Benay Britton | NSM Ft. Lauderdale at Caps of Love Grand Opening

Benay Britton from NSM #132, was out supporting Caps of Love's Re-Grand Opening.  Caps of Love is a local organization that recycles Caps, and uses the money to Buy and Re-Furbish Seating and Mobility Equipment.

NSM Ft. Lauderdale has been involved with helping Caps of Love, with equipment service and repairs.  Caps of Love is truly an asset in our community helping make South Florida better.

The Fort Lauderdale Office of National Seating and Mobility, is located in Pompano Beach, Florida and covers Dade, Broward and Palm Beach County. It's focus it to Make Every Day Independence Day through seating and mobility equipment. 

MDA MUSCLE WALK | PALM BEACH | SEPTEMBER 25TH, 2016

Carey Britton, and Debra Britton were out at the MDA Muscle Walk at Roger Dean Stadium today supporting Families with MD, and the MDA of South Florida.  On this beautiful morning, we met many families, friends and other community resources; heard amazing stories, and believe we were able to provide experience, knowledge and support.

NSM Branch 132 is located in Pompano Beach, with over 25 years of experience, the staff is a resource to those who need seating and mobility equipment and services. Our office covers from Port Saint Lucie to Homestead.  Our office located in Pompano Beach (Ft. Lauderdale) has a seating room, full parts/service department and showroom.  NSM has additional Florida locations in Miami, Orlando, Tampa and Jacksonville.

NSM Corporate has committed their support to the MDA, watch for NSM at MDA and other Local Events.  Thanks for your continued support.


NSM is located at 1406 SW 13th Court, Pompano Beach, Florida. You can reach them at (954) 946-5793.

Father’s Day, a Day to Appreciate Dad.

I am sitting here reflecting on My Dad who I lost a year after He and I started South Florida Mobility Inc. D/B/A Active Mobility Center in 1992.  My Dad was an electrician by Trade, and was able to teach me a lot about mechanical and electrical equipment., which I use every day.  I was lucky to have a Dad and Family that gave me the opportunity to succeed and find my passion in helping others maximize their abilities. It was my Dad who found a Medical Equipment business for sale, when I was dismayed about medical school. 

On this Father’s Day, spend some time reflecting on how your Dad has made you better, and appreciate what you have. 

Happy Father’s Day from Active Mobility Center. 

We Still Need your Help to Make a Change in CRT- HR 942

I am sitting here on the first day of June, thinking of how far we have come in our quest to change Complex Rehab Technology.  CRT is a relatively new term, which covers custom configured equipment including ultra light weight wheelchairs, powered mobility and seating and positioning equipment. 

It is mostly understood that, CRT is not a order and drop equipment, and requires skilled staff to help with the evaluation and assessment, the gathering and submission of paperwork to insurance funding, the ordering, assembly, delivery and fitting of this specialty equipment. 

Unfortunately our industry has not done enough to police itself and has a black eye, as it is lumped in with DME.  Every month you can see in the news DME suppliers investigated for fraud and abuse.  It is unfortunate that instead of CMS doing a better job screening their suppliers, they have placed higher and higher requirements which are negatively affecting the beneficiaries. What CMS/Medicare does, is adopted by all other insurance carriers.

I am excited to tell you at this moment we have 130 House Co-signers and 15 Senators who have Co-Signed on to this Legislation. This is a great start but we need more to make this legislation to be important enough for Congress to move on this.

None of us know if/when we may need these products and services; and there is a real concern that if things do not change, then this industry will certainly change; and possibly disappear.

A friend of mine reminded me that, Orthotics and Prosthetics went through this Journey several years ago, and it took them over a decade to be recognized and have their products/services separated from basic DME and are understood that it takes a special group of people to take care of those with special needs.

Take a moment to sign on to the petition to separate CRT. If you want to be move involved please contact me and I can put you in touch with several groups who are leading the charge to change CRT.

This Article was written by Carey Britton, ATP/SMS, CRTS for Active Mobility Center. He can be reached for comment at (954) 946-5793 or at cbritton@wheelchairguys.com.

What can you do to help fix Funding for DME.

The item coalition, as well as NRRTS, RESNA, NCART, and countless other groups and manufacturers have been fighting a battle for the mobility challenged community. For years, it has been up to our industry to police itself, and there have always been a few bad apples that have ruined our system, reducing our credibility and have forced CMS to take action. As a long time supplier, I remember the signs “FREE LIFT CHAIR”, which providers abused until Medicare blocked the code, and made it difficult for consumers to get these items.

