Section 1: KAREN BREWSTER: Well, we're on. Okay, I’m Karen Brewster and here in Valdez with Pat Lando.

PAT LANDO: Lando, that’s a good French name for you, huh, except it's spelled differently.

KAREN BREWSTER: And today is April 29, 2012 and this is for the Mental Health Trust History Project. Thank you, Pat for letting us come -- interrupt your Sunday.

PAT LANDO: I’m missing church because of you, you know, so we’re both going to go to hell.
KAREN BREWSTER: Okay.
PAT LANDO: Okay.

KAREN BREWSTER: Good, we’ll meet you there. Before we get into the Harborview story, I just want to start a little bit with some of your personal background.

Where you were born, where you came from?

PAT LANDO: Okay. I’m from Minnesota and went to the St. Thomas College.

My only claim to fame is I went with Vince Lombardi, Jr.’s son, so that was a -- that square-headed guy sat in front of me for four years, so -- but at the time was -- anyway.

Then I went -- had a Masters Degree up in Canada at the University of Manitoba.

KAREN BREWSTER: In what subject?
PAT LANDO: In social work. And then I worked in a variety of settings from you name it to --

in state hospital setting in Minnesota to a private residential treatment center for adolescents to foster care to adoption stuff up in northern Minnesota.

I worked in Canada in several settings up there.

Section 2: And then I decided I needed to go to Alaska and broke my parents’ heart and took the only grandkids they had and we came up here in ’72.

So I had a variety of experiences prior to coming up here and I had a job offer that was basically to be the first social worker of the Harborview Institution and --

KAREN BREWSTER: Was that something you applied for?

PAT LANDO: I applied for and they were looking for somebody -- back in those days a MSW was hard to come by and hard to recruit any professionals up in Alaska and so

a little bit of -- I don’t want to get off on a rant here, but my original application was on that airplane, the only airplane Alaska Airlines that crashed -- in Juneau.

KAREN BREWSTER: Oh, right.
PAT LANDO: Do you remember that, back --
KAREN BREWSTER: Yeah.

PAT LANDO: My application was on that and so I, you know, I should have been here several years before that, but I -- everything got lost and then that's apparently what happened. So that was kind of a fun little twist of fate.

But then I reapplied and showed up here in a pickup truck and, you know, and it was hardly a place.

We didn't have a bed to sleep in and Valdez was a very humble place. Seven hundred people, 800 people.

Fortunately, the Harborview had its own housing, which was a crucial part of the puzzle because there was no housing for anybody.

So we had a neat housing complex that we were able to get an apartment because without housing you didn't have employees. So that’s how it all began and I was in my late 20’s.

KAREN BREWSTER: And you were already married with children?

PAT LANDO: Married with children, dragged them up there and they said what am I doing up here in godforsaken Valdez.

But it was very simple times. No TV. Housing was strictly trailers for the most part.

KAREN BREWSTER: 'Cause this wasn't long after the earthquake?

Section 3: PAT LANDO: The earthquake in ’64. The house, you know, as you know the old town was moved four miles to the current place of, you know, on higher ground and the real piece of the puzzle was, you know, this was Bill Egan's hometown and he was the governor at that time.

And he, you know, opened up the Harborview Memorial Hospital and that was the name of it.

And that was, you know, there was no hospital and the hospital was destroyed over in Old Town.

And so that was an interesting thing. Here you had a state operated city hospital, you know, and

it was curious when they have a patient would come in, they’d have to shut down and then the nurse would run over and open up the hospital to take care of the patient. There was one doctor in town.

An interesting fellow named Dr. Shunk (phonetic) from Wyoming who was past his prime

and we won't get into some of the details of that, but the nurses basically ran the hospital,

and Dr. Shunk would come in when he was -- had all of his faculties together, and he used to take care of business.

But we had some very powerful nurses back in those days and Lynette McCoy was certainly one of them. She was the director at the time.

Section 4: KAREN BREWSTER: Yeah, tell me about that. That was -- Morningside was closing down.

PAT LANDO: Morningside, yes. The Morningside Hospital in Portland and I was not there, but I --

Lynette came up -- Lynette and Helen Nye were the two parties that came up here and before that the medical director of that facility was also -- came up and I think he only spent about a year here and then Lynette took over as the superintendent.

But that was a bit of a -- as I remem -- as I was told it was the classic institutional mess, you know.

I mean it was in terms of level of care --
KAREN BREWSTER: That -- what Morningside?

PAT LANDO: Morningside and the -- the what really happened over those years during territorial days as I understood,

you know, they were shipping -- everybody got shipped out to Morningside Hospital.

And I'm talking kids, three, four, five year old kids all under the old statutes, under the old Mental Health Statute, the old commitment laws.

It was modeled after the Oregon Commitment Laws.

So you had basically kids that were, you know, had disabilities, some of them were marginally disabled, you know, with maybe a seizure disorder.

And they were being put in with adult psychiatric patients.

And, you know, you talk about a bad mix.

And the conditions as I was told were very poor.

And if you weren't disturbed, you were after you spent time in Morningside, because these kids were, you know, these were often kids from the villages. We had many, many of -- seventy percent of our population was from the villages.

These good-hearted nurses would go up and pluck them out of these villages and put them on an airplane and ship them down to Morningside Hospital.

And God knows, you know, what they were exposed to and some of them that I met early on were, you know, hardly impaired in terms of their mental retardation,

but they had all kinds of other behavioral problems associated with just the environment that they were in in Morningside, so --

Section 5: KAREN BREWSTER: So do you know why -- when Lynette McCoy and Helen Nye and they brought those children here to Valdez, and when they did?

PAT LANDO: The original group came up in -- right after in ’67 and then --

KAREN BREWSTER: So they brought them to --

PAT LANDO: They brought a group up. They flew them up here.

One of my first assignments was to -- I chartered an airplane, a twin engine airplane,

and we went down there and we went to -- the other place that they went to was called Baby Louise Haven.

And I went there and visited and those kids are basically in big cage-like, you know, enclosures and there was certainly no active treatment going on.

You know, it was basically custodial care. And I visited down there. They were in Salem, Oregon.

