November 2008

Take Action & Be Heard!

As promised, I am sharing part of the latest legislative update from NCART:

The November 4 election marks a change in the executive branch of government and its effect on the HME industry and complex rehab is unknown. President-elect Obama has not addressed the issue of HME and his selection of Department of Health and Human Services Secretary and CMS administrator will be key. Health care reform is a top priority for President-elect Obama and Democrats in Congress have said they are committed to making a comprehensive effort to reform our health care system. Work is currently underway to lay for foundation for legislation next year.

Under President-elect Obama’s proposal, most individuals would continue to receive coverage through their employer. Individuals who are uninsured would have access to a new public plan – modeled on the current federal plan for federal workers, or to private coverage through a “National Health Insurance Exchange.” This Exchange would also reform the private insurance market, incorporating a ban on excluding coverage due to health status. The plan includes a “pay or play” mandate for employers to provide insurance or contribute a percentage of payroll toward the cost of the national plan. Small businesses would be exempt from this mandate and would receive tax benefits to help purchase coverage.

President-elect Obama’s proposal includes an array of health system changes to improve quality, reduce waste and drive down health care costs. Proposed system changes include the use of comparative effectiveness research, disease management and care coordination, preventing Medicare waste and fraud, and increasing competition in the insurance and drug industry. Many elements of these reforms have support from Democrats and some Republicans.

Medicare is likely to be a big part of the debate. Many Democrats believe coverage through a public program is part of the solution for the uninsured and many leading Democrats have sponsored legislation that would allow individuals to “buy-in” to Medicare. Congress could also turn to Medicare savings as a way to finance health reform. President-elect Obama and many Democrats have called for reductions in payments for Medicare Advantage and for Medicare prescription drugs, among others. Any of the proposals for Medicare savings debated by Congress in 2007 and 2008 could be on the table, including the elimination of the first month purchase option for power wheelchairs.

Sen. Baucus (D-MT), chair of the Senate Finance Committee, expects to release this week his options for health care reform, and Sen. Kennedy (D-MA), chair of the Senate’s Health, Education, Labor and Pension Committee has been working on a proposal also. NCART will monitor these efforts at comprehensive health reform and advocate for more reasonable reimbursement of complex rehab and to avoid policies and programs that could potentially harm people with disabilities who need complex rehab technology.

Other health care legislation to be considered in 2009 includes the reauthorization of the SCHIP program which expires in March, and legislation to “fix” the current physician reimbursement reduction scheduled to go into effect in September. These two pieces of legislation, in addition to health reform legislation, are possible vehicles for attaching a proposal to eliminate the 9.5 percent reduction for complex power wheelchairs.

2009 is quickly approaching, now is not the time to sit back and wait to see what direction the new administration and Congress will take Complex Rehab and the HME industry. Now is the time to be vocal and let your Legislators know what you (either as providers of Complex Rehab, or consumers of these devices) need!

What actions are you taking to be proactive? How are you making your voice heard?

Popular Mechanics Magazine recently recognized a wheelchair invention as one of the Top 10 Innovations of 2008. The wheelchair was invented by some engineers from California who were brainstorming with students and professors from Guatemala. Utilizing wheels from mountain bikes, their wheelchairs are less expensive and more durable to withstand the potholed streets and rugged roads in Guatemala.

They have formed a nonprofit organization called Intelligent Mobility International, which designs, produces, and distributes affordable and durable wheelchairs to help people with disabilities find sustainable employment, and new hope in their lives. They have also partnered with Transitions, a Guatemalan charity, who employs mainly wheelchair-bound people to build the chairs.

What do you think of this wheelchair, created for the developing world?

Did you see this video on 60 Minutes? It features a guy with ALS and a lady with a stroke who are both completely paralyzed and nonverbal. Neuroscientists have found a way to tap into the thoughts in their brain, and make them into actions performed through a computer. The gentleman with ALS is able to communicate by choosing letters on the screen, and the woman was able to move a cursor around the screen and even operate a power wheelchair with just her brain power. They also showed a monkey who actually controlled a robotic arm with his brain.

The hope is that the technology can help people with disabilities to communicate and control mechanisms like a wheelchair. See for yourself!

Watch the 60 Minutes video “Brain Power” or read the text version of the story here.

Because I sit in my wheelchair most of the day, my trunk muscles are not strong enough to steady my gun. Standing in my EasyStand helps me to steady my hand, making it easier to hit my targets.

One of the many activities I enjoy while standing is target practicing in from my patio. By utilizing my EasyStand Evolv stander, I feel it gives me the true position needed to target practice.

First of all, Iʼm in a standing position. Second, the tray on top of the standing frame helps steady my shot. Third, I have a better view. Finally, the support and balance the standing frame gives me is by far the most beneficial.

