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AT Program News
News for and from the State AT Act Programs, the Alternative Financing Programs, and their community partners

November 2011 "The Reuse Edition"
In This Issue
The Reuse ReMEDy for Birmingham
Nebraska's AT4ALL (Does It All)
Vermont AT Reuse Project Receives Governor's Award
Christmas Comes Early Through ReMEDy
Pass It On Center Happenings
Jack's Story
The Reuse ReMEDy for Birmingham

Birmingham Baptist Association taps a deep need for durable medical equipment with the help of STAR, Alabama's Assistive Technology Resource

Over the last fifteen years, Alabama's STAR Program
STAR logo
(through the Dept. of Rehabilitation Services) has used its limited federal AT Act dollars to develop a statewide network of equipment reuse programs through public-private partnerships. It's a model the Pass It On Center--the national provider of reuse program technical assistance--has been working to highlight. STAR's diverse partners range from disability services organizations, like Easter Seals and United Cerebral Palsy, to low-income and faith-based charities, like Goodwill and the Birmingham Baptist Association (BBA). STAR offers its modest grants to community-based organizations that already have the infrastructure, sense of purpose, and community roots to nurture and establish successful reuse initiatives within their communities. In return, equipment reuse programs are often effective outreach for their private partners, raising awareness of the full range of services their host agencies provide.

Reused Medical Equipment Donated by you (ReMEDy) is one such program. It started in 2009 when a long-established faith-based charity--the Birmingham Baptist Association (BBA)--applied for STAR support to begin a durable medical equipment (DME) reuse project in western Birmingham. Although Birmingham is Alabama's largest city (pop. 212,000), up until that time people seeking refurbished power chairs, gently used walkers, shower chairs, etc. had to drive the 60 miles to STAR's Reclaim/Refurbish/Reuse (3-R) Project in Anniston. This was true despite the logical need for DME reuse in a city where 27.8% of residents live at or below the poverty line and nearly a third of whom do so with some form of disability (2010 US Census data).

ReMEDy has now completed two years of service and despite limited marketing, word has gotten out. According to Jim Branum, a missionary with BBA and ReMEDy's program director, since inception they have received 644 requests; but last August they received 85 in the one month alone. "We knew we were just scratching the surface of the need here," Branum acknowledges. Still the program is having an impact. So far 466 items have been donated to the program and 326 have been reassigned for long term loan. Indeed, ReMEDy estimates it has saved consumers a total of $233,191 to date.

What helped successfully launch ReMEDy and what has the program learned along the way? AT Program News had the opportunity to speak with both Branum and Helen Baker, executive director of Alabama's STAR Program. Below is more of what they shared.

Origins

According to Branum, Debbie Duke, director of Congregational Nursing Program for Baptist Health System (BHS), "clocked a lot of time driving to Anniston for equipment until she asked why we didn't have a reuse program right here." BBA is the parent organization to BHS (which runs four hospitals). 3-R Project staff referred Duke to Helen Baker, executive director of Alabama's STAR Program to discuss the idea. "The answer, it turned out, was that no one had ever asked before."

In 2007, Duke brought the situation to the attention of Princeton Hospital's Director of Chaplains, Lynn Gavin who helped run with the idea. "He was frustrated advocating for seniors, learning that insurance providers wouldn't pay the $85 for a shower chair. He wanted other options." Gavin helped pulled together meetings with reps from BHS and BBA. Eventually BBA Director Mike McLemore, and others from BBA (including Branum) went to meet with Baker.

BBA's Community Assets

For BBA, identifying the need for a DME reuse project met with perfect timing. In 2009, BBA was in the process of creating initiatives for a new ministry center in western Birmingham--the Center at Central Park. The Center would re-purpose a large BBA church facility that had once housed a congregation of close to 3,000 people and was now down to fewer than 100. There was space to adopt. Also helpful was the Center's location; western Birmingham is a distressed community in need of revitalization, and an ideal location for a program offering free durable medical equipment. Of course it helped, too, that BBA has an over 100 year history of operation within the community including the provision of health care. Today ReMEDy is the Center's cornerstone initiative, anchoring and raising awareness of other Center offerings.