So that was one of my first little jobs was to put that altogether and we brought up another I’m guessing 40 to 50 patients. And we weren’t calling them patients, we called them residents.

We brought them up and I remember landing. That was before we even had a runway out here.

We just had a gravel strip out here and it was pretty rudimentary things, but we brought the --

so at that point, probably not very much after I was there, we had up to 120 some people at Harborview.

So that was a pretty good chunk of humanity, you know. So --

Section 6: KAREN BREWSTER: But that first group that McCoy brought, that was before the Harborview facility was built, you say --

PAT LANDO: Okay, now -- she wasn't party to that -- and that was a little piece of history.

And, in fact, I remember the -- I sent that to the archives actually.

The head -- actually the title was "First Mental Health Patients Arrive in Alaska."
KAREN BREWSTER: Uh-huh.

PAT LANDO: And they went to the nursing home in Old Valdez.

And I’m guessing it was like 12 or 16 of them came up from Morningside.

And then when the earthquake happened --

KAREN BREWSTER: So do you know when that happened -- what --

PAT LANDO: That was ’61 as I remember and this is I’m flashing back, you know, 40 years here, but I just remember --

I have a good memory. That’s one thing I have that's still intact,

but I remember the article and when I shut down the joint we went through all the archive stuff and I sent things I thought were pertinent for historical reasons to Juneau.

And I remember that jumped out at me and I was told that that was, you know, that had occurred.

KAREN BREWSTER: Do you know why they brought them here?

PAT LANDO: Good question. I don’t know how that was done.

KAREN BREWSTER: Or who -- and that wasn't McCoy?
PAT LANDO: No, no, no, that was before Lynette.
KAREN BREWSTER: Okay.

PAT LANDO: And I don’t know who pioneered that,

but all I know is it didn't last very long because the earthquake happened and then at that point API was built, the Alaska Psychiatric Institute was built and then they had to -- I mean everyone had to evacuate and they moved those clients up to API.

And then a lot of them probably filtered back down to Harborview after that.

KAREN BREWSTER: Actually, that was one of my questions -- where did --

Section 7: PAT LANDO: Yeah, and so many of them filtered from API. API became a screening agent for a lot of the clients because again they were mixing and matching people were in a, you know, in a psychiatric facility that shouldn't have been in there.

And then API actually had a unit, as I remember, of -- for developmentally disabled people, but there again there was no active treatment.

It was strictly under the old medical model, you know, and --

So we brought them back down to Harborview so we often, you know, that was a screening thing that they would send them down to us and we would, you know, proceed from there.

KAREN BREWSTER: That was my question about the first ones because originally the Harborview Nursing Home was built in -- well it was remodeled in ’60 to ’63.
PAT LANDO: Okay.

KAREN BREWSTER: And then the earthquake was ’64 and so those people went to API?
PAT LANDO: Right.

KAREN BREWSTER: API had already been built, okay.

PAT LANDO: API was -- had to have been built within a couple of years before --

I don’t know exactly the date of API --
KAREN BREWSTER: I can't remember either.
PAT LANDO: -- was built, but it has to be somewhere --

KAREN BREWSTER: Somewhere in there.
PAT LANDO: In ’63, ’60, yeah.

KAREN BREWSTER: It was right after statehood, I think --
PAT LANDO: Right.
KAREN BREWSTER: -- it was started.
PAT LANDO: Yeah, yeah.

KAREN BREWSTER: And so then those res -- after the new Harborview was built in ’67, those residents were brought back here or --
PAT LANDO: Correct.
KAREN BREWSTER: Okay.

PAT LANDO: I don’t know how many -- we used to, you know, there was a constant referral process that went on, you know.

They would do their diagnostic stuff and then think that they'd be more appropriate for Harborview and so they, you know, they would send them down.

Section 8: The original population that we saw at Harborview were very high functioning.

These folks were really a mixed bag of, you know, talking about mixed diagnoses, you know, of mental illness and

oftentimes it started out with a seizure disorder and then it developed into other behavioral things and psychiatric issues, so they were a real mixed bag of problems.

A lot of them we -- we -- weren't properly diagnosed.

In those days, God knows how many were alcohol syndrome related and again many came from the villages and their prenatal care was always, you know, an issue.

God knows, you know, the conditions they came from and there were lots of strange feelings amongst the Native people about disabilities.

You know, they were often, you know, treated very poorly because of their --

there was some kind of voodoo kinds of mentality, you know, about seizure disorder, for example.

And so many, many of our people had seizure disorders and that frightened the locals and they would then be ostracized from the villages.

So that was -- because I found that out firsthand.

Another little thing that I did, interestingly we chartered the only plane in town

and I took six clients and we flew them from here all the way up to the villages, and I brought them home before they even talked about de-institutionalizing.

These were very high functioning clients,

and brought them back to the villages in Dillingham and Qwethluk and Nome and we flew, you know, actually Dave Kennedy was the only air service in town, Kennedy Air Service.

We chartered his airplane and took them all.

I brought a great big camera, you know, this big old camera thing must have weighed 60 pounds and I was going and it went to hell on me the first village we got into.

But I wanted, you know, kind of revisit what they were going into and how they were being received by the families.

KAREN BREWSTER: What year was that?

PAT LANDO: That was probably in ’74, yeah.

KAREN BREWSTER: How did you arrange that? Did you contact the families?

PAT LANDO: Oh, yeah and that was part of my -- we, you know, we were pretty savvy at that point.

We knew these people, you know.

They were often young adults that didn't need to be here and we contacted them and tried to make provisions.

The -- what wasn't there, of course, was Special Services.

I mean these villages at that time and still now, you know, the services aren't up there.

If you've worked in Barrow, you know about what I'm talking about.

The other thing we found out later on was that many of these people do not want them back in their home.

There was a whole idea once you’re gone out of sight, out of mind, you know,

and I found that out the hard way when I tried to get folks to, you know, rethink taking kids back in the villages

because there wasn't services there and often there wasn't -- the people didn't want them.

The other thing I found out even some very prominent people in Anchorage, which I won’t even get into, had family members down in Morningside and Baby Louise and they did not want them back in Alaska.

