Well the thirty's then
really your money today.

I think it was valuable in
buying by the National And

I mean how do you want
to levy zero zero zero

zero and that would be just like
you know right there with you.

I just like you love and

over and behind if you read you

to be an eagle may

I know that you're already.

You know.

All right thank you thank you.

Claudia and we're really thrilled
to be here and look forward to

sharing with you a little bit about
our dream with how it came to be.

And so with that what we're going to
be focusing on today it and we'd love

to come back some time and talk with you
about all our initiatives with tools for

life which is a state assistive technology
at program and with about a half an hour

we figured this is a small amount of time
to cover a whole lot of information about

kind of how we came to be how reuse came
to be its national focus who is involved.

What's happening prevalence and looking at
the purpose and activities of our center

and then also to have that time at the end
to have some conversations about you

know how can we collaborate with
Georgia Tech and with some of the.

Things that you're doing.

Starting out when we define
assistive technology

it's assistive technology as well
as durable medical equipment.

So we say assistive technology it's
anything from software to help people with

disabilities to we'll Cheers to adapted
homes which some of you are involved in

it's that whole big gamut that we call
assistive technology and that was

really defined in the eighty Act of one
thousand nine hundred eighty eight really

lute utilized A.T.M. We're going to get
into some other definitions that go dig

a little bit deeper later on but it's any
item piece of equipment that's used again.

OK so it's just very simply.

That's realized eighty who's involved and
it centers for Independent Living

churches groups like our internationally
known friends of disabled adults and

children here in Georgia anybody centrist
in seeing that particular group and

what they're doing and

how they're doing at we have to reuse
programs here in Georgia that are that

have really been sort of highlighted
this national examples of eighty reuse.

So there are lots of people doing
this historical foundations back in

the one nine hundred eighty S. there
were groups doing realisation friends of

disabled adults and children I think you
were founded in one thousand nine hundred

eighty six the National Cristina
Foundation which has done a lot with

computer reuse began to start talking
with corporations about how we could

reuse this stuff keep it out of landfills
and and assist people with disabilities

get what they couldn't afford to always
get themselves then in one thousand nine

hundred eighty eight this the national
the federal law for the Technology Act

was passed and that authorized all states
and territories to develop programs to

really help bring assistive technology
to people to make that happen.

And so in the one nine hundred ninety S.
there were a lot of these state programs

including our efforts here in
Georgia that began getting involved.

With the radius and then in the late one
nine hundred ninety S. and also in two

thousand there were several reuse that's
sponsored by a group that some of you may

know it's called Reznor we have engineers
of North America is what the tagline used

to be and after that then Hurricane
Katrina hit in two thousand and five.

It's kind of a perfect storm.

What happened with Katrina was there were
lots of people with disabilities who

lost their dreams in that one evening or

in several days over a period of several
days there were some people that we know

of who lost their lives because they were
in will chairs and the floodwaters came

into their homes they had no way to
escape our partner program for tools for

a life as a group in Louisiana and
they all of a sudden were set with this

issue of how do we replace devices
that people have lost those

who who lived and friends of disabled
adults and children was scrambling

to get equipment that was needed reused
clean equipment to Katrina victims.

So that's those sort of a perfect storm.

And so the office of special education and

rehab and Rehabilitation Services which
is in the U.S. Department of Education.

That's the group that was sponsoring
all the programs all over the country.

They basically said hey you know we
need to do something about this.

We have a lot of state eighty programs
are doing reviews but we need to do

more effort because there's a lot we don't
know about what's going on with reuse so

they funded twelve demonstration Grant
projects on a competitive basis and

we're happy to say that Georgia got one
of those in Friends of disabled dolls and

children and tools for
life was very much involved in that and

is really to demonstrate you know safe and
effective and propre it reuse and

what that would mean you know what
does that look like they also funded

a Technical Assistance Project and that
was the birth of the Pass it on center we

competed with other
programs we were awarded.

Grant.

It's a five year grant we're in a six
year extension and we're working on

sustainability plans because the truth
is there are so many groups across

the United States have said you guys
need to continue what we're doing.

We've begun to scratch the surface.

There's so much more we need to do.

And so there's also supported the first
national conference in two thousand and

six at the Georgia Tech hotel and
conference center.

And there were about two hundred people
from all over the country who came in and

really talked about what
are the challenges with eighty reviews.

And I want to go through this very very
quickly but when we talked together we

found that we don't know
the legal issues surrounding this.

We don't understand the federal regulatory
issues there's C.D.C. has laws about this.

The F.D.A. does you know what kind of
liability will this post to the programs.

