February 2010 O&P Almanac by AOPA

Almanac OP The American Orthotic & Prosthetic Association

FEBRUARY 2010

WWW.AOPANET.ORG

THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY

The Realities of

ELDER CARE

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Professional GRANT WRITING Tips Revealed REAL-LIFE CHALLENGES Facing Facility Owners

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O&P Almanac FEBRUARY 2010, VOLUME 59, NO. 2

COLUMNS

COVER STORY

Strategies for Serving Seniors By Kim Fernandez

[16]

Caring for older patients involves attention to age-related conditions such as strokes and osteoporosis. But practitioners who specialize in elder care stress the importance of also understanding and managing patient expectations to improve outcomes.

By Deborah Conn

Looking for an outside organization to fund your next O&P research project? Donâ&#x20AC;&#x2122;t apply until youâ&#x20AC;&#x2122;ve read this primer on the basics of grant writing and the review process.

[22]

Reimbursement Page Learn the consequences of HIPAA non-compliance

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DEPARTMENTS

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FEATURE STORY

CONTENTS

AOPA Contact Page How to reach staff

In the News Updates and company announcements

AOPA Headlines News about AOPA initiatives, meetings, member benefits, and more

Marketplace Products and services for O&P

Jobs Opportunities for O&P professionals

Calendar

Upcoming meetings and events

Ad Index

Visit O&P Almanac online at www.AOPAnet.org.

O&P Almanac (ISSN: 1061-4621) is published monthly by the American Orthotic & Prosthetic Association, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314; 571/431-0876; fax 571/4310899; e-mail: almanac@AOPAnet.org. Yearly subscription rates: $59 domestic; $99 foreign. All foreign subscriptions must be prepaid in U.S. currency, and payment should come from a U.S. affiliate bank. A $35 processing fee must be added for non-affiliate bank checks. O&P Almanac does not issue refunds. Periodical postage paid at Alexandria, VA, and additional mailing offices. Postmaster: Send address changes to: O&P Almanac, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314. For advertising information, contact Dean Mather, M.J. Mrvica Associates Inc. at 856/768-9360, e-mail: dmather@mrvica.com. FEBRUARY 2010 O&P ALMANAC

AOPA CONTACT INFORMATION AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION (AOPA) 330 John Carlyle St., Ste. 200, Alexandria, VA 22314 AOPA Main Number: 571/431-0876 AOPA Fax: 571/431-0899 www.AOPAnet.org EXECUTIVE OFFICES

MEMBERSHIP AND MEETINGS

Thomas F. Fise, JD, executive director, 571/431-0802, tfise@AOPAnet.org

Tina Moran, CMP, senior director of membership operations and meetings, 571/431-0808, tmoran@AOPAnet.org

Don DeBolt, chief operating officer, 571/431-0814, ddebolt@AOPAnet.org O&P ALMANAC Thomas F. Fise, JD, publisher, 571/431-0802, tfise@AOPAnet.org Josephine Rossi, editor, 703/914-9200 ext. 26, jrossi@strattonpublishing.com

Kelly Oâ&#x20AC;&#x2122;Neill, manager of membership and meetings, 571/431-0852, koneill@AOPAnet.org Steven Rybicki, communications manager, 571/431-0835, srybicki@AOPAnet.org Michael Chapman, coordinator, membership operations and meetings, 571/431-0843, mchapman@AOPAnet.org

OP Almanac &

PUBLISHER Thomas F. Fise, JD EDITORIAL MANAGEMENT Stratton Publishing & Marketing Inc. ADVERTISING SALES M.J. Mrvica Associates Inc. DESIGN & PRODUCTION Marinoff Design, LLC PRINTING United Litho Inc.

BOARD OF DIRECTORS OFFICERS President James A. Kaiser, CP, Scheck & Siress, Chicago, IL President-Elect Thomas V. DiBello, CO, FAAOP, Dynamic O&P, LLC, Houston, TX

Catherine Marinoff, art director, 786/293-1577, catherine@marinoffdesign.com

Erin Kennedy, office, meetings administrator, and associate editor, AOPA in Advance, 571/431-0834, ekennedy@AOPAnet.org

Dean Mather, advertising sales representative, 856/768-9360, dmather@mrvica.com

AOPA Bookstore: 571/431-0865

Steven Rybicki, production manager, 571/431-0835, srybicki@AOPAnet.org

GOVERNMENT AFFAIRS

Immediate Past President Brian L. Gustin, CP, BridgePoint Medical Inc., Suamico, WI

Kathy Dodson, senior director of government affairs, 571/431-0810, kdodson@AOPAnet.org

Executive Director/Secretary Thomas F. Fise, JD, AOPA, Alexandria, VA

NEW!

Erin Kennedy, staff writer, 571/431-0834, ekennedy@AOPAnet.org

Visit O&P Almanac online at www.AOPAnet.org.

Devon Bernard, reimbursement services coordinator, 571/431-0854, dbernard@AOPAnet.org Joe McTernan, director of reimbursement services, 571/431-0811, jmcternan@AOPAnet.org Reimbursement/Coding: 571/431-0833, www.LCodeSearch.com a

Vice President Bert Harman, Otto Bock Health Care, Minneapolis, MN Treasurer James Weber, MBA, Prosthetic & Orthotic Care, Inc., St. Louis, MO

DIRECTORS Kel M. Bergmann, CPO, SCOPe Orthotics and Prosthetics Inc., San Diego, CA Rick Fleetwood, MPA, Snell Prosthetic & Orthotic Laboratory, Little Rock, AR Russell J. Hornfisher, Becker Orthopedic Appliance Co., Troy, MI Alfred E. Kritter, Jr., CPO, FAAOP, Hanger Prosthetics & Orthotics Inc., Savannah, GA Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI Mahesh Mansukhani, MBA Ossur Americas, Aliso Viejo, CA

2010 EDITORIAL ADVISORY BOARD Rick Bowers Amputee Coalition of America

Joel J. Kempfer, CP, FAAOP Kempfer Prosthetics Orthotics Inc.

Rick Fleetwood Snell Prosthetic & Orthotic Laboratory

Tabi King Ossur North America

Steve Hill, CO Delphi Ortho

Anita Liberman-Lampear, MA University of Michigan Orthotics and Prosthetics Center

Russell J. Hornfisher Becker Orthopedic Appliance Co. Fran Varner Jenkins Fillauer Companies Inc.

O&P ALMANAC FEBRUARY 2010

David Rotter, CO, CP, LO, LP, L.Ped Scheck and Siress Gary Steren, CPO Cornell Orthotics & Prosthetics Inc.

John H. Reynolds, CPO, FAAOP, Reynolds Prosthetics & Orthotics Inc., Maryville, TN Lisa Schoonmaker, CPO, FAAOP, Tandem Orthotics & Prosthetics Inc., Sartell, MN Frank Vero, CPO, Mid-Florida Prosthetics & Orthotics, Ocala, FL Copyright 2010 American Orthotic and Prosthetic Association. All rights reserved. This publication may not be copied in part or in whole without written permission from the publisher. The opinions expressed by authors do not necessarily reflect the official views of AOPA, nor does the association necessarily endorse products shown in the Almanac. The Almanac is not responsible for returning any unsolicited materials. All letters, press releases, announcements, and articles submitted to the Almanac may be edited for space and content. The magazine is meant to provide accurate, authoritative information about the subject matter covered. It is provided and disseminated with the understanding that the publisher is not engaged in rendering legal or other professional services. If legal advice and/or expert assistance is required, a competent professional should be consulted.

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In the News

Photo: © Shawn G. Henry

New MIT Device Aids Amputee Runners

Herr demonstrates the PowerFoot.

Massachusetts Institute of Technology (MIT) Associate Professor Hugh Herr and his biomechatronics group are developing devices that may not only restore but also improve function for amputees. The research team has already developed a robotic ankle and foot, called PowerFoot, which will be commercially available in the near future. Their latest creation is called ActiveRun, a device that would be used for running. Its position and pressure would be monitored by processors and sensors in its “ankle.” It will be able to sense the rhythm of the stride and use a steel cable that will compress a spring at just the right time to increase the power of the runner’s push off the ground. Herr, who is the inventor of Ossur’s Rheo Knee, is himself a double-amputee, having lost both legs below the knee in 1982 as the result of frostbite. Herr is

recognized for pioneering research to develop a new class of biohybrid or “smart” prostheses. Another MIT researcher, Ernesto C. Martinez-Villalpando, is working on a prosthetic knee that will function similar to the PowerFoot ankle. The battery-powered Antagonist Agonist Knee Prosthesis features springs on both the front and back of the thigh, and sensors and processors to discern the knee’s position. The device would be capable of making hundreds of small adjustments per second. Herr’s team also is working on a running exoskeleton that would allow the user to run but use no more energy than would be needed for walking. Herr’s goal for the design is permitting a runner to save up to 30 percent of his or her energy. For more information, visit http:// biomech.media.mit.edu/index.

Thought-controlled Hand Tested in Italy

O&P ALMANAC FEBRUARY 2010

was comfortable using the device. To do so, Petruzziello had only to concentrate on sending the device the same messages he would have sent to his natural hand. By the time the experiment ended, the device obeyed Petruzziello’s mental commands 95 percent of the time. The electrodes remained attached to the amputee for a month, but the goal is for a longer term and eventually permanent attachment. The team estimates it will be two to three years before a similar device can be tested for a longer period of time.

Petruzziello and LifeHand

Photo: Associated Press

The LifeHand, a bionic hand that can be controlled solely by the user’s thoughts, has been tested successfully on an Italian amputee. The subject was able to wiggle the fingers of the device independently, make a fist, and grab objects, reports British newspaper The Sun and other news sources. The device was developed at the Bio-Medical Campus University of Rome as part of a reported $3.3 million project. LifeHand was tested on the 26-year-old amputee, Pierpaolo Petruzziello, who lost most of one arm in a car accident. He first underwent surgery to implant electrodes in his residual limb. Within a few days, he

In the News

Debate Continues Over Runner’s

PROSTHETIC ADVANTAGE A new study published in The Journal of Applied Physiology says that Paralympics champion and double-amputee Oscar Pistorious’s use of prosthetic blades may have given him a competitive advantage after all. Pistorious’s quest to compete against able-bodied runners first gained international prominence before the 2008 Beijing Olympics. Scientists working for the International Association of Athletic Federations announced that his prosthetic blades gave him an advantage over other athletes. Pistorious appealed to the Court of Arbitration for Sport in Switzerland, which performed further testing and concluded that the devices offered no special advantage. The new study, written by researchers Peter Weyand and Matthew Bundle, says the advantage comes from Pistorious’s ability to turn over his blades—which are lighter than biological legs—faster and with more power than a runner with biological legs. A counterpoint section in the paper, written by five researchers who examined Pistorious in 2008, argues that the prosthetics do not give Pistorious an advantage. The sprinter tried out for Beijing, but missed the qualifying time by 0.3 seconds. He says he’ll continue competing and will try out for the 2012 Olympics in London. a 8

O&P ALMANAC FEBRUARY 2010

TRANSITIONS

PEOPLE IN THE NEWS

Curt A. Bertram, CO, has joined the board of directors of the American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc. (ABC). Bertram has been volunteering with ABC as an orthotics examiner and a member of the exam team for many years. He is currently the area practice manager for Hanger Orthotics and Prosthetics, Inc., in Wisconsin. Charles H. Dankmeyer, Jr., CPO, also has joined ABC’s board. Dankmeyer, who has more than 40 years of experience in the O&P profession, was ABC’s president in 1977, and served on both the character and fitness, and facility accreditation committees. He owns Dankmeyer, Inc., which operates several facilities in Maryland. Roy B. Davis, III, PhD, PE, has been selected by ABC’s board of directors as a new public member of the board. Davis has spent his career researching and teaching in the engineering field and currently serves as director of the Motion Analysis Laboratory for Shriners Hospital for Children in Greenville, South Carolina. Public members of the board are full voting members and represent the interests of consumers, patients, and other public groups

TRANSITIONS

involved in ABC issues. As part of his new role, Davis will speak at orthotic and prosthetic events, participate in amputee educational conferences, and serve as the contact for the general public. Donald Deane Doty, Jr., CPO, has become president of ABC, succeeding Robert S. Lin, CPO, FAAOP, of Wethersfield, Connecticut, who will continue on ABC’s board as immediate past president. Doty joined ABC’s board in 2005 and has been involved in creating many of ABC’s current policies. He has nearly 30 years’ experience in the O&P profession. Gilberto Mejia, CP, was recently honored with the 2009 Volunteer of the Year/Medical Diplomat Award from Physicians for Peace. Mejia was recognized for his efforts in the Dominican Republic, working for eight years with the Physicians for Peace Walking Free program to provide amputee care and physical therapy education to patients and prosthetists. Meija, who has been with Hanger Prosthetics and Orthotics for 35 years, has made nearly 30 trips abroad to help local practitioners create sustainable prosthetic programs.

