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Parents confront SDC chief

Sonoma Developmental Center Interim Director Patricia Flannery addressed parents and family members of residents of the state-run facility at a meeting Saturday morning on the SDC campus. During the meeting of the Parents Hospital Association (PHA), a group that advocates for SDC residents and that often serves as a liaison between family members of residents and the administration, Flannery made remarks leaving the audience confused about the Glen Ellen facility’s future.

While the family members were quick to praise the work of caregivers and staffers at SDC, they were also equally angry and confused with the center’s administration and with what they seemed to feel was a lack of clarity about the future of the facility.

“The future of Sonoma is about change,” said Flannery, effectively saying nothing and leaving parents and family members with serious questions about the fate of their loved ones.

Flannery came to Sonoma from the Department of Developmental Services (DDS) in Sacramento, where she is deputy director for developmental centers. Her position in Sonoma is only temporary, and she is expected to return to her post at DDS once the position is permanently filled, following a nationwide search she said is ongoing right now.

She took the reins at SDC in October 2012, amid myriad allegations of abuse at the facility and under the cloud of a California Department of Public Health (CDPH) evaluation that threatened to decertify the center. That action, if upheld, would, cost the center up to $117,000 a day in federal Medicare and Medicaid funding for its Intermediate Care Facility (ICF), which houses 290 residents. In December, SDC received notification that it would in fact fail to be recertified. On Jan. 4, the deadline for the decertification passed, though SDC held off a denial of federal funds by filing appeals to both the plan to revoke SDC’s license and its certification.

The Centers for Medicare and Medicaid returned to SDC in January and conducted a new survey, which, according to Flannery is still ongoing. She said officials from CDPH were also still observing conditions and services in the ICF.

“Like with every formal process, we know that there’s timelines associated with the filing of appeals, our opportunity to pull together information and evidence to challenge the efforts to terminate both our certification and our license,” Flannery told the approximately 100 family members assembled at SDC on Saturday. But she declined to give any timeline or plan for SDC, even when pressed to do so by an audience member.

Most contentious to the parents and family members, it seemed, was language in a July 2012 trailer bill that they think hints at plans to eventually close the facility.

At issue immediately is a moratorium on all new admissions to SDC that was included in the bill, and that would mean, if only by attrition, that SDC will eventually close. The population is rapidly aging – 63 percent of the 517 residents are over the age of 52.

“With that (trailer bill) language, what that really means is, the issue isn’t ‘Will the center close?’ it’s ‘When it will close.’ I don’t have that answer, and I don’t believe that DDS really has an answer,” said PHA President Kathleen Miller. “So, I don’t think anybody knows when, but we now all pretty much know, ‘yeah, it will close.’”

But Flannery broke in at that point to say, “There is no discussion today about ‘When will Sonoma close?’” and as she began a lengthy and somewhat convoluted explanation of the factors contributing to the moratorium, the father of a resident in the audience stood up and interrupted.

“I’m sorry, I have to speak,” he declared, his voice quavering, “because you are pushing the wrong envelope, and you can’t push me anymore.” And when Flannery again began to speak, interrupting him, the patient father became angry and said, “Yes indeed. You’re lying. There is a move on the part of DDS to get this closed. Of course you are going to get this closed.”

He told Flannery pointedly, “You’re a politician,” and said, “And you’ve managed to put in this trailer bill language, while we weren’t watching.”

He turned to the other parents and family members and implored, “We will be fools if we think that the DDS staff is necessarily on our side.”

While Flannery was at the meeting as the interim director of SDC, she said she also spoke as a representative of DDS. That acknowledgment, and the sometimes technical and bureaucratic nature of her responses, seemed to contribute to parents’ ire.

More than once Flannery mistakenly referred to the facility as Santa Clara instead of Sonoma, and seemed to not be completely in touch with the community.

Her mandate is to right a listing ship, and she outlined at the PHA meeting two of the main things she needs to tackle first.

Filling the many staffing vacancies at SDC is one of the immediate concerns the administration faces according to Flannery. Chronic understaffing has resulted in involuntary overtime shifts, and reports of staffers working 16-hour days.

While SDC has recently hired about 50 employees (most of whom are level-of-care nursing employees, said Flannery), there has been a significant loss of staff through retirement. In addition, she said, there are about 40 additional potential hires, including 25 psychiatric technicians and 10 to 15 registered nurses, currently in the background screening stage. When Miller asked Flannery if she had any idea of the net gain in employees, Flannery could not provide that information.

“We have a challenge with our staffing today,” Flannery said. “We’ve certainly had some people say to us, after they’d gone through the clearance process, ‘With all the scrutiny, all the news media attention, I don’t think Sonoma’s the place for me to come today.’”

Later Flannery said, making a similar allusion for the third or fourth time, “Staff feel somewhat demoralized by all the media attention.” That prompted a family member to retort, “The media attention is not the problem. It’s what they’re talking about.”

Besides its hiring efforts at SDC, the administration has also looked into getting temporary support from staff at other state facilities run by DDS to help stabilize the staffing problems at SDC.

One of the largest holes, and perhaps the hardest to fill, is the one currently occupied by Flannery herself. The search for an executive director has been extended nationwide (a move that required a special exemption to look outside California). The administrative services director position is also open; the roles had previously been held by Karen Clark, who went on to become interim executive director before Flannery came from Sacramento to take over, and has since retired.

The administration is also focused on ensuring that residents are in the appropriate housing. “Over the past year or year-and-a-half, there have been a number of residence closures, which has required consolidation of people from one home to another, ” Flannery said. The closures have mainly occurred due to the dropping population numbers of the center, but also sometimes because of incidents (such as a Taser assault, which resulted in the closure of the unit in which the assault occurred), and in one incidence because of a major roof leak. “What we have today,” said Flannery, “is really a number of residences in ICF where we’re not sure we have the right grouping of men and women living together.”

This process is still in the assessment stage, Flannery said.