Program Nuts and Bolts:
  • Two half-time staff members operate the program. Branum and an administrative assistant, Myra Patterson, are tracking data, writing grants, training and coordinating volunteers, sanitizing and finding storage for equipment, and responding to community requests and donations.
  • Marketing has been largely word-of-mouth, both through established healthcare networks and among community members served.
  • Equipment transport is provided by equipment donors and recipients whenever possible, and by program staff when not.
  • ReMEDy provides a monthly inventory to STAR that is incorporated with other reuse centers' inventories and posted on the STAR Program Web page. (STAR is looking at converting to the AT4ALL data system--see the AT4ALL article this edition).
Additional Program Partners:
  • The Community Foundation of Birmingham provides a $15,000 grant.
  • AT&T organizes a twice-yearly equipment drive among its 2000+ area employees.
  • In addition to BBA, local churches--including the United Methodist church across the street--donate storage space, volunteers, and financial support.
Lessons Learned:
  • Do not reinvent the wheel. "One of the keys to starting a program," Branum asserts, "is that you go see one that is active." Branum and McLemore studied how the 3-R program in Anniston is organized. Eventually Branum also visited the Huntsville and Montgomery programs, as well as FODAC in the neighboring state of Georgia. Branum learned about sanitizing equipment, storage, inventory, and policies and procedures through the PIOC online knowledge base, and by attending two PIOC conferences in Atlanta.
  • Negotiate your liability insurance at the outset. BBA's insurance provider would not cover a DME reuse program that includes equipment involving breathing or blood, and ReMEDy had to assure that they would have safe practices with the mobility and seating equipment they loan out.
  • Get trained on data reporting. Branum credits Baker for providing training on how to effectively track and report data. STAR requires that certain data be consistently collected and reported as a requirement of the STAR grant.
  • Document as you train others. Branum is creating a manual he calls "The ReMEDy System" to house all the necessary forms and other program documentation, policies and procedures, and systems for program operation. "It's hugely complicated if you don't grow up with it," he realizes. On the statewide level, Baker is also making use of the ReMEDy start up experience, and is at work on a manual: "How to Start a Reuse Center" which will include a policies and procedures template.
  • Be flexible with equipment transport. "Our program would be in its infancy if we had said from the outset that we would never collect or deliver equipment. We had to be willing to go to people's homes and work with them." Branum has been using his own vehicle and trailer, but recently received a donated cargo van for this purpose.
  • Keep learning. Branum is facing challenges with building the program's capacity to meet the rising demand for services. He plans to explore Americorp/Vista internships and additional grant sources. Baker is looking to bring together additional stakeholders to discuss ongoing sustainability.
  • Create a network of reuse programs. On the state level, Baker is working to connect the STAR reuse programs more closely for sharing and problem-solving. She has recommended, and is in the process of developing, a statewide AT Reuse Network and Summit among other initiatives.
Learn more about the Alabama STAR reuse network:

Check out the PIOC 08/31/11 webinar on partnerships to expand reuse. Helen Baker provides a lively overview of the STAR reuse network.

Contact: Helen Baker, executive director of Alabama's STAR Program

Explore PIOC Knowledge Base modules:
  • A model reuse program operating budget is available under Finance>Budgeting
  • Marketing/PR provides over a dozen articles ranging from "Community awareness--developing a strategy" to targeted advice, such as "Press Releases--how to use."
  • Sustainability offers strategies ranging from capacity building and funding to stakeholder engagement.
Nebraska's AT4ALL (Does It All)

AT 4 ALL logo. An overview of Nebraska's popular equipment reutilization platform from Program Coordinator Barbara Schultz

Our Web site address evokes our mission statement--assistive technology 4 all ages, disabilities, and locations in Nebraska--but our impact has gone beyond state lines. AT4ALL.com was developed in 2005 to help Nebraska achieve its statewide mission by providing an easy online tool for individuals with disabilities and others to learn about and locate assistive technology. Today 12 additional states have adopted the platform, customized for their own use.

AT4ALL's structure is popular because its database is integrated. The site allows users to search for equipment available for demonstration, short-term loan, or reuse (sale or donation) in just one step, utilizing one search box. Users may also list equipment to sell or give away, or they may post "want ads" for items they cannot find. Visitors exploring the site to learn about AT by category are also directed to find what is available to try from those pages. In short, the site quickly takes visitors from learning and exploration to the opportunity "try before they buy."

Benefits for consumers and professionals
  • Visitors to the site can browse recent listings and search for equipment by name, category, zip code, price or whether an item is free, for sale, loan or demonstration. Photos and links to the manufacturers are included and items can be bookmarked for future reference.
  • Persons who do not have access to the internet can call for assistance to access the equipment available on the website.
  • In Nebraska, in-state partners utilize the site to share their equipment, including the Commission for the Deaf and Hard of Hearing, Commission for the Blind and Visually Impaired, Centers for Independent Living, schools, and non-profit organizations.
Benefits for administrators
  • Streamlines federal reporting. The site tracks inventory and activity (equipment loaned, reused, exchanged, as well as demonstrations), generates a variety of reports, and uses a federal auditing tool developed by Nebraska (to flag issues that need addressing).
  • Provides tools for managing site activity. This includes automatic email reminders/overdue equipment notices and a Loan Agreement Form. The form printed for transactions includes the device's Web site ID number, its value, and the borrower's information. Terms, a liability statement, and the user's signature are also included, along with the required federal satisfaction survey.
  • Includes a Quick Start Guide for users and a resource manual for managers.
Lessons learned

✓The database template is adaptable and expandable as states' needs change or federal reporting requirements shift.