BUSINESSES IN THE NEWS

The Buffalo VA Medical Center has been selected National Prosthetic Facility of the Year by the Department of Veterans Affairs. The award was presented at the hospital on November 16, 2009, National Prosthetics Day.

Touch Bionics has received a $25,000 Rapid Outreach grant from the state of Ohio. The grant will support expansion of the company’s facility in Hilliard, Ohio, and is expected to add as many as 20 fulltime jobs.

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Reimbursement Page

By Devon Bernard, AOPA government affairs department

Proactive HHS Compliance Audits Debut Under HITECH, expect scrutiny and monetary penalties for HIPAA violations

ast month, we focused on some of the upcoming changes to the Health Insurance Portability and Accountability Act (HIPAA) under the Health Information Technology for Economic and Clinical Health (HITECH) Act. Here, we’ll recap those changes with a few more details, and discuss other changes as well as the consequences of not complying with the new regulations. As a reminder, the new regulations for HIPAA are in effect, but active enforcement will begin on February 22. First, here’s a quick recap of what we reviewed last month: • Business associates (BA) are now required to directly comply with all HIPAA statutes. So, you will want to review any agreements that you have with your BAs and determine if the agreements need to be amended. If your current agreements allow for unilateral changes, then there may be no need to rewrite your agreements. • Second, you, as a covered entity (CE), are now required to notify patients in a timely manner—no less than 60 days—when you learn of a breach of protected health information (PHI). These breach notifications must be in writing, unless you’re using a substitute 10

O&P ALMANAC FEBRUARY 2010

method because you do not have current contact information. You also are required to submit a yearly record of all breaches to the Department of Health and Human Services (HHS). You must notify HHS immediately if a breach containing the PHI of 500 or more people occurs. We also discussed how to determine if a PHI disclosure would constitute a breach. Two key aspects of whether or a not a disclosure constitutes a breach revolve around HITECH exemptions and the results of a risk assessment. The three exemptions, designed to allow for good-faith company disclosures, are as follows: unintentional, inadvertent, and unauthorized. Instead of again reviewing definitions (provided in last month’s issue), the following provides examples of each exemption.

• Unintentional access exemption. In the daily course of business, your biller needs the file for Jane Smith, but instead pulls the file for Jane Smyth. Once the biller realizes the mistake, she places the file back and doesn’t discuss Jane Smyth’s file. There was no breach because the access of the file was done during routine work under her authority and didn’t result in any further uses or disclosures. • Inadvertent disclosure exemption. Your billing company, with whom you have a BA agreement, sent you an explanation of benefits for a patient who is not yours, or you fax a detailed prescription to the wrong physician. Once you realize what has occurred, you correct the action, and the PHI is not disclosed or used any further. In both cases, there is not a breach because all parties involved were authorized to view

Reimbursement Page

the PHI, and are bound by HIPAA not to disclose or use the PHI. • Unauthorized disclosure exemption. During a patient visit, your staff places a different patient’s chart in the examining room with the patient. They immediately recognize the mistake and retrieve the wrong chart. This wouldn’t constitute a breach because there is a good-faith belief that the patient didn’t have enough time to review the chart and retain any of the information. Under HITECH if a breach is discovered, a CE is required to conduct an analysis and document the findings to determine if the breach poses any harm to the patient. This new requirement reinforces the new definition of a breach, and is referred to as a risk assessment or risk of harm standard. This analysis will aid you in your decision as to whether you must notify your patient(s). Within your organization, you will want to appoint an individual who will be responsible for conducting the investigation of breaches and for documenting the outcomes of the risk assessment. Once an individual has been chosen to conduct the risk of harm analysis, what should he or she be looking for? What you wish to include in your organization’s risk assessment will be up to you, but it should include at least the following four components or questions. When reviewing these components and any others you wish to include, be sure that your responses are thorough, fact-based, and well-documented. • First, you will want to determine who accessed the PHI, or to whom the PHI was disclosed. If the PHI is accessed by an individual in your organization who is not authorized to view this information, this could be viewed as a high risk and may require notification. However, if the PHI was impermissibly disclosed to an entity that is governed by HIPAA (i.e. sent the information to

the wrong facility) the likelihood of harm is lower, and may not require notification. • Second, you want to determine the likelihood that breached information was or will be accessed or used. A laptop containing patient information is stolen and later recovered. If you can determine––and prove–– that the information was not accessed, then the risk of harm may be low and notification may not be required. If you can’t prove the information wasn’t accessed, then the likelihood of harm is high and a notification would be required.

The burden of proof is on you to prove that there was no risk or a low risk of harm to a patient, or that the breach falls under one of the exemptions. That is why the individual who conducts the breach investigation must thoroughly document findings and ensure that all results are fact-based. If the individual determines that a breach poses no or low risk to the patient and a notification is not required, this should be documented, as well. This documentation must be retained for six years and be made available to HHS, if it so requests.

Be sure that your responses are thorough, fact-based, and well-documented. • Third, you will want to determine the type and amount of information that was breached. If the information breached was just a list of your patients and no other information, the risk of harm may be low. If the list of names contains Social Security numbers, then the risk of harm is high and would require notification. • Lastly, you will want to document the steps you took to limit the possible chance of harm. You faxed information to the wrong facility, and you were able to get assurance from that facility that staff received the material and shredded the document. In this case, the risk of harm may be low. If you contact the facility and staff says the document was not received, then the risk of harm may be high. The assessment should be done as soon as you learn of a breach, or believe that a breach may have occurred. The reason you want to conduct an immediate assessment is because you are on a tight deadline to meet the notification requirements. Remember that you must notify patients of a breach in a timely manner, but not to exceed 60 days.

The changes we have discussed thus far were geared directly to you and your BAs, but provided indirect protection to patients, enabling them to be aware of breaches of their PHI. Patients also should be made aware of another change that allows them to have control over who may view their PHI. Currently, under HIPAA you are under no obligation, unless patients request and you agree, to put restrictions on the disclosure of their PHI. You are now required to fulfill patient requests for restrictions, if the restriction is for PHI pertaining to a service for which the patient paid out of pocket. This means the patient can request that you do not notify an insurance company, or third-party payer, of a treatment, if the patient pays for the service. This change means that you should make the patient aware of this option, perhaps through your notice of privacy practices. If you decide to update your notice of privacy practices, you will have to notify all patients of the change. As such, you may decide to have them all re-sign the form. When you are conducting staff training about the new HIPAA policies, you also may want to stress the importance of their individual compliance. FEBRUARY 2010 O&P ALMANAC

Reimbursement Page

HIPAA VIOLATIONS TIER 1: “Reasonable Diligence” TIER 2: “Reasonable Cause” TIER 3 and 4: “Willful Neglect”

This is critical because they can be held responsible for violating HIPAA. Bear in mind that not only you, as a covered entity, but also an individual employee can be prosecuted for violating HIPAA. HITECH allows the Office of Civil Rights (OCR) to investigate and impose fines on individuals for violating any part of HIPAA. This includes any criminal violations, as long as the Justice Department is not also seeking criminal charges. Finally, HHS has adopted a new tiered approach for handling civil monetary penalties for HIPAA violations and has relinquished all enforcement activities to the Office of Civil Rights. OCR was previously only responsible for enforcing the privacy provisions of HIPAA, but now it will also be responsible for enforcing the security provisions. The first tier is “did not know” or “reasonable diligence” violations. These are HIPAA violations that occur without your knowledge, and couldn’t have been foreseen due to your policy and procedures. These also are violations that occur because you do not have a complete understanding of the laws. In tier one, the minimum penalty is $100 per violation but not to surpass $25,000 in one year for the same violation. The second tier is “reasonable cause” or a violation where you were unable to comply with the standards, but made attempts to become compliant. This means you attempted

O&P ALMANAC FEBRUARY 2010

to comply, but for some reason were unable to do so; you were not intentionally ignoring the laws. In tier two, the minimum penalty is $1,000 per violation and not to surpass $100,000 in one year for the same violation. The maximum amount for a violation in tiers one and two could reach $50,000 for each violation, but not to exceed $1.5 million.

If no attempt is made to correct the violation, tier four will apply, and the penalty will be $50,000 per violation. Tiers three and four are linked because they both hinge on the term “willful neglect.” This means that you intentionally or willfully ignored your obligations under the HIPAA statutes. Tier three will be applied if you take actions to correct the violations. Tier three carries a minimum penalty of $10,000 per violation, but not to surpass $250,000 in one year for the same violation. The maximum amount for a violation in tier three is $50,000 for each violation, but not to exceed $1.5

million. If no attempt is made to correct the violation, tier four will apply, and the penalty will be $50,000 per violation, but not to surpass $1.5 million in one year for the same violation. What does this tier system mean? In simple terms: no more free passes. The new system will allow for increasing penalties depending on your culpability and negligence, and result in a fine of at least $100 per violation. You may argue your case and possibly lower your fine, because the OCR will look at six factors to determine the penalty (i.e., extent of the violation, harm caused by the violation, and past history of compliance). The burden will be yours to prove that the violation was not caused by willful neglect but rather reasonable cause or due diligence. In the past, investigations into HIPAA violations were only done on a complaint-driven basis. HHS would only investigate covered entities if there were a complaint lodged against them. This is no longer the case; under HITECH, the HHS is required to do proactive compliance audits. It is not certain how or what may trigger an audit, or if the audits will be random, but you should be prepared, as the audits may begin this month. The HITECH Act also has granted much greater authority to state attorneys general (AG) in regard to their ability to enforce HIPAA violations on the state level. If HHS and the OCR don’t intend to fine or bring some type of sanction against a covered entity or individual for violating HIPAA, a state’s AG may do so. This means that an AG can now bring a civil action against a covered entity or individual in federal court and seek damages for any HIPAA violations, if the AG believes the actions have harmed the residents of the state. a Devon Bernard is reimbursement services coordinator for AOPA. Reach him at dbernard @AOPANet.org.