What are the implications for
consumers in agencies of device reuse.

If Medicaid reuses devices what does that
mean you know what are consumers going to

think about that when I say consumers.

We're talking about individuals
with disabilities and

also their circles of support their
family members their agencies.

What's the net effect on the D.M.A.

enter St We don't want to
put anybody out of business.

What is the value of these devices.

You know what's the cost benefits of
doing eighty reuse How can a small

nonprofit afford to do this so they can
stay in business and do it properly.

What makes a good program.

How do we know when Reus is being done
safely effectively and appropriately.

And what how much is this going on.

We knew that there were
programs across the country.

In fact there were about eighty six
programs I think that were identified

as doing some form of eighty reuse.

So when the passed it on center received
its funding in two thousand and

six we formed a national advisory
taskforce and that group came

together one of the very first things we
did is we need to look at the definitions

because guess what a lot of these programs
are saying they're doing recycling.

But when you look at recycling What
does that mean that in the life.

That's where you dispose parts and
you know the very end of life and

so we identified a number of
different definitions device exchange

programs those are kind of like want to
add see there you go up on Craigslist.

You'll think people putting Will chairs
up their device opened one programs

are eighty programs were loaning devices
out that would just stay out and not come

back or if they came back then they would
be you know put out again but it's just

sort of a loan program reassignment
where devices come into a program.

They're just basically cleans
maybe a tire is inflated and

if it's a wheelchair and it's given
to the person you know who needs it.

Next refurbishment we came up with
a definition is where we're not only

cleaning we're looking at it we're
maybe getting parts from some from

the manufacturer replacing parts Repub
placing upholstery replacing batteries and

there's a higher cost to
remain you've actually.

And then we talked about recycling so
we came up with those definitions and

what I'm going to do at this point is
turn it over to Carolyn to talk about

some of the activities that we've
been involved in all right.

So joining me today and

this is my first down there so
what we really like to do

with a significant injury and
I don't mean other folks.

I mean if we start reaching out and

saying hey we're here if they're
doing reviews with different fuel

was just so

we started with about eighty and

it's grown we have two
hundred centers were almost.

Here or is there a couple that don't have
any reason activities that are listed here

working with them and
we get this database for

a few kids search for specific types
of devices used to search for ages.

And say you know what the person I'm
working with is fifty five or over.

They're looking for something who does.

And then you can click a button and
see that in the United States.

You get.
Also the six states.

So this is work there's
one other states that you

know a lot of us are transit we have folks
all over the country that we care about.

We love and so
they think of their loved ones.

You know I'm cared for
somebody in Florida.

I don't know the Georgia
border does this so that right

there right there

hundred twenty three reassignment
activities and and then the rest of this.

I don't have access to this like that but

it gives you the breakout as to what
are these activities and who's doing.

Here's the Web site.

Because we got the grant we sort

of sign this website we have the website
the money just a basic web site and

it's very very grown here some of the
stats from that as far as how many folks

are visiting our website and
how much time they're spending.

It's exciting because folks are spending
an average of twelve minutes

website which is a dream.

If you.

You know our web designer you're
like well that's awesome.

So we very focused on solutions.

Well if you are in their home and
we have You Tube station you're

going to hear about this
a little bit more social media so

that will create conferences and
things like that.

I'm Association for
the technology industries association and

we just have that ship that
we're doing that again Orlando

different information and I'll talk
some more about that one of the guests

Palin and
Senator Edwards pass it on Senator.

Thank you.

Yes So we also have this great tool
called the I.Q. This is for indicators

of quality versus the technology we use
it to sell the sense that you go in there

you know take the interest of Russians and
I'll tell you more about that.

So we have an outer space that
we created where we went out and

we said you know what show shouldn't
take more and show us how you.

You know your decision tree for

the people that are NOT show us how
you market to folks who are seniors.

I'm sure was how you.

Match equipment to folks who
may not speak English and so

we moved there in there with
an searchable data base.

Once again our goal was to have
like three hundred you know

resources which are a list of videos and
all of that we've got

forces that we've got over thirteen
hundred plus the country and

it's exciting to see how folks
are sharing that information.

Really.

I was unaware of an hour
yesterday teaching a bunch of or

you know all about likeability issues and

isn't everything remarkable valuable that
knowledge that is really your friends that

we were that we actually had this year and

so there we are and it's literally
from all over the country and

leaders in this field and also in
other fields of the system technology.

So here was.

Work on their blog and

find out you know what it is that really
doesn't have quality programs and

you know are you sanitizing me that they
are just kind of ideas of what is right.

