October 2009 O&P Almanac

Almanac OP The American Orthotic & Prosthetic Association

OCTOBER 2009

&

WWW.AOPANET.ORG

THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY

FIT AND COMFORT Post-mastectomy care challenges practitioners’ skills, emotions, and business savvy

Is Your Facility OSHA COMPLIANT? Understanding Functional and Uncommon Modifiers

Ten Years Went Fast...

And C-LegÂŽ Wearers are Going Even Faster!

Whether your patient likes their horsepower on four legs or four wheels, the C-Leg microprocessor knee has transformed how thousands of transfemoral amputees travel.

As you tapped into the stability and proven outcomes of new C-Leg technology, you helped create a proven standard of care for more than 30,000 people around the world.

Visit www.clegstories.com and www.facebook.com/ottobockus with your patients to share more details.

limblogic™ Vs Waterproof vacuum suspension

Filip Carroll adoring father | lifeguard instructor | medical professional | retired military | amputee

Reliable suspension and stability in and out of the water is what filip needs in order to keep up with his little dynamo. thanks to limblogic Vs, families like the Carroll’s can have endless pool-time fun and the ability to retrieve pool toys time and again with ease. an improved sealing system and a thorough testing regimen enable limblogic Vs to exceed electronic industry standards for water submersion. this allows the 4-Hole Controller to be completely immersed in fresh water and to continue to provide a secure vacuum suspension. this advancement makes limblogic Vs the only waterproof electronic vacuum suspension available.

R eal solutions foR R eal people

Fo r m o r e i n Fo r mati o n call 8 00.8 4 8.4 93 0 o r 74 0.8 6 9.3377 o r vi s it o u r W e b s ite WWW.oWWc o.c o m

inside COLUMNS

COVER STORY 12

12

08

Fit and Comfort

By Kim Fernandez Working with patients in any specialty of O&P can be emotionally difficult, but those who fit breast cancer patients with post-mastectomy forms and devices say success requires the right balance of technical expertise, emotional sensitivity, and mastery of the insurance and reimbursement process.

Part 2 of a two-part series on modifiers

DEPARTMENTS

04

AOPA Contact Page How to reach staff

06

In the News Updates and company announcements

24

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

FEATURES

20

Reimbursement Page

Safety in the Workplace

By Don Pierson, CO, C.Ped If an OSHA inspector arrived for a surprise visit, how would your facility fare? Use these strategies to take the necessary steps now to ensure the safest working environment possible.

38

Marketplace Products and services for O&P

42

Jobs Opportunities for O&P professionals

46

Calendar Upcoming meetings and events

34

5 Questions‌ for Pete Seaman, RTP Pete Seaman, RTP and boardeligible prosthetist, interviewed 50 lower-extremity amputees about the quality of their care.

48

AOPA Membership

48

Ad Index

Applications

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 571/431-0899; 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.

3

O&P AlmAnAc OCTOBER 2009

table of contents

Volume 58 Number 10

n

OCTOBER 2009

n

AOPA contact information

OP Almanac &

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 (Cont’d.)

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

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

Don DeBolt, chief operating officer, 571/431-0814, ddebolt@AOPAnet.org O&P ALMANAC

Michael Chapman, coordinator, membership operations and meetings, 571/431-0843, mchapman@AOPAnet.org

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

Kelly O’Neill, manager of membership and meetings, 571/431-0852, koneill@AOPAnet.org

Angela Brady, editorial director, abrady@strattonpublishing.com

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

Josephine Rossi, managing editor, 703/914-9200 ext. 26, jrossi@strattonpublishing.com

AOPA Bookstore: 571/431-0804

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

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

Dean Mather, advertising sales representative, 856/768-9360, dmather@mrvica.com Erin Kennedy, staff writer, 571/431-0834, ekennedy@AOPAnet.org MEMBERSHIP AND MEETINGS Tina Moran, CMP, senior director of membership operations and meetings, 571/431-0808, tmoran@AOPAnet.org

GOVERNMENT AFFAIRS

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

OCTOBER 2009

Vol. 58, No. 10

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 Brian L. Gustin, CP, BridgePoint Medical Inc., Suamico, WI President-Elect James A. Kaiser, CP, Scheck & Siress, Chicago, IL Vice President Thomas V. DiBello, CO, FAAOP, Dynamic O&P, LLC, Houston, TX Treasurer Mark H. Emery, Ossur Americas, Aliso Viejo, CA Immediate Past President Bradley N. Ruhl, Otto Bock HealthCare, Minneapolis, MN Executive Director/Secretary Thomas F. Fise, JD, AOPA, Alexandria, VA directOrs Kel M. Bergmann, CPO, SCOPe Orthotics and Prosthetics Inc., San Diego, CA Rick Fleetwood, Snell Prosthetic & Orthotic Laboratory, Little Rock, AR Russell J. Hornfisher, Becker Orthopedic Appliance Co., Troy, MI Marc N. Karn, CP, The Prosthetic & Orthotic Center of New England, Portland, ME

OP Almanac

Alfred E. Kritter, Jr., CPO, FAAOP, Hanger Prosthetics & Orthotics Inc., Savannah, GA

&

2009-2010 EDITORIAL ADVISORY BOARD Rick Bowers, Amputee Coalition of America Rick Fleetwood, Snell Prosthetic & Orthotic Laboratory Steve Hill, CO, Delphi Ortho Russell J. Hornfisher, Becker Orthopedic Appliance Co.

Tabi King, Ossur North America Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center David Rotter, CO, CP, LO, LP, L.Ped, Scheck and Siress Gary Steren, CPO, Cornell Orthotics & Prosthetics Inc.

Fran Varner Jenkins, Fillauer Inc. Joel J. Kempfer, CP, FAAOP, Kempfer Prosthetics Orthotics Inc.

4

O&P AlmAnAc OCTOBER 2009

Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI John H. Reynolds, CPO, FAAOP, Reynolds Prosthetics & Orthotics Inc., Maryville, TN Lisa Schoonmaker, CPO, FAAOP, Tandem Orthotics & Prosthetics Inc., St. Cloud, MN Frank Vero, CPO, Mid-Florida Prosthetics & Orthotics, Ocala, FL Copyright 2009 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.

n

in the news

TRANSITIONS

ACA: Nothing Hampers These Campers

PEOPLE IN THE NEWS Frank Friddle, Jr., CO, FAAOP, was awarded the William D. Beiswenger Volunteer Award from the ABC at the AOPA National Assembly, held in Seattle.

The ABC board of directors honored Friddle for his “extraordinary volunteer work supporting ABC’s mission and for embodying the spirit of the award.”

Friddle began his service to ABC in 1983 as an examiner for the technician and CPM examinations.

He was named to the ABC board of directors in 1999 and served for eight years, including a term as president in 2004. Currently, Friddle serves as an orthotic certification examiner, the candidate liaison on the Orthotic Exam Committee, and the logistical coordinator for the technician and CPM examinations. He joined the board of directors for NCOPE in 2009. He also served three terms as the president of the South Carolina Society of Orthotists and Prosthetists, and is a past president of an AOPA region.

All children need the experience of summer camp, and thanks to the ACA, 50 children living with limb loss or limb differences were able to pack their gear and head for the campgrounds.

ACA’s Camp Joy Outdoor Education Center in Clarksville, Ohio, welcomed campers from 28 states for the 10th annual program, held July 25-29, 2009. The children were able to explore new sports and activities in a safe, accepting environment.

“Every year, we have the great pleasure of seeing children leave camp with a sense of accomplishment and heightened self-esteem,” says Derrick Stowell, MS, CTRS, ACA’s youth activities program coordinator. “By trying new activities and meeting new people, the campers conquer their fears and discover they are not defined by their disability.”

More information is available at www.amputee-coalition.org.

Claudia Zacharias, MBA, CAE, has been named president of the BOC. Zacharias has more than 20 years of experience in association, credentialing, and institutional recognition and accreditation programs. She has worked extensively in the health-care field, most recently with the American Nurses Credentialing Center.

BUSINESS IN THE NEWS

Annual Kick-a-Thon Aids Children with Limb Loss Kicking for Kids Who Can’t (KFKWC) will hold its annual kick-a-thon on Sunday, Oct. 11, 2009, on the National Mall in Washington, D.C. The program, founded in 2006 by Ginna Goodenow, has raised nearly $75,000 for the Limbs for Life Foundation, a 501(c)3 not-for-profit organization that provides assistance to those affected by limb loss. The money raised by KFKWC is specifically directed to helping children.

The kick-a-thon is the program’s flagship event, along with a variety of fundraisers throughout the year.

