Vermont explores reuse program

Friday, October 31, 2008

MONTPELIER, Vt.--Vermont seeks to join the ranks of states that refurbish and redistribute used wheelchairs, but provider Chris Henry has his doubts about the effectiveness of reuse programs.

Among Henry’s top concerns is safety. Because of the state’s rural nature and cold winters, equipment takes “a significant pounding,” he said.

“Everyone’s heard the story where someone gets a wheelchair and a month later either doesn’t use it or has passed away and then you have a perfectly good wheelchair that’s not being used,” said Henry, Vermont chair of the New England Medical Equipment Dealers (NEMED). “But that’s the exception to the norm.”

The Vermont Assistive Technology Program has been working for several years to coordinate a pilot reuse program with Medicaid for high-end wheelchairs and lifts, said Julie Tucker, program director. It has already collaborated on a regional equipment exchange Web site and created a computer-based system for schools to track assistive technology inventory. The pilot program will be smaller in scope, Tucker said.

As part of the program, qualified providers would retrofit the equipment for a fee to be determined, Tucker said.

Henry expects bringing providers on board will be another hurdle. Providers, concerned that a reuse program will hurt sales, want to be reimbursed fairly.

“With reimbursement rates in this industry, they always underestimate the true costs for the delivery of this equipment,” he said.

For the last six years, a reuse program in Kansas has had success working with providers to redistribute equipment ranging from power wheelchairs to vision devices, said project director Sara Sack.

Vermont is modeling some aspects of its program after the Kansas Equipment Exchange, which is a partnership between Assistive Technology for Kansans and the state’s Medicaid program. Most of the equipment comes from private pay sources and is distributed from five assistive technology sites located across the state. Last year, the program brought in 700 devices valued at more than $694,000 and redistributed 596 items valued at $670,000, Sack said.

A strong partnership with providers keeps the program afloat, Sack said.

“The DME providers are the huge champions of this program,” she said. “They are paid real quick, but that seems to be almost the more minor element to this. They’re really known as the good guys.”

Some wonder, however, if there’s a large enough need to sustain reuse programs.

“We contacted one of the primary DME companies that was involved with Kansas’ program and this provider told us that he had been with the program for two years and hadn’t used one piece of equipment,” said Karyn Estrella, executive director of NEMED.