Yes I want you there to tell
the blueness of the reason for

this is I work and
I give you work on this.

So you know.

Yes yes absolutely.

Yes Yes I mean I'm a technology and
so we're sorry but

we've also done with all
of our loneliness and

it is a shame sterilisation what
this tool is actually enter

questions answered resources immediately
within the knowledge base and

hopefully will grow and then we're hoping
this will be a loop where as you grow

when you change and you develop your
program more you'll give us more resources

that we can use to further develop
the network and sure that's happening.

We're seeing where that was
happening over and over which is so.

Business Plan sustainability
is extremely important and so

we hope the more that remedy is one of
those which is a program in learning

basic or strategic plans

to me literally thousands

of times because the sessions
twelve minutes of people as most of

that are in the you know technically
since that's that's great.

So our numbers are pretty
impressive with us this time

but not just providing technical
assistance from a distance but.

Really that hands on.

Let's get together let's
give folks a room and

figure out what it is that people really.

And this is joy and the thing that you're.

This is a north Marco with the words
of seventeen of these summits and

states and that's we've had over.

Actually most every state and
territory disappeared in

our summits which is great when we
get folks together I love this.

I am we should never have a small group of

buffel citizens can
change the world leader.

The only thing that ever happens.

And we've seen that manifest again and
again and a lot of times people measure.

You know their success by the size of
folks you know I mean how many people

showed up at your trainees and all that
and we have found that joy is going to

come the day that just a moment that we
can create incredibly positive results

just by working hands on with
a small group which is great and

then here is a picture of me with a guy
like me and he's from Arizona and

resentment on this and
trying to distance myself bad.

Works in Arizona and when I went out to
do every year is summit with the state

of Arizona primarily they were focused on
the folks who are aging that was the that

was the topic of conversation and everyone
of the work that's who they wanted

to serve there was one group and they're
the survivors that were under eighteen.

Everybody else was you know saying OK you
know listen figure out service delivery

folks you know and so we've learned a lot
and I've been have a discussion we're

going to go there but here's a list
of differences that we just worked on

this last year and we're really having
Alaska as the other states this year.

So here's a just a little
less of the preconference and

friends of these yesterday
where we got that strain and so

you were more you can go to the beach here
uses the technology industries and change.

In Orlando and
what the sessions that I did in Chicago

was one that Arthur him with tears looking
at assistive technology and reviews for

sensory related disabilities and now has
the best conversation with those we have

a lot of people there are like ours we
have a lot of folks from the AAA is their

area agencies on Aging around the country
and I'm really focused on you know what

does it look like the other big initiative
that we have as emergency management and

assistive technology we use what's
the rule of assistive technology for

use in emergencies and we're finding
that it's an increasing role.

It's a national that it's
something that happens often and

someone to come up with
a organized way of doing that and

so we presented with first friend
who reads this representative

from friends of the single of the children
at the National Hurricane Conference and

very Talk to us about coming back and
doing that bigger community again and

looking at functional needs for folks and

one of the topic here is that they said
hey it's really need to figure out how we

can give those who are you know aging
them plays and to save the environment or

work and we need to help them figure out
how to give kids and then all of that.

So we're having that happen to us
too specifically and we've also had

to do regional summits where we
have folks from all every state and

region four was represented and
they have been working on state plans for

assistive technology Review's with their
plug in that into their plans were and

I just kept Philadelphia where we
have the region free zone that

has been great about helping us resist
painting of this and we're seeing where

these big fans really are making it so and
I'm going to turn it over to the north.

The next couple.

Information is still needed trying to

help where I think we start you know the
many lately where people just come from

her purse and her cell to me a lot that

I just wanted to license you know I would
hear from you all so we do last night.

Well we definitely don't think he's
one of the really we get a video.

Letter and I guess I don't get

the make sure it's all like your

we on trying to work together.

There's not as our main person
we like to get it right.

Legion right and there's a little
this will be a hundred a picture

we all really work together as one that
really made all the information like I'll

manage an article about a baby but
if you look back you really

really want to believe

the resource center is a lot of her life
going to be a time when she has amazing

day with the country to
live different ways we

met when I was with Laura.

Another area of video there that also

a lot of different places to
make sure we actually had

people with online.

It was a very good to be able to

make sure it was on my plea.

Here here today actually going to

react with you and you're

really just the website for our walk

through the You Tube managed it
was like right there next to it

but I don't know if the walk

in are like nine hundred ninety six.

This is actually you know and
look you know we have one hundred one

life and it's also want to kind of cool
that with you know actually you know

people like

me really help with
actually watch video you.