For more information, visit kickingforkidswhocant.org. a

6

Dr. Comfort has just received approval from NCOPE for the company’s new DrC Certified Fitter of Therapeutic Shoes (CFts) education course. With this approval, Dr. Comfort’s new course now meets the education prerequisite requirement for individuals seeking to become certified by the ABC to become CFts. The course will be taught by Brian Lane, C.Ped, Dr. Comfort’s director of education, who previously served as the director of pedorthics for a large podiatry practice in Atlanta.

For more information, contact Brian Lane at brianl@drcomfortdpm.com or 262/402-7220.

Orthocare Innovations’ Compas system is among this year’s winners of the prestigious R&D 100 Award.

Compas represents a significant advance in the fitting and ongoing management of prosthetic devices. This new technology assists practitioners in achieving optimal alignment through objective feedback and analysis using embedded sensor technology. R&D 100 Awards salute the 100 most technologically significant products introduced into the marketplace over the past year. Products are selected by an independent judging panel and the editors of R&D Magazine.

O&P AlmAnAc OCTOBER 2009

n

reimbursement page

L

ast month’s Reimbursement Page discussed the importance of using modifiers to ensure that Medicare claims are processed correctly. Without certain modifiers, Medicare may deem that your claims cannot be processed, leading to unnecessary delays or loss of revenue.

In addition to proper modifier use, the previous article also discussed directional and informational modifiers. This month, we’ll focus on the two remaining types: functional level modifiers and uncommon modifiers.

Functional Level Modifiers These modifiers are used exclusively with claims for lower limb prostheses—specifically with codes that describe prosthetic knees, ankles, and feet. Medicare established functional levels to alleviate the need for a specific Certificate of Medical Necessity for lower limb prosthetic claims.

Patients are assigned a function level based on their expected ability to ambulate using a prosthesis. The functional level assignment should be

By Joseph McTernan, AOPA government affairs department

Modifiers: Crucial to Ensuring Processing and Payments Functional level and selected uncommon modifiers confirm what’s medically necessary a joint decision involving all members of the rehab team as well as the patient.

Functional levels range from Level 0 - Level 4 and are defined as follows: • Level 0: Does not have the ability or potential to ambulate or transfer safely with or without assistance, and a prosthesis does not enhance the patient’s quality of life or mobility.

• Level 1: Has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. Typical of the limited and unlimited household ambulator.

• Level 2: Has the ability or potential for ambulation with the ability to traverse lowlevel environmental barriers such as curbs, stairs, or uneven surfaces. Typical of the limited-community ambulator.

• Level 3: Has the ability or potential for ambulation with variable cadence. Typical of the community ambulator who has the ability to traverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic use beyond simple locomotion.

• Level 4: Has the ability or potential for prosthetic ambulation that exceeds basic ambulation skills, exhibiting high-impact, stress, or energy levels. Typical of the prosthetic demands of the child, active adult, or athlete.

8

O&P AlmAnAc OCTOBER 2009

All codes that describe prosthetic knees, ankles, and feet must contain a functional level modifier that consists of the letter K followed by the patient’s assigned functional level (e.g., K0, K1, K2, etc.). These modifiers are used to verify that the components that are being billed are covered for the specific patient to whom the components are being provided.

Without a functional level modifier, the claim will be automatically denied as not medically necessary. It also is important to note that K0 functional level patients do not qualify for a prosthesis according to Medicare policy guidelines. Any claims submitted with a K0 functional level modifier will be denied as not medically necessary.

Uncommon Modifiers The modifiers discussed to this point should all be part of your everyday orthotics and prosthetics practice. Many other modifiers exist that are far less common but may prove very useful in helping the correct processing of your Medicare claims. While the list can be very long, we will focus on a few of the more important modifiers.

Medicare allows providers to bill patients for upgraded items that go beyond the scope of what is considered to be medically necessary. In the past, if a patient wanted an upgraded item, he or she had to be willing to pay for the entire device by signing an Advance Beneficiary Notice (ABN).

Shoes Specially Designed for O&Ps

TM

to Accommodate Mild or Severe Foot Problems Off-the-Shelf and at Low Prices

502-C Casual Dress Shoes (Charcot)

Medicare Approved

502-X, 502-E Feather Light Casual Dress Shoes (Expandable padded collar available as modification)

(Build-in Medial Charcot, Laces available) Built-in medial charcot Long hook/loop strap Mis-matches 502 or 502-x, 502-e Charcot Boots also available with laces and hook & loop strap

Supra depth & extraordinary volume Accommodate to severe edema Covering width to 14E

Medicare Approved

502-X

502-E

708, 718 Paul Bunion / Bunionette Shoes (Cut-off flex area for more release, come in black and beige) Flexible Lycra to fit hammer toes/claw toes Extra Long hook/loop strap

502-C

708

718

Medicare Approved

801, 802 Heavy Duty Supra-depth Shoes Extended width to 9E 3 Layers of Removable Inserts Extended strong medial & lateral counters 801

802

(Laces available)

9205, 9209 Women's Premiere Comfort Shoes Extremely light 7 ounces per shoe Added depth(8mm or 5/16") deeper Three widths (M/W, WW, XW) 9209

9205

(Other colors also available)

Apis Footwear Company 2239 Tyler Ave. South El Monte, CA 91733 Tel: 888-937-2747 Fax: 888-990-2245 www.bignwideshoes.com

Footwear Co.

n

reimbursement page Currently, specific modifiers may be used to isolate only the additional cost of the upgrade, which then becomes the responsibility of the patient. The three modifiers that are involved are GA, GK, and GL. The GA is used to indicate that an ABN is on file to address the additional charge for the upgrade. The GK modifier indicates the service or item that Medicare actually covers. The GL modifier indicates that the upgrade

foot (L5974). In this case, the patient can choose to upgrade to an energystoring foot and pay the difference in cost between the two. Both codes will be listed on the claim form, but the modifiers will tell Medicare that only the energy-storing foot was provided.

Assuming the foot is provided on the right side and the patient has signed an ABN, the two claim lines would be 1 x L5974 GKK1RT and 1 x L5976 GAK1RT.

Patients are assigned a function level based on their expected ability to ambulate using a prosthesis. The assignment should be a joint decision involving the rehab team as well as the patient. is being provided at no charge to the patient and no ABN is on file.

Claims for upgrades should always contain one line item that includes the covered code and the GK modifier, and a second line item with the code that describes the upgrade and either a GA modifier or a GL modifier.

An example of billing for an upgrade involves a situation where a patient believes she will benefit from an energy-storing foot (L5976), but she is a functional Level 1 patient who only qualifies for a single-axis

An important modifier that is used when providing O&P services to a patient who has elected to use his or her hospice benefit is the GW modifier. The Medicare hospice benefit covers palliative treatment of the symptoms of a terminal disease.

While under hospice care, treatments of conditions that are not directly related to the patient’s terminal disease remain covered as traditional Medicare benefits. For Medicare to properly process these claims, providers must include a GW

10

O&P AlmAnAc OCTOBER 2009

modifier indicating the service is unrelated to the patient’s terminal disease or illness.

While most surgical dressings are statutorily not covered by Medicare, coverage is available for compression garments used in the treatment of open venous stasis ulcers. The three codes that are covered in this scenario are A6531, A6532, and A6545.

The AW modifier must be used with these codes to indicate that they are being provided in conjunction with a surgical dressing.

The CG modifier indicates that specific spinal orthosis codes are being used to describe items that are flexible but not elastic in design.

Medicare recently released a policy statement that indicated that devices made of elastic materials do not meet the rigidity requirement in the definition of a brace and, therefore, are non-covered. Several codes that describe flexible spinal orthoses can be used to describe devices that are elastic in nature and devices that are flexible but not made of elastic materials. Because these non-elastic items remain eligible for coverage, providers have been advised to use the CG modifier to identify flexible spinal orthoses that are not made of elastic material.

The GD modifier is used to indicate that the number of units of a particular item or service exceeds published medically unlikely edit (MUE) numbers, but the provider believes the higher number of units is medically necessary. While this modifier may require further explanation, it may avoid automatic denial of claims that exceed published MUEs. Modifiers are an essential part of the overall claims process. While they may not seem as important as the codes themselves, they provide valuable information to payers that assist in the proper processing and paying of O&P claims. a Joe McTernan is AOPA’s director of reimbursement services. Reach him at jmcternan@AOPAnet.org.

A K Extreme Liner Extreme Advantage-Indicated for Above Knee (transfemoral) OR below Knee (transtibial) Active amputees; Reduce on-hand inventory cost and space requirements through application on either AK or BK amputees.

