State Officials Appeal CDPH Decision to Decertify ICF Units at Sonoma Developmental Center

State officials announced on Monday that they had submitted a formal request on August 8, 2014 for an appeal and full evidentiary hearing on the decisions and findings of the California Deparment of Public Health (CDPH) relating to their enforcement action on July 25th against seven intermediate care units at Sonoma Developmental Center (SDC). That action was the decertification of the intermediate care facility at SDC, which means the loss of $2.5 million per month in federal funding for the Center

That appeal will give the center valuable time to correct problems CDPH found and to bring the facilities fully into compliance, according to Nancy Lungren, assistant director of communications at the Department of Developmental Services (DDS), which oversees Sonoma Developmental Center.

The decertification at SDC would not go into effect for 90 days from the date of the decision by CDPH (July 25th). The appeal gives DDS and the Center an additional 120 days beyond that to correct everything.

from the official press release...

In January 2013 Sonoma removed 4 units from federal participation and entered into a Performance Improvement Plan (PIP) with the CDPH to continue federal funding 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, a great deal of progress has been made at Sonoma to come into compliance with the federal requirements.


"Sonoma 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," said Karen Faria, Executive Director of Sonoma Developmental Center. "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.
"Most importantly, we are committed to providing a safe and secure environment for our residents, and one in which they thrive," said Ms. Faria.


Some of the improvements at Sonoma include:

• Expanded opportunities for Sonoma residents to access the community and expand independent skills.
• Improved human resources systems that resulted in the hiring of 321 additional staff resources in both the clinical and administrative operations.
• Developed and implemented an extensive re-training program with a focus on direct care staff in competencies in areas of client protection, abuse reporting, nursing care, behavioral services, active treatment, and the person-centered planning process.
• Augmented the policy development and review process which led to a substantial number of revised and more comprehensive facility policies that guide and direct services and daily operations.
• Restructured the Executive Committee and Governing Body oversight and monitoring process to ensure a comprehensive overview of the Center's operations including facility policy revisions; improved data and trend analysis, and increased systems for staff deployment and training.
• Implemented a system of review (Whole Person Review) processes that ensures ongoing monitoring, oversight and accountability in areas related to resident rights, access and treatment programs to assist and support individuals with behavioral and psychiatric support needs.

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The letter sent on August 8, 2014 to Mr. John Dexter, Chief, CDPH, Licensing and Certification Program follows:

STATE OF CALIFORNIA
DEPARTMENT OF DEVELOPMENTAL SERVICES
EDMUND G. BROWN JR., Governor

SONOMA DEVELOPMENTAL CENTER

P.O. BOX 1493 ELDRIDGE, CA 95431

August 8, 2014

John Dexter, Chief
California Department of Public Health
Licensing and Certification Program Provider Certification Unit
MS 3100
P.O. Box 997377
Sacramento, CA 95800-7377

Dear Mr. Dexter:

This letter is submitted as an appeal and a formal request fora full evidentiary hearing, in accordance with Title 22, CCR, Division 3, §51048.6 by the Department of Developmental Services (DDS) with respect to the decisions and findings of the California Department of Public Health (CDPH) as stated in their letter dated July 25, 2014.

In January 2013 Sonoma Developmental Center (Sonoma) removed 4 units from federal participation and entered into a Performance lmprovement Plan with the CDPH to continue federal funding 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 a great deal of progress has been made at Sonoma to come into compliance with the federal conditions of participation.

The management of Sonoma has been focused on continuing 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. Some of the major improvements made at Sonoma are:

• Expanded opportunities for Sonoma residents to access the community and expand independent living skills.
• lmproved human resources systems that resulted in the hiring of 321 additional staff resources in both the clinical and administrative operations.
• Developed and implemented an extensive re-training program with a focus on direct care staff in competencies in areas of client protection, abuse reporting, nursing care, behavioral services, active treatment, and the person-centered planning process.
• Augmented the policy development and review process which led to a substantial
number of revised and more comprehensive facility policies that guide and direct services and daily operations.
• Restructured the Executive Committee and Governing Body oversight and monitoring process to ensure a comprehensive overview of the Center's operations including facility policy revisions; improved data and trend analysis, and increased systems for staff deployment and training.
• lmplemented a system of review (Whole Person Review) processes that ensures ongoing monitoring, oversight and accountability in areas related to resident rights, access and treatment programs to assist and support individuals with behavioral and psychiatric support needs.

Therefore, Sonoma requests a review of the determinations cited by CDPH in their letter dated July 25, 2014. DDS reserves the right to supplement this Request for Hearing with pertinent information, evidence, and claims, and to present additional information, evidence, and claims at the hearing on this matter to show substantial compliance in areas where violations were cited. Please direct all correspondence regarding this matter to the Quality Assurance Department of the Sonoma Developmental Center.

Please feel free to contact my office with any further correspondence and/or if you have any questions.

Sincerely,
KAREN FARlA Executive Director