Community Builder: A man who sees the connections
Editor’s Note: Community Builder is a periodic Q & A series providing perspectives from local people who have been involved in significant change in Southern Oregon. Today’s conversation is with Don Bruland, retired director of Senior and Disability Services for Rogue Valley Council of Governments.
Q: Describe the role of Senior and Disability Services at Rogue Valley Council of Governments?
Don: Initially the position was only about seniors. It was under the Older Americans Act, and the goal was to help seniors stay as independent as possible as they age. The idea was to build a network of local agencies to support seniors as they grow older. But the job evolved over time. Oregon, more than any other state, became involved with the longterm care needs of seniors and individuals with disabilities. Oregon looked at the future of longterm care and how to control the costs. We decided there should be a better way other than just nursing home care. Our region was chosen as a pilot to create a better system. We prioritized programs to serve seniors in their homes and more homelike settings. Studies show 75% to 85% of seniors want to stay in their own home. It is a “win-win” solution for both taxpayers and seniors. When I started, I was the staff, the whole staff. When I retired, we were responsible for more than 130 employees.
Q: Does Southern Oregon have a large senior population?
Don: We’ve had a large senior population for a long time. When I arrived, Southern Oregon was consistently recognized as one of the top 10 places to retire in the United States. There were many Camp White soldiers who went through here and thought, “Wow, what a beautiful area. When I retire, I want to come back.” We have a lot of people migrating up from California looking for a less hectic lifestyle, but we also have a lot of people from the Midwest and Alaska. People want to move from a harsher to a more moderate climate. The senior population in Josephine County is currently about 25%, and Jackson County around 20%.
Q: Do you think conditions for seniors in Southern Oregon have improved?
Don: Yes. Are they where they should be or where I would like to see them? No, and we’ve still got a ways to go, especially in providing mental health supports for seniors.
Q: What about housing issues for seniors?
Don: I’m involved in Rebuilding Together Rogue Valley, which evolved from a small nonprofit begun by Sharon and Howard Johnson that is helping create safer homes. A key part is doing inspections and pointing out safety issues. “Roll that rug up, let’s put a light here so you can see at night,” a lot of simple things like installing grab bars to help prevent falls. One of my hopes for the future is a national certification program for lifelong housing that will help a person stay as independent as possible for as long as possible. Rogue Valley Council of Governments currently operates a local certification program.
Q: How has health care changed?
Don: I was involved in the transformation of the longterm care system. Southern Oregon was the pilot. It became what Oregon adopted, and it is now becoming THE national model. We’ve had people from other states and other countries come to examine our model for community-based care. Just as I was retiring, the governor and the health department got legislative approval for a different approach to health care. It’s based on what is called The Triple Aim — better services, better health and lowering the cost curve for rising health care costs. If we could move away from just picking up the pieces when people become sick and instead start addressing factors that help them stay healthy, that is the best way to save money. It is also the best way to provide care. This requires us investing in the social determinants of health, such as housing, education, prevention, addiction needs and adverse childhood experiences.
I think our local area is doing a pretty good job of this. The coordinating care organizations have become invested in addressing these social determinants of health. Oregon received a federal waiver based on our plea to give us flexibility and we’ll guarantee we will keep the cost curve rising at a slower pace. Unfortunately, the federal government and the Medicaid/Medicare structure at the national level still controls costs by auditing last year’s medical costs and then setting the rate for the next year based on those costs. Our CCOs have been succeeding at keeping health care costs down by addressing social determinants, but those social determinants such as wellness, diet and exercise are seen as nonmedical and therefore not utilized in determining the next year’s rates. The regions that spend more on health care get higher rates the next year. It’s a negative incentive.
Q: What are the policy issues that you are involved with and advocating for?
Don: A couple. One is advocating around coordinated care organizations. This battle has to be fought largely at the federal level. We would like to have the flexibility to support the social determinants of health without being financially penalized. It’s a challenge, Oregon has a very tight budget. Without state matching dollars we lose federal funds. And then there is competition for those state dollars. Education and health care are the big budget drivers, and they are interconnected. A lot of what CCOs are doing now is in schools. America emphasizes independence and people being on their own. That’s important. I pushed for years for Project Independence, helping seniors stay independent. The truth is we’re all interdependent. I am also working on health equity issues for our deaf community, which utilizes American Sign Language as its primary language.
