Dec. 6, 1997

State boosting group homes

SOCIAL ISSUES: California has 30 days to remedy deficiencies in its care of the developmentally disabled.

By JEFF COLLINS
The Orange County Register

State officials threatened with federal funding cuts said Friday that they are already improving their embattled program for residents suffering from autism, epilepsy, Down's syndrome and mental retardation.

Health-care funding has been increased and officials have expanded monitoring of the group homes and care facilities that house 35,000 residents -- 3,200 of them living in about 300 Orange County group homes, said Paul Verke, spokesman for the state Department of Developmental Services.

An Orange County Register investigation published in August found a program riddled with health-care and supervision deficiencies.
This week, the federal Health Care Finance Administration issued a report giving the state 30 days to correct deficiencies, or else face a cutoff of more than $200 million.

The state responded in the months after the Register report with improvements that included increasing payments to group homes, reducing staff caseloads and hiring ``client-rights advocates.''

``The state is taking this very seriously,'' Verke said. ``The state is confident they will comply with the 30-day timeline.''

At issue is California's $431 million Home and Community-Based Services program for the developmentally disabled -- most of whom suffer from mental handicaps, often in combination with other disabilities. Some are extremely fragile or in need of constant supervision.

The state has been moving many of those residents from large institutions such as the Fairview Developmental Center in Costa Mesa to group homes, where the cost of care is cheaper.

But the Register investigation found that residents in group homes had a 72 percent greater mortality rate than their counterparts in institutions. Many died from treatable illnesses or preventable accidents.

The newspaper report also discovered that many group home residents are routinely overmedicated or suffer from physical or sexual abuse. The system also is hampered by inadequate training of staff workers and lax oversight by the state.

Among the worst problems identified:

� A blind, mentally handicapped Tustin woman choked to death on her own vomit while living in an Alhambra group home.

� A 30-year-old autistic man drowned in a bathtub at a state-licensed care facility in Costa Mesa.

� A 6-year-old girl with cerebral palsy was found dead in her wheelchair at a Garden Grove care facility.

� A 14-year-old Redlands boy died from a punctured colon at a Costa Mesa group home after a blunt object was inserted into his rectum.

A decree from the Health Care Financing Administration issued findings that patients are ``at risk'' because of program deficiencies, and ordered California to come up with a plan to correct the problems by June 30.

The order bars new admissions to the program.

``Some enrollees' health and ability to function are markedly declining, and mortality rates are of concern,'' the federal report said, describing state supervision as ``scattered and inadequate.''

Many facilities ``are unsanitary, lack appropriate supervision, fail to provide adequate nutrition and employ staff who lack skills and training necessary to serve this population,'' the report said.

Verke said the federal government audited five of the 21 regional centers last summer, before the state implemented many of its solutions.

But one Santa Ana group home operator was skeptical that the state's efforts will solve many of the problems. Jim Walker, owner of the 18-resident Orange Avenue Board and Care Home, said a proposed 3 percent increase in payments is too little to improve quality in group homes.

``Until you get the money to the consumer and cut some of the bureaucracy out of the thing, the system is going to get worse,'' Walker said.