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SERVING SENIORS Strategies for

O&P ALMANAC FEBRUARY 2010

BY KIM FERNANDEZ

Emotional support and new perspectives on device usage are musts

ary C. Spires, MD, knows all too well that even the slightest modification to elderly patients’ equipment or therapy feels like an enormous obstacle to them. She sees this reaction every day in her role as professor at the University of Michigan’s Department of Physical Medicine and Rehabilitation, and also as the daughter of an elder patient. “My mother is going to be 97 years old soon,” she says. “And it took us a couple of months to get her to use a walker the right way.” Spires says her mother wanted to make the best use of the equipment, but found it challenging, and even overwhelming, to master the physical skills to do so. “Elderly people are no different than the rest of us,” she says. “They want to use the equipment in the most expedient manner and the easiest way, and that’s not always the best way.” Instead, seniors often develop shortcuts for devices that may be easier to learn and use immediately, but don’t accomplish the goals that were intended by their doctor or practitioner. It’s a challenge that orthotics and prosthetics professionals face every time they work with an elderly patient: Even if the right devices are correctly matched to the seniors, teaching how to use them properly and regularly can be frustrating for both the patient and practitioner. A major obstacle is that many older patients see orthotic devices as visible signs of their loss of independence and strength. This perception often stalls or halts learning to use the device and continue with ongoing therapy. This is further complicated if the patient suffers from memory loss or confusion,

and if family members are not in agreement with the course of treatment for their parent. As a result, practitioners say they spend much of their time serving as a counselor or therapist when a patient is fitted with a new device or prescribed a new therapy, but they add it’s not a role they’re generally trained to handle. They also say that device training also may involve teaching and supporting caregivers or adult children, many of whom also are elderly. According to the experts, a threefold prescription can help perplexed practitioners deal with elderly patients: • Maintain a strong sense of respect for older patients, treating them with dignity, despite the physical and mental challenges that come with age. • Try to think differently about the way devices will be used once the patient leaves the office and returns to their home and daily routine. • Exercise a healthy dose of patience, and provide both the elders and their caregivers and families with the necessary emotional support.

Manage Emotions and Expectations Eric Weber, CPO, LPO, Hanger Prosthetics & Orthotics, Tacoma, Washington, says that most of his elderly patients have had a stroke (post-cerebrovascular) or suffer from an acute or chronic illness or vascular compromise, most often as the result of diabetes or another age-related issue. While a few may have fractures or other injuries, most seniors work with Weber for help with stability, mobility, and other issues that impair day-to-day functions.

FEBRUARY 2010 O&P ALMANAC

“There’s a pass-the-buck mentality with these patients,” he says. “Usually, physicians have reached the bottom of what they can do for the patient, so they end up dumping them into orthotics and prosthetics. The doctor doesn’t know what to do and can’t help them with just walking around their houses, so he or she sends them to an orthotist.” Harry Layton, CPO, LPO, Lawton Brace & Limb, Lawton, Oklahoma, agrees, saying that because his patients are referred for help with issues like balance, they often perceive the consultation as demeaning. “I see a lot of resistance,” he says. “They don’t recognize what’s happening; they don’t see that they’re ailing in that way. So, they don’t want the devices to begin with.” A first step, practitioners say, is to get the patient to not only accept the prescribed device, but also embrace it and learn to use it properly. But this is complicated when doctors prescribe something that’s not appropriate for an older person. Layton says he frequently sees patients prescribed with a device 18

O&P ALMANAC FEBRUARY 2010

that’s impossible for them to use, given their physical limitations. Weber suggests solving this problem carefully. It’s not effective, he says, to question a doctor’s orders with the patient, who may become confused or defensive. Instead, he evaluates the order and then leaves the room. “I try to make sure nothing is said to the patients about their prescription until I’ve evaluated them,” he says. “If I feel what’s been prescribed may be inappropriate, I speak directly with the physician to share what I’ve found and ask if we can find another option for that patient. I then tell the patient, ‘I just spoke with your doctor and we both feel like the limitations of what he wrote aren’t realistic. Let’s think about this.’” Often, he says, there will be a grown child or other caregiver with the patient who can help convince the older person that the O&P practitioner has their best interests in mind. “Ideally, a caregiver or a family member can help me explain what the process is,” he says. “But it’s a very tough situation, especially because they may not even

know why they’re getting whatever they’re getting.” When elderly people don’t agree they have physical challenges, says Layton, grown children can point to specific times when the parent needed extra assistance or couldn’t get around, and then explain how the device or therapy might help. But those same family members also may need support. “Family members, especially grown children, have a tough time watching Mom or Dad start to fail,” says Lawton. “Their parents, who were always larger than life and strong, now need help with the most basic things. That’s really hard on these people.” Some adult children, he says, even refuse to recognize their parents’ problems, which may lead to in-fighting. This puts added stress on elderly patients, who are then too worried about their families to focus on how to use their devices or follow their therapies. “In the worst cases,” he says, “people in their 80s who’ve been married for 60 years get divorced. They resent each other for the stress and for their physical issues, and the whole family can be torn apart.” Spires says when a patient comes in with two or three family members, she asks the family to pick one person who will be her point of contact for the patient. “I need one person who will come with the patient regularly,” she says. “When you set out your criteria, you explain that we need one person who can come every week with you, and it has to be the same person so he or she can learn it, too, and can become teachers at home.” She often asks elderly spouses to also bring along another adult, even if the spouse seems willing to help. “I don’t push the spouse out, but I do ask for another person to come,” she says. It’s also important to recognize that many elderly patients have children who are facing their own age-related issues. “I have patients in their 90s whose kids are in their 70s,” says Weber. He advises young practitioners to get some background in psychology or counseling if they plan to work with the elderly.

It’s important to be aware that elderly patients can have memory and comprehension issues. He says it’s not unusual to have to explain the use of a device over several different appointments. “Many times, patients will come back for a follow-up after a device has been fitted and evaluated,” he says. “We come up with a plan when the device is fitted, and then the patient comes back and still doesn’t understand what’s going on. They were confused at the doctor’s office, and they’re confused by what we’re telling them.”

they need so much support that they’re being fitted with an AFO or an artificial leg, there’s pressure where they’re feeling it. And they’ll tend to find any excuse to talk about why you couldn’t make a brace that they can’t feel or see. Many will decide they don’t need that thing at all. It’s hard to match their expectations.” Spires agrees, saying that most of her patients are fit with prosthetics, not orthotics. “I have to really talk with them about what their expectations are and what we can offer them,” she says. “We may all come at this with a little different perspective on what’s being done and why.”

The Right Perspective

He also spends time with family members to offer support and information. “I get a lot of eye rolls from adult children when a patient is telling me he or she doesn’t need whatever device it is,” he says. “I get nods from family members, with a gesture like, ‘We’ve been over this a million times.’ And then they try to help, explaining ‘You can’t go without it, remember this time?’ They’re supportive, but they’re exhausted.” Weber stresses that it’s important to understand and manage patient expectations. “People become frustrated, especially if it’s a device that’s not easily made invisible,” he says. “If 20

O&P ALMANAC FEBRUARY 2010

“Elderly people can be very detailoriented; they’re very fearful of falling,” Spires observes. “They can be resistant to new equipment because the message is that they’re weak or frail. The device is a symbol of not being as independent.” She finds it helpful to phrase explanations in ways that are optimistic and play down the patient’s physical challenges. “We try to minimize any setback they’re experiencing,” she says. “You kind of have to take on a new view of it. They have a very hard time seeing their own need for a walker or a cane, so sometimes you can win on that by explaining that while they don’t really need it so much, other people need it to know to give them a little space.” Taking time with these patients is key, she says. So, too, is writing down directions, with the hope that patients will both keep track of the document and refer to it. “We do a lot of repetition,” she says. “I also like to have someone go into the house and see them use their equipment there. You really have to integrate the learning into their specific living situation. Teaching them something in the clinic and then having them go home and do it makes for a transition that a lot of elderly patients have difficulty with. I like to use home-visit nurses to go in and say, ‘Here’s where you should set your walker.’”

Then, she says, provide a reason for a follow-up visit in a month or two. “It’s hard to translate learning in a clinic to learning in their house,” she says. “We’re teaching them in generalized situations, when they do things better if they learn in their own world.” She also asks some patients to come see her more frequently, depending on how many challenges they have physically and how much help they’re getting at home. “If I have someone who’s driving himself here, I’ll have him come more often so I can drill the instructions into him,” she says. “Sometimes, they’ll have church members or volunteers along who are willing to check in and learn, as well. And a lot of visiting nurses or therapists will come in and make sure everyone’s on the same page.” Part of her job entails recruiting medical students to work in her clinic, and Spires advises them to get to know older people in their own communities if these are the kinds of patients whom they want to treat. “This helps them know that when they come into the clinic, they’re people just like anyone else,” she says. “It helps them interact better with older patients to know them not just on a medical basis. You can relate them as people, and that helps them absorb things. You need to take an interest in them personally.” Layton agrees. “I’m 54 and I’ve been doing this for more than 30 years,” he says. “You have to have respect for the elderly patients you’re working with. I tell younger people in the business to remember that these people are people. They’re not just symptoms, and a brace for this and a brace for that or an artificial limb. There’s a lot more to them; they’re scared and they’re worried, and they’re losing their independence. What we stand to offer them is so important, and we need to spend time with them. The patients I spend time talking with tell me that no one has ever done that before.” a Kim Fernandez is a contributing writer to O&P Almanac. Reach her at kim@ kimfernandez.com.

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O&P ALMANAC FEBRUARY 2010

BY DEBORAH CONN

Grant Proposals That Work To make the cut, applications must be clear, cogent, and compelling

he country may still be reeling from the recession, but the experts point to a little-known bright spot: Funding is still available to advance research and discovery in the orthotics and prosthetics industry. Two key issues are heightening interest in supporting research: Injured soldiers returning from the wars in Iraq and Afghanistan who need rehabilitation, and the growing needs of an aging population, according to David Boone, PhD, MPH, CP, who is editor of the Journal of Prosthetics and Orthotics, and chief technology officer and co-founder of Orthocare Innovations, based in Seattle. “There are research grants to be had,” he says. “But it is competitive, because there is a limited pot of money. I think that’s a good thing. It helps drive the quality of the proposal pile.” Typically, O&P researchers look for grants from such federal agencies as the National Institutes of Health (NIH) and the National Institute on Disability and Rehabilitation Research (NIDRR). But Boone points to other sources such as the Department of Defense, private charitable foundations, universities, and even states. Each funding source sets its own guidelines and requirements, but the basics of good proposal writing apply to all. Grant writing may be an art, but even beginners can succeed if they

heed the wealth of information available in books, online, and from experienced proposal writers in their own organizations. “If you’re just starting out, you need a mentor,” recommends Stefania Fatone, PhD, BPO (Hons), who works in Chicago as a research associate at the Northwestern University Prosthetics Research Laboratory and Rehabilitation Engineering Research Program (NUPRL & RERP). She also is a research assistant professor at Northwestern University’s Department of Physical Medicine. “Grant writing is predominantly about defining the project and clearly explaining its merits. But there is a lot of ancillary paperwork, and a mentor can help you navigate the paper trail,” she explains. Fatone’s own mentors include Dudley Childress, director emeritus of the NUPRL & RERP, as well as the current director, Steven Gard, PhD. Fatone’s position is fully grantfunded, which means she must write compelling grants to continue working. She and her colleagues have just finished the first year of the current cycle of a five-year, multimillion-dollar NIDRR grant supporting 12 research and development projects, as well as research training and dissemination activities. While Northwestern has been the grant’s recipient since its

inception, it is still open to competition, and Fatone and her colleagues must reapply every five years. More typical, she says, are proposals for single research projects such as those NIH funds through its individual institutes. “Typically, these grants extend for about three years for a few hundred thousand dollars a year,” she says. “Initially, you worry about finding funding for yourself, but as you grow, grants begin to support more people. The NIDRR grant is partially supporting four graduate students, four faculty members, and a handful of other research engineers and assistants.”

