PIGGY BANKS: QUINCECREATIVE/PIXABAY
While there are many benefits of managing
posture 24 hours a day, getting funding for
this equipment can be a challenge.
“There are frustrations over preventative
measures with some funding sources,”
said Ryan Rhodes, MS, OTR/L, ATP/SMS,
Pediatric Sales Specialist for Leckey at
Sunrise Medical. One example: “Some
won’t pay for a cheap shower chair for our
elderly population because third-party
funding does not find it medically necessary.
But they’ll pay $100,000-plus for
surgeries, hospital stays, therapy and home
care when [the client] falls and breaks a hip.
“Same thing with postural supports.
If we’re only sitting them in a beanbag
or a chair, five years from now, we
could be doing full-on spinal surgery
with Harrington rods, or we may have a
permanently dislocated hip that we now
have to manage with pain medication and
palliative care, which is not cheap and that
we could have avoided with a $2000 piece
of equipment 10 years ago.”
Rhodes recalled working as an occupational
therapist is Louisville, Ky., when
“we were very blessed with what was
funded. When a kiddo came in, I would
write a letter for a new mobility piece of
equipment, some sort of specialty bed
with a specialty mattress, a car seat if
necessary, a bath chair, a standing frame,
a gait trainer, an activity seat — all of it for
24-hour positioning.
“We’d talk about activities of daily living,
bathing, toileting. ‘Mom and Dad, how are
you doing with these transfers? What can
I help with on that?’ All while looking into
the future with the lens of avoiding further
complications to improve quality of life.”
Matching the Optimal Equipment
to the Activity
Linda Bollinger, PT, DPT, ATP/SMS,
Pediatric Sales Specialist for Leckey
at Sunrise Medical, said some payors
question the need for multiple pieces of
positioning equipment.
“We’re challenged by funding approving
all these devices,” she explained. “‘Do you
need a stander and a gait trainer?’ Well,
yes: For standing, we want to try to develop
the hip, and we’re looking to try to elongate,
and with a gait trainer, we’re trying
to increase functional gait and ambulation.
They’re not mutually exclusive. Funding is
sometimes also a challenge for bath seats,
the Sleepform [sleeping] system, toileting
systems: ‘Why do you need a bath seat and
a toileting seat?’”
Bollinger said she still recommends the
equipment she believes will best serve the
child. “Every funding source is different,
but as a therapist, I recommend what they
need and let the chips fall where they may
in trying to get funding,” she said. “Look
for alternative funding: Is there a waiver,
is there a great aunt who can pay for it, is
there a fundraiser?
“I think sometimes therapists are
reluctant to recommend so much
equipment, but if we make those clinical
recommendations and then address the
funding afterwards, I think the outcomes
are better. If the therapist is comfortable
with the seating system being the same in
the mobility base and the activity [base],
then that works out. But if they’re looking
for two alternatives — so in the mobility
base, I want this to be achieved, and in the
activity seat, I want this — then that might
be a challenge. That’s for the clinical team
to decide. Are they looking for multiple
[pieces of equipment] because they’re
trying to achieve alternative positioning?
Or are they looking to have that same
position and consistency? It just depends
on how they’re approaching each child.
Every child has different needs.”