Briefing Report: The Proposed Closure of Lanterman Developmental Center

Wednesday, May 12, 2010

Introduction

On January 29, 2010, the California Department of Developmental Services ( DDS) announced its intention to close Lanterman Developmental Center (LDC), located in Pomona, California. LDC is an 82-year-old facility that provides 24-hour residential care for approximately 398 individuals with developmental disabilities, including cerebral palsy, epilepsy, Down syndrome, autism and other lifelong conditions. 1

The proposed closure has profound implications not only for current residents, but for LDC employees, the state budget, and the surrounding community as well.

Background

In a letter announcing the proposed closure, DDS Director Terri Delgadillo states:

"As specified in Welfare and Institutions Code Section 4474.1, the planning process for closure of a developmental center requires that DDS prepare and submit a detailed plan to the Legislature by April 1, 2010, and receive approval prior to beginning closure activities in Fiscal Year 2010-2011. …The Department will convene various stakeholder meetings and at least one public hearing will be held in the Pomona area to obtain input during development of the plan.

"DDS operates four large developmental centers and one small community facility serving approximately 2,145 consumers. Based on the State's obligation and commitment to provide opportunities for consumers to live in the least restrictive environment that can meet their needs (Olmstead v. L.C., 527 U.S. 581 (1999)), the developmental center population has been steadily decreasing as consumers have moved into community settings and admissions have stabilized. Lanterman has the smallest population and the highest per consumer cost among the developmental centers. In addition, it is one of the oldest facilities and the infrastructure is in need of major repairs and capital improvements, which will drive a significant investment of state funds during the next few years.

"... The campus is located in Pomona, California, on 302 acres of state-owned land. ... The facility employs over 1,300 staff and has an annual budget of approximately $116 million. Lanterman opened its doors to 61 consumers in 1927, and in 1962 the population was at an all time high of 3,050. Today it serves 398 residents.

"DDS will utilize the individualized planning process to achieve the least restrictive living environment appropriate to each resident's needs, either in the community or at another developmental center, and ensure a safe transition for all consumers to their new living options. DDS will also develop strategies and work with employee unions to assist employees in finding opportunities for future employment.

"After engaging stakeholders in extensive dialog and comment about the closure, the details of the closure process and timeline will be described in the closure plan that will be submitted to the Legislature by April 1, 2010. While we antici pate that the closure process may take approximately two years, consumers will not move until appropriate services are available.” 2

Resident Demographics

LDC is licensed as a General Acute Care Hospital with distinct licenses for an Intermediate Care Facility (ICF) and Nursing Facility (NF). As of March 3, 2010, 393 people were in residence at the facility with 92 individuals (approximately 23%) living on one of five NF residences and the remaining 301 (approximately 77%) residing on one of the facility's 11 ICF residences.

59% of residents have lived at LDC for more than 30 years. As for the remaining residents, 15% have made LDC their home for 21-30 years, another 15% for 11-20 years, 6.5% for 5-10 years, and 4.5% for fewer than 5 years.

LDC's population is older, with more than 80% of the residents over the age of 40. People 65 years of age or older make up 8.6% of the population; the oldest resident is 85 years of age. In contrast, there are no children under 18 years of age at LDC and only 7 are under 21 years of age.

The resident population is diverse in both gender and ethnicity with 59% of the population male and 41% female. 70% of the population is Caucasian, 18% Hispanic, 8% African American, 4% Asian and Pacific Islander, and the remaining small percentage identified as "Filipino” and "Other.”

