Gratefully Giving

HOW SOME O&P COMPANIES AND CHARITIES CARED FOR THEIR COMMUNITIES, PATIENTS, AND EMPLOYEES DURING A CHALLENGING YEAR

THE O&P PROFESSION has always excelled at giving back to the community. Orthotists, prosthetists, and O&P business owners continuously go the extra mile—not only to help their individual patients, but also to strengthen the entire limb loss and limb difference population.

That commitment to philanthropy was on full display over the past year, as the COVID-19 pandemic took a heavy toll on communities and economies around the world. Despite reduced patient loads and revenues, pay cuts, staffing challenges, and ongoing fears of contracting the coronavirus, O&P facilities stepped up their efforts to help others—within their communities, across the country, and even around the globe. From manufacturing face shields for first responders, to building mobile units and swabs for COVID-19 testing, to raising money to fund devices for the uninsured, O&P professionals consistently rallied to lift people up.

Taking a closer look at just a few of the many acts of kindness committed by those in and associated with the profession shows us just how much can be accomplished by companies and people who take the time to help others—and sets an example for how to approach a new year filled with uncertainty.

Convening Famous Faces for O&P Fundraising

In 2005, Billy Brimblecom Jr., a professional drummer from Kansas, lost his left leg to Ewing’s sarcoma, a form of cancer. After his friends—including successful Hollywood actor Jason Sudeikis—rallied to raise money for a prosthetic leg, Brimblecom decided to pay it forward.

He’s now the executive director of the Steps of Faith, a charity composed of several O&P clinicians and other individuals who coordinate prosthetic care by purchasing components and asking clinicians to donate their time. On November 14, Steps of Faith hosted Thundergong!, its fourth annual gala fundraiser— conducted virtually this year. The popular event featured performances by Sudeikis, fellow “Saturday Night Live” alums Will Forte and Fred Armisen, Wynonna Judd, Brandi Carlisle, Ben Harper, and many more well-known names.

So, what is Steps of Faith all about? “The short answer is: It’s about hope,” Brimblecom says. “More specifically, we restore mobility and possibilities for amputees in need by getting prosthetic limbs to those who have no health insurance or have no prosthetic coverage.”

This assistance has been particularly important in 2020. Between February and May of this year, more than 5 million Americans lost their health insurance, explains Brimblecom. “Due to the pandemic, we’ve seen people requesting our assistance who need a new leg or new prosthesis who never thought they would need to rely on charity to do it for them,” he says. “I dream of a world in which Steps of Faith doesn’t need to exist. But unfortunately, that is not the world that we currently live in.” Össur helped custom manufacture mobile patient isolation units for transporting patients during the early months of the COVID-19 pandemic.

Donating COVID-19 Test Swabs While O&P manufacturing firm Össur has a large presence in the United States, Europe, and Asia, the company is based in the relatively tiny capital city of Reykjavík, Iceland, where the population hovers around 122,000.

Being a small, isolated country didn’t spare Iceland from COVID’s wrath. When the virus landed on Iceland’s shores after locals returned home from ski holidays in the European Alps last winter, it spread quickly, according to news reports. Luckily for Iceland, Össur was prepared to help.

An Icelandic genetic research company called Decode took the lead for its country in conducting COVID-19 testing as hundreds of Icelandic residents began to fall ill. But supplies quickly ran low, and procuring reinforcements was proving next to impossible. Enter Össur. The manufacturer donated 20,000 swabs it had on hand for testing devices and machinery. Conveniently, the swabs also worked as nasal swabs for COVID-19 testing.

“Decode and the health authorities performed tests on them to make sure that they were, indeed, up to snuff, and it turned out they were just good enough quality to use in the testing,” explains Edda H. Geirsdottir, the company’s vice president of corporate communications. “We could see that the infection rates were rising. So, it was kind of a sigh of relief for everyone.”

In addition to donating swabs for testing, Össur also was called upon by the Icelandic government to help custom manufacture mobile patient isolation units for transporting infected patients from remote parts of northern or eastern Iceland to hospitals in Reykjavík.

Methodist Orthotics and Prosthetics staff manufactured face shields using an injection-molding process typically used to make O&P devices.

“We had about six or seven people all-hands-on-deck within [our research and development and engineering sectors], and they just ripped five units off within a week,” Geirsdottir marvels.

She says the entire Össur team was gratified to be able to help their country at a time when so many people felt helpless. “We’re lucky enough to be working in an industry where people are proud of what they do. But, in a situation like this—where this is literally life-and-death—and people are banding together as a team ... it all just hit really close to home,” she says. “That was extremely important for morale. Everyone wants to do something good. And, the fact that we were just in a position to do that was incredibly valuable.”

Manufacturing Face Shields for the Most Vulnerable Based in Flowood, Mississippi, Methodist Orthotics and Prosthetics might not be the biggest name in the O&P profession, but the company had a huge impact on its community when COVID-19 began to surge in the South last spring.

Sensing a need among its own employees, other healthcare workers, and police officers, the facility modified an injection-molding process typically used to make O&P devices to manufacture face shields. The first batch of shields went to protect residents and staff at Flowood’s Specialty Care Center, a long-term care facility that is home to 60 severely disabled residents, who may be especially vulnerable to infections due to conditions such as quadriplegia and amyotrophic lateral sclerosis. Shortly thereafter, Flowood Emergency Operations Director Nathan Harvell accepted 50 face masks for use by the city’s police department during the crisis. “It was a great gift,” Harvell says. “While this [pandemic] is going on, we are being extra cautious. And this is an extra tool we can use to protect our officers. It really helps and we appreciate that.”

