Bill Coffelt Letter to the EditorNewspress.com
Santa Barbara, California
http://news.newspress.com/index.html
Monday, August 7, 2000
Letters to the Editor
Developmental centers on way out
Kudos to Terry Boisot for an accurate depiction of California's state-run
institutions for people with developmental disabilities.
Boisot was pretty much right on, since her series brought out the
institutional zealots with their twisting of facts, omissions and outrageous
assertions.
The war between institution and community advocates has been long-standing,
but fortunately it is just about over. In the next five years, California's
developmental centers will be on the way to being a part of history. It
won't be community advocacy that leads to their closure so much as it will
be the California Department of Finance. I don't often agree with Barbara
Turner, but her quote "This is being driven by money -- money, money,
money," in the February 25, 1997 edition of the San Francisco Chronicle, is
even truer today than it was then.
For years, the developmental center system has been unable to keep up with
the times. When I placed my son at Sonoma Developmental Center in 1989, two
directors tried to allay my concerns, telling me the centers were privately
accredited, state licensed and federally certified.
Shortly after, California stopped applying for the private accreditation
because the centers couldn't meet the updated standards. A few years ago,
the Health Care Financing Administration (HCFA) began surveys in which the
feds joined the state in conducting the certification surveys. It
becamethings got a little tighter and it was hard for the centers to meet
minimum standards. Even with a tremendous staffing increase through the
Department of Developmental Services Four Year Staffing Augmentation
Program, the developmental centers staffing ratio has only risen from near
last in the country to just below the national average.
Agnews Developmental Center lost certification in April, 1999, and hasn't
regained it, costing the general fund $2.1 million a month. The Sonoma
decertification costs taxpayers $3.1 million per month. A loss of a few
million here and a few million there and it won't be long before we start
talking about real money.
If the centers can't meet federal standards now, how will they meet them
when updated standards that place even more emphasis on self-determination
and person-centered planning are implemented? How will they meet
certification when HCFA goes beyond the "partnership surveys and conducts
the surveys using private contractors? They won't.
Most of the costs of the centers will come right out of the state's General
Fund, while community services for similarly situated people will be
receiving 50 percent federal Medicaid reimbursement. This is a turnaround
from a decade ago when community services got very little federal money and
the incentive was to try to make the institutions better.
States react to federal policy, not because they are told to, but because of
the incentives. That's why it is all about money and the money will go to
the community. It is going to happen on several fronts through litigation
and legislation.
I advise the institutional zealots to cut their losses, accept reality, and
look closely at the DDS five-point plan. It's the best deal they are going
to get.
Bill Coffelt
President, The Oaks Group
Pollock Pines