Extreme Contact-- 80% Less Vertical Stretch As compared to other Alps gel liners, resulting in demonstratively increased contact while substantially eliminating pistoning.

Extreme Suspension-New GripGEL™ is more tactile than EZGel to gently but firmly support the residual limb and sensitive tissues.

Extremely Affordable-No other liner on the market provides this quality, durability and performance at this price... absolutely no other!

Alps New AK Extreme Liner is available in 3mm or 6mm Uniform thicknesses in 8 sizes, to fit circumferences of 16 cm to 53 cm.

NOW IN STOCK: Š 2008 ALPS. All Rights Reserved.

800.574.5426 www.easyliner.com info@easyliner.com

FitComfort and

POST-MASTECTOMY FITTERS GO BEYOND MEETING PHYSICAL NEEDS TO ALSO SOLVING EMOTIONAL AND FINANCIAL ISSUES

A

fter years of working to fit mastectomy patients with prosthetics and apparel, consultant Constance Niclas, CMF, CF-M, says she knows the singlebiggest mistake others in the business make—even before they open their doors for the first time.

“A lot of them do this out of compassion. They think they’ll love doing this because they’re survivors themselves. But it can’t be a hobby. It has to be a business,” Niclas advises.

Maintaining a professional focus is necessary for a multitude of reasons, she says. Breast forms and post-surgery bras are not fast-selling items. The fit is individualized, so product lines have to be extensive and varied to give customers plenty of choices. Securing payment for these products from insurers and Medicare, especially when each woman requires a customized fit, can be especially challenging.

Certainly, working with patients in any specialty of orthotics and prosthetics can be emotionally difficult. But those who fit breast cancer patients with post-mastectomy forms and devices say their jobs require special care and compassion to help women who’ve just lost one or both breasts. Practitioners contend that success in this field requires the right balance of technical expertise, emotional sensitivity, and mastery of the insurance and reimbursement process.

Grief—and Relief Amber McCann, a certified bra and mastectomy fitter at A Woman’s Place on Main Street in Laurel, Maryland, says she was surprised by the emotional requirements of her new specialty when she decided to expand her business from breastfeeding supplies to mastectomy products about a year ago. With that decision,

12

O&P AlmAnAc OCTOBER 2009

she became a fitter and counselor, saying that it’s a role that not everyone can take on.

“Some of the people we hired became very nervous and uncomfortable in the counseling role we take on,” she says. “They were qualified, but they couldn’t do that part of it and they didn’t work out.”

McCann’s shop, which is furnished like the living room of a luxury home, provides plenty of boxes of tissues, alongside bras and prosthetics. Customers often get emotional both from the trauma of breast loss and from the relief that they can be fitted with the right form.

“You still play cheerleader, even when someone is years out of surgery,” she says. “It’s not unusual at all to have tears in here.”

Nina Miller, CMF, Snell Prosthetic and Orthotic Lab, Little Rock, Arkansas, agrees. “These women are not just dealing with the loss of part

By Kim Fernandez

13

O&P AlmAnAc OCTOBER 2009

“ of their body,” she says. “They’ve lost something very emotionally important to them that makes them feel whole. What we do is make them feel better. We help them know that when they leave here, other people can’t tell they’ve had breast cancer. They look just like everybody else, and that’s really important to them.”

Challenges and Changes Post-mastectomy prosthetics have undergone dramatic changes over the last 10 years. For one, they’re much lighter than they were even five years ago. Manufacturers now realize that lighter is better to ensure greater comfort and wearability for women.

That’s a change from early products that tried to simulate natural breast weight in order to balance the body. Now, forms are made as light as possible, and users approve.

While product improvements are beneficial to customers, shop owners and fitters are faced with the challenge of how to recommend the right

We help them know that when they leave here, other people can’t tell they’ve had breast cancer.

––Nina Miller, CMF

prosthetics—and ensure that products get sold, and that their business is profitable.

“You need a framework to understand the pricing of the products,” says Niclas. Mastectomy boutique owners can quickly become overloaded with products. “It’s not a quick-turn business, and you can easily end up with storage issues,” she suggests.

Understanding the features and benefits of products is critical, and so is knowing what prosthetics insurance will cover. “I have to know: Should I put a woman into a swimming form?

Would she be better off if we gave her a shell? And you have to understand the insurance regulations of what you’re selling. If I have a choice of putting a woman into a shell that costs $230, or a swim prosthetic which is bulkier but cheaper, those are issues

14

O&P AlmAnAc OCTOBER 2009

”

a shop needs to understand. What’s going to drive business back?”

You have to know the products, agrees Angela Sombrano, CMF and office manager for Scope Orthotics & Prosthetics in Torrance, California.

“A lot of people think women have to buy a bra anyway, so what’s the difference? But a lot of manufacturers are just too expensive and insurance won’t pay,” she warns.

When insurers balk, customers must either decide to pay the difference for a product upgrade, or purchase a different product that meets insurers’ requirements.

Sombrano says she’s seen a shift in what customers are willing to pay for, and they’re being more selective.

“Most patients now don’t want to pay for the upgrades,” she says. “Years ago, they did. But with this economy, they’re not doing it.”

Our Mission is Comfort...

Each year millions of people will develop foot complications due to health problems. Properly fitted shoes are essential for reducing these risks. Dr. Comfort shoes are made from the finest leathers and are scientifically designed for various foot complications. Call now to experience exceptional quality and profitability with our exclusive turn key program for your professional practice.

The Finest Quality Comfort Footwear and Inserts Period!

1-800-992-3580 www.drcomfortdpm.com Š2009 Dr. Comfort Shoes All Rights Reserved

“

Customers need to realize that bras, like cars, require maintenance and are not designed to last a lifetime.

”

––Constance Niclas, CMF, CF-M

Recognizing this shift, Sombrano now asks customers if they want to see products only covered by insurance, or if they’re willing to pay some out-of-pocket costs for upgraded prosthetics.

“I’ll show a patient the style of bra their insurance will pay for,” she says. “If they say they’re willing to pay, I’ll show them everything.” But, because upgraded bras can be prettier and more stylish, she says, it can be too difficult for women to see them and then be told their insurance won’t cover them.

Unfortunately, Niclas says, not all shops can keep extra merchandise on hand, so customers sometimes must have products ordered without having tried them on. And because these products are expensive and not quick sellers, many shops maintain a no-return policy. Some customers find they’re stuck with a bra that looked good on paper, but now simply doesn’t fit right.

“People don’t have money to spend like they used to,” she says.

“Breast cancer rates increase with age, and you get a lot of elderly women who don’t want to spend $300 this year on something, even though Medicare will reimburse them.”

Customers who go online to buy cheaper products can end up with illfitting prosthetics that make them feel even more self-conscious.

Knowing the Limits Niclas says it’s vital for mastectomy shops and boutiques to ensure that staff members are trained and certified in fitting. They also need to

know that different products fit differently, and that ordering various items in one size won’t result in the same fit on a real body.

“It comes down to knowing the customer’s body” and advising her that as she ages, her product needs will change, says Niclas. “It’s a good idea to keep a birthday list and get in touch with customers on their birthdays. Let them know that it’s been two years since they’ve been in, and Medicare will allow them to come in for a fitting.” Customers need to realize that bras, like cars, require maintenance, and are not designed to last a lifetime, says Niclas.

“I’m a firm believer in fitting them into something that looks good on them,” says Sombrano. “Not every style looks good on every woman, and not every form looks good on every woman.”

Niklas also advises checking in with customers a week or two after their fittings to see if they’d like their fitting rechecked, and if they’re satisfied with their purchase.

“The insurance companies don’t like us to keep up with patients,” admits Sombrano. “They don’t like us to send reminder notices.” But she says that women should be buying a new bra every year.

16

O&P AlmAnAc OCTOBER 2009

Insurers and Medicare typically allow mastectomy patients to purchase two bras every year, and one form every two years. These restrictions often make women overly anxious about choosing new products because they worry about being stuck with a bad choice. Women who don’t have insurance and don’t qualify for Medicare often cannot afford prostheses. “These women are without anything and have a hard time finding the means to pay for any prosthesis,” says Miller.

The latest challenge, she says, has resulted from the move toward providing reconstructive surgery during mastectomy procedures.

While older women tend to pass on the procedure, many young women do take advantage of this option, but are surprised when the results aren’t totally perfect.

