AT Reutilization Programs have never been more important! Read the latest AT3 Center Issue Brief.
Rollators and walkers may not be on the FDA’s medical device shortage list, but acquiring them, along with other new durable medical equipment (DME), has run up against waves of supply chain challenges in the last year. In 2020, the COVID-19 pandemic sensitized the nation to the public health risks inherent to shortages of masks and ventilators. Two years into the pandemic, supply chain issues have rippled well beyond the ER and personal protective equipment to include non-COVID-related medical supplies.
“We’re up against some of the same problems faced by other industries, including insufficient labor to load or offload trucks carrying medical supplies and devices, as well as just regular supplies. [….] There also aren’t enough truck drivers to deliver everything, and general labor shortages,” observes Allison De Paoli, a healthcare benefits consultant (in Employment Benefit News). Shortages of raw materials also impact supplies; the price of aluminum has more than doubled in the last two years. Nationwide, hospitals face inadequate inventories of walkers, wheelchairs, crutches, and even exam tables and plastic bedpans. Last September, one medical equipment supplier reported that bedside commodes were back-ordered for three to four months. “That’s an item you usually can order and get right away,” Cindy Juhas, CMEs chief strategy officer, told Reuters.
The result has been delays in consumers obtaining the equipment they need to be safe and independent or even discharged home, in some cases creating a bottleneck preventing hospital admissions. The result has also been a new role for AT Reutilization Programs.
What is AT Reutilization?
Assistive Technology Reutilization Programs support the reuse of assistive technology—often durable medical equipment—that is no longer needed or used by the original owner. AT reuse activities include refurbishment (previously owned devices are cleaned, repaired, and/or reconditioned and then provided to new owners) and device exchange (e.g., online classifieds). In some reutilization programs, a device is provided on an open-ended loan basis until the recipient no longer needs it.
AT Reutilization Helps Fill Gaps
Obstacles to obtaining durable medical equipment are usually inadequate insurance coverage or long waits for the delivery of complex customized devices. Medicaid may replace a wheelchair every five years only; children can grow faster than their equipment can adapt; backup equipment is often not provided should a primary device need repair; additional (unfunded) equipment is needed for use in the community. AT Act Programs and their reuse partners work to fill these gaps, sometimes coordinating networks of providers to achieve statewide coverage. Now that supply chain challenges are creating new and extended delays, the work of these programs is even more essential.
Tens of Thousands of Devices Are Reused Each Year
AT Act Programs have a history of working together across the states and territories to provide reuse equipment for national emergencies, including disaster recovery. Three states also have partnerships with Medicaid to refurbish and reassign gently-used equipment to speed consumer acquisition, stretch dollars, and preserve Medicaid’s DME benefit for additional needs by the consumer. In FFY21, despite the pandemic, AT Reuse Programs nationwide reassigned more than 68,000 devices to 49,500 recipients. Over 90% of recipients report they could not have obtained the equipment any other way.
Spotlight on Virginia
In September of 2021 and again in January of 2022, hospitals in southwestern Virginia had to delay discharging patients because the bedside commodes and rolling walkers they needed for safety and independence were unavailable. At the same time, these hospitals had overcrowded emergency rooms because admissions were not possible due to a shortage of beds. For weeks, the Virginia AT Act Program reuse partner, the Foundation for Rehabilitation Equipment and Endowment (F.R.E.E.), had the only available inventory of these basic DME items on hand.
“Discharge planners contacted F.R.E.E. and explained that there were no rolling walkers available due to the aluminum shortage, staffing shortages, and shipping delays,” reports VATS Director Barclay Shepard. “DME vendors said that equipment was, ‘Stuck on freight boats in the Atlantic.’” Shepard says F.R.E.E. immediately stepped in and delivered a load of gently-used and sanitized rolling walkers, bedside commodes, and crutches within 24 hours of the request. As a result, patients could be safely discharged home. “F.R.E.E. is maintaining stockpiles of DME in anticipation of meeting an ongoing demand in this time of crisis,” Shepard says.
Download the latest AT3 Center Issue Brief: Supply Chain Challenges.
Refurbished Walkers and Wheelchairs Fill Gaps Created by Supply Chain Problems (Kaiser Health News)