Options for Options

The Gazette Editorial Board

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In 1966, a group of parents and advocates for people with intellectual and physical disabilities created a support and service organization in Linn County. In 1969, the initiative became a county-run department.

Today, Options of Linn County provides services to about 250 people with disabilities. About half of them also work in Options' sheltered workshop through contracts with employers.

Options has been a nationally accredited operation for 30 years. It's well-regarded in the community, and parents and relatives of the clientele vouch for its value.

Options' budget, funded primarily by the state and federal government through Medicaid, is sound - for the immediate future.

PROBLEMS LOOM

But serious challenges loom. Whatever the future brings, the level of service provided by Options must not be significantly compromised, for the sake of the clients. The Options' situation also serves as a major debate point for the future of how Iowa takes care of this at-risk population.

Medicaid's reimbursement payments aren't expected to match Options' expenses by 2016. Both the state and federal portions are likely to adopt a flat rate based on the average costs statewide.

Sheltered workshops are being phased out across the country, as the federal government pushes for placing the developmentally disabled in community-based settings.

Options' situation also has parallels to the conditions that led the non-profit Abbe Center to close its Marion facility that served the mentally ill. Abbe's large residential facility there no longer fits what the federal government wants to fund.

Options' workshop is the only one like it in Iowa that is run by county government and with a union work force.

Looking ahead, county supervisors recently created a task force including representatives of families of the disabled, clients, other agencies that provide services to the disabled, local agencies that could provide funding and county officials to study the situation. They're trying figure out what options there are for Options' future and the people it serves.

Director Jim Nagel and other Options officials tell us that their facility and services are top-notch and that they have a “mandate” from residents to continue. However, they also acknowledge the difficulties facing them.

UNION PAY SCALE

One of the financial challenges is that Options pays its employees union-scale wages and benefits that, for direct-care workers, average about $30 an hour. Statewide, such employees at other private and non-profit agencies average between $10 and $13 an hour in pay, with benefits that are generally less robust than those provided by Linn County, Nagel told us, citing data from the Iowa Association of Community Providers, of which Options is a member. Abbe Center also had a union work force, although it was not operated by the county.

The pay discrepancy issue is a big one. Nagel points out, however, that the Options staff is well-trained with little of the turnover that tends to be prevalent in other agencies across the state. Options' 34 direct care workers average 20 years in longevity, and only four of them have less than five years of service. All of them receive regular training and updates on the latest practices in their field.

The task force, which met for the first time Nov. 21, wants to see whether there is a way to protect Options as is and, if not, then make sure that non-county providers can ensure quality services and opportunities for the people Options serves. County supervisors also have discussed lobbying the Iowa Legislature for special funding consideration.

TOUGH ISSUES

We see several difficult issues in this scenario.

One is how our state collectively values the challenging work that direct-care employees provide to those with a wide range of intellectual and physical disabilities, many of them profound. If as a community and a state, we say we want to take care of our residents with disabilities in a humane and constructive manner, then is $10 to $13 an hour with limited benefits adequate to attract and retain quality employees who can provide consistent, effective service?

We also think it could well be a waste of resources to see the Options facility, including the large workshop area, shut down. It occupies the first floor of the Linn County Community Services building at 1240 26th Ave. Ct. SW, which was built after the original Options facility on Seventh Street SE was destroyed in the 2008 flood. There also are in place many smooth-running partnerships involving employers and other agencies.

Parents and advocates say the work opportunities, although they pay little because of an industry standard formula tied to productivity, are vital to creating a sense of worth and well-being, as well as a constructive and instructive use of time, for these adults with disabilities. If you tour the workshop and talk with and observe those working there, as we did, it's hard to argue with those claims.

CHANGES LIKELY

Still, given the federal government's current direction and fiscal constraints, Options as it exists today may have to eventually give way to a new or revised model. It's also not likely that Iowa lawmakers any time soon would be willing to make a financial funding exception for one county within the ongoing revamp of the state's mental health and developmental disabilities system into a regional approach - one that aims to provide a consistent level of services to all counties. Down the road, we believe a higher level of funding will be needed to ensure adequate services.

If Options can't be preserved in its present form, its replacement likely must be a multifaceted collaboration. We would hope a network of other local providers would step up their collective capacities and match what Options provides. We also think it makes sense to find a way to keep the workshop center operating.

None of this, regardless of what the task force decides, will be easy. Changes may be inevitable. But taking care of people who can't take care of themselves is an obligation we all share.

Let's not allow what Options has achieved to be unduly diluted.

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