The Basics A successful grant proposal must start with a good idea, something that will capture people’s attention and imagination. Expressing this idea clearly is essential. “People have to be precise about the basic concept of the grant,” says Boone. “They may have a goal of making an improved orthosis, but there’s nothing there for the grant reviewer to comment on. You have to give details about what the population is, and why this is different from what’s been done before.” The proposal needs to include a thorough background, including a discussion of similar ideas. It is important to differentiate the research project FEBRUARY 2010 O&P ALMANAC

Tips for Writing Successful Proposals Merete Gerli, information research specialist with the Congressional Research Service, shares advice for successful proposals. To develop a convincing proposal for project funding, the project must fit into the philosophy and mission of the grant-seeking organization or agency. As important, the need that the proposal is addressing must be well-documented and well-articulated. Typically, funding agencies or foundations will want to know that a proposed activity or project reinforces the overall mission of an organization or grant seeker, and that the project is necessary. To make a compelling case, the following should be included in the proposal: ✪✪ the nature of the project including its goals, needs, and anticipated outcomes ✪✪ how the project will be conducted ✪✪ timetable for completion ✪✪ how best to evaluate the results (performance measures) ✪✪ staffing needs, including use of existing staff and new hires or volunteers ✪✪ preliminary budget, covering expenses and financial requirements, to determine what funding levels to seek. An effective grant proposal must make a compelling case. Not only must the idea be a good one, but also so must the presentation. These important elements should be considered: ✪✪ All requirements by the funding source must be met: prescribed format, necessary inclusions, deadlines, and so on. ✪✪ The proposal should have a clear, descriptive title. ✪✪ The proposal should be a cohesive whole, building logically, with one section leading to another. This is especially important if several people have been involved in its preparation. ✪✪ Language should be clear and concise, devoid of jargon; acronyms and terms, which may be unfamiliar to someone outside the field, should be spelled out and explained. ✪✪ Each part of the proposal should provide brief but informative content, and supporting data should be featured in the appendix. 24

O&P ALMANAC FEBRUARY 2010

and explain how it will fill in any gaps in previous studies and what its impact on the field will be. Boone notes that it is even possible to win a grant to redo something that has been successfully demonstrated, as long as you propose new technology or a new angle to the design or testing that is unique. He points out that many reviewers will have a deep and broad knowledge of your field, and they will immediately think of similar studies. “If you address this issue, you have them on your side,” he says. “But if you say your idea is entirely novel, it will turn off the reviewers immediately.” A subject with broad applicability is attractive to reviewers; one with a smaller scope may be harder to sell. An example might be a new prosthesis design for shoulder disarticulation. Unfortunately, says Boone, reviewers might say that the target population is too small. So, while the members of this small group would welcome an improved prosthesis, it might be difficult to find funding for such limited numbers. In contrast, a new orthosis that can aid millions of stroke victims might generate more excitement and opportunity. Once you have presented the hypothesis, you need to be explicit about your plan. “How are you going to achieve this goal?” asks Boone. “You must break it down step by step. It’s like constructing a house: You have to pour the foundation, then frame the exterior walls, then do the windows and doors. Each step builds on the last.” It is essential to include a timeline that shows each step, including alternate paths if negative results are encountered along the way. Flowcharts and decision trees can help illustrate your progress. In describing the plan, you must include information on the person or team who will be performing the work. “Say you’re a good clinician, and you’re proposing an electrical engineering development. You must have a specific electrical engineer involved, even as a consultant, and you must show his credentials,” says Boone. “Reviewers need to know that

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you have that expertise on the team to actually formulate the question and supervise the person who’s doing the work.” Physical resources also are important. If you propose a sophisticated project but you are working from your home office, you won’t seem credible. Boone suggests partnering with someone who has the engineering, scientific, or clinical facilities appropriate to the project. This also is a good idea if you don’t have a research track record, but your partner does. The final element is to show how you will measure the results. Successful proposals include sound methodology for evaluating whether the researcher achieved what he or she set out to do. “Just making a new orthosis is not the success,” says Boone. “Real success is showing the clinical impact of that orthosis.”

Think Like a Reviewer Normally, funding agencies assemble panels to review grant proposals. They may include reviewers who know a great deal about your field as well as those with a more superficial understanding. It’s important to write clearly enough that anyone will understand your message. Explain acronyms and define technical terms; don’t assume that reviewers will understand what you are talking about. “If you ever get the chance to serve on a review panel, take it,” says Fatone. “Even reviewing journal articles and papers will hone your skills.” By experiencing the grant process from the other side of the table, you will be able to identify the elements that make a proposal appealing and easy to follow. Many commercial proposals rely on fancy packaging–slick graphics and an appealing presentation—to increase their visibility. Such tactics are not necessarily appropriate in the academic world, says Fatone. “It takes enough time to get the science right without worrying about production values,” she says. “But if something helps convey a complex idea in a simple way, that would be an asset.” For example, some proposals may 26

O&P ALMANAC FEBRUARY 2010

be submitted electronically, allowing such additions as embedded video clips. But, says Fatone, the idea is to communicate your ideas more clearly, not dazzle the recipient.

What Doesn’t Work Boone says his grant proposals have about a 90 percent success rate. What about the other 10 percent? He suspects that he didn’t convey the value of his ideas well enough to the reviewers. “We all value things differently,” he says. “When you get an idea, it may seem like the most important thing in the world. But you have to convey the impact or importance of your idea really well to get other people to recognize it.” In other cases, Boone believes he may have had the right idea at the wrong time. “Many years ago, my colleagues and I proposed a comprehensive system of measuring functional outcomes of an amputee,” he relates. “The response was that nobody uses functional outcome measures in the amputee population. That was true at the time, but if you look at the industry today, functional outcomes are on everyone’s mind. If we had started then, we’d have 10 years of data to work with.” Disorganized presentations also can lead to rejection. Grant reviewers must look at many proposals, and if they have to work too hard to figure out what yours is saying, they are likely to set it aside. Many funders ask that you follow a specific format so that reviewers will know exactly where to find each piece of information. You don’t want your proposal to stand out

because it ignores that requirement. Another pitfall is applying to the wrong funder. Your proposal must match the mission of whoever is funding it, cautions Fatone. “It might be a good idea in the wrong place.” It may seem obvious that poor grammar, punctuation, and usage will work against a proposal, but reviewers do receive proposals that violate these basic rules. It’s a good idea to have several people proofread the proposal before submitting it, both for proper English as well as for readability and clarity. Include experts in your field as well as readers with less knowledge to make sure everyone can understand the proposal.

Where to Get Help Grant-writing tips are widely available. Many community colleges and private companies offer workshops and seminars in this field. The Center for O&P Learning (www. centerforoandp.org) has published How to Write a Successful Research Grant, and most funding sources offer comprehensive guidelines and tips on their Web sites. An excellent guide to developing and writing a research proposal is available online from the Congressional Research Service (http://assets. opencrs.com/rpts/RL32159_20090609.pdf), and the NIH Web site covers writing tips (http://grants.nih.gov/grants/writing_ application.htm) as well as all other aspects of submitting proposals. a Deborah Conn is a contributing writer for O&P Almanac. Reach her at debconn@ cox.net.

Facility Spotlight

By Deborah Conn (Clockwise from the bottom left) Co-Owner Dennis Ebbing, CPO, with a pediatric patient; and Clinical P&O’s Saratoga, Hudson, and Albany, New York, offices

Increasing Efficiencies

Technology, streamlining help Clinical Prosthetics & Orthotics LLC battle familiar challenges

FACILITY:

Clinical Prosthetics & Orthotics LLC

LOCATION:

Several locations throughout upstate New York

OWNERS: Dennis Ebbing, CPO Glen Case, CPO David Misener, CPO

HISTORY:

12 years in business

O&P ALMANAC FEBRUARY 2010

ith five offices along the Hudson River Valley in upstate New York, Clinical Prosthetics & Orthotics is co-owned by Dennis Ebbing, CPO; Glen Case, CPO; and David Misener, CPO. The facility’s two primary offices are located in Albany and Kingston and include fabrication labs that service the entire practice, including smaller offices in Saratoga, Hudson, and Poughkeepsie. Clinical P&O has been in business for about 12 years, and serves an equal number of prosthetic and orthotic patients. The practice has a staff of 12, evenly divided among CPOs, technicians, and administrative employees. Each of the co-owners’ specialties contributes to a more holistic business. Ebbing spends about 70 percent of his time on prosthetics. A former Iron Man triathlete, he helps amputees who bike, run, ski, rock climb, and

swim resume their favorite activities using cutting-edge prosthetic technology, such as microprocessor feet and ankles. Case is highly specialized in pediatric orthotics, which accounts for the vast majority of his cases, as well as geriatric prosthetics. Misener has a degree in human kinetics and a strong biomechanics background. He sees patients of all ages, dividing his time equally between prosthetics and orthotics. In addition to providing patient care, the owners take an active interest in the advancement of the field and humanitarian work. Case is a past president of the American Academy of Orthotics and Prosthetics of New York State, and Ebbing is both a prosthetic examiner for the American Board for Certification in Orthotics and Prosthetics and a member of AOPA’s Coding Committee. Both men also

Facility Spotlight

make an annual trip to Queretero, Mexico, where they volunteer their services at the nonprofit clinic CRIMAL (Centro para la Rehabilitacion Integral de Minusvalidos del Aparato Locomotor). Misener focuses his volunteer efforts closer to home, where he recently provided prosthetic services to a Guyanese woman brought to the United States by a philanthropist.

Ebbing works with fellow practitioner.

Dealing with Medicare, Documentation Ebbing’s seat on AOPA’s Coding Committee gives him particular insight into what he considers the most significant issue facing his practice: changes to Medicare and Medicaid policies. “One of the biggest changes in the field is the deletion of addition codes for custom devices,” he says. Previously, practitioners could break out elements of a custom device 30

O&P ALMANAC FEBRUARY 2010

and bill for them separately. Now, the billing codes are all-inclusive, which means lower reimbursements, Ebbing points out. As a result, he believes practitioners will have no choice but to reduce the quality of materials or the complexity of devices. “At some level it will filter down to a lower standard of care or passing on the expense to the patient. In some cases, we have to decide whether to provide the service at all or to choose not to accept assignment from Medicare,” he says. In an attempt to preserve a high level of care with lower reimbursements, practitioners at Clinical P&O focus on increasing efficiency. For example, staff members are cross-trained so that if someone is out, someone else can take over. The facility practices just-intime inventory management, and practitioners verify insurance coverage and inform patients of any financial responsibility before proceeding with fabrication. All offices are connected electronically, using practice-management and inventory-control software for maximum efficiency, and the owners also are considering using a web-based billing/practice management system in place of a private network and high-speed data transfer as a way to further save money. Clinicians and technical staff work extensively with CAD-CAM (computer-aided design and manufacturing) to fabricate and modify devices. Ebbing (who has degrees in mechanical engineering and business) also looks for cost-saving innovations in fabrication techniques and materials as well as more efficient business processes. Ebbing’s work on the Coding Committee has made him acutely aware of documentation requirements as well. “Medicare policy has become

(From left) Co-Owners Glen Case, CPO, and David Misener, CPO

very complicated, and it’s easy to lose out on coverage unless you pay very close attention and follow up with excellent documentation,” he says. The practice’s move to electronic notes has contributed to more thorough recordkeeping and puts the facility well on its way to becoming a paperless office. Clinicians dictate their notes into iPhones or computers, which convert them to text. “Not only are our case files more legible, they are more accessible online, which is especially important to a multiple-office facility,” Ebbing says. Despite the use of these cost-saving technolgies, Clinical P&O has had to slow down deliveries. “We’ve had no other choice,” says Ebbing, “especially with HMOs, which take 48 hours to respond. Our speed of delivery is almost dictated by how quickly we can review policies and procedures.” While Clinical P&O hopes to expand in the future, the practice is focusing on more short-term goals, according to Ebbing. “Until the economy settles, we want to remain efficient and lean. And if there are further economic downturns, we’ll be ready to handle them.” a

Deborah Conn is a contributing writer for O&P Almanac. Reach her at debconn@ cox.net.

