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Recorder Online

August 19, 2010

Population shrinks, PDC expands

Although Porterville has been home to California’s most severely mentally disabled violent offenders for more than a decade, the treatment and rehabilitation facility in which they live has never been larger, plusher or more likely to be unoccupied.

The state began developing Porterville Developmental Center’s secure treatment program in 1997 in anticipation of the closure of a state hospital in Camarillo. It sent 200 suspected violent criminals to live in communal areas built in 1953 in southeast Porterville, keeping them behind fences, protected by security guards and police officers, where they continued treatment and training for social development, communication, self-care and physical motor coordination skills. Less than 10 years later, ground broke on the construction of a 96-bed expansion to the rare program.

Twenty-two of those clients deemed the least functioning are now living in single bedrooms, walking on polished hardwood floors and showering in their own quarry-tiled bathrooms. They were relocated from the original units in May to the new units, and are swimming in an Olympic-size pool and exercising in a $6 million state-of-the-art gym.

In 2003, the Legislature appropriated $85.7 million for the expansion to accommodate an increasing number of judicially-committed clients, only to place a cap on the number of people who may reside there five years later. While population peaked for a short time, there has since been a steady decline. Coupled with the Legislature’s intent to plug the number of forensic patients and therefore lessen the blow to California’s budget, there appears a possibility that the Secure Treatment Center will never be filled to capacity — at least not any time soon.

On a recent tour of the state hospital, Executive Director John Sawyer pointed toward an expanse of vacant land abutting the new expansion.

“You might wonder why we put all this fence all the way around all that open space,” he said. “This project, the 96-bed project, was the first phase of a three phase. Originally we were going to put in 286 beds and we put in the first 96 and then were going to see what happens with the population. That’s why everything is built big, so when you see the gymnasium it’s really to accommodate 285 clients, plus the 200 that are already here. So, it looks like a big gym and it is, but that’s the reason why.”

During construction, administrators not only called for the erection of a fence to someday encompass future buildings, but also installed the infrastructure necessary for an additional 190 beds. But as the Porterville campus expands, its population dives and other state developmental centers are shuttered.

According to the state Department of Developmental Services, the population at its developmental institutions topped 13,300 residents in 1968 and has since sunk to 2,064 residents as of June 30.

Many clients have been transitioned into the community, or are receiving help from nonprofit corporations, many of which contract with the state department to provide a myriad of community–based services, such as transportation and day programs.

The development of community service-based care as an alternative to institutions mirrors national trends. Implementation of the Coffelt Settlement agreement resulted in a transition of more than 2,320 persons between 1993 and 1998. The U.S. Supreme Court decision in Olmstead stated that services should be provided in community settings when it has been determined that community placement is appropriate.

“There were very specific things that happened, both a legal movement and a social movement, to make sure developmentally disabled people would have lives more like the lives of the people who don’t have disabilities,” Barbara Dickey, an attorney with Disability Rights California, said.

Because of the efforts to deinstitutionalize the developmentally disabled, and the increasing costs associated with operating such large facilities, the Department has closed three developmental centers and one community facility in the past 15 years. The developmental center in Stockton closed in 1996; followed by Camarillo in 1998 and Agnews in 1999. Additionally, the Department submitted a closure plan for its Lanterman Developmental Center in Pomona to the Legislature in April, and is awaiting approval.

Recently, the number of judicially-committed clients living in the Secure Treatment Center has also dwindled from 284 in Fiscal Year 2008-09 to 263 as of July, 2010.

In 2008, the Legislature capped the secure treatment area population when it adopted its budget, prohibiting the total number of clients from exceeding 297. Considering the substantial costs associated with treating defendants at a hospital, the decision to limit the population will likely result in less of a strain on the cash-strapped state.

The Department of Developmental Services has budgeted $289,722 per client in Fiscal Year 2009-10, spokeswoman Nancy Lugren said, noting that the department’s “fiscal system” does not allow it to sort costs per client in its treatment area. According to the nonpartisan Legislative Analysts Office, incarcerating an inmate is far cheaper — about $49,000 in Fiscal Year 2008-09.

Currently there are 13 defendants, in various phases of court proceedings, awaiting entry into Porterville’s secure treatment program. Once there, they are required under California law, to receive care and treatment in a way that will promote their “speedy restoration to mental competence.”

“We still have a waiting list, a lot of it depends on what their needs are,” Sawyer said. “Most of them are housed in jails or in groups waiting to come here.”

In 2008, Gov. Arnold Schwarzenegger and lawmakers approved a budget that reduced funding to the developmental centers by $86.4 million, a change that reflected the forthcoming closure of its Agnews facility and a reduction in the developmental center population as consumers transition into the community. The budget cut included maintaining current capacity at the Secure Treatment Center in Porterville, “thereby generating savings by reducing staffing needs associated with the previously proposed expansions, and reducing operating expenses and equipment for all developmental centers. As a result of not fully staffing forensic beds at Porterville, it will take longer for consumers in county jails to enter the Secure Treatment Program. Reductions in operating expenses and equipment will require that preventative maintenance and non-critical purchases be deferred.”

According to Disability Rights California, while those judicially committed defendants are waiting for a bed to become available at a state hospital, they often find themselves in a county jail receiving inadequate mental health treatment for long periods of time. At a state hospital, they receive 24-hour care and supervision, including health care, like physical activity and nursing, and assistance with daily activities and behavior intervention and behavior skills.

Those who have the most needs, like help brushing their hair and teeth, are selected to live in the new units at the 96-bed expansion, while others will remain living in the dormitory-like structures in the original secure facility, Sawyer said.  

“They’re here because they’re developmentally disabled. We’re here to try to treat them and try to place them back into the community. We’re not a prison where we house them and throw them out on the streets and wait for them to come back in six months,” he said.