“I see patients afterwards who come in because the reconstruction isn’t perfect,” she says. Fitting these women with prosthetics to remedy the imperfect reconstruction is sometimes much more complex than fitting a patient with a total breast form. “Maybe 5 to 8 percent of my patients have had reconstructive procedures that aren’t good,” she says.

oscillator Knee • 5-Bar glide-flex polycentric knee • Rotary hydraulic control system • Adjustable stance flexion feature • High strength zinc-aluminum alloy • Rated for 300 lbs (136 kg)

endurance Knee • Extreme durability • Adjustable A-P stability • Low maintenance • Compact Size • Rated for 300 lbs (136 kg) • Standard stance phase hydraulic control

Active Knee Solutions

from Hosmer

• 1.800.827.0070 • +46 8 505 332 00 • 1.800.251.6398

AD276 05-09

Custom Devices While most fitters say that offthe-shelf forms fit most women, there are some who have had such radical surgery that custom devices are needed. These women also must often face months of battling with their insurers, which can be both exhausting and emotionally draining.

And the fitters are often in the midst of these difficulties.

“Twenty-five percent of our women have damage to muscles in their backs or sides, and they need a custom item so they can even walk, and do normal things, without a lot of pain,” says Miller. “And insurance companies just won’t pay for it.”

Rick Fleetwood, CEO, Snell Prosthetic and Orthotic Lab, acknowledges the major difficulties many of these women face to get custom-fabricated prostheses. “You have to jump through hoops and just do unbelievable things to get that prosthesis.

“

It’s almost impossible. And it seems just not fair.” It’s “unbelievable,” he says, that women who’ve endured breast loss and who need a prosthesis cannot get a product that’s the exact right fit. “It’s a lack of understanding or a lack of education,” he says.

“There’s a huge heightened awareness about breast cancer itself. But when it comes to custom-fabricated devices, there’s this huge black hole.

Nobody understands why it’s not done, and why it’s not okay.”

Fleetwood says that the prosthetics industry needs to be vigilant about other practices to effectively serve breast cancer patients. For instance, he says that his company mandates that only women fitters work with mastectomy patients.

“Part of our corporate philosophy is to make sure that women are talking to women in this situation,” he says. “Normally, we don’t do that. But in this particular situa-

We find it’s imperative that we have women taking care of women.

––Rick Fleetwood

”

tion, we find it’s imperative that we have women taking care of women.”

Other fitters say they, too, believe that in this one segment of the industry, special rules should apply.

“It’s a big issue,” says Sombrano. “I ask my women, and they say they don’t want a man putting them back into a womanly figure. Years ago, there were quite a few men who used to do fittings. In the past 10 years, I haven’t seen a man out there doing it anymore.”

Miller says her shop also recruits female volunteers—former cancer patients—to help mentor new patients as they go through their first fittings.

“Some of the volunteers may have been patients of ours,” she says. “They mentor women who are going through it now because they’re not just losing their breast. They’re facing chemotherapy or radiation, and they’re facing a whole lot of emotion.”

McCann agrees. “Another woman is going to have a unique perspective,” she says. “I don’t want to sound discriminatory, but I don’t think a man can fully comprehend the part of our identity that’s wrapped up in our breasts. I think having another woman working with them is terribly important.”

She says that a supportive viewpoint matters in every part of her job, starting when customers walk through the door.

“A woman came in fresh from surgery and said she was scared to hug anyone because she didn’t want them to feel that she was different,” she says. “I hugged her, and I could assure her that I didn’t feel anything different. That’s nothing I planned when I got into this business. But we certainly play that role.” a Kim Fernandez is a contributing writer to O&P Almanac. Reach her at kim@kimfernandez.com.

18

O&P AlmAnAc OCTOBER 2009

The iPecs* (Intelligent Prosthetic Endoskeletal Component System) is a wireless prosthetic gait lab without floors or walls to limit your research goals. It is destined to change the type of prosthetics research possible and allow for measuring things in a “real word� environment like never before.

The iPecs accurately measures all the forces & moments experienced by an amputee while performing nearly any activity in a variety of settings. The precision data is collected and transmitted wirelessly to your PC or onboard memory. iPecs is considered a vital tool for developing evidenced based outcomes. And, the iPecs unit easily integrates into a finished endoskeletal prosthetic with the use of an industry standard 4-hole adapter. Once again, College Park continues to lead the way with innovative ideas and products. * The project described was supported by Award Number R43HD059285 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development or the National Institutes of Health.

17505 Helro Drive • Fraser, MI 48026 800.728.7950 | FAX: 800.294.0067 586.294.7950 | FAX: 586.294.0067

www.college-park.com

IN THE

SAFETY

WORKPLACE

Proactive strategies ensure OSHA compliance, reduce risks for your employees and visitors

BY DON PIERSON, CO, C.PED

A

ccidents in the workplace can—and will—happen. No employer wants to see anyone harmed and, certainly, in the current economic environment, no one wants to be faced with costly outcomes.

Smart business owners and managers know that it’s best to be proactive and to take the necessary steps to ensure the safest working environment possible. This strategy will matter if a serious accident occurs. Your preparedness will pay off even more because of what the law requires: your compliance with standards set by the Occupational Safety and Health Administration (OSHA).

20

O&P AlmAnAc OCTOBER 2009

What’s OSHA’s Scope?

Mention OSHA, and many business owners cringe. A typical worry is that if a disgruntled employee reports a company to OSHA for noncompliance, and violations of safety standards are found, an employer can face steep fines and other penalties.

But, anxieties aside, it’s necessary to understand what OSHA does— and what you need to do to comply as a prudent owner or manager of an orthotics and prosthetics business.

Until 1970 no uniform and comprehensive laws existed to protect working Americans against workplace safety and health hazards.

Congress created OSHA under the Occupational Safety and Health Act, which was signed into law by President Richard Nixon in 1970. OSHA’s mission is to prevent work-related injuries, illnesses, and deaths. Since the agency was created in 1971, occupational deaths have been cut by 62 percent, and injuries have declined by 42 percent.

Any business that has at least one employee who is not a family member falls under OSHA’s jurisdiction and must comply with OSHA standards. It is not common for OSHA to drop in and inspect your facility without any specific cause. The agency has a staff of 2,150, including 1,100 inspectors— not a large number, compared to the number of businesses that fall under the agency’s authority. OSHA typically conducts 37,000 to 38,000 inspections each year, based on the following priority categories: • reports of imminent dangers— accidents about to happen • fatalities or accidents serious enough to send three or more employees to the hospital (Employers must report such incidents to the nearest OSHA office within eight hours.)

• employee complaints, which are the primary reason for an OSHA inspection • referrals from other government agencies • targeted inspections, such as the Site Specific Targeting Program,

which focuses on employers that report high injury and illness rates (e.g., construction sites), and special emphasis programs that zero in on hazardous work, such as trenching or equipment such as mechanical power presses • follow-up inspections.

Focus on Preparedness You know you must comply with OSHA regulations, and you probably already have efforts underway. Here are some key steps that will not only help to enhance your preparedness but also contribute to an even safer workplace: • Visit the OSHA Web site, www. osha.gov: On this site, you will find comprehensive information about the agency, enforcement, compliance assistance, including e-tools, and much more.

• Perform worksite self-inspections. Be aware of what you have in your office and facility that present potential hazards. For instance, make sure that someone hasn’t been “creative” with electrical wiring; that all containers are labeled properly; and that material safety data sheets (MSDS) are available.

• Conduct job hazard analyses.

If an employee is exposed to potentially hazardous fumes or other dangers as part of his or her daily activities, you can have analyses performed to detect if the potential hazard is legitimate. OSHA itself will send out an industrial hygienist to perform such testing at no charge to you.

This is not the same as an OSHA inspection, and the hygienist will only concentrate on the area assigned for the testing. However, if a serious hazard is found, you must correct the problem in an appropriate and timely manner.

Remember, it’s best to get authoritative information. An employee’s opinion is not an OSHA-approved detection device.

• Investigate accidents. This should be obvious: If you are aware of an accident, take an active role

21

O&P Almanac OCTOBER 2009

You must comply with

OSHA regulations.

Tools for the Trade In addition to the OSHA Web site, these software packages offer the necessary forms and detailed information that safety managers can use to plan their company safety meeting: OSHA Compliance Suite by Regsoft. This package offers tools to help you create and customize your own materials, plus access to OSHA regulations, PowerPoint safety presentations, sample forms and meetings as well as an interactive training tool and a standards search engine.

OSHA Navigator PRO. This version includes all regulations, plus safety plan templates and inspection forms; PowerPoint presentations, handouts, and quizzes for training; compliance directives and interpretation letters; and recordkeeping forms, tools, and database.

in investigating the details and recording your findings.

• Fulfill required recordkeeping.

