Credentialing: Division stalls Missouri initiative

ST. LOUIS - Those who had hoped to add Missouri to the list of states that have raised the bar to provide wheelchairs and scooters will have to wait at least one more year. State Rep. Jay Wasson, R-4th district, introduced a bill in February that would have required RESNA certification to provide manual and power wheelchairs and scooters, but the bill died a slow death in subsequent months, when providers voiced strong disapproval with several provisions. At the crux of the debate: Whether the state should require standards for basic wheelchairs and whether the state should limit its certification requirements to RESNA. "(Wasson) decided he would rather put forward a bill that a majority of providers can agree on rather than a bill that there's a lot of disagreement over," said Brady Vestal, the Missouri chair of the Midwest Association of Medical Equipment Services (MAMES) and HME manager at Stephens Pharmacy in Bolivar, Mo. "We, as an industry and as providers, agreed with that." Had the bill continued to work its way through the system this year, Missouri could have become the third state to put a rehab certification bill on the books, joining Tennessee and California. Georgia, Alabama and Massachusetts have Medicaid policies in place. MAMES has created a panel to work with Wasson to draft a new bill for the next legislative session, which begins in January. The panel was slated to meet in July, according to Rose Schafhauser, the association's executive director. The new bill will likely require standards from RESNA or NRRTS rather than just RESNA, said Darren Jernigan, director of government affairs for Permobil. (Since it helped pass legislation in Tennessee in 2003, Permobil has encouraged other states to follow in that state's footsteps. In addition to Missouri, the company plans to work with Texas and Virginia to get legislation or policy requiring certain standards passed next year.) Ron Burns, director of rehab for Home Support Systems in Springfield, Mo., said providers "are all on the same path--we're just trying to figure out how to get where we want to be." Personally, Burns would prefer that Missouri seek policy vs. law, because that way the industry has more flexibility. He'd also prefer that standards be required for all wheelchairs and scooters. "If you provide a standard wheelchair and it's wrong--one wound can cost you thousands," said Burns, a member of the Missouri board of directors of MAMES. "Who's to blame then?"