AOPA Headlines AOPA WORKING FOR YOU

Ready Resources Enable

RAPID RESPONSE AOPA turns a Medicare fraud story into a powerful ad for health-care reform.

he CBS 60 Minutes segment that aired on October 25 offered a rare opportunity for AOPA to turn the impact of a $60 billion south Florida Medicare fraud story into a hard-hitting ad directed at policymakers. The ad appeared in the November 5 issue of Roll Call, an inside-the-beltway publication read by legislators, staff, and lobbyists, and also part of The Economist magazine’s prestigious family of publications. On the Monday morning after the program aired, AOPA leadership seized the opportunity to turn the segment of a nationally televised program seen by more than seven million viewers into a testimonial calling for the inclusion of the provisions of H.R. 2479 in the current health-care reform measure. The ad also touted the $100 millionplus in savings each year for the American taxpayers.

This rapid-fire response by AOPA leadership to an unusual opportunity had its roots in the 2007 AOPA member survey and the subsequent strategic initiatives drawn from what members identified as their most important concerns. The ad explained how fraud and abuse is curtailed when a provider is licensed or accredited according to strict education and training standards; otherwise, there would be no reimbursement by Medicare. Featuring the logos of the AOPA and the Amputee Coalition of America (ACA), the ad also urged Congress to do something positive for amputees by passing H.R. 2575, the orthotics and prosthetics parity measure. H.R. 2575 would keep private insurers from denying access to the artificial limbs that are 32

O&P ALMANAC FEBRUARY 2010

needed by amputees so they can return to work and lead productive lives. In the process, taxpayers also win again because of savings in vocational rehabilitation expenses and the tax dollars that are generated by re-employment of amputees. The Medicare scam involved mostly former drug dealers who saw Medicare as a new cash cow and viewed fraudulent Medicare billing as a less risky way to continue their criminal activities instead of selling cocaine. No wonder it has become the crime of choice in south Florida. The ad appeared on the back page of Roll Call, ensuring widespread readership by Washington policymakers. Appearing just two days before the House passed its version of health-care reform, H.R. 3962, it couldn’t have been more timely. This rapid-fire response by AOPA leadership to an unusual opportunity had its roots in the 2007 AOPA member survey and the subsequent strategic initiatives drawn from what members identified as their most important concerns. Legislative advocacy and public relations topped their list of identified needs. Both lobbying and public relations require a significant investment, and what made this investment possible was AOPA’s restructuring in June 2008. Nearly $1 million in annual fixed costs were eliminated to free up necessary dollars to retain the very best lobbying and public relations talent. More than most of the annual fixed-cost savings is now invested in just these two critical initiatives. Having the necessary financial resources budgeted and available is of paramount importance when trying to wage public opinion and public policy warfare. Issues and opportunities cool quickly, and successful public policy organizations have learned that time cannot be wasted to pass the hat to fund opportunities that may quickly pass. Another benefit of resource availability and a timing advantage was AOPA’s collaboration with ACA to bring 40 amputees to Washington to lobby Congress. These visits occurred on the same day Sen. Max Baucus (D-Montana)

ORLANDO

unveiled the Senate Finance Committee’s version of health-care reform. Reporters flocked to the Senate Finance Committee office area, and ACA members were highly visible to legislative staff, members of the Senate, and the press. Photos in The Washington Post documented the presence of amputees in the midst of the Sen. Max Baucus health-care reform process. Excellent CNN coverage of the joint ACA/AOPA lobbying blitz coincided with interviews by CNN Hero Jordan Thomas and AOPA Executive Director Tom Fise, along with four members of Congress. Funding decisions and managing the logistics to bring ACA members to Washington all happened in just a few days. Since health-care legislation remains undecided, the AOPA Board has decided to take advantage of this vacuum and mobilize members for a Policy Forum in 2010. AOPA will release details of the 2010 Policy Forum as soon as they are confirmed. Last year’s Policy Forum yielded more than 100

SAVE thE DAtE

visits with lawmakers and staff. Putting a human face on our O&P field and telling our unmatched story of restoring people’s lives is the best insurance O&P can provide to protect our ability to deliver quality patient care. The enthusiasm generated by the 2009 Policy Forum clearly deserves much of the credit for getting AOPA on the congressional health-care reform radar screen. (Details on how the last-minute, down-to-the-wire effort by Sen. Ron Wyden (D-Oregon) came close to getting the provisions of H.R. 2479 into the Senate Finance Committee’s health-care bill appeared in the November issue of O&P Almanac.) The Forum also provided the platform for carrying the message about H.R. 2575, O&P parity legislation. The 2009 Policy Forum provided the opportunity for several participants to spend quality time with Sen. Wyden and help deepen his understanding of how legislation like H.R. 2479 helps curb fraud and abuse. His understanding paid off when he fought the good fight on behalf of O&P patients in Senate Finance Committee deliberations. For more details about the 2010 AOPA Policy Forum, visit www.AOPAnet.org and click on the government affairs menu tab. You also can see the Roll Call ad by clicking on the press room tab. a

Rosen Shingle Creek Resort

September 29 – OctOber 2, 2010

We look forward to seeing you at the AOPA 2010 National Assembly September 29–October 2, 2010, at the Rosen Shingle Creek Resort in Orlando, Florida! For more information, visit our Web site at www.AOPAnet.org.

FEBRUARY 2010 O&P ALMANAC

AOPA Headlines

Count on Complete Coding Education in 2010 The first “Mastering Medicare: Advanced Coding & Billing Techniques” seminar of 2010 will be held February 18-19 in Atlanta at the Intercontinental Buckhead Hotel. At this valuable two-day course, you will • learn how to code complex devices, including repairs and adjustments, through interactive discussions with AOPA experts and your colleagues • join in-depth discussions on compliance with Medicare billing rules and documentation expectations • understand how to assess compliance risk areas and deal with them • learn successful appeal strategies and hints on avoiding claim denials • join breakout sessions for practitioners and office staff • get detailed information on “hot topic” issues in the orthotics and prosthetics field. Plus, attendees can earn 14 credits in two days. The cost to attend is $550 for the first attendee from a given location; any additional attendees pay just $500. (For nonmembers, the cost is $750 for the first attendee and $700 for any additional attendees.) This course also

ATLANTA

will be offered May 24-25 in Pittsburgh and October 14-15 in Las Vegas. If you haven’t taken advantage of this valuable learning opportunity yet, plan to join us in 2010—and send any staff who regularly work with coding and billing. Get the most out of your AOPA membership. Hundreds of members have attended the “Mastering Medicare” seminars, often more than once. Previously, the in-person seminar dealt with more basic coding and billing information. AOPA knows that many companies continue to need this information to inform new staff members or enable current staff to brush up on coding and billing basics. All employees can benefit from AOPA’s webinars, a series of nine Web casts that present the fundamentals of

coding and billing, and feature ongoing updates as they emerge. Topics include • Module 1: What is Medicare? • Module 2: Filing Claims • Module 3: Medicare as Secondary Payer • Module 4: Administrative Documentation • Module 5: Hospital/SNF Billing • Module 6: ABNs and EOBs • Module 7: O&P Coding Basics • Module 8: Orthopedic and Diabetic Shoes • Module 9: When Bad Things Happen Cost for members is $99 per module or $693 for the series—that’s nine sessions for the price of seven. (Nonmembers pay $199 per module or $1,393 for the series.) An unlimited number of staff from the same office may participate in each webinar for one fee. Participants can obtain 1.5 CE credits per module by taking the provided quiz and scoring at least 80 percent. Registration is available online at www.AOPAnet.org. For more information, contact Erin Kennedy at ekennedy@ AOPAnet.org or 571/431-0876.

Register Now: Learn How to Pass Supplier Inspection February’s Medicare audio conference, “Hints on Passing Your Supplier Inspection,” will be held on Wednesday, February 10, from 1-2 p.m., Eastern time. Join AOPA’s Medicare experts to learn: • What questions do auditors always ask? • What documentation will they want to see? • What are my options if I fail the inspection?

O&P ALMANAC FEBRUARY 2010

• How do I prepare my staff for inspections? Cost is just $99 per line for member companies, and an unlimited number of staff may participate. (Nonmembers pay $199 per line.) Participants can obtain 1.5 CE credits by completing the provided quiz within 30 days and scoring at least 80 percent. Registration is available online at www.AOPAnet.org. For more information, contact Erin Kennedy at ekennedy@ AOPAnet.org or 571/431-0876. a

Marketplace

ALLARD USA KIDDIEGAIT SOFTSHHELL

and bunionette situations. The Lycra top will allow more room in the shoe for claw or hammer toes. The outsole is constructed with total EVA materials so that the practitioner can modify the bottom very easily, whether for a wedge, out flare, lift or rocker. More questions? Please call our friendly customer service at 888/937-2747.

COMFORT PRODUCTS INTRODUCES SPECTRACARBARALON™ STOCKINETTE

COLLEGE PARK’S NEW ONYX FOOT KiddieGAIT SoftSHELL combines the soft interface system of SoftKIT with a fun-print textile cover, made just for kids! A clever slip-on sleeve design, the KiddieGAIT anterior shell slips in-between the plush SoftKIT interface and fun-print front cover. The straps have D-Ring cinch-close closure that offers easy, adjustable tension application. Choice of pink or red background with fun-print pattern. For more information call 888/ 678-6548 or visit www.allardusa.com, info@allardusa.com.

APIS FOOTWEAR PRESENTS THE NEW BUNION/EMEDA SHOES

Apis Footwear is proudly presenting the new Bunion/Emeda shoes that are available off-the-shelf. The entire collar of the shoe is made of expandable elastic foam fabrics, designed to conform to the shape of the ankle and significantly reduce Achilles pressure. The leather counter will reflex which allow for more flexibility for support or for release, with built in flex area on medial and lateral side of the shoes, this unique design will accommodate mild or severe bunion

O&P ALMANAC FEBRUARY 2010

Onyx Foot

Integrating a dynamic pylon, the multiaxial Onyx Foot allows active users to demand more. Highly customizable, with four degrees of plantar-dorsiflexion Angle Control and adjustable Stride Control for fine-tuning gait, the sleek Onyx Foot delivers balanced energy with ideal comfort and enhanced terrain compliance. Key benefits include: • Dynamic Pylon foot • superior terrain compliance • the only Dynamic Pylon foot with four degrees of plantar-dorsiflexion Angle Control • precision gait matched for out-of-the box performance • adjustable Stride Control to fine-tune foot stiffness from heel strike to heel off • three-year warranty • Onyx–Balanced Energy, Ideal Comfort. For more information, call 800/7287950 or visit www.college-park.com.

