Commonwealth Journal

Local News

May 9, 2008

Oakwood brass: Residents staying put

Cabinet has no plans to relocate Oakwood residents ... yet

Just because the state of Kentucky will soon be picking up the tab for Oakwood doesn’t mean any of the mental health facility’s residents are going anywhere soon — necessarily.

State representatives confirmed to the Commonwealth Journal Thursday that there were no plans for a wholesale move of the troubled complex’s clients, despite reports last week which highlighted efforts to transfer mentally challenged individuals into other community settings.

When it was announced last week that Medicaid funding for the Bluegrass Oakwood Community Center’s 224 developmentally disabled residents would be cut off May 15 — presenting a “gap in federal funding,” as Cabinet for Health and Family Services (CHFS) Secretary Janie Miller put it in the state’s press release — the news caused a stir among those who believed residents would be transferred out of the facility en masse.

Indeed, ever since Oakwood’s woes with the Center for Medicare and Medicaid Services (CMS) began in the thick of 24 straight Type A citations during 2005 and 2006, the assumption has been bandied about that a loss of funding would necessitate the moving of the facility’s residents. And for months now, efforts have been in place to help some number of residents make voluntary transitions to other care settings — 24 are already in the process of being moved to community placements, and Miller said she believe one of these individuals might have been transitioned out just in the last couple of weeks.

So when the press release last week, Miller was quoted as saying, “Recognizing that we may experience a gap in federal funding, the Cabinet will explore, in cooperation with families of the Oakwood residents and providers, opportunities for transition to community placements or alternative settings.”

As a result, concerns among may in this community grew that the lack of funding would require at least a temporary move for the bulk of Oakwood’s clients. The release also stated that “CHFS plans to meet with parents, guardians and other constituent groups to discuss the loss of federal funding and to explore transition opportunities. The Cabinet also plans to work with the Division of Protection and Advocacy to ensure additional assistance from advocacy organizations and with community providers with proven histories of successful support of individuals similar to Oakwood residents.”

So is Oakwood being forced to shut down shop during the funding gap? No one need be alarmed, says Miller — that’s not what she meant.

“That’s not the case at all,” said Miller. “(Transition efforts are) not anything new.”

Miller confirmed a portion of the letter CMS sent in late April which said that CHFS should make “reasonable efforts to transfer residents to other facilities or alternate care.” However, Miller suggested that didn’t mean anyone should expect any sort of mass exodus from Oakwood.

“We will receive funding 30 days beyond April 15 date” that an administrative law judge ruled against the Cabinet’s appeal efforts on Oakwood’s behalf, said Miller. “One of the stipulations of doing that is making reasonable efforts to transfer individuals (to other settings). That will in no way effect our efforts to transition (the 24 individuals, and) it’s no different from what we’ve been doing the last several months.”

Miller stated that additional transitioning efforts would simply mean identifying other patients suitable for a community placement move after the two dozen already in the process.

“We’re not doing anything differently than what we would have done already,” said Miller.

But what will happen to the residents during the funding gap? CMS money pays all but about $19 million of Oakwood’s annual $78 million budget. The state will now have to pick up that funding slack. With no extra money coming in from federal sources, what exactly will be the status of those current residents?

“We’ve not been where we’ve had to address that issue,” said Miller.

Instead, the state’s focus is getting Oakwood back into a position to have reinstatement into the CMS program approved as soon as possible, almost as if it was a new facility applying for certification.

“Obviously, our goal would be to minimize the period of time that we have a gap in federal funding,” said Miller. “That has been our sole focus right now ... what we need to be doing to get ready for the survey.”

Joseph Toy, president and CEO of Bluegrass Oakwood Mental Health-Mental Retardation, the Lexington-based non-profit organization the state hired to take over operations of Oakwood in November of 2006, said he didn’t expect any of those in his care would be moved during the funding gap period, and that efforts would be made quickly to bring in a team of CMS surveyors to assess the state of the facility — which has seen its number of Type A citations virtually shrivel up and blow away in the months since Bluegrass took over. On Bluegrass’ watch, Oakwood has received only three citations in a year and a half, compared to the slew of citations in the two years previous.

“We’ve worked every day to get this facility ready to be licensed,” said Toy. “We will go back and reinforce our believe that is fine, dot every ‘i’ and cross every ‘t’.”

Toy said he “could understand why” the press release issued by CHFS would have some thinking residents would be transitioned out quickly, but added, “It’s my strong belief that everything’s been done correctly at Oakwood in the last year and a half, our license will be restored, and Medicaid funding will be as well.”

In the doomsday scenario, Toy said, residents would likely have to be transferred out from under the Bluegrass umbrella — Eastern State Hospital in Lexington would not be an option.

“We would try to accommodate as many as we could, but the worst-case scenario is not something we anticipate having to deal with,” he said.

CHFS spokesperson Gwenda Bond was quoted as saying the state was “exploring all contingency options.”

She added, “Clearly, this is a difficult situation.”

•••

The Associated Press contributed to this article.

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