How would you define complex rehab?


As part of today's and tomorrow's Webinar, NCART distributed a "working definition" of complex rehab. The definition is one of the first steps in creating a separate benefit for complex rehab. Here are some snippets of the definition, abridged and in yellow, followed by comments and questions:

The products: The definition includes manual and power wheelchair systems, adaptive seating systems, alternative positioning systems and other mobility devices that require evaluation, fitting, adjustment or programming. Augmentative and alternative communication devices may be added at a later date.

The separate benefit will cover only Group 3 power wheelchairs. The word on the street is that there is a list of about 250 codes being considered.

The person: Individuals with 21 diagnoses, including traumatic brain injury and cerebral palsy, as well as “other disability or disease that is determined through individual consideration,” may require complex rehab products and services.

The word on the street is that the "individual consideration" clause is a catch-all of sorts. For example, there may be an individual that doesn't meet the requirements for a Group 3 power wheelchair, but he still needs alternative controls. The definition is written in a way to cover that individual.

The process: Consideration is given to a person’s immediate and anticipated medical and functional needs, including activities of daily living, mobility, positioning, pressure relief and communication. The provision of complex rehab has two components: clinical (physical/functional evaluation, treatment plan, goal setting, preliminary device feature determination, trials/simulations, fittings, function-related training, determination of outcomes, and related follow-up) and technology (evaluation of the home environment, transportation assessment, technology assessment, equipment demonstration/trial/simulation, product feature match to determine physiologic and functional needs, configuration, fitting, adjustments, and product-related training and follow-up).

Both include trials, simulations, fittings. Duplication of efforts?

The professionals: The clinical services are provided by a licensed/certified PT or OT. The technology-related services are provided by a certified, registered or otherwise credentialed complex rehab technology supplier.

Why didn't they mention any of the certifications by name (ATP, RTS, CRTS)?

Check back in tomorrow for my story on today's Webinar.

Liz Beaulieu