Being the executive director of one state association is hard. Two, well then you would have to be Michael W. Hamilton. “His knowledge base and contacts are extensive,” says Leigh Ann Matthews, co-owner of Complete Care in Fort Payne, Ala, and the president of the Alabama Durable Medical Equipment Association (ADMEA). “My company has been in the Alabama association for 12 years, and I don’t think there would be an association without the work he has put into it.”

The gregarious Hamilton has been in the oxygen industry since 1955 and his enthusiasm for the home health business has only grown over the years. At a time in life when many think of retirement, Hamilton is instead transferring ownership of his home oxygen business, Hamilton Oxygen Service Inc in Birmingham, to two of his employees so he can devote more time to managing the state associations of Georgia and Alabama.

“I have very little training in this kind of thing, but a whole lot of experience,” he says.

Raised in DME
Though Hamilton inherited his business from his father, he learned about the industry by working his way up from an entry-level position. “My father hired me when I was still in high school to work in the warehouse after class and on the weekends cleaning and repairing equipment,” he says.

After high school, he worked outside the company for a few years to gain business experience he could not get from working for his father and then returned to Hamilton Oxygen Service in 1973 to take over the business.

Hamilton came back just in time to see Medicare administrators begin to look more closely at the DME industry. When Alabama dealers started to experience payment problems with their local Medicare carrier, Hamilton and a few other dealers investigated. They quickly realized that to address reimbursement problems in a meaningful way, they had to organize and work together.

In 1977 they formed a loose association. “Most people thought we were crazy,” Hamilton says. “They said, ‘You are actually going to get in a meeting room with your competitors and talk about business?’”

It was a pioneering effort that would eventually pay off. “The issues were very clear—if your competitors are sending in dirty claims, sooner or later they are going to land on top of your clean ones,” Hamilton says. “So it is in everyone’s best interest to make sure that everybody knows how to file them. Everybody gets paid on known medical policies in a timely manner, which is what we were seeking.”

In 1979 Hamilton helped get the ADMEA incorporated. He served as president for the first 2 years followed by secretary and secretary/treasurer, a position he has held ever since.

Hamilton also helped negotiate the merger between the Association of Independent Medical Equipment Suppliers (AIMES) and the National Affiliation of Durable Medical Equipment Companies (NADMEC), forming the National Association of Medical Equipment Suppliers (NAMES) in 1982. NAMES members elected him to vice president and chair of NAMES the first 2 years it was in existence.

Juggling Act
From the ’70s to today, Hamilton has managed Hamilton Oxygen Service and dedicated a large amount of his time to helping dealers solve problems. But when his administrative secretary retired, it became too much for one person to do. “Something had to change because I could no longer afford to donate the time required to manage the association effectively by myself,” he says. “There were too many things that needed to be done that weren’t getting done.”

Hamilton decided to make some business changes. “I have a couple of employees who have been with me for more than 25 years,” Hamilton says. “I now have an agreement with those two employees to buy Hamilton Oxygen Service with the provision that they let me lease my office along with the use of some office equipment,” he says.

With an agreement in place to sell his business and allow him to maintain some office space, Hamilton saw an opportunity to turn his love of association management into a job. “I took a proposal to the Alabama Association board, offered them a management services contract, and we worked out an agreement. I have now turned over about 90% of the management of Hamilton Oxygen Service to the future owners, and I work almost full-time on the management of the association,” he says.

In his new role, Hamilton helped ADMEA get a state HME licensure bill passed. He believes licensure is the answer to Medicare and Medicaid abuse and fraud. “Being able to control the abuse and fraud that has plagued this industry ever since the government started putting large pots of money out on the street corner, daring people to come pick it up, has been a constant problem for honest dealers,” he says. “An honest dealer cannot compete effectively with someone who is willing to break the rules.”

Crossing State Lines
When Sue Rains, the former director of the Georgia Association of Medical Equipment Suppliers (GAMES), resigned, the GAMES board discussed potential replacements. The president, Ron Street, called Hamilton, who made a proposal similar to the one he offered to Alabama. The GAMES board agreed and Hamilton became the executive director of GAMES on November 1, 2000.

Being the executive director of two states is challenging, but it also has some advantages. Both ADMEA and GAMES benefit from Hamilton’s knowledge and experience while sharing the cost of travel, computers, fax machines, copiers, subscriptions, software, and training. Bringing in speakers for meetings also is more economical since the speakers can give presentations to both Georgia and Alabama members.

The same month Hamilton became executive director of GAMES, the ADMEA surprised him by making him an honorary member. “It was difficult to slide that one past him without him knowing,” Matthews says. “You don’t get many things past Mike.”

Fortunately for the associations, Hamilton makes it his business to let little get past him. “He does an incredible job of keeping us informed about everything,” Matthews says. And he goes to great lengths to share his knowledge.

Since taking the position with GAMES, Hamilton has worked on building the same kinds of relationships he has in Alabama with the people of Georgia, making contacts that benefit the state’s association membership. For example, in Alabama Hamilton used his connections to establish a strong association newsletter.

Hamilton is also looking forward to helping GAMES accomplish some of the things that have been done in Alabama, including licensure and an exemption on sales tax on assigned Medicare and Medicaid claims.

“I like to help people and I enjoy being a teacher,” Hamilton says. “I have joked that I got tired of doing it and decided to teach it.”

Sharon Johnson is a contributing writer for Dealer/Provider.