Is it Important to be Certified?

It can be an unconscious decision to entrust someone who is an authority in the field we need assistance from. Whether it is building a house, having a major renovation, having your automobile repaired, having a medical procedure; there is value and peace of mind knowing that your choice is certified and reputable.

You may find it surprising that when it comes to Seating and Mobility equipment; many insurances including local Medicaid's do not require any certification or licensing that the person recommending, and providing the equipment has no certification.  At the time I am writing this, only Medicare and a few Private Insurance carriers require at a minimum an A.T.P. certification.  The ATP (Assistive Technology Provider) is a RESNA certification that requires an individual have some basic experience in DME (Durable Medical Equipment), and who sits for a test.  This certification was established to set a minimum standard to ensure that the person who was involved with the equipment has some experience, and who is requires continuing education. 

As you can imagine, some individuals take this test to gain the minimum standards required by Medicare and never increase their skills as it is not a requirement. Is that enough? There are several people who have been in this industry for decades that have great experience; however when you are looking for an expert, how do you separate a veteran ATP versus one who passed the test last week?

If you are needing basic Seating and Mobility equipment then maybe a newbie can help, but if you are facing challenges; wouldn't you want someone who you can trust? 

The NRRTS organization felt that the ATP was a good starting point, but felt that Seating and Mobility is a specialty and felt there needed to be a higher standard.  NRRTS established the RRTS (Registered Rehab Technology Supplier) which you become after meeting their standards and are listed on a Registry.  After two years of being registered, with no complaints against you, you become a CRTS (Certified Rehab Technology Supplier).  The CRTS has been the gold standard when it comes to finding an expert Seating and Mobility Specialist. 

In the past few years, there is a new SMS certification. This Seating and Mobility Specialist Certification is tested on experience, and was created by RESNA.  This test requires years of experience as there is no manual, or book to read to pass the exam. 

I find it puzzling how if you want compression stockings, only a certified fitter can help you; however with a custom wheelchair with many insurances anyone can fit you for this equipment.  I am happy to see that it is changing, but in my eyes not soon enough. Many lobby that the reason more insurance carriers do not mandate these certifications are that they may not be enough ATPs around.

There was a time where every community had an amazing physician, or an amazing therapist who were the expert in Seating and Mobility; and where the equipment supplier only had to know about their product(s).  Today, with budget cuts, and increased productivity demands; the Physician and Therapist do not have the time or incentive to be the expert. They have higher demands and expectations on the Equipment Supplier for measurement, assessment and recommendation of equipment.

The Equipment Supplier is now suffering from the same budget cuts, and now have a reduced menu of services which depend on the funding source. These insurance pressures are forcing providers to provide what is minimally necessary to maintain a level of profit for the company to ensure their doors can stay open. 

At the end of the day you have to decide who will help you, who will recommend equipment equipment that will affect your life.  The equipment supplier has to make a profit for survival; however your equipment supplier must have your best interests in mind.   The certification(s) are a layer of protection for the consumer, not only for the knowledge and ongoing education.

Not unlike another Medical Professional there is a board that they are accountable for and where their licenses or certifications can be taken away and where it will affect their ability to work. 

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

The Shabbat Scooter

Offered in Small and Mid Sized

For many wheelchair users, getting around the home is difficult but getting to the Synagogue can be impossible during Shabbat.  Amigo offers a product that is certified by the Zomet Institute to offer a solution to people with mobility challenges to maintain their independence and faith.

Orthodox Jews don't drive vehicles or use anything motorized during the Shabbat, or Sabbath, which lasts from sundown Friday to nightfall Saturday. Amigo Mobility International has a specially designed scooter that allow Orthodox Jews to follow their beliefs and still make it to the synagogue.

Shabbat Controls

Amigo is  the Manufacturer of the only certified "Kosher Scooter," Amigo works in partnership with Zomet Institute in production of the Shabbat Amigo used on the Sabbath. A toggle switch changes operation from normal to Shabbat mode. With no throttle lever activation by the rider, the module’s timing circuit sets the chair in motion after 7-11 seconds, satisfying the “no work” Sabbath restriction. Each Shabbat Amigo is halachically-approved, individually inspected and certified by a Zomet representative.