This is very important. Your company could face a $1,000 fine for not having required forms readily available if and when an OSHA inspection occurs. Download required forms at www.osha. gov/recordkeeping/handbook.

Take an active role in investigating and record your findings.

It is vital to know what specific recordkeeping is required. One form that must be available is Form 300, Log of WorkRelated Injuries and Illnesses.

Failure to have this completed document on hand will certainly result in a $1,000 fine. Form 300A, Summary of Work-Related Injuries and Illness, must be posted annually in an area of your workplace that is easily accessible to employees. Form 301, Injuries and Illnesses Incident Report, also must be kept and updated. An OSHA inspector will ask to see all three of these forms.

Note: You are only required to have these forms if you have 10 or more employees.

In a related matter, all employers must post the federal or a state OSHA poster to provide employees with information about their safety and health rights. You may order a printed copy from the OSHA Publications Office at 800/321-OSHA, or download and print one from the OSHA Web site in English or Spanish. Again, you’ll face a $1,000 fine for failing to display the poster if you’re found in violation.

You also may want to consider being proactive and sending to your local OSHA office copies of documents that show what you have done to provide a safe environment for your employees. This

would include information about safety presentations held for your employees, a copy of your hazard communication and chemical safety program, and the like.

If your facility is ABC-accredited, you could show how you have complied with the safety requirements set forth by ABC. Upon receiving your information, OSHA will start a file on your company.

If a complaint about your firm is ever made to OSHA, the agency will refer to this file, and see how proactive and well-organized you are. It’s likely that OSHA will start the investigation into the complaint with a phone call to you, rather than with an unannounced site inspection. With the call, you may then be able to respond by supplying photos and other requested materials that address and correct the situation.

Special O&P Concerns In O&P facilities where fabrication takes place, odors from adhesives and laminations are common. If any of your employees uses a respirator, you must be aware of OSHA regulations pertaining to their use, and these rules are quite complex.

First, you must have a written respiratory protection policy. You must adhere to OSHA’s other strict standards, including proper training on the use of respirators, the selection of appropriate respirators, and main-

22

O&P Almanac OCTOBER 2009

tenance of the respirators. You must make sure that employees undergo a medical evaluation to determine their ability to use a respirator prior to their being fit tested or being required to use the respirator in the workplace.

The reason is that respirators restrict the flow of oxygen, which may cause an employee to lose consciousness. If OSHA were to do an inspection and observe an employee wearing a respirator, the inspector will inquire about your respiratory protection policy; if you fail to produce one, you may be subject to heavy fines.

O&P labs face many safety concerns and hazards for which your employees must be prepared: • If you spill a can of solvent, how should it be cleaned up, and how should materials used for cleanup be disposed?

• What constitutes first aid versus professional medical care, and what should be recorded on OSHA forms?

• Have you designated a safety manager for your office? How do you handle safety concerns voiced by an employee?

• Are you responsible for the safety of your patients or visitors who enter your facility as part of OSHA compliance?

Again, the OSHA Web site will be your most helpful resource. You also may want to do safety training for your employees, using local companies that specialize in such training. You also can obtain software programs on workplace safety that include forms, safety lessons and tips, and more.

One of your most critical priorities as an owner/manager is to ensure preparedness and the safety of your workplace for your employees—and for all those who enter your facility. a Don Pierson, CO, C.Ped, is director of operations for Arizona AFO. He, along with John F. Schulte, CPO, FAAOP, and Ruediger Gerstemeier spoke about workplace safety at the 2009 AOPA National Assembly in Seattle. Reach him at don@arizonaafo.com.

AOPA HEADLINES

AOPA WORKING FOR YOU

Why Is It So Confusing?

How the O&P PAC and Capital Connection operate and are supported

A

t a recent gathering of AOPA’s Board of Directors, the discussion was dominated by concern and frustration over lagging orthotics and prosthetics industry contributions to the Political Action Committee (PAC), which have fallen under the $100,000 annual goal.

With all the threats facing O&P with health-care reform, only 31 members made contributions through July 31.

Several members, in fact, say they are confused about the need for both the O&P Political Action Committee (PAC) and the Capitol Connection.

They ask: Why both? What is the difference?

At its simplest, the PAC can make direct contributions to campaigns of elected officials at the federal level. The PAC can accept only personal contributions––no corporate checks––and there are limits on how much a person can give in any one election cycle.

support the political campaigns of those members of Congress who support the O&P policy agenda—issues such as parity and CMS enforcement of BIPA 427. We have to make sure that O&P’s interests are represented when health-care issues that can affect us are on the table.

Frankly, it’s common sense to support those politicians who understand and support O&P concerns to ensure appropriate patient care and, to curb fraud and abuse.

Certainly, some might feel that it would be so much simpler if AOPA could just write a check drawn on funds from AOPA annual member dues. But that is just not the way it works.

Funds contributed to both the PAC and Capitol Connection are not only segregated from AOPA funds but also further scrutinized by AOPA’s auditors to verify that we are in compliance with federal election laws. Penalties for non-compliance are stiff.

In fact, federal election laws create a lot of frustration related to PACs and other political activity. The law states that anyone who is employed by an AOPA member can make a voluntary contribution to the PAC. As you might imagine, however, not too many unsolicited checks float over the AOPA transom.

But the law also provides that the PAC cannot solicit an AOPA member for money unless he or she has granted permission to be asked. This is why AOPA constantly encourages members to sign the PAC authorization form, which is easily found on the AOPA Web site—and in this issue on page 28. The authorization is good for five years, and the owner or top management of an AOPA member company also can authorize the PAC to solicit contributions from its employees.

Please take a moment to sign and send in the PAC authorization form.

Sending the form doesn’t obligate you to give, but it will give the PAC the ability to reach out to you to explain why it’s in your best interest to do so. Rick Fleetwood is this year’s O&P PAC chairman. Those of you who know Rick personally also know how passionate—and persuasive—he is Rick Fleetwood about this cause.

The federal election laws have other requirements, as well. Quarterly filings with the Federal Election Commission require the name and address of anyone making a

The Capitol Connection cannot contribute directly to federal campaigns because it may accept corporate as well as personal funds. The Capitol Connection creates and distributes educational materials designed to advance the policy issues supported by the O&P industry. It also can underwrite political education Web sites, such as AOPAvotes, which provide detailed information about the issues, candidates, voting procedures, voter registration, and, even, specifics as to where to vote.

Both the O&P PAC and the Capitol Connection are political mechanisms important to O&P members and to our industry. It’s vital that contributions be made to

24

O&P AlmAnAc OCTOBER 2009

NEW NEW

M e d i c a l

W h i t e

3-IN-1

Complete Care

S A D M E R C

A P P R O V E D

L S O

L O 6 3 7

1. Post-op Immobilization Brace

2. Rehabilitation Brace LSO LP

LSO

TLSO PPK

TLSO DLK

Now, you can have the same superior support in NEW Medical White. The 3-In-1 versatile Stealth adapts easily and quickly to you patients’ therapeutic needs.

Simply exchange, add or remove included panels to transform the Stealth into a complete care support system. The Stealth is guaranteed to fit and support like no other brace.

Call us today at 1-888-982-8181 to experience the Stealth Advantage.

975 PROGRESS CIRCLE LAWRENCEVILLE, GA 30043

3. Corset Support

n

AOPA headlines

a result, when a candidate is invited to participate in a PAC event in his or her honor, the candidate’s fundraiser will typically be interested in reaching a targeted goal amount: typically $15,000 to $25,000. Since the PAC itself is restricted to giving an amount that’s only a fraction of this overall goal, contributions from individuals attending the event are critically important. Without them, your O&P PAC would essentially be prevented from ever sponsoring a successful fundraiser.

Finally, it’s important to recognize those very generous individuals who support the PAC and also contribute to individual fundraisers. A dozen times each year, AOPA accepts invitations to events for deserving legislators or agrees to host such events as it has done for Rep. Shelley Berkley (D-Nevada), Sen. Ben Cardin (D-Maryland) at the recent AOPA Policy Forum, and more recently for Rep. Bill Cassidy (R-Louisiana). These events usually require individual donations of $250 on up to $1,000 or more. (And by law, payment always must be by personal check or credit card.) In addition to the 31 contributors to the O&P PAC, another 28 people stepped up to support these political fundraising events. In doing so, they became members of the AOPA President’s Dinner Donors. A complete list of PDD members—along with those recognized as members of the President’s Circle, Senator’s Table, and Chairman’s Table—is posted on the AOPA Web site on the government relations page, under Get Involved/O&P Honors. a

contribution in excess of $50; for those in excess of $200 per calendar year, the occupation and employer also must be provided. In fact, the laws are so complex and the penalties so onerous that AOPA retains a firm specializing in PAC filings to handle the paperwork and to ensure compliance.