They wanted them gone and, you know, when I approached them I met with a lot of resistance because I met with all of them.

Section 9: The other thing that was really of astounding and which it's a wonder someone didn't sue somebody.

All these people were down and these kids were down, you know, under the old statutes.

None of them had guardians. None of them had guardian ad litem's.

They were down there on what authority? Who knows.

But, you know, in terms of disservice how would you liked to have had your child pulled out of a village, shipped to Morningside Hospital,

put in that kind of environment, which I guess would be very bad and --

and so again one of my first jobs was to get guardians appointed for all of the clients, because they were basically in a limbo status.

Many of them, you know, were sent down there as, you know, when they are three and four years old and I --

now they were 18. We would have them at Harborview by what authority?

I mean it was really a -- so I spent a whole bunch of time trying to get the attorney general’s office to get guardians appointed for these people.

And it took me a couple of years. And then I, of course, the first people I went to was the families.
KAREN BREWSTER: Uh-huh.

PAT LANDO: Do you want to become the guardians?

And many of them did not want to become the guardians.

So then we had public, you know, people -- what do you call them the certain officials? I’m trying to think of some of the people that were actually signed as guardians, guardian ad litem type things that were --

KAREN BREWSTER: Like a social worker?

PAT LANDO: Right, you know, there was a number of them that took down that responsibility.

Public guardians is what I am trying to think about.

The public guardians, the Office of Public Guardians is what I'm thinking about.

KAREN BREWSTER: So when you took those people back to the villages, those six people you're talking about, what was the reception from the --
PAT LANDO: I --

KAREN BREWSTER: -- community and their families?

PAT LANDO: You know, it was -- it was -- it was one of these -- back in those days you kind of did what you wanted to do, you know.

We didn't have a lot of oversight.

Section 10: It was, you know, Lynette and I guess we talked about and she says I think these people need to be back home and let’s do it, you know.

We didn't have to -- we didn't have to have permission from somebody in Juneau.
KAREN BREWSTER: Uh-huh.

PAT LANDO: And I really like to make that point because we -- we -- life was a little different, you know. We could make decisions. We -- I think sound decisions without having somebody sitting down in Juneau giving us permission to do everything.

We had full line authority to do pretty much what we thought was in the best interest of the clients.

And I think we for the most part did the right thing by them.

That changed dramatically, particularly when we got into the Medicaid stuff.

Someone came along with the brainstorm, and probably rightly so that we needed to get into the Medicaid business.

And with that came all the regulatory stuff.

And Lynette left in ’76 because she didn't want to be party to having people tell her what to do.

And she didn't want anyone from Juneau telling her what to do and she wouldn't.

If they came down, I could tell you some interesting stories. She’d crush them.

You know they’d come in with their little suits and ties and she would literally, you know, it was quite a way she had --

KAREN BREWSTER: It sounds like she was quite a strong willed woman.

PAT LANDO: She was a more than a strong willed -- She was an old Army nurse and she had a --

she had the smile of Bill Buckley. You know Bill Buckley, the famous -- you've heard of Buckley.

He wrote lots of books.
KAREN BREWSTER: Oh, William Buckley.

PAT LANDO: William Buckley.
KAREN BREWSTER: Yeah, yeah, yeah.

PAT LANDO: She had that same smile as William Buckley and she could sit back in a chair and she could just crush them.

And I was always amused by it, because they’d come down and she would basically say that isn't the way we’re going to do it here, you know.

That was before Unions.
KAREN BREWSTER: Uh-huh.

PAT LANDO: It was when central office had about ten people, and most of them could care less about Harborview.

KAREN BREWSTER: And she was -- Lynette McCoy had been a nurse at Morningside --

PAT LANDO: She was at Morningside and then before that she was a nurse in the Army -- Army nurse, so --

KAREN BREWSTER: In Korea, you said?

PAT LANDO: Yeah, and she was a psychiatric nurse because she -- me and her were talking about having to deal with the soldiers, you know, and the psychiatric, you know.

And they didn't have the equipment.

They didn't even have the medications, you know.

I think Thorazine was the only thing they had on -- had going in those days.

KAREN BREWSTER: But so she -- she came up here to Harborview with patients or residents from Morningside as part of the transfer?

PAT LANDO: Right. And I don’t know at what point she came in and then they came in. It had to have been very close together because the place opened up in sixty what - I’d say sixty --
KAREN BREWSTER: Sixty-seven.

PAT LANDO: Sixty-seven. And I remember seeing pictures of the big -- they had a big ceremonial whatever going on and they had lots of --

I’m sure the governor was there and they had a lot of celebrities there and it was a big deal because the town needed -- needed it, you know, probably.

And I think at the time the clients needed it too -- the clients that were out there in Morningside.

KAREN BREWSTER: But Morningside was closing?

PAT LANDO: Yeah, so there was a, you know, there was a rush and at that time the economy in Valdez was gone.

We, you know, the port was gone. This was a major port for Alaska, and that port ended up going to Anchorage.

So the -- there was very little going on in terms of the economy.

So between Harborview and the Highway Department, Department of Transportation had a -- quite a group of engineers,

and those two entities kept the town going.

Section 11: KAREN BREWSTER: Do you know why Harborview was placed here in Valdez?

PAT LANDO: Well, I’m telling you it was Bill Egan's gift to his home town.

And that's how it was always perceived.

And that’s how I always talked about it. You know, he's -- his town -- his hometown was in, you know, had been destroyed and he knew the economy was gone, and it was extremely unpopular, believe me.

KAREN BREWSTER: What building Harborview here?
PAT LANDO: Yes.

KAREN BREWSTER: Why?
PAT LANDO: The ARC -- the Association for Retired Citizens up in Anchorage.

They went livid, and they -- that stuck in the craw of the Anchorage group from the very beginnings to the very end.

They were absolutely -- and there was some that they never -- they never forgot about that and it was the driving force.

The first thing I heard when I walked in the door. Well, they’re going to be closing Harborview and that was in ’72.
KAREN BREWSTER: Seventy-two.

PAT LANDO: Don’t expect that this will be here very long.

KAREN BREWSTER: And when did it close?