Over the past few years, since powered wheelchairs have become fashionable and attractive; suppliers had found a loop hole which could be very lucrative. We have all seen the people who receive powered wheelchairs, but can still walk. We have also recently witnessed many providers becoming indicted for billing for this equipment and never providing it to their patients.

I have repeated over the years, to my congressman, to organizations, consumers, and professionals; that the only solution is to rid the industry of its bad apples. The problem stems from the manufacturers, who see increased demand of their equipment through outlets who do not offer service, customization, or any choice to the consumer. If manufacturers demanded their suppliers were credentialed, and provided adequate service with the capacity to follow up the product; our industry would be very professional and respectable. Instead today, suppliers are looked at as people you cannot trust; and only in it for the money.

There is a genuine concern about the competitive bidding program that Medicare is initiating. As a supplier my concern is that to put something out for bid in an industry which is already providing (in many cases) substandard equipment; the allowable for equipment will plummet. Competitive bidding means that in a community all providers bid their lowest price they can provide a service for. Since many suppliers are providing non-US equipment, the price ceiling would most likely be set for these lower imported products.

The obvious concern here is that when reducing costs so much, what happens to the service. What many individuals do not understand is that most equipment that is provided (by responsible providers) requires an assessment from the provider, with a team consisting of a physician, therapist, and family to provide the best solution for the patient. When you set a capped amount on equipment, both the choice of equipment and the specialty of customizing, and fitting a mobility product will disappear.

What most people don’t know, is that most physicians and therapists are not familiar with equipment and depend on the supplier they are working with to recommend the most appropriate equipment. In reality the equipment that is being prescribed, is left up to the supplier to choose. When you reduce the funding, and reduce the choices, you will lose the specialty providers; and have only a delivery system. Would you rather a delivery person drop off your equipment, or a specialist who can instruct, train, adjust, modify and make suggestions to you?

The competitive bidding issue still has a long battle ahead, as there are too many uncertainties; like if you award a company a particular demographic; and they turn out to be a bad provider; what is the recourse. When you award one provider the work for an entire area, you will certainly force many of the other providers out of business. So how do you replace a provider that fails to perform?

The larger picture may be that by providing cheaper products that will be outsourced to non US countries, our Gross National Product declines. To spend billions of US dollars on healthcare for most of that revenue to be sent outside the US , is not good for our country. Even worse, is the amount of unemployed, skilled workers from local equipment suppliers, and from national manufacturers.

Now is the time to get involved, voice your concerns to legislators; tell them of the importance of local providers who can supply, fit, repair and customize products. Nothing in this world is free, when you see these ads for free power wheelchairs, no cost to you, qualifying people who can still walk- turn them in to Medicare. We cannot be blind and turn away as this problem is not going away; and when you need Medicare benefits they are not going to be there.

This article was provided by Carey Britton, seating and mobility specialist for Active Mobility Center. He can be reached at 954-946-5793 or at cbritton@wheelchairguys.com

What Can You Do to Help Make a Positive Change

If you know me, you know that I attempt to do the very best at whatever I choose to do in life.  In regards to my work, I am passionate about helping others through Seating and Mobility.  Over the past few years, there has been an attack by CMS/Medicare on this small industry that positively affects so many people; allowing them to live a more productive and independent life.  With the help of Active Mobility, I have been able to spend time advocating and lobbying for access to these services.

The number one (1) complaint that we here at Active Mobility Center, is that it takes too long to receive new equipment, and that the hoops needed jump through are unbearable.  As an industry we have done a poor job educating the public on how to advocate for themselves. We, as a collective group, always want to satisfy our customers, avoiding all the negativity of the increasing pressures.  When there was more of a margin/profit on medical equipment, we could hire more staff and facilitate equipment faster; however now with these changes- we have to do more with less.

These increased funding pressures, combined with the amount of requirements now to qualify and prior authorize equipment is making this process much more lengthy. CMS/Medicare had created new watch dogs who are bounty hunters only profiting by finding errors in paperwork, so suppliers have to spend much more time on the details; than the actual equipment provision.

Over the past few years, you may have heard of a program called competitive bidding. This program, no longer only a Medicare problem; has been finding it's way into the private sector; and if Obama's plans go into affect in 2015, will affect state medicaid programs. 

