Blueprints are emerging for the way Iowa will deliver services for the mentally ill and developmentally disabled that, in part, eventually will include the end of sheltered workshops as they now function like the 40-plus-year-old Options of Linn County program.
No changes for the Options program and its 200 participants and their families is imminent, though Mechelle Dhondt, director of Linn County MHDD Services, told the five-member Linn County Board of Supervisors on Monday that the question is not if changes to the Options program will come, but when.
None of three supervisors in attendance, Ben Rogers, Brent Oleson and John Harris, was happy about all that they heard.
The supervisors established a task force last fall when they and Dhondt discussed changes confronting Options and other sheltered workshops in Iowa and the nation, changes driven by the federal government’s push to not segregate populations of the development disabled and mentally ill from the general population.
Dhondt said it’s become a civil rights issue.
The three supervisors on Monday said that the Options program long has been designed to try to find jobs for its clients in the community, but some clients need training at Options first, some can’t succeed at a job site and others in Options’ "day habilitation program" have more pronounced intellectual disabilities and can’t work.
Dhondt said federal incentive funds through the "Ticket-to-Work" disability program will get more sheltered workshop clients into jobs outside the workshop as the program funds job coaches on a one-to-one and one-to-two, coach-to-client basis. The coach will be with the client at the job, she said. It may prove more costly than the sheltered workshop, but it comes down to "who will pay for it, said Dhondt, meaning the federal government will pay.
"I hope this works," Oleson said. "But when I walk out (to Options), I don’t see the turkey farm they are trying to prevent."
The reference is to the group of 32 intellectually disabled men from Texas who were housed in a dilapidated bunkhouse in Atalissa, Iowa, for years while working for very-low wages at the turkey plant in West Liberty, Iowa.
"I understand that we don’t ever want that story to repeat itself; it was a horrific story …," Oleson said. "But that’s not Options. It seems government … to stop this problem we’re going to kill everything else that does any good to make sure. Where is the happy medium?"
The supervisors also wondered if there were a sufficient additional number of employers in the community to provide special work arrangements for the Options clientele, to which Dhondt said the program may hire a sales staff to specialize in identifying such employers.
Rogers said new rules may make it harder to find employers because they will not be able segregate this clientele away from their other employees.
Dhondt said some disabled clients, including those with accompanying physical disabilities, will not be able to work at work sites and will spend time in day-habilitation programs where they don’t work. However, Dhondt said such programs likely will be located in places other than the current Options site — now housed in the less-than-three-year-old Linn County Community Services Center, 1240 26th Ave. Ct. SW — so they do not have a segregated flavor to them.
All of this discussion is coming at the state of Iowa’s direction as the state’s 99 counties have now aligned in 15 regions designed to provide region-wide services to take the place of county-by-county services.
John Brandt, Linn County’s community services director, said on Monday that the transformation coming to Options also will take place at five other sheltered workshops in the nine-county region that consists of Linn, Johnson, Dubuque, Jones, Delaware, Iowa, Buchanan, Benton and Bremer counties. Brandt said implementing the changes could take five or six years.
Of more immediate focus for the region is creating a new landscape for those with mental illness who need shorter-term, crisis residential care and those who need longer-term, "subacute" residential care less intense than hospital care.
Both needs have been identified as crucial ones by mental-health providers in Linn County in the wake of the closing of the Abbe Center for Community Care last September. Some 80 residents with mental health needs were shifted from the Abbe residential facility to lower-cost residential facilities in the region or relocated in group homes added in the community.
Dhondt on Monday said the nine-county region is apt to see one new 15-bed subacute residential facility or two eight-bed units plus more crisis beds in group-home-like settings and an increase in the use of adult foster care for both the mentally ill and the developmentally disabled.