A fundamental goal of our organization is to help individuals with spinal cord impairment (SCI) get their lives back and become fully participating members of society. The process, of course, begins with initial treatment and rehabilitation, and then securing the means to resume life back in the community. One basic and necessary tool to accomplish the latter is, in most cases, a wheelchair or scooter.
As we continue to navigate the world of Medicare and Medicaid, we unfortunately find that the rules and regulations for the issuance of “durable medical equipment” become ever more stringent, and the regulating bodies more remote from direct access by consumers. The plethora of paper work—prescriptions, refills of prescriptions, justifications, etc.—required to get not only a wheelchair, but component parts and services gets ever more monumental and seems, in essence, to be designed to keep people with disabilities in their homes.
The Center for Medicare and Medicaid Services (CMS) is the federal agency that decides which health care costs Medicare will cover. Under current Medicare rules, individuals are issued a wheelchair or scooter only if they need one to ambulate in their home. No consideration is given to basic needs like shopping, going to a movie, going to a restaurant, let alone going to school or work.
At present, persons with SCI are being rehabilitated, given employment training, and are then denied the basic human need to get about and do the things that make them feel that they are in control of their destinies. That this is occurring in our day and age is both disgraceful and inhumane and goes counter to the provisions of the American with Disabilities Act (ADA), whose objective is to ensure that people with disabilities have equal access to employment, government services, public accommodations, and telecommunications systems.
There’s a distinct double message here: the ADA recognizes the civil rights of people with disabilities; the CMS and other administrative bodies are doing all in their power to discourage pursuing getting one’s life back after a severe injury or illness. In the New York City area, the problem has recently been exacerbated by the closing of a Medicaid Office which was moved to Albany. Items that used to take hours to get approved or taken care of, now routinely take weeks, months or even longer. With reports that we are going to see budget cuts on both the federal and state levels, we can only assume that these Medicaid and Medicare restrictions will broaden and become more severe.
We will, of course, be doing all in our power to advocate for improvement and to prevent an already bad situation in Medicare and Medicaid from getting worse. At the same time, we are also going to be facing some new and serious challenges in VA health care. With the VA budget also expected to experience reductions, and with the recent change in chairman of the Veterans Affairs Committee and the departure of the Secretary of Veterans Affairs, we anticipate troubled times ahead. The House Chairman of the Veterans Affairs Committee was replaced despite House rules which would have allowed him to serve two more years. It is widely believed that he was replaced because of his past advocacy for increased health care budgets to fund VA hospitals. With increased demands on the system from returning veterans from Iraq and Afghanistan, the situation can only get worse.
We will be keeping a close a watch on both these situations. However, we will also need you to contact your congressmen, senators, and government officials concerning these issues. Please monitor our Web site www.unitedspinal.org to keep abreast of the latest developments. On the bottom right-hand column of our homepage you can sign on to electronically receive any legislative alerts we may need to initiate.
Gerard M. Kelly
Executive Director