✓ Expanded usage across states assures usability with emerging technologies and 508 compliance.

For the states in this consortium, the relationship is "win-win." Each state program shares in the cost of hosting the Web site and votes on annual upgrades. Three additional states are considering the database to manage their program in 2012.

Interested? For more information contact me:
(402) 471-1301 barbara.schultz@nebraska.gov
Vermont AT Reuse Project Receives Governor's Award

Project Coordinator Sharon Alderman attributes recognition, in part, to the growth of Vermont's AT School Exchange

Logo for the VT AT Reuse Project showing New England states with VT highlighted and recycle arrows. Also VT Family Network logo.

Congratulations are in order to the Vermont Assistive Technology (VT AT) Reuse Project. In June the project received the 2011 Governor's Award for Environmental Conservation Excellence in Justice and Sustainability. VT AT Reuse initiatives include the Medicaid Equipment Reuse Project (recapturing publically-funded durable medical equipment for those who need it), the Assistive Technology Exchange in New England (a Craig's list style device "swap and shop"), and the Assistive Technology Exchange for Vermont Schools (helping share equipment among schools). "We received the award because our programs effectively and uniquely achieve the award's ideals," notes VT AT Reuse Coordinator Sharon Alderman. "We're lucky to operate in a state that values both environmental conservation and economic justice." Indeed, in federal fiscal year 2010, VT AT Reuse helped find a second life for over 285 Adapted Vehicles, DME and AT items, keeping many devices out of landfills and closets and in the hands of Vermonters with disabilities.

AT School Swap Now Includes 57% of Vermont's Supervisory Unions/Districts

Alderman is particularly encouraged by the growth of the AT Exchange for Vermont Schools (AT School Swap). The initiative helps Vermont schools share AT for the benefit of students with special needs. In June of 2009, nine months after launch, the AT School Swap had 16 VT Supervisory Unions signed on to share unused AT. As of October 2011, the program has grown to include 34 participating Supervisory Unions, 57% of the state's total. "It's steady growth. It doesn't yet reflect big savings to schools--just $19,000 in FY2010--but we're getting there."

The AT School Swap concept began as a way to keep devices out of school closets and with students who need them. As student needs change or they graduate or move out of district, many items go unused. By learning about and agreeing to exchange unutilized equipment, schools would have affordable fast access to AT. The first task, however, was getting schools on board.

Alderman believes Vermont is succeeding because it's flexible with how people use and access the School Swap. Participants do not have to share or sell anything they don't want to, and they learn about available and needed equipment in different ways. "We started with a web-based approach akin to the getATstuff platform [the Web site for the AT Exchange in New England]. But we realized that the School Swap site would have to be just one tool among many needed to establish a reuse network with schools." Alderman estimates that 40-50% of AT School Swap users do not make use of the Web site directly and prefer email and the toll free number. "Monthly email updates are a reminder that we're here, that equipment is available, and it puts school system needs under the noses of authorized swap-users around the state. Swap participants don't have to remember to periodically go to the site to search equipment. But we are encouraging them to post there, and slowly it is happening."

A web-based school swap system may be achievable, even inevitable, down the road. But in the meantime, Alderman's "coordinator" position is aptly titled. Alderman and her interns learn of available equipment, and devices sought, by phone and email (often in response to their monthly email), and frequently connect donors and sellers with recipients.

An AT Reuse Concierge?

Providing reuse "concierge" services is achievable in a state with a population that's not quite 626,000 (2010 Census), and builds program buy-in among participants--who in the case of the AT School Swap are school personnel in a position to network with one another. Alderman, however, has also become a point person for reused AT among state agencies, the medical community (including skilled nursing facilities and rehabilitation centers), private non profits, and most recently the Vermont FEMA disability coordinator (post Tropical Storm Irene). And she is able to directly assist individual consumers; the getATstuff site allows administrators to see visitors and what listings they view, which means she may contact them to offer help.