Chris Wallace, CPO, FAAOP, director of Methodist O&P, explains that they donated the face masks not only to local first responders and law enforcement, but also to each of their state legislators—to enable them to meet more safely in-person. “It was a wonderful thing, and I think it was a morale boost for our staff as well,” says Wallace. “We had several of our techs who were not as busy as they needed to be because of COVID, and we had some furloughs that were taking place throughout the organization. We needed something positive to happen just to keep people coming to work with a good attitude every day. It just gave everybody a common goal to work toward.”

Caring for Displaced Patients and Communities Hanger Clinic has gone to great lengths to keep its patients and clinicians safe during the pandemic. But sometimes it’s the small things that make the biggest impact.

In early October, a Hanger patient from Phoenix traveled to Houston and was unexpectedly hospitalized. Hanger’s team in Houston was there to help. Sandra De La Garza-Perez, Alexis Santana, CPO, and Keith Sardo, MBA, CPO, LPO—employees from Hanger’s Houston location—jumped into action. At the request of the patient’s Phoenix clinician, Jillian Okimoto, CPO, they helped secure and deliver some art and craft supplies and set up a way to get her service dog some regular exercise.

Hanger clinicians went above and beyond when a patient was unexpectedly hospitalized—including ensuring her service dog got regular exercise.

“We not only care about our patients’ mobility, but we also want them to be comfortable wherever they are in the country,” says Jeffrey Elms, MBA, CPO, the Houston regional director of Hanger. “We wish to help in any way we can.”

The Hanger staff members in Houston also were motivated to help out their greater community in September, when hurricanes battered the Gulf Coast, destroying many homes and neighborhoods. Lake Charles, Louisiana—a two-hour drive from Houston—was hit particularly hard, but official help was backed up for months, creating a need for volunteer workers. Elms helped organize a crew that spent Saturdays in September travelling to Louisiana to help clear trees from homes and cut them up, clean up debris from properties, and repair roof damage.

“We make braces or artificial limbs for people, but it’s more than that,” Elms says. “We take care of people. That’s what we’re here to do.”

Donating Face Masks To Those in Need When the pandemic hit in March and accelerated in April, Knit-Rite employees were given a measure of comfort in the fact that making personal protective equipment (PPE)—and Hanger clinicians from Houston traveled to Louisiana in September to help repair hurricane damage.

masks in particular—was right in their wheelhouse, says Kam Howard, KnitRite’s executive vice president. The Kansas City-based designer, marketer, and manufacturer began focusing on making washable, reusable face masks. “We were able to step in and help with PPE and put aside some of the other things that we typically make, and just ramp this up,” Howard recalls.

The company’s charitable goal was to give away one washable, reusable face mask for each one it sold. To date, Knit-Rite has given away a jaw-dropping 120,000 masks, many to those who struggle to put food on the table or keep a roof over their head, much less purchase a high-quality mask to navigate society. “People that could not obtain a mask otherwise, that’s who we really focused on first,” Howard explains.

“We were running around the clock,” she adds, referring to the manufacturing process. “I think our employees are proud that they were able to be part of that and give back to our community. And that’s kind of the core of our mission.”

Boosting Mobility and Athleticism Among O&P Patients Ottobock is a large manufacturing firm based in Duderstadt, Germany, with nearly 50 offices around the globe. So, when the company pitches in, it makes a big impact.

In fact, the company’s stewardship group gave donations to 45 nonprofit organizations in the United States and Canada last year alone, says Aaron G. Holm, the company’s manager of marketing and consumer engagement. Both Steps of Faith, mentioned above, and Andy Roddick Foundation— based in Austin, Texas, and named for the tennis pro who helps at-risk youth—were among the entities that benefitted from Ottobock’s donations. “It’s incredible the impact that we can make on these organizations, and … a lot of them are prosthetic focused,” Holm says. “It could be giving running blades or activity blades to individuals or prosthetics like those in the Endeavor Games, Paralympic-style events held annually.”

Holm, who lost his legs in 2007, also serves as founder and executive director of Wiggle Your Toes, which has a mission to help amputees regain independence and mobility. The nonprofit, which typically focuses on events that help amputees gather and participate in sports, was hamstrung by the COVID crisis and its strict social distancing requirements this year.

“We wanted to spend the money that we had budgeted for 2020, but we needed to shift gears, and that’s where we came up with a ‘Stronger Fitness’ giveaway,” Holm explains. “We talked to the team at Ottobock, and they gave us a great access to their fitness componentry and a nice discount. So, we were able to just start fitting

individuals with running blades and fitness blades. We just tried to keep the disabled community active during the pandemic” by offering equipment to accommodate running, jogging, and other activities. “It’s really helpful to them.”

Celebrating Employees During the Holidays A century-old O&P manufacturing firm with offices around the world, Fillauer values tradition. So, when COVID-19 put the kibosh on the company’s annual in-person holiday celebrations, the Tennessee-based company decided to innovate. “We do give back to our communities, but our employees have gone through a lot this year,” says Vikki Ledbetter, the company’s marketing director. “As a global company with campuses around the United States, and … some business in Europe ... we’ve been thinking about how to unite everyone.”

To that end, the company is compiling a digital photo album comprising photos, stories, or traditions submitted by employees. “It’s just giving people an opportunity to share what’s going on in their lives, even though we can’t all be physically in the same rooms at the same time,” Ledbetter explains. And instead of the traditional office cookie swap, they’ve sent out a call for recipes. Those recipes will be assembled into a cookbook to be distributed to employees at the end of the year.

“These are some of our [company] traditions, so we want to figure out how to carry that on but be respectful of everyone’s health. One of the things I think this helps with is inclusion of different diverse backgrounds or traditions,” Ledbetter explains. “If we can get a recipe or a story or a photo from someone in Sweden about how they’re celebrating the holidays, compared to someone here in Tennessee, that might look very different.