This article was contributed by Carey Britton, Seating Specialist from Active Mobility Center. He may be contacted at (954) 946-5793 or cbritton@wheelchairguys.com .

Walker & Wheelchair Combo

For years we have consulted customers for four wheeled walkers and companion wheelchairs. For individuals who limited ambulation and nee the support from a walker and fatigues needing a seat, the four wheeled walker has been a great solution. For long distances, these walker users, have sat on the seat and had a caregiver push them which is not safe; but for many transporting a walker and wheelchair is not practical.

Now mobility challenged individuals have another choice, a 4 wheeled walker, with seat that converts to a companion wheelchairs.

 

 

 

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



Change can be Hard, not being able to help is even harder........

I met a women the other day, where I was asked by their therapist to see if we could make some suggestions to improve the way she sits. This patient suffered from Quadriplegia and was currently in a new powered wheelchair. The therapist was concerned that the company who recently provided this new powered wheelchair did a poor job due to the appearance of her posture.

This patient was sitting slid forward in a posterior pelvic tilt, with a significant rounded back posture (khyphosis). This is a typical position for anyone post SCI who was not initially provided structured seating.   She was being held in the chair by her seat belt.  She had to hook her arms around the back canes (push handles) to stabilize her posture.

On inspection, it was concluded her ROHO cushion was over inflated, and her back support provided only support to her scapula with a huge gap between her pelvis and lower back support. Patient complains about sitting pain, and the therapist is deeply concerned that her posture will only progress and that it is destructive and will lead to significant health complications.  She also stated the company who provided the chair had to provide more foam to the back support since it was provided.

I asked the woman, who has been using a powered wheelchair for over thirty years, what her concerns were. She said discomfort, and in-stability.

When discussing the cushion, she said she had inflated the cushion as when it was delivered the cushion was too unstable and she added air to make it more stable. We discussed that the cushion for its therapeutic value needed to be less inflated she said that was not a possibility. We discussed that a different cushion may have been more appropriate, but she had always used a ROHO, and nobody asked her those questions. her insurance only covers a one cushion every five years.  When we discussed the back support, I offered that a back that was more contoured, possibly even molded would improve her stability and posture. She said that if she had a back that was more confining it would affect her ability to move and she was not willing at this time to compromise.

After several minutes of listening and learning what her needs were, and more importantly what she was unwilling to compromise over; it was obvious that there was little we could do to improve the situation.  She is an adult and can make her own informed decisions. At this time her function outweighs any physical complications that will result in the future from sitting in a destructive manor.

I offered her some information, and suggested she watch her postural progression and remember that there are other options if and when she is open to trying them. As a Seating and Mobility Specialist, I was disappointed that I could not help; however understand that I am not in her body, and understand that it is ultimately her decision.

Carey Britton, is the seating and mobility specialist forActive Mobility Center. He can be reached at 954-946-5793 or at cbritton@wheelchairguys.com .  

Our Staff is Committed Getting Better !

Beginning this week, during our Wednesday staff meetings we will have a new topic discussed to help improve staff knowledge and performance.  This week, from Sarah P, was Power Operated Vehicles or commonly called scooters. These devices are very common, come in various shapes, sizes and in three and four wheel configurations.

It was discussed that since the changes in Medicare, providing indoor models, that we are seeing more wear and tear, more need for service and maintenance.  We discussed that when talking to customers, ensure they have reviewed the owner's manual and that the customer is performing preventative maintenance or having at a minimum a yearly check up on their equipment.

Sarah had listed several common questions coming from customers calling in.  One was from Scooter Store customers, do we provide service and is it covered under Medicare?  Since the Scooter Store was closed down, this is very common. We discussed our policy on needing medical documentation on all equipment that is provided and how to request it from the customer. 

List of Questions:

1. What is your scooter doing or not doing?

2. What happens when you turn you key on?

3. when was the last time you charged it?

4. Can you move the scooter when the key is turned off?

5. Could it have gotten wet?

6. Is the battery pack engaged/connected?

7. When was it last serviced?

We discussed many more senerios....The staff was asked to bring a list of common questions and solutions to next weeks' meeting.

Great Job Sarah !

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