VT AT Program staff recieve the governor's award for environmental justice and sustainability.
VT AT Program staff accept Governor's Award
Indeed with the research assistance of Alderman and her interns, Vermont schools, individuals and families, nursing facilities, non profits and others have received devices through in-state as well as interstate initiatives. Reuse programs as far away as Kansas and Georgia have provided equipment to Vermonters with specific needs.

Congratulations Vermont!

VT AT Reuse Project Nuts and Bolts:
  • 1 full-time project coordinator initially funded through a Medicaid infrastructure grant.
  • 2 part-time skilled interns majoring in marketing and mechanical/bio medical engineering at area colleges. Alderman's interns have created marketing materials and press releases as well as data tracking systems.
  • $1,447,707 have been saved by consumers (over the cost of new equipment) since the VT AT Reuse Project's inception in FY2008.

Project Partners:

  • VT AT Reuse Project is an initiative of the VT Assistive Technology Program which is part of the Dept. of Disabilities, Aging, and Independent Living and the VT Family Network (a private non profit).
  • GetATStuff.com was developed and is maintained by a consortium of the six New England states.
  • The AT School Swap platform is maintained by 3 states of this consortium: VT, CT, and MA (site improvements are ongoing),
  • ReSTORE in Barre, a division of ReSource in VT, has initiated an AT-DME area with the support and technical assistance of the AT Reuse Project (and an initial donation of medical equipment from New England Medical to the VT AT Program).
  • Yankee Medical and other DME vendors are providing additional supports to the project.
Learn more:

Download the Vermont AT School Swap Power Point. This is a very detailed overview of VT's AT School Swap which Alderman presented last January at ATIA 2011 Orlando.

Attend "Optimizing AT Resources in Schools: School Swap and More" on Saturday, Jan. 28th at ATIA 2012 Orlando presented by Sharon Alderman with Liz Persaud and Carolyn Phillips of the Pass It On Center.

Contact:

Sharon Alderman
project coordinator, VT AT Reuse Project
Nationwide Toll Free 1-888-827-2714
Quick Links
Christmas Comes Early Through ReMEDy


By Jim Branum

ReMEDy client in new power wheelchair smiling. ReMEDy has many success stories. After all, the goal of the program is to loan used durable medical equipment to people who are unable to otherwise purchase what they need. So you can understand that we feel like it is Christmas every day we go to work and get to see the faces of the people we are able to serve.


The story of C.M. is one such success story. It begins with Carolyn, a member of one of our Birmingham Baptist Association Churches (BBA), who worked at a metal manufacturing company in the western area of the city. She would see C.M. every day that it was not raining. He would pass by her place of business pulling a rolling, plastic trash can tied by ropes to the back of his wheelchair. C.M. made his living by making a daily trip picking up aluminum cans and taking them--using his wheelchair--to a local recycling center. His daily journey started from where he lived, which was a 10-by-20 storage building he rented located in the back yard of his landlord's house, and continued out through the streets of Birmingham, passing businesses that would save cans for him. He would then return home going down different streets collecting cans beside the road.


C.M. had lost both legs some 50 years earlier in an accident, but he seemed to me to be one of the happiest people I have known. In the yard outside his storage building home were old wheelchair parts that C.M. would use to repair his manual chair when it broke down from everyday use. He also had an old, worn-out, power chair that no longer worked.


One day, while stopping at Carolyn's business, C.M. asked her if the men at her company would try and fix the power chair for him. They agreed to try. For the next 6 months they had it at the business, working on it. But they never could get the old power chair to work.

So eventually Carolyn called her church. She was referred to the BBA to ask if there was any help for C.M. through the different BBA ministries. That is when she called and spoke with me at ReMEDy.


I called C.M. and asked if he would agree to replace his old power chair for a loaner--a beautiful working power chair through the ReMEDy program. He agreed. And so I used my truck and trailer, got the old chair out of the way, and delivered C.M. his new chair (after providing him with safety and operational training).

I wish I could share the look on his face! It was as if Christmas had arrived as C.M. transferred over from his old, worn-out, pieced-together manual wheelchair into the working power chair loaned to him for as long as he'd need it.

Jim Branum is the director of ReMEDy, a durable medical equipment reuse program operated by the Birmingham Baptist Association in partnership with STAR, Alabama's Assistive Technology Act Program.

Pass It On Center Happenings

The Pass It On Center is the provider of technical assistance to AT reuse programs nationally. PIOC provides site visits to established and emerging programs, offers webinars, teleconferences, and workshops for training purposes, and organizes reuse summits to foster regional collaboration and planning. The PIOC Web site is a deep resource of toolkits, archived webinars, and a "knowledge base" that includes everything from how to sanitize equipment to advice with choosing board members. Below are some recent and upcoming PIOC happenings.