As of April 1st 2014, Manual Tilt in Space wheelchairs as well as some other DME products will become capped rentals. Many providers have already voiced their concerns that they will no longer be able to accept this and will no longer provide these services.

Equipment providers can no longer afford to be the sole Advocate for the users of medical equipment. The pressures exerted have taken the profit out of the system and where equipment users will need to get involved to avoid access to these services.  There are many ways that you can get involved, from contacting CMS/Medicare, your state and local representatives, or attend lobby groups to show how important this is to you and others.

Staying in touch through NRRTS.org, NCART.us or other similar organizations can help guide you and help your voice be heard.

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

Is Medical Equipment too Expensive?

I have seen many posts lately on Face Book and in Blogs about the high prices for DME and Medical Equipment. I have seen comparisons to Sport Aid and other online pricing compared to the brick and mortar companies. 

As a tax payer, and after taking an Ethic course and discussing the outside perception of the costs of Medical Equipment; I understand the concerns.  It is hard to fathom that a powered wheelchair may cost as much as a car, that an ultra light weight wheelchair may cost $3000. 

That being said, have you seen how much a refrigerator, furniture or a racing bicycle may cost?  I have a friend that has a bicycle that costs $5K.  I understand that the racing bicycle may be considered a luxury and where a wheelchair is not; but there are a lot more bicycles sold yearly than the same custom wheelchairs. Bicycles do not have the same requirements and liabilities as do wheelchairs.

As a Complex Rehab,  DME supplier and Board Member of NRRTS, I see the other side of the equation.  Generally Medical Equipment is funded through Insurance and all insurance companies follow Medicare guidelines. Unlike the Sport Aid type companies, we are forced to comply with all Federal, State, Local, Accreditation, and Insurance guidelines.  Unlike Sport Aid, we have to follow the clinical model and have to provide a report that builds a case for medical necessity, we have to chase all the paperwork, submit the request to funding, help with any appeals, order, assemble, deliver, fit and then submit the claim for billing; which can take up to one year to be reimbursed. 

Retail companies, advertise their products, take a deposit or the entire amount up front, and ship the equipment to the customer.  There is little cost and risk in this process. Catalog and On-line companies can be anywhere, allowing them to reduce costs, they do not have to have the insurance coverage, they do not need to be accredited, inspected, or follow the same standards as Insurance providers.

There are costs associated with playing the game. In retail, it is all about price and value. When providing equipment through insurance, you have to have a location that is certified, inspected, accredited, bonded and insured. The costs above the rent, staff, trucks, equipment, parts; etc. is the Professional and Liability Insurance ($10-$20K / year), Accreditation ($3-$5,000/year), Medicare and Medicaid Licensing ($1K/year), Bonding ($1K/year). There are regular audits by the insurance carriers, which cost much time, and expense in fulfilling the requirements and ensuring payment for services.

DME companies offer and provide knowledge, education, and their experience to improve the quality and successful outcomes. I am the first to agree that there are not enough safe guards in the DME world, which is why NRRTS is aggressively promoting trying to carve out Complex Rehab Equipment from DME.

There are studies that have been conducted, showing that in Complex Rehab that the net profit for most DME's are under 7% which is very low in comparing to other industries. This offers very little room for growth, pay increases to staff, or any additional benefits to workers. 

Competitive Bidding was introduced, reducing payments for many DME products. After the first year 33% of the winning providers went out of business as they could not afford to stay in business.
It is important to remember, that DME companies purchase the equipment they are providing, and help with all the insurance paperwork and do not receive any compensation until the equipment is delivered.  All of the labor costs from the intake, evaluation, quoting, requesting medical documentation, submission for approval, ordering, assembly, and ensuring there is a service staff to help with concerns is all funded through the sale of the product.  It is a semi-flawed system, however if insurance companies paid a lower rates, and considered labor hours for the entire process; the price of the equipment would be higher than it is now.

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

Active Mobility Center says to Emb(race) Everyone

Emb(race) is an event put on by Stand Among Friends at FAU to support diversity.  Active Mobility Center was pleased to support the 4th annual race on February 23rd of 2014. Hundreds of people came out to support this all-inclusive family fun event that features a 5k & 10k walk/run and one mile family walk; all to enhance the lives of people with disabilities.

