People with severe developmental disabilities need around-the-clock care. For decades, state institutions were thought to be the best option. In recent years, though, moving people into residential neighborhoods has emerged as the way to go.
In Chula Vista, one program provides a home-like environment for people who need constant care.
On a quiet, tree-lined residential street in Chula Vista, nurse Carrol Ames gets one of her clients out of a specially-equipped van.
"Okay Robby. Are you lookin'? Look both ways! Is anything coming?" says Ames.
Ames pushes Robby's wheelchair across the street, and up a ramp leading to the front door of a house.
"Say hi guys, I'm back," says Ames, as she and Robby enter the house.
The single story house has polished hardwood floors and is spotlessly clean.
Robby and three other adults who have severe developmental disabilities live here. All of them suffer from cerebral palsy. Some also have mental retardation. None of them can walk or talk.
This home and two others like it make up a program called Ryan's Way. Each house has four residents and two staff members to look after them.
Life in an institution is quite different -- they're hospital-like settings. Residents usually have to share rooms with three or four others and staff have to care for a lot of patients. Community outings are rare.
Ames says life is more normal here.
"Today was the outing day for a couple of the houses, so they went and did some window shopping out at the mall," Ames says. "And then we do things with them in the homes. We have wheelchair dancing, and, it really is like being with a big family."
Jamie O'Conner Florez started Ryan's Way in 2005. The program is named after her son, who was born with cerebral palsy.
"I look at it as, how would I want, if Ryan had to live in a facility, what type of setup would I want for him," Florez says. "So we tailor everything based on the individual, and what's going to best meet their needs. You know, they didn't ask to be born with these disabilities. So, how do we make it the best, given the situation that we have?"
The homes are customized to accommodate wheelchairs. Each bedroom has a door to the outside, for easy evacuation in case of emergency. Each home has a landscaped backyard, where residents can get a taste of the outdoors.
Florez says caring for her clients requires a lot of sensitivity. You have to be a careful observer.
"Sometimes it's their facial expressions, their eyes," says Florez. "It's the subtlest thing that you pick up on, that you'll know whether they like something or they don't like something. They do it their way, not our way, and it's up to us to get in there and figure out, what it is they need."
Ryan's Way gets its funding from the San Diego Regional Center. It's one of 21 centers in California that distributes state money to programs for the developmentally disabled.
Carlos Flores heads up the San Diego operation. He says Ryan's Way fits with the idea of de-institutionalizing people with severe disabilities.
"The emphasis is living in the community, with persons without disabilities," Flores says. "They're people first, and we want to give them every opportunity to be with people in general."
There are still about 2,000 people living in the four remaining California institutions for the developmentally disabled.
State officials recently announced they're planning to close one institution in Pomona. That means 24 clients originally from San Diego County will coming back here to live. Some have been institutionalized for more than 40 years.
