Kathleen Miller is desperately afraid that her disabled son could not survive outside the Sonoma Developmental Center.
She previously tried moving Dan Smith, who is 46 and has autism and bipolar disorder, into board-and-care homes. Both times he was kicked out.
"It was horrible," said Miller, 67, who lives just north of Santa Rosa.
Her son's future and that of 1,510 of California's most vulnerable residents is on the line with a new task force that will recommend whether the state's four developmental centers are still viable or should be scrapped.
California's Health and Human Services Agency is leading the effort, which again confronts the long-standing dilemma of where best to care for people whose disabilities are so profound they require constant and expensive monitoring.
Developmental centers are saddled with aging infrastructure, declining populations and, in the case of the facility in Sonoma Valley, loss of federal funding related to problems that include patient abuse.
But community-care options, as Miller can attest, aren't a panacea.
"This has been the only home they've known," Sonoma County Supervisor Susan Gorin, whose district includes the developmental center, said of the nearly 500 people who reside at the facility, the largest of its kind in the state. "It's just not safe for them to be in these group homes or community care centers."
The demise of developmental centers has long been predicted in California. Advocates of keeping the institutions open are particularly worried in this instance by the timing of the task force and its stated mission, which includes setting a "timeline for future closures."
The panel was created following media reports detailing graphic examples of abuse at the state's 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 troubled facility.
In an effort to correct the problems and restore that funding, the center has entered into a federally approved performance improvement plan
Karen Faria, the center's new executive director, declined comment through a spokesman. In a May 22 letter to staff obtained by The Press Democrat, she wrote that the task force does not change the center's mission.
"All the staff of Sonoma have lived and worked through some hard times lately and I am confident that, despite the unpredictable future we face, we all will continue our commitment to the people we serve," she wrote.
A spokesman for the state's Health and Human Services Agency also declined to say whether the task force is a clear indication the state is moving to shut developmental centers.
To Miller, it seems obvious.
"I think the task force is another notch in that direction," she said.
Nevertheless, Miller, who is president of the center's Parent Hospital Association, accepted a personal invitation from Diana Dooley, secretary of the state Health Agency, to be a member of the panel.
"Am I going to say, 'No,' in having a voice in helping to shape the future? Please. No way. I have to do that," she said.
The task force will begin meeting no later than June 15 and is supposed to wrap up by Nov. 15.
State Sen. Noreen Evans, D-Santa Rosa, said she understands why those who have loved ones at developmental centers might look askance at the task force.
"I understand their concerns and fears, but I do think it (the task force) is an appropriate thing to do to have stakeholders involved in making some recommendations," she said.
Evans, who is a member of the Senate Human Services Committee, said it is "important" to continue to provide services to residents of developmental centers and to do so in communities where their families reside.
"Whether it has to be in a state hospital or not, that's a whole different story," she said.
The Eldridge facility is Sonoma Valley's largest employer with a workforce of about 1,200 and an operating budget of about $146 million for this fiscal year. It has been a community fixture since 1891.
In 1965, the Legislature, alarmed at conditions in state institutions, created two pilot programs, known as regional centers, for providing community services in San Francisco and Los Angeles.
The program expanded to 21 regional centers in 1977 with the idea that the developmentally disabled should be cared for in the "least restrictive" setting.
The exodus into community care continued through 1990, when William Coffelt of Vallejo sued the state after his 11-year-old son, Billy, was found in a pool of his own blood in a shower stall at the Sonoma center. The state settled the suit in 1993 by agreeing to move 2,000 people out of institutions within five years, cutting the population by one-third and closing centers in Stockton and Camarillo.
The population at developmental centers has steadily declined since then, from 6,544 in 1992 to 1,510 today.
At the same time, the cost to treat patients has soared, from an average of $162,000 per resident in 2001 to $300,000 today. Advocates of the centers argue that's because the facilities treat the most difficult cases.
Gorin said, "We should do whatever it takes to keep the (Sonoma) developmental center in operation as long as possible." She also acknowledged having discussions about what to do with the property should the center be closed or scaled back. She declined to identify those taking part in the conversations.
Gorin toured the property on which the center is located on April 6 with representatives from several environmental groups that have long eyed the property for its proximity to Jack London State Historic Park and the Sonoma County Regional Park next to Highway 12.
"I think it's important for community groups to come together to envision what we might plan for in the future," Gorin said. She plans to tour the medical and housing facilities later this month.
Megan Gordon, a longtime psychiatric technician at the Sonoma center, said she's not worried about the center closing and she and her co-workers losing their jobs.
"We provide very specific services that can't be duplicated," she said. "I think we're going to be here for awhile."
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