FAIRVIEW’S EARLY HISTORY

Fairview was established by the Oregon Legislature as “an institution for the feeble-minded, idiotic, and epileptic.” It grew from 39 “inmates” in 1908 to become the state’s largest institution in the 1960s with 61 buildings on a 275 acre campus that housed 3,000 residents. It was like a city.

In 1963, President Kennedy advocated for a system that would care for individuals with mental disabilities in smaller community settings. By the 1970s, reform efforts to empty institutions gained momentum throughout the country.

Oregon followed suit, and the now renamed Fairview Training Center population dropped to 2,000 as individuals moved into the community. Cooper says the goal during this period was for individuals to become self-sufficient, develop vocational skills, and moved into community homes. Staff ratios were one staff person to 41 residents, and locked time-out rooms, restraints, and drugs were frequently used.

THE BEGINNING OF THE END

Even with the focus on training, independence, and community placement, Fairview ran afoul of the law in 1986. A lawsuit filed by the Oregon Advocacy Center (OAC) [now Disability Rights Oregon] on behalf of the Arc of Oregon, along with another lawsuit filed by the Department of Justice, alleged civil rights violations and failure of Fairview to protect residents from harm.

As the legal wrangling waged on, the Health Care Financing Administration found deplorable conditions at Fairview and decertified the institution in 1987, cutting off Medicaid funding for 14 weeks. The state had to make up $7 million dollars in lost funding.

By 1989, fearing the further loss of Medicaid funds and expensive legal costs, the state agreed to hire additional staff and upgrade facilities to improve the care and safety of residents. As estimated $30 million of state funds were spent on improvements. State officials also agreed to downsize the institution.

James Cronin, a longtime Fairview employee who stayed on to the end as a building manager, remembers that time well. He takes strong issue with the bad rap that employees got. According to Cronin, the residents were like family to many of the staff who performed challenging work for modest pay. Cronin remembers, “In the heat of the federal reaction, there were a lot of people who had a hard time saying they even worked here.”

LEGAL DIFFICULTIES BRING A MAJOR SHIFT OF PHILOSOPHY

Under the cloud of criticism from federal regulators and advocacy groups, the administration launched a major campaign to treat people with more dignity and respect. Staff were taught to avoid power struggles with clients and to shift their roles from guards to caregivers. According to Cooper, “Some employees left, and a lot made that cultural change.”

Sue Coffey, a staff member who spent over 27 years at Fairview recalled, “At first, given the clients’ behaviors, it was hard for staff to see how things could be done any other way.” She said power struggles would frequently be over a second cup of coffee or a piece of bread.

Cooper says the shift yielded dramatic improvements for residents. Before the last residents left, he checked the log books from the 1970s. “A number of these people were in all kinds of restraints and on a lot of drugs,” he said. Now they are able to integrate successfully into the community with the proper supports and the use of psychotropic drugs has drastically reduced.

Even after massive resources were infused into Fairview, the legal travails were not over. In 1994, eleven Fairview employees were indicted on charges of abusing residents. The story received close scrutiny by the Clarion through the summer of 1995.

Because of the age of the cases, the inability to get testimony from the victims, and the reluctance of staff to make allegations about co-workers, few of the accusations could be proved. By August of 1995, the state had guilty charges on nine out of 82 counts (with three trials still pending at that time.)

However, the public allegations did result in some positive changes. Procedures around reporting abuse were changed so that the “code of silence” among employees was broken. Also, pre-employment drug screening was instituted with a zero-tolerance policy for drugs on campus.

HIGH COSTS RING FINAL DEATH KNELL FOR FAIRVIEW

As Fairview downsized from 1,500 residents in 1986 to 300 residents in 1996, costs soared to nearly $200,000 per year.

The resources poured into the institution took a big bite out of the state Developmental Disability budget: thirty percent of the total dollars went to serve three percent of the population who resided at Fairview. Meanwhile, the waitlist of individuals receiving no services grew to over 3,000 and their demand for services grew louder.

Finally, in July 1996, the state unveiled the Long Range Plan for Developmental Disability Services, which included a plan to close Fairview and move the remaining residents into community placements.

While advocates had for years called for the elimination of dehumanizing institutions, it was the financial realities that finally convinced the legislature to fund the plan. James Toews, Assistant Administrator for the Office of Developmental Disability Services, acknowledged, “A significant portion of the plan is driven by cost.”

The plan projected that millions of dollars in savings could be redirected to pressing needs in the community service system. Monies would go to a wage increase for direct care staff to reduce a horrendous turnover rate, new community services for those on the wait list, and regional back-up services to handle crises and diversion. But it was clear the money would not be enough to expand the 24-hour care system.

Despite resistance by the Fairview Parent’s Association and the employees’ union, the Long Range Plan was adopted by the legislature in 1997, and the institution’s fate was sealed – it was to close by July 2000.

THE FINAL DAYS

With the adoption of the plan, Fairview went into full gear to get the remaining residents ready to transition into the community. The insititution also had to deal with dispaced employees and button up the facilities.

The process was carefully planned and executed. “We had the resources to do it the right way,” says Cooper.

For residents, the first step was to set up living situations on campus that were as close as possible to how things were going to be when they moved, including staff and housemates. A trial visit lasting one day to one week in the person’s home helped smooth the transition. Each resident had a person-centered plan to guide services in the community.

Many employees, with a comprehensive assistance program from the state, moved with residents to become care providers in the community settings. Others retired or found new positions within the state system or other new jobs. According to Cooper, “The Governor’s office and the Department of Human Services have been really supportive in this process. That has given employees a sense of security that they wouldn’t have had otherwise.”

 SOME THINGS ABOUT FAIRVIEW WILL BE MISSED

Two of the last residents out, Walter Fiest and his roommate, said without hesitation that they will miss about Fairview is their friends (see Walter’s story.)

Special events were loved by residents. Everyone came to the Friday night dances. A Fourth of July parade and fireworks was a popular community event in Salem. And practically the entire city of Canby came to the Fairview campus at Christmas time to celebrate with the residents.

The critical mass at Fairview made possible some the highly specialized services for residents that may be hard to find in the community.

The institution had an expensive “fitting chair” with multiple hydraulics. After it was adjusted to perfectly fit an individual, a cast was made and turned into a foam back for the person’s wheelchair.

The campus had a brace shop, a hospital, and hydro tubs. “There was nothing our physical and occupational therapists couldn’t do with adaptive equipment,” says Karen Shields. “Is that level of quality services going to be provided in the community?”

The dental department did a substantial amount of general anesthetic dental work – also difficult to find in the community.

But Walter and his housemate hit the nail on the head. It’s probably the relationships people will miss the most. “Fairview, because of its isolation and low turnover of staff and residents, created a sense of family… there was a level of acceptance here that we haven’t gotten to yet in the community,” says Cooper. Sue Coffey agrees. “I’ve spent over half my life here and watched many of our clients grow up – it’s like losing a member of your family,” she says.