Their programs help them transition to greater independence; learn work, technology and social skills while emphasizing their talents, interests and education. We help them realize and achieve their career aspirations and widen their social opportunities--so they can experience a meaningful life, both personally and professionally.

Through a comprehensive employment program, state-of-the-art assistive technology program and lab, vocational evaluations and community outreach efforts, Stand Among Friends helps people regain their independence and dignity. Over 1,200 individuals have participated in our programs and we have placed over 500 individuals in active employment.

The Disabilities Center is located on the campus of the Florida Atlantic University in the Christine E. Lynn College of Nursing in Boca Raton, Florida. The Center, which is designated as a Center of Excellence in the State of Florida University system, coordinates research efforts to develop new approaches, products and services for people with all disabilities.

Thanks to all that came out ad supported this event. Carey Britton, seating and mobility specialist, can be reached at cbritton@wheelchairguys.com or 954-946-5793.

Active Mobility Supports PBC Schools at the S.T.A.R.S. Conference

 

Active Mobility Center was honored to support the Palm Beach County Schools 9th Annual S.T.A.R.S. (Start Transition And Realize Success) conference at John I Leonard High School in Lake Worth, Florida.  This year was amazing, with a student panel who discussed their struggles, successes and made suggestion on how to make it better for the next generation. 

 

The group was very wise at 20-23 years old; Burn Your Path, Follow your Dreams, and Have Fun. 

 

One of the speakers said it is important to have Patience, Advocate for yourself, Belief that anything is possible, Setting Goals, Building a network of support.

 

We were priveleged to meet some very inspiring young people, and were able to network with many professionals to increase the value we can offer to our customers.

 

Carey Britton, Seating and Mobility Specialist can be reached at 954-946-5793 or at cbritton@wheelchairguys.com . 

Active Mobility Center at the Muscle Walk in Palm Beach

The Muscle Walk !

Last week, Active Mobility Center participated in the MDA Muscle Walk at Roger Dean Stadium in Jupiter Florida.  The Muscle Walk supports the efforts of the MDA helping to research treatments and an eventual cure for this terrible condition.

This year Active Mobility Center will be more visible in the community, listening and learning on how we can be a more valuable resource to South Florida. Please help us by making any suggestions on how we can be more valuable.

This article was written by Carey Britton with Active Mobility Center in Pompano Beach. Any questions or commetns can be directed to Carey at cbritton@wheelchairguys.com or (954) 946-5793.

Be Friendly to Others this Februrary

Happy Valentines Day to you all.  I met with Dr. Teri Cooper over the weekend, who in addition to sharing information about an amazing new company with products that are making anti-oxidants inferior; she discussed how people have lost the ability to communicate.

Blame it on technology, or the fear of being hurt; people today are not has friendly. You can see this when you head down the sidewalk, and wave or say hello; most people give you a weird look. 

I would suggest in the observance of Valentines Day, that you make the effort to reach out, and be nice to anyone you encounter during the month of February.   Remember how good you feel when someone goes out of the way to show kindness.

Powered Wheelchairs and Medicare Guidelines

Medicare Guidelines for Powered Wheelchairs

Let's start by stating that Medicare (CMS) is operated by the Federal Government, they set codes and fee schedules to all Medical Equipment and Services.  They determine what is appropriate and necessary based on reported information about the patient.  With any government agency there are requirements to meet their determination of medical necessity.  All other insurance providers follow the governmental plan, so everyone should be concerned when Medicare makes a change.

Mobility Related Activities Of Daily Living

This is a fancy way of saying what you do in a day. MRADLs as they are commonly called, need to be reported to any insurance as this is how someone at Medicare can create a mental picture of the beneficiary needing the equipment.  Although Medicare is diagnosis driven, there is a lot of variance within a diagnosis. One person with MS (Multiple Sclerosis) maybe ambulatory, and the other in a multiple function powered wheelchair. Mobility Related Activities of living is a list of items that you can and cannot provide without the equipment being recommended.

For an individual who cannot ambulate, getting around the home is a challenge. Additionally they may or may not be able self feed, toilet, transfer, get out of the home, or some other activity of living.  These items help justify or deny the new equipment needed.

