Ruling may cost Sonoma Developmental Center $2.5M a month

A litany of management and health care failures at Sonoma Developmental Center is outlined in a 207-page report released by the California Department of Public Health (CDPH) July 25, that could eliminate federal funding of $2.5 million a month for 240 residents of the Eldridge facility near Glen Ellen.

The list of negative findings includes the charges that SDC staff “failed to maintain an effective pest control system, failed to ensure maintenance was conducted and timely repairs done in the environment, failed to keep food safe during dining service and storage, failed to routinely monitor the dishwashing machine in the main kitchen to assure it was functioning properly.”

SDC management, states the report, “failed to ensure implementation of the following policies and procedures; food handling, receiving, storage, and equipment; Human Rights committee, whole person reviews, individual planning coordinator role and responsibilities, informed consent, psychotropic medications, physical, medical supports and restraints; abuse/mistreatment/neglect prevention and reporting; bowel care management, notification to the physician/nurse, gastrostomy tubes, and infection control.”

Additionally, states the report, “The facility failed to maintain systems that would prohibit abuse, neglect and mistreatment of clients residing in the facility. The Governing Body failed to ensure all alleged violations were reported immediately, investigated thoroughly and corrective actions were taken. The facility failed to ensure the Human Rights Committee reviewed and monitored programs that involved risks to client protections, including the informed consent process, unnecessary drugs and active treatment, locked doors, opportunities for choice and self-management i.e., manage monies, engage in the community and appropriate dressing and grooming.”

Residents covered by the deficiency assessment are housed in seven Intermediate Care Facilities (ICF) and are largely characterized as having often-severe behavioral issues related to their developmental disabilities. Last December, the facility’s four other ICF units lost federal funding after a survey found similar compliance issues. Federal dollars fund part of SDC program costs through the state’s Medi-Cal program, and CDPH has responsibility for ensuring that care and treatment meets federal standards.

The facility has 90 days before the ruling to decertify takes effect, and another 120 days after that if an appeal of the ruling is filed by the Department of Developmental Services (DDS), which oversees the state’s developmental centers.

SDC currently has 439 residents, approximately 1,200 employees and is in the center of a difficult review of future treatment options being focused on all four developmental centers in the state.

A task force convened by CDPH released findings early this year recommending that a significant percentage of SDC residents – if not all of them –be transitioned out of the facility into smaller, less expensive group homes situated in local communities. Current per-resident costs are estimated to average $400,000 a year, compared to about $50,000 a year for state prison inmates.

But despite the costs associated with care at SDC, the parents and guardians of residents there continue to express support for the facility and some insist that many, if not most, of the resident population is too severely disabled to leave the supportive environment and the 24/7 medical care available on the bucolic campus.

According to DDS spokesperson Nancy Lungren, a decision is imminent on whether or not to file an appeal of the CDPH action. “We are analyzing all aspects of the survey report,” she stated in an email, “including where the facility has progressed since the last survey, and where it can make improvements; the Program Improvement Plan and other compliance activities.”

CDPH could have revoked SDC’s state license to operate, but that would have triggered a housing crisis no one is currently prepared to address. A recently reconvened meeting of the Task Force exploring future scenarios for developmental center residents, focused on cost assessments for creating the community infrastructure needed to move developmentally disabled residents into smaller group homes. But a local ad hoc group formed to lobby for preservation of some SDC services has argued that no viable community infrastructure currently exists in Sonoma County.

How the looming decertification of ICF units and potential loss of millions in federal funding will affect SDC’s future remains an open question.