Tuesday, October 21, 2014

Feds mandate ‘profound’ COF changes

By DOUG CARDER, Herald Senior Writer | 8/4/2014

COF Training Services Inc. might have put its building up for sale at 1516 Davis Road, but the not-for-profit corporation is not going out of business, its top executive said Monday.

Ottawa-based COF is in a strong financial position and plans to continue to provide support and services to people with intellectual and developmental disabilities in Coffey, Osage and Franklin counties, Christopher Patton, COF chief executive officer, said.

COF Training Services Inc. might have put its building up for sale at 1516 Davis Road, but the not-for-profit corporation is not going out of business, its top executive said Monday.

Ottawa-based COF is in a strong financial position and plans to continue to provide support and services to people with intellectual and developmental disabilities in Coffey, Osage and Franklin counties, Christopher Patton, COF chief executive officer, said.

“This is a close-knit community, and COF is an important part of the community,” Patton said. “We have been here since 1968 and we plan to continue to be here for the next 45 years and hopefully much longer.”

A landscape-changing ruling issued in March by the Centers for Medicare & Medicaid Services provided the impetus for the building’s sale, Patton said.

Boiled down, the ruling stated all organizations like COF that provide employment, work, residential and support services for individuals with disabilities must provide those services in the most integrated way possible, Patton said. CMS’s “Final Rule” is based on the Americans with Disabilities Act and what is known as the Supreme Court’s “Olmstead Decision” which provides the lawful backing to ensure equal rights and full integration of people who have disabilities, he said.

COF’s Davis Road building that houses its sheltered workshop and other day services doesn’t meet these guidelines, Patton said. But COF is not alone. Thousands of sheltered workshops across the country — a cornerstone of the support system provided to people with disabilities for the past 40 to 50 years in the U.S. — also will not be in compliance, he said.

Why?

In as much as sheltered workshops are settings that exist explicitly for the purpose of providing services to people with intellectual and developmental disabilities, they are by definition settings that have the effect of isolating people who have disabilities from people who do not have disabilities, Patton said. Paid staff workers do not count toward the integration of sheltered workshops, he said.

“This is the biggest thing I’ve encountered in my 35-year career,” Patton said. “The ramifications are profound. We’re not just talking about workshops. This also affects residential housing and other services — with the focus being on the setting.”

With more than 90 percent of COF’s funding coming from Medicaid, it’s not a ruling the entity can choose to ignore, Patton said. Quite the opposite, he said.

“We are taking a very proactive approach to integrating the [CMS] Final Rule,” Patton said.

Though the ruling is a federal mandate, it will be left to each state to implement, Patton said. The state contributes roughly 45 cents of every Medicaid dollar spent, with the federal government picking up the balance, he said.

“The federal government wouldn’t be dealing directly with COF — it will be up to the individual states to ensure that the ruling is put in place,” Patton said.

COF also operates a sheltered workshop in Burlington, which would have to be adapted to meet the integration guidelines, but that building is not for sale, Patton said.

“We are working on some different scenarios for how we can use that building,” he said.

The Centers for Medicare & Medicaid will not allow COF and other organizations like it to indefinitely continue delivering services in what it deems to be isolated settings such as sheltered workshops, Patton said. The ruling gives organizations that provide services to those with disabilities five years to implement a transition plan, but Patton said the language is explicit that the government expects the transition to occur as soon as possible.

“We are working on a new business model which will ensure integration and meets the intent of the final rule,” Patton said. “The federal government is not trying to take away services, but rather to ensure services are being delivered in an integrated way so a person is not inadvertently isolated in any way. We will continue to provide services and supports, and we will push and push to keep developing meaningful work opportunities in more natural settings.”

The ruling also is taking a look at housing to ensure that it meets the integration standards as well, Patton said, with particular scrutiny given to entities like COF that are the owner and operator of the housing.

COF owns and operates eight eight-bed group homes, six three-bed group homes and an apartment complex in its three-county service area, Patton said.

Patton is optimistic COF’s housing will satisfy the integration requirements because the housing is integrated into neighborhoods in the communities and individuals can come and go as they please and are involved in the community in a variety of activities, he said. COF provides different levels of support to individuals living in its housing, depending on their needs, he said.

COF’s top executive said he did not anticipate the implementation of the federal ruling would lead to any staff layoffs.

“That’s not our intention,” Patton said.

Patton realizes that until the new business model is developed and implemented, not knowing yet exactly how those services will be delivered once the transition takes place can prove stressful for individuals, parents and others vested in the COF support system, he said.

But Patton was quick to add that COF has no intention of going anywhere.

“We are selling the building [on Davis Road] because we don’t need all that space, but we will still need to find another, smaller building [in Ottawa] that can serve as a hub where people can go during the day,” he said. “And we will still be providing supports and services [to individuals with disabilities]. None of that is going away.”

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