Just what the practitioner would order: • easy workability, wets out well, strength & fatigue resistant • light weight, contours superbly, no delaminating • people friendly material: mitigates skin irritation • tubular goods facilitates ease of usage • available in 5 yard and 25 yard rolls • comes in 2-3-4-5-6” and 8” widths • half the cost of carbon material • can be modified using a heat gun without delaminating. For more information call Comfort Products, the innovation leader in knitted orthotic and prosthetic products, at 800/822-7500.

CUSTOM, LOW PROFILE, EXTREMELY LIGHT WEIGHT ORTHOSIS Our theory of bracing is that less is best. Many patients present with one or several gait and or stability issues. Our method of dealing with these problems is to identify exactly what is deficient in the gait cycle and just address that deficiency. The result is a low profile, extremely light weight orthosis. We manufacture AFO’s in three categories: energy return for patients with normal joint stability, rigid designs for immobilization and hybrid designs for those patients that need mid-stance stability without interrupting the rockers of gait. We also provide two models for partial foot amputees. For more information, contact Custom Composite Manufacturing Inc. at 866/273-2230 or visit www.cc-mfg.com.

high energy return with a lightweight and low profile structure. It can be reheated and remolded several times without damaging the material and is easy to grind. It also does not require any special storage! For more information about the DS Blue Shaped Orthotic or the rest of the DS family including plates, sheets and preformed orthotics, please call 800/3782480 or visit www.euroorthotics.com.

FILLAUER COMPANIES The GeriMac knee is a single axis knee incorporating a novel automatic mechanical lock providing maximum stability during the stance phase of gait, perfect for Geriatric needs. The GeriMac requires very little maintenance. Features of the GeriMac include • automatic knee locks at full extension • rated for up to 175 pounds • adjustable stance flexion • low-profile proximal adapter • free-swing design • friction-swing control adjustment. Contact Fillauer at 800/251-6398 or www.fillauercompanies.com.

DYCOR's New CFS Partial Foot

DEPENDABLE & VERSATILE: DS 2000 COMPOSITE SHAPED ORTHOTIC

Are you looking for a lightweight, durable composite orthotic? The DS Blue Shaped Orthotic (4-9-0-179V-size) is a slightly shaped foot plate, cutout to the shape of a foot. It features fiberglass knitting with vertical fibers and acrylic resin. The DS Blue Shaped Orthotic provides strong support and

Dycor's new CFS Partial Foot incorporates an integrated custom silicone liner with an advanced carbon fiber/epoxy composite socket and urethane nylon composite upper. This combination enhances pressure dissipation and reduces bulk. The custom silicone liner is available in 4, 5 and 6 millimeter with optional zone padding, soft, medium and firm. The cosmetic cover is either a silicone or urethane/nylon composite. Function is facilitated with either passive or flexible keel feet and optional Velcro closure, depending on ADLs and ablation level. Modified model, tracing of contralateral foot and shoe are required. Allow 10 working days for fabrication. Samples available upon request. Weight including 5mm liner and flexible keel foot is 8 oz. (26med.). Prior to casting, please call our Technical Services dept. at 800-794-6099.

Visit our website at www.dycormfg.com. . FEBRUARY 2010 O&P ALMANAC

Marketplace

INTRODUCING KISS SUPERSLIDER™ The Superslider™ simplifies test socket dynamic alignment. It allows linear alignment changes, in the transverse plane, and slides one inch in all directions. It is durable and reusable. Combine with KISS Superhero™ damage-free test socket plate, with pyramid or receiver, and achieve superior test socket slide and angular adjustment. • KISS Superslider™ Part #: CMP28/A • KISS Superslider™ KIT (includes KISS Superhero™) Part #: CMP29/A. Contact KISS Technologies at 410/663-KISS (5477) or visit www.kiss-suspension.com.

OHIO WILLOW WOOD CUSTOM FABRICATION

Ohio Willow Wood’s Custom Fabrication team provides high-quality craftsmanship and prompt turnaround for prosthetic fabrication jobs. Our Custom Fabrication department offers a full range of services, including check sockets, single- and double-wall socket laminations, and Alpha DESIGN® Liners. Skilled in both traditional and CAD/CAM workflows, Ohio Willow Wood’s Custom Fabrication team has the best turnaround in the industry.

O&P ALMANAC FEBRUARY 2010

Casts and CAD files (OMEGA® Tracer® and AOP) accepted. Same day shipping available on BK & AK check sockets for orders received before noon (EST). Maximum turnaround for more complex fabrication jobs is four days. For more information contact Ohio Willow Wood at 800/848-4930 or www. owwco.com.

3C86/3C96 COMPACT™ MICROPROCESSOR KNEE

ÖSSUR LAUNCHES NEW RHEO KNEE® WITH MULTIPLE ADVANTAGES The new and improved RHEO KNEE, the latest addition to Össur’s innovative Bionic line, now offers a higher weight limit (275 pounds), increased torque, faster swing speed, and improved aesthetics. Thanks to its low build height, the RHEO KNEE is compatible with the entire Össur Flex-Foot line. Together they deliver maximum dynamics and a natural gait experience. As always, the RHEO KNEE recognizes and responds immediately to changes in speed, load, and terrain, restoring the user’s ability to walk naturally, comfortably, and confidently at any speed. For more information, please call 800/233-6263 or visit our web site at www.ossur.com.

There’s more than meets the eye with the Compact Microprocessor Knee. Compact offers unprecedented stability and a remote control for Static Stance to lock the knee for extended standing. For patients who weigh up to 275 lbs (125 kg), this knee is designed for people who are (or have the potential to be) community ambulators, need a high degree of stance phase stability, but would not benefit from highly variable swing phase dynamics. The Static Stance feature makes the Compact an excellent option for people who need to stand for extended periods of time. Find out more about how you can get your patients in Compact today, call 800/328-4058 or visit www.ottobockus.com.

TAKE A STEP IN THE RIGHT DIRECTION! E-MAG ACTIVE STANCE CONTROL KAFO

NEW SHEARBAN® OVALS AVAILABLE FROM PEL SUPPLY

Easy to fit for practitioners and even easier for patients to use, this integrated, low-profile joint provides the best in electronic stance control and helps your patients get into a more active lifestyle. The E-MAG Active calibrates itself to capture the user’s unique gait pattern with the help of the simple onboard programming. This unique feature adds a whole new dimension of functionality for people who previously have had limited bracing options, such as a locked knee brace or manual device. Help your patients get back into the swing of things with the E-MAG Active! Find out more by calling 800/3284058 or visit www.ottobockus.com.

The latest addition to the ShearBan® product line from Tamarack™ Habilitation Technologies –ShearBan Ovals— is now available from PEL Supply. New ShearBan Ovals provide a shape ideal for preventing and treating the diabetic foot. They are particularly suited for placement in footwear under the metatarsal heads, or next to the big toe—places where ulcers develop. ShearBan Ovals are effective, affordable, and easy to use for ulcer prevention and relief. Tamarack is committed to the research, testing and development of low-friction technologies, including ShearBan products, offering long-lasting solutions to friction-induced blisters, calluses and diabetic foot ulcers. ShearBan products are marketed by Becker Orthopedic and may be purchased through O & P distributor PEL Supply. For more information on new ShearBan Ovals, or any of the Tamarack ShearBan products, as well as the full line Becker Orthopedic products— contact any helpful PEL customer service specialist at 800/321-1264, by fax 800/222-6176, or e-mail customerservice@pelsupply.com.

NEW WARRANTY POLICY ON ALPHA LINERS PURCHASED THROUGH SPS

Effective Jan. 1, 2010, SPS will be implementing the new Warranty and Return Policy on all Ohio Willow Wood Alpha Liners purchased through SPS. Critical elements of the new policy which will benefit all SPS Customers are • Each Alpha Liner will now have a warranty of 12 months from fit date or distributor invoice date. Previously Alpha liners carried a six-month warranty per liner. • Alpha Liners will have a 10-day trial period from the fit date or distributor invoice date. You may return liners if the bag has been opened. This policy applies to any Alpha Liner fit after Jan. 1, 2010. For more information, contact SPS Customer Service at 800/767-7776 x 3 or your SPS Sales Manager. a

FEBRUARY 2010 O&P ALMANAC

Jobs Mid-Atlantic

INCREASE EXPOSURE AND SAVE!

Place your classified ad in the O&P Almanac and online on the O&P Job Board at jobs.AOPAnet.org and save 5% on your order. BONUS! Online listings highlighted in yellow in the O&P Almanac.

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

O&P Technician Suffolk, Virginia Looking for an O&P tech with three years of minimum experience. We will consider a recent graduate of an O&P technical program. Applicant must be self-motivated and a team player. We are a privately-owned, well-established O&P practice with three offices in southeastern Virginia. Competitive salary, medical, dental and matching IRA contributions with possible relocation allowance. The southeast is an excellent area for raising a family: It is close to beaches, mountains, and historic areas. Send your resume in complete confidence to:

Steve M. Stevpehs, CP Tidewater Prosthetic Center, Inc. Fax: 757/925-4973

Inter-Mountain

- Pacific

CO, CP, and/or CPO

Use our map to find which region you fit into!

CLASSIFIED RATES Classified advertising rates are calculated by counting complete words. (Telephone and fax numbers, e-mail and Web addresses are counted as single words.) AOPA member companies receive the member rate. Member Non-member Words Rate Rate 50 or fewer words $140 $280 51-75 words $190 $380 76-120 words $260 $520 121 words or more $2.25 per word $5.00 per word Specials: 1/4 page, color 1/2 page, color

$482 $634

$678 $830

Advertisements and payments need to be received approximately one month prior to publication date in order to be printed in the magazine. Ads can be posted and updated at any point on the O&P Job Board online at jobs.AOPAnet.org. No orders or cancellations are taken by phone. Ads may be faxed to 571/431-0899 or e-mailed to srybicki@ AOPAnet.org., along with a VISA or MasterCard number, the name on the card and the expiration date. Typed advertisements and checks in U.S. currency made out to AOPA can be mailed to P.O. Box 34711, Alexandria, VA 22334-0711. Responses to O&P box numbers are forwarded free of charge. Company logos are placed free of charge. JOB BOARD RATES Visit the only online job board in the industry at jobs.AOPAnet.org!

Member Rate $80

Non-member Rate $140

Save 5 percent on O&P Almanac classified rates by placing your ad in both the O&P Almanac and on the O&P Job Board, online at jobs.AOPAnet.org.