Or as well

we're video video they get

a pretty short wave with one

minute my

life is a country

out there in my life.

Yeah yeah

well you

were like trying to

get here and

this is a great.

Well they might drill and

mark down with dressing or

having her purse imagine Congress at the
same time we have people in power to go.

What do we do.

I mean there are merely the cover them up.

It covers a list reside in our chairs that
we cover up here but I don't like that but

I know I'm I'm happy that

it was a purple it was several although
there might be a very good tablecloth.

You know that's what
you're supposed to do.

That's what Marcy Roth with
a disability coordinator was sank.

You need to cover somebody and I will
share to try to take them off of it out of

their welfare put them under the day
old as cover them with a blanket and

that we're not just great and

we do everything my third and

every marriage and there you

are in ours we also offer

real credit.

Actually we are all our women are so

if you miss it you want to go back
you just don't worry about what I

hear something like that

out of my life and all are kind O..

Trans you know you have

different ones going green first.

OK Thank you.

Martha and thank you.

Carolyn.

And so a couple of other
things that we're working on.

And is models project to really sort of
encourage eighty reuse by looking at.

And also understanding that by looking at
the different models for eighty reuse.

I mean there is no cookie cutter for
these kind of programs whatsoever.

So there are a number of them that are
sponsored through nonprofit organizations

and centers for independent living.

We've seen in school systems we've seen
some where the umbrella organization

is a state entity and

they're contracting with a number of
non-profits that are sort of in a network.

So it's been a struggle for
us to say OK how do we categorize them and

we've come up with small medium and
large and found that that

relates to their budget the number of
devices they're putting out there and

it doesn't make any assumptions about
you know whether it's better to do it in

a nonprofit organization or you know
a state agency or anything like that.

So we're looking at that and we're also
doing quite a bit of research looking at

return on investment and
we expect to be doing.

More webinars about that
a little bit later on.

We've done some but
we're building on that process and

we've come up with a new model which
I won't go into to it today but

it really kind of looks at everything
volunteer time the value of that and

everything and
comes out with a return on investment.

Why are we doing that because
there are number of people who say

yeah you know we'll do reuse
threw up a shingle and

then all of a sudden they don't
have the resources or the people or

what have you to really make it happen or
the knowledge and so we want to make

sure that people are really looking at
everything real cohesively although we do

believe there are always enough resources
there are always enough people.

There's always enough
information out there.

It's a matter of making everybody work
in those teams and creating that center.

And this is a picture of let's
see I believe that's the picture

project manned in San Antonio.

And that's been one of our very
successful programs out there along with

you know photo and.

Peer quad in Missouri and

then another very very successful program
in Virginia in that particular model.

There's a state program they do
subcontract with nonprofits.

But then they also partner
with Goodwill Industries

because they found that goodwill was
trying to refurbish death or just put

stuff out there wasn't very safe for them
but they're involved in the distribution.

So you know of course we're thinking
what about that X. What about U.P.S.

What about other shipping
industries people where that sort

of like a natural thing that they do.

How can we create even more
effective national network so

that when there's a debt disaster
like the tornadoes in Joplin.

We have a really good
network of response and

responded by sending I don't know how
many pallets of stuff over there.

We also are looking at the twelve
grantees that we worked with to

look at what they plan to do what
their outcomes were what are they.

What are the best practices that they
identified successful practices and

how do we know that they're successful.

So we're becoming You will be
developing sort of a final report and

I hate to call it a final report because
we see this effort is continuing.

But in terms of the lessons learned
from all those twelve grantees and and

where we go and how can we use that in
educating other programs on a continuing

basis training and also legislative
advocacy very very important.

If you look at some of the data and

this was developed by a system called the
National Information System for eighty.

And it's now being operated
through our say so

if you tried to google that I don't think
you're going to get anything right now but

it is information that all the state
eighty programs like tools for

life are required to report
on every year in your in.

Number from early retired about how all
these programs many of them are doing

reuse activities.

So we've been required to report for
a number of years.

And I'm going to give you just a quick
little snapshot to give you some ideas of

the incidence of this the prevalence of
this happening and also the estimated

cost savings of reduce activities and
if you look at ninety eight or

two thousand and six when we first
started looking at this data.

There were reported a little bit
under five thousand recipients

getting reused items.

All of the Senate jumped in the report for
two thousand and ten.

Two on about twenty seven thousand
six hundred ten recipients.

Now part of it's because they
were more activities going on.

Part of it had to do with data reporting.