Medicare Hierarchy of Equipment (Complexity)

You may have heard Least Costly Alternative to solve medical needs. This is true with Medicare andstandard wheelchair, then light weight wheelchair, then ultra light weight wheelchair, then scooter and finally a powered wheelchair.   The powered wheelchair is on top of the mountain and as such requires the most documentation to support the need.
all insurance providers. They have created a chart, from basic to complex equipment that is easy to follow.  If you cannot ambulate, you may use cane, if a cane does not provide enough support, maybe a walker or crutches will help. I this does not allow you to perform your activities of daily living, then a

A Good Medical Equipment Supplier

This has never been as true as it is today.  In the past your supplier was just that a company who provided and serviced the equipment. With all the new rules/requirements,  your equipment company will navigate the system and reduce the amount of time involved.

Documentation Requirements

This is where you need a good team to help you. Documenting and Submitting a request to Medicare is a challenging process, and over the past few years has gotten much more difficult. You will need to find a supplier that will help guide you through this process.

Medicare now requires a Face to Face (F2F) visit for all powered mobility equipment. This requirement will soon affect most other medical equipment as well.  The Face to Face is a visit with
your physician where you are present, and where the reason for the visit is to discuss Seating and Mobility Equipment.  The physician must document what he does in a normal visit; vital signs, list of conditions, list of needs, etc.  The physician must document your ambulatory status, your need for assistive technology ranging from the cane, walker, wheelchair, scooter or powered wheelchair.  He must document how you presented to him in the office.  If you physician has a challenge with the level of documentation required, they may refer you to a physiatrist (physical medicine doctor), or a physical or occupational therapist who can further describe your conditions.

In today's medical model, most physicians are not familiar with seating and mobility equipment, so after they provide the Face to Face document, and 7 Element Prescription, they generally refer a patient to a physical or occupational therapist. 

During this therapy evaluation, the equipment supplier should be sending their RTS (Rehab Technology Supplier) to be present to be part of the team who assesses and recommends the most appropriate equipment to fulfill your mobility needs within the Insurance Guidelines.

The therapist is responsible, through their letter of medical necessity (LMN) to paint the picture of the mobility and functional status of the patient. They will document the patent's range of motion, their posture, and ability to reach and perform daily activities of living.  This document will be very detailed and is what the insurance reviewer will be looking for to approve or deny the equipment requested.

From this point, the RTS will print out all the manufacturer order forms, and create a detailed product description. This lists all the equipment the patient requires, based on the assessment, and lists the insurance code that references the item. This report will be sent to the therapist who will ensure that the LMN discusses each item listed, and will send their LMN back to the supplier.  The supplier will send the LMN, along with their reports back to the physician for review and signature.

Once all documents are received, they are sent to Medicare for prior authorization.  When Medicare responds, it is either with an approval, denial or request for more information.  If approved the equipment is ordered, of denied, an appeal can be submitted. If more information is requested, the supplier with the beneficiary's help can gather more information from the physician and/or therapist.

Time Line

This can be a lengthy process as there are many professionals involved. Beneficiaries need to have patience through this process.   Prior to the F2F requirement equipment was evaluated, and approved within 30 days.  Unfortunately this is no longer the case.  Physicians are busy, and getting an appointment can take weeks, waiting for the documentation from the physician can take time, if they send you to a specialist; between scheduling and reporting this can take weeks.  Waiting for an authorization has taken up to 30 days. Additionally several weeks;  ordering, assembling and scheduling for delivery.

Provider Certifications

Medicare requires a minimum certification to assist with Powered Mobility Equipment evaluations.  This requirement is expected to be increased; and at the time of this article it is a ATP; Assistive Technology Provider. This staff member must be present and involved through the evaluation of the equipment.  You should know that there are providers who have higher qualified and trained individuals above the ATP.  These individuals are the SMS and CRTS  SMS stands for Seating and Mobility Specialist, where they have went beyond the ATP and trained to the highest standard.  The CRTS, Certified Rehab Technology Supplier, is harder to receive, and shows the commitment, dedication and experience.

Five Year Rule

Like most insurance providers and DME (Durable Medical Equipment), the life expectancy of the usefulness of the equipment is five years.  This means that Medicare will not fund a replacement for this term.  There are exceptions to every rule, however short of a theft, or natural disaster; a beneficiary will wait five years to receive new equipment. In the event the equipment you have no longer solves your mobility equipment, you may be eligible for equipment that his more complex.