O&P ALMANAC FEBRUARY 2010

Arizona Immediate openings for motivated practitioners at privately owned company in beautiful Arizona. Board-Eligible practitioners will also be considered. Clinical and fabrication skills preferred. We offer a generous benefit package including competitive salaries, health insurance, profit-sharing and productivity bonuses. E-mail or fax resume in confidence to:

Fax: 602/569-7500 E-mail: rongoldstein@apos.net

Certified Prosthetist/Orthotist Boise, Idaho Gorgeous IDAHO beckons! Practitioner with three or more years experience. ABC certified. Pediatric/neuro orthotics, adult LE prosthetics required. Modern facility with collegial staff. Pension; continuing education; health insurance. Submit resume to:

Gilda Roberts, Business Operations Manager Fax: 208/344-9968 E-mail: sawtoothorthotics@yahoo.com

CO/CPO El Paso, Texas Locally owned and operated family O&P business, we offer a competitive salary and exceptional benefits package and retirement plan.Â Please send or fax resume to:

Susan M. Guerra, RN Total Orthotic & Prosthetic Solutions Inc. 900 E. Yandell Dr. El Paso, TX 79902 Phone: 915/541-8677 Fax: 915/541-8678

Southeast

Northeast

CPO CO Board-Eligible Orthotist or Prosthetist BOCO or BOCPO C.Ped CFO Maine • Are you looking for something more? • Do you want to be more than a number? • Do you want a great life and a great job? • We are a terrific practice looking for some nice people. Is this you? We are a well-established, patient-oriented, ABC-accredited facility seeking to strengthen our staff. Competitive salary offered, with bonuses commensurate with productivity, and renumeration for required educational credits. Offices located in picturesque Maine, just a short distance from our coast and mountain regions. Learn more about joining our team of dedicated specialists by contacting:

O&P Ad 25356, O&P Almanac 330 John Carlyle St., Ste. 200 Alexandria, VA 22314 Fax: 571/431-0899

Join us and see how your career can shine. Marshfield Clinic is one of the largest patient care, research & educational systems in the United States with over 7,000 employees in nearly 400 occupations.

Live & work in one of America’s Dreamtowns* Marshfield, Wisconsin, a town that is safe, low-stress, friendly & fun: • • • • •

Low-cost of living in family-friendly neighborhoods Short commutes with low traffic volume Excellent private & public educational opportunities Cultural & recreational activities for all four seasons Access to Chicago, Madison, Milwaukee, Minneapolis

CO or CPO

ABC Certified in Orthotics & Prosthetics and 3 years of experience required. Experience in Pediatrics would be helpful.

Apply online at www.marshfieldclinic.jobs, Reference #MC090202

Certified Prosthetist/Orthotist West Columbia, South Carolina Progressive ABC-certified prosthetic and orthotics facility looking for ABC-certified prosthetist and orthotist. Located two hours from mountains or ocean, Columbia, South Carolina offers southern climate and weather and is bordered by a 50,000-acre fresh water lake. We emphasize patient care and teamwork, opportunity for future ownership for the right individual. Competitive salary with benefits including 401(k), health insurance, continuing education, vacation, and great people to work with. If you are interested in joining this progressive team, want to focus on patient needs, and have the ability to market and develop new relationships, then we would like to have your resume with education, work experience and salary requirements. All inquiries will be kept strictly confidential.

Lexington Prosthetics and Orthotics R. Michael Russell, CPO, FAAOP 205 Medical Circle West Columbia, SC 29169 Phone: 803/939-0097 Fax: 803/939-1103

Barb Burr Renae Wesolowski FROM: Cori Maki DATE: 12/2/09 Orthotics/Prosthetics Practitioners RE: Minneapolis, O&P Almanac MN TO:

Fairview Health Services Staff

Fairview Health Services has full time openings for Staff Orthotics/Prosthetics Practitioners in our Rehabilitation Services t These c individuals will Departments in Minneapolis,e MN. Inc. conditions of the limbs provide care to patients with disabling and/or spine or with partial or total absence of limb. Duties will P h o n e :evaluation, 2 6 2 . 5 0 2 . 0design, 5 0 7 F afabrication, x : 2 6 2 . 5 0 2fitting, . 0 5 0 8 and include performing alignment of prostheses and/or orthoses.

ADZ

Qualifications: Bachelor’s degree and an Orthotics/Prosthetics Practitioner degreeMFC120120-OPAlmanac required. Must be certified by the American Board of Certification in Orthotics and Prosthetics within one year of hire date. At least 1 – 3 years of experience working in O&P Almanac either a hospital or clinic preferred.

Circulation: We offer competitive compensation with15,606 the flexibility to select benefits that best fit you and your family’s needs. Learn more and apply online at fairview.org/recruitment and search for January 2010 Job # 09-29220 and 09-29300. 1/4 page (3.5” x 4.5”)

1000 N. Oak Ave., Marshfield, WI 54449 Marshfield Clinic is an Affirmative Action/Equal Opportunity employer that values diversity. Minorities, females, individuals with disabilities and veterans are encouraged to apply.

America's Dreamtowns, http://www.bizjournals.com/specials/pages/181.html

Space: $567.07 (less 5% with online posting) $567.07 less 5% = $538.72 FEBRUARY 2010 O&P ALMANAC 41 One month http://jobs.aopanet.org: $110.00

EOE/AA Employer

Jobs Southeast

North Central

CPO, CP, CO or Board Eligible

CO, CP, and/or CPO

Palm Beach, Florida Immediate opening and excellent opportunity for a motivated Florida-licensed, prosthetist/orthotist, prosthetist, orthotist or board-eligible practitioner. Great future and growth potential. Excellent compensation and benefits package. We are an established O&P company in New York, New Jersey, and Florida with an opening in our Palm Beach County location. E-mail or fax resume in complete confidence to:

Euclid, Ohio Well-established and respected O&P company has an immediate opening for an Ohio licensed orthotist or other licensed practitioner whose scope of practice includes orthotics and prosthetics. We are a fully accredited broad spectrum practice that offers opportunities in all aspects of orthotic and prosthetic care. A competitive salary and benefit package are offered. Respond to:

Modern Rehabilitation Technologies Phone: 561/748-5657 Fax: 561/748-5658 E-mail: mrtinfo@modernrehabtech.com

Tom Heckman, CO Orthotic & Prosthetic Specialties, Inc. Fax: 216/531-5376 E-mail: OS1023@aol.com

Why do I work at Hanger?

Chad Simpson, BOCP, LP, Practice Manager

In a word, access. At Hanger, I have access to the very latest technologies and that keeps me on the leading edge in my clinical practice. I also have access to the depth of knowledge that comes with being part of a national network of skilled practitioners. In todayâ&#x20AC;&#x2122;s uncertain economy, I have job security. I benefit from the strength of an established company, and at the same time,

AVAILABLE POSITIONS Orthotist Phoenix, AZ Rancho Mirage, CA Stockton, CA Waterbury, CT Tallahassee, FL Aurora, IL Springfield, IL Evansville, IN

Orthotist/Prosthetist Thomasville, GA Philadelphia, PA

enjoy the freedom I find in my work as a local practice manager.

For more information visit www.hanger.com/careers

Jackson, MI Fairfield, OH Toledo, OH Tahlequah, OK NW PA/NE OH Milwaukee, WI Wheeling, WV

El Paso, TX

Prosthetist Hollywood, FL Bowling Green, KY

Hattiesburg, MS Jefferson City, MO

Prosthetist/Orthotist Beverly Hills, CA Cameron Park, CA Denver, CO Washington, DC Marietta, GA Columbia, MO Jackson, MS

Contact, in confidence:

Sharon King, Director, Recruitment 5400 Laurel Springs Pkwy., Suite 901 Suwanee, GA 30024 Tel: 678-455-8865, Fax: 678-455-8885 sking@hanger.com www.hanger.com Hanger Orthopedic Group, Inc. is committed to providing equal employment to all qualified individuals. All conditions of employment are administered without discrimination due to race, color, religion, national origin, sex, age, disability, veteran status, citizenship, or any

O&P ALMANAC FEBRUARY 2010

Meridian, MS Las Vegas, NV Bend, OR Clackamas, OR Fort Worth, TX Alexandria, VA Bremerton, WA

Certified Pedorthist Tucson, AZ Waterbury, CT Columbia, MO

other basis prohibited by federal, state or local law. Residency Program or Certificate Primary Education Program Info, contact: Robert S. Lin, CPO/Dir. of Academic Programs. Hanger P&O / Newington O&P Systems, Ph. 860.667.5304 â&#x20AC;˘ Fax 860.667.1719

Toledo, OH Wheeling, WV

Now available in sizes 25-30 cm. 800.728.7950 I www.college-park.com

Calendar

2010 FEBRUARY 8-12: Applied Technology Institute (ATi) Orthotic Fitter School. Long Beach, CA. VA Hospital. Independent comprehensive course to prepare for certification exam. Approved entry-level school by NCOPE and BOC, and for continuing education by ABC and BOC. To register, contact Lois Meier at 888/265-6077, e-mail lois@kasseledu.com, or visit www.kasseledu.com. ■■

■■

PROMOTE EVENTS IN THE O&P ALMANAC

CALENDAR RATES Telephone and fax numbers, e-mail addresses and Web sites are counted as single words. Refer to www.AOPAnet.org for content deadlines. Words

Member Non-member Rate Rate

25 or less 26-50 51+

$40 $50 $2.25 per word

$50 $60 $3.00 per word

Color Ad Special: 1/4 page Ad $482 1/2 page Ad $634

$678 $830

BONUS! Listings will be placed free of charge on the Attend O&P Events section of www.AOPAnet.org. Send announcement and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711, fax 571/431-0899, or e-mail srybicki@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. For information on continuing education credits, contact the sponsor. Questions? E-mail srybicki@AOPAnet.org.

AOPA-sponsored activities appear in red.

O&P ALMANAC FEBRUARY 2010

FEBRUARY 9: Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 1:00– 2:00 pm ET. Course covers lengthening and strengthening muscles and improving range with postural support and therapeutic/stretching assist. Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems.com or 800/220-6670. ■■

FEBRUARY 10: AOPA Audio Conference: “Hints on Passing Your Supplier Standards Inspection.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@ AOPAnet.org. ■■

FEBRUARY 17: Ultraflex: Adult UltraSafeStep™ Continuing Education Course, via WebEx, 1:00–2:00 pm ET. Course covers clinical assessment and compensating for adult gait deficits with the new Adjustable Dynamic Response (ADR) technology. Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems.com or 800/220-6670. ■■

FEBRUARY 18: Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 1:00–2:00 pm ET. Course covers clinical assessment and compensating for pediatric gait deficits with the new Adjustable Dynamic Response (ADR) technology. Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems.com, 800/220-6670. ■■

FEBRUARY 18-19: AOPA Mastering Medicare: Advance Coding and Billing Seminar. Atlanta. Intercontinental Buckhead Hotel. To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org. ■■

FEBRUARY 19-20: PrimeFare West Regional Scientific Symposium 2010. Salt Lake City. Salt Palace Convention Center. Contact Jane Edwards at 888/388-5243 or visit www.primecareop.com. ■■

FEBRUARY 24-27: 36th Academy Annual Meeting & Scientific Symposium. Chicago. Hyatt Regency Chicago. Visit www. academyannualmeeting.org for the latest information. Contact Diane Ragusa at 202/380-3663, ext. 208 or dragusa@oandp.org. ■■

MARCH 10: Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, Noon– 1:00 pm ET. Course covers lengthening and strengthening muscles and improving range with postural support and therapeutic/stretching assist. Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems.com or 800/220-6670. ■■

MARCH 10: AOPA Audio Conference: “Billing for Refused/ Returned Devices and Deluxe Features.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org. ■■

MARCH 11: Ohio Willow Wood: LimbLogic VS™ Applications Practitioner Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static and dynamic socket fitting, vacuum pump configurations, fob operation, system evaluation, liner options, alignment, and troubleshooting. Credits: 7.25 ABC/7.0 BOC. Registration deadline is February 18. To register, call 877/665-5443. ■■