PAT LANDO: It closed in ’99. I literally turned off the lights.

I stayed until the very end and I, you know, and there was some things that happened in between that I -- Kim and I, and time went on and we --

anyway there's a lot of things that kind of came into place, but,

you know, you know the Medicaid Waiver that came in.

Section 12: As you probably know the Medicaid waiver that diverted funds over to the nonprofits to the, you know, to the --

KAREN BREWSTER: No, I don’t know.
PAT LANDO: Okay.

Well, the Waiver Program was really a big step. It took a long time to get in place.

Basically, it took money that would -- you know, the only way you could get federal money is to have them institutionalized, you know.

And the Medicaid money that came into Harborview was very important to the -- to the budget, the Mental Health budget.

We brought in three or four million dollars every year.

Our budget at one point was up to 8 million dollars, so it was a hunk of change that came into town.

Half of that was, you know, federal match monies. I can’t play with my toys?
KAREN BREWSTER: No.
PAT LANDO: Okay.
KAREN BREWSTER: No. It makes too much noise.

PAT LANDO: But anyway that was -- that was a big one and --

and the fact that we became certified as a Medicaid provider was a big step because that opened the door for the funding.

And it also opened the door for major changes in philosophy and delivery of service.

Section 12: KAREN BREWSTER: Wow. Well, why don't we step back a sec -- then what was the original philosophy of delivery of service?

PAT LANDO: The original service -- because the folks that ran the place were medical nurses. The place was full of nurses.

They did it more of the -- remember "One Flew Over" don’t you?
KAREN BREWSTER: Uh-huh.

PAT LANDO: Okay, well it had that kind of mentality. It was -- but it was a benign kind of "One Flew Over" believe me, but it was controlled.
KAREN BREWSTER: Uh-huh.

PAT LANDO: You know you control them, you medicate them, you restrain them, you -- you, but it was done in a loving way, I’ll tell you that.

Lynette was strong handed and the philosophy was strong handed, but the clients were not mistreated,

although I can harken back to some of the restraint policies that would not be acceptable today.

Some of the people we had were really difficult to handle and they didn't have the --

the repertoire if you will of medications that we have today, you know.

So there was some restraint stuff that was probably una -- you know, very unacceptable now.

KAREN BREWSTER: Such as?

PAT LANDO: Talking about leather restraints, you know.

Four point leather restraints and it was, you know, these people were -- some pretty difficult people.

I mean they would be physically abusive to themselves and others.

I’m talking -- you ever been in an adult psychiatric facility?

KAREN BREWSTER: Not personally, no.

PAT LANDO: Well, I have and I, you know, you’re talking about people who are going to gouge your eyes out, you know, I mean.

And you’re talking about physically, you know, safeguarding yourself and others and --

KAREN BREWSTER: And Harborview had those types of --

PAT LANDO: We had some of those folks, some very difficult ones, very tough ones.

So that, you know, the model at that point was we had -- we had a large number of nurses.

Section 14: They had a recreation department and another little interesting piece of the puzzle was we had a recreational camp out here just past the house called The Salmonberry Camp.

It was built by the -- clients actually helped build it. And it took them several years and it was 80 acres.

It was developed into a camp and they used to live out there in the summertime and they made a movie of it.
KAREN BREWSTER: Yeah.

PAT LANDO: Called The Salmonberry Story.
KAREN BREWSTER: I think I’ve heard of that.
PAT LANDO: And it was a really neat movie to watch and it is some place in the archives.

KAREN BREWSTER: It’s -- the library has it at UAF. We have a copy of that.

PAT LANDO: So that was built by -- up there and now it's the -- the city just turned it into a ski -- ski hill.

Section 15: But anyways there was programming going on, but -- but the overall philo -- you know, philosophy of treatment was medical.

So we went from the medical model, if you will, to the educational model and the -- when you became accredited under the ICFMR label.

KAREN BREWSTER: What does that stand for?
PAT LANDO: It’s Intermediate Care Facilities for the Mentally Retarded I think is what the title.

It was a, you know, then there's skilled nursing. There's a whole bunch of levels of Medicaid care, but this was -- then we got into the regulatory stuff that was overwhelming.

Overwhelming to the point were we had I don’t know how many nurses quit on us because they just didn't want to get into that bag and we literally reclassified every position in the house.

We changed nurses from nurses into unit supervisors. I’m going to have to do something with my critter out there I see.

But anyway we -- we changed their whole world, but it was for the better and we went into individualized treatment programs for the clients.

Section 16: KAREN BREWSTER: What do you -- give me an example of individ --

PAT LANDO: Well, it was a multi-disciplined, you know, the multi-disciplinary approach to -- to providing services.

We had a, you know, the other thing I did or tried to do, I built a team and I recruited all over. I mean I brought in the first physical therapist to town, the first occupational therapist.

I brought in some great rec therapists. I -- we had the first psychologist. We had on contract the Langdon Clinic, for example.

We had contracts with a whole bunch of docs from Fairbanks. Dr. Kinn, used to own the clinic in town here originally.

KAREN BREWSTER: I don’t know.
PAT LANDO: Well, William Kinn is from Fairbanks. He was an ophthalmologist and all of his docs, this was their playground, but they also provided services for our clients and for the town and so they were all on contract. We had ENT , ophthalmology, all the specialty services, orthopedics.

So we had a, you know, that all came down to down here.
The other great piece of the puzzle was the school district.

Section 17: And our -- it took a while, but the City of Valdez built a special school and it's still there today called the Hermon Hutchens Special School and it's now converted over to the elementary, but that whole half of that building and it was a beautiful building and it still is, was designed for Harborview clients.

So all of our people went to school every day on a school bus. They came -- the school bus came, our staff would go with them over to school. They had six Special Ed teachers at least and speech therapists, a hydropool and you name it.

It was top of the line and they went over there for a full day of school, which was a remarkable, you know, change, you know, we got them out of the institution.

They went over to school and it was pretty neat and -- and, of course, the school got their funding off of it, you know, because they could count them as a student, but they did get some special grant money to build the Hermon Hutchens School, which is still there today and it is the elementary school.

