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Sonoma Developmental Center loses federal certification again

CALIFORNIA DEPARTMENT OF PUBLIC HEALTH took enforcement action against SDC’s intermediate care facility. Robbi Pengelly/Index-Tribune file photo

CALIFORNIA DEPARTMENT OF PUBLIC HEALTH took enforcement action against SDC’s intermediate care facility. Robbi Pengelly/Index-Tribune file photo

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The embattled Sonoma Developmental Center – home to some 439 residents with a variety of developmental disabilities on a 1,000-acre campus outside Glen Ellen – was notified on Friday that its Intermediate Care Facility does not meet Medi-Cal compliance standards following a survey completed this month, and the facility will lose federal funding for 166 residents.

The ruling takes effect 90 days from last Friday.

That news follows the 2013 decision to decertify four of 10 residential units in the facility’s Intermediate Care Facility (ICF) because of failure to cure 57 “deficiencies” and four cases of “immediate jeopardy to resident health and safety.” At that time, federal funding for the care of 112 residents was lost, costing the state some $1.37 million a month.

Prior to that, the facility was rocked with revelations of abuse, including rape and assault with a Taser weapon.

Friday’s decertification letter from the California Department of Public Health (CDPH) affects seven units of the ICF, although a press release from Nancy Lungren, spokesperson for the Department of Developmental Services, which oversees SDC, stated that the affected ICF “units remain fully operational and services for residents will not be interrupted.”

The CDPH survey was an outgrowth of noncompliance issues reported before the 2013 decertification measure. And while Lungren reported that “many improvements have been made at Sonoma DC,” she added, “upon review by CDPH it was determined that the facility did not reach sufficient compliance.”

As a standard practice, said Lungren, DDS will review findings of the survey before deciding whether to file an appeal of the decertification.

According to a CDPH press release, the actions against SDC, “follow the conclusion of the Sonoma Developmental Center’s Program Improvement Plan (PIP), initiated in March 2013, by mutual agreement between CDPH and DDS. The PIP stipulated actions Sonoma Developmental Center would take to achieve sustainable compliance with all eight conditions of participation in Medicaid participation to forestall termination. During a survey initiated on May 5, 2014 and concluded today, CDPH determined Sonoma Developmental Center had not met the requirements of the PIP and was not in compliance with all the Medicaid conditions of participation.”

Meanwhile, a task force initiated by California Health and Human Services Secretary, Diana Dooley, reconvened July 24 to further explore the state of alternative, “community based” resources into which SDC residents could be moved.

A task force report issued in January concluded that the expense of maintaining large developmental centers can’t be sustained. It currently costs the state close to $400,000 a year to house and care for each SDC resident, and no one believes that cost can continue indefinitely. The task force recommendations include the proposal 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.

But how many SDC residents can be safely and humanely moved, and where they can be moved to, are questions no one has yet answered.

Serving that declining resident population is a work force currently estimated at about 1,200 employees, including medical staff, direct care givers, support staff, facilities staff, police and fire personnel, along with specialty technicians, some of whom have pioneered the development of adaptive equipment, including everything from special wheelchairs to custom-made shoes. Some of those services are thought to be unique to SDC and would be hard to replicate, facility advocates say, in the outside world.

SDC is the largest employer in the Sonoma Valley, with a payroll that will be difficult to replace.

Family members and other advocates for the care of SDC residents have united in defense of the services provided there and argue that moving many of the increasingly disabled population would dramatically reduce their quality and length of life.

Despite widespread fears to the contrary, the task force report did not recommend declaring SDC, and other developmental center lands, surplus and putting them on the market. Rather, the task force concluded that “unused (current and prospective) state DC land should be leveraged to benefit consumers rather than being declared surplus … the property should be considered for future State-operated facilities and to develop community services, including the Health Resource Center and mixed use communities similar to Harbor Village in Costa Mesa.”

The Task Force added that, “ … state land should be retained and the State should enter into public/private partnerships to provide community integrated services, where appropriate …”

All California Developmental Centers are currently under an admissions moratorium, which accelerates their declining populations, but approval was recently granted for the creation of a crisis care unit at SDC that could admit five patients.

Precise details of the compliance failures found at SDC in the most recent survey, which lasted more than 10 weeks, were not announced on Friday, and the precise amount of federal money to be lost was not reported.

Lungren’s press release stated that, “The Department appreciates all of the hard work and effort by the dedicated staff in making improvements that have been implemented over the past few years … The Department will continue to support the improvements at SDC and remains committed to regaining federal certification.”