“So, it’s just giving exposure to one another, and just the different ways and things that people do, that they’re proud of, and feel good about around the holiday.”

Helping People When Insurance Won’t Last spring, Teri Kuffel, JD, vice president and co-owner of Minnesotabased Arise Orthotics and Prosthetics, learned that Wiggle Your Toes was advocating for a bilateral amputee in Tuscon, Arizona, whose lower-limb devices were in serious disrepair.

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The Trowbridge Terra-Round foot mounts directly inside a standard 30mm pylon. The center stem exes in any direction allowing the unit to conform to uneven terrain. It is also useful in the lab when tting the prototype limb. TheThe unitunit isis waterproof and has a traction base pad.

The nonprofit organization Wiggle Your Toes assists in donating componentry that helps individuals with limb loss stay active.

The woman, a single parent of two young boys, works in a restaurant and spends a lot of time on her feet, so her defective prostheses were making life difficult. To make matters worse, the woman was having a hard time finding a provider in her Medicaid network to meet her specific needs.

Kuffel’s brother, Joe Pongratz, CPO, FAAOP, owns Pongratz O&P Tucson so she got on the phone and asked him to help. Teaming up with Aaron Holm, founder of Wiggle Your Toes and a manager with Ottobock, Kuffel and Pongratz were able to secure two new Ottobock Challenger Blades. The multi-purpose foot is designed for varying demands, from everyday walking to recreational sports. Kent Sluder, CPO, clinical lead at the Pongratz O&P Tucson office, provided the care.

Wiggle Your Toes seeks to help those with active lifestyles and a commitment to improving their lives. The client in Tucson—a congenital amputee who enjoys working out and staying active—fit that bill.

“Aaron (the founder of Wiggle Your Toes) is amazing, and I am so fortunate to be able to work alongside him on this journey (to be able) to give these gifts to people,” says Kuffel, who serves on the Wiggle Your Toes board. “We do what we can when the insurance doesn’t cover it, and there’s no coverage for things like running blades. So, we look for individuals who fit the WYT mission, who seek to heal, recover, and flourish.”

Michael Coleman is a contributing writer to O&P Almanac.

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Researcher on the Rise

Natalie Harold, MSPO, CPO, begins her first study as principal investigator, thanks to an AOPA/COPL grant

O&P Almanac introduces individuals who have undertaken O&P-focused research projects. Here, you will get to know colleagues and healthcare professionals who have carried out studies and gathered quantitative and/or qualitative data related to orthotics and prosthetics, and find out what it takes to become an O&P researcher.

NATALIE HAROLD, MSPO, CPO, hopes that one day soon, “COMET” will be part of the O&P vernacular. She is currently working on a project, funded by a grant from AOPA and the Center for O&P Learning (COPL), titled, “Development of a Customizable Outcome Measures Electronic Toolkit (COMET).”

The primary goal of this project is to develop a clinic-ready mobile application and web-based management

Natalie Harold, MSPO, CPO, works with a patient while studying related outcome measures data.

PHOTO: Natalie Harold, MSPO, CPO system to increase the utilization of outcome measures within O&P clinics to support evidence-based practice, according to Harold. “There are dozens of outcome measures available for clinicians to use; however, they lack standardization of their selection and implementation, as well as difficulty with analysis and follow-up,” she explains.

“Outcome measure data can not only improve patient care, but it can also strengthen provider documentation for payor reimbursement,” adds Harold. By creating a tool that will help to standardize the process, she hopes to enable practitioners to select appropriate outcome measures, administer them accurately, analyze results quickly to help inform the treatment plan, and expand the wealth of data collectively from clinics across the United States.

Taking Root

Harold currently has positions as both a research prosthetist/orthotist at Orthocare Innovations in Edmonds, Washington, and a clinician at Cornerstone Prosthetics and Orthotics in Everett, Washington. “My role as both an O&P clinician and O&P researcher are to complement one another and keep me focused on the issues that truly matter to our patients and our profession,” she says.

Harold studied mechanical engineering as an undergraduate at Seattle Pacific University, where she also played for the women’s soccer team. It was during that time that she was introduced to O&P. “In my first engineering seminar course, I was given the assignment to report on an engineer whose work I found to be inspirational. I reported on Dean Kamen,” she recalls. Among other accomplishments, Kamen’s work on innovative medical devices, including his contributions to the “LUKE” arm for the Defense Advanced Research Projects Agency, inspired Harold to pursue a path within engineering that she believed would have a positive impact on people’s lives.

“From there, every project I completed until graduation was focused on prosthetic technology. Pursuing a master’s in O&P from the University of Washington was an obvious next step,” Harold recalls. She earned that master’s in 2016 and went on to residencies at University of Michigan Orthotics and Prosthetics Center and Cornerstone Prosthetics and Orthotics. As she completed the pathway to clinical practice, she never lost touch with her passion for research and innovation. “Today, I’ve found the perfect balance, working as both a research prosthetist/orthotist as well as certified and licensed clinical provider of prosthetics and orthotics.”

Branching Out

While the COMET project represents Harold’s first grant award as principal investigator, she has been involved in many other research endeavors over the past several years. Currently, she is part of an ongoing study, through a collaboration with Seattle Children’s Hospital, to evaluate the effectiveness of a tuned ankle-foot orthosis (AFO) and footwear combination versus a traditional solid ankle AFO for use on children with cerebral palsy. “For this study, I am primarily responsible for the walking gait data collection and gait data processing using the VICON motion capture system,” she says. Results of this study are expected to be published in early spring 2021.

