Disabled agency refuses to cut waste

Nov. 29, 2012

By Katy Grimes

The Department of Developmental  Services is a massive state agency that could immediately cut $500 million from its annual budget, according to lobbyists and experts, by getting rid of the antiquated institutions that the developmentally disabled have lived in for decades.

The DDS employs 6,000 people and maintains a budget of $4.7 billion, of which $550 million funds five state-run residential care developmental centers.

Yet strangely, state lawmakers introduced legislation last year to increase the number of employees at this agency.

During a July inspection by the Department of Public Health at the Sonoma Developmental Center, licensing officials found many violations, including sexual assault, stun gun injuries, generally abusive treatment of the developmentally disabled residents, failure to provide appropriate medical treatment, and an unsafe environment.

“Individual freedoms have been denied or restricted without justification,” the report read.

Following the discovery, the Legislature held hearings and demanded corrective action. But little has actually changed, according to lengthy testimony at an October hearing.

Terri Delgadillo, the director of the Department of Developmental Services, said that “corrective action is ongoing.” She added that the agency is paying consultants to advise on corrective actions.

Carl London, a lobbyist for the California Disability Services Association, said that 10 years ago the agency did the same thing and hired consultants, but never implemented the recommended corrective actions.  “It’s time to close the developmental centers as efficiently as possible,” London said. “It costs $500 million to service 1,500 to 1,600 individuals in institutions. There are programs that take care of people coming out of institutions.”

That pencils out to more than $300,000 per year for each person in the institution.

Bad history at agency

Similar stories of abuse ran 10 years ago.  State officials debated whether to overhaul the agency’s police force or dismantle it. In the end they did nothing.

Shortly after the most recent allegations of abuse surfaced, lawmakers in the state Senate Human Services Committee demanded immediate changes to the investigative procedures at the state institutions. Gov. Jerry Brown recently signed legislation requiring the institutions to notify outside police when a death occurs, as well as allegations of abuse and injury.

The Office of Protective Services, the police investigative arm of the development centers for the disabled, has made egregious mistakes and bungled investigations, including investigations of abuse, mystery injuries and patient deaths.

Families want institutions closed

London said that most families of the developmentally disabled prefer to keep their loved ones in their own homes, or in community centers.

I interviewed a couple, both 70, with a developmentally disabled adult son in his mid-30s. They also have two other adult children with no disabilities. They have successfully kept their son at home for all of his life. He has a job and goes to work every day, goes to the movies with friends, and has his own rock band. He is able to live a rich, happy life, which they say is the result of never institutionalizing him.

This family echoed the sentiment that the state’s developmental institutions should be shut down.  “They are hell holes where all kinds of abuses occur and are tolerated,” the mother said. “The developmentally disabled people in these institutions are afraid to report violations because of the fear of reprisal.  Many have accepted these abuses as part of life, as they have been occurring for so long.  There is a strong code of silence and abusers think that no one will believe what a developmentally disabled person has to say.”

At the October hearing, there was testimony from former employees and medical professionals about the abuse and the employee code of silence.

The other issue is that many of the developmentally disabled living in these institutions are older and do not have family members who oversee the quality of their care or advocate for them.  When the state closed several developmental centers years ago, some older parents were against the closings.  “Most of these parents and their disabled children were older and were afraid of the unknown, and how the community homes would work for them,” the mother said. “Their children were born at a different time.  They had not been allowed to attend regular school, people were cruel to them and life was difficult.”

Shielded from the cruel public, ostensibly living with “well-trained and caring  staff,” the developmental centers seemed like the best option at the time.

Unfortunately, most of the institutions have historically lacked oversight.

But there are also amazing personal stories of the people who have come out of these institutions and successfully integrated into the community. There were several developmentally disabled people who testified at the October hearing how they had to sue the state for the right to be released from the institutions. They won their lawsuits and once out, living in the community, they told stories of getting jobs, making friends and living well. One man holds a regular job and works as Santa Claus every Christmas.

Institutions not needed

The institutions are not needed, according to London and other experts, because there are plenty of licensed care homes in the communities that take care of a smaller number of people more efficiently.  These homes are usually located near the resident’s families. Family members can visit, even unannounced, on a regular basis.   Residents of these facilities attend local day programs, sporting and entertainment events, and have easy access to community health care.

Living in the smaller licensed care homes, they are seen by more people in the community so there is less chance that issues of abuse will go unnoticed.  “They are not perfect, but are a much better option and more economical that the larger facilities,” the woman said.

Bureaucracy trumps quality of care

Aside from the outrageous stories of abuse within the institutions, there are larger management issues:

* 80 percent of the employees in one facility are always out on some type of medical leave. This suggests that there are morale problems, as well as many employees abusing the state’s lenient leave system.

* Patient abuse cases take at least three years before any citation is issued. One psychologist testified at the October hearing that, at one developmental center in which he worked, there was a code of silence with the staff involving abuse cases, which greatly slowed the investigations.

* Delgadillo ordered the rates paid to the community centers be cut by 10 percent, as part of the overall state budget cuts. The community centers are far more efficient, and provide better quality of life and care, according to parents and experts. And the state institutions are only partially full, yet maintain a full staff, including a police force at each facility. The institutions are like small cities, with every conceivable service available.

What needs to happen?

“Someone needs to go to the regional centers and ask how quickly they can handle the people from the institutions,” said one industry expert who asked to remain anonymous. He reported that the regional and community centers can adjust quickly, and with more flexibility, based on the needs of the people they serve. “They could close the institutions tomorrow, and still keep half of the money in the system,” he said.

It is obvious that this state agency does not want to give up any of the $550 million used to fund the institutions. At the October hearing, Delgadillo seem more concerned about the state employees working at the institutions, than of the disabled people they serve.

There is a strange silence coming from the Brown administration about requiring cuts, consolidations or closures of the antiquated, unhealthy institutions. “The future is not in ongoing, crappy institutions,” the expert said. “The future is in nonprofit community care centers, doing the mission intended.”

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