Service and Follow Up

With any mobility equipment, your supplier needs to be your friend. They will be needed for maintenance, service/repair, and for modifications to your equipment over the five years. Prior to several changes, it was easier to switch providers after receiving the equipment. Since the equipment supplier has the documentation sent to Medicare for support that the beneficiary needs the equipment, a new supplier may require to you go back through the process as Medicare audits all providers. If the service provider cannot prove the equipment the beneficiary is using is medically necessary (has all the documentation from the doctor/therapist/etc), then Medicare could recoup the funds. 

All Insurances are following these guidelines, and for this reason beneficiaries must be more involved and aware of this process. There has been a lot of change, and continues to be changes at Medicare that affect your ability to receive quality equipment.

This article was written by Carey J. Britton, ATP/SMS, CRTS with Active Mobility Center. He can be reached at cbritton@wheelchairguys.com or (800) 326-4463.

Running Out of the Gate

2014 is here, and things are not slowing down.  Active is looking at the industry as the glass is half full, and where there is great opportunity.  We are seeing many national companies buying up local companies and intimidating the local providers like Walmart.  Insurance is changing, and we are now learning the affects of Obama Care.  There is constant pressure to change, and the staff at Active are embracing this not to ensure survival but to become better.

Over the next few months, our customers and partners will see some major changes. Our office is having some renovations to increase it's display space, increase the retail and accessories available to our customers.  We are improving our inventory management system. A face lift on our website will be completed by February to offer a more friendly site to navigate and access the information.  An event calendar will be added and will show local and regional activies, and events to allow the community more involvement.  You will see a higher level of community visability and involvement. More interaction between our customers and business partners to help us become more valuable to the community and remove any inefficiences. Last but not Least, we will be adding more FUN.  We understand that the Medical Equipment business can be sterile and we want to improve the experience not only for our customers but also for our staff.

We realize change is occuring with or without us, and understand that we need to be ahead of the curve to ensure that we are here for our customers, partners and health care professionals.  We also know that what we do is very personal and that our customer wants a company who listens, who cares, who is local, and who will be there to support and educate them.

Thank you for your continued support. We understand that there is a choice for Medical Equipment and know we have to continue to earn your business and referrals.  Please continue to send in comments or suggestions on how we can continue to improve to be your number 1 choice.

This article was written by Carey J. Britton, ATP/SMS, CRTS from Active Mobility Center. Active Mobility Center, located in Pompano Beach, Florida provides and supports; seating, mobility and specialty rehab equipment.  Carey can be reached at (954) 946-5793 or at cbritton@wheelchairguys.com .

Looking Forward to a Great 2014.

2013 has been an exciting year filled with change. Active has expanded into more clinics, we have make improvements in our technology, in our systems and in our improved office and service center.  We have partnered with organizations to improve our community involvement and are continuing to listen to our customers and referal sources on how we can get better and become more valuable.

We see great opportunities within the community where we can become more of a resource, where we can add value, and where we can continue to grow.

We look forward to continuing to hear from the community on what you want, on how we can get better and how we can earn your business and support.  Our team will be continuing to get better, and creating the best experience posisible.

With Sincere Gratitude,

The Staff at Active Mobility Center

Tis the Season for Gratitude

A morning ritual for me is to take a few minutes and write something that I am thankful for.  At each staff meeting, I go around the table and ask not for what problems we face, but what Positives we want to share with each other.

If you are involved in the Health Care field than you already know that generally we have thankless jobs. Nobody gets up and says I want to go and see a physician, therapist or wheelchair specialist. We glory in our outcomes and success stories whether told or seen through our own eyes. 

This brings me to my point....Life is not perfect or fair, and if we dwell on the negative, and there certainly is a lot of that in the world, then our projection/signal to the world will be reflected in the same light and we will miss the most valuable thing in life.....TIME.

I would encourage you, during this time of year, to reflect on the good in you and your family/friends lives.  Stop judging yourself on what you have not achieved and Celebrate and Appreciate what you have.

Happy Holidays from the Staff at Active Mobility Center.  Carey can be reached at (954) 946-5793 or at cbritton@wheelchairguys.com .

The TEAMS behind your Medical Equipment

Any time you want something done right, you need a team behind you.  Whether it is a medical procedure, a legal matter, or acquiring new equipment- you need a team to ensure that the job is done right.

