National Spinal Cord Injury Association

Our mission is to provide active-lifestyle information, peer support and advocacy that empowers people living with spinal cord injuries and disorders (SCI/D) to achieve their highest potential.

New Video Highlights Benefits of Complex Rehab Technology

The real world benefits of matching people with mobility equipment that meets their unique needs.

So what exactly is complex rehab technology?

Basically, it includes mobility devices such as manual and power wheelchairs that are professionally tailored to fit a person’s medical and functional needs.

No matter what disability someone may live with, whether it’s spinal cord injury or traumatic brain injury, nobody falls under the same umbrella of needs. We are all different, and that’s a good thing.

Some folks in DC do not recognize the positive impact that complex rehab technology has on many lives. They’d rather group everyone into one category. And why not, it’s easier–except for those who must learn to live with equipment that strips them of their independence and health. A wheelchair that works for one person, doesn’t work for everyone else.

For people who don’t use wheelchairs, think of it this way. How would you feel if you were told you couldn’t get any other vehicle other than a 76 Chevy Chevette that broke down every few miles? There is no doubt, some people out there are wheeling around in equipment that very much feels like 76 Chevettes, but the effect on their lives is much worse than just driving around in a crappy old car. The point is, complex rehab technology isn’t a luxury, these devices are medically necessary.

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Fortunately, the National Coalition for Assistive and Rehab Technology (NCART) has released an educational video explaining the benefits of complex rehab technology.

Far from the run-of-the-mill preachy production, the video offers up perspectives from individuals who use complex rehab technology for their health and independence, physicians that prescribe it, and consumer organizations like United Spinal Association that work to protect access to it.

Click the play button above to check it out.

NCART works with consumers, clinicians and physicians along with federal, state and private policy makers and agencies to establish and maintain a viable coverage and reimbursement environment. Another way of saying it: They push buttons and knock on doors to ensure people get the proper mobility equipment–without having to pay for it on their own or get a headache trying.

After watching the video, I recommend you check out NCART’s website for additional info on complex rehab technology that may be useful in your own fight to get the mobility equipment that’s right for you.

Also be sure to visit United Spinal’s UsersFirst program, which also advocates for greater access to appropriate wheelchairs, mobility scooters and seating systems for people with disabilities. They are looking for some new blood to join the movement to help change archaic policies.

Tom Scott
Web Editor

Iowa Rec Clinic Going Strong

When was the last time you went skiing, hunting, golfing, bowling and off-roading in the same day?

If you answered never, you’ll have a chance to rectify that glaring bucket list omission at this year’s 7th Annual Adaptive Sports

United Spinal Continues to Push for Policy Change

United Spinal recently met with Marilyn Tavenner, Acting Administrator, Centers for Medicare and Medicaid Services (CMS) to discuss the importance of people with disabilities having access to the proper mobility devices and equipment that will enable them to live the lives they choose.

During the discussion, United Spinal addressed its concern over a CMS “power mobility demonstration project” requiring prepayment review and prior authorization for approval of power mobility devices for Medicare beneficiaries living in seven states. Unfortunately, the project was created without input from the disability community or those that advocate on their behalf.

We believe this project––initially scheduled to take effect this January––will contribute to confusion and chaos in the name of reducing expense. CMS should not restrict access to medical care or rescind care that has already been provided.

In early December, United Spinal urged CMS to work with Congress and power mobility stakeholders to identify alternative approaches that will fulfill CMS’ interests in reducing overpayment, fraud, and abuse without significant disruptions to the disability and aged communities. In late December, CMS announced that they were delaying the demonstration and that they would give stakeholders at least 30 days’ notice before the start of the demonstration and in our meeting in January we were told that we would be given a couple of months’ notice as part of the formal notice and comment period.

The discussion then shifted to the importance of creating a separate benefit for complex rehab technology. This type of technology matches people with disabilities, living with spinal cord injuries and disorders, with mobility equipment and devices that meet their unique needs.

We also raised our concerns about the CMS competitive acquisition program, especially its impact on the disability community. The program has resulted in a steep reduction in the number of medical equipment providers who are deemed eligible to serve Medicare beneficiaries. This drastically limits access to the appropriate equipment and services that individuals with disabilities require in order to live functional and independent lives.

United Spinal is in dialogue with CMS personnel in reviewing the prepayment/prior authorization model to provide our input on medical necessity documentation and physician evaluations and has also requested to represent the disability community in future discussions involving the competitive acquisition program. Our dialogue with CMS regarding all issues affecting the SCI/D community continues. For more information on the prepayment/prior authorization project and other United Spinal related activities, click here.

Ms. Tavenner was receptive to our concerns regarding Medicare’s ‘in-the-home’ restriction on wheelchairs and is going to see what she can do as there have been a lot of legislative changes in the disability policy space over the last twenty years––including the Olmstead ruling and the rise of home- and community-based services.

United Spinal meeting representatives included Paul Tobin, President and CEO of United Spinal Association, Jim Weisman, Senior Vice President and General Counsel, Joe Isaacs, Vice President, Public Policy and Alexandra Bennewith, Director, Government Relations.

