Why are there pieces of durable medical equipment on curbsides, flea markets, yardsales…and in dumps? What about re-utilization of quality equipment?
The State Assistive Technology Act, first passed in 1988, is a federal law that requires state responsibility in four areas regarding equipment: (1) demonstration (2) loan (3) support for financing and….did you know? (4) equipment re-utilization.
“We want people to have good quality equipment and to use it to it’s maximum potential,” explains Sara Sack, one of the initial draft writers of the statewide Assistive Technology Act program in Kansas. “We want to maximize use of equipment through its lifetime. We don’t want to see any equipment abandoned.” Well, definitely. Who wouldn’t agree?
Kansas is one state where it’s actually happening. And here’s the story.
Assistive Technology for Kansans (ATK) was launched with Sara Sack as the co-director, and later as director of the program. Kansas University (KU) serves as the lead state agency for Kansas’ statewide Assistive Technology Act program. Sara is on the faculty at the research department of the University.
Early on, ATK started several disability programs focused on assistive technology. ATK makes the best possible use of public and private funds to enable people to obtain good technology. Initiatives were developed with funds from Kansas Medicaid.
Then, the rubber hit the road. In 1999, the Kansas Legislature was doing a budget review. When they looked at the Medicaid durable equipment budget line, one of the legislators asked a question that was the bombshell: “Do you have an equipment inventory and tracking program?”
Why are there pieces of durable medical equipment on curbsides, flea markets, yardsales….and in dumps? What is the state doing in terms of re-use of quality equipment?
The Medicaid staff that was presenting the budget was not prepared with a reply. “We’ll need to get back to you on that,” they said. And then they got on the phone. Who did they call? ATK.
“We got together at that point, and talked about a re-utilization program. We did not have an equipment recycling program,” remembers Sara Sack. “We began envisioning what it would look like.” Good for consumers, good for equipment providers, good for the state. Then, they prepared to actually trial their concepts.
The National Institute on Disability Rehabilitiation and Research (NIDDR) supported them with a field-initiative grant. After doing a pilot program study with several models, KU honed in on a good one.
And the Kansas Equipment Re-use program was born, as a partnership between Kansas University and Kansas Medicaid. Check out their website.
“Kansas Equipment Exchange gives families the excellent opportunity to use a variety of good quality equipment in their homes,” explains Heather Odell, PT, who volunteers for the program. “This allows families to provide their loved ones with age and skill appropriate equipment without financial concerns.”
That’s a fact. It’s fantastic. “It’s growing by leaps and bounds,” says Sara Sack, KEE Program Director. And KEE is only three years old.
What happens is this. Kansans call in with their requests for equipment, or log onto the KEE website. There are five locations across the state that serve the total geographic area. At these AT access sites, used equipment is refurbished up to standard.
Individuals are able to receive refurbished items at no cost. If transportation is a barrier, there is even free delivery of equipment provided by a volunteer network. All Kansans are eligible to receive the equipment, although there is a priority rating. Medicaid beneficiaries are given choice of equipment first.
Medicaid constantly looks at KEE’s equipment inventory. When they locate a piece of refurbished equipment required by a Medicaid beneficiary, they will ask the Medicaid client: Would you accept a high quality piece of equipment that is lightly used? It’s the consumer’s decision. Consumers are happy about that.
But are stockpiles of used equipment a problem? A precautionary rule was set in place before the program started: No equipment can remain at one site for more than 90 days. Equipment should be transported to one of the other four sites to be utilized.
“No, there are no stockpiles of equipment!” Sara laughs. “There is a lot of equipment coming through, a lot of consumers being served. But it’s a high turn-around program. We have just the opposite problem, we need more equipment!”
“We get MANY calls from people requesting Rifton equipment,” says Sharon Morton, KEE Program Coordinator. “Standers, Gait Trainers, Bath Chairs. Rifton obviously has a good name and great products. Because we are totally non-profit, we certainly appreciate the fact that Rifton furnishes replacement parts at no charge!”
Where does the equipment for KEE come from?
When Medicaid authorizes a purchase of new equipment for a consumer, the equipment provider puts a bar code on the equipment. The KEE staff does a follow up call with the recipient of this equipment in one month. Did they get the equipment? Is it working? Do they need any additional training for best use of the product? If training is needed, KEE makes sure it happens.
The KEE staff will call again in another 6 months. And in another 6 months after that.
If at any point the consumer no longer wants the product for any reason, KEE makes arrangements to bring it back in to one of the five AT access sites, re-furbish it, and get it on to another individual. And there you have it: inventory, tracking, and re-utilization. Following each piece of bar-coded equipment from it’s initial manufacture through its lifetime. Maximizing the use.
Besides this, there are public service announcements calling for donations. A lot of equipment comes in from people who obtained items through private insurance, or else purchased the products themselves. They no longer need the equipment, and want to donate it.
“In fact, over 90% of the equipment that comes through, is donated to us by private individuals who did not receive it through Medicaid,” reports Sara Sack.
Sara says KEE has barely scratched the surface. What’s happening so far has happened with minimal public awareness activities for this program. There’s a lot of scope for more donations, more technology getting to people who need it.
If the state of Kansas can do it, it can be done. “It has been very successful,” acknowledges Sara Sack. “But to operate it in the manner we do takes a lot of coordination. To replicate it, you could start this program for just a city, or a region of the state.”
Or, you could do something else, besides.
“When we began the re-utilization of technology, we found that it went beyond our state borders,” tells Sara. “There were people with good equipment over in eastern Colorado or northern Oklahoma, wanting to donate it.”
And Kansans were quite willing to drive there and pick it up. “So we looked at the concept of an on-line marketplace for new and used technology that had no boundaries,” says Sara. Match up the one who has the assistive technology with the one who needs it.
And they did it. KEE is an equipment program that primarily focuses on Medicaid-purchased equipment, and Medicaid beneficiaries. The ATK organization further serves as an on-line marketplace for all. Within four months of its inception, 18 other states already jumped on board, incorporating this website into their federally-required Assistive Technology Act programs. And more states are actively interested.
States will take responsibility to inform their citizens about equipment re-utilization with ATK/KEE. Also, states will use the website as a springboard to inform their citizens about their own state’s Assistive Technology Act program and any alternative finance programs offered by their state.
Why are there pieces of durable medical equipment on curbsides, flea markets, yardsales…and in dumps? What about re-utilization of quality equipment?
Those who say it can’t be done are usually interrupted by others doing it.
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