Fairview Hospital to Move Out 400 Clients by 1999 : Mental health: A Bay Area court ruling will force relocations to community housing, which disappoints some relatives.

The Fairview Developmental Center plans to move roughly 400 of its retarded clients out of a hospital setting and into community housing as the result of a legal battle in Northern California that pitted advocates for the mentally retarded against some families who wanted their relatives to remain in institutions like Fairview.

A San Francisco Superior Court on Wednesday approved a settlement requiring the state to reduce its institutionalized population of mentally disabled from 6,300 to 4,300 during the next five years. For Fairview, the second-largest state hospital, that means 400 of its 1,027 clients will be relocated by 1999.

The lawsuit was filed in 1990 by Protection and Advocacy Inc. on behalf of 14 individuals and six disability groups. It was later certified as a class-action lawsuit and broadened to include all clients living in the state’s seven developmental centers.

In addition to slashing the number of retarded or mentally disabled persons who will be allowed to remain in state hospitals, the court agreement requires the development of new community housing for 300 people, as well as crisis counseling and other services.

“I’m elated. It’s been a long struggle,” said William Coffelt, 52, who led the legal charge after discovering that his son, Billy, then 16, had been badly bruised and found in a pool of blood in a bathroom while living at the Sonoma Developmental Center, the largest facility in the country.

The lawsuit contended that the clients or patients in such facilities were unable to choose community-based residential living, because California had not done enough to provide a sufficient number of such residential facilities, nor was it doing what was necessary to ensure proper care in those that did exist.

*

The advocacy group contends that the settlement is the largest of its kind in the United States, to be carried out with $334 million in federal Medicaid dollars. Previously, those funds could only be used to support people living in state institutions. Under the new agreement, the money can be used for community-based residential care facilities, according to state officials.

The state Legislature has already set aside $20 million for the first year of the program.

Currently, there are about 500 residential-care facilities in Orange County that serve developmentally and mentally disabled people. About 6,000 people with developmental disabilities are served by the state’s Orange County Regional Center.

Community homes are typically in residential neighborhoods and house up to six individuals with two full-time staffers. But state officials said clients could also live with relatives, with paid roommates or in foster homes.

However, some relatives worry that the patients will be forced into the community before they are ready, and into smaller facilities that are not equipped to care for them.

Buena Park resident Blanca Wolfenstein is among those who wonder who should decide where her 32-year-old autistic son, David, should live: a judge in San Francisco, or herself.

David has been in and out of community housing, and the experience was a disaster, Wolfenstein said, compared to Fairview, where the quality of service was much better.

Once, she said, her son’s doctor called her at 6 a.m. to tell her David had had a seizure. “You’d never find that in community placement,” she said. “I don’t want him to be moved. It’s going to be a big fight” if the center suggests he be moved, “because David is very happy where he is.”

Wolfenstein is a board member of a statewide coalition of about 2,000 relatives of retarded clients that tried to block the court settlement.

“There’s a presumption that residents are better off in community facilities rather than development centers,” said Keith Hearn, a consultant for the California Assn. of State Hospital Parent Councils for the Retarded.

“The problem is that over the last five to 10 years, the developmentally disabled clients who could be placed in the community have already been placed. The people who remain in the centers are the ones who need the centers,” Hearn said.

“We’re definitely disappointed” with the court ruling, said Matt Guglielmo, 74, of San Marino, whose 31-year-old daughter, Annie, has been living at Fairview since 1975.

Annie has Down’s syndrome, profound retardation and is legally blind. Guglielmo said she cannot speak or chew, needs help getting dressed and sometimes has tantrums in which she strikes herself and others.

“I believe she’s in the best place for her. . . . If she is left alone, she could be taken advantage of,” Guglielmo said.

Coffelt disagreed with the critics of the plan.

“For every story of abuse in a state hospital there is a story of abuse in a community facility. Where we differ” with the group that tried to block the settlement “is that they tried to make state hospitals better; our effort was to improve the services in the community,” Coffelt said. “People who don’t want to be (in state facilities) shouldn’t have to.”

And no one will be pressured to move, the supporters of the agreement said.

“We believe there will be competition among those who obtain the placements, not pressure applied to those who don’t want to go,” said Ellen Rosenblatt, the attorney for the advocacy group that filed the lawsuit.

*

In anticipation of the court settlement, the state in 1992 launched a project to identify those clients who would make good candidates for community living.

Since August, 1992, 43 people have voluntarily left Fairview with the consent of their families and the blessings of the staff, said Dawn Lemonds, the project’s director.

“We will not take chunks of people and plop them in” a facility, Lemonds said.

However, the $91,000 in state and federal funds spent each year for each patient could be cut in half if they lived in the community, Lemonds said, adding that in her opinion, their quality of life would likely improve.

“I know of a significant number of people (at Fairview) whose parents gravely object to them being placed in the community,” Lemonds said. But she tries to encourage them to consider the options by saying, “Please come with me and look (at the housing) before you say ‘No.’ ”