A close reading of the 207-page “Statement of Deficiencies” at Sonoma Developmental Center, released July 25 by the California Department of Public Health, leads to a variety of disturbing conclusions, by no means all of them about the quality of care at SDC. Those findings are of critical importance because they could lead to the loss of $2.5 million a month in Medi-Cal funding for the beleaguered facility.
A significant number of compliance problems reported in the statement were related to simple hygiene practices like hand washing, an understandably important concern among a population of people often physically and emotionally incapable of practicing good hygiene for themselves. Reading through the list of hygiene errors, it appears that some line of care staff did not practice hand-washing protocols as persistently and rigorously as required. Those failures could be – and should be – easily remedied.
More complicated is the care and attention required to monitor and respond to changes and issues with client health, particularly their bowel movements, a crucial indicator of gastrointestinal health, especially among patients who cannot properly chew their food and must sometimes be fed or hydrated through a tube. Several cases indicate failures in properly monitoring patients with bowel issues, including one patient who died after contracting sepsis from peritonitis caused by a torn intestinal wall.
A lay reader leafing through the treatment notes on cases like this one is struck at once by the complicated and detailed record keeping and reporting necessary for monitoring and responding to the health issues of each patient. It is hard to escape the conclusion that, rather than punish the facility with the cutoff of federal funding, an appropriate solution would appear to be better training and monitoring of SDC line of care staff. These are not, as far as we can tell from a variety of contacts, indifferent, incompetent or uncaring people.
It is even harder to escape the conclusion that, if these resident patients, many of whom are not only incapable of properly caring for themselves, but often can’t articulate vital information about their own condition, were moved out of SDC to small group homes in the community, the level of supervised care would plummet.
The Department of Developmental Services website expresses a similar concern when it states, “ No one denies there are problems, but many of those problems can be traced to a lack of funding in difficult economic times ... Those who work with the developmentally disabled need to be better trained and educated. Development of facilities needs to be better planned and monitored.”
Punishing SDC for a systemic problem by withdrawing funding seems, at one level, to be counter-intuitive and make little sense. We hope this “deficiency” crisis can be used to heal instead of punish.
Maestro Marcelo
Rarely is one person so closely associated with the success of a signal fundraising event and the causes it serves, as Marcelo Defreitas who engineered the La Luz Center’s Noche event for the fourth straight year.
Defreitas is the first to insist he doesn’t do it alone – scores of volunteers make it happen – but those volunteers are quick to credit Defreitas as the engineer driving the train. In this case he pulled into the station Saturday night with a record $400,000 raised for La Luz community programs. A very bright light indeed.
– David Bolling
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