California site visit:

This past summer, PIOC Director Carolyn Phillips was invited to visit the Ed Roberts Center (for independent living) in Berkeley, CA. The new Center is a model of thoughtful accessible design.

Ed Roberts CIL interior with spiral ramp.
Ed Roberts Center interior
Phillips was in Berkeley as part of a PIOC team to advise on the design of a new AT Reuse Center to be constructed on the site of the former CIL.

Carolyn with Yomi, a child in a chair on the site of the former CIL.
Carolyn Phillips with Yomi on the site of the former CIL.

Upcoming Webinars:

Five years ago, the Department of Education funded 12 projects that showed promise as models of how to expand AT Reuse. In Novemeber and December, PIOC's Joy Kniskern and Trish Redmon will review what the grantees proposed, what they have accomplished, and some lessons learned with regards to sustainability and outcomes during the following webinars:

November 29, 2011
Sustainability: Lessons Learned from the 12 Demonstration Projects
2:00pm to 3:30pm EST

December 13, 2011
Outcomes: Lessons Learned from the 12 Demonstration Projects
2:00pm to 3:30pm EST

Access them at the PIOC Webinars page

Reuse Workshops at ATIA Orlando:

The Assistive Technology Industry Association is holding its annual ATIA Orlando conference from January 25-28th, 2012. The PIOC is teaming with reuse programs from around the country to provide a reuse strand of workshops including:

Thursday, Jan 26th
8 a.m. to 9 a.m.
The Trend of Reused AT for Sensory Disabilities.
Martha E. Rust, Sara Sack, Liz Persaud

1:15 pm to 2:15 pm
Meeting Community Needs Through AT Reuse Programs
Joy Kniskern, Barclay Shepard, Sonja Schaible, Liz Persaud

2:35 pm to 3:35 pm
"i" Am Ready: "Apps" for Emergency Preparedness
Liz Persaud, Amy Goldman

4:00 pm to 5:00 pm
Filling the Gap! AT Reuse Helps School and Community Transition
Liz Persaud, Carolyn Phillips, Joy Kniskern, Lindsey Bean-Kampwerth

Friday, Jan. 27th
8 a.m. to 9 a.m.
AT Reuse is Making Environmental and Community Access Possible
Carolyn Phillips, Liz Persaud, Lindsey Bean-Kampwerth

4:00 pm to 5:00 pm
Including AT, AT Reuse, and Emergency Preparedness in Pre-service Training
Amy Goldman, Sara Sack, Liz Persaud

Saturday, Jan. 28th
8 a.m. to 9 a.m.
Optimizing AT Resources in Schools: School Swap and More
Liz Persaud, Carolyn Phillips, Sharon Alderman

Learn more at this ATIA Orlando Web page
Jack's Story

by Kristine Godin

Jack smiling in his stander.


Jack is a middle school student who likes watching hockey, playing video games, and his favorite school subject is Spanish. For this past September, Jack needed a stander. The stander he had used at school was on loan and had to be returned, and the new school year was fast approaching.

Jean, Jack's physical therapist, learned of getATstuff.com and the Assistive Technology School Exchange (AT School Swap) through Marcy, an occupational therapist at Jack's middle school. Marcy uses getATstuff.com (the AT Exchange for New England) and is a Vermont AT School Swap authorized user. Unable to locate a stander on either Web site, however, Jean called Sharon, the Vermont Assistive Technology Reuse Project coordinator. Sharon knew of equipment retrieved through the Medicaid Equipment Reuse Program that was not yet listed on either Web site. Soon she located a stander less than a year old: an Easy-Stand EVOLV with features especially appropriate and desirable for Jack.

Finding the stander so quickly has provided immediate benefits for Jack and his family. For one, Jack's home stander does not have to be moved to and from school. This would be a cumbersome task considering how difficult it is to fit a stander in his family's vehicle. Also, this stander allows Jack the option to do school work while standing or sitting. Jack likes standing because it helps strengthen his leg muscles and bones, and because he can hug people more easily! But his new stander is comfortable enough for just sitting and relaxing too.

Jean says she found everything about her experience with Sharon and the AT Reuse Project to be positive, and she appreciated that Sharon was so accessible, available, and generous with her time. Jack's school purchased this stander from ReStore in Barre (a VT AT Reuse Project partner) for a minimal administrative fee, potentially saving their budget over $4,000 compared with the cost of a new one. Jean notes that, in general, new equipment is very expensive, and she appreciates the ability to purchase such high-quality, safe, used equipment because it helps schools, families, children, and the environment.

Kristine Godin is an intern with the Vermont AT Reuse Project and a senior studying business management at Johnson State College.


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