Open Letter to Secretary Dooley: On the possible closure of Sonoma Developmental Center

Dear Secretary Dooley,

I am writing you regarding the current status of Sonoma Developmental Center (SDC) and it's possible closure. I am both a staff physician at SDC and a citizen with a brother who is living in the community with intelectual disabilities (ID) . As such I feel I have a unique perspective on the effects facility closure would have on our clients with ID.

I have significant concern regarding the possiblity of closing SDC. Currently we have a unique and highly dedicated staff of nurses, physicians and consultants with expertice in disability medicine that I do not believe can be matched in the community setting. Closure of the facility would have a dramatic negative impact on the well being and medical management of our clients, in my opinion. My collegues and I all have anectodal experience of poor outcomes, and in my case at least one death, due to transfer of clients into the community setting. Unfortunately, despite our efforts to obtain objective data of follow-up and outcomes of our clients following communty placement, we have been unable to obtain such data. While anecdotal evidence should not determine policy, the medical staff here is unanimous in our assessment that closure of this facility could be extremely burdensome if not catastrophic for our most challenging and sickly clients, especially the elderly residing most of their lives here.

As a brother of a person with ID I can not tell you the frustration and challenge I have had obtaining proper medical care for him in the community setting, with regards to his epilepsy and mental health needs . While his doctors are compassionate and well intentioned, it has become obvious to me, especially since working at SDC, that their expertice in managing his special medical needs are lacking. I have had, on numerous occasions, had to prescribe urgent or emergency medical management to him due to lack of availability or knowledge base of his physicians. My recurrent  thoughts in such incidents are: "we are both extremely fortunate I have this unique medical training." and " what do others who have no such training do for their family or loved one with such disabilities in these settings?"

Rather than closing such a valuable institution I believe we would all be best served by strengthening it to both maintain residence for those most challenged individuals, and even expanding its services. As an outpatient referral center for those already residing in the community who require specialty care in neurology, psychiatry, physical medicine, geriatrics and palliative medicine, our facility, physicians and consultants would be uniquely trained to offer state-of-the-art, cost-effective medical care to this underserved demographic of our citizenry.

As I physician practicing disability medicine for some of our most challenged citizens, and as a brother of one such citizen struggling to maintain his health in the community, I urge you to strongly consider the negative effects of SDC closure on these vulnerable individuals.

Sincerely,

Gerald Camarata, MD