Wednesday, March 25, 2009

In California, Agnews Developmental Center, 120 years old, closes

From the San Jose Mercury News:

After sitting outside with her son so he could feel the wind in his hair, Gail Bowen finished packing his toys and clothes, then leaned over to tell him the news.

"Michael, this is the last time you'll be here, son," she said last week in the hallway of Agnews Developmental Center, where 32-year-old Michael Kauss, who is severely mentally retarded, has lived for the past 22 years. "You're going to a new home."

Just over 120 years after it accepted its first patients, the sprawling facility that once cared for 800 developmentally disabled residents — and earlier for the mentally ill — is finally entering its final chapter. Agnews is expected to close by the end of the week.

The closing comes after the state changed its vision over the decades of how to care for the developmentally disabled, from large centralized centers to smaller homes within neighborhoods. Agnews' last resident will leave by March 27.

"It is a landmark event from a number of perspectives," said Julia Mullen, deputy director of the Community Services and Supports Division of the state Department of Developmental Services.

Earlier deadlines to close the sprawling facility were pushed back as plans for some of the state's most vulnerable residents were strengthened. Agnews was part of a statewide system of centers that had long served the mentally ill and made a transition in the 1960s to serving the developmentally disabled. Agnews has 46 buildings covering more than 671,000 square feet of space.

After a state law was passed to place developmentally disabled in the least restrictive housing, residents began to be relocated to community homes. Eventually there were not enough residents left to justify the huge expense of operating centers like Agnews — $200,000 for each resident annually versus $80,000 in a community-based home.

Agnews' closing will leave four remaining centers, including one in Sonoma. The future of the 81 acres at Agnews, located at the north edge of San Jose, is undecided, though the state Department of General Services will take over the property. For a time, an outpatient clinic will remain open to provide medical and dental care for the former residents during the transition to private care.

About 150 remaining staff members will be let go on March 27 and an additional 50-60 will stay to help run the clinic and maintain the grounds and buildings. Once as bustling as a small city, with live concerts on the lawn and visits from Santa Claus in a helicopter, Agnews already has the feeling of a giant quiet zone. But everything on the campus, every building, every area, "has many memories," said Kathleen Lee, director of volunteer services for 20 years and now part of the transition team.

Some parents were glad to see their loved ones moved into the community.

"Initially, I was very upset," said Joanie Pepper, whose 51-year-old son was born with severe brain damage and lived at Agnews for 30 years.

With the severity of her son's disabilities, "having him in a developmental center was a real safety zone," she said. "All of the medical care was provided right there."

But it's been 16 months since her son was moved to "a lovely home in Morgan Hill," she said, and he is doing well.

Despite "bumps in the road, I have to give a lot of kudos to the San Andreas Regional Center and the Department of Developmental Services. Everyone in that home has blossomed."

Other families, including Bowen and Kauss, fear the state's budget problems will lead to cuts in service down the road. They also worry their loved ones will not receive the same level of care in the community they had at Agnews.

Since July 2004, 340 people have moved from Agnews to other settings, including 16 transferred to other centers, said Harold Pitchford, executive director of Agnews.

Nine former residents who moved to the community since 2004 have died. One resulted in a home being cited, according to the state Department of Developmental Services. During the same time there were 40 deaths at Agnews.

The move into the community has been a very positive experience for the majority of clients," said Brian Boxall, president of the Association for the Mentally Retarded at Agnews, a parents and family advocacy group for the residents. "But it's also been a negative experience for a minority of the clients."

Boxall's brother has severe autism with equally severe behavior problems and lived at Agnews for 81/2 years before being moved to a community-based home in November.

"We were very happy about the care he received at Agnews," Boxall said. "Let's have the same conversation five years from now, and hopefully we will still be pleased then."

State officials said residents have been moved on a person-by-person basis. The medically fragile were moved last. An administrative law judge ruled that Sonoma was the best "least restrictive" place for Michael Kauss, but stipulated that a Superior Court judge had to approve the transfer. But that judge placed Kauss into a community-based home.

Against his parents' wishes, Kauss was moved Friday to a new privately run community-based home in San Jose. It is one of dozens in the Bay Area designed for former medically fragile residents of Agnews.

Michael Kauss, for instance, has profound mental retardation, an IQ of 10. He cannot see, walk or talk. He has a feeding tube in his intestines, severe scoliosis, deformed hips and pelvis, and suffers seizures, among numerous other medical conditions. He requires 24-hour nursing care.

James Kauss said his son has lived far longer than expected because of the good care he received at Agnews, in addition to that care being monitored closely by Bowen and their daughter, Kim.

At Agnews, Michael Kauss had "not a normal life but a relatively happy life,'' his father said. e likes being talked to and touched. He does holler out, but it's not words. He seems to recognize certain people," and he loves the wind blowing through his hair.

As Michael Kauss adjusts to his new home, Bowen said, "all I can do is say a prayer." Before he was born, "I decided to name him Michael after the archangel. I knew he was going to make it."