{"id":7039,"date":"2022-08-18T07:16:27","date_gmt":"2022-08-18T11:16:27","guid":{"rendered":"https:\/\/www.silvercentury.org\/?p=7039"},"modified":"2022-08-19T07:29:08","modified_gmt":"2022-08-19T11:29:08","slug":"colorado-passes-the-first-right-to-repair-bill-for-wheelchairs","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2022\/08\/colorado-passes-the-first-right-to-repair-bill-for-wheelchairs\/","title":{"rendered":"Colorado Passes the First Right-To-Repair Bill for Wheelchairs"},"content":{"rendered":"

When a power wheelchair stops working, that can totally immobilize the person who uses it, and getting it repaired is difficult and time consuming. In this article, journalist Markian Hawryluk digs deeply into why that\u2019s so, what Colorado is doing about it and why problems may persist. <\/span><\/i>Kaiser Health News<\/span><\/a> posted Hawryluk\u2019s article on June 2, 2022. It also ran on <\/span><\/i>U.S. News & World Report<\/a>.<\/span> Funding from the Silver Century Foundation helps KHN develop articles (like this one) on longevity and related health and social issues. <\/span><\/i><\/p>\n

Robin Bolduc isn\u2019t the type of person who takes \u201cno\u201d for an answer\u2014particularly when it comes to fixing her husband\u2019s wheelchair.<\/span><\/p>\n

Her husband, Bruce Goguen, 69, is paralyzed from multiple sclerosis. And without his chair, he would be stuck in bed, at risk of developing pneumonia or pressure sores that could lead to sepsis and death.<\/span><\/p>\n

When components of the chair wear out or break down, the road to repair is littered with obstacles. Recently, the Broomfield, CO, residents had to replace a button that Goguen presses with his head to control his wheelchair. They considered going through his wheelchair supplier for the repairs.<\/span><\/p>\n

\u201cIf we did that, he would literally be in bed for months,\u201d said Bolduc, who, along with her husband, is a member of the Colorado Cross-Disability Coalition, an advocacy group. \u201cThere\u2019s a quality-of-life issue\u2014he could be lying in bed staring at the ceiling. He has no movement without his wheelchair.\u201d<\/span><\/p>\n

But instead, Bolduc tracked down the manufacturer, ordered several buttons online for $20 each and discovered that replacing the part herself was simple.<\/span><\/p>\n

\u201cIt\u2019s a plug,\u201d she explained. \u201cIt\u2019s like charging your cellphone.\u201d<\/span><\/p>\n

The multibillion-dollar, power-wheelchair market is dominated by two national suppliers, <\/span>Numotion<\/span><\/a> and <\/span>National Seating and Mobility<\/span><\/a>. Both are owned by private equity firms that seek to increase profits and cut spending. One way they do that is by limiting what they spend on technicians and repairs, which, when combined with insurance and regulatory obstacles, frustrates wheelchair users seeking timely fixes.<\/span><\/p>\n

The $70 billion durable medical equipment market has been an attractive target for private equity investment because of the aging US population, the increasing prevalence of chronic conditions and a growing preference for older adults to be <\/span>treated at <\/span>home<\/span>,  according to the investment banking firm Provident Healthcare Partners. Medicare\u2019s use of competitive bidding favors large companies that can achieve economies of scale in manufacturing and administrative costs, often at the price of quality and customer service.<\/span><\/p>\n

Wheelchair suppliers usually keep few spare parts on hand and wait for approval from insurers to order more. <\/b><\/p><\/blockquote>\n

Regulations set by Medicare and adopted by most Medicaid and commercial health plans have led to lower-quality products, no coverage for preventive maintenance and enough red tape to bring wheelchairs to a halt.<\/span><\/p>\n

