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California and the West

U.S. Report Lists Problems at State Homes for Retarded


WASHINGTON — Buttressing findings announced last month, a federal report to be released later this week details troubling conditions in California's homes for the developmentally disabled, citing instances of deaths and unsanitary conditions, and saying there is inadequate oversight.

In their first official response, California authorities responsible for the system of care for 35,000 of the state's most severely mentally retarded people acknowledged many problems, but maintained that the state is working to repair the network.

The report by the U.S. Department of Health and Human Services obtained Wednesday includes accounts of "unexplained deaths," "filthy bathrooms" and kitchens infested with "roaches, flies, flour beetles."

At issue, at least in part, is whether the federal Health Care Financing Administration will continue to help pay for the care of developmentally disabled people. The federal government pays California $250 million a year.

The agency announced last month that it may withhold the money as of the end of June unless the state significantly improves care.

California has 35,000 developmentally disabled people living in thousands of small group homes throughout the state. The program costs $500 million annually and is funded jointly by the state and federal government.

An official at the Health Care Financing Administration said that while the report "documented some intolerable problems," the agency is "encouraged that the state is addressing them."

The report cites some instances in which people in the facilities received psychotropic drugs with no review of their conditions for years at a time. Some residents were found to be wandering their communities with little or no supervision.

In one case, a resident obtained illegal drugs before returning to the group home. In another, a person with a history as a sexual predator was "allowed to interact with other vulnerable" patients.

Among the most striking findings in the report are accounts of two deaths. In both cases, 25-year-old developmentally disabled residents of group homes died and few efforts were made to investigate the cause of death. The report does not identify the homes.

California's system includes 21 regional centers spread across the state. They oversee the care of patients in the group homes. The program functions under terms of a so-called waiver granted by Washington that is aimed at helping move people out of state hospitals.

About 3,800 developmentally disabled people were housed in state hospitals last year, down from 6,700 in 1991. The state has moved the patients in part to save money, but also because of a lawsuit by parents of patients that forced the state to further empty hospitals.

"We have some problems and we need to deal with them," said Cliff Allenby, director of the state Department of Developmental Services.

Allenby said the state has until June to solve the problems and reach a new five-year agreement with the federal agency, or face losing the money.

In their response to the federal report, state Department of Health Services and Department of Developmental Services officials said they "take the findings and recommendations . . . seriously," and already have resolved some problems.

The state also criticized the federal report, saying: "In many cases, broad findings and recommendations were based on little more than anecdotes from a handful of interviews. Additionally, the report appears to deliberately ignore any new initiatives implemented by the state."

Among the improvements, the state has directed workers from the 21 regional centers to regularly visit each recipient of care. The centers' workers have been instructed to take immediate action, including removal of patients, if the homes are not safe and clean.

Rubin reported from Washington and Morain from Sacramento.

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