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December 14, 2016

Nursing Shortage for San Diego Regional Center Consumers Goes Unreported To State and Feds

*UPDATE:
In June, 2017, another mother of a severely disabled child filed an administrative law hearing against San Diego Regional Center. In the final decision we find the Judge writes, "Finding nurses to staff [the child's] care has been difficult. Despite the nursing level care hours Medi-Cal and SDRC authorized, claimant has been recently receiving only approximately 24 hours of nursing care per week. Claimant’s parents provide her care when nursing staff is not available." 

"According to Ms. Flores, claimant’s mother has experienced difficulty finding nurses to staff claimant’s Medi-Cal and SDRC funded nursing and respite care due to a nursing shortage. In addition to the nursing shortage..." 

Source: 
https://www.documents.dgs.ca.gov/oah/dds_decisions/2017030241.084.pdf

Yep, just like I've been saying for years, Carlos Flores, the Executive Director of San Diego LIES to Department of Developmental Services (DDS) when he files official reports to DDS saying there's SUFFICIENT nursing services for SDRC clients. I hate to say I told you so, but I told you so and if you haven't figured out by now that this guy is full of shit and should be removed as the Executive Director, I don't know how you can claim to care about people with disabilities. I'm an eyewitness to how some of these people operate over there at SDRC. I've fought against them many times. They are ruthless. They LIE to Judges. Pretend they are helping, but ignore parent's cries for help and only gather information a few weeks before a Fair Hearing to deceive Judges that they are doing something. They lie to DDS. They play dirty. They attack parents. They IGNORE serious issues that need to be addressed. It's shocking to see people behave this way who advertise to the public, while getting federal and state funds, that they advocate and protect disabled. Read the OAH case I provided in link above. And scroll down here to see what Flores tells DDS again. And you tell me, is this the kind of Executive Director you want running an agency that is supposed to be providing services to people with developmental disabilities? 
Fast facts: 


California has 21 Regional Centers that provide services to persons with developmental disabilities. 


San Diego County is served by San Diego Regional Center (aka, SDRC).


Many medically fragile disabled "consumers" require nursing respite or skilled nursing services to remain safely at home. 

However, there aren't enough licensed vocational nurses available through home health agencies or as independent vendors, to provide these needed nursing services. 

San Diego Regional Center has known about this nursing shortage for many years and has done very little to resolve it. Consequently, families who have nursing services for their medically fragile children aren't getting the help they need. And it's going unreported. In fact, SDRC tells the state that everything's going swell....

The problem with this BS is that you can't fix a problem if you pretend it doesn't exist  California Regional Centers report to Department of Developmental Services (DDS), in Sacramento. In essence, DDS is their boss.

Department of Developmental Services answers to the Federal Government, specifically Center of Medicaid Services.

Thus, if there's a problem with lack of sufficient nursing, the San Diego Regional Center unit (which is in my area) has a responsibility to NOTIFY DDS.

Unfortunately, SDRC's chronic nursing shortage affecting disabled persons has not been properly or truthfully revealed to Center of Medicaid Services.

State has a responsibility to ensure that there is sufficient and appropriate information being submitted to CMS.

How can State, specifically, DDS, ensure information is submitted to CMS, if a Regional Center isn't telling DDS the truth about a chronic nursing respite shortage for consumers?

For example, many mom's who receive nursing respite services from SDRC for their children report that they aren't  getting sufficient nursing or respite care services.

This should be of great concern to the State and the federal government since San Diego Regional Center's Executive Director submitted a report to DDS that states there is 'sufficient nursing services' available.

SEE: 2015 report from Executive Director, Carlos Flores---sent to California Department of Developmental Services. Flores states,

"As of January 5, 2015...San Diego Regional Center (SDRC) funds licensed nursing respite care for 421 clients. SDRC has substantially increased the number of individually vendored Registered and Licensed Vocational Nurses. The current total of 218 vendored nurses and 18 Home Health Agencies is sufficient to meet the needs of SDRC clients." This is pure BS. And Flores knows it. 