Power wheelchair users have long been fighting for the right to repair their wheelchairs themselves or through independent repair shops. Medicare and most insurance companies will replace complex wheelchairs only every five years. The wheelchair suppliers that have contracts with public and private health insurance plans restrict access to parts, tools and service manuals. They usually keep a limited inventory of parts on hand and wait until health plans approve repair claims before ordering parts.<\/span><\/p>\n

Some chairs require a software passcode or a physical key for any repairs. Wheelchair users who make fixes themselves may void their warranty or lose out on insurance payments for repairs.<\/span><\/p>\n

\u201cWhat bothers me is that the wheelchair company, knowing that the buttons wear out, won\u2019t keep any in stock,\u201d Bolduc said. \u201cThey\u2019ll risk my husband\u2019s life, but they won\u2019t risk $20 to buy a button and not get reimbursed for it.\u201d<\/span><\/p>\n

That could soon change. The Colorado legislature has passed a first-in-the-nation <\/span>right-to-repair bill<\/span><\/a> for power wheelchairs that will allow owners and independent repair shops to access parts, embedded software, tools and documentation needed to perform diagnostic, maintenance or repair services. Colorado Gov. Jared Polis is expected to sign the bill into law this month.<\/span><\/p>\n

The right-to-repair bill may help, said <\/span>Mark Schmeler<\/a>,<\/span> an associate professor of rehabilitation science and technology at the University of Pittsburgh, but it\u2019s not a perfect solution. \u201cThere is a serious problem with wheelchair repairs, and the consumers are basically crying out for help,\u201d he said.<\/span><\/p>\n

Part of the problem, Schmeler said, is a Medicare decision not to cover preventive maintenance for power wheelchairs. Many wheelchair users are unfamiliar with or unable to do routine maintenance, such as tightening the bolts or cleaning the casters. As a result, problems aren\u2019t addressed until something breaks down, often leaving the user stranded.<\/span><\/p>\n

Suppliers tend to lose money on repairs, so they have little incentive to hire more technicians.<\/b><\/p><\/blockquote>\n

Additionally, Medicare officials have interpreted the statute establishing payment for durable medical equipment to cover wheelchairs only for in-home use. Consequently, many power wheelchairs aren\u2019t designed for outdoor use and are prone to failures when users take them outside. \u201cIt\u2019s like you\u2019re outside walking around all day with your slippers on,\u201d Schmeler said.<\/span><\/p>\n

When Medicare adopted competitive bidding for durable medical equipment in 2011, it allowed large companies to undercut the pricing of smaller, local wheelchair shops. Numotion and National Seating and Mobility bought out many smaller companies and now dominate the market.<\/span><\/p>\n

Competitive bidding encourages suppliers to press manufacturers for lower-cost wheelchairs, which spurs manufacturers to use lower-quality parts. More than one in four repairs results in users being stranded, missing a medical appointment or missing work, according to <\/span>a study<\/span><\/a> published in 2016 in the journal Archives of Physical Medicine and Rehabilitation.<\/span><\/p>\n

Wheelchair suppliers make most of their money by selling the wheelchair and tend to lose money on repairs. So there is little incentive to hire more technicians or pay for training.<\/span><\/p>\n

Suppliers testified against the Colorado bill. \u201cThe problem with this legislation is that it does not provide a good solution to address the problems responsible for the delays,\u201d said Seth Johnson, senior vice president of government affairs for Pride Mobility Products, a Duryea, Pennsylvania-based supplier of power wheelchairs. If repairs are done incorrectly, he said, patient safety could be jeopardized.<\/span><\/p>\n

Medicare regulations add to the problems, with low reimbursements, and Medicare pays only for parts and labor, not for technicians\u2019 travel time. Another cause for delays: Medicare sometimes requires physicians to document that an individual still needs a wheelchair and that it needs to be repaired.<\/span><\/p>\n

