Sonoma Developmental Center losing millions in federal funding

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The Sonoma Developmental Center is losing millions more in federal funding that likely will have to be made up by California taxpayers after health officials discovered a disabled patient in February hooked up to an empty oxygen tank, triggering decertification of several units.

The patient did not suffer lasting harm as a result of the snafu, according to officials. But the incident has profound implications for the Eldridge facility near Glen Ellen, including the loss of an estimated $26 million in federal funds that would have gone toward patient care.

The situation further clouds the immediate future of the center, which the state is seeking to close by 2018. Some advocates for the disabled say patients aren’t safe at the facility, and the state should move more quickly toward finding alternative care for them in community-based settings.

State Sen. Mike McGuire, D-Healdsburg, called the incident “absolutely unacceptable,” and said the state Department of Developmental Services, which oversees the Sonoma facility, “should have been much more diligent” ensuring patients were receiving proper care.

But McGuire, who has vociferously fought against the state’s timeline for closing the Sonoma facility, said he does not believe, based on the latest findings, that patients are in immediate danger. He called the February discovery an “isolated incident.”

Others disagreed.

“This really shows that Sonoma can no longer safely meet the needs of its residents,” said Will Leiner, an attorney for Disability Rights California. “The state needs to take immediate action.”

Gov. Jerry Brown has set the goal of shutting the center by 2018 as the state moves toward operating a limited number of smaller safety net and crisis residential services. But how to care for the hundred of patients still residing in one of the state’s three remaining developmental centers is a contentious and vexing concern.

The latest problems at the Sonoma center are focused on the intermediate care unit, which treats patients for ailments ranging from traumatic brain injuries to disorders that cause them to eat inappropriate things.

State health officials in 2014 gave notice they were planning to decertify seven of the 11 units within the intermediate care facility over the deficient and unsafe care of hundreds of disabled patients after officials noted facility deficiencies ranging from failing to keep accurate medical records to not adequately protecting clients from abuse.

The developmental center appealed the decertification, allowing it to continue receiving federal funding.

But in February, health officials uncovered more problems, including the empty oxygen tank. The survey was conducted by the California Department of Public Health, which has dual oversight of state licensing and federal Medicare and Medicaid certification of California’s health care facilities.

In the February incident, the agency declared an “immediate jeopardy” at Sonoma based upon the discovery of the patient’s empty supplemental oxygen tank. Staff replaced the empty tank and checked the individual’s oxygen level, which was found to be within normal limits, officials said.

But the survey also found standards were not being met in three categories — including client protection — that were part of a 2013 settlement agreement seeking improvements at the center.

That same year, the center 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.

State health officials on May 13 notified acting center director Aleana Carreon that the facility had failed to “substantially comply” with the terms of the settlement agreement.

As a result, federal funding for patients residing in the seven units of the intermediate care facility will terminate July 1, according to the letter. Officials estimate the loss will amount to $26.4 million next fiscal year.

The state’s action could result in approximately 135 clients in the intermediate care program — more than a third of the center’s population of 352 residents — losing federal funding administered in California through Medi-Cal, which covers about 40 percent of the cost for qualifying patients.

An official with Developmental Services insisted patient care at Sonoma remains a top priority.

“DDS employees will continue to make improvements and provide quality care and services to our residents as we move forward with the safe transition of Sonoma residents to the community by the end of 2018,” Dwayne La Fon, deputy director for the Developmental Centers Division at DDS, said in a statement.

Leiner, the attorney for Disability Rights California, said the situation reflects the need for the state to accelerate development of community-based care programs to handle the influx of developmental center residents.

“Rather than continuing to invest money on an outdated model of care, it should be used to build out community capacity instead,” Leiner said.

But Kathleen Miller, president of Sonoma’s Parent Hospital Association, expressed concerns that the process of closing the Sonoma facility is being rushed. She said the center still provides quality care.

“Oh please, I’m there all the time,” said Miller, whose adult son resides at the facility.

Gov. Brown’s proposed budget for developmental centers this coming fiscal year seeks a nearly $45 million reduction in spending. His proposed $526 million budget for developmental centers represents an almost 8 percent reduction over previous year spending.

“The state is going to have to pick up the cost that was once being born by the feds, because we can’t jeopardize the livelihoods of residents just because the feds have decided to pull the plug on funding,” McGuire said.

The senator said the funding problems are not reason to hasten the facility’s closure. He called the current three-year timeline “hogwash,” saying it will take longer for the state to figure out how to care for some of the state’s most medically fragile people without comprising their well-being.

For decades, California has been undergoing a seismic change in how it cares for the disabled by systematically closing institutions and shifting that care to community-based programs.

Brown’s proposed $6.7 billion budget for developmental services for the coming fiscal year reflects that trend; the governor recommends spending about 90 percent of the budget for community-based programs and services, as well as administrative costs.

In addition to closing the Sonoma facility by 2018, Brown is seeking to shut the Fairview Developmental Center in Southern California and the nonsecure treatment portion of the Porterville Developmental Center by 2021.

Just over 1,000 people reside in the state’s three developmental centers, compared with an estimated 302,000 in community settings by summer 2017.

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

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