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. \

Wayne Onken, MS., CRC, Job Placement Specialist at Complete Career Services, St. Cloud, MN.