Kenny Maestas of Lamar, CO, has been in a wheelchair since his spine was severed during a rollover vehicle accident in 1987. His wheelchair supplier, located more than 150 miles away, won\u2019t schedule a repair visit unless it has another client nearby that needs a repair. When his battery begins to die and won\u2019t hold a charge, he becomes tethered to an outlet, unable to leave his home for more than 20 to 30 minutes at a time until the supplier replaces the battery.<\/span><\/p>\n

\u201cIt\u2019s such a broken system,\u201d Maestas said.<\/span><\/p>\n

Given the right to repair, wheelchair users can buy parts and do the work themselves or go to independent repair shops. <\/b><\/p><\/blockquote>\n

Julie Jennings, 56, of Denver, was diagnosed with multiple sclerosis in 1995 and now can\u2019t walk.<\/span><\/p>\n

She described a lengthy ordeal to get even a simple wheelchair fix\u2014the supplier waited for insurance to approve the repair before ordering the parts. The last time she needed a repair visit\u2014to replace the battery, armrests, and a joystick controller\u2014the entire process took three months.<\/span><\/p>\n

\u201cI try to be proactive, and I try to keep an eye on the wear and tear,\u201d she said.<\/span><\/p>\n

The right to repair could help reduce the kind of delays that Maestas and Jennings have experienced by allowing users to purchase the parts and repair the wheelchairs themselves or to call in independent repair shops.<\/span><\/p>\n

Consumer advocates with the Colorado Public Interest Research Group said the power-wheelchair industry is the first sector required to provide repair access since Massachusetts voters approved a right-to-repair measure for cars through a 2012 ballot initiative.<\/span><\/p>\n

Car manufacturers decided they didn\u2019t want to fight that battle in all 50 states and opted to apply the same standard across the country.<\/span><\/p>\n

Don Clayback, executive director of the National Coalition for Assistive and Rehab Technology, an industry group representing wheelchair suppliers, said whether the industry would change its policies nationwide was unclear. \u201cWe would expect changes will be limited to Colorado,\u201d he said.<\/span><\/p>\n

Last year, President Joe Biden issued an executive order that directed the Federal Trade Commission to draft regulations that limit manufacturers\u2019 ability to restrict independent repairs of their products. At least three right-to-repair bills have been introduced in Congress this year. Massachusetts and Pennsylvania are also considering bills that address wheelchair repairs.<\/span><\/p>\n

For now, Bolduc is prepared to go to any length to get her husband\u2019s chair repaired. Once, she took away an uncooperative technician\u2019s keys until he fixed the wheelchair. She then returned his keys and gave him a big candy bar to smooth things over.<\/span><\/p>\n

\u201cThey\u2019ll turn me into this crazy woman because my husband\u2019s life is on the line,\u201d she said. \u201cIf I have to kidnap somebody to get his chair fixed, I\u2019ll do it.\u201d<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Robin Bolduc isn\u2019t the type of person who takes \u201cno\u201d for an answer\u2014particularly when it comes to fixing her husband\u2019s wheelchair.<\/span><\/p>\n

Read more Colorado Passes the First Right-To-Repair Bill for Wheelchairs<\/span> ›<\/span><\/a><\/div>\n

<\/p>\n","protected":false},"author":61,"featured_media":7040,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"_FSMCFIC_featured_image_caption":"","_FSMCFIC_featured_image_nocaption":null,"_FSMCFIC_featured_image_hide":null,"footnotes":""},"categories":[49,7,4,20],"tags":[],"class_list":["post-7039","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-featured","category-healthspan","category-issues-in-aging","category-supports"],"cc_featured_image_caption":{"caption_text":"","source_text":"","source_url":""},"wps_subtitle":"But there\u2019s still no easy fix for wheelchair users","_links":{"self":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/7039","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/users\/61"}],"replies":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/comments?post=7039"}],"version-history":[{"count":6,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/7039\/revisions"}],"predecessor-version":[{"id":7048,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/7039\/revisions\/7048"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/media\/7040"}],"wp:attachment":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/media?parent=7039"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/categories?post=7039"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/tags?post=7039"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}