NCART: "Increased Expenses Will Continue"
Mobility Management asked NCART
Executive Director Don Clayback and
NCART Associate Director Mickae
Lee for their perspectives on how the
COVID-19 pandemic will continue to
impact day-to-day Complex Rehab
Q: What long-term impacts do you
see for CRT and its stakeholders? For
example, we’ve seen that shipping delays
are slowing down production because
manufacturers cannot get the raw materials
A: CRT manufacturers and providers
are continuing to work both internally
and externally on finding solutions to
the many challenges from the pandemic.
While the hope is we will begin to see
improvements as we move farther into
the year, these issues will likely extend
through at least 2022 and likely longer.
These COVID-19 challenges have been
significant and continue to present major
difficulties to people with disabilities
having timely access to CRT equipment
and supporting services.
Supply chain issues have been costly
in terms of both extended delivery times
and increased freight costs. CRT products
typically consist of components from
multiple manufacturers to develop the
final CRT configuration (wheelchair bases,
seating and positioning items, specialty
controls). So you are relying on several
manufacturers, not just one, and each
manufacturer will have its own system
and shipping protocols. This compounds
the barriers and costs.
The shortage of computer chips has
a direct negative impact on access to
power wheelchairs and related electronic
equipment. The solution to much of this
relates to what progress will be made in
CRT manufacturers and providers
have incurred significant cost increases
on many fronts. These include increased
expenses related to provision of personal
protective equipment for employees
and customers, higher payroll expenses
due to the COVID-19 environment, and
the need to retain qualified staff in a
time of national workforce shortages,
major raises in freight charges, increased
material costs (product costs and related
surcharges), and higher distribution
expenses related to rising gas prices.
These are not short-term issues, and
solutions need to be provided so access
to CRT is not negatively impacted.
Q: We’ve seen the prices rise for
everything from gas to groceries. Other
retailers pass along costs to consumers…
but that’s not an option for CRT. Do you
anticipate that higher costs of doing
business will continue? How does this
impact various stakeholders, from manufacturers
to suppliers to consumers?
A: The expectation is that the
increased expenses mentioned above
will certainly continue based on the
new “operating environment.” As you
indicate, CRT is funded through a thirdparty
insurance plan system. So the real
challenge in protecting continued access
is getting needed increases in fee schedules
to cover these higher costs.
NCART and other stakeholders are
working with federal, state, and private
payors to obtain needed fee schedule
increases and other types of financial
assistance. It will be critical that these
increases be implemented so that CRT
access does not suffer.
Q: What can stakeholders do to preserve
access not just to CRT for consumers,
but also to preserve the development of
innovative new technologies?
A: Advocates need to do more of what
we have been doing. That is to educate
policy makers on what CRT is, the benefits
it brings, and the access barriers that
need to be eliminated. This increased
awareness and understanding will
accomplish two things. It will get needed
policies in place that will improve access,
which is critical. And, also important, it
will create a stable economic environment
that will encourage businesses to invest
in continued research and development.
A healthy marketplace will drive better
products and more competition.
This article originally appeared in the Jan/Feb 2022 issue of Mobility Management.