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News: 01/15/2017

Special health centers proposed for SDC clients

Speedy proposal focuses on Santa Rosa for new clinic

As 2017 kicks off, there's a flurry of activity surrounding the impending closure of the Sonoma Developmental Center, Sonoma Valley's biggest employer and still home to the more than 300 severely disabled people who live there. All are due to be removed and the institution closed by the end of 2018.

In order to do that, suitable homes must be prepared and staffed, appropriate health services found, and decisions have to be made about what to do with the 863 acres of prime property and buildings in the heart of the Valley of the Moon that will be left behind.

Health care facilities proposed

In May of 2015, hope still existed that health care for developmentally disabled clients of Sonoma Developmental Center (SDC) could continue at the sprawling facility just south of Glen Ellen. That hope eroded to the point that Sen. Mike McGuire and other North Bay representatives announced this past December a proposal to build an off-campus clinic to carry on the work of providing very special care to the most disabled and fragile of the developmentally disabled clients who will be scattered around the Bay Area by the start of 2019.

The SDC has been Sonoma Valley's largest employer, tending to the needs of up to 4,000 clients since its inception 125 years ago. Parents and guardians, caregivers, and staff have all been keenly concerned about the Federal government's decision to close all remaining institutions housing more than a few developmentally disabled - a term that includes autism, Down Syndrome and a variety of other physical and mental conditions that require focused care. Disabilities range from minor to profoundly severe, the latter being the majority of the remaining 332 clients at SDC as of Dec. 28.

On Dec. 16 last year, McGuire announced the plan to build a Federally Qualified Health Center (FQHC) to house the specialized caregiving and health care developed at SDC - special footwear, special wheel chair and adaptive locomotion gear, special beds, dental and medical procedures to cope with patients who do not always understand what's happening. Often, medical care and special needs of the covered population pose difficulties for mainstream medical services.

FQHCs are basically federal funded - or partially funded - clinics for medically underserved populations, with over a dozen in Sonoma County, alone. With most SDC clients being transferred to one of six Northern California Regional Centers for “community based” housing, the Request for Proposal was sent out on Dec. 27, 2016, and has a deadline of Jan. 27, 2017 to respond. Serious candidates will be interviewed and a final selection made by Feb. 28.

While this seems to be an extremely short period to prepare and reply to a complex proposal, North Bay Regional Center Executive Director Bob Hamilton said that the local centers and operators of those centers - the people most likely to respond to the RFP - have been aware of the pending proposal for months.

California has put aside $2.5 million dollars to fund the initial process of designing, building and staffing the new special clinic, though the final cost is likely to be much higher.

Hamilton said that the decision to locate the clinic in Santa Rosa was made because the most potential clients are in that area, as opposed to Petaluma or East Bay cities.

Special homes being built or remodeled

North Bay Regional Center (NBRC) is one of three centers that will house 300 of SDC's remaining 330 clients, with Golden Gate RC serving Marin, San Francisco and San Mateo counties, and the East Bay RC serving Contra Costa and Alameda counties. NBRC serves Sonoma, Napa and Marin counties. NBRC is the lead agency for the new clinic proposal since the SDC is in its jurisdiction.

California's 21 Regional Centers manage the finances and care for the 300,000-plus people who qualify for developmental disability aid. They buy, build, or rent housing to provide the “least restrictive” environment for clients, manage health and community issues, and oversee the thousands of people, agencies and private companies (both for profit and nonprofit) who contract for the daily provision of these services.

In contrast to Regional Centers, Developmental Centers have typically centrally housed a more problematical population, those whose medical and psychological conditions require close monitoring and sometimes restrictive environments. An issue of appropriate living arrangements has become more acute as more and more Developmental Center clients with behavioral issues have been moved into community settings. A sizeable number have wound up in law enforcement situations and even been sent to jail or prison for want of more appropriate settings once enjoyed at the Centers. After Sonoma and Fairview DCs are closed, only a fairly small facility at Porterville in Southern California will remain, along with a number of small, intense treatment “Star” homes designed to quickly moderate behavior problems deemed correctable.

Regional centers are building more homes designed for closer confinement and monitoring of behaviorally challenged people with developmental issues.

Hamilton noted that North Bay and other RCs are moving forward to find or build enough special homes for the remaining DC populations. Called an Adult Residential Facility for Persons with Special Health Care Needs (ARFPSHN), these are homes that qualify for supplemental money to pay higher wages and provide extra services, housing four or five clients. There are 38 such homes existing, with another 58 needing to be built to serve the coming transfers out of the DC system.

Getting these homes ready by the end of 2018 is a giant task.

“We are supposed to have every home identified, escrow closed and begin to have them rehabbed by March (2017),” Hamilton said. “We have to search and acquire houses we believe will be appropriate from the information we get from (DDS).”

After that, it's just the simple process of getting a major renovation and staffing project through city, state and county regulatory agencies.

Site assessment contract is imminent

In other SDC news, the Department of General Services, which holds title to most state property, has picked a major firm to undertake a site assessment and develop a master land use plan for an 863-acre portion of the SDC. The contract has not been signed yet, but will likely be done by Philadelphia-based Wallace Roberts Todd Design, licensed architects in California, who will evaluate the existing physical campus and develop the master land use plan over the next year.


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