MARCH 12-13: Ohio Willow Wood: LimbLogic™ VS Applications Technicians Course. Mt. Sterling, OH. Learn all aspects of fabricating LimbLogic VS for various applications: socket materials, controller configurations and care, fob operation, troubleshooting. Fabricate sockets following recommended techniques for airtight socket designs. Credits: 11.75 ABC/11.5 BOC. Registration deadline is February 18. To register, call 877/665-5443. ■■

MARCH 12 OPGA: Bioness Training Course. Las Vegas. Oneday course covers NESS L300 system evaluation and hands-on training. Instructed by John Michael, MEd, CPO/L, FAAOP, FISPO. The NESS L300 is a user-friendly neuroprosthetic designed to improve gait for individuals experiencing foot drop. 7 MCEs from ABC. Register at www.opga.com or 800/2146742. ■■

MARCH 16: Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, Noon–1:00 pm ET. Course covers clinical assessment and compensating for pediatric gait deficits with the new Adjustable Dynamic Response (ADR) technology. Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems.com or 800/220-6670. ■■

MARCH 22-23 Advanced Orthotic Design Workshop, Fillauer. Chattanooga, TN. Course includes solutions and techniques that optimize gait; address the new orthotic components that emphasize dynamic motion guidance; and presentation of case studies containing unique challenges and subsequent clinical solutions. To register, contact Beverly Godsey at 423/624-0946. ■■

MARCH 25: Ultraflex: Adult UltraSafeStep™ Continuing Education Course, via WebEx, Noon–1:00 pm ET. Course covers clinical assessment and compensating for adult gait deficits with the new Adjustable Dynamic Response (ADR) technology. Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems.com or 800/220-6670. ■■

APRIL 8: Ohio Willow Wood: LimbLogic™ VS Applications Practitioner Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static amd dynamic socket fitting, vacuum pump configurations, fob operation, system evaluation, liner options, alignment, and troubleshooting. Credits: 7.25 ABC/7.0 BOC. Registration deadline is March 18. To register, call 877/665-5443. ■■

APRIL 9-10: Ohio Willow Wood: LimbLogic™ VS Applications Technicians Course. Mt. Sterling, OH. Learn all aspects of fabricating LimbLogic VS for various applications: socket materials, controller configurations and care, fob operation, troubleshooting. Fabricate sockets following recommended techniques for airtight socket designs. Credits: 11.75 ABC/11.5 BOC. Registration deadline is March 18. To register, call 877/6655443. ■■

APRIL 16: Wisconsin Society of Orthotists, Prosthetists and Pedorthists State Meeting. Madison, WI. Sheraton Madison. Contact Andrea Pavlik, CO, at 920/803-9610 or andrea.pavlik@physiocorp.com. ■■

APRIL 17: Ohio AAOP Chapter Annual Spring Technical Meeting. Columbus, OH. Hilton Columbus Hotel. Contact Richard Butchko at 614/6590197 or richardbutchko@ ohiochapteraaop.com. ■■

APRIL 22-24: International African American Prosthetic-Orthotic Coalition. Memphis. Crown Plaza Hotel. For information contact Jack Steele, CO at 901/270-5471 or fax 901/7251114 or visit www.iaapoc.org. ■■

APRIL 14: AOPA Audio Conference: “Documenting for Success: Chart Notes, Prescriptions and Physicians’ Records.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org. ■■

APRIL 22-24: Northwest AAOP Chapter Meeting. Seattle. Bellevue Courtyard Marriott. Contact Dan Abrahamson at 206/598-4026 or abrahams@u.washington.edu. ■■

APRIL 14-17: Texas Association of Orthotists and Prosthetists State Meeting. South Padre Island, TX. Sheraton South Padre Island Beach Hotel. Contact Elizabeth Carlstrom at 512/266-8600 or ejcarlstrom_ opbs@att.net. ■■

APRIL 15-16 Transfemoral Optimization Methods Workshop, Hosmer Dorrance Corp. Campbell, CA. Course addresses the challenges of fitting transfemoral prostheses; discussion and comparison of ischial containment fitting fundamentals, alignment methods, voluntary control and various knee designs; and relative benefits of shock/ torque absorption, stance flexion and rotation. To register, contact Clay Bergren at 800/827-0070. ■■

APRIL 26-27: New York AAOP Chapter State Meeting. Albany, NY. Desmond Hotel. Contact Joann Marx, CPO, FAAOP at 518/374-6011 or marx4nysaaop@aol.com. ■■

MAY 10-15: ISPO World Congress and International Trade Show for Prosthetics, Orthotics and Rehabilitation Technology: “Orthopadie + Reha-Technik 2010.” Leipzig, Germany. www.ispo-2010-leipzig.de. ■■

MAY 12: AOPA Audio Conference: “New Rules for HIPAA: Are You Still Compliant?” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org. ■■

MAY 13-15: WAMOPA/COPA Combined Meeting. Sparks/Reno, Nevada. Nugget Hotel. Combined meeting of Western and Midwestern Orthotic and Prosthetic Association and California Orthotic and Prosthetic Association. For information contact Steve Colwell at 206/440-1811 or Sharon Gomez at 503/5214541 or visit www.wamopa.com. ■■

MAY 14-15: Oklahoma AAOP Chapter State Meeting. Oklahoma City, OK. Francis Tuttle Technical Center. Contact Tom Ferguson at 405/271-3644 x 41028 or thomas-ferguson@ ouhsc.edu. ■■

MAY 19-22: Pennsylvania AAOP Chapter Spring Conference. Pittsburgh. Sheraton Station Square. Contact Beth or Joe at 814/455-5383. ■■

MAY 20-22: Louisiana Association of Orthotist & Prosthetist Meeting. Lafayette Hilton. O, P & C.Ped Credits. Come take in Louisiana’s creole culture and culinary delights! Contact Sharon Layman, 504/464-5577 or laymansh@yahoo.com or visit www.LAOP.org. ■■

FEBRUARY 2010 O&P ALMANAC

Calendar

MAY 24-25: AOPA Mastering Medicare: Advance Coding and Billing Seminar. Pittsburgh. Hyatt Regency Pittsburgh International Airport. To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org. ■■

JUNE 2-5: Association of Children’s Prosthetic-Orthotic Clinics 2010 Annual Meeting. Clearwater, FL. Sheraton Sand Key Resort. For more information, call 847/6981637, e-mail acpoc@aaos.org, or visit www.acpoc.org. ■■

JUNE 4-5: PrimeFare East Regional Scientific Symposium 2010. Nashville. Nashville Convention Center. Contact Jane Edwards at 888/388-5243 or visit www.primecareop.com. ■■

JUNE 9: AOPA Audio Conference: “When Disaster Strikes: Implementing a Contingency Plan.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org. ■■

JUNE 10: Ohio Willow Wood: LimbLogic VS™ Applications Practitioner Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static and dynamic socket fitting, vacuum pump configurations, fob operation, system evaluation, liner options, alignment, & troubleshooting. Credits: 7.25 ABC/7.0 BOC. Registration deadline is February 18. Contact: 877/665-5443.

JUNE 10-11: Michigan Orthotics & Prosthetics Association (MOPA) Continuing Education Seminar. Mt. Pleasant, MI. Soaring Eagle Casino & Resort. For details visit www.mopa.info or contact Mary Ellen Kitzman at 248/615-0600 or MOPA_ meeting@MOPA.info. ■■

JUNE 11-12: Ohio Willow Wood: LimbLogic™ VS Applications Technicians Course. Mt. Sterling, OH. Learn all aspects of fabricating LimbLogic VS for various applications: socket materials, controller configurations and care, fob operation, troubleshooting. Fabricate sockets following recommended techniques for airtight socket designs. Credits: 11.75 ABC/11.5 BOC. Registration deadline is February 18. Contact: 877/6655443. ■■

JULY 14: AOPA Audio Conference: “Medicare Appeals Strategies.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@ AOPAnet.org. ■■

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AUGUST 6-7: Texas Chapter of the American Academy of Orthotist and Prosthetist (TCAAOP). Annual meeting and Scientific Symposium. Austin, Texas. Sheraton Austin Hotel. Contact Jonathon Cassens, CPO. 979/255-5165 or ctoplp@aol.com.

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AUGUST 11: AOPA Audio Conference: “Medicare’s Knocking: How Good Is Your Compliance Plan?” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

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AUGUST 20-21: Arkansas Orthotic, Prosthetic, & Pedorthic Association State Meeting. Little Rock, AR. Peabody Hotel. Contact Tonya Horton at 501/663-2908 or thorton@ hortonsoandp.com.

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SEPTEMBER 8: AOPA Audio Conference: “Missed Billing Opportunities: Are You Billing Everything You Can?” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

OCTOBER 13: AOPA Audio Conference: “You’re Going To Pay Me WHAT? Hints on Managed Care Contracting.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

OCTOBER 14-15: AOPA Mastering Medicare: Advance Coding and Billing Seminar. Las Vegas. Mandalay Bay Resort. To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

NOVEMBER 10: AOPA Audio Conference: “The Ins and Outs of Billing in a Part A Setting: Hospital, SNF and Hospice.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

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DECEMBER 8: AOPA Audio Conference: ”New Codes and Medical Policies for 2011.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org. ■■

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O&P ALMANAC FEBRUARY 2010

JULY 15-17: Alabama Prosthetists and Orthotists Association State Meeting. Birmingham, AL. Birmingham Hilton. Contact Fred Crawford at 205/2801666 or crawfordfc@huges.net or visit www.alabamapoa.org. ■■

AUGUST 4-5: Canadian Association of Prosthetists and Orthotists Meeting. Quebec City. Hilton Quebec. Contact Kathy Kostycz at 204/949-4970 or capo@mts.net. ■■

SEPTEMBER 29OCTOBER 2 AOPA National Assembly. Orlando, FL. Rosen Shingle Creek Resort. Exhibitors and sponsorship opportunities, contact Kelly O’Neill, 571/431-0852, or koneill@ AOPAnet.org. ■■

2011 MARCH 28 - APRIL 2: Association of Children’s Prosthetic-Orthotic Clinics 2011 Annual Meeting. Park City, UT. The Canyons. For more information, call 847/698-1637, e-mail acpoc@ aaos.org or visit www.acpoc.org. a ■■

Ad Index For free product information from these advertisers, enter the advertiser name online at www.opalmanac.org/shop.

Company

Page

Phone

Web site or E-mail

Allard USA Inc. ALPS American Board for Certification in Orthotics, Prosthetics & Pedorthics Apis Footwear Arizona AFO College Park Industries Inc. Custom Composite Daw Industries Dr. Comfort Euro International Fillauer Companies Inc. KISS Technologies LLC Ohio Willow Wood OPTEC Ossur Americas Inc. Otto Bock HealthCare PEL Supply Company SPS

9 25

888/678-6548 800/574-5426

www.allardusa.com www.easyliner.com

35 47 19 43 27 1 5, C3 7 29 31 2 14, 15 C4 C2 21 13

703/836-7114 888/937-2747 877/780-8382 800/728-7950 866/273-2230 800/252-2828 800/556-5572 800/378-2480 800/251-6398 410/663-5477 800/848-4930 888/982-8181 800/233-6263 800/328-4058 800/321-1264 800/767-7776 Ext. 3

www.abcop.org www.bigwideshoes.com www.arizonaafo.com www.college-park.com www.cc-mfg.com www.daw-usa.com www.drcomfortdpm.com www.eurointl.com www.fillauercompanies.com www.kiss-suspension.com www.owwco.com www.optecusa.com www.ossur.com www.ottobockus.com www.pelsupply.com www.spsco.com

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O&P ALMANAC FEBRUARY 2010

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