Yes, it would be so much simpler if the annual dues investment by AOPA members also could cover the PAC’s needs. But that’s not the way the world works.

Contributions from individuals attending the event are critically important.

Instead, it’s Rick’s job to continually remind you how important it is for the voice of O&P to be heard through the political campaign donations made by the PAC and the political education efforts conducted by the Capitol Connection. Both fill a genuine need and have a specific role in helping achieve O&P’s public policy goals.

The O&P PAC is restricted by law to give no more than $5,000 to any candidate’s primary election campaign; another $5,000 contribution is permitted if that candidate survives the primary to enter a general election campaign.

But, the cost of election campaigns continues to spiral. As

Post-Surgical Camisoles and Bras

By Wear Ease® Comfort with Style Featuring: built in support • feminine styling • quality finishing & fabric

866.251.0076 • www.wearease.com

26

O&P Almanac OCTOBER 2009

For 50 years, PEL has offered the O & P practitioner outstanding

SERVICE

on the most popular products available from the industry’s leading manufacturers.

Your order is carefully packaged by a reliable PEL warehouseman, like Dave, for expedient and dependable shipment – over 98% of popular products ship the same day.

Dave Watson, Shipping Supervisor • Joined PEL in 1978!

• Super dedicated and reliable for over 30 years • Avid golfer – especially with son, David • Bowling and football fan, too • First and foremost love is Family

Trulife Matrix Curve AFO • Slim, lightweight, carbon composite AFO • Dynamic, low profile design • Optimal energy efficient gait • Custom fit calf band and footplate • Lateral strut • For low to high activity level wearers with unilateral or bilateral drop foot • Four sizes, S to XL

Anatomical Concepts, Inc KMO® Brace • Adjustable range of stabilization of knee in sagittal or coronal plane • Pre- and post-operative management of bony and soft tissue injuries • Ideal for hamstring releases, ligament repairs, total knee arthroplasty, chronic systemic conditions • Immediate prophylactic protection at end range until treatment plans are finalized

ALPS ALPS EZ Flex liner • Offers the best of both worlds • Anterior fabric allows an unlimited restriction of stretch for knee flexion • Posterior fabric limits stretch to reduce pistoning and bunching in popliteal region • Formulated with the ALPS EasyGel to provide the patient with comfort and durability • Wider distal end to ease donning • 1-yr warranty, 2-yr on two liners ®

Experience the Power of One.

50 years of one stop shopping for all your O&P needs.

Phone: 800-321-1264 Fax: 800-222-6176 E-mail: customerservice@pelsupply.com Web: www.pelsupply.com

Authorization Form Authorization Form O & P PA C 2 0 0 9

PLEASE COMPLETE TO BE ELIGIBLE TO DONATE PLEASE COMPLETE Date: _________________ TO BE ELIGIBLE TO DONATE

IMPORTANT O&P O &Political P P AAction C 2Committee 0 0 9 (PAC) Information:

Date: _________________ You must have a current signed PAC Solicitation Authorization Form on file with AOPA to donate. Although your authorization may be on file––in case it has expired, please complete the authorization form below.

IMPORTANT O&P Political Action Committee (PAC) Information:

YES,signed I want PAC to support the O&P PAC and Form authorize the O&P PACto todonate. share information withauthorization may You must have■a current Solicitation Authorization on file with AOPA Although your andexpired, others associated with this as designated be on file––in caseme it has please complete thecompany authorization form below.by me below. My company has not authorized a federal PAC solicitation by another trade association during any calendar year in which this “authorization” is granted to the O&P PAC and signing this card in no way ■ YES, I want to support the O&P PAC and authorize the O&P PAC to share information with obligates me or others to contribute. me and others associated with this company as designated by me below. My company has notcommunicate authorized a federal PAC solicitation another trade association during any calendar The O&P PAC may in any of the followingby ways: (check one) year in which this “authorization” is granted to the O&P PAC and signing this card in no way ■ Myself only obligates me or others to contribute.

■ Myself and individual listed below are executive officers and employees who have policy making, managerial, or professional responsibilities.

The O&P PAC may communicate in any of the following ways: (check one) ■ Company employees registered for AOPA meetings, but only during these events ■ Myself only ■ Myself and individual listed below are executive officers and employees who have policy making, managerial, By my signature my authorization is valid for the years checked below: or professional responsibilities.

■ Company employees registered for AOPA meetings, but only during these events Signature______________________________________________________________________Credentials ________________________ By my signature my authorization is valid for the years checked below: ■ 2009

■ 2010

■ 2011

■ 2012

■ 2013

Signature______________________________________________________________________Credentials ________________________ You may also communicate with these eligible employees: ■ 2010 ■ 2011 ■ 2012 ■ 2013 ■ 2009 Name ________________________________________________________________________Credentials ________________________ You may also communicate with these eligible employees: Name ________________________________________________________________________Credentials ________________________ Name Name Name Name Name Name

________________________________________________________________________Credentials ________________________ ________________________________________________________________________Credentials ________________________ ________________________________________________________________________Credentials ________________________ ________________________________________________________________________Credentials ________________________ ________________________________________________________________________Credentials ________________________ ________________________________________________________________________Credentials ________________________

Name ________________________________________________________________________Credentials ________________________ Name ________________________________________________________________________Credentials ________________________

THANK YOU FOR YOUR SUPPORT. To be eligible to donate, please complete this form and return to AOPA, Tina Moran, by fax or mail.

THANK YOU FOR YOUR SUPPORT.

AOPA, Attention: Tina Moran To be eligible to donate, please complete this form American Orthotic & Prosthetic Association and return to AOPA, Tina Moran, by fax or mail.

330 John Carlyle Street, Suite 200 Alexandria, VA 22314 AOPA, Attention: Tina Moran Fax: 571/431-0899 American Orthotic & Prosthetic Association Phone: 571/431-0808 330 John Carlyle Street, Suite 200 Alexandria, VA 22314 Fax: 571/431-0899 Phone: 571/431-0808

28

O&P Almanac OCTOBER 2009

DEMAND THE BEST Your patients do!

Why shouldn’t you?

ABC facility accreditation is the BEST. We offer the: :: Best value :: Highest standards :: Longest track record for excellence in the orthotic, prosthetic and pedorthic professions

We Can Help The American Board for Certification in Orthotics, Prosthetics and Pedorthics Inc. 330 John Carlyle St., Ste. 210 Alexandria, VA 22314 703-836-7114

ABC facility accreditation isn’t just about meeting the minimum standards—it’s about you and the quality of care you provide.

Accreditation from ABC tells your patients that the highest standards in the profession have been met.

Contact us today at 703-836-7114 and join the best in the profession. Download the accreditation guidelines and an application at www.abcop.org.

www.abcop.org

ST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST DEMAND THE BEST D THE BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND T

n

AOPA headlines

LETTER TO THE EDITOR

Today’s Vision of Tomorrow

I

stimulation (FES) may soon take the place of bracing as we know it. Current applications are being used to control drop foot for a number of diagnoses such as stroke, peripheral neuropathy, muscular dystrophy, and others. In the future, this concept will likely be used to electronically control Scoliosis, Kyphosis, and other spinal disorders without any external support at all. Many of the new residents graduating in coming years will be “computer programmers” of these devices, and their understanding and knowledge surely will become an integral part of the certification process.

The utilization of today’s new and innovative devices, materials, and concepts will ultimately become tomorrow’s tried-and-true methods of treatments by future orthotist. Will today’s wheelchair be replaced by a Segway-style powered device that allows the paraplegic to propel themselves throughout their ADL? Could today’s KAFO become a computer controlled and powered device that “walks” for the patient? The futuristic concept now in the testing stage of BLEEKS technology to make today’s soldier stronger, may soon become tomorrow’s method of choice to help the paralyzed patient become ambulatory. Tomorrow’s orthotist will certainly be a design engineer who incorporates tomorrow’s version of FES to control the Valgus movement at the ankle, or multiple site electrodes to not only manage but ultimately control or eliminate Idiopathic Rotary Scoliosis curvature in adolescents.

Remember, it is the need to develop new treatment options and the introduction of the newly trained orthotists to our field that helps us keep our minds open to new concepts and ideas. Let our imaginations run wild!