Seating and Mobility Equipment can be intimidating, and the process painful and confusing.  A team with the knowledge and experience in this area is essential.  There are two teams, the one that helps you select and provide you with your equipment and the one that keeps it working for the equipment's useful life.

The initial team would consist of  you, your physician, a physical, occupational and possibly a speech therapist, your family, caregivers and the equipment supplier. Each of these individuals are crucial in providing information to ensure that the equipment fulfils your needs, and your goals.  You are responsible for helping the team what your goals/desires are for your future, what you need your equipment to do to keep up with your life demands.  Your physician will need to provide a history, and any goals/concerns that they have. The Physical and Occupational Therapist(s) bring information on body posture, functional capability, and expected prognosis.  These clinicians perform a functional assessment and are very involved with the equipment prescription. Your family and caregivers need to voice their concerns about function, equipment and accessibility issues. The supplier brings equipment knowledge and works directly with all involved to help recommend the most appropriate equipment based on all the information that is gathered.

This team works really hard to trial and document the equipment, which is sent to the insurance for consideration.  This team works with the insurance provider to provide any additional documentation that is needed to receive an approval. On delivery, the Equipment supplier works with the user, the clinicians, and the caregivers to adjust and optimally fit the equipment.

Once the equipment is used on a daily basis, the technical service department because the support team to help maintain, adjust and repair the equipment; until such time the equipment is worn out and needs to be replaced. 

In the event that the equipment no longer fits, or there is a change of condition, the user is referred back to the physician and clinical team to review the equipment and make any recommendations on changes needed.

This article was written by Carey J. Britton, ATP/SMS, CRTS at Active Mobility Center. Active Mobility Center is a Seating and Mobility Specialty company located in Pompano Beach, Florida. Carey can be reached at (954) 946-5793 or at cbritton@wheelchairguys.com .

Understanding A Small Moment in the Life of a Wheelchair User

I was watching behind the scenes of Jamie Fox playing Ray Charles, and he didn't become the character until the director had his eyes sealed with a prosthetic.  Until he was able to experience life without vision, he didn't understand what it was truly like.

Similarly, the public has not realization on what a wheelchair user goes through both physically and emotionally. I will not pretend to understand or know everything; but do have each staff member working with us spend quite a lot of time sitting in and using the equipment we provide and try to perform daily tasks.  This is an eye opening process, and even though they can get out of the equipment; they learn a valuable lesson.

A few years ago the PVAF held a bowling event where everyone had to bowl from a wheelchair or scooter device.  It was a great opportunity not only to raise money; but awareness. 

Any time we as a group can glimpse at the lives of others it builds a understanding and brings down barriers.

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

What's More Important Wheelchair Brand or Wheelchair Configuration?

The Wheelchair Frame or the Wheelchair Configuration?

It is important to understand that when you are using a wheelchair, scooter or powered wheelchair; the seating and frame configuration is more critical than the brand of chair that you own/buy.  As an expert in the industry, I find most consumers coming to me with questions on which brand; Quickie, Invacare, Colours, Permobil or Tilite wheelchairs and which is the best.  If you had asked me a few years ago, I may have had a preference, however today through innovative new technology there are only subtle differences.

The wheelchair frame is important, however the configuration of the frame and the seating is much more critical to the function and well being of the user.  As I am sure you will agree, many wheelchair users posture is less than perfect in their wheelchair; even if the chair brand is a good one.  You can have the best of equipment but if it isn't configured properly it is only contributing to the problems you are facing.

How Can I Improve My Posture & Function? 

/As a professional, when I am asked this question, I suggest they see their physician or their physical/occupational therapist.
Their medical professionals may have insight on why they sit the way that they do. It is good practice for any wheelchair user to use a team of people to help solve these issues. 

Assuming their physician clears the user with no physical limitations, we can work to improve posture and positioning.  This may require only an adjustment; or it could require new seating and positioning equipment or an entirely new device.

The goal is aways to start at the pelvis. The human pelvis is where everything is attached, and requires the greatest attention in sitting. The goal is to place the pelvis in as close to neutral position as possible. Of course for some individuals having the pelvis anteriorally tilted or posteriorally tilted will be necessary. A stable pelvis is the route of function, which equates to mobility and quality of life. The seating supports are also very critical in the positioning and stabilization of the pelvis.

The position of the lower extremities (legs/feet) are important to consider, as they are tied to the pelvis and require support and positioning.  The angles at the feet/ankles,  the angles at the knee and the angle of the hips are very important for positioning as well as for function and mobility.

