. They end up getting kicked out of homes, sometimes many times,” said Kathleen Miller, president of the Parent Hospital Association at the Sonoma Developmental Center. “We don’t have the answer for that.”
Miller is a member of a state task force that is reconvening in Sacramento this week to examine services for the developmentally disabled in the community, after the same group last year recommended downsizing the state’s four remaining developmental centers, which serve nearly 1,500 clients.
The vast majority of the state’s disabled population — approximately 275,000 people — receive community care at an annual cost of $4.7 billion.
But Miller said gaps in community care still exist, notably for clients who may have mental-health or substance-abuse issues on top of their disabilities.
The Sonoma Developmental Center in Eldridge cares for 443 patients and employs about 1,400, making it Sonoma Valley’s largest employer.
Advocates of the facility, and of developmental centers in general, say they are equipped to handle the most difficult cases, and that some residents could suffer harm or even die without specialized care. Critics argue the facilities are outdated, expensive to operate and harbor patient abuse.
Doubts about the future of California’s developmental centers have percolated for years as institutionalized care has fallen out of favor. Funding has become a major issue as the cost to treat patients in developmental centers has soared, from an average of $162,000 per resident in 2001 to more than $400,000 today. The centers serve 1,239 residents, at a cost of $528 million for this fiscal year.
Diana Dooley, California’s Health and Human Services secretary, convened the task force last summer following media reports detailing graphic examples of abuse at the developmental centers and the failure of law enforcement to properly investigate the crimes. The Sonoma center has given up federal funding for 112 seriously disabled patients amid investigations into problems at the facility.
The task force includes consumers, consumer advocates, regional centers, community service providers, organized labor, families of developmental center residents, members of the Legislature and Department of Developmental Services staff.
The group ultimately recommended the state operate a limited number of smaller, safety-net crisis and residential services and get away from larger, more expensive to operate institutions.
Gov. Brown’s budget for this fiscal year reflected the recommendations, setting aside $2.4 million for two transitional homes and an adult residential facility, and $1.2 million to increase regional center staffing. The governor also was granted authorization for $1.1 million to establish a new crisis unit at the Sonoma Developmental Center. The unit, which would serve no more than five clients and be staffed by 14 employees, would be one of two in the state.
Dooley is now calling the task force back to Sacramento to develop recommendations to strengthen the community system in the context of the state’s growing and aging disabled population and constraints on resources. The group’s first meeting is Thursday.