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.

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 .  

Assessible Travel Part 2 : Cruising

Crusing the World

Crusing has become a very popular way to travel the world; and the vacation of choice for people with mobility challenges.  Where else can you book a vacation, and do not need for a vehicle, access to enterainment, meals, and more....

Cruise ships docking at U.S. ports are required to have accessible facilities for disabled travelers, under the Americans with Disabilities Act (ADA)._¹ This includes on board services suitable for special needs travelers who must use motorized wheelchairs and/or mobility scooters in order to get around while vacationing.

 Accommodations for travelers with special needs will vary by cruise line and among individual ships. You should discuss these itesm when booking your cruise.

• Assistance from airport to pier; during embarkation & debarkation
• ADA-compliant cabins, doorways, corridors and ramps
• Grab bars, raised toilets, wheelchair-friendly bathrooms
• Areas to charge power wheelchair batteries and store mobility equipment

 Air Travel to your Destintation

It may be necessary to travel by air to the location of the cruiseline.  This can be stressful and confusing, Active Mobility Center has provided you with information in a previous article that can help.

Accessible Vacation Information

Cruise ship passengers who need to use a wheelchair, power chair, or power scooter should research accessible vacation options before setting sail. Here are a couple of places to start.

1. Cruise Line Websites Information on cruises with accessible itineraries and other disability travel services is easily found online. Begin by searching for 'disability cruises' or 'cruising with a wheelchair,' and go from there.

2. Accessible Travel Agents This type of agent specializes in disabled travel booking.

As demand grows for wheelchair accessible vacation packages, more cruise lines are expected to provide a wider range of travel services specially designed for the disabled traveler.
When you need personal mobility assistance, look to Active Mobility Center first for the highest quality in wheelchairs, scooters and power wheelchairs, compact scooters and wheelchair accessories. Simply contact us at 1-800-326-4463 to learn more.

Buying Locally is it Important?

As a consumer, we all wrestle with the decision on whether to make a purchase locally or from a catalog or from a website. Many times you can get a lower price from a catalog or website, but sometimes at a huge cost.

If you are in the market for a book, Amazon is the leader; not only because of the price, but because of the selection. It only takes a few times of going to a local book store and not finding what you are looking for and are told they can special order it for a premium; that you become an Amazon Fan.

There is a trend of people shopping on line for medical equipment. The reason many times, is that a local brick and motar company is more expensive than the catalog or on line company. As a consumer I understand that every dollar needs to go farther these days; but also understand that when buying equipment that needs service and support I need someone in my corner when there is an issue.

I receive regular phone calls from customers asking me to repair their equipment, to modify equipment that they bought on-line or to take their on-line equipment as a trade when they find out it doesn't work for them. 

Although the mission of Active Mobility Center is to help the community, we have had to make tough decisions on how to best service our customers. This is a trend in the Medical Equipment industry; as when a customer calls and asks us to put tires on their wheelchair that they purchased on line to save a few dollars, or wants us to consult them on how to fix, or modify a chair they purchased online cheaper that doesn't fit.  Most companies have adopted the policy that they didn't provide the equipment than they do not service it.

Not to sound uncaring, but the costs to operate a medical equipment company are tremendous. Like other brick and motor companies, there are the standard operating costs. Unlike many of these other companies, medical equipment companies have additional insurance, accreditation fees, yearly fees to work with Medicare, required continued education of staff, contstant retraining of staff to the changes in the industry and with insurance, and much more. 

To spend time with those customers who do not patronize the local provider takes valuable time and resources from the firm's loyal customers; and the key to keeping customers is ensuring their needs are met.

Your local medical equimpent company provides the valuable services of their knowledge, their experience, and their network.  This experience and available follow up service/support is what you pay extra for; and to ensure your local support will be there when you need it. Because they are local, they have to be the expert to keep people coming back, they need to have a network so when you have a question or problem, they can recommend a person or place to solve your issue.

Please contact Carey Britton at cbritton@wheelchairguys.com with any questions or comments, he can be reached at 954-946-5793.

Happy 4th ! from Active Mobility Center

Every year at this time, I reflect on how Active Mobility Center and our Country's Independence Day have much in common.  For many people with walking impairments, it is a time to celebrate; as not to long in our history, people with mobility impairments were left inside their homes and were not felt as EQUAL.  Their impairment left them "Disabled" or "Invalids" and were looked down upon. 

With the passing of the ADA, Americans with Disabilities Act,  in 1990;  the world has literally opened up doors, improved access, and increased independence for all. 

Active Mobility Center, in 1992, opened its doors to ALL people with Mobility Impairments, with the goal to maximize their abilities, and to Make Every Day Independence Day ! It may sound like a corny expression, but each and every day, our experienced staff listen to our customers, gain knowledge and understanding of what their obstacles are and offer solutions with equipment, or with recommendations to other professionals within our community. 

Through Equipment; wheelchairs, scooters, powered wheelchairs, gait trainers, walkers, bicycles, and handcycles; we are allowing people to stand and be equal.  We believe it is our duty, to ensure that all have access to mobility allowing everyone to be MOBILE, INDEPENDENT and FREE.


From all of us at Active Mobility Center, Happy 4th, !
Carey

Carey Britton is the resident Seating and Mobility Specialist wth Active Mobility Center, he can be reached at cbritton@wheelchairguys.com, or at (800) 326-4463.

Wheelchairs, Medicare and the Five Year Rule

As is a theme in Durable Medical Equipment (DME), there are established guidlines for how long equipment needs to last and how often in can be replaced. In this article we will be discussing Seating and Mobility Equipment guidelines; it is important to know that all equipment has a usable and functional life and is listed in the fee schedule. 

Ultra Light Wheelchair

CMS/Medicare generally set's the standard for all other insurance companies follow their guidelines, it is after all easier to copy than create your own standards; and if it is good enough for the government than it is safe for other insurance companies to follow.

Seating and Mobility Equipment has a five (5) year usable life expectancy.  Until a few years ago, it was an expected entitlment that after five years you get a new wheelchair, scooter, powered wheelchair or seating system.  Although it is the eligaiblity requirement, due to over utilization, there are new guidelines that require an equipment provider detail why the equipment is no longer working, too costly to repair, is discontinued, is outgrown, or no longer provides for some other need; even after the five year term.


Scooters

It is also important to know that Medicare allows for condition progression and will consider new equipment if a patient has changed and where the current equipment no longer provides function and independence.  An example may be a patient receives a wheelchair, and loses the ability to self propel. With adequate documentation, this patient may then qualify for a scooter or powered wheelchair depending on their needs; prior to using the equipment for five years.


It is also a requirement for much more documentation to support the need coming from a physician 

Power Wheelchairs

and/or clinician. 

If you have questions on the Five Year Rule, or if you are having problems with your currently equipment, contact Carey Britton, your guide to Seating and Mobility. Carey is the resident Seating and Mobility Specialist at Active Mobility Center. He may be reached at cbritton@wheelchairguys.com or (800) 326-4463.