Additional past and current research projects have included collaborating Harold (far left) has met with legislators to advocate on behalf of O&P patients and the profession.

to develop a system to improve the prescription of AFOs, studying the effects of concurrent tasks on walking in individuals with transfemoral amputation compared to those without limb loss, researching low back pain among individuals with transtibial amputation, designing AFOs to improve stroke outcomes, and collaborating to develop an energy-harvesting knee prosthesis.

Her commitment to aggregating data and evidence-based practice led Harold to pursue an AOPA/COPL grant to take her COMET project to the next level. “The importance of using outcome measures in clinical practice and in research has been continuously reinforced since I was initially introduced to the topic by Brian Hafner, PhD, as a student in the University of Washington MPO program,” explains Harold. “Practitioners face a challenging reimbursement climate, with record numbers of insurance claim denials and audits.” Adopting an evidence-based approach to clinical care helps patients as well as clinicians, who benefit by safeguarding their investments, she explains. “There is no better protection from an insurance audit than having data on hand to support the choice in prescribed devices or componentry selection and to show the effect that each decision has had on the patient function.”

That being said, Harold recognizes that it isn’t always easy to remember to collect outcome measures with every patient. “I am among one of the worst offenders for forgetting to collect outcome measures, when as a clinician my focus is on patient care, where it should be,” explains Harold. “This is why I’m committed to making the process easy to use for busy clinicians—and even easier to remember to integrate into each patient appointment.”

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More than 630 athletes participated in a race across America as part of the Forrest Stump initiative. In addition to her research endeavors, Harold says she enjoys innovating new and exciting prosthetic and orthotic technologies to help patients restore or improve their abilities. On a personal note, the athlete in Harold enjoys outdoor activities such as backpacking, cycling, running, skiing, and snowboarding—and she takes pleasure in helping others participate in athletics or other activities and adventures as well.

“I continue to seek out any opportunity that comes my way for learning more about adaptive sports equipment and fitting principles because it is what I enjoy doing the most,” she says. In 2017, after completing an ultra-triathlon along the entire West Coast, Harold and her partner, Nicole Ver Kuilen (a transtibial amputee), co-founded a non-profit advocacy group called Forrest Stump (www.forreststump.org) to help raise awareness and improve access to the assistive technologies needed for individuals with disabilities to participate in physical activity. The organization has recently completed a nationwide initiative called “We Just Felt Like Running” to deliver to Congress a signed petition to uphold “The Rights of Americans With Disabilities to Exercise,” according to Harold. The campaign gathered more than 7,000 signatures in support of the petition, recruited over 630 athletes to participate in a virtual race across America, and raised more than $12,000. All of this was achieved in just under five months after the cancellation of the Hood To Coast Relay, which was originally set to take place in August. Of course, Harold will continue to focus on her research and move forward with the COMET study, as well as other investigations related to evidence-based practice. “I believe that one of the most pressing O&P-related questions that can be answered by research—and perhaps identified by outcome trends— is the question surrounding what type of prosthetic or orthotic componentry is most appropriate for a patient’s current and potential functional abilities,” Harold asserts. “A prosthesis or orthosis should enable someone to reach their physical potential and/or athletic goals, but it seems that this technology is often deemed ‘not medically necessary’ and excluded from coverage by many insurance plans. There is a huge amount of ambiguity surrounding medical necessity that I think can be

Active Growth

Harold is co-founder of Forrest Stump, an organization that raises awareness and improves access to assistive technologies.

resolved through scientific research.” Harold presented at the ISPO PACRIM conference in January 2020.

When coverage policies are determined by a lack of evidence, “it should signify the need for researchers to identify knowledge gaps and stimulate further scientific investigation,” Harold adds. “Furthermore, I believe that this research needs to take place in the clinic because if outcomes data can be collected nationwide in a consistent and standardized way, then it has the potential to create a unique wealth of evidence that couldn’t otherwise be studied. If an outcome measure analysis is only considered for an individual patient, clinic, or single research subject pool, then it can only provide anecdotal evidence at best.”

Importantly, Harold emphasizes that issues surrounding patient access should be central to the product development. “I, too, am interested in advancing the cutting edge of prosthetic technology, but not at the expense of making healthcare more expensive and therefore out of reach to the majority of patients.”

Telemedicine as a Tool

New York facility adopts virtual medicine for collaborative appointments

IN 1968, WILLIAM SAMPSON SR. launched Sampson’s Prosthetic and Orthotic Laboratory in the town of his birth: Schenectady, New York. The business was a success, and following the senior Sampson’s death in 2010, his son, Bill Sampson, CP, took over as president. Like his father, Bill Sampson is committed to learning about and adopting new technology to benefit patients.

Sampson works with a patient who lost an arm in a car crash, after targeted muscle reinnervation surgery.

“Forward thinking definitely sets us apart,” says Sampson. He stays current on O&P research and development and offers patients the latest technologies and devices. “We are involved in research in a number of areas, including prepreg manufacturing, and we work closely with the company PVA to develop new 3D devices and technology,” he says. In addition, “we fabricate partial foot prostheses with dynamic spring, do prepreg layups, and build toe-off ankle-foot orthoses.”

Today, Sampson’s P&O Lab remains headquartered in Schenectady but has expanded within the state by opening offices in Albany, Amsterdam, Saratoga Springs, and Queensbury. The company employs 22 staff members and manufactures most devices at the Schenectady office. Sampson’s

From left: Ellie M. Thompson, CRM, CPA; Joseph K. Fairley III, MSPO; Brian E. Clark, CPO, practitioner team leader; Bill Sampson, CP, chief executive officer; Gary D. Morey, CPT, CPA, technical team leader; Jacob Praga, MSPO; and Thomas Heller, CPO, LPO. Seated from left: Sarah Glowa, MSPO, CO, and Radha Bakshi, MSPO, CPO

FACILITY:

Sampson’s Prosthetic & Orthotic Laboratory

OWNER:

Bill Sampson, CP

Bill Sampson, CP

LOCATIONS:

Schenectady, New York, with offices in Albany, Amsterdam, Saratoga Springs, and Queensbury

HISTORY: 52 years

wife, AnneMarie, is a registered nurse and serves as one of the facility’s two compliance officers.

