According to the kaiser commission on medicaid and the Uninsured, 49 states have planned to implement Medicaid cuts this year. It is a startling figure, but it did not hit home for me until last month when I visited the Rancho Los Amigos National Rehabilitation Center in Downey, Calif, one of the many facilities facing closure because of a lack of funding.

Walking around Rancho’s sprawling grounds with Greg Thompson, its director of social work and a former Rancho patient, is like walking through the history of rehab. Rancho started physical and occupational therapy in the ’20s and became a leader in rehab research in the 1950s during the polio epidemic. Its basketball courts served as trial grounds for some of the first lightweight wheelchair prototypes, and the innovations continue today with leading manufacturers sending new products to Rancho for field testing, says Will Robinson, MSPT, ATC, a physical therapist in Rancho’s seating center.

Rancho handles a total of about 68,800 patient visits each year and is a major source of equipment referrals for area HME providers who make rehab excellence a priority. “If Rancho closes, it is going to give every dealer out there, no matter how experienced they are, a free-for-all,” says Joe Garcia, RTS, with South Bay Home Health Care of Torrance, Calif.

Garcia has seen many patients end up in inappropriate seating systems that can lead to dangerous and costly urinary tract infections and pressure sores after visiting physicians and HME providers without expertise in rehab. “If it happens now, it is going to happen a lot more after Rancho closes,” he says. “I am truly disappointed.”

However, just as on the national level, making local legislators see the long-term costs versus the short-term savings is an uphill battle. The county commissioners in charge of Rancho listened to 41¼2 hours of testimony from patients and 1 hour of testimony from physicians and still they did not change their minds about closing Rancho, Thompson says.

For HME providers, such as Garcia, coming to the aid of referral sources and patients hurt by government funding cuts can be challenging. Not only does the HME industry face its own set of government funding cuts that require company owners’ time and attention, but advocating publicly for a consumer cause can make legislators wonder about a possible financial motive for the support. “We pretty much can’t do anything about the closure of Rancho but sit and wait,” Garcia says.

However, support does not have to be big and splashy to count. Listening, using a newsletter to pass along information to customers about political issues, and lending financial support to consumer protests and lobbying can be invaluable. “No vendor that we have worked with has come in scared,” Robinson says. “They are not concerned about losing business. They are more concerned about us.”

As the HME industry continues its fight against inherent reasonableness reimbursement reductions and competitive bidding for DME, getting consumer support for these issues will be invaluable. However, the HME industry cannot expect consumers to support it without supporting consumer issues in turn.

For more information on the efforts to save Rancho, visit the California Community Found-ation’s Web site at www.calfund.org/8/giving_rancholosamigos.php.

Lena Lindahl
llindahl@medpubs.com