But a part of it was just you know people
began to see this is on the map we

need to do more of it and
we need to make that happen

if you look at the number of devices
that the numbers aren't the same and

why is that because you're some recipients
of many three different kinds of things

are for so
you have a higher number of devices and

it shot all the way up to almost thirty
six thousand in two thousand and ten.

And that's just with
the state eighty programs.

So there are other programs that
are listed on that database the program

locator the map of the U.S. that are in
a part of this system many of them are but

there's some that aren't listed so
this is just you know it's a pretty good

idea as to what's going on but it surely
is not everything that's going on.

OK so if we look at the cost savings
in this is based on a report from

the program as to what a consumer
somebody taking a device.

What the estimate would be that they would
have to pay if they had to buy a new.

And where we factoring in ten percent
less a lot of the programs where

we're factoring in twenty percent.

Less than manufacture sales price.

And so we came up with all those devices
and this is two thousand and ten date a of

a little under eighteen million
dollars that we're safe through this.

Now this is not a return on
investment figure by any means.

Because it doesn't take into account all
the costs that you have to figure in

the value of services things like that but
it gives you a picture is to you know

this is kind of the elephant
in the living room.

I want to give you a personal
example because I know

that Claudia talked about
the dreams of people.

And I'm sure.

Carolyn has others that she could share
one of the things that really resonated

with me was an example that came through
friends of disabled Datsun children and

there was an individual who had had
a spinal cord injury he was using

a sip in Perth Wiltshire system
that cost over twenty five thousand

dollars with no costs the cost of
the system was very very high his

co-pay was going to be over twenty
five thousand dollars on that system.

It was time to replace it.

Wasn't eligible for Medicaid wasn't
eligible for Medicare too young for

Medicare didn't have yet insurance but
he had paid us his co-pay.

Not very good insurance
didn't have the money.

What do you do.

On an on the fly people
from the Shepherd Center in

the rehab engineering
department called Photo act.

Chris brand the executive director
answers the phone he says let me check.

I think we just got one in
exact size exact manufacture

exactly what this guy's
been using had been used.

Maybe a couple times they replaced
the tubing and got it over.

There's a big issue in the country about
whether or not reuse program should be

doing what is called complex rehab
meaning stuff that's really kind and

you don't want to take business
away from the manufacturers but

what do you do when somebody doesn't
have the money to pay for it.

And that's part of why there's been such
a great interest in reuse is by no means

the only real.

And why it doesn't mean that example
doesn't mean that Medicare Medicaid

artificially embrace it.

These are you know it's very complicated
there are many issues but it gives to you

at least a picture is to you know a lot
of the people are going to reuse programs

have no way to pay for devices and
there are some other reasons to

wilt will jump back to that in a second
the environment if we look at where reuse

is happening you can see a huge amount
is to help people in community living.

These are not people
necessarily who are looking for

employment small percentage their
education will under ten percent.

We also measure.

Why do people go to reduce and

only afford eighty through the state
wide program the respond gram.

It was only available through
the state wide program.

It was available through other systems but

the system was too complex
interesting right.

How many of you have looked at your
insurance benefits and you're going.

What what does this mean.

And if you're getting close to being
maybe Medicare eligible it's like you.

Gads you know this is really hard.

You need navigators for all this stuff.

And so we also look at consumer
satisfaction highly satisfied almost

eighty six percent satisfied fourteen
percent somewhat satisfied point thirty

three percent and then very few people
who are weren't satisfied by this and

so you know pretty good information there.

So Carolyn would you like to add anything
you Martha are generated and then we'll.

Well just one other little
story that you know I don't

see this is a personal issue and

users from your genetic and

and when I was in my group.

I don't need friends and so
we have promised my mom and

Arsenal and my dad who has AS and
all kinds of things happening.

My partner was a train wreck.

Right.

You know a lot of things going on too.

And we were trying to figure out how
do we keep them at home you know

because that's what we wanted to do so
we had to create an accessible environment

which we were able to do but we weren't
able to afford all of the eight he needed.

And so some of those things that were
saving heart attacks are those you know

the less boyhood specifically is the more
we got we got that from friends of his and

well those and children we would not
have been able to otherwise we could

get a hospital bed for one of our parents
but the other one didn't follow right.

So we're really a hospital that's for
the specific kinds of three gives and

that I personally I appreciate
the reuse efforts that that happen.

My mom actually used for a little while
a speech device that was really used and

we knew there was only little period of
time that she was going to use It savors

been six thousand dollars on this.

When she was only going to use it for
me here and that got back into

another community somebody else
was using that very successfully.

So really this makes a lot of sense and
that's just a personal experience of being

able to you know for my parents dream
of been able to live and I and my dad

passed in March we were like you know that
was peaceful and good and that was good.