KAREN BREWSTER: So before that special school was built --
PAT LANDO: We had --
KAREN BREWSTER: Were the students of Harborview educated?

PAT LANDO: Yes. We -- before that was built we had the teachers come over here and we actually had some -- some -- some buildings put in there. They were temporary buildings.

They were built and the teachers actually -- and the upstairs -- well, Harborview was a very big complex, eighty some thousand square feet, okay, a very large building.

That building was meant to be here a hundred years. It was -- it was eight foot of concrete above, below and is the only approved bomb shelter in town.

It was built to be here forever. It was built by the Army Corps of Engineers and there was an annex part of that building and -- which was a gymnasium and then upstairs was a whole other area which was school and then we had a school down there.

So we actually had our own school in-house and this is all flashing back in my distant mind.

So we had the teachers actually there and so the kids would go off to school right in the same building.

Section 18: And then when we got into this -- the big -- the big picture was to get this -- the Hermon Hutchens thing going on and that -- a good friend of mine George Mycowski (phonetic) and Hermon Hutchens were both administrators at the time and they --

we remember we had to go down and petition the folks in Juneau for that money to build that school and it wasn't real popular because they didn't want money to go for that purpose.

Plus, you know, anything we did that was construed as sealing the fate of the Harborview Complex never sat well with a lot of people, well Margaret Lowe, for example.

KAREN BREWSTER: And why was that?
PAT LANDO: Because it was another piece that was -- that would have to be unraveled if you were to get away from, you know, shut down Harborview, that's --

I mean I heard that word so many times for so many years I, you know, we became very antagonistic towards it.

And, you know, to -- to further develop the empire, if you will and to further, you know, would make it more difficult to close it down, so the more money you spent here and so there was some people that didn't see that as --

I remember I'd be sitting down with the Governor’s Council for the Gifted and Handicapped, you know, that was the group, you know, and it was mixed group of providers and consumers and it was always -- always antagonistic towards Harborview.

Section 19: Their agenda was from the very onset to shut the doors down here and we certainly didn't fight it in terms of philosophy, you know, but we did fight it for some other reasons.

We had our own selfish reasons I suppose, but, you know, we -- we always had to -- to fight the battle to -- to maintain what we did.

But the bottom line was we maintained our accreditation for many, many years and we always came out on top.

We, you know, we always made the grade, if you will. Every year as you know you get the local -- the state auditors come down and they go and it's always a stressful time when they come and do a state audit.

It's like what they do in hospitals, you know. And then the feds would come in. The feds would do an oversight on the state surveyors and that was even more of a pressure because the regs changed each year.

Section 20: There'd be new regulations, you know, and as you know, if you've ever been in the hospital you know they spend more time filling out paperwork than dealing with patients, you know.

So that was always a problem. You had to document everything you did, everybody had to have a, you know, individualized program.

It was all a lot of behavior modification stuff, a lot of basic psychology, basic positive rewards and, you know, we -- each one was, you know, all beh -- we had a lot of behavioral stuff.

We had a -- I say we had several psychologists over the years and they developed the psychology of trying to work on different behaviors.

You had to identify behaviors that you're trying to modify and work towards and it was all done and then, of course, we were critiqued on how you did on those individual programs.

And again we had multi-disciplinary meetings, you know, and there was a constant interchange between all the disciplines.

So we had a lot of players. Then we had, you know, of course we had the local docs on contract and then in that group we had several very, very good doctors that came into town and Dr. Todd and Dr. Embick

and some of the other docs in town that have come and gone, but there are some of them Dr. Todd is still here.

So they were our primary physicians and they fed into it a lot because there was always medication reviews and, you know, you always had to have a medical point.

And we still had a very strong nursing contingency there. We had a director of nurses and we had to have nurses on every shift, but they did not dominate the whole scene,

you know, it was all -- they were player of it but they didn't dominate, you know, and that was the difference between a medical model and, you know, and the educational model, or behavioral model or developmental model is basically what it's all about.

And it still goes on today I’m sure and so it was a major -- that was a major change in what occurred.

Section 21: KAREN BREWSTER: Now the other staff besides the nursing staff, what kind of staff was there and what kind of training did those people have?

PAT LANDO: I think I mentioned to you already we had --
KAREN BREWSTER: You had aides and --

PAT LANDO: We had a whole -- at one point we had -- I’m trying to think of when I first got here I think we had like 160 positions at one time, which was huge we had then, but we also were responsible for housing.

We -- I rise -- I ran the state housing. Are you cold? That door would close, if you would.

We had a -- then during -- what really made life different was when the oil -- the pipeline was developed. I mean this town when bananas when the oil -- they started laying the line.

We had 10,000 guys come into town. Every employee left, every male. I think we were down to about two males in the whole institution.

So it was very difficult to keep aides and we went through staff at that time 10 and 15 a week and that was a very hectic, hectic time.

But the good news was the unit supervisors, some of the department heads, were -- stayed with us for 20, 25 years, including myself, for whatever it is worth.

But we had a very stable structure and these were good people. I mean solid, solid people.

Our director of nursing Gail McGee (phonetic) actually is good friends with Lynette McCoy she's -- the PT and OT were gals from Montana that were in their twilight time of their careers.

They came up in their sixties and they were both really strong people with a lot of backgrounds in --

one of them unfortunately couldn't pass the PT thing because she had been doing it for 50 years and, you know, and couldn't pass the -- they had to get licensed you know.

I remember her trying to -- trying to get them to bend a few things because how do you expect to have someone to pass a test, you know, after 50 years of changes and stuff.

The other people, the psychologist people, did have backgrounds, you know, they had Masters in Psychology.

We had a -- the nurses were all -- we had lots of RN’s and so, you know, we had a pretty good mix of -- of people with good backgrounds.

When we hired unit supervisors they changed the, you know, the job descriptions were all changed and we wrote up -- basically we wrote up our own individualized job descriptions and requirements.

We call them QMRP's - they are qualified mental retardation professionals and again this is all dictated by the regs, which means you had to have a Masters or a degree or at least a BA degree and so many years of experience in developmental disabilities

and so it was clearly spelled out and that was always a problem. Recruitment was always a problem.