The latest technology is only as good as its effectiveness, and Sampson studies the results. The facility allows patients to test different types of components, such as microprocessor knees, and uses Össur’s ProApp tool to collect data. Patient surveys are standard. “Our goal is to improve functional levels,” says Sampson. “This type of research allows us to make continuous adjustments to improve patient outcomes, based on what works and what doesn’t.”

Some of that in-person research has taken a backseat during the COVID-19 pandemic. While the facility’s physical offices are open, Sampson allows most administrative staff to work from home, rotating in-office duties so that fewer people are on site at any one time.

The facility now relies on telemedicine, combined with in-person visits, to treat many patients. “We set up three-hour virtual clinics,” he explains. “New patients come in, and we conduct videoconferences with medical professionals while they are in the office. The physicians can see our patients on screen, ask questions, and observe as we assess range of motion, skin integrity, contractures, and other situations.” Sampson plans to maintain this hybrid approach even after the pandemic is over. “It allows us to do our job, it minimizes the number of places a patient has to go for treatment, and it definitely saves time and money.”

Before 2020, Sampson’s educational and marketing efforts included hosting continuing education sessions for physical therapists. Virtual training sessions are not as effective, Sampson has found, because some elements require physical interaction, such as gait evaluation. Similarly, many of the facility’s community outreach efforts have been put on hold. The facility sponsors an annual Sarcoma Strong running event, which this year took a virtual approach. The group encouraged participants to run wherever they chose and share their experience on social media before, during, and after the run.

Sampson’s P&O Lab’s commitment to education includes involvement with the residency program of the American Board for Certification in Orthotics, Prosthetics, and Pedorthics, with three residents currently on staff. “We turn out a lot of residents,” says Sampson. “Several did preliminary stints here as techs, and then went off for graduate studies. We are fortunate to have them back as residents.

“We have a great team here,” he concludes. “We are passionate about patient care, and it shows.”

Deborah Conn is a contributing writer to O&P Almanac. Reach her at deborahconn@verizon.net.

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ALPS Liner Selection Tool

We are pleased to present our newest creation: Choose Your Liner!* This is the first tool starting from the patient clinical condition to help select the best solutions. After five quick questions to answer, you will know what Alps product to choose from. Questions can range from activity level, amputation level, limb shape, and various clinical conditions, to help pin-point your exact specifications. This great new online tool is also available on mobile devices as well, via Google Play. Explore it and share your experience with us.

Call us or visit www.easyliner.com for more information.

Apis

Apis custom programs offer practitioners best options and services for patient compliance. All products are covered under risk-free guaranteed-fit promise. We stand firmly behind our words.

Call us at 1-888/937-2747.

The Original Preflexed Suspension Sleeve

ESP created the Flexi family of suspension sleeves as a comfortable, durable, and cost-effective alternative to traditional suspension sleeves. Preflexed at 43 degrees for maximum comfort and natural unrestricted movement.

For more information, call ESP LLC at 888/932-7377 or visit www.wearesp.com.

Coyote Design’s Zero-Clearance Lock

The Proximal Lock is a zero-clearance lock mechanism that also controls rotation. Mounted on the side of the liner and socket proximally instead of distally allows for the use of any distal adaptor.

The Proximal Lock was designed to work with and can be primary suspension for long limbs that may not have room distally for other lock options. The lock can also be used with seal band liners.

This lock was created for Matt Perkins, chief executive officer of Coyote. Matt won five ITU Triathlon World Championships wearing this lock and still wears it every day.

For more information, contact Coyote Design at 208/429-0026 or visit www.coyotedesign.com.

Aria Plate Valve by Cypress Adaptive

The Aria Plate Valve by Cypress Adaptive is a simple and reliable solution for any suction suspension application that requires auto-expulsion function with push-button release. The Aria Plate Valve saves on fabrication time as it simply bolts to any four-hole mounting plate. It is cost effective, durably constructed, and easily disassembled for cleaning and servicing.

To learn more, visit us at www.cypressadaptive.com or call 888/715-8003.

Custom Dynamic Walk

Fillauer’s Custom Dynamic Walk is recommended for patients who need to accommodate the unique shape of their foot and leg, or specific functional needs. Whether the patient needs greater toe lift or unique sizing, including pediatric sizing, this device can be made to suit their needs.

Order yours at Fillauer.com.

LEAP Balance Brace

Hersco’s Lower-Extremity Ankle Protection (LEAP) brace is designed to aid stability and proprioception for patients at risk for trips and falls. The LEAP is a short, semirigid ankle-foot orthosis that is functionally balanced to support the foot and ankle complex. It is fully lined with a lightweight and cushioning Velcloth interface, and is easily secured and removed with two Velcro straps and a padded tongue.

For more information, call 800/301-8275 or visit www.hersco.com.

Naked Prosthetics

Naked Prosthetics designs and manufactures high-quality prosthetic devices specifically for finger loss. Our mission is to assist people with digit amputation(s) and positively impact their lives with fully articulating, custom finger prostheses. Our product aims to restore the ability to perform most tasks, supporting job retention and an active lifestyle. Our customers have lost fingers to power tools, equipment malfunctions, injury in the line of military service, random accidents, and infections; in some cases, multiple digits have been lost. NP provides a viable functional prosthesis, as opposed to a passive cosmetic solution. Our design mimics finger motion and utilizes the remainder of an amputee’s digit to power the device.