United Spinal’s senior leadership and Public Policy department continue to play an active role in advocating for people with disabilities––implementing programs to ensure both federal and state governments improve the quality of life of individuals with spinal cord injuries and disorders (SCI/D) such as multiple sclerosis, amyotrophic lateral sclerosis, and spina bifida.

Alexandra Bennewith
Director of Government Relations
United Spinal Association

Life in Action Editor’s Note: What’s your gadget?

Ian Ruder, Editor, Life in Action

A much wiser man than I once dubbed disability the grandmother of invention. If you live with a disability, or know someone who does, you know how true this is. And though no one knows for sure who invented the first wheelchair, I suspect it was a creative soul who was frustrated by his own lack of mobility. His innovative solution opened up a world of possibilities for other individuals in similar situations.

Hundreds, if not thousands, of years later, we can look back on a long history of revolutionary innovations that have not only improved the lives of people with disabilities, but have actually made many people’s lives possible. From simple inventions like appliance-holding cuffs, to the most complex ones, like the medical techniques that allow many people who sustain spinal cord injuries to survive, the promise of innovation is all around us.

I hope that this issue removes some of the mystery around innovating and inventing and gets you to realize that you have everything required to create the next life-changing gadget
or gizmo. No one knows the needs of people with spinal cord injuries better than people with spinal cord injuries. As one paraplegic I interviewed said, “Things that work for me work for a lot of people.” Indeed. If you have a problem, someone else likely does too, and if you have a solution, you can be sure they will be glad to know. Get your idea out there, and see what people think. Maybe it’s a hit, and you have the next iPad. Maybe you have the next iBot. Either way, you’re contributing to the rich history that has given so many options to the disability community. And who knows, you might get rich, too.

Paying It Forward

I lived through an absolutely incredible week recently.

Late in the day on Tuesday, December 20th, I received a phone call from my friend and work colleague of more than 31 years, United Spinal Association Senior Vice-President Jim Weisman. He was close to home on his return trip from Albany where he helped to negotiate a wheelchair-accessible taxi bill for New York City. While it still has to be ratified by the State Legislature next month, Jim told me over the telephone that New York Governor Andrew M. Cuomo was the key person in the negotiation process.

Great work, Jim. And thanks, Governor Cuomo, for understanding that moving around Manhattan in a yellow cab is something that should be available to ALL citizens and visitors.

The agreement is fairly complex so I’m going to break it down to numbers that I can easily understand. Probably sometime in 2012 or early 2013, there could be up to 2,000 new yellow taxi medallions sold at public auction. All would have to be used only on wheelchair-accessible yellow taxis. Eventually, over a reasonable period of years, the entire yellow taxi fleet here will become accessible to all people with disabilities.

New York City has five “boroughs” (known elsewhere as counties). Our yellow taxis operate mainly in the borough of Manhattan south of 96th Street, and to and from Kennedy and LaGuardia airports. The taxis that operate in the northern part of Manhattan, the Bronx, Queens, Brooklyn and Staten Island are known as livery vehicles.

So, the aforementioned agreement also establishes a new type of livery vehicle called a “street-hail livery.” These vehicles, expected to number 18,000 over a period of time, will require a special operating permit that will allow them to both pick up street hails and accept requests for service via radio dispatch. A total of 20 percent of these vehicles, or 3,600 such vehicles, will need to be wheelchair-accessible street-hail liveries.

Later in the evening of December 20th, I searched the Governor’s website and I found a release used for the earlier press conference, with a link to a video of it. Jim Weisman was the first speaker, and his was the shortest and best speech. He thanked the Governor for his hands-on involvement; said that this was a good agreement for the world-class city that is New York City; and, concluded by mentioning that it will benefit disabled people, veterans and the aging population.

I might be putting words in my friend’s mouth, but I don’t think so. It doesn’t matter who you are now. If you are a person with a disability today, veteran or non-veteran, the advantage of an accessible taxi and livery system in New York City is obvious. And if you are not a veteran or you don’t have a disability, and you live here or you don’t live here, if you live to be an aging person, you may one day need on-demand access to taxi and livery service, too. It is the beginning of the aging of America.

One of the two other events that happened last week is that I changed age, so now I’m part of all three populations noted above.

Last but not the least, on Friday, December 23rd, the judge in a U.S. District Court case in Manhattan, in which United Spinal Association is one of many plaintiffs, granted our motion for summary judgment against the Taxi & Limousine Commission under one section of Title II of the Americans with Disabilities Act, noting in part that persons who must use wheelchairs or scooters “are not provided meaningful access to the benefits of New York City taxicab service.” To me, this decision adds great credibility to the new State bill agreement.

Paying it forward? I want everybody in this country with a disability, or who works for or volunteers with an organization of persons with disabilities or veterans or aging Americans, to know about the agreement detailed above. If it happened here, it can happen anywhere. Pay it forward with me.

Terry Moakley
United Spinal’s Accessible Taxi Advocate

Further Reading: Judge Rules NYC Taxis Violate Americans with Disabilities Act

New Video Highlights Benefits of Complex Rehab Technology

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United Spinal Continues to Push for Policy Change

Life in Action Editor’s Note: What’s your gadget?

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United Spinal Continues to Push for Policy Change

Vote Yes by Friday, February 3rd for Accessible Taxis in Philadelphia

New Video Highlights Benefits of Complex Rehab Technology

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