The 2016 DEMOGRAPHIC SURVEY update simply updates a few numbers. Says there's now 20 home health agencies and  more vendored nurses. SEE: http://sdrc.org/resources-support/publications/

What it's not telling the public or DDS or CMS is that if you analyze the "vendored nurse" list, half the names aren't active, some of the LVNs on list are retired, others no longer work for SDRC, some have expired licenses (you'd have to cross check names on SDRC vendor list with CA. Board of Vocational Nursing to see this, by the way, since SDRC doesn't check or show it). As for the home health agencies, you'd have to ask the parents for the truth. Nobody at these vendored home health agencies likes to admit they aren't able to staff cases. These nurse agencies, (Maxim, etc...) want the luxury of staying on SDRC's vendor list, without actually sufficiently or consistently staffing nursing respite cases for Regional Center consumers. Worse, there's reports from parents that some nurse agencies bill for services provided when the nurse was a "no show" making it appear as if services were provided. MMM....


Source:
http://sdrc.org/wordpress/wp-content/media/2015/03/DemSurvey15color.pdf

* SDRC clients not getting proper nursing services has been going on for YEARS.
*To deceive the State, specifically DDS, into thinking everything's okay, is not fair to vulnerable clients who NEED SERVICES and families struggling to find nursing services for their children.

How can DDS offer "technical assistance" or help improve shortage of nurses for vulnerable San Diego Regional Center consumers, if SDRC is pretending there isn't a nursing shortage for SDRC clients? 

And how can Center of Medicaid Services help resolve the situation, if they aren't being told by DDS, that there's a nursing shortage for San Diego Regional Center clients? 

I'm not sure what other Executive Directors of other Regional Centers are telling DDS, but I know for sure, Carlos Flores, the Executive Director of SDRC, isn't telling DDS the TRUTH about nursing shortages for respite care. His letter to DDS is evidence he is deliberately hiding the failure of SDRC to recruit and retain nurses, either through Home Health Agencies or as independent contractors to provide services, from DDS. This is inconsistent with the spirit of Lanterman Act. 

Flores and others at SDRC have been  repeatedly told that their Home Health Agencies can't supply enough nurses to provide services. Yet, every year, Flores, as if he's got a boilerplate ready, still writes a Demographic survey to DDS, that says there is sufficient nursing services. 

Meanwhile, reality...................................

Parents who get nursing respite services from various vendored home health agencies at San Diego Regional Center report on social media:

1. "Nursing agency says there are no back-up nurses, but are trying to hire in our area." (2015)

2. "No respite nurse worker available with experience working with disabled clients....the nursing agency is sending nurses who have never worked with children  with special needs." (2016)

3. "It's been weeks...no nurses to cover my daughter's 32 hours of respite care nursing...I'm exhausted. I don't know what to do." (2016, parent of SDRC consumer).

4. "We don't have any nursing coverage until tomorrow's noc shift. We're sick and feeling quite run down. I'm really praying my nursing company comes through with a Friday evening and night nurse. New nurses schedule is not what I was hoping it would be. Not sure what to do next." (2017, post from mother of daughter with nursing respite care from SDRC).

5. "Our situation is we have the respite hours [san diego regional center] just cannot find a company who can provide nurses for the shifts we need. Every company called..says..they have a shortage of nurses." 2017 post. 

Interestingly, San Diego Regional Center has a Clinical Service Department which employs several registered nurses. Why haven't they notified DDS? 




Has SDRC Clinical Services done a community outreach to improve this chronic nursing shortage for SDRC clients?

Inform community colleges that have nursing schools that San Diego Regional Center can hire independently vendored Licensed Vocational Nurses to work with clients who have special needs?

Speak to nursing schools about teaching new nurses interested about special needs patients? Recruit nurses who have past experience working with disabled?

As for the home health agencies that seem to never have sufficient nursing staff to help San Diego Regional Center consumers, has anyone at SDRC Clinical Services ever met with their vendored home health/nursing agency representatives to see how they work together to improve this? Probably not.

Insufficient services provided by San Diego Regional Center home health agencies isn't limited to nursing. Parents who receive general respite care aren't getting sufficient services. 

When is DDS going to interview families, allegedly getting nursing and/or respite services, to confirm whether they are ACTUALLY getting nursing/respite services? Clearly, one can't rely on information sent from SDRC.....as it doesn't reflect reality. 













2 comments:

Willie said...

The money is wasted on DDS and Regional Center executives and overspending from for profit contracts. There is a nurse like job called psychiatric technician offered at some junior colleges they ate at least partially train in developmental disabilities like autism but they very rarely work respite because of low wages. Governor Brown is total neuro diversity so specialized medical group homes are going out.

Kim Oakley said...

Good point, Willie. It would be great if community colleges with nursing programs started focusing on training nurses specifically for special needs patients that are largely medically underserved across San Diego County.

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