Mount Angel is a small town in west coast Oregon, USA. Land in the Willamette Valley is fertile, with prosperous market-gardens and nurseries; most residents are farmers, small businesspersons and commuter to nearby Salem or Portland. In the past quarter-century a large number of Mexican and Russian workers have also settled in the area, but most of Mount Angel’s 2955 inhabitants are descendants of German nineteenth-century migrants. The town is transformed into a miniature ersatz Munchen during Oktoberfest each September (why not October? You may well ask!) with oompah bands, yodelling, sauerkraut, and the Mount Angel Brewing Co. (My kids give their beers a definite thumbs-down anyway, I prefer the produce of flourishing new valley vineyards.) Many of the town’s storefronts have been embellished with Black Forest motifs and titles. Bochslers’ Hardware (where you can buy just about anything) is subtitled Eisenwarenhandlung, and the solicitor’s office is labelled Advokat. The roof of St Mary’s, the town’s Catholic church and architectural pride, was destroyed during an earthquake in 1993 and townspeople raised funds to restore it to its full gothic glory. On top of the bluff above the town is another Willamette Valley landmark, Mount Angel Abbey, which was founded by Swiss Benedictine monks in 1883.
On a recent visit in Oregon, I called on the Mount Angel Training Center, which has provided services for adults with developmental and other disabilities for over two decades. It used to be located on the campus of Mount Angel Academy, where I attended secondary school in an earlier part of this Millennium. Two years ago, in their own changing circumstances, the Benedictine nuns rescinded the leasing arrangement, giving the disability service agency several anxious months before they found an alternative location. The Traegers, a local business family who were moving premises, offered to adapt their former building for the training centre.
Lillian Elliott, Assistant Director for Vocational Services, gave me a tour of the training centre during her would-be morning break. She explained the range of services which the agency provides to the local community 60 vocational places and 24 residential places. Their catchment area extends over approximately a twenty-mile radius, with some clients travelling from their homes in Salem or nearby farming districts. There is a group home for ten people in Mount Angel, a supported-living home, and three others in Silverton, five miles away. There are also ten apartments with staff-monitoring. About half the service users attend the agency from their family homes.
The Mount Angel trainees include a wide span of age and ability. Some have a dual diagnosis, with challenging behaviours or mental health difficulties. Some attend on short-term rehabilitative training after injury or trauma. The state of Oregon provides approximately 50-60 per cent of the agency’s resources; there are also some private-pay trainees who are supported by their own families. There is a vocational staff of sixteen, with an in-centre staff-client ratio of about 1:8, although some trainees require and receive closer supervision and support.
The Mount Angel training centre carries out sheltered workshop contracts and has a supported-employment service and a janitorial work team. Some former trainees are also in competitive employment, needing only periodic staff support. Lillian Elliott’s own job includes recruiting trainees, seeking work contracts, supervising job coaches, speaking Spanish to trainees from Mexican migrant families, and, as required, providing guided tours to expatriate Oregonians.
The physical facilities at the Mount Angel Training Centre are by no means luxurious. The building, in the small town centre, is a low timber construction, basically a warehouse with partitioned front and attic office space. The main part of the building is open-plan, with work tables, a kitchenette/lunchroom area, and, along the other side, a storage area with its own delivery door. Lillian has a desk and some shelves across from the lunch area.
On the Monday when I visited there were 30-40 trainees in attendance on most days more of them would be on work placements or outings. There was to be a lunch rota that day because of limited table-space. After their morning break outside for a cigarette, down the street to the shops trainees sat down along long tables and began to assemble hospital admission kits (a contract they fulfil for six nearby hospitals). Those who were to handle the plastic water jugs and handbasins donned rubber gloves. Other work contracts include dismantling/recycling devices for the area electrical supply company, shrink wrapping products and various short-term contracts.
The trainees are well integrated into the local community. One of the trainees had recently died, and nearly fifteen trainees had gone to his memorial service at the local nursing home (and hospice) to speak about their friend. Last year, Tim and some of his friends helped to erect stalls for Oktoberfest around town, and they produced a Mount Angel Community Cook Book. (Fortunately, it was spiral-bound mea culpa, but as soon as I bought a copy, I ripped out every recipe including sauerkraut, in spite [or perhaps because] of my childhood memories of a weighted crock of cabbage fermenting in the basement.)
Because I’ve been away far too long to have a handle on developmental disability services in Oregon, I also made a brief visit to the Office of Developmental Disability Services, (DDS) where I picked up leaflets on enabling people with developmental disabilities to live in the community, including guides for hairdressers, restaurants, grocery stores and dentists. The leaflets have obvious value in raising public disability awareness; they give information on potential customers with learning disabilities and advice on how to serve them, with contacts for further information.
I have not investigated educational service provision in Oregon. I’m sure that like everywhere else, the delivery of service may vary, but with the much-vaunted ADA, the IDEA and Individual Educational Plans, I presume that at least the system is in place to respond to most needs, and in most places. I was, however, surprised by a comment from the officer in the Oregon DDS that there is no entitlement to service for persons once they complete their years in education.
I have been in contact with an Oregon mother and advocate, whose daughter completes her educational entitlement (at age 21) soon. There will then be private pay bill of approximately £850 per month for her to avail of a day programme. I was told that the post-schooling service in Oregon and this will sound very familiar to Irish readers strictly crisis based. If parents die, for example, and there is no one to take care of the person with disabilities, the state would put them in the crisis diversion system where they would receive funding for 24-hour care. They might go to a group home, a foster home, or a smaller care facility, and would need to have a day program of some kind since these settings are not staffed during the day. This gets VERY expensive. The term waitlist is rather a misnomer, since there is no order to it. Some people have been waiting for 30 yearsî the only way you get off and get some service is to go into serious crisis.
On the optimistic side, I have also learned about Oregon’s self-directed supports which are planned for individuals with developmental disabilities and their families. Fairview, a long-established institutional village community for persons with developmental disabilities located in Salem, is finally to close next year. Some of the state funding freed-up in that process will be diverted to new family support schemes. A consultant or support broker will help individuals and their families to plan, find and manage their own supports in employment and community activities, enabling them to buy the supports they may require for their own needs. The support broker will work, within a county developmental disabilities office or other community organisation, to help people determine and direct their own supports. Customers will judge the quality of the help they receive and look elsewhere if they are not satisfied. The consultant will assist customers who are on the wait lists, as well as those who have public funding, private resources or no resources at all. The brokerage service will provide bookkeeping and benefits-assessment services as well. It is intended help families, instead of accessing a take-it-or-leave-it, existing slot in a service, to give families the opportunity to put together a plan and services tailored specifically to their child, rather than trying to fit the child into an existing program. It is admitted that the programme will work best with people who like the idea of being in charge of services tailored to their unique needs who are willing to consider new approaches.
The self-directed supports scheme sounds fantastic, and perhaps more than a bit idealistic.
This is just a snapshot view, and perhaps doesn’t do justice to the services in Oregon. What it does show is that we can find things we can all learn from each other, while recognising that (as I say in the editorial in this issue) nowhere are disability services perfect and I’ve been away too long to make valid generalisations. My visit to Mount Angel offers only a snapshot of one frontline agency in a complex range of services. Resources will be reallocated and services redesigned. In Oregon, as in Ireland, service delivery is changing.