Trying to get qualified people to come to Alaska, to come to Valdez, because if you didn't have one, you’d be -- you’d be in -- you would, you know, you would be in the deficit when it came to, you know, you have your oversight come in and they’d say well you know you’re lacking, you don’t have a PT or you don’t have a, you know, someone with this kind of background.

So we would often have to do it by contract. We had a pharmacist on contract. The pharmacy was very important obviously because we had to have overview of meds all the time. We had constant medication reviews.

We had contracts with dental hygienists. We had contracts with again I mentioned all the doctors, the specialty docs that used to come down and contract with the clinic.

We had Dr. Wolf, you mentioned Dr. Aaron Wolf came down for many years.

Dr. Langdon himself used to come down for a few years so --

Section 22: KAREN BREWSTER: So how did you -- how did you recruit people?

PAT LANDO: Any way I could. Make up any story I could. I would get them to think about coming to Alaska.
KAREN BREWSTER: Did it work?

PAT LANDO: Not well. I finally did get some. We actually had several good ones after that, but it was very difficult to get them to come up.

I hired a psychologist and I remember meeting her. I went all the way to meet her to try to talk her into it because she had a resume that would knock your socks off in terms of background.

I mean, she had written more documents and I won’t even get into her name because she ended up suing the Alaska Psychiatric Institute because I think she had her own psychiatric agenda and it was very personalized, believe me

and she -- after I spent some time with her she left and went up to API and ended up with a long-term issue with API and that did not go away.

But anyway that was another story, but, you know, she looked good on paper and she had more background than you could shake a stick at.

She was from out on the East Coast, but in terms of her functioning, it didn't work with us and --

Section 23: KAREN BREWSTER: Now you started in ’72. You weren't the director right away were you?

PAT LANDO: No, I was a social worker for three years, yeah, three or four years and then Lynette left in April of ’76

and somehow I became I guess her -- whatever I did she liked apparently, so she -- she was quite a mentor of mine.

And she kind of said I want me to take over the job, which didn't go real well with the folks in Juneau.

She told them what she wanted done and that didn't sit well with some people down there.

But at the time I was here and I kind of knew what I was doing I guess and had some background.

So I -- I kind of took off from there and I was only in my early thirties and I took on a great responsibility and probably wasn't completely well equipped to it, but I did it.

KAREN BREWSTER: So that made you the main administrator of the facility?

PAT LANDO: I was the superintendent yeah. So, given, you know, in retrospect, you know, I was before my time I guess because I was only like 31 years old and had all these people, particularly and you don’t -- you don’t tell these old nurses what to do.

They don’t like to be told what to do by young guys, you know, but, you know, I -- I somehow was able to schmooze my way through it.

I never got in trouble, which was amazing.

Survived all those years and the key was keeping the secretaries happy.

And that’s the God’s truth. I had some great secretaries and some great -- because they make the world go around. I mean they can do more to -- so if you keep the ladies happy by just being nice and dealing with them as not in any kind of an arrogant way, you know, the -- my whole philosophy was to keep a happy family.

Because if the family started fighting -- feuding, care goes out the window and so I -- my whole, I guess modus operandus was to kind of cruise a the unit and I spent a lot of time -- I didn’t spend a lot of time traveling like a lot of your administrators love to go off to conventions, you know, and that kind of stuff

and they love to do their thing away from -- I spent my time kind of wandering and kind of being part of the group, you know, And so I got to know everybody.

The other thing is the town is so intimate that every family in town had people that worked at Harborview.

I’m talking about every family. Former legislators, former you name it, they worked at Harborview, so you were very a closely knit group.

Everybody knew everybody. I mean it was a -- the problem was that you got too big -- when you had to discipline someone and then you'd see them out in a restaurant or bar scene or whatever, it was very hard to live because it was, you know, it was too -- too close.

But literally and it was a great starting off point for so many people.

The mid-level employment in Valdez is gone.

So every kid that came out of high school had a great little job they could start and they could work their way up through the resident aide. We had a whole series of resident aides and then they could jump into something and they could go off.

Section 24: The other piece of the puzzle that was really neat was the Prince William Sound Community College.

They developed a whole curriculum just for Harborview.

And they had at least three or four staff and some of them are still here today.

Janice Johnson is one. She could tell you all about and they developed a whole curriculum that our aides were required to take and it was all behavioral educational model.

So they had to go through this whole repertoire of classes so you weren't thrown in, you know, without having some background, so that was neat.

So they -- they partied up with us and -- and all of our aides had to go through that educational process. So that was kind of -- again it was a kind of thing that you could do in this little town because you kind of knew how everything worked and --

KAREN BREWSTER: Didn’t they offer a degree in Developmental Disabilities?

PAT LANDO: Yes, they did, yeah. They had a -- they actually offered an undergraduate AA degree in Developmental Disabilities.

And Janice and a gal named Wendy Weidaman (phonetic) and there was how many -- they had three or four people that were kind of really gung-ho and Janice is here today.

Section 25: KAREN BREWSTER: In terms of the staff getting along with each other, I wonder how did that work with the long-term employees who'd been here under the old nursing model

and then these new --
PAT LANDO: Well --
KAREN BREWSTER: Guys coming in with this different --
PAT LANDO: Yeah, yeah.
KAREN BREWSTER: Model. How did that work?

PAT LANDO: It -- it -- it didn't work for some. I had some nurses that basically were so threatened by the concept of changing their name.

Nurses are very funny people, as you probably know or don’t know. Well, I know.

They're very, you know, they, you know, they have their own very pointed view and, you know, nurses don’t like to be told what to do, except by a doctor, you know.

And they don’t like, you know, if it’s -- it’s an assault against their nursing profession or they perceive it as an assault, it can get real sticky.

So I had some nurses who got up in arms, you know, and I can't -- I cannot do this. I’m a nurse. You’re threatening my license. I cannot do this kind of stuff, because we basically took a nurse position, an RN, and said you are now going to become a unit supervisor.

You are going to manage a unit. That's the other part that I should mention to you that Harborview was built like a wheel, okay.
Section 26:

The building was a -- had a centerpiece, which was called the, you know, it was an arena if you will and it was -- and each spoke went off. There were six spokes that went off and each of those became -- so we went to the unit system, which again --

KAREN BREWSTER: So each spoke was a unit?