For more information, visit www.npdevices.com.

The Xtern Foot Drop AFO by Turbomed Orthotics

Think outside the shoe! This one-of-akind orthosis (AFO) is a game changer for foot drop patients: The Xtern is totally affixed outside the shoe to maximize comfort, and prevent skin breakdown and rubbing injuries. Its flexibility promotes maximal ankle range of motion and calf muscle strength. The Xtern allows running, walking, and even mountain hiking as long and as far as you want without any restrictions, and moves from sandals to boots flawlessly.

Turbomed’s innovative products are designed in Quebec, Canada, sold in over 26 countries, and distributed by Cascade in the United States. Visit turbomedusa.com to get your life back!

Amparo Confidence TT Socket by Ottobock

Are you ready for a revolution in interim socket technology? The Amparo socket is formed over a liner directly onto the user’s residual limb which means a new socket can be made in one go. Benefits include: • One-visit fittings • Easy alignment with offset distal adapter • No plaster casting required • Re-moldable material for fast socket (re)shaping and adjustments • Mobile oven and toolset for anywhere, anytime socket adjustments • Valve or pin suspension options.

For more information, contact your sales representative or visit professionals.ottobockus.com.

Ottobock Master Technicians at Your Service

At the Ottobock After-Sales Service Center, our mastertrained technicians are here to help with reliable, routine maintenance and high-quality repairs. We also offer the most generous loaner program in the industry so your patients can continue to live their lives safely while their devices are being serviced. Get peace of mind for you and your patients.

For help with maintenance or repairs, call us at 800/328-4058.

PROTEOR RUSH ROGUE®

The PDAC-approved RUSH ROGUE® provides the most realistic & dynamic foot and ankle motion available. The Vertical Loading Pylon (VLP) provides vertical shock relief while offering +/- 8 degrees of torsion, allowing the user to push the foot and themselves to the limits. The RUSH ROGUE is made of our advanced fiberglass composite, which is three times more flexible than conventional prosthetic feet. The roll-through characteristics of the foot provide exceptional energy return with no “dead spot.” The RUSH ROGUE is also available in the EVAQ8 elevated vacuum and H2O models. #goROGUE

Spinal Technology Inc.

Spinal Technology Inc. is a leading central fabricator of custom spinal and scoliosis orthoses. Our ABC-certified staff orthotists collaborate with our highly skilled, experienced technicians to provide the highest quality products and fastest delivery time, including weekends and holidays, as well as unparalleled customer support in the industry.

Spinal Technology is the exclusive manufacturer of the Providence Nocturnal Scoliosis® System, a nocturnal bracing system designed to prevent the progression of scoliosis, and the patented FlexFoamTM spinal orthosis.

For information, contact 800/253-7868 or visit www.spinaltech.com.

Statement of Ownership, Management and Circulation (required by U.S.P.S. Form 3526)

1. Publication Title: O&P Almanac 2. Publication No.: 1061-4621 3. Filing Date: 9/28/20 4. Issue Frequency: Monthly 5. No. of Issues Published Annually: 11 6. Annual Subscription Price: $59 domestic/$99 foreign 7. Complete Mailing Address of Known Office of Publication (Not Printer): American Orthotic & Prosthetic Association, 330 John Carlyle St., Suite 200, Alexandria, VA 22314 8. Complete Mailing Address of Headquarters or General Business Office of Publisher (Not Printer): Same as #7 9. Full Names and Complete Mailing Addresses of Publisher, Editor, and Managing Editor: Publisher: Eve Lee, address same as #7. Editor: Josephine Rossi, Content Communicators LLC, PO Box 938, Purcellville, VA 20132. 10. Owner (Full Name and Complete Mailing Address): American Orthotic & Prosthetic Association, same as #7 11. Known Bondholders, Mortgagees, and Other Security Holders Owning 1 Percent or More of Total Amount of Bonds, Mortgages, or Other Securities: None. 12. The purpose, function, and nonprofit status of this organization and the exempt status for federal income tax purposes: Has Not Changed During the Preceding 12 Months. 13. Publication Name: O&P Almanac 14. Issue Date for Circulation Data Below: August 2020

15. Extent and Nature of Circulation:

a. Total number of Copies (Net Press Run) b. Paid and/or Requested Circulation (1) Paid or Requested Outside-County Mail Subscriptions (2) Paid In-County Subscriptions (3) Sales Through Dealers and Carriers, Street Vendors, Counter Sales, and other non-USPS Paid Distribution (4) Other Classes Mailed through the USPS c. Total Paid and/or Requested Circulation d. Free Distribution by Mail (1) Outside-County as Stated on Form 3541 (2) In-County as Stated on Form 3541 (3) Other Classes Mailed through the USPS (4) Free or Nominal Rate Distribution Outside the Mail e. Total Free or Nominal Rate Distribution f. Total Distribution g. Copies not Distributed h. Total i. Percent Paid and/or Requested Circulation Avg. No. Copies Each Issue During Preceding 12 Months

11,387.64

10,817.27 0 27.55

4.45 10,849.27

0 0 0 369.64 369.64 11,218.91 162.64 11,381.55 97% No. Copies of Single Issue Published Nearest to Filing Date

11,134

10,880 0 0

3 10,811

0 0 0 134 134 10,945 191 11,136 99%

Opportunities for O&P Professionals

Job Location Key:

- Northeast - Mid-Atlantic - Southeast - North Central - Inter-Mountain - Pacific

Hire employees and promote services by placing your classified ad in the O&P Almanac. Include your company logo with your listing free of charge.