77% of the consumers residing at LDC have profound mental retardation and 13% have severe mental retardation. The remaining 10% are persons who have been assessed with mild and moderate levels of mental retardation. A majority of consumers have additional disabilities including 54% of the population with epilepsy, 13% have autism, and 10% have cerebral palsy. Additionally, 74% of the residents have challenges with ambulation, 46% have vision difficulties, and 18% have a hearing impairment. 3

Public Hearing and Closure Plan

On February 24, 2010, a formal public hearing was held on the LDC campus. 92 stakeholders provided testimony and the general sentiment communicated to DDS, predominantly by families of residents, employees, and unions, is that LDC should not close. Advocates and regional centers support closure and emphasize the need for individualized program planning and for the expansion of community resources. 4

In addition, DDS received written input from 276 stakeholders. The following is an excerpt of a letter written by the parents of a LDC resident: "We are the parents of (name redacted), a 33 year-old autistic, retarded man. (Name redacted) has lived at Lanterman for nearly 20 years. He cannot talk. But he uses a few words in sign language, such as 'toilet,' 'more' and, his personal favorite, 'candy.' ... Several years ago, (Name redacted) also lost his sight. He is now blind.

"We adamantly oppose the closure of Lanterman, but it appears that the DDS has already decided to recommend this course of action to the legislature.

"Make no mistake: COMMUNITY PLACEMENT IS A LIFE-THREATENING OUTCOME FOR OUR CHILD.” 5

As promised, DDS presented the closure plan to the legislature on April 1, 2010. The entire plan and other information related to the proposed closure may be obtained at:
http://www.dds.ca.gov/LantermanNews/Index.cfm

LAO Recommendations

In its recent review of the DDS LDC closure plan, the Legislative Analyst's Office (LAO) recommends the following:

Recommend Closure on a Policy Basis. We think the proposal to close Lanterman DC has merit on a policy basis. As discussed above, this proposal is consistent with state and federal laws, legal rulings, and past actions of the Legislature. As the population of DCs continues to decline, and more individuals with disabilities receive services in a community setting, it makes sense for the state to close these facilities.

We also think that Lanterman is a good facility to close because of the age of the facility, and the high per capita cost for residents. At $289,000 per resident, Lanterman has the highest per capita cost of the remaining DCs. This is primarily because of the high fixed costs to operate the facility and the small and declining population.

Withhold Recommendation on Closure Plan Until More Information Is Provided. We withhold recommendation on approval of the closure plan submitted by the administration pending the receipt by the Legislature of additional details on the fiscal and programmatic aspects of the plan.

We recognize that a full determination of the costs of the closure will largely depend on the individual needs of Lanterman residents and the mix of services required to serve the population in the community. Until those assessments are completed, the department will not know with certainty, for example, how many residents will transfer to another DC versus being placed in the community; and, of those placed in the community, what type of residential placement option they will be provided.

However, we believe that the department can provide more fiscal and programmatic detail to support the closure plan. In particular, the department should be directed to provide an estimate of the potential one-time and ongoing costs associated with the various community placement options, as well as the department's initial estimate of the number of individuals expected to be placed in each type of community setting after closure of Lanterman. Such information could be based, in part, on the actual costs for consumers who have recently transferred to the community from Agnews. The administration should also provide the Legislature with information on the current availability of community programs in the Southern California region for persons who would be moved from Lanterman.

We believe this additional information is critical if the Legislature is to understand the operational and fiscal implications of the closure plan and that DDS resources are neither overbudgeted nor underbudgeted in the 2010-11 spending plan. 6

Conclusion

Members of the Legislature will likely have to make several decisions over the next couple of years regarding the path the proposed LDC closure will take. As there are passionate voices on both sides of the closure issue, members will do well to ignore appeals based on emotion and stick to the facts as they consider what is in the best interest of LDC residents and California.

 

Endnotes

  1. DDS press release, January, 29, 2010.
  2. Letter from DDS Director to the Legislature and Other Interested Parties, January 29, 2010.
  3. LDC Closure Plan, April 1, 2010, Pages 5-6.
  4. Ibid., Page 3.
  5. Ibid., Attachment 3, Written Input Received.
  6. LAO, Lanterman Closure Proposal Has Merit, but Plan Lacks Fiscal Details, May 4, 2010.

 

For more information on this report or other Human Services issues , contact Joe Parra, Senate Republican Office of Policy at 916/651-1501.