PAT LANDO: Each unit, yes. And each unit had a designated name we made up, I think they were all called various things like we -- birds of Alaska I think we called them.

We had a ptarmigan unit and we had a -- we had an eider unit. We had a swan unit. We had an eagle unit.

Anyway, each one had a supervisor, so that was a way of -- of managing a unit.

It's much more difficult, you know, to have a -- if you know anything about how institutions work.

If you get someone coming in and try to manage this whole conglomerate you, really -- really difficult.

You have, you know, the charge person that comes on, you know, is -- so we found by partializing it out by segments was a much more, you know, better way to manage.

So you'd have, you know, 16 clients and so many staff and, of course, maintaining the staff ratio was a very critical part of it.

Section 27: KAREN BREWSTER: What was that ratio?

PAT LANDO: We tried to keep it, you know, again this is all dictated by regs. Everything we did was by regs and I -- it was like a one to two ratio, one to three that I remember.

I could get a little vague on that, but we had, you know, and that was a trick, because you had to have so many on during the day shift, so many on the evening shift and so many on the night shift.

And again with the turnover problem and it had to do with the pipeline activity it was really tough.

So some of them stuck through the whole process and were with us for 30 years.

Some of them, you know, we just had a group that just came and went and came up for oil jobs and worked for six months and be gone, but that was the trick.

Section 28: But the units -- the unit system and I should tell you the other part of it that we -- that was very critical was we -- the building was built in an open expanse,

which was not very good for what we were trying to do. So we took each unit and broke it into individualized bedrooms, semi-private bedrooms were built on each unit, which made it more homey.

So our whole philosophy was to create a home-like environment, you know, trying to, you know, and the more you could break it up and partialize it and give people space and privacy and all the little amenities that you try to do.

The only thing we didn't do was having semi-private bathrooms and we had to get a waiver for that.

There wasn't enough room physically, but again the regs require that they have 80 square feet or something per client and we called them residents, but anyways -- we spent a lot of money remodeling the building.

In the meantime that compromised the duct work because the duct work is based on an open system, so it got more complicated and the other part of the puzzle that was eventually probably part of our demise was all the heat came from the Department of Transportation.

They had a huge high pressure boiler system. So that in itself kept six people working because that was -- had to be monitored 24 hours a day and that was piped underground over to Harborview.

Huge underground pipes that went over to the Harborview facility, which was fine when it was built when fuel was, you know, 70 cents a gallon or whatever it was back then, but it became so extraordinarily expensive.

So the overhead ate us up, you know, the heating costs became extraordinary.

It was not many years before we had to close the place. We actually separated ourself out and built a, you know, we put like four million dollars in that building and the sad part of it and then they go and tear it down.

But we put in our own private boilers and we redid the whole boiler system so to make it more economical, but it was still, you know, very expensive and so --

KAREN BREWSTER: That open expanse land did that mean that the residents were sort of in dorm I mean --

PAT LANDO: Open -- open bays. Each unit was open and there was some semi partitions, but it wasn't very private.
KAREN BREWSTER: So they were allotted blocks --
PAT LANDO: Yeah
KAREN BREWSTER: Per space?

PAT LANDO: Right. And there was more clients, so we reduced the total population down to 96 I think was what we got down in terms of what the square footage would accommodate,

but I say it was up at one point up to 120 some as I remember, which is -- but it was way too many, you know. But when we actually made it into bedrooms then we, of course, the numbers had to come down.

And again so much -- everything you did was done because of regulatory requirements. I mean everything that you could think of was -- is down in regulations and so that’s what we were constantly trying to keep -- keep ahead of the curve.

For that, you know, that dictated most of our activities, you know, and it was -- it got expensive, you know. And this is what happens in all your -- all your medical facilities and that's why it's so damn expensive now.

I mean I can -- I watched the nurses. I was in the hospital not many months ago and they spent their whole time, you know, filling out papers, constantly filling out papers and it does take away from patient care and I kind of shook my head and said this looks real familiar.

Section 29: KAREN BREWSTER: As the philosophy of care changed with this behavioral model, how did that go over with the employees? Were they willing to do that?

PAT LANDO: I think it went over great, you know. I’m telling the initial response was I can think of at least three nurses that were absolutely, you know, they got their nose out of joint and they just -- they literally walked.

Said I can’t do this any and then overall everyone bought into it. I remember our chief nurse -- well there's a -- there's a road right up there called Dylen Drive. It's right across the street from here -- she was our chief nurse

and she was in tears because it was overwhelming to think, you know, being trained as a nurse, she was actually a chief nurse up at API

and she came down here and, Joyce Dylen, and but she was overwhelming when she had this thing come changing her whole way of doing business, you know.

And so, you know, some of them didn’t fare too well and -- but overall, you know, they did buy into it. We had some really great nurses.

The nurses made the worse employees and they also made the best employees.

They were very strong willed, very conscientious, but if they got on a rant or they got off on, their own little tangent, then they became a problem.

KAREN BREWSTER: But you had other employees who weren't nurses?

PAT LANDO: Of course, and then that's why the job descriptions were written to incorporate again under the QRMP definition thing.

It included all number of disciplines. You could be a -- have a BA in psychology, social work or a Masters or whatever, in any number of disciplines and you had to have some related experience in developmental disabilities.

And so we were able to hire -- I know we hired God knows how many different people with other backgrounds, you know, teachers, people in other educational backgrounds.

So we had a pretty good spectrum of other disciplines that came along. And they came some would stay for two or three years or four years or whatever then they would kind of move on.

Section 30: We had a person -- we had -- we had a staff that all it did was in-service training, a couple of great ones.

You know, we had in-service training programs that were constantly going. We brought things up to this state that were -- a guy named David Mandt. I don’t know if that name rings a bell. M-A-N-D-T.

He was a -- he was a the one that could teach control measures without being aversive, you know.

He had all kinds of ways of approaching very difficult clients and so he came up and was our mentor for that and then he was snatched to do work up at API and then corrections got a hold of him and so he made himself quite a living just coming up to Alaska and teaching his philosophy of dealing with difficult clients without getting into, you know, restraints.

