Good
Rehabilitation Not Enough
Courage Center Models Holistic Rehabilitation
by Clarence Schadegg
In a recent interview
with Access Press, Jan Malcolm reflects on her first year as Courage
Center’s Chief Executive
Officer.
How would you describe your first-year experience as the CEO of Courage
Center?
“It’s been a year of learning. Courage is a complex organization
with many parts, so I’d say I’m still climbing the learning
curve, and will be for as long as I’m here! I’ve also
developed a tremendous appreciation for several specific things about
Courage: the professional skills and caring of our staff; the tremendous
support we get from the community in terms of volunteering and charitable
contributions to our mission; and the trust our clients put in us,
the effort they give to setting and achieving their goals and the
difference we are able to make together in the quality of their lives.”
How did your role as Commissioner of Health for the State of Minnesota
from 1999 to 2003 prepare you for your role as CEO of Courage Center?
“The Health Department’s charge is to protect and improve
the health of all Minnesotans, certainly including those with disabilities
and other complex conditions. I hadn’t worked in a government
public health agency before I became commissioner, just like I hadn’t
worked in rehabilitation before joining Courage. My job as commissioner
was to work with a lot of different stakeholders to help set an overall
vision and direction for public health in the state; it was not to
be an expert in every one of the many programs MDH runs. Similarly,
my job at Courage is to provide leadership, and to help the organization
play the strongest role it can in service to the disability community;
it is not to do management at a detailed level—especially since
we have very talented managers and operational leaders who know far
more about rehabilitation than I ever will.”
What is your current operations budget? How has it changed since you
stepped into the role as CEO?
“We have total revenues of just under $40 million dollars.
Our 2007 budget grew by about 15%. About 2/3 of our revenues come from
reimbursement for services like our inpatient and outpatient therapies.
Between 25% and 30% of the budget comes from the community’s
philanthropic support—individual donors, corporate and foundation
grants, and special events like the Walk ‘N Roll with Courage
and the annual Celebration of Courage.”
Are you still actively involved with federal health care initiatives?
And how do these health care initiatives benefit/support people with
disabilities?
“Nancy Larkin, our Chief Operating Officer, and John Tschida
are both active in national rehabilitation organizations such as the
American Congress of Rehabilitation Medicine, a research and policy
group, and the American Medical Rehabilitation Providers Association.
There are some real concerns at the federal level about where Medicaid
and Medicare are headed. The rehabilitation industry continues to be
challenged by Medicare changes that are investing fewer dollars in
the equipment people with disabilities need, such as wheelchairs. We’re
also seeing Medicare reimbursement changes that are not creating the
kind of consumer-focused financial incentives that contribute to positive
health and independence outcomes. Medicaid changes in the last year
could also mean higher co-payments for people with disabilities, and
we know people can’t afford the co-pays we have in place today.
We’re hopeful that the next Congress will take us in a more
positive direction.
My own focus is now more
specific to state-level policy, but I am still involved with a couple
of national organizations having to do with public health administration
and health services research. While not specific to disability concerns,
these organizations are working on improving access to health services,
and improving health status for all people. I believe that part of
what we in the disability community need to do is to be at the “big table” of
health reform, so that the needs of the people we serve are central
to the design of health policies, not an afterthought.”
Do you support stem cell
research? Why do you or do you not believe stem cell research may
benefit people who live with spinal cord injuries, Parkinson’s
disease, and/or blindness?
“My personal belief is that stem cell research offers a lot
of promise and certainly ought to be pursued. I do worry that our cultural
biases toward searching for “cures”—and spending
almost without limit for new technologies—can (if we’re
not careful) crowd out basic investments in therapies and social supports
that help people with disabilities to live as independently as possible.
I hope we will always take a “both/and” rather than an “either/or” approach
that recognizes the need for balanced funding. Technological and research
advances over the last 50 years have created our first elderly generation
of people with disabilities, and this is a good thing. People are living
longer and happier lives because of the incremental advances that science
has achieved. Disability is a natural part of life that we’ll
all experience someday if we live long enough. Science will never change
this reality. But as an organization we’re open to any scientific
breakthroughs that positively contribute to quality of life — for
those with and without disabilities.”
Reflecting back on one year as a leader of Courage Center, how are
your directives as CEO different from those of your predecessors?
“I’d like to acknowledge the important contributions of
all of Courage’s past leaders. Wilko Schoenbaum was a real visionary,
and he clearly never knew the meaning of “can’t do.” He
saw a world of greater opportunity for people with disabilities and
did so much to help create it. Dave Hershey worked with Wilko for many
years and Dave took over the directorship of Courage Center when Wilko
moved over to help build the Courage Foundation. Dave unfortunately
died after just one year, but contributed greatly at Wilko’s
side. Dave Phillips brought great fundraising skills to Courage and
deepened Courage’s relationships across the community. Eric Stevens
brought new strengths in business and financial management and strategic
planning. I have the opportunity to build on all of these strengths
to help position Courage for the next stage of our long and distinguished
history. I have more of a health care background than my predecessors,
so I hope I can help to solidify Courage’s place in the larger
health care continuum. I do strongly believe, though, that health and
independence require more than just good medical rehabilitation. Courage’s
holistic approach to health, vocational and social integration is an
important model of how the system should work in a coordinated, client-centered
way.” ![]()
To learn more about Courage Center,
go to www.courage.org or call 763-588-0811.
