Tuesday, June 22, 2010

What’s Wrong with Used AT?

By Allan Friedman, CFILC's Technologies Manager

There seems to be some reluctance on the part of many AT professionals to recommend or assist consumers in acquiring used assistive technology devices. Medi-Cal, Medicare, the Veteran's Administration and other funders will not fund the purchase of a used AT device; only new will do. Why?

The number one barrier to getting AT is cost. Consumers who lack insurance are often ineligible for funding from other sources. With little or no income of their own, they are regularly forced to endure long waits to replace worn out devices or to get AT in the first place. Used devices could fill this void, allowing more people to live independently.

The need is especially great for durable medical equipment (DME). Wheelchairs, scooters, lifts and other devices can mean the difference between dependency on others and maintaining one’s independence and quality of life.

With such a great need and demand for AT, I wonder why so few organizations serving people with disabilities are willing to accept donations of used AT. Indeed, much of the DME that is donated often ends up overseas, serving a valid need in the third world. But much of that equipment could just as well be serving the need here at home.

While there are challenges to running an AT reuse program, especially for DME, successful programs in other states prove it can be done without harm to the organizations or compromise on the part of the consumers. By extending the useful life of devices, we keep waste out of our landfills, fill a need in our communities and maximize the return on investment for cash strapped government programs that are often the funders of new AT.

New is not necessarily better. Properly sanitized and refurbished, most AT and DME can continue to be useful and meet a need for those who receive them. We’ve got to give up our tendency to dispose of things and begin to think seriously about reuse. It is the easiest and least expensive way to expand the availability of AT and DME for people in our communities with the greatest need and least resources.

The above article represents the opinion of the author.

13 comments:

  1. Which organizations in California accept donations of used wheelchairs?

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  2. The hardest thing about dealing with Used AT is storing the equipment and having it ready for future consumers. Our offices are already cramped and our cubicles are not big enough. Even though we would love to pass the down the AT we cant.

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  4. i know i have post this before but as i read it i realize that it had some mistakes, so here it is again sorry.

    I think recycling used DME is a good idea, but you have to keep in mind too. The manufacture and how old the equipment is. Some manufactures only will only carry parts for equipment that more than 7 years old, and you have to look at who will be going to look at the equipment before it goes out to the consumer. I myself am in a power wheelchair and I know a lot about power and manual wheelchairs so when I know someone that is in needs of a loaner or just needs a wheelchair, I check it out first and make sure that it is in good working condition before it goes out. Now our local ILC has a lot of used DME but again who is going to make sure that it is in good working order? Now if we could get insurance companies to pay for that service before it goes out and pay for the repairs when needed, that would be great but as far as I know they will not. I think that would be good if they did because there’s a lot of good used DME out there going to waist.
    David Mensch
    A.T. Technician
    Kern Assistive Technology Center

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  5. Typically, with little or no funding available for recycled DME restoration (e.g., scooter/power wheelchair repairs) or to secure storage space to maintain equipment, this very worthy AT service, unfortunately, is almost impossible to implement and sustain.

    In our community (Marin County), our ILC is fortunately linked with a dedicated recycling program which arranges for pick up and distribution of local DME donations.

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  6. The idea of development of used AT Closet would be beneficial in many ways.

    LIABILITY our particular administration does not permit receiving used AT donations due to liability reasons.

    CONDITION The first two or three years discussion of the AT program re this issue was centered on DME not considered safe based upon health and hygiene issues.

    My personal point of view is to determine the kind of used AT that can be reused in a safe and reliable manner.

    OTHER ISSUES Space to develop and house this AT Closet, staff to triage and recondition items, etc.

    Veronica Addison, AT Services Coord., WCIL

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  7. I am also interested in AT reuse and am happy that others are too.

    Based on your comments it sounds like space for AT storage, liability issues, funding and staffing all need to be considered before beginning an AT Reuse program.

    Can anyone who works for an organization currently engaging in AT reuse comment on what is working now?