Only by allowing this to happen will we evolve into tomorrow’s orthotic practitioners.

had the privilege of being a part of the 2009 AOPA National Meeting in Seattle. As I attended the various programs and viewed the exhibits, one common theme prevailed: changes within our field. On the flight home, I had time to ponder how the field has changed from when I was a fledgling practitioner in the very early 1970s, and what future practitioners will be doing in the years to come.

Orthotics as we was knew it a decade ago is no longer the practice we know today. Tried-and-true materials, such as metal and leather, are oftentimes considered obsolete in today’s medical environment, and the trusty bending iron is now a “contouring instrument.”

In the past, prescriptions received designated the degree to which to limit joint motion. Now, double-action joints with multiple stop limits have replaced the Klenzak joint, offering but another dimension to our abilities.

When drop locks failed or prematurely wore, increasing mechanical joint motion, we developed stronger and more user-friendly designs. Those diagnosed with Polio Syndrome now receive the French or Cam lock or an offset joint to ensure an uneventful daily regime. Footwear is an integral part of the device in most cases, and when not part of the device, split or oversized shoes often are necessary.

Polymers, in liquid and sheet form, now make up the majority of materials in our treatment arsenal.

When non-porous foams started being used as support mechanisms, it signaled the beginning of the concept of controlling motion instead of locking it. The idea to remove material to prevent a device from being too restrictive helped change the thought processes within our field, and we have further stretched the limits of these ideas with the introduction of carbon fiber materials and pre- and post-preg materials.

Swing and stance-control orthotic knee joints, and in several applications, computer-programmed and incorporated knee joints now allow a more natural gait cycle with decreased energy expenditures for the user. Functional external

John F. Schulte, CPO, FAAOP The Fillauer Companies Inc.

30

O&P AlmAnAc OCTOBER 2009

Dennis Amtower, CPO

�

Now, my partial foot patients are able to return to activities they enjoy.�

BlueRocker gives them a functional solution TM

Incorporating a socket with a filler prosthesis onto the BlueRocker provides the best of both limb preservation and gait restoration.

Contact Allard USA for a Voice Over Power Point program detailing the step-by-step protocols for accomplishing your goals for all levels of partial foot amputations.

www.allardusa.com

ALLARD USA, INC. 21 Pine Street, Suite 120 Rockaway, NJ 07866-3130

info@allardusa.com Toll Free 888-678-6548 Fax 800-289-0809

n

AOPA headlines

Get the Facts on O&P Billing:

register nOw!

AOPA will present a special audio conference, Oct. 14, 1-2 p.m., Eastern time, designed to address and dispel the myths and confusion surrounding billing for the orthotics and prosthetics industry. Some of the topics to be discussed will include: • billing for diabetic shoes involving amputees • financial liability on non-assigned claims

• proper use of the KX modifier • prostheses and power wheelchairs • billing for unlisted procedure codes.

Join AOPA’s staff experts in learning how to identify possible myths, learn the right answers, and make sure that you don’t get caught up in rumors and misinformation about these vital topics.

The audio conference has been approved for 1.5 CE credits by both the ABC and the BOC. Those seeking credit should complete and return the provided quiz within 30 days and must score 80 percent or better to receive credit. Any number of listeners may participate at each location. The cost to participate is $99 per line for members ($199 for non-members).

Download the registration form at www.AOPAnet.org. For more help, contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

Sign Up Today for the Final Mastering Medicare Seminar in Las Vegas

T

he final 2009 seminar, “Mastering Medicare: Advanced Coding & Billing Techniques,” will be held Nov. 16-17 at the Mandalay Bay Hotel & Casino in Las Vegas. This seminar is the premier forum for both practitioners and billing staff to discuss their toughest coding questions with AOPA’s coding and billing experts, members of the AOPA Coding and Reimbursement Committee, and their colleagues. The first day’s afternoon session will feature two breakout sessions, for practitioners and for billing staff, where each group can ask specific questions.

This seminar is an invaluable resource for anyone who works with Medicare coding and/or billing. Register by October 17 and save $25 per registration; members register for just $525. Save when more than one person from an office attends; the second person and any additional registrants are eligible for a $50 discount. For more help, please contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

32

O&P AlmAnAc OCTOBER 2009

EZ Flex Liner

Practical Magic Hardly just a pretty face,the EZ Flex Liner delivers unequaled function without sacrificing anything.

Unified Flexible Front

The unique fabric on the anterior surface provides unlimited stretch over the patella for greater elasticity while reducing pressure on the knee and the amount of energy required to flex the knee

80% Less Vertical Stretch Posteriorly

As compared to other Alps gel liners, virtually eliminating pistoning while minimizing bunching behind the knee during flexion

Medial view of the knee in flexion demonstrates the greater elasticity of the anterior fabric to extend over the front of the knee. Paring it with the limited vertical stretch posterior fabric reduces the overall effort expended by the amputee to bend the knee and increases comfort.

Alps New EZ Flex Liner (anterior view shown above) is available in 3mm or 6mm Uniform thicknesses. Eight sizes fit circumferences of 16 cm to 44 cm.

NOW IN STOCK: Š 2009 ALPS. All Rights Reserved.

Antioxidants & EZ Gel Protect Skin--

Antioxidants in EZ Gel help protect the skin from damage caused by free radicals.

ALPS EZGel is perfect for those with poor skin characteristics or sensitive tissues.

Budget Friendly-No other liner on the market provides this quality, durability and functionality at this price... absolutely no other!

800.574.5426 www.easyliner.com info@easyliner.com

5

QUESTIONS FOR…

Pete Seaman, RTP

Pete Seaman, RTP, board-eligible prosthetist, interviewed 50 users of lower-extremity prostheses for a residency research project while working at Fourroux Prosthetics in Huntsville, Alabama.

1.

Why did you choose patient satisfaction as the topic of your study?

While taking prosthetic courses at Century College, I read an article about a 1991 survey of amputees.

Two topics covered by the survey caught my interest. One addressed the fact that information needs of amputees were not being met, and the other touched on amputees’ overall dissatisfaction with their prosthetic care.

By choosing to pursue a prosthetics career—at the age of 50—I was seeking the gratification that would come from helping amputees get their lives back. The fact that this survey suggested that many amputees were not satisfied with their prosthetic care quite honestly concerned me. I wondered if such a high level of dissatisfaction among amputees still existed and if so why. So, as a non-amputee entering a profession dedicated to serving amputees, I thought I could fast forward my learning curve. I hoped that this information would help me to become a more effective practitioner, and I also intended to share the results with others in the prosthetics profession.

2.

What was the most surprising fi nding?

The fact that on average, the 50 participants in this survey were treated by almost three different

prosthetists in the eight years that they’d been wearing a prosthesis.

This equates to these amputees going to a different prosthetic facility about every three years.

I wasn’t sure what I expected when asking this question, but the responses definitely surprised me.

I guess I had assumed that once an amputee found a prosthetist, they would be friends for life, but that does not seem to be the case. As a follow-up question, I asked why they had gone to different prosthetists, and two factors accounted for 62 percent of the responses: Forty-four percent said they were not happy with their prosthetic fit, and another 18 percent said they were not happy with the service they received from their prosthetist.

I think this is a very unsatisfactory overall level of “customer satisfaction” for a profession that has such a direct impact on a person’s wellbeing and lifestyle. If these statistics hold true across the lower-extremity amputee population of the U.S., the prosthetics profession should be ashamed and driven to take proactive measures to improve in these areas.

3.

What other key information came out of the study?

Seventy-four percent of the amputees surveyed said they would recommend between 25 and 50 percent of the prosthetists they’d been treated by. Or, stated in another

34

O&P AlmAnAc OCTOBER 2009

way, only 26 percent would recommend more than half of their past prosthetists.

Fifty-nine percent said that little or no information about prosthetics was available to them prior to or immediately following their amputation. As I continue to interact with new amputees, this fact has been repeatedly confirmed. A variety of health-care professionals interact with patients prior to and immediately after their amputations, but apparently they are not sharing much information with them about prosthetics.

Only 8 percent of the respondents had met with a prosthetist prior to their amputation surgery, and 52 percent said they had not met with a prosthetist until three or more weeks after their amputation. For the sake of the amputee, this is another unacceptable statistic.

If the results of this survey are representative of the U.S. amputee population, then our profession needs to acknowledge these shortcomings and determine how to: enhance patient satisfaction levels (from both a clinical and customer service perspective); make educational information about prosthetics more readily available to individuals scheduled to have an amputation; and avail prosthetists of opportunities to meet face-to-face with amputees much earlier in their recovery cycle, preferably prior to their amputation surgery.

New Kid in Town

Meet the 3R60-PRO Smaller, thinner and lighter, the new addition to the 3R60 EBS family keeps up with its sibling and is even 10% shorter.