Refer to www.AOPAnet.org for content deadlines. Ads can be posted and updated any time online on the O&P Job Board at jobs.AOPAnet.org. No orders or cancellations are taken by phone. Send classified ad and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711 or email jburwell@AOPAnet.org along with VISA or MasterCard number, cardholder name, and expiration date. Make checks payable in U.S. currency to AOPA. Note: AOPA reserves the right to edit calendar listings for space and style considerations.

O&P Almanac Careers Rates

Color Ad Special

1/4 Page ad 1/2 Page ad

Member

$482 $634

Nonmember

$678 $830

Listing Word Count

50 or less 51-75 76-120 121+

Member

$140 $190 $260 $2.25 per word

Nonmember

$280 $380 $520 $5 per word

ONLINE: O&P Job Board Rates Visit the only online job board in the industry at jobs.AOPAnet.org.

Job Board

50 or less

Member

$85

Nonmember

$280

For more opportunities, visit: http://jobs.AOPAnet.org.

SUBSCRIBE

A large number of O&P Almanac readers view the digital issue— If you’re missing out, visit issuu.com/americanoandp to view your trusted source of everything O&P.

WANTED!

A few good businesses for sale.

Lloyds Capital Inc. has sold over 150 practices in the last 26 years.

If you want to sell your business or just need to know its worth, please contact me in confidence.

Barry Smith Telephone: (O) 323/722-4880 • (C) 213/379-2397 Email: loyds@ix.netcom.com

AOPA’s O&P Career Center

Connecting highly qualified O&P talent with career opportunities

EMPLOYEE Research who is hiring Apply online for job openings Free résumé review

EMPLOYER Post your job in front of the most qualified group of O&P professionals Search anonymous résumé database to find qualified candidates Manage your posted jobs and applicant activity easily on this user-friendly site.

CareerOpportunities...

California CO-Sacramento CO-Modesto CPO-Salinas

Oregon

CPO –Corvallis & Salem

Washington CPO-Richland

To apply, submit resume to: careers@pacmedical.com

Established in 1987, Pacific Medical Prosthetics and Orthotics has become a tenured company in the industry for superior patient care, products and services.

The positions we offer are created for candidates that are looking to create opportunity, self-driven, motivated, and enjoy serving and helping others.

A competitive salary, benefits and profit sharing are offered based on position/experience.

OurCulture & Commitment “We willserve andhelp othersgrowpersonally, professionally, andstrive toputothers needs first andforemostas demonstratedby ourpositive attitude, teamworkandprofessionalism. ”

AD INDEX

Advertisers Index

Company Allard USA ALPS South LLC American Board for Certification in Orthotics, Prosthetics, & Pedorthics Amfit Apis Footwear Company Becker Orthopedic Cailor Fleming Insurance Coyote Design Cypress Adaptive LLC ESP LLC Ferrier Coupler Inc. Fillauer Companies Inc. Hersco Naked Prosthetics Ottobock PROTEOR USA Surestep Spinal Technology Inc. TurboMed Orthotics Page 5 31

47 37 40 21, 45 43 17 15 29 39 7 1 19, 33 C4 9 23 27 3 Phone 866/678-6548 800/574-5426

703/836-7114 800/356-3668 888/937-2747 800/521-2192 800/796-8495 800/819-5980 888/715-8003 888/WEAR-ESP 810/688-4292 800/251-6398 800/301-8275 888/977-6693 800/328-4058 855/450-7300 877/462-0711 800/253-7868 888/778-8726 Website www.allardusa.com www.easyliner.com

www.abcop.org www.amfit.com www.apisfootwear.com www.beckerorthopedic.com www.cailorfleming.com www.coyotedesign.com www.cypressadaptive.com www.wearesp.com www.ferrier.coupler.com www.fillauer.com www.hersco.com www.npdevices.com www.professionals.ottobockus.com www.proteorusa.com www.surestep.net www.spinaltech.com www.turbomedorthotics.com

WEBINAR

www.AOPAnet.org.

December 9

New Year: New Codes, Fees, and Updates. For more information, visit

APPLY ANYTIME. TEST ANYWHERE. Become a BOC-certified orthotic fitter, www.bocusa.org mastectomy fitter, or durable medical equipment specialist. Exams are offered year-round: in-person at test centers and select conferences and online from the location of your choice with a live, remote proctor! Visit www.bocusa.org/certification/apply.

Cascade Dafo Institute Nine free ABC-approved online education courses to enhance your clinical practice. Take anytime, anywhere, and earn up to 14.5 CE credits. Visit cascadedafo.com or call 800/848-7332.

2020

December 1

ABC: Application Deadline for February Written & Simulation Exams. Applications must be received by December 1 for individuals seeking to take the February written and simulation certification exams. Contact 703/836-7114, email certification@ABCop.org, or visit ABCop.org/individual-certification.

December 1

ABC: Practitioner Residency Completion Deadline for Winter CPM Exams. All practitioner candidates have an additional 30 days after the application deadline to complete their residency. Contact 703/836-7114, email certification@ABCop.org, or visit ABCop.org/individual-certification.

December 7–12

ABC: Written and Simulation Certification Exams. ABC certification exams will be administered for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, orthotic and prosthetic assistants, and technicians in 350 locations nationwide. Contact 703/836-7114, email certification@ABCop.org, or visit ABCop.org/individual-certification.

2021

January 1

ABC: Practitioner Residency Completion Deadline for February Written and Simulation Exams. All practitioner candidates have an additional 30 days after the application deadline to complete their residency. Contact 703/836-7114, email certification@ABCop.org, or visit ABCop.org/individual-certification.

WEBINAR January 8

Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.

