What is Complex Rehab Technology ?

CRT (Complex Rehab Technology) is the newest term, developed over the last few years to describe specialty equipment that which is more involved than basic  DME (Durable Medical Equipment). As you may know DME encompasses everything from disposables  to custom wheelchairs and Orthotics/Prosthetics. You may wonder why a new term was created if it is part of DME? 

Invacare Rear Drive Powerchair

For years, DME vendors have been given a bad name, with a few bad companies taken advantage of the system and many times committing fraud.  CRT was born, when Medicare created the Competitive bidding process and they didn't understand the level of involvement with Specialty Seating and Equipment. After much work from the Rehab industry, some specialty equipment was exempt from the competitive program; including ultra light weight wheelchairs, tilt in space wheelchairs, and group 3 powered wheelchairs.  Medicare, who sets precedent for Medical Equipment to all funding sources, accepted that the skill level and expertise in providing this level equipment was above the typical DME provider.

Since that time, NRRTS ( National Registry of Rehab Technology Suppliers ) and NCART ( National Coalition of Assistive and Rehab Technology ), has been lobbying Congress to further separate Complex Rehab equipment from DME.  It is understood that there is a value for this equipment provided and that there needs to be increased safeguards, and education from individuals providing this level of equipment. If  this industry is not protected, and the value shown, it will disappear in the upcoming years.  The average age of Rehab Technicians are late 30's, with most over 40, and few new people learning this trade.

Carey Britton

 With the baby boomers aging, we will need more specialists  involved; helping match proper equipment for seating and mobility needs.  A further issue causing challenge, is that there are fewer physician and therapists specializing in this field; leaving more pressure and expectations on the Seating and Mobility Specialists.   Although the Seating and Mobility Specialist is a critical component in the team that provides and supports these services; the clinician is  the gatekeeper, and we need more clinicians  to step up become community leaders. 

In order to ensure  good outcomes, we continue to progress in this industry with increased credentials, increased education, and increased safeguards to protect patients.  Our industry needs to continue to educate the allied services to become more involved in the team that is required to improve seating, function and overall satisfaction.

This article was written by Carey Britton, Seating and Mobility Specialist at Active Mobility Center. He can be reached for comment at 954-946-5793 or at cbritton@wheelchairguys.com  .

 

Active Mobility Previews CinemAbility.



Carey and Jenni

I was lucky enough to be invited to the screening of CinemAbility on 10/19/2013 at the Muvico at Pompano Beach. CinemAbility is a documentary of Disability on the Silver Screen from the the early silent films  through the present day.  Jenni Gold, Director created an amazing journey with viewer, with a star studded cast. Our local celebrity Danny Murphy had several parts helping to show the importance of using actors with disabilities in TV and in the Movies to help bring more awareness  and realism.  Jenni explained that few movie writers give much thought to the disabled community when writing their screen plays; there is a push to bring more awareness to writers toward inclusion.


This Documentary will be traveling the US over the next few months, it is a must see.  It is being considered for an Award in the Documentary Category- Tell your friends, and family.

 

For anyone in South Florida, there will be another screening (part of the Ft. Lauderdale Film Festival) on November 2nd.

 

This article was written by Carey Britton, Seating Specialist for Active Mobility Center. Carey can be reached at 954-946-5793 or at cbritton@wheelchairguys.com .



Danny and Carey

Active Mobility - Inservice at Young Body Rehab

Active Mobility Center provided an Inservice for Young Body Rehab in Palm Beach on Freedom Concepts, bicycles and chill out chairs. Freedom Concepts is a manufacturer of bicycles for mobility challenged indivdiuals who are are able to use or be supported on traditional bicycles.

Freedom Concepts offers several bicycle systems for small children to adults. These systems can be customized for size, shape and abilities. These systems can be provided with caregiver stearing systems to allow the user to concentrate of movement, or the caregiver can push the bike moving the user's feet in the standard bicycle pattern.  These bikes can be operated by foot or hand. Options include shoe holders, seat and back supports, belts and harnesses, headrests, adjustable and adpative handle bars.

The Chill Out Chairs offered in mobile and rocker base, and provide an alternative, safe seating surface for children and adults with mobility challenges. 

For an Inservice or more information, please contact Carey Britton at 954-946-5793 or at cbritton@wheelchairguys.com . 

Active Mobility Center at Medtrade Orlando

Last Week (Oct 8-10) I attended Medtrade East, a yearly event where manufacturers of Home Medical Equipment present their products to equipment providers. Many new products and vendors provide a resource for offerings to people recovering, rehabing or requiring equipment for life. 

I have been attending Medtrades since the early 1990's, in a time where equipment funding was much better than today; and it showed with the event's attendance. Medtrade used to take up the entire convention center, and this year only spread 19 rows.  This proves that this industry is hurting and needs your support to ensure it is there for future generations.

This year, there were very few rehab (complex rehab) companies exhibiting. Many companies providing retail and products not affected by the Medicare competitive bidding program.

