Letters to the Editor
Rehabilitation
Services’ policies inhibit the use
of small providers
I recently spoke to the State Rehabilitation Council
on this issue. I have a small, private for-profit company that provides
job placement services to persons with disabilities. We have been
in business since February of 1988. Following is what happens with
an individual or company wants to provide services:
To start, Rehab Services
allows service provision under their “limited
use provider” policies. With this system, an organization basically
indicates that they are a legal entity, that they don’t discriminate,
and that they adhere to appropriate ethics in the provision of services.
However, once they receive $20,000 of authorizations, they are forced
to become certified by CARF (Commission on Accreditation of Rehabilitation
Facilities). This is very expensive and for small agencies, inappropriate,
as CARF is designed for large, full-service, community rehabilitation
providers. Following are the reasons this is a burden on small providers
and a major burden on large providers.
• Currently, it
costs $900 just to apply.
• They have updated standards manuals each year, which cost
several hundred dollars.
• They charge $1,300 per surveyor, per day. They pay their
surveyors $50 per day.
• They say they do “peer” reviews, which has never
happened in the six surveys we have had at our organization, as we
have non-profit administrators try to make sense applying nonprofit
standards to a for-profit company. Needless to say, none of these
people have ever provided direct job placement services.
• At least two people in Rehab Services administration are
employees of CARF. To be a surveyor, they need to complete at least
three surveys per year. This means that they are taking at least
three out-of-state trips, to do surveys that may last from two to
four days. This is a conflict of interest and I believe their time
would be better spent surveying agencies in MN.
In my company, we have
always received the highest level of accreditation, with numerous
commendations. However, other than paying a lot of money to have
someone tell us we’re doing a good job, we have
not received any benefit from this process other than to be able
to continue to provide services through MN Rehab Services. The last
time we were surveyed, we had one surveyor for three days, and he
was done in two days, yet we pay for the full three days. So at current
rates, that’s $3,900 plus the $900 to apply, plus the costs
of the standards manual, and not counting all the hours preparing
for the survey and being available on the survey days to provide
information and answer questions.
Minnesota currently has more than 40 community rehabilitation providers
that are CARF accredited. The vast majority of these providers have
multiple programs, multiple sites, and pay anywhere from $14,000
to more than $30,000 to have CARF survey them. Using an average of
$20,000, this means CARF is receiving fees in excess of $800,000
from Minnesota in a three-year cycle. I believe this money could
be better spent providing services to persons with disabilities,
than paying someone from out-of-state to be certified. ![end of story bullet]()
Wayne Onken, MS., CRC, Job Placement Specialist at
Complete Career Services, St. Cloud, MN.