What DO I  Need to Know ?

If you are are a wheelchair user, you need to understand that how you are positioned in your wheelchair frame, the orientation, and the seating supports will improve your posture, improve your stability, improve your function and improve your health.  Failure to consider this early, when he body is flexible can result in contracture and deformity that can increase life complications. 

Who Can Help Me?

There is a seating and mobility specialist in nearly every community. This may be a physician, therapist or RESNA or NRRTS. These organizations maintain a list of practicing experts who can assist you with all your equipment needs. You should find and align yourself with a team who can monitor and make recommendations as your body changes or when you are confronted with an obstacle.

This article was written by Carey J. Britton, ATP/SMS, CRTS to offer general but important information on wheelchair configuration and seating.  Carey is the resident Seating and Mobility Specialist for Active Mobility Center. He can be reached at cbritton@wheelchairguys.com or (800) 326-4463.

Is a Wheelchair is a Medical Failure ?

I was appalled when I first heard that a Wheelchair is a Medical Failure. Apparently in the Medical Model, it is taught that when resorting to long term use of wheelchairs and other mobility devices, that you have given up.

It is not surprising then, that the community perspective is that a person in a wheelchair is lame, an invalid, or handicapped....all negatively describing a person's DISABILITIES. This is also why that Prosthetics are much more acceptable, even when they are not as functional.

It may come at a surprise, but mobility equipment is provided not for mobility or independence but to reduce the medical costs associated with an individual stuck in bed. It is clear that a bed bound individual will cost the Health care system more than what it costs to get them out of bed.  Cushioning and Positioning is not for the comfort of a wheelchair user, but to reduce injury, reduce skin breakdown and to reduce contracture and deformity.  We look at this equipment to increase function, independence and quality of life, but the funding sources (all based on Medicare's policy) does not.

Therapy services for individuals with long term mobility challenging conditions are limited. It seems that the Medical Model if there is not documented gain in function then therapy services are not needed. After spending over 20 years in this industry, the question should be without therapy services how much loss will occur. 

Medicare who creates Medical and Equipment Standards, approves equipment based on use within the home and has little flexibility about looking at equipment for recreation and vocation. 

In my 20+ year career, I have seen huge change.  I am concerned with the changing policies that more equipment users need to voice their challenges and their victories.  Not unlike the Women's Rights Movement, where women didn't have a voice, and where they were stuck in the home; equipment users deserve the same. 

If this article has moved you, I encourage you to look at www.usersfirst.org, or www.ncart.us and get involved, share your story, and be heard.  You can reach Carey Britton, Seating and Mobility Specialist at Active Mobility Center at 954-946-5793 or cbritton@wheelchairguys.com .

Event Management at Active Mobility Center

Sitting here looking at the date of December 1st, 2013, I am scratching my head wondering where this year has went.  Reflecting over the last 11 months, one of the best changes we have made is managing tasks and events...and not time.

We all have the same 24 hours in a day, and some people are able to accomplish much more within these hours...why?  At Active Mobility Center we use task management instead of time management. We cannot slow down time, but we can manage our tasks better to improve our efficiency and accomplish more.

Making a Plan

Any time we want to change something, we cannot leave it to our memory, but must write it down.  We must make it a commitment and arrange our day to ensure we carve out a space to work on this.  Without a plan any goals or dreams you have cannot ever be accomplished. 

It is effective to write down what your desired destination is in five years. If your destination is too large, it make feel unattainable.  Taking that 5 year goal, and breaking it into five year pieces, you can break it down to where you need to be each year to get there, and then breaking that down to quarters of the year will make it seem attainable.

Writing It Down

Whether it is a to-do list, a 5 year plan, or 90 day goals; it needs to be written down so you can review it on a regular basis to see where you are and what you need to do next. Many people find it helpful to have a  on-going list of tasks to complete, and taking that list and picking 2-3 items each day to complete. This way each day there is a feeling of winning, instead of looking at your final destination and giving up.

Not Just about Business

These ideas can be used by anyone to improve their efficiency, and to accomplish more of what we set out to do.  Once you put this in motion, it develops into a habit and your life is changed forever.
 

The thoughts and ideas listed are that of Carey Britton, with Active Mobility Center. Carey can be reached at (954) 946-5793 or cbritton@wheelchairguys.com .