Some of the new items that I thought could help our customers were;

Environmental Controls- these controls allow a mobility challenged user to use voice ,touch, or other input to operate and control items around the home including the TV, Radio, Lights, Appliances, Door Openers, Electric Beds and more.  In the past these systems were clunky, complicated and very expensive. I was impressed a few companies using tablets and smart phones to operate home devices.

Beach Powered Wheelchairs- it was interesting to see a beach powered wheelchair for under $7000 that fits on an adaptive van lift. This will certainly offer more people access to the beach as well non paved areas.

Rifton Toileting Chair- rifton has redesigned it's toileting chair to allow attachment to multiple bases, including a tub base, and a tilt in space base. Their new design is much improved from the current version and will release shortly.

New Information Companies- there were some companies that provide some interesting information management systems that can help efficiency and the paper process.

Ram Mounts- the Ram company is making several mounts to be used on wheelchairs including, smart phone, tablet, cup holders, lap top computers, and much more.  This will allow wheelchair, scooter and powered wheelchair users to be more functional and have increase Access.

Modular Ramps- there are more companies offering more options of modular ramps. Once only available in aluminum are now available in wood and steel allowing for more options and reduced costs.

Portable Scooters- there are more companies offering foldable and compact scooter devices; some which can fit in a suitcase. This makes sense as the baby boomers are aging and need more mobility options.

ASL- Adaptive Switch Labs has some new switch options allowing powered wheelchair drivers additional options.

Pride / Quantum- has an increased number of accessories for their powered wheelchairs including cup holders, hydration systems, cell phone holders and more.

Although the show was small, with the reduced traffic attendees were able to navigate the show floor and spend more time with the vendors learning about what is new and what can help our community.

This article was written by Carey Britton, Seating and Mobility Specialist for Active Mobility Center. Carey can be reached at (954) 946-5793 or at cbritton@wheelchairguys.com

Active Moblity Center at DisAbilities Expo 2013

This past Sunday, October 5th, was the Disabilities Expo which is the longest running expo for special needs in South Florida.  Active Mobility Center has been participating in this expo for nearly 20 years.  This years exhibit was larger, and more attended.  In addition to having equipment providers, there were several adaptive vans, many support organizations and a large number of new sports activities and groups to allow individuals with special needs an opportunity to get out there and be involved.

This year there was an all day wheelchair basket ball tournament and a runway fashion show. 

It was great to see many of our satisfied customers, and see many more individuals who were looking for education and guidance through the seating, mobility and equipment process. 

This was the first year we were able to have five members of Active Mobility Center at the exhibit to help showcase our products and services, as well to learn about other opportunities and services from other exhibiting providers.

If you didn't get a chance to get out to this event, look for this to recur next October. Carey Britton, is a Seating and Mobility Specialist with Active Mobility Center. He can be reached at 954-946-5793 or at cbritton@wheelchairguys.com

Nova South Eastern University OTs come to Active Mobility Center

On Monday, we welcomed nearly 40 second year Occupational Therapy Students for a morning Seating and Mobility training.  Each year, we host this training to provide a glimpse into the world of complex rehab and assistive technology equipment.  We divided the group in to four groups and created stations including; Insurance Coverage and the process of getting equipment, manual wheelchairs and scooters, seating and positioning, and powered wheelchairs.

With smaller groups, the OTs were able to ask questions and interact with each presentation. At the Insurance coverage session, the groups heard how complicated the process is. There are many changes in health care that make the intake, insurance verification and needed documentation a specialized process. The groups were disappointed in learning that the complex rehab process can take 2-4 months for patients to receive their permanent equipment.

At the manual wheelchair and scooter group, they learned about standard through ultra light wheelchairs, about tilt in space and recliners, and the differences in scooters. The groups were fascinated on how the process to determine the equipment was more involved that thought. They had not learned about competitive bidding and how it is negatively affecting individuals needing this type of equipment.

The groups learned about how many different types of foam cushions, contoured cushions, and molded seating types there were. Some were overwhelmed not sure how they could ever grasp how much information, and options were available.

In the powered wheelchair group, the students were shown the different types of powered wheelchairs, different ways to control them, powered seating systems and were able to trial driving these chairs; including a stand and drive permobil. 

Concluding the program we discussed how important the team (physician, therapy staff, equipment provider, individual and caregivers) is in equipment provision.  We discussed how the physician initiates and drives the process; however the PT and OT are just as important, and in some cases more important.  We discussed the importance of a good dialogue on the history of the patient, their past equipment experience, patient environment, patient dimensions, patient goals, and caregiver needs.  It is critically important to gather this information, and openly discuss the options to ensure that the patient is satisfied and that their life is improved. What is selected and provided affects that patient for a minimum of five years. 

It was impressed on these students, that if they find themselves helping someone with complex rehab, that they seek assistance if they are unsure of what best resolves the needs.  We explained that ego's should be checked at the door as the process is not for us, but the individual needing this equipment.  We suggested that once they find a position that they find a peer mentor to help them. Additionally they should find a RESNA and/or NRRTS registered provider to be part of their seating and mobility team/program.