January 8–9

ABC: Orthotic Clinical Patient Management (CPM) Exam. ABC Testing Center, Tampa, FL. Contact 703/836-7114, email certification@ABCop. org, or visit ABCop.org/individual-certification.

WEBINAR January 13

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

January 22–23

ABC: Prosthetic Clinical Patient Management (CPM) Exam. ABC Testing Center, Tampa, FL. Contact 703/836-7114, email certification@ABCop. org, or visit ABCop.org/individual-certification.

February 1

ISPO 18th World Congress Deadline for Symposia and Instructional Courses. For more information, contact the ISPO World Congress team at info@ispo-congress.com or call +49/341-678-8237.

WEBINAR

WEBINAR February 5

Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.

February 10

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

March 5

Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.

WEBINAR March 10

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

March 29

ISPO 18th World Congress Deadline for Free Papers. For more information, contact the ISPO World Congress team at info@ispo-congress.com or call +49/341-678-8237.

WEBINAR April 2

Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.

WEBINAR April 14

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

May 4–7

47th Academy Annual Meeting & Scientific Symposium. Hyatt Regency, New Orleans. For more information, visit www.oandp.org/page/annual_meeting.

WEBINAR May 12

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

May 12–14

New York State Chapter of American Academy of Orthotists and Prosthetists (NYSAAOP) Meeting. Rivers Casino & Resort, Schenectady, NY. For more information, visit nysaaop.org/meeting.

WEBINAR

WEBINAR

WEBINAR May 14

Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.

June 4

Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.

June 9

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

WEBINAR July 2

Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.

WEBINAR July 14

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

WEBINAR August 11

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

WEBINAR September TBD

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

September 9–12

AOPA National Assembly. Boston. For more information, visit www.AOPAnet.org.

WEBINAR October 13

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

November 1–4

ISPO 18th World Congress. Expo Guadalajara Convention & Exhibition Centre in Guadalajara, Mexico. For more information, contact the ISPO World Congress team at info@ispo-congress.com or call +49/341-678-8237.

WEBINAR

WEBINAR November 10

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

December 8

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

2022

January 9–11

U.S. ISPO Pacific Rim Conference. Waikoloa, Hawaii (Big Island). For more information, visit www.usispo.org.

Calendar Rates

Let us share your next event!

Phone numbers, email addresses, and websites are counted as single words. Refer to www.AOPAnet.org for content deadlines. Send announcement and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711, fax 571/431-0899, or email jburwell@AOPAnet.org along with VISA or MasterCard number, the name on the card, and expiration date. Make checks payable in U.S. currency to AOPA. Note: AOPA reserves the right to edit calendar listings for space and style considerations.

Words/Rate

25 or less 26-50 51+

Color Ad Special

1/4 page Ad 1/2 page Ad

Member

$40 $50 $2.25/word

$482 $634

Nonmember

$50 $60 $5.00/word

$678 $830 For information on continuing education credits, contact the sponsor.

Questions? Email info@aopanet.org.

Information Sharing

Updates from Illinois, New York, Oregon, and Virginia

Each month, State by State features news from O&P professionals about the most important state and local issues affecting their businesses and the patients they serve. This section includes information about medical policy updates, fee schedule adjustments, state association announcements, and more.

Request for Information

AOPA is seeking information from its members on current efforts to address health disparities and inequities in O&P patient populations across the country. If you are working to develop any initiatives or are aware of initiatives in your state, AOPA would like to hear about them. Please send information to AOPA’s Ashlie White, MA, at awhite@aopanet.org.

These reports are accurate at press time, but constantly evolve. For up-to-date information about what is happening in your state, visit the Co-OP at www. AOPAnet.org/resources/co-op.

Illinois

The Illinois Society of Orthotists and Prosthetists is working with the Illinois Department of Financial and Professional Regulation (IDFPR) to include online learning as an accepted form of continuing education due to limited in-person options as a result of the pandemic. The state’s Orthotics, Prosthetics, and Pedorthics Practice Act of 2000 was enacted when there was no virtual learning available; therefore, the IDFPR interprets the current Education Rule to require “solely in-person” learning unless other options are included in the language of the Administrative Rule. The IDFPR is not offering continuing education unit (CEU) waivers or reduction in CEUs for the September 2021 license renewal requirement, but it has negotiated a temporary Emergency Rule.

New York

O&P facilities in New York continue to pursue a Medicaid O&P fee schedule increase and have secured support from New York State Assembly Members Richard N. Gottfried (D-District 75) and Alieen M. Gunther (D-District 100). The group is working on a multipronged approach to garner support for the effort, including outreach to patient support groups and associations as well as the development of a white paper with supporting claims data. For more information, contact Ted Drygas at ted@carecrafters.com.

Oregon

AOPA members in Oregon are working on efforts to increase Medicaid reimbursement for cranial remolding orthoses and to find a pathway for appropriate coding and reimbursement of contracture/serial casting. Nathanial Hampson, CPO, has shared a draft letter outlining the need for an appropriate pathway for reimbursement in order for orthotists to provide contracture/serial casting for patients with appropriate indications. The letter argues that serial casting is a proven protocol that maximizes functional outcomes without the risk or cost associated with surgery. A copy of the letter is available on the Oregon page of the AOPA Co-OP.

Virginia

O&P providers in Virginia have expressed increasing concern with the lack of Medicaid coverage of orthoses for adult patients and the scope and enforceability of the Virginia Insurance Fairness Law. Following AOPA’s testimony to the Virginia House of Delegates in support of HB 503 and SB 382 last year, the Virginia Orthotic & Prosthetic Association confirmed that similar efforts would be pursued during the next legislative session.

Submit Your State News

To submit an update for publication in the State by State department of O&P Almanac, email awhite@AOPAnet.org.