Rep. Alissa Keny-Guyer (D-Portland) plans to introduce a bill this fall that aims to help families waiting for durable medical equipment -- while keeping used equipment in circulation.
She first heard about the problem from David Komeiji, a physical therapist who works with orthopedically impaired children. He told the legislator that a Medicaid only allows the purchase of durable medical equipment such as power wheelchairs, walkers and medical beds every three to five years – with average waits being on the longer side.
“Medicaid has this rule where, especially if you order high end equipment, say a high end power chair, they only will purchase new equipment, three to five years and usually five years,” said Joseph Low, a member of Health Share of Oregon's community advisory council .
Lowe said when he received his new power wheelchair, he fought the state for a year to get a chair that fit him properly, as the first one he was issued caused him back pain. Lowe and Komeiji both noted the three-to five-year restriction even applies to children, who usually grow a great deal in that period.
While manual wheelchairs can often be adjusted as a child grows, most power wheelchairs cannot, and growing children who need them – and adults who've gained or lost weight, or who need adjustments or repairs for another reason – get stuck in a long waiting period.
Then, when people no longer need a particular piece of equipment, Komeiji said, there isn't a single place they can return or donate it. What often results is an informal market where families sell items on eBay or Craigslist, or old equipment ends up piling up in the closets of long-term care facilities.
“When there's no need for (unusable) equipment, the equipment has nowhere to go,” Komeiji said.
As a result, Keny-Guyer introduced a bill in 2013 to fund a pilot project where coordinated care organizations would set up a more formal repository to repair and refurbish broken or used durable medical equipment, and families who are waiting for approval can get a new device that immediately meets their needs. Although House Bill 2137, died in committee, Keny-Guyer told The Lund Report she plans to reintroduce it during the February session.
The draft legislative concept asks for a $50,000 allocation to the Oregon Health Authority to create a pilot project administered by coordinated care organizations in the Portland and Salem areas to store, refurbish and redistribute used durable medical equipment – using a warehouse and a web-based searchable inventory.
But the repository wouldn't just be available to members of the CCOs: a provision in the legislative concept says CCOs could be reimbursed on a fee-for-service basis for the costs of providing, delivering and servicing equipment for people eligible for medical assistance, but not necessarily on such assistance.
Keny-Guyer said the new legislation was written with help from families with disabled children, including a woman who told her she had to drive all over the state to find used medical equipment for a child with severe physical disabilities.
“It's very hard for people who need equipment to find equipment,” Keny-Guyer said.
The draft bill would also require the state to track and analyze data on the success of the project and report on results to the legislature by 2016.
Lowe supports the draft bill with several caveats. First, its definition of “durable medical equipment” – equipment primarily used for a medical purpose and appropriate for use in the home – is consistent with Medicaid's definition, but he would prefer a definition that includes language about community access, since people use durable medical equipment to get around not just in their homes, but to travel to school, work and other public settings.
Second, he said he would like to see the data collection process include gathering feedback from consumers who participate in the program.
Komeiji said he is hopeful the project would allow more people to have regular access to community settings, making it easier to do errands and participate in activities.
“It's so abstract but it's also so concrete at the same time,” Komeiji said. “I think what I'm having to think about is, our state is so lucky that we actually care about people in a very tangible way.”
Christen can be reached at [email protected].