You know that he was able to do that
when it happened had we not had you know

there's the boards and that's why is it
we can talk about the resources and and

help folks you know meet those goals.

You know you would have said you
know my goal was to die at home but

that was my next goal.

So we see this manifest again and again
the young people we've been working with

you know six months old oldest one
hundred four and helping people.

Just realize these trains and this school
so what questions do you have a point

of collaboration what do
you think what you meant.

Well yes you're right.

Were they you know we would.

Yes we actually believe it is a computer
use program we started here Georgia and

we looked at different models we
actually were very closely with

the National Foundation and
we created a charter and

right and mapped out a plan and
we actually have data.

You know proof of concept parents there's
a review here on this very active and

there's also been Brazil.

So we've seen where you can take
the model and actually watch it and

workers actually see it but the review and
here are some of there's also are one

one are in the significantly more
reviews of computer one Georgia.

So it's interesting to see how model when
you get those who can be creative and

I think one of the thing is we've also
seen where people can take technology and

make it very specific you
know if you have a good model

again different technologies and
we see a National where for

example somebody you know will turn
needs to have a very different culture

you know just the type of terrain you're
playing with and so we've seen where

we can actually take the use model acted
to the will shooters modified as well.

Chairs.
Make something really well as a matter of

fact there was back in that two thousand
I think it was at the one nine hundred

ninety S. conference on reuse.

One of the groups that we saw a video
about was a group of women in Uganda and

there's a gentleman in his name.

I can't remember at of California.

He's done a lot of international work and
works with local materials and

tries to capture best practices and.

And these women actually Bill
will cheers out a bicycle wheels.

When you think about it.

That's pretty good deal and

these were all women with disabilities
who wanted to help their kids in Canada.

Very interesting.

They were doing reuse more
formally before we were in this

country as far as we know it there.

Also when I did a lot of research
just to see what's out there

in terms of the literature.

There were only like about
three articles that had

anything to do with three years
back in two thousand and six.

Now we know we at least have one more
because our program did what one journal

article in the assisted technology
outcomes and benefits but

this group in Canada was doing
you know actually did so

usability kinds of work with people who
are using reuse that we need a lot more

research in that in the other
thing that might be potential for

collaboration as we know that
with our reboot program.

There were some people at Georgia Tech
who actually went out and

redesigned the whole way equipment was

processed through their system and
that was very very helpful and I know.

Claudia had some students
who were it was and

you had your baby quite quickly and it's

great.

So

we're really

you're right but

I think there's a you know Brian and

I think that you know the whole
process of doing and done.

Trail design and looking at you know if
you've got a reuse facility out there.

How did things flow through
the the whole system and

what could you do to make it
more efficient as a process.

Good.

Well good great.

Well we you know there
are a lot of ways that we would

be very happy to collaborate and
I just wanted to mention that

we are hoping that this agreement
will be finalized very soon.

But we're expecting to move
on campus actually with

alternative media access center.

Hopefully very soon.

And so we're excited about becoming
better friends with everybody and

yeah we're off a Macas off of Main Street.

By

one

of the.

ME ME

YEAH ME X. lot.

Right absolutely.

We read here you

know we are.

You're absolutely right.

Yeah right you

go and

lets the Mahdi absolutely right and

there's right stories right
here right here network but

they have a huge story.

One of those five that goes

we're all black here and

reverse you know a lot of
new polling around right.

Do they

tell that the new users that they
have one that is using recycled parts

I might be OK with work and

all their private land.

Right right.

No I mean work your way.

When.

I was crying so

bad right now it's absolutely right there.

You're right there right.

Well I think I think so too in it but

yet it's a very slippery slope right
now because there was in New Jersey

a while back and it was what early two
thousand two thousand and one or so.

And a person.

There was a lawsuit because there was
a provider that was doing reused equipment

and the parent didn't have a choice.

And this was Medicaid funded it
was a really bad scenario and

there was an improper reuse of
this particular type of device and

a child actually lost his life and so
a lot of the complex rehab providers

are very wary of the recession it's not
just about taking business away from them.

They're worried about all those
kinds of things that you think about

you know when do you know if
piece of metal has had so

much stress on it that it really shouldn't
be reused is a you know basic example so

there are a lot of things
that we're looking at there.

Our position is that if there are groups
like Medicare or Medicaid and

there are some programs that are working
very effectively with Medicaid

in a very interesting way but.

That the consumer needs to have choice.

You know you need to
give them some choice or

you're going to have something that's good
safe effective or utilize device or you.

You know or
you want to have something that's new.