Q: It seems like community service is in your blood. Why is it important to you?
Don: I come out of a faith background. I believe we are called to act justly; love mercifully and walk humbly with our God. After I got my BA, I went to seminary in New York. I dropped out and made a decision to find other ways to do that ministry. I chose social work.
Q: What about your childhood?
Don: I came from a very low-income family. My father had his first stroke when I was 5. We survived by my mother cleaning houses and later working in a school cafeteria and finally as a helper in a hospital cafeteria. Money was tight, although there was some Social Security and a small veteran pension as my father was in World War I. So you might say, “Well, Don pulled himself up. Why can’t others?” I lived at a time in California, when taxpayers supported schools. I was able to get a good education. College was $50 a semester, most of which was an activity fee. I came from a family that didn’t have money, but I didn’t come from a poor family. My family loved me and invested in me. I lived in a small community that was supportive also. That helped me get my education.
Q: How did you end up calling Southern Oregon your home?
Don: I had a degree in social work from San Diego State. I got a job at Oregon State University when the first nutrition program was coming out for seniors. Then a job opened in Medford, for an Area Agency on Aging director. To my surprise, I got the position. Our first child was only a year old. My assumption was that I would be here two, three, maybe four years and then move on. But we loved the area and the people.
Agencies here worked together for the most part rather than competing. People truly tried to make things better. I’d put in lots of hours, get tired and sometimes frustrated, but then I’d realize how lucky I was. I got to work on something I believe in. I got to do things that make a difference. I got to work with people I like and respect. And I got paid a decent salary. Most people are lucky if they have one of those four things. I had all four.
Q: What do you love about the area?
Don: It’s beautiful.
Q: Was it always beautiful?
Don: You’re remembering when we would get socked in with smog in the winter. The smoke and air pollution together with the inversion was not ideal, but still the area was beautiful. It has clearly improved, except during bad fire seasons.
Q: What would make living here better?
Don: It’s the whole area of housing. I think if you talk to almost anybody, they will mention the lack of affordable housing. I would add, the lack of supportive housing. For the homeless people you need supports to deal with mental health and addiction issues. For seniors you need housing stock that helps them remain independent for as long as possible. And helping people stay independent will keep down health care costs. Creating supportive housing for homeless, supportive housing for seniors and just plain affordable housing is critical for our region.
Q: How is retirement?
Don: I’m very busy. People ask, “What do you do for fun?” I play tennis still. We visit our children and grandchildren, that is one of the true joys. One of the most enjoyable things I do is meet with people who are still working and help them think through issues.
Q: What do you bring to those conversations?
Don: I think I have some perspectives on how you work with people and how you can avoid unnecessary confrontations, even when you are on different paths. I challenge people by asking, “Have you thought about approaching it this way?” Really what you want is a resolution. True partnerships are a win-win. I don’t see people as good or bad people. Most people care about other people and the collective good. I remind them that almost everyone wants to do the right thing.
Steve Boyarsky is a retired educator and longtime resident of the Rogue Valley. He continues to be involved in educational and youth programs.
Don Bruland bio
Don graduated from Fresno State College in 1967 and then attended Union Theological Seminary in New York City. After leaving seminary he worked for South West Indian Foundation in program development. Don earned his Master of Social Work from California State University, San Diego.
Following his MSW program, he accepted a position with Oregon State University training Senior Nutrition Program directors in practical gerontology and program development. In 1975 he became director of the Area Agency on Aging for the Rogue Valley Council of Governments and evolved to director of Senior and Disability Services for RVCOG, with overall responsibility for serving seniors and persons with disabilities in Jackson and Josephine counties.
Don retired in 2012. His current activities are: All Care and Jackson Care Connect Citizen Advisory Committees; Jefferson Regional Health Alliance; AARP Community Action Team; Continuum of Care Board; Rebuilding Together Rogue Valley board member; Hope Village Steering Committee; Ascension Lutheran Church Administration Committee; Southern Oregon Center for Community Partnerships board member; Deaf Issues Workgroup of RVCOG’s Disability Services Advisory Council.
Don has been married to Margaret for almost 50 years. They have two children, Jeannie and Peter, who live in the San Francisco Bay Area.