Sunday, January 31, 2010

California to close its last large institutional care center for people with disabilities

From the LA Times:

Reporting from Sacramento - The Schwarzenegger administration plans to close one of California's last large institutional care centers for people with profound developmental disabilities.

The 82-year old Lanterman Developmental Center in Pomona, which houses 398 people with severe autism, cerebral palsy and other lifelong disabilities, could shut its doors within two years, said Terri Delgadillo, director of the state Department of Developmental Services.

The population of the 302-acre campus has dwindled from a peak of nearly 3,000 in the late 1960s, when a change in state law discouraged housing the developmentally disabled in large institutions. Since then the trend has been for the state to offer home-based services or to place people in group homes in their own communities.

With Lanterman's aging buildings and more than 1,300 employees, Delgadillo said, "it's just not economical for us to continue it."

The news came as a shock to residents' families.

"It's devastating for us," said Ann Grivich, whose brother-in-law Bobby Grivich, 61, has lived at Lanterman since 1969. He has the mental capacity of an 18-month-old, she said; without constant supervision, he smears himself with feces and wanders into traffic.

"People like Bobby are actually more confined in the community. At least [at Lanterman] he can wander the grounds safely," Grivich said.

Brad Whitehead, who works in the dental and eye clinics at Lanterman, said residents struggle to get services when they go back to their neighborhoods.

"They run into offices that don't want to treat them because of the challenges they present," Whitehead said. "The second someone goes out in the community, they lose about 80% of the services they were going to receive."

The state closed two other 24-hour care facilities in 2009: Agnews in San Jose and Sierra Vista in Yuba City. In both cases, Developmental Services officials went to great lengths to make sure the residents wound up in smaller facilities equipped to provide proper care, Delgadillo said.

The current Developmental Services budget and the one just proposed by Gov. Arnold Schwarzenegger provide enough money to do the same for residents at Lanterman, Delgadillo said.

In general, advocates for the developmentally disabled give Delgadillo high marks for finding suitable places for people last year. But as the budget noose tightens on state agencies, they're skeptical that the department will still have enough money to do painstaking evaluations of each case.

"In this fiscal climate, I think it's going to be very hard to figure out what people need," said Terry DeBell, who speaks for a group representing families of Lanterman residents.

A common concern among patient advocates is that the smaller community facilities don't require as much staff training as bigger institutions. But even with a well-paid, professional staff, Lanterman has faced its share of regulatory hurdles in recent years.

In 2005, the state health department fined the center $25,000 after staff failed to promptly treat a resident's bowel obstruction, a condition they knew he suffered from. The man subsequently died in a hospital emergency room.

The state also cited the center in 2003, after a 31-year-old resident died from internal bleeding caused by blows to the stomach. In his five months at Lanterman, he had been injured at least 12 times -- including with cuts, bites and broken fingers. Investigators never determined who killed him.

Also in 2003, federal inspectors found that Lanterman administrators had failed to properly investigate 55 patient injuries.

But families of some of the neediest patients viewed such incidents stoically, seeing them as the exceptions not the rule.

"We're happy with the care at Lanterman," Grivich said. "There's some good people and some bad people, but for the most part, we didn't find Nurse Ratched," she added, referring to an oppressive character from the novel and movie "One Flew Over the Cuckoo's Nest."

The closure plan still requires approval from the Legislature. Employee unions, such as the California Assn. of Psychiatric Technicians, with 511 members working at Lanterman, have vowed to fight it.