Sonoma Developmental Center appeals state penalty

The Sonoma Developmental Center submitted a formal request on Aug. 8, for an appeal of the decertification findings brought against the Glen Ellen facility by the California Department of Public Health (CDPH).

According to a Monday press release from Nancy Lungren, spokesperson for the Department of Developmental Services (DDS), the appeal requests a full evidentiary hearing on the decisions and findings of the CDPH survey that was conducted at the center over the past several months. The CDPH enforcement action was announced July 25 against seven units of SDC’s Intermediate Care Facility (ICF), alleging numerous program failures that do not meet the statutory requirements of the Social Security Act. The decision affects federal payments for 166 residents. The result, if the decertification action is upheld, would mean the loss of $2.5 million a month in federal funding through the Medi-Cal program. No funds will be withheld during the appeal.

The July action followed the decision in January 2013 to remove four ICF units from federal funding because of noncompliance with CDPH standards. SDC entered into a Performance Improvement Plan (PIP) with the CDPH to continue federal funding for those units after extensive discussion with both CDPH and the Centers for Medicare and Medicaid Services (CMS). Under the plan, DDS contracted with outside experts, subject to the approval of CDPH and CMS, to implement improvements at Sonoma. With the assistance of those independent experts, claim SDC administrators, a great deal of progress has been made at Sonoma to come into compliance with the federal requirements.

According to a press release statement by SDC executive director Karen Faria, “Sonoma (Developmental Center) has made improvements in all aspects of care and services to the men and women residing at Sonoma, including an emphasis on medical, behavioral and training services. We have evaluated all aspects of operations and direct care of the individuals who reside at Sonoma, and will continue to work closely with CDPH and CMS in making improvements in areas as needed.

Added Faria, “Most importantly, we are committed to providing a safe and secure environment for our residents, and one in which they thrive.”

In a letter to CDPH Chief John Dexter, Faria outlined an extensive list of program improvements she said had already been achieved at SDC.

Included on her list were:

• Expanded opportunities for residents to access the local community and expand independent living skills.

• Improved human resources systems that resulted in the hiring of 321 additional staff in both clinical and administrative operations.

• Development and implementation of an extensive re-training program with a focus on direct care staff, client protection, abuse reporting, nursing care, behavioral services, active treatment and person-centered planning.

• Restructure of the facility’s executive committee and governing body oversight and monitoring process to ensure a comprehensive overview of the center’s operations.

• Implementation of a “Whole Person Review” process that ensures ongoing monitoring, oversight and accountability.”

The resident population at SDC has been in steady decline since a legislative moratorium was imposed on all the state’s development centers two years ago. DDS lists the current resident population at 439, down from nearly 1,200 in 1994.

The current estimate for the average annual cost of housing each resident at SDC is $400,000.

That cost is a primary reason state officials are exploring an alternative treatment model based on smaller group homes embedded in communities, but there is currently insufficient infrastructure in Sonoma County to absorb the SDC resident population, county officials have warned.

Meanwhile, acknowledging that SDC has a set of professional skills and resources unavailable in smaller housing models, the state has approved admittance of five more, critical care residents and a specialized treatment program to care for them.