Two pilot programs intended to address chronically delayed wheelchair repairs are themselves taking months longer than planned to launch.
MassHealth, which is responsible for the pilot programs, was supposed to have two vendors in place to run the programs by this fall. The state’s Medicaid administrator now anticipates both contractors won’t be in place until August 2024.
One pilot program would create a supply of loaner chairs that wheelchair owners could use while their primary chairs are being repaired. The other would establish a mobile team that could make simple repairs. Eventually, MassHealth would give more businesses, potentially including bike repair shops, access to Medicaid reimbursement for simple repairs.
Painfully slow wheelchair repairs have become a nationwide problem. Several Massachusetts residents described waiting months for basic repairs, and living in pain or having their mobility severely curtailed in the meantime. Delays obtaining insurance authorization for repairs and scheduling complications play a role, but advocates say the $59.7 billion durable medical equipment industry has failed to properly invest in repair services, resulting in understaffed and overworked repair teams.
State legislation introducing mandatory two-year warranties on new wheelchairs and requirements for companies to respond to repair requests quickly is under consideration in the Senate’s ways and means committee.
“Expanding the options for people that are legal and covered by insurance such that they would still be eligible for a warranty and they don’t have to go outside the system to get timely repairs, that’d be ideal,” said Harry Weissman, director of advocacy at Boston’s Disability Policy Consortium.
Bonnie Denis lives in Malden now, but while living in Somerville she occasionally relied on a local bike shop to change the tubes on her wheelchair tires. Wheelchair tubes are often interchangeable with those for bicycles, she said. The work cost $20, which she would pay out of pocket.
Medicaid reimbursement for bike shops for small repairs would be a significant benefit, she said.
“There are many people who can’t afford to do it,” she said.
The two pilot programs are designed to run for three years, but they were going to be funded with $3.7 million in federal pandemic recovery funds that must be used by March 2025. Under the original timetable, that funding would have supported the first two years of operation. Because of the delays, though, that federal money will expire earlier in the life of the programs. MassHealth officials said they expect to find state revenue sources to support the program.
“We are committed to improving this for Massachusetts residents,” said Leslie Darcy, chief of long-term services and supports at MassHealth. “We really want to engage in more problem solving.”
Roughly 10,000 wheelchair owners on MassHealth could be eligible to use the pilot programs, though each person’s unique circumstances and insurance coverage could affect eligibility.
Getting the programs underway requires two new vendors: an operations manager, company, or organization to administer the programs, and a support company with experience providing durable medical equipment. The operations manager would hire technicians, build a stock of loaner chairs, and handle the administration of the two programs.
The support company would train repair workers, determine whether repairs should be covered under a warranty, and coordinate the complicated process of determining whether MassHealth or Medicare would be responsible for reimbursing the pilot programs’ work.
MassHealth started seeking applicants for the operations manager in November 2022, and a contract was supposed to be awarded by last April.
“We’ve been told they’re in final negotiations with one entity,” Weissman said. “We don’t really know what the holdup is.”
Finding a company willing to take on the support role has been harder. The agency did not receive any interest after releasing a request for applications this summer. MassHealth had hoped a support company would have been selected by September, according to state documents.
Ironically, the company most likely to receive the contract to assist the pilot programs is one of those that now infuriate wheelchair users with their slow response to repair requests. The wheelchair industry is dominated by two large national suppliers, Numotion and National Seating and Mobility; those companies stand to benefit from the pilot programs’ success, Weissman said. Giving wheelchair users more places to get simple repairs should free larger providers to focus on more complex work, he said.
Though wheelchair users already turn to bike shops, or handy friends, for easy fixes, many don’t realize that’s an option. MassHealth’s pilot program seeks to expand awareness of that resource, and assuage concerns that relying on a bike shop could invalidate the warranties on newer chairs.
“People have not come to understand the concept that a wheelchair can be repaired from a bicycle shop,” said Murshid Buwembo, a Somerville man originally from Uganda who uses a manual chair.
The difficulty getting quick repairs led him to develop a close relationship with Mike Grunder, of Arlington, who has made some repairs himself and helped Buwembo find a new wheelchair.
“I’m not really a wheelchair mechanic,” said Grunder, who met Buwembo through volunteer work at Malden’s Refugee Immigration Ministry. “I’m just a guy trying to help another guy.”