1. DEVELOPMENTAL CENTER UPDATE
Presented to the
RCOC Board of Directors
By Randy Laya
March 4, 2010

2. Historical Perspective of the Developmental Center System
1960s – At its peak, California had seven “state hospitals” serving 13,400 people
1969 – Lanterman Mental Retardation Act signed by Governor Reagan
1976 – Lanterman Act was amended affirming the right to treatment to people with developmental disabilities
1978 – “state hospitals” renamed “developmental centers”
2010 – 5 DCs serve ~2,200 people

3. System Overview of Developmental Centers
The Department of Developmental Services (DDS) is the independent State agency that oversees the regional center system and state developmental centers
~243,000 people are served by 21 regional centers – RCOC ~17,000 people (~7% of total)
~2,200 people still reside in state developmental centers – RCOC ~140 people (~6% of total)

4. WHAT IS A DEVELOPMENTAL CENTER?
Requires an annual court commitment
Most restrictive environment
Locked facilities
Large campus
Institutional/hospital-like setting

5. MANY LEVELS OF CARE Intermediate Care Facility (ICF)
Skilled Nursing Facility (SNF)
Short-term Acute Care
Use of restrictive devices/procedures
Locked helmets, restraints, contingent seclusion, emergency medication as needed for dangerous behavior

6. HOW MANY RCOC CONSUMERS LIVE IN DEVELOPMENTAL CENTERS?
Fairview = 124
Lanterman = 12
Porterville* = (+ 2)
Total = (+ 2)
* RCOC placements at Porterville are ordered through criminal court due to crimes such as fire setting, murder, pedophilia.

7. WHY DO SOME CONSUMERS LIVE IN DEVELOPMENTAL CENTERS?
Intellectual Disability (Mental Retardation)
Judicial commitments:
In re HOP, 29 Cal. 3d 82 (1981)
Gravely disabled
Welfare & Institutions Code (WIC) §6500
Danger to self and/or others
California Penal Code § (a)(1)(B)
Incompetent to stand trial

8. In re HOP, 29 Cal. 3d 82 (1981) Gravely Disabled
24-hour Nursing
Sensory Deprived
Gastrostomy Tube (G-Tube)
Severe uncontrolled seizure disorder
Oxygen, PRN (as needed)
Diabetes/IM (injections)
Multiple diagnoses

9. WIC §6500 – Danger to Self/Others
Self Injury/Pica/Locked Helmet
Violent/Injury to others/Property destruction
Verbal abuse
Elopement
Severe behavior plans
Multiple diagnoses
Multiple failure with community placements
Multiple failure with treatment

10. California Penal Code §1370.1. (a)(1)(B) Incompetent to Stand Trial
Person accused of a criminal act
Unable to understand or aid in own defense
Requires ongoing competency training
Porterville
Secure Treatment Area
Competency training

11. Community Placement Options
Licensed
Community Care Facilities (CCF)
Intermediate Care Facilities (ICF)
Congregate Living Health Facility (CLHF)
Unlicensed
Supported Living (SL)
Due to unique needs that cannot be met in licensed settings because of licensing restrictions

12. Developmental Center v. Community Placement Cost Comparison
Average annual cost for persons living in DCs
$275,970*
Average annual cost for persons who moved from DCs into the community since July 1992
$60,068**
*Controlling Regional Center Costs: Report to the Legislature, December 2007
** “Components Contributing to Expenditure Growth – to ,” Department of Developmental Services, Budget Analysis, presented to the California Senate Budget Subcommittee #3 during a May 7, 2007 hearing.

13. RCOC COMMUNITY PLACEMENTS
* FY10-to-date: 5 additional consumers are in active placement activities

14. BARRIERS TO COMMUNITY PLACEMENT
Long-term institutional behavior
Reluctant parents/families
Reluctant Interdisciplinary Teams at DCs
Process for transition
six months to two or more years (reluctant providers)
Court involvement

15. PLANNED CLOSURE OF LANTERMAN DEVELOPMENTAL CENTER
DC closure outlined in WIC §4474.1
Meeting w/ Lanterman Family Group – 2/20/10
Public meeting at Lanterman DC – 2/24/10
Written input can be submitted to DDS on or before 3/5/10
Closure plans to be presented to the Legislature by 4/1/10
Closure activities to take place in FY
More information at

16. IMPACT OF LANTERMAN DC CLOSURE ON RCOC
Business as usual
12 RCOC consumers at Lanterman DC
RCOC staff have met with Lanterman staff to preliminarily assess needs and identify supports
Formal meeting on 3/10/10

17. EXISTING CHALLENGES WIC §6500 Danger to Self/Others
Including 2 at Lanterman DC
Some people have difficulty with moves/ transition
Self Injurious Behavior (SIB)
Cannot use restrictive devices/procedures in the community
Long-term institutional behavior
Family opposition
DC staff opposition

18. QUESTIONS?