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  8. At ILSNC we have had a long standing reuse program. We take in wheelchairs, walkers, or anything that is reusable and not something that would need special sanitizing. We then laon or give them to consumers or others in the community who need them. We do not have a budget to fix items but are able to spend time on the process. We keep all the items in an offsite storage and it seems to run smoothly. I wish we had the funding to refurbish items but we simply act as a place people can donate itmes to and we get it out to people who need it.

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  9. At KATC we do very little recycling of equipment primarily because of a lack of funding to support the recruitment, reconditioning of, and redistribution of equipment.

    Aaron Markovits
    Director

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  10. We do have a recycling program at FREED, but not a refurbishing program. Stuff that is donated has to be in good working condition. If it isn't we donate it to Wheels for the World. We are fortunate to have a large space to accommodate recycled AT right across the street from our office, and the storage does cost money. Popular items are wheelchairs, various kinds of walkers and shower benches/chairs. If we had more staff time for recruitment of items, we'd probably have more stuff, although our stockpile of commodes is probably enough for a small country. I actually incorporated our infinite supply of commodes into our emergency planning process (no water, no electricity, shelter in place). Maybe Jeff or Mike will also weigh in....

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  11. Mary Krieger, UCP of San DiegoJune 28, 2010 at 10:05 AM

    UCP of San Diego has operated an informal DME recycling program for many years. We don't have the resources to do refurbishment so we accept equipment that is in good condition and give it out at no cost. We have recipient to sign an "as is" condition to cover liability and instruct to obtain their own PT support for wheelchairs adjustments, etc. For things that aren't in great shape we give them to people who will take it to Mexico for the most part if we have storage room at the time.

    We take in alot of pediatric equipment from parents, as well as scooters, wheelchairs, standers, bath/toilet equipment, walkers, etc. Our biggest obstacle is having enough space to store items and keep track of what we have. We receive equipment from our Thrift Store truck pickup and parents or others who want to see the equipment go to another parent or consumer. We do have the ability to help fund some repairs when needed and have resources to help fund new equipment if the person cannot afford this or has no third party funding. We have recycled some AT equipment on a small scale in the same informal way. It would be great to have some financial resources to run a program.
    Mary Krieger, UCP of San Diego

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  12. We utilize used donations with the limitation of storage area. I have connected quite a few consumers with re-used AT equipment. I think the big problem is storage for our agency. That and transporting larger, heavier pieces begins to become an issue. I think staffing is also an issue as most AT service providers already have their plates pretty full with consumers, grant writing/funding, trainings, etc. These I feel are the biggest hindrences to doing more with a recycle program than anything else.

    The issue with condition is also a big consideration, you don't want to be storing equipment that isn't usable. Not all equipment will work for consumers in need. Someone may need a manual wheelchair, and you receive a manual wheelchair, but it doesn't come with the foot rests or is more of a transport chair and needs to be one the person can control on their own. It is dificult to find people to refurbish for free or low cost too. Some repairs can be up in the thousand dollar range. There are so many variables. We basically take in what we have room and practicality for and refer the potential donors to other organizations that collect AT too like Scottish Rites, Lions Clubs, etc.

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  13. Most callers looking to dontate their AT want to get rid of it ASAP. When I mention to them that our center doesn't have storage for it and it may take me up to a week to find a suitable consumer and make other arrangements, they seem to give it away later that day to the Salvation Army or other charities. Most places like that will even pick it up from their house. So our process is much slower than donators want to go through.

    Another problem is delivering AT. Electric wheelchairs, hospital beds, and lifts are not easy to load and transport. Most consumers do not have vehicles to transport these items and often rely on their ILS to help them out, which I have done in that past. But these items are pretty heavy for me to load into my truck by myself, which is often the case because we have limited staff and some consumers may not have a strong circle of support to offer help. This operation places many barriers to the delivery of AT to our consumers through our Center.

    I think the storage and transportation of AT are the two key shortcommings and are the main reasons why our center in Sacramento underutilizes an AT Reuse Program.

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