Karen Miner Advocates for People with Spinal Cord Injuries

Karen Miner of Roseville, Calif., suffered a spinal cord injury in an automobile accident 19 years ago, and has been in a wheelchair ever since. But don’t tell her that she’s confined to a wheelchair because she believes her power wheelchair allows her to be independent.

“For people like me, a wheelchair is something that gives you freedom,’’ said Miner, a quadriplegic. At age 60, she’s still able to live by herself with somebody coming in for short periods in the morning and evening.

Miner was recently quoted in a story written by Michael Reinemer at the American Association for Homecare, and she is quoted in the April 2012 issue’s AAHomecare Update column on page 41. She criticized policies implemented by the Centers for Medicare & Medicaid Services (CMS) that are restricting access to power mobility devices.

“I’m very disappointed in the people at CMS responsible for this,’’ she told AAHomecare.
In a telephone interview with HomeCare magazine, Miner said the nation needs a strong shot of common sense added to its approach to power mobility. “Common sense just isn’t that common,’’ she said.

The big problem is a one-size-fits-all strategy to many patients needing power mobility, she said. For example, insurance purchased her first wheelchair, and it served her well for several years. Then Medicare helped purchase another chair that cost $20,000, and it didn’t fit properly. She couldn’t return it, and eventually gave it away to somebody who could use it. She ended up purchasing the next one herself, for $7,000.

“It was lucky that I could afford it,’’ she said. “Many people can’t.’’

Poorly fitted wheelchairs are a constant problem, she said. Just look at the Craigslist ads for power wheelchairs that have only been used once. “A lot of people don’t get fitted,’’ she said. “That’s so important.”

Without a proper fitting, patients run serious risks of pressure sores and other health problems. Unfortunately, government reimbursement policies can lead to more difficulty accessing the expert care many power wheelchair users need.

For example, the provider who fitted and supplied Miner’s current chair did a good job. But that provider no longer handles wheelchairs, and has shifted to other, more profitable HME products. “A lot of people are getting out of the wheelchair business,’’ Miner said.

The exodus of power wheelchair providers is particularly troublesome in areas affected by Round 1 of Medicare’s Competitive Bidding Program. For instance, the number of active suppliers for standard power wheelchairs in the Cleveland-Elyria-Mentor, Ohio, Competitive Bidding Area dropped from 120 to 13 after the program started in 2011. Active providers of complex rehab power wheelchairs dropped from 114 to five.

Miner said reducing the number of providers also reduces the number of choices for people who need power mobility devices.

There are now 1.3 million Americans with spinal cord injuries, and they all have different needs, she said. “There isn’t one size that fits all.’’