in the spotlight

California Legislature Asks State Auditor to Investigate Deficiencies that Create Potential for Continued Abuse at California Developmental Centers

In July 2012, a California Department of Public Health recertification survey of the Sonoma Developmental Center (SDC) found "dozens of safety deficiencies, including four issues that it believed put resident health and safety in immediate jeopardy."¹ A subsequent inspection at Sonoma's Intermediate Care Facility (ICF) in December 2012 found uncorrected systemic deficiencies that led to DDS voluntarily terminating Medicaid certification at four of Sonoma's ten ICF residential units.² California Watch reports that this has led to a loss of over $1 million per month in federal funding.³

At the request of the California Joint Legislative Audit Committee, the California State Auditor recently audited the status of resident safety at developmental centers operated by the California Department of Developmental Services (DDS).⁴ The audit report, published in July 2013 and entitled "Developmental Centers: Poor-Quality Investigations, Outdated Policies, Leadership and Staffing Problems, and Untimely Licensing Reviews Put Residents at Risk," found systemic problems that potentially put residents with severe developmental disabilities at risk of abuse. The four largest state developmental centers house and care for approximately 1,550 persons with significant developmental disabilities.

The State Auditor concluded that DDS needs to improve its oversight of resident safety in the developmental centers.⁵ Specifically, the audit found deficiencies in investigations by the DDS's Office of Protective Services (OPS), which is charged with investigating alleged abuses of residents. The report noted that OPS "does not appear to routinely follow its established procedures for investigations of alleged abuse"⁶ and stated that the investigative deficiencies "may allow for continued abuse at the developmental centers."⁷ It also noted that OPS does not regularly provide the specialized training its personnel need to work with residents, especially those who are nonverbal.

The audit report also noted weaknesses in the California Department of Public Health's (CDPH's) oversight of the developmental centers. For example, it found that during the last seven fiscal years, CDPH only performed 29 of 50 state licensing surveys, which relate to operating health facilities. It also found that CDPH has never prepared an annual report on the effectiveness of its enforcement system in maintaining the quality of care at long-term health care facilities, even though state law requires it to do so.

On March 13, 2013, the CDPH and DDS entered into a Program Improvement Plan (PIP), an agreement that provides a framework for improvements that the SDC must meet in order to continue having Medicaid certification for the six units that are still certified. The PIP requires SDC to contract with an "independent entity that will perform a root cause analysis, develop action plans to correct identified deficiencies and report monthly progress to CDPH."⁸

1. CALIFORNIA STATE AUDITOR, REPORT 2012-107, 12 (July 2013).

2. California Department of Public Health Statement January 18, 2013 (last visited Aug. 7, 2013).

3. California Watch, New director to take over troubled Sonoma disability center, March 7, 2013 (last visited Aug. 7, 2013).

4. CALIFORNIA STATE AUDITOR, REPORT 2012-107 (July 2013).

5. CALIFORNIA STATE AUDITOR, REPORT 2012-107, 12 (July 2013).

6. CALIFORNIA STATE AUDITOR, REPORT 2012-107, 1 (July 2013).

7. CALIFORNIA STATE AUDITOR, REPORT 2012-107, 1 (July 2013).

8. California Department of Public Health, CDPH and DDS Sign Plan for Sonoma Developmental Center's Intermediate Care Facility (last visited Aug. 7, 2013).

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People With Disabilities Foundation is an operating 501(c)(3) nonprofit organization based in San Francisco, California, which focuses on the rights of the mentally and developmentally disabled.

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