The following article ran recently in The Kenwood Press as a guest editorial. It comes after several months of attention focused on California's developmental centers and Sonoma Developmental Center in particular.
Clarifying the situation at SDC
by Kathleen Miller, President, Parent Hospital Association
PHA (Parent Hospital Association) is an organization that includes the families and friends of the residents of Sonoma Developmental Center (SDC). Our primary focus is the safety and well-being of SDC’s residents. We support three guiding principles: transparency, open communication, and options for California’s developmentally disabled citizens. We also continue to support the Sonoma Developmental Center as one option for a select group of vulnerable disabled and we continue to believe in the care given to our loved ones residing at SDC.
Recently there has been a series of news articles that portray Sonoma Developmental Center and the care there in a negative context. While we welcome oversight, including the coverage on issues by the news media, we are concerned that some of these articles and stories contain inaccurate information and do not fairly portray SDC, its staff and residents. We also are concerned that in recent months there has been a decline in the care of SDC residents. In reviewing the hundreds of pages from the recent licensing survey of the behavioral residents at SDC, a common thread appears – reductions in staffing have led to staffing shortages that have directly or indirectly contributed to many of the concerns cited in the licensing survey.
In one article by California Watch, Terri Delgadillo, Director of the Department of Developmental Services (DDS), stated that she “recognizes the actions necessary to ensure the health and safety of the residents of Sonoma Developmental Center.” She goes on to talk about how she has replaced executive staff. Such actions are insufficient. The truth is that SDC has a history of staff shortages. The shortages have been compounded by salaries that are noncompetitive with salaries at other mental health and correctional facilities in the state. They have been further impacted by furloughs and long standing hiring freezes. The DDS response to these shortages is to reduce allocations for line-of-care staff and other licensed positions. Even with these reduced standards, overtime has been a continuing issue at SDC with line-of-care staff being subject to mandatory holds (overtime).
It is the role of DDS to oversee the developmental centers and ensure the care and safety of the residents. We recognize that the staff at SDC and DDS have worked hard on plans to improve the care at SDC, and we commend their efforts. However, even in light of the recent licensing survey, DDS is trying to once again reduce staffing standards in a behavioral unit. The most recent survey was no doubt influenced by the recent media reports and, in fact, cited the highly publicized incidents in their report.
Importantly, we want to point out that SDC has not, in fact, lost their certification for behavioral residents, despite the recent licensing survey. Further, the recent licensing survey for the nursing residents found no conditions out of compliance. The news articles on the licensing survey were incorrect in stating that SDC was the only developmental center in danger of losing certification. In fact, Porterville Developmental Center has no current certification for many of its residents.
While SDC has lost certification in the past, as have other developmental centers, they have successfully regained it when plans of correction were put into place. It is the job of the licensing staff to identify deficiencies and to seek improvements in the system. We must be careful not to allow the media to misstate or sensationalize a process that is an inherent and necessary part of the system.
A sister paper to California Watch, the Bay Citizen, recently issued a story entitled “14 California Hospitals Fined for Dangerous Mistakes.” It is not at all uncommon for licensing to find conditions out of compliance in many of their surveys. Sometimes when you go in with a hammer, you are going to find a nail. This is the process that allows for growth and improvement in the care at the centers and in other health care settings.
We also feel it is important to shed the light not just on the potential for abuse at the developmental centers, but elsewhere in our service system. It is a sad fact that despite hiring practices that attempt to exclude those who might do harm, a few bad apples get through. The hiring practices at SDC match or exceed those for community homes in their scrutiny of potential employees. The reporting practices and procedures at SDC exceed those in place in any other setting. The abuse at SDC was discovered because alert staff reported it.
Families of SDC residents have concerns that in isolated community homes where sometimes only two individuals may be working at a time, and those may be friends or family members, reporting may actually be less likely to occur. The truth is there is often no way to know what goes on in some community homes. The Department of Health works hard to oversee some community homes, but many are solely licensed by the Department of Social Services (DSS). Some community homes may not receive a visit from DSS staff even once a year! We feel there is room for improvement in the oversight of many community homes.
We are grateful for the intense scrutiny that takes place at SDC and feel that as much as possible, it ought to be duplicated in community homes as well.
Finally we are concerned that there is little transparency about what happens to developmental center residents who are placed into alternative homes outside the center. We requested data from the DDS on behavioral clients who have left the centers in the past few years to see how many were forced out of their alternative homes and ended up in acute psychiatric settings or even jail. At first we were provided information indicating that there were no such instances. When we challenged that information, we were told by DDS that they did not have access to that data. When we sent a Public Records Act request to get information on the incidents of deaths during the transition and closures of Agnews and Lanterman Developmental Centers, we were, and continue to be, largely ignored. This, despite the fact that the closure laws themselves called for analysis and reporting on the impacts of these closures.
How can we trust that alternative placements will live up to the needs of our loved ones when we cannot know the results for those who have already been displaced from the centers? We have been told many anecdotal success stories, but these are not enough. We need the facts!
For the reasons listed above, and many more that include our own personal stories, we continue to believe in the care SDC provides for our loved ones and pray that it continues to remain an option. Refine it, improve it, even restructure it, but do not let us lose it. There simply is no replacement that has worked for our loved ones who call it home.
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