Although many of these OTs may never be involved with Complex Rehab Equipment, they now have some basic knowledge, were give some valuable tools and have  a better respect for Complex Rehab Equipment.

This article was provided by Carey Britton, Seating and Mobility Specialist for Active Mobility Center located in Pompano Beach, Florida. Carey can be reached at 954-946-5793 or at cbritton@wheelchairguys.com .

Quickie QM710 Power Wheelchair- Product Review

Scott Sweeney, representative from Sunrise Medical was in the office to provide an update on the Quickie QM710, Mid Drive Powered Wheelchair.  The QM710 has been marketed with Spider Track technology, where the chair has an aggressive suspension allowing it to traverse rougher terrain; including 4" curbs. Additionally the suspension dampens the ride reducing the seating displacement of the rider.  In the past year, we have seen several satisfied wheelchair users who have decided on this product to meet their needs.

New Improvements:
* New Lower Seat to Floor Height Available (16 1/2")
* Power Legrest Extension to allow standing on the footrest for transfers
* Black Wheel Option
* 12" Seat Elevator, scissor mount, and can drive at reduced speed when elevated

The QM710 is a good option for patients to consider when choosing a mid wheel drive system. 

Any comments can be directed to: Carey Britton, Seating and Mobility Specialist for Active Mobility Center. He can be reached at 954-946-5793 or cbritton@wheelchairguys.com.

Adaptive Car Seats

This week, we were fortunate to have Debra Britton provide a presentation on Car Seat Positioning Equipment. This is a regular training program at Active Mobility Center to promote and educate products to the staff, customers and professionals. If you have an interest in any specific products or services, let our office know so you can receive an invite to the programs.

Car seats are essential and mandatory for small children in motor vehicles. As children grow, or have seating and positioning needs greater than a off the shelf carseat, an Adaptive Car Seat may be necessary.  Off the shelf car seats have been crash tested as they sit so it is not recommended to add any foam/changes to these systems. Although this may work well, it changes the product and places any legal responsibility on this person in the event an accident arises.

Car Seats can be a challenge for parents with special needs, as they are not covered by Medicare, Medicaid and most insurance carriers. Medicare (Sadmerc) determined coding, and Car Seats as a transportation device and used outside the home are not covered items.  It is important to note that there are alternative funding sources that may be able to help.

Car Seats are more safe than transporting children in their primary mobility systems (ie. wheelchairs) even if transport brackets are added. Transport Brackets, also not funded through most insurance, although allow a place to strap a wheelchair into a bus or van, are not intended, as stated in their owner's manuals, with the use to be seated in the chair while it is strapped down.  Tie downs are a topic for another presentation. 

There are several products available for this purpose including products from; Columbia Medical, Convaid, SnugSeat, and Thomashilfin.  These products should not be looked at as a one product fits all, and each have certain benefits which can help a particular child.

Car Seats

The Traveller Plus EL, Carrie, Hippo, and IPS are all adaptive Car Seats. These system are similar to off the shelf systems, but are larger, and offer more padding and support to provide support and stability for a special needs child/adult.  These systems allow for a 30 pound to over 100 pound person to use them with the abililty to adjust many of them in seat depth. Some of these offer foot supports and some allow the feet to hang.

Booster Car Seats

This category comprised of the Recaro, and Pilot offer another option for support and adjustability. These systems look more like the off the self booster / car seat systems. They work really well, but have limitations in width adjustment.

More Supportive Car Seats

Recently the Carrot and Spirit systems have entered the market, offering supports similar to what you would see in a wheelchair in a car seat. For larger and involved clients needing extensive support; these systems may be the answer.

Common Questions

How do I know what product to Pick?
These products range from $500 to several thousand depending on the options and needs. Choosing a product should include the assistance of a Physiatrist, Physical or Occupational Therapist and a Seating Specialist. Since this equipment is expensive, you do not want to waste valuable resources on the wrong product.

Where do I get these products?
Most Seating and Mobility companies stock Demo's of these products and can assist you in trialing them for fit, and helping make recommendations after discussing the vehicle and assessing the patient with a therapist or physician.

Who Installs these products in my vehicle?
This is getting more difficult due to our litigious society.  There are certified people in the community who install car seats and should be consulted if after reading the directions you have any concerns or questions.

We want to Thank Debra for providing an outstanding training program and look forward to her next topic.  This article was re-written by Carey Britton, Seating Specialist for Active Mobility Center. Carey can be reach at (954) 946-5793 or at cbritton@wheelchairguys.com .

 

Active at Joe Dimagio Special Needs Fair

On Sunday September 28th, Active Mobility Center supported the Joe Dimagio/Memorial Health Care System for the sixth year.  It was a great representation of the community which offers services to the special needs community.  There were groups from Hospitals, Therapy Centers, Respite, Day Training Programs, Home Accessiblity, Financial Services, local support groups/services and ofcourse the Pirates and Mermaids. 

We saw many of our loyal customers and referral sources.  It was a great time.


Carey Britton, is the seating specialist with Active Mobility Center. He can be reached at (954) 946-5793 or cbritton@wheelchairguys.com.