Welcome to the Disability and Rehabilitation Research Projects (DRRP) Program: Research on Healthcare Policy and Disability
‘Assessment and Investigation of New Coverage Policies for Complex Rehabilitation Technology (CRT) within a Contemporary Accountable Care Environment’
Our Mission is to partner with academia and key disability, industry, and policy stakeholders in a series of interrelated project activities to investigate how current wheelchair (i.e. CRT) health policy impacts health and function, community living and participation of working age people with disabilities.
This project is guided by NIDILRR’s mission to “Generate new knowledge and promote its effective use to improve the abilities of people with disabilities to perform activities of their choice in the community, and also to expand society’s capacity to provide full opportunities and accommodations for its citizens with disabilities.”
Common reasons for non-participation during the outcome measurement process: wheeled mobility service delivery quality improvement reporting
The purpose of this paper is to describe non-participation during the outcome measurement step of the wheeled mobility service delivery process (WMSDP) based on the Functional Mobility Assessment (FMA)-Uniform Dataset (UDS) Registry. The WMSDP is a standard framework for the provision of wheeled mobility devices, and several factors influence the client’s experience throughout the process. A retrospective descriptive study was conducted on the FMA-UDS Registry to measure the response rate during the outcome measurement step of the WMSDP and describe the reasons an individual did not complete the FMA-UDS. The FMA-UDS was examined at two time points: pre-delivery and post-delivery of the wheeled mobility device. As of September 2, 2021, 10,253 cases have been entered into the FMA-UDS Registry. 2,247 cases were no longer participating pre-delivery, and an additional 3,905 cases were no longer participating post-delivery. The most common reasons for non-participation in the FMA-UDS pre-delivery and post-delivery included: equipment not delivered; provider no longer participating in the FMA-UDS; funding issues; no new equipment; client opted out; loss in contact; deceased; returned equipment; and other.
Right-to-Repair: What it Means for You
Right-to-repair legislation is being considered in states across the country, aimed at allowing people to repair everything from electronics to tractors themselves without fear of voiding the warranty. Legislation recently passed in Colorado has extended the right-to-repair to include mobility equipment such as wheelchairs.
“Recently, we spoke to Dr. Mark Schmeler, occupational therapist and associate professor at the University of Pittsburgh, about the complicated and multilayered issue. Here are a few of his thoughts about the repair and service side of the complex rehab technology (CRT) industry and how insurance providers, suppliers, clinicians and customers can work together.
The Health Inequity of CRT Service and Repair and the Need for Reform
Mike Swinford, Numotion CEO has published a whitepaper expanding on the changes needed to the ecosystem for service and repair.
It is time for the Complex Rehab Technology (CRT) ecosystem for service and repair to fundamentally change. The current model is inadequate and is contributing to a health equity issues for people with disabilities.
Four primary root causes:
- Unnecessarily heavy administrative burden
- Reimbursement models for service and repair are insufficient
- No preventative maintenance reimbursement or backup equipment funding
- Disconnect between what new equipment payors reimburse for and how customers use it
Five specific recommendations to address:
- Eliminate need for a prescription and prior authorization for all repairs under $2000
- Reimburse for travel to perform service at customer’s home
- Pay for preventative maintenance for “wear and tear” part replacement or backup parts
- Manufacturers and Payors require CRT equipment providers to service products they provide
- Align consumers and providers on guidelines for simple self-repairs
U.S. Rehab and VGM Government Relations Attend Congressional Briefing in Washington D.C.
Published in Government Relations and Regulatory Assistance on September 19, 2022
Wednesday, Sept. 14, was a momentous day of advocating for CRT and other key legislative issues. Greg Packer, president, U.S. Rehab, and Tom Powers, consultant, VGM Government Relations, spent time in Washington D.C. attending the NCART/NRRTS Virtual Congressional Fly-In and a congressional briefing on power seating and standing systems for power wheelchairs.
The congressional briefing was held Wednesday afternoon in Washington D.C. and was attended by U.S. Rehab, NCART, and many other industry advocates. There were over 50 people at the briefing, and over 20 congressional offices had some form of representation present.
The briefing was held to continue the discussion about why it is incorrect for Medicare to list power seat elevation and standing systems for power wheelchairs as “not medically necessary” for people with disabilities.
Dr. Mark Schmeler (pictured left, sitting down in a blue suit) offered his research perspectives on power seat elevation. The briefing was finished with congressional perspectives from Sen. Tammy Duckworth (D-IL) and Rep. Dan Meuser (R-PA).
Functional mobility, employment and safety benefits of seat elevating devices
The purpose of this retrospective study was to evaluate the relationship between use of Seat Elevating Devices (SEDs) on power wheelchair user satisfaction in performing common activities of daily living as measured by the Functional Mobility Assessment (FMA) and associated Uniform Data Set within an existing wheelchair outcomes registry. The sample consisted of 1,733 power wheelchair users and compared cases who had a seat elevator (n=265) versus those who did not have one (n=1468). Results showed those with SEDs had statistically significant higher total FMA scores, higher reach and transfer scores, had higher rates of reported employment, and fewer reported falls than those without SEDs. These findings were likely due to SEDs promoting safer transfers by allowing a person to align surfaces so that they are level thus reducing falls during transfers. Additionally, SEDs allow people to more effectively reach and carry-out tasks at different surface heights. SEDs further facilitates face to face communication and visibility. This study is the first to use large datasets to provide stronger research evidence to the benefits of SEDs to improve overall functional mobility, transfer, reach, facilitate employment, and reduce falls.
A cross-sectional descriptive analysis of complex rehabilitation technology (CRT) supplier opinions on the current state of wheelchair repair services
It is documented that wheelchair failures occur frequently, repair times are lengthy, and users often experience adverse consequences. This study aims to gather evidence on efficiency of current wheelchair repair processes from the perspective of Complex Rehabilitation Technology (CRT) suppliers who provide wheelchair repairs within the United States. A 20 statement survey was developed based on interviews of 10 experienced providers and experts in the field of CRT to identify barriers and facilitators related to wheelchair repairs across the domains of administrative and operational factors as well as to identify their opinions on future opportunities and strategies for improvement. A total of 127 responses were received from CRT suppliers of which highlights the direct importance and barriers faced within the wheelchair repair industry by CRT suppliers. There is agreement among survey respondents of opportunities to investigate further telehealth and remote strategies, preventative maintenance coverage, and online tracking for wheelchair repairs.