So, you know, we were able -- the other part of the puzzle that evolved later on was we got into a Dementia Unit.

We had one of the very first dementia units in the state.

And we had a gal and her name slips my mind. She was from Oregon -- Portland, Oregon, who was the guru of dementia. She wrote several books on Alzheimer’s and she came up and we had the Sourdough Unit.

This was towards the end of our career as the clients were moving out.

We took the most difficult dementia clients in the state and did very well with them, because we had the behavioral backgrounds to deal with them.

You know, nursing homes don’t know what to do with them, you know.

And we had all the tools to deal with these very difficult -- we had guys that were -- my favorite was Wild Bill and he's from Kodiak.

I won’t give his name, but he’s gone now. But he lived in a cabin for 50 years in Kodiak and I just happened to know where he lived because I had a cabin not very far from him,

but he was so wild that they couldn't deal with him, so they shipped him over to us and he hadn't taken a bath in 50 years and,

but anyways he -- we dealt with some of them -- some very, very difficult dementia clients.

But that again was towards the end of our -- of our Harborview career and that unit went on for about -- what was happening was we were looking at a number of things.

We were looking at populations that we thought we could deal with as the DD clients were leaving and there was a whole process of that as the private providers grew

and they grew as the Medicaid money came in. So, you know, we were basically seeding our own demise, which is we kind of knew what was going on.

Hope Cottages, as you know, was a big one. I mean Hope Cottage thought they were the best thing that ever happened

and I’m sure they -- they probably were in some ways, but we -- they led the charge and they became an institution under themselves, but they had a huge, huge impact because they -- and they are still active up in Anchorage I know.

Section 31: But all the providers, you know, were very strong and every year when it came budget time they all got on airplanes and went down and lobbied the legislature.

I mean a tremendous force they put on the legislature. And it always was we need to get the money out of Harborview and pull it up into the nonprofits and that -- we went through that for so many years I became numb to it.

A lot of things happened during that time. We had a very strong legislative group here that -- that, you know, and unfortunately it got into some politics.

We didn't fight the philosophy of home care and getting folks out of the institution. We supported it. We were the ones that started it, but, you know, the issue became as the population depleted the per diem costs escalated.

You know it’s all a matter of numbers, you know. You have to have a fixed group, you know, whether you have one or twenty or fifty.

So the per diem costs became more glaringly obvious. So the population went, you know, from those kinds of numbers we’re down to the 80’s and then we were down into the 60’s and then the numbers were just, you know, would skyrocket.

So they would rush down to Juneau and say look at what it costs to keep a person down at Harborview and it was very, very expensive.

It would get into the couple hundred thousand dollar range, you know, I mean if you looked at the numbers because to keep the building open with no clients at all was like a million dollars.

I mean the heat bill, electric bill was huge. I mean I’m talking about half a million dollars for heat and electric. That building was a very big, plus the hospital was there.

The other thing that I didn't mention, which is kind of -- was interesting change was that, you know, the community hospital was taken over by the City of Valdez.

We could not run that, although we did for a number of years, but it was, you know, when things started happening with the pipeline and all the accidents and things,

we were running scared how can we possibly run a medical thing and then do our own thing over at Harborview.

So we -- the city took it over on a lease basis and they then contracted it out to what they call Lutheran Home Society.

Now it's Providence, as you know or don’t know, came in and then -- and then after whatever I -- I’m getting ahead of myself, but, you know, the, you know the thing was waying down and the -- kind of the final piece of the puzzle is that the -- they got the right people in the right place, you know.

Tony Knowles got down there. He’s from Anchorage. They got the right commissioner in there, who was from Anchorage and they got the right medical director and they had all the pieces that it would take to bring the final demise of Harborview.

And, you know, we were able to finally -- and the obvious thing they did first was to freeze -- freeze hiring. Freeze hiring and freeze client, you know, we could not accept any clients.

KAREN BREWSTER: No intake, yeah.
PAT LANDO: Yeah and no intake.

I mean that’s -- so that’s the first thing they did and my good friend Mike Renfro, you know, he knew how to, you know, get to the jugular and you -- basically if you freeze that then all the numbers just go up and looks so conspicuous.
Section 32:

So there was a strategy and it was, you know, but it was, you know, a long time in coming and we knew -- my, I guess my concern was I -- we had such a great staff. I’m not just making this up.

This -- these folks had lots of talent and it was -- and they wanted to get here and I tried to get corrections to take it over and open up, as you know or don’t know, the city -- the state was spending twenty million dollars sending folks to Arizona and they still are sending -- spending that kind of money, probably a lot more.

And they opened the one up there in Anchorage now. I don’t think it’s open yet. But anyway they were spending twenty million dollars to Arizona as I remember the numbers and we said well why don’t we take Harborview and develop it into a minimum security corrections program.

So we spent several years trying to do that, but again this was towards the end when I knew that -- that our population was going to be leaving and we almost had it happen, but I think the City of Valdez didn't want to be dirtied with -- I least that's how I perceived it, because everyone was -- thought it was a great idea.

We had architects already in there and it would have made a nice fit, you know, and it would have saved, you know, a lot of money. It would have been a fix for the community in terms of an economic base, because right now the whole city is hanging its hat on the -- across the bay here in ’96 or ’94.

KAREN BREWSTER: Alyeska.
PAT LANDO: Ninety-four percent of the total budget comes out of Alyeska.

I mean it is a one-horse town and that’s -- and if that pipeline, which is behind the house here, you know, and is down to like half I think whatever the levels are. If that ever goes down, you know, this whole town is going to blow away.

KAREN BREWSTER: But as you said Harborview was a really big employee here in the earlier days --

PAT LANDO: In the early days it was a big hunk of the employment. Everybody -- everybody worked at Harborview.

It was -- I still run into people too. In fact, I had a guy at the swimming pool yesterday say were you writing your reference letter?

I says Tom I haven’t -- I haven’t -- that’s 15 -- or so years ago. So yeah, every day I run into people that, you know, have worked there so.
KAREN BREWSTER: We’re going to take a -- tape change.