With all things considered, the stander helps prepare me for the real hunt. Thanks to EasyStand for improving my quality of life as a T5 paraplegic.

To read more about Jadian Foley, his activities, and standing routine, read his EasyStand customer story.

Does standing help you perform tasks or activities that are otherwise more difficult when in a wheelchair? What activities do you do while standing?

Now, with the election behind us, and new President-Elect Barack Obama ready to take over the office in a couple months, the United States is bracing itself for change. Barack Obama plans to empower people with disabilities through these key positions:

1. Provide the educational opportunities that Americans with disabilities need to succeed
2. End workplace discrimination and promote equal opportunity
3. Increase the employment rate of workers with disabilities
4. Support independent, community-based living for Americans with disabilities

To watch Barack Obama’s video detailing his plan to Empower People with Disabilities, visit http://www.barackobama.com/issues/disabilities/. You can also view the complete Disability Plan Fact Sheet in PDF format.

In Obama’s acceptance speech on November 4th, 2008, he specifically mentioned “people with disabilities”.

Barack Obama has a plan to empower people with disabilities.

“If there is anyone out there who still doubts that America is a place where all things are possible, who still wonders if the dream of our founders is alive in our time, who still questions the power of our democracy, tonight is your answer. It’s the answer told by lines that stretched around schools and churches in numbers this nation has never seen, by people who waited three hours and four hours, many for the first time in their lives, because they believed that this time must be different, that their voices could be that difference.

It’s the answer spoken by young and old, rich and poor, Democrat and Republican, black, white, Hispanic, Asian, Native American, gay, straight, disabled and not disabled. Americans who sent a message to the world that we have never been just a collection of individuals or a collection of red states and blue states.We are, and always will be, the United States of America.” – President-Elect Barack Obama, Nov. 4, 2008

What do you think of Barack’s plans to empower Americans with Disabilities?

Hi! My name is Ginny Paleg and I am a pediatric physical therapist in Maryland. My specialty is getting children with severe gross motor dysfunction (GMFCS Level IV and V) to take steps in gait trainers. To get to this goal, I use passive standing, body weight supported gait therapy over a treadmill, and am investigating passive/assisted cycling and vibration platforms. My “dissertation” (final project for my DScPT) was a systematic review on passive standing and a webinar presenting what I found. I sorted the articles by level of evidence, clinical outcomes, diagnosis, type of stander, and length of standing time.

I hope the flow charts can help folks decide how long to stand, which type of standing device to use, typical complications of standing, as well as appropriate measurable attainable clinical goals of standing. I included research studies on standing combined with oscillation, vibration, electrical stimulation and exercise programs.

Check out my Supported Standing webinar and other supporting materials, such as the Synthesized Literature Review on Standing Therapy (PDF) on the EasyStand website. I hope you find this information useful. I would appreciate feedback, questions and/or comments!

Goto www.easystand.com/ginny to see the Free Webinar on Standing Therapy!

I ran across this video on Youtube showing Matt, a young man who has ALS- Lou Gehrig’s disease, using the EasyStand stander. Shartrina is Matt’s wife and caregiver, and demonstrates how she transfers Matt into the stander and gets him into the standing position. She also has some tips on making it more comfortable, adapting it for use with a ventilator, and more.

Matt and Shartrina have an inspirational website called the Matt White Cure ALS Foundation where they have documented their story and are educating others on ALS. I encourage you to check out www.cureals.org to read about their story.

What do you think of the video? Do you know a person who has ALS?

Bill Fertig and I are proud to have raised $6596.00 for the NSCIA

As you know Bill Fertig and I raced in the Marine Corp Marathon on Sunday. I had my personal best of 4:03:48 but I know I could have gotten below 4 hours if all those people would of just gotten out of my way. This was Bill’s first time hand cycling a marathon and he did it in 3:04:45. Here is what he had to say about it, “It was big fun as you say! But I was humbled by the experience of competing next to so many combat injured solders who returned as single or double amputees. I haven’t been addressed as ‘sir’ so many times in my life as I was by the many hundreds of Marines who worked the MCM!”

Bill and I raised $6,596.00 for the National Spinal Cord Injury Association, which was short of our goal of $10,000, but we are hopeful there are a few late supporters yet to sign up.

The most moving sight for me was a group of three runners with the US Marine Corp and MIA full size flags running ahead of me. Just as I was catching up to them they suddenly turned off from the race and stopped at the Vietnam Memorial to bow their heads in respect for about one minute, then continued running.

Many runners had pictures or messages on the backs of their shirts, stating they were running for brothers or sons killed or injured in the line of duty. This made me think about the reason I was running, for the many more people in civilian life that have also suffered, from SCI/D. This stopped me from whining about the pain and helped me get through the last six miles. It is an experience I will never forget.