Well then that becomes kind of funny
because they're not caps on how

much an individual would get with
Medicaid I mean they can't really do that.

Per se.

So you're right.

Though.

Every.

Right right.

That's right.

For Greece and Ireland and.

All that.

Yeah I mean to raise.

I mean you know.

Yeah yeah and Harris town.

You're Harrisburg probably right right.

All right so

everyone and their good work.

Yeah.

Absolutely yeah.

So it sounds like there are so
many excellent examples from industry like

your you know that one way and working
with partners at Georgia Tech would

be to really look at you know is there
a way to look at this from a good business

standpoint where the vendors
who provide this kind

of complex rehab equipment and other kinds
of equipment it's got to be a win win.

We think for everybody.

Consumer the vendor the reuse programs.

Yeah.

Right.

They will never know yeah yeah yeah right.

That's why when I was.

So you know I think what

you know all based

on what those things
are a lot of the world

in the same thing happens with
developing company countries and

get Peters and also will pay us.

You know.

Right here.

You know we have seen where
there are some things were said.

To the trade and
live picture of what's yours since it

will play.

It's a pretty explosive device and
they started.

Reclaiming those notes in the Motor City
very thing like that and then getting them

back up to their standards and then we
saw the thing is they don't market but

if you're in the loop you know that
there is this where people say

I just can't afford it then bring out
what we do have this other program.

So yes and also we've worked
with some groups of vendors.

There's a rumor that actually
is a Tampa custom ability

that has been doing this for upwards
of eight years where they are taking

it back you know and that's part of
the miss that it's a terrible name.

Yes there was something
I missed better a mess.

Miss it.
Which is not a great name and

part of the a little bit
about the language there and

it's going to see how they've been able
to work that into their market and

you know seven years ago people
didn't really want to know.

So it was her service
to the tree right and.

She was right.

Yeah well yes it was

one of those eleven other processes
happening where they are.

Reclaiming get him back up and
then going back.

And then we the groups that have
worked with Medicaid one in particular

in Kansas done a fabulous job and
in working with and

fact Medicaid even cited their partnership
in a transformation of Medicaid

agencies publication that they did and
other Medicaid agencies are kind

of listening to what they've done there
and what the state eighty program did is

really a tracking system inventory
tracking system where they look at you

know they get information about everyone
who's purchased Medicaid equipment or

where Medicaid equipment has been
purchased and they work with the providers

to assure that number one the person got
what they had needed and requested and

so on and then any Medicaid
equipment is stickered so

that the program learns about it in
the end and Medicaid pays them to do this.

It's almost like more
fraud control process but

then they use this funny
funding to reimburse vendors.

To take a quick meant that has been
that is ready to be realized and

repurpose it and then they assign that
to the people in their network they

were hurt the vendors are actually paid to
do the refer to their part of that work.

And how yeah.

Well.

That's really the business model.

Yeah.

You know that would be good.

First some of the presentations
that we we do we have a one

called the business case for a T. reuse
where we get into return on investment and

taking a look at other industries that
have done that might be really good way to

kind of shore up that presentation.

Yeah that's great.

Freedom scientific Yeah.

Great great comments and
we do have a national task force and

in fact that is representative and
very happy about that and

if there are other people who can bring
sort of that business model thinking and

to what we're doing we really welcome
that kind of conversation we this

year will be meeting just to save expenses
probably not a face to face meeting but

we have different work groups who
work on different projects and.

It's a lot of fun because
it's a sort of a mix and

blending of skills from
many different folks.

So.

Yes.

Hey Karen.

Good good.

Comet Carroll.

Yes actually you know you
know we've found is that

it usually is related to user group.

You know.

Somebody has outgrown it.

Or somebody has passed.

So that's that's our body.

But it is also you know just that they
want to try something before that and

so they want to try it not for

like you know we're sort of a they
want to try it for maybe a year.

And so it's more of that stuff.

Yeah you know and then they were
able to turn that into them.

You know.

But yes I agree with you
about that I was talking to

a guy who I was and
this was actually in Philadelphia and

he was talking about you know when
you're in the same thing as abandonment.

You know where all your returns.

It's usually is.

That's that's agree with me.

We have data study over the past year
where we looked at people at photos at

Friends of disabled adults the other end
of the question is you know why are you

looking at really is to quit that what was
your experience and it required layers of

work because sometimes people did not
know you know where they eligible for

Medicaid Medicare and one person
had seen a doctor and ten years.

And so you know we really that was
very interesting information kind of

shored up what we know that a lot of
people find the system too complex and

just get fed up with it.

