New crisis home signals evolving future of Sonoma Developmental Center

The Sonoma Developmental Center, which is fighting to remain open amid criticism that care offered at the 124-year-old facility is substandard and too expensive to maintain, this week debuted a new crisis home where a modern design is meant to complement what officials touted as cutting-edge treatment protocols.

The dining area inside “Northern STAR” includes wine art on the walls and a completely remodeled kitchen where clients will be encouraged to cook their own meals. One of the two recreation rooms has a large TV, roomy couches and an arcade-style basketball game. A sign above the washer and dryer reads: “This home has endless love & laundry.”

The homey touches complement what center officials described during a media tour this week as a less-restrictive way of treating people who are suffering severe psychological and emotional distress, on top of lifelong physical and mental disabilities.

On the whole, Northern STAR, which will accept its first client next week, and a similar facility opening at Fairview Developmental Center in Orange County represent visible examples of change at the facilities, which are battling declining admissions, licensing problems and calls to shut down to save taxpayers money.

With admissions limited to a maximum of five people, the new crisis homes - meant to quickly treat people and return them to outside care providers - are unlikely to make a major dent in the overall care of the state’s severely disabled population, which numbers in the hundreds of thousands. But proponents say the homes will serve a crucial need by caring for people who might otherwise wind up in jails or in psychiatric wards at hospitals. The homes could be expanded in the future, supporters said.

“I think we have to start somewhere,” said Kathleen Miller, president of Sonoma’s Parent Hospital Association.

One advocate of community-?based care for the disabled, however, raised concerns about the number of people who can be admitted to the new crisis home, saying five is too many.

“You really have to focus your attention and care on people who have those issues,” said Bob Hamilton, executive director of the North Bay Regional Center, a Santa Rosa-based nonprofit organization that serves more than 8,000 disabled people in Sonoma, Solano and Napa counties. “If you have too many people having issues at one time in that one place, it can get scary and crazy.”

The state Legislature mandated the creation of the two crisis centers as California envisions a new future for care of the developmentally disabled. A state task force that includes Miller last year recommended closing or dramatically downsizing the state’s three remaining developmental centers in favor of smaller, crisis-intervention facilities, with longer-term care provided in partnership with regional centers and other ?community-based programs.

But critics of developmental centers are demanding that they simply be shut down. A Republican lawmaker has introduced legislation calling for the developmental centers to be closed within three years. The state Legislative Analyst’s Office made a similar recommendation, on the grounds that the centers are a significant drain on the state’s budget.

In Sonoma County, a local coalition led by Supervisor Susan Gorin is pushing back with plans to convert the buildings and land at the 1,000-acre site near Glen Ellen into other uses, while also maintaining some level of service for the disabled who reside at the center, in some cases for decades.

In that sense, the new crisis home could offer a window into the center’s future. Karen Faria, the center’s executive director, pointed out Northern STAR’s features this week while taking reporters on a tour of the facility, which will serve Northern California. The home’s acronym stands for “Stabilization, Training, Assistance and Reintegration.”

The clients admitted to the facility are likely to be at imminent risk of harming themselves or others due to serious and potentially life-threatening conditions. They cannot be facing serious criminal charges. Stays are limited to a year.

“Our job is to bring them back to where they were before the crisis,” Faria said.

Brad Backstrom, the program’s manager and supervising psychologist, said staff has undergone extensive training in how to de-escalate tense situations without having to resort to physical controls.

“I’m really confident we’re going to be successful re-stabilizing people,” he said.

That approach is worlds apart from when the Eldridge campus opened in 1891 as a school and asylum for the “feeble-minded.” It’s also an update on the current standard of care at the facility, which is home to 409 people, a number that continues to drop due to a moratorium on new admissions; transfers to community-based programs; and deaths.

Advocates of the facilities say they handle the hardest cases - treating the most severely disabled, including people who cannot feed themselves or speak - and that closing the developmental centers entirely risks endangering people’s lives. Faria noted that 75 percent of the people who reside at the Sonoma Developmental Center are over the age of 50, with the oldest being 91.

Hamilton, who favors closure of the developmental centers, said there is a need for a crisis home like the one unveiled this week in Sonoma Valley.

He said his nonprofit organization has resorted to putting people in hotels and monitoring them around-the-clock as an alternative to jail or a psychiatric ward.

“Any port in the storm,” he said.

Hamilton said his preference would have been to establish the new crisis homes outside institutional settings. He said about 100 residents currently reside at the Sonoma Developmental Center who were referred there by the North Bay Regional Center, one of 21 nonprofit care providers around the state created by 1965 legislation urging treatment of the disabled in the least-?restrictive setting possible.

“We have trouble getting folks out of there once they’re in there,” he said of developmental centers.

However, Hamilton also acknowledged that the regional center received no bids after putting out a request to create a similar crisis home in the community, either at an existing location or as a new facility. He blamed the lack of interest on uncertainty over program and building regulations for such a home, including disability requirements.

Gov. Jerry Brown’s proposed 2015-16 budget seeks $515 million from the state’s general fund for the state’s three developmental centers, representing an 8.5 percent funding decrease over the prior fiscal year.

The new crisis home at the Sonoma Developmental Center was formerly used as an intermediate care facility. The center spent $94,478 to remodel the kitchen, install fixtures and refurbish the residence, according to a spokeswoman for the state Department of Developmental Services. The state task force estimated the annual operating costs for both crisis homes to be $8.8 million.

In defending the cost, Faria on Monday said the future of the developmental centers “depends on the ability to serve more than 1 percent” of California’s total caseload of developmentally disabled people. The centers serve about 1,000 people. By contrast, an estimated 288,137 disabled Californians will be treated in community care settings by 2016, according to the Legislative Analyst’s report.

Many signs point to a continued population decline at the Sonoma center. That includes, according to Faria, the facility next week shutting down another of its nursing facilities.

The center in 2013 voluntarily withdrew federal certification for four units in the intermediate care facility, costing it $13 million annually in federal funding that had to be made up by the state’s general fund. The center currently is fighting to maintain federal certification for the remaining seven units in the intermediate care facility.

This week’s tour highlighted some of the services that the center has performed for decades but in some instances could be in jeopardy going forward.

In the center’s shoe department, where custom footware is made and fitted for physically disabled clients, employee Lisa Glover showed off a pair of high-tops manufactured by a private company that have become popular on the campus.

Asked whether she was concerned about such manufacturing putting her out of a job, Glover replied, “I’m pretty much near retirement. Anything they get out of me is icing on the cake.”

Nevertheless, the center, with about 1,300 employees, remains Sonoma Valley’s largest employer. Faria also noted that the center is hiring to help offset what she said are a “significant” number of looming staff retirements.

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