We have all heard at least one if not many devastating stories of people who are forced to use a wheelchair. These stories are not ones that involve short-term injuries that result in a temporary inability to use a limb. I am referring to stories in which those affected are left permanently needing to utilize a wheelchair to complete everyday tasks. Let us imagine for a moment that you become one of those people.
Like most everyone else get up for work on a Monday morning get ready, hurry out to your car, turn the key and race off to work. As you merge on to the interstate a driver distracted by his or her cell phone fails to yield to you as you merge into traffic. This causes there car to collide into yours sending you off the shoulder of the road as your car’s tires screech trying to gain traction the vehicle rolls. In the morning rush, you failed to fasten your seatbelt as a result, when the car rolled your body made contact with the roof of the vehicle at approximately sixty-five miles an hour. You back breaks. This immediately fractures your spinal cord at the T-4 vertebrae causing paralysis from the chest down. Tragically, you are now one of the between 245,000 and 353,000 Americans suffering from spinal cord injuries in the united states according to 2017 statistic on SpinalCord.com . You wake up days later to be told by a team of doctors and surgeons that you are now a T-4 paraplegic and must rely on a wheelchair.
Let us fast forward now five years past the seven-month hospital stay, the very well written but only briefly impactful news story, and the Go Fund me page that helped take care of your very expensive medical bills. You are well-adjusted to life on wheels, and like anything, man made your wheelchair after five years of functioning as your legs begin’s to have issues. After consulting your doctor he writes a prescription for a new chair. The proper documents are submitted this includes notifying your insurance company of the need for a new chair. Something both you and your doctor agree is essential to you living a productive life. Approximately two weeks after the prescription was submitted to insurance you receive a letter in the mail from Cigna, your health insurance provider. The letter states that a new wheelchair is not medically it is a “selective service or accessory at this point in time” and Cigna will not be paying for it. An appeal is filed that outlines in detail the nature of your injury and prognosis only to again be later denied. You attempt to then work out a payment with the medical equipment company, but with the cost of a proper wheelchair costing anywhere from $3200-$6100 a feasible payment plan is not reached. After exhausting all options you have no choice but to use a wheelchair that is no longer functioning properly for months or even years until your insurance company will approve you for a new one or you and your family can pay for it out of pocket.
This is a reality that almost every long-term wheelchair user must face at some point.
Lift with Purpose is a Nashville, Tennessee based nonprofit organization whose mission, or as Michael J. Worth states in his book Nonprofit Management: Principles a Practice “the reason the organization exists” (Worth 5) is to help people with disabilities become more independent. After hearing multitudes of stories like the one previously described. Lift with Purpose, a fitness-based nonprofit began an internal program in 2016 called Wheels with Purpose. Wheels with Purpose refurbishes previously used, wheelchairs for those in the disability community who cannot obtain a new wheelchair through traditional means. Although programs like Wheels with Purpose are effective the need for their services is growing at such an astounding rate it is hard for them to make a noticeable difference.
With the introduction of the Affordable Care Act by former President Barrack Obama on March 23, 2010, both private and public medical insurance providers are willingly paying for less and less. This has made obtaining the proper wheelchair substantially more difficult for people with disabilities. Since 2010 The Centers for Medicare and Medicaid (CMS) services have developed a pricing system to distinguish what mobility aids and exactly what percentage of the cost of these mobility aids Medicare and Medicaid will pay for these items. The CMS specifically cut their payouts for claims involving manual or self-propelled wheelchairs. These chairs are the most commonly used. As a result, the majority of the disability community is affected. The United Spinal Association writes, “what Medicare calls “accessories” are critical components” (Protect Access to Essential Complex Rehab Manual Wheelchair Components Support HR 3730). The current CMS indicates most of the manual wheelchairs that designed to make a permanent user more independent are just “accessories”.
This struggle has not gone unnoticed in by Congress. On September 11th, 2017 bill H. R. 3730 was introduced to the House of Representatives. H. R. 3730 is an effort to stop the Centers of Medicare and Medicaid from using this from using its current coverage policy. If this bill was passed the United States government would be in effect forcing Medicare, Medicaid, and private insurance companies to pay higher percentages toward the cost of manual wheelchairs for their clients. This would be the difference of independence and dependence for so many of the nation’s wheelchair dependent population. If H. R. 3730 were to pass it could be life-changing for so many.
In order to make to make those in political office aware of the power, H. R. 3730 could have we at Lift with Purpose ask that on November 14, which is National Congressional Call-In Day that across the nation you reach out to your Representative and ask to pass H. R. 3730. Disabled or not you can make a difference. The disability community cannot waist any opportunity to be heard. We must fight for change with your help programs like Wheels with Purpose could no longer need to exist.
Reference
Clayback, D. E. (2017, September 12). Help Get H.R. 3730 Passed To Protect CRT Manual Wheelchair Accessories. Retrieved December 2, 2018, from http://blog.ncart.us/help-get-h-r-3730-passed-to-protect-crt-manual-wheelchair-accessories/
Team, C. (2018, June 19). 2017 Spinal Cord Injury Statistics You Ought to Know. Retrieved December 2, 2018, from https://www.spinalcord.com/blog/2017-spinal-cord-injury-statistics-you-ought-to-know
WORTH, M. J. (2019). NONPROFIT MANAGEMENT: Principles and Practice(4th ed.). S.l.: SAGE PUBLICATIONS.