It's just one of their about
the abandonment issue.

The the other thing that we have heard
over and over and I remember when I

started working with even the building
that program the number is that a lot of

times we were so attached to their systems
I love the idea of it being really use so

they don't want to go to landfill and
so there are people that come in and

we've actually we've got a women are where
we talk about how do you receive a woman

you know because you want to honor that
you know when you say things and toss it

because I like that was my voice for ten
years and you know or that was my brain.

You know I don't do that.

So yeah.

So it is interesting how a lot of people
just makes them happy to know somebody

else will you say yeah and
an organ transplant and what.

That's right.

Right off your ass you did.

Yeah well and facts are you want to

one of the Allied issues there is just
getting enough good equipment donated and

gently used equipment is the ideal thing
that really is programs like to get a lot

of gently used equipment and
one of our partners found that they and

they had to do this very very
carefully very tactfully but

funeral homes were a good place to go to
because people would often ask you know.

Gee you know my dad died and I got this
equipment and you know I don't know what

to do with it and so they actually did
the the program actually did some training

of people who are going to be going out
and working with the families who did

say that they had a quick end to donate
and they got great equipment they also

got great donated equipment if they found
that if they work with the Red Cross and

set up booths and just you know talk with
people going through to donate blood.

Why knows but this is the same program
that works with Medicaid with a sticker

in program and yet
ninety four percent of the equipment

that they receive come through
private donations funeral homes

red cross lines things like that very
interesting on the sticker program.

Yes.

Right.

Excellent question.

Excellent.

Yes Yes And that was one of those
big questions that we looked at what

what are some of the regulatory
issues around that.

So for them.
What we found was that the manufacturers

of durable medical equipment have

cleaning standards all kinds of standards
that we you know refer to there.

We looked at whether or not we when we
didn't see anything through the F.D.A.

per se.

About although there's a lot on
device recall a realization.

There it doesn't go a layer deeper and
we don't want to go there.

Really you know.

So we have a number of things that
we've pulled together from C.D.C.

sent zation standards F.D.A.

OSHA there's some information I believe
from OSHA as well and I put together some.

Guidelines that programs can follow for
things like sanitization that

relate to the manufacturer requirements
and all of these pieces and

steps that they should take
each step along the way we

did not want to put ourselves into any
situation of being a certifying body.

Lots of Lee a liability people

sign off on you know I'm accepting this
is a piece of reasons equipment all

the programs do have that
we've also recommended that

they get an insurance rider that
covers you know what they're doing.

I know that photo has a substantial one.

And you know the training policies and
procedures we have or

it's a ninety

day warranty and really.

You know so we recommended programs is you
really need to look at all these things on

the knowledge base we've got a document
where an attorney went in and

looked at F.D.A. standards we talked with
manufacturers and we really worked a lot

on this one document to give people the
pointers of the things they need to do to

mitigate their liability and to also be
sure that they're doing something that

is safe and appropriate effective and if
anybody has any question about whether or

not something should be reused we say
you know don't do it because you know.

All right.

Right.

Well yes well.

Very interesting with that
the manufacturer one of the things that

we have recommended people do is they
follow the manufacturer's recall list.

OK and that the program make sure that
anybody who takes this equipment.

Keeps informed with when
the manufacturer has issued a recall.

So I think implicitly
the manufacturer recognizes

that if they don't put
out their recall lists or

advise people of hazards that that
would put them in a situation.

We've also advised that people
not put their stickers like photo

AK over anything that covers
up what the manufacturer.

You know the labels there and
you know so that's really.

And so

I know that people are letting folks
know when the manufacturer has a recall.

Not all programs but it's what we've
advised them to really do realize there's

or are in certification or.

They're just trying to train their.

Really you know so we are.

I mean we're both right that there's

this yesterday on

the surface of you were
the first of our lives.

I would say really.

And all these things that we have one
of the things we are urging we go to

the state summits and
you know people is checking to see if

it's in your head is over there and
sort of see where your story.

It's where you are used.

It's not covered right
now because we looked at

the Good Samaritan laws it has to
do with somebody helping somebody

alongside the roadway that kind of thing
but it is the way it is it could be.

Yeah yeah North Dakota sort of
mirrors which is why I thought

it was

a good great we know you're coming from
many different backgrounds here we weren't

sure but we're thrilled that you were
here and we would love to come back and

spend time with you talking about our
state eighty program our assistive

technology resource centers anything
on eighty apps we're in the process of

working on development of apps for a T.V.
very excited about that and now that there

are lots of people here who are interested
and maybe share some of those interests.

Thanks so much.

Thank you.