--- BACKGROUND: The approval of California's 2010-2011 budget sealed the fate of the proposed Lanterman closure. Its passage served as the trigger to initiate the closure of Lanterman DC. A specific closure date for Lanterman DC has not been set although the DDS has stated that the process should take at least two years. The DDS has also stated in the Lanterman Closure Plan that was submitted to the Legislature that the Lanterman residents will not be moved until the services and supports identified in the individual's IPP are available either in the community or in another DC! The model for the Lanterman Closure Plan will be based on strategies developed specifically for the closure of Agnews DC in 2009. This is a very significant point because these new and innovative strategies were not used in the closing any other DC's prior to Agnews! The Agnews closure introduced three key objectives. They were to:
--- Introduce new residential service options designed to better serve individuals with severe and enduring medical needs.
--- Develop a program for the Agnew's staff to continue working with former residents after they had transitioned into the community.
--- Create an enhanced community health care system to provide needed service for this specialized population.
The passage of this fiscal year's budget and its accompanying trailer bills did confirm that the goals outlined above will also be included in the Lanterman Closure Plan. And, so far based on most of the feedback received from parents and individuals involved personally in the Agnews closure, as tiring, taxing, and painful as it must have been, the DDS did, for the most part, accomplish the above stated objectives!
Regarding the Lanterman Closure Plan, the DDS has stated that the "overriding priority for the Plan is to meet the individual needs of each resident while he or she continues to live at LDC through every aspect of transition into another living arrangement and be ongoing thereafter. Efforts will focus on identifying or developing services and supports to meet the specific needs of each resident and in ensuring the quality of those services through monitoring and oversight functions." In addition, the department has expressed a strong commitment to the continued employment of Lanterman employees."
As of September 29, 2010 there were 363 residents at Lanterman DC. Approximately 23% of the current population resides in one of five Nursing Facility residences. The remaining 77% reside in one of the facility's 11 ICF residences. The third level-of-care is provided at the Acute Care Unit where residents are transferred to receive short-term medical and nursing care when they experience an acute health care condition. The majority of residents have lived at Lanterman for many years with 59% having resided there for more than 30 years. The breakdown on the length of stay for the remaining residents shows 15% have made Lanterman their home for 21-30 years, another 15% for 11-20 hears, 6.5% for 5-10 hears, and 4-5% for fewer than 5 years. Lanterman's population is older, with more than 80% of the residents over age 40. Residents who are 65 years of age or older make up 8.6% of the population. The oldest resident in the facility is 85 years of age. In contrast, there are no children under the age of 18 at Lanterman and only 7 are under 21 years of age.
MOVING FORWARD: Prior to the passing of the 2010-2011 budget, a significant amount of stakeholder input was received by the DDS regarding the impact of the proposed Lanterman closure and its impact on the resident's who live at the facility. The vast majority of this input originated from the families of Lanterman residents and facility's employees. (NOTE: Not surprising since these two groups of people know the individual residents far better than anyone else in the world and what a devastating impact a move of this type could have on their loved ones. And, their opinions deserve to be heard!). And, to DDS's credit, they were! Based on the input received (all 397 pages), DDS decided that there were a number of issues that also should be addressed to ensure a safe and successful transition for the residents in addition to the lessons learned from the Agnews closure.
The following items summarize the new laws that have been enacted that authorize important important community resource development and future blueprint for closure activities:
" Extension of Adult Residential Facilities for Persons with Special Health Care Needs: This statute brought about a "re-birth" of the "962" home! This type of housing option was first used in the closure of Agnews DC. It is specifically designed to fill a critical gap for DC residents who have a combination of specialized health care and intensive support needs. A 962 Home is able to provide a wide range of health care and special medication needs. If these homes are used as they were in the Agnews' closure, they will provide a nursing staff on duty 24 hours a day.
" Use of State Staff in the Community. - The new statute authorizes DDS employees, who are now working at Lanterman, to transfer into the community to work with former residents while remaining state employees. This law will be in effect for up to two years following the transfer of the last resident from Lanterman, unless a later enacted statute deletes or extends this provision. This program is designed to bring continuity and the expertise of the Lanterman employees into the community-based services system to meet the needs of the transitioning Lanterman residents.
" Implementation of the Lanterman Outpatient Clinic. - Existing statute was modified to authorize the DDS to operate the Lanterman Outpatient Clinic. Like the Outpatient Clinic at Agnews, available medical and health services will be provided to individuals who move from the developmental center into the community, ensuring the continuity of medical care and services as individuals transfer to new health care providers. The DDS will be required to operate this Outpatient Clinic until the department is no longer responsible for the property.
" Provisions for Health Care. - Existing statutes have been amended to provide access to a system of high-quality health care through local managed care plans for persons transitioning from Lanterman into the community. This part will involve setting up the roles and responsibilities of key parties required to provide a comprehensive system of health care for the transitioning Lanterman people. The plan will address such essential components as referral practices, coordination of case management, education and training, the management of medical records, and provider reimbursement.