You've Changed: How Scooters/POVs Have Evolved
It's A Roundup!
If a scooter could talk, what do you think it would say? Scooters might say, "I am … compact, lightweight, portable, three-wheel or four-wheel," but with the technology and design features of newer scooters, the bragging rights have just gone up a notch. Companies are designing scooters, otherwise known as power operated vehicles (POVs), for increased maneuverability, safety, stability and expanded usage both indoors and out.
Often viewed as only recreational vehicles by consumers, there's no question that today's scooters are serious mobility contenders.
"If you listen to a lot of the therapists and people in RESNA (Rehabilitation Engineering and Assistive Technology Society of North America), they were saying that scooters can't be used indoors because they aren't maneuverable, but realistically you can build a scooter that is a lot more maneuverable than a lot of power wheelchairs," says DuWayne Kramer, CEO of Pacesaver/Leisure-Lift, Kansas City, Kan.
Pacesaver/Leisure-Lift introduced its Fusion Total Environment Vehicle (TEV) at Medtrade in Atlanta, offering a scooter that doesn't "compromise," according to Kramer.
Trend: Indoors and Out!
"You can have an indoor scooter or an outdoor scooter or a compromise scooter, but what we are able to do now is provide a short turning radius of 29 1/2" that is going to be more indoor maneuverable than rear-wheel-drive wheelchairs and some front-wheel-drive wheelchairs. The idea was to be in the total environment," Kramer explains.
At Medtrade it was evident that manufacturers are aligning their research and development closely with the feedback they are hearing from DME providers who are requesting versatile POVs for real-world environments both indoors and out.
Golden Technologies, Old Forge, Pa., offers a dual-jockey front wheel of its Golden Liteway Scooter for added stability. "This is a fresh new design not typically found in scooters with a 300-lb. weight capacity. It quickly captured the attention of everyone who came into the mobility side of our booth at Medtrade," says Rich Golden, CEO of Golden Technologies.
Trend: Increased Durability!
Pamela Torain, director of sales and marketing at Landlex, Tampa, Fla., says, "A mobility scooter regardless of its use for the elderly or the disabled has always represented an increase in freedom and independence. The growing trend is an increase in the use of scooters for the part-time user who simply cannot walk as far as he or she used to and carry things at the same time. This user still leads a very active life through occupation and recreation. Scooters for this market are more durable, offering a wider variety of terrain capabilities, such as the ability to maintain consistent motion on thick grass, rough pavement and steep inclines. Our European counterparts in the United Kingdom and Germany are marketing scooters that travel as fast as 8-10 mph and, in some cases, sport ultra-rugged wheels."
Trend: Scooter-Friendly Automobiles!
Automobiles, and not just vans, are also becoming scooter-friendly. Equipped with the proper rear suspension, cars are now able to handle the additional weight of a trunk lift or attached outside lift to raise and transport a mobility scooter, according to Torain, who says, "The trunk lift is an excellent, cost-effective option for the part-time user."
Trend: Multiple Options!
The list of additional options for scooters is seemingly endless: foldable baskets, drink holders, oxygen tank holders, cane and crutch holders, canopies and rear-view mirrors, to name a few.
"The future is bright for the mobility scooter manufacturer who considers the changing face of its users," says Torain.
MM took a look at the latest technology and trends of scooters showcased at Medtrade. To see for yourself, check out Scooters/HMV's and Accessories in the New Products section. The Radius of Scooter Reimbursement
The Radius of Scooter Reimbursement
The POV market has had its share of news in the last year — both good and somewhat ambiguous.
Overall, many industry members indicate that the scooter market is growing each year and positioned for future growth as baby boomers age. Even the Centers for Medicare and Medicaid Services (CMS) reports a 2,700-percent increase in utilization of overall power mobility in the past eight years.
"Medicare scooters are going to be going up because they are going to become the old consumer power wheelchairs, says DuWayne Kramer, CEO of Pacesaver/Leisure-Lift. Kramer says a lot of people who received wheelchairs would have qualified medically for POVs. Future consumer power purchases are going to be scooters. "A lot of people that have wheelchairs can turn a tiller," Kramer says.
And now that a specialist in physical medicine, orthopedic surgery, neurology or rheumatology is no longer required to prescribe a scooter, this spells more good news for the POV market, as the playing field has been opened up for any physician to prescribe a scooter.
The national coverage determination also moved the industry away from the rigid "bed-or chair-confined criteria" to a more functional criteria where beneficiaries will be assessed on whether they have a mobility limitation that prevents them from performing one or more mobility-related activities of daily living (MRADL), such as bathing, dressing and eating.
The local coverage determination (LCD) issued Aug. 15 and later revised and somewhat improved on Sept. 20 lists the MRADLs as basic coverage criteria for beneficiaries to qualify for a scooter/POV, but for those beneficiaries who initially qualify, there are several other factors to be considered. A beneficiary must:
- have a mobility limitation that cannot be addressed using canes or crutches
- lack the upper extremity function, strength and range of motion, endurance or freedom from pain needed to use a manual wheelchair for MRADLs
- be able to transfer on and off a scooter safely
- be able to operate a tiller steering system
- be able to maintain posture and position while operating the vehicle
- possess the cognitive and physical abilities to operate the POV safely
- have a home environment that will accommodate the POV
- significantly approve in MRADL ability through the use of POVs
The revised LCD pushed the implementation date of the power mobility policy (the 64 new codes, the fee schedule and the proposed new testing standards) from Oct. 1 to Nov. 15, 2006 and suppliers will likely have until Aug. 1, 2007, to retest their POVs by an independent testing laboratory.
Although suppliers of POVs indicate that the new testing requirements for POVs will ensure quality products and hold manufacturers accountable to certain standards, many are concerned with the fact that overseas suppliers don't have to meet the same requirements.
Kramer also member of RESNA's POV standards committee, explains, "There are no sections of the standards that test the quality of the controllers and motors from the standpoint of power. The government is complaining that they are buying all of these products from China, import chairs, and they are replacing all of the parts and motors and it's costing them a fortune. But there is nothing in the standards anymore that says the motors or controllers are going to last."
Kramer referred to the old standard that said a POV had to make it over a 2" curb, but now that standard has been modified so that suppliers can quote the level of angle a POV can meet. "RESNA will need to have a performance motor standard. It's probably several years down the road, but they need to put this in — they don't have anything right now that guarantees the motor isn't junk," Kramer says.
The testing standards result in a certain amount of ambiguity upon interpretation. "We talk all the time about doing hill tests, making sure that motors don't fry when you use them the first time outside," Kramer says. "We send out news releases all the time about the power and stuff you need in the real world. Dr. Doran Edwards (SADMERC medical director) really tried hard on this, and he's a great guy, but there are a whole lot of other people involved that have a different agenda. Junky motors are dangerous as heck," says Kramer.
The allowables, released Oct. 2, spell bad news for the industry with proposed cuts to Medicare payments ranging from 21 to 41 percent.
Although the reimbursement cuts are most significant with higher-end power chairs, suppliers of POVs indicate that these cuts could potentially put providers out of business, with the extra costs of labor and time in meeting the documentation paperwork requirements and the added responsibility of in-home visits.
"It takes a lot of time and effort to get the doctor's records. A lot of dealers won't be able to do it anymore; they will have to turn some people away," Kramer says.
While the POV industry continues to grow, knowing how the dust will settle from all of the legislative and reimbursement changes is yet to be fully realized.
This article originally appeared in the November 2006 issue of Mobility Management.