It’s all in the genes. The 3R60-PRO features a movable proximal pyramid adapter (10 mm anterior/posterior) that makes alignment optimization quick and easy. The PRO’s name refers to its ability to deliver progressive levels of stance flexion depending on the user’s gait. Faster, more aggressive steps are damped more while slower, less aggressive steps are damped less.

For the smaller-framed patient — 165 lbs/75 kg or less and in K3/K4 activity levels — this knee offers the ultimate in performance.

Learn more about this small marvel by visiting us at www.ottobockus.com or www.ottobock.ca.

3R60

3R60-PRO

n

ORLANDO

5 questions

4.

How has this research experience changed your interaction with patients?

I conducted this survey to fulfill the research portion of my residency requirements, so as a “prosthetist in the making,” it helped more to shape my approach to patient interaction rather than change it.

The results reinforced my belief that as practitioners we need to exhibit good people skills, be better listeners, and spend more quality time with our patients. Even if we tire of it due to repetition, we also need to be constantly educating/ informing our patients as to what we are doing because I think that our profession is viewed as being somewhat mysterious by many of our amputee patients. By interviewing over three-quarters of these 50 survey respondents face-to-face, I also developed an appreciation for how much trust and faith amputees place in their prosthetists. In fact, 84 percent of the survey participants

ranked prosthetists as “equal to” or “better than” other health-care professionals in terms of professionalism. So, it is important that we exhibit confidence—not to be confused with arrogance—when dealing with our patients even when we’re frustrated and struggling with a troublesome fit. After all, they are depending on us to help them achieve their desired ADL’s.

5.

If you could conduct the study over again, what would you do differently? Why? I would conduct all the interviews on a face-to-face basis because this allows more opportunities for exchange, elaboration on the part of the amputee, and it presents a better learning opportunity for the interviewer. I would omit certain questions that really did not yield substantive or worthwhile information, such as, “How many hours a day do you wear your prosthesis?” as I now understand it is more

SAVE thE DAtE

important to know how many hours a day the amputee is active in their prosthesis.

I would add questions that would yield more specific responses. For example, one of my questions was “How would you rate your overall experience with your first prosthetist?” The three possible answers were “favorable,” “neutral,” or “unsatisfactory.” In hindsight, this question was too general.

I also would attempt to have the survey repeated in different parts of the country to see if the responses are similar from region to region while also expanding the survey sample population. Overall, I was pleased with the outcome of the surveys, I learned a lot from conducting it and I would highly recommend that owners of prosthetic businesses throughout the U.S. conduct their own patient surveys to determine what they could be doing to yield more favorable results for their patients. 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.

36

O&P Almanac OCTOBER 2009

The patented Soleus foot is another first in a long line of innovative and unique designs from College Park. The Soleus integrates multiple composite springs through a tough, flexible plantar ligament. This unique design produces the quality and range of motion College Park is renowned for while also returning very high levels of energy. The Soleus is sure to find a place in your practice and in the hearts of the amputees that wear it.

17505 Helro Drive • Fraser, MI 48026 800.728.7950 | FAX: 800.294.0067 586.294.7950 | FAX: 586.294.0067

www.college-park.com

n

marketplace

cOllege PArK’s new Onyx fOOt

fillAUer’s gerimAc And minimAc Knees

fillAUer: new sfx frOm hOsmer

Integrating a dynamic pylon, the multi-axial Onyx Foot allows active users to demand more.

Highly customizable, with four degrees of plantar-dorsiflexion Angle Control and adjustable Stride Control Onyx foot 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/ 728-7950 or visit www.college-park.com.

Lock and load with automatic locking knees from Fillauer LLC. The GeriMac and MiniMac knees include the following features and benefits: • Automatic lock at full extension and adjustable release at heel off • Adjustable stance flexion provides shock absorption and smooth gait • Designed for K2 activity level providing confidence and control • GeriMac knee includes external extension assist technology • A simple, stable, and lightweight alternative to polycentric knees.

Contact Fillauer at 800/251-6398 or www.fillauercompanies.com

The all new Sfx from Hosmer adds adjustable stance flexion to most endoskeletal knee-shin systems. This compact and light weight stance flexion device provides added stability, increased balance, and moderate shock absorbtion in a modular configuration. Sfx offers 10 degrees of adjustable stance flexion resistance and three different load levels. The Sfx comes with a proximal pyramid receiver and distal tube clamp making it easy to add to most prostheses.

• Improved stability and balance • Absorbs shock for smoother gait • Adjustable up to 10 degrees • Three stiffness options • Rated for 275 lbs / 125 kg • Available with Weight Activated Locking Knee (W.A.L.K.).

Contact Fillauer at 800/251-6398 or www.fillauercompanies.com

fillAUer’s cOneiAK POlishing ArBOrs

fillAUer’s dUrAshOcK

Fillauer is proud to introduce its new line of Coneiak Polishing Arbors.

These grinding and polishing arbors work well with any standard thermoplastic materials within the O&P industry.

The uniquely designed arbors are currently available in four designs: • Grooved arbor: used for grinding radiuses • Tapered arbor: designed for polishing and grinding in smaller , tighter areas • Ballnose arbor: used for basic grinding and polishing • Slim arbor: designed for polishing and grinding inner surfaces of tight radiuses.

Contact Fillauer at 800/251-6398 or www.fillauercompanies.com

38

O&P AlmAnAc OCTOBER 2009

The main benefit of a shock/torsion reducing pylon is that it simulates the rotation and shock absorption of the natural limb during stance phase.

All lower limb amputees benefit from shock/ rotation reduction, especially transfemoral users, who require greater motion damping at heel strike since the knee and ankle are not present. Beneficial for everyday use, shock/torsion reduction is most noticeable during activities such as gardening, hiking, tennis, or golf.

Contact Fillauer at 800/251-6398 or www.fillauercompanies.com

n

The unique design of this plate allows for easy casting tape removal without damage.

Damage-free casting tape removal allows this plate to be reused, saving costs. Available direct and from SPS, Pel, Knit Rite, and Cascade.

For more information, call 410/663-KISS or visit www.kiss-suspension.com.

DuraLite Proves Durable & Lightweight Ohio Willow Wood’s DuraLite foot weighs only 356g and provides highenergy return.

Prosthetists can chose a pyramid receiver or rotating pyramid for the proximal adapter. The proximal adapters allow the foot to be easily field-height adjustable without drilling holes. The foot’s maximum and minimum heights are 13” and 5.9”. Other features include: urethane toe pad, split heel, and two heel heights. Amputees testing the DuraLite experienced successful foot performance while working construction, completing barn and livestock chores, hiking and jogging. The DuraLite has a 36-month warranty.

Patient weight limit: 300 lbs. For more information, contact Ohio Willow Wood at 800/848-4930 or www.owwco.com.

Brighten Up 2009 with OPTEC’s Stealth and Vertamax

Now you can have a choice. OPTEC is offering the revolutionary Stealth and Vertamax orthoses in new appealing colors. The Stealth and Vertamax will be offered in white and beige respectively. Both spinal systems will continue to be available in black.

The Stealth and the VertaMax continue to offer superior support and comfort, which your patients deserve. Call 888/982-8181 for a free 30-day trial sample of the Stealth and Vertamax.

Ossur’s New Iceross Cushion Liner and Iceross Sleeve The Iceross Cushion Liner and Iceross Sleeve offer three of the most sought after features: durability, comfort and flexibility. Vascular patients and those with sensitive skin will appreciate Ossur’s Active Skin Care ingredients, while the DermoGel Silicone and elastic Supplex cover offer excellent durability and security when using a vacuum system.

Iceross Cushion is available with the Wave Feature for additional knee flexion. For a more intimate fit add the Cushion Liner’s counterpart: the Iceross sleeve. Improved mobility, a more secure fit and optimal comfort— an unrivaled liner and sleeve solution.

For more information, call 800/233-6263 or visit www.ossur.com.

39

O&P Almanac OCTOBER 2009

Otto Bock’s Balance Liner Find your Balance!

Otto Bock’s New 6Y93 Balance Copolymer Liner was designed for low to moderate activity level transtibial amputees. The user-friendly, heat-moldable copolymer (TPE) material offers great protection against socket forces for both cushion and locking liners, while encapsulated medical grade mineral oil keeps skin supple and moisturized. Its unique shape is designed with balance in mind too, with differing wall thicknesses to provide 6 mm of cushioning and reduced shear forces where your patients need it— and 3 mm of anti-bunching flexibility where they don’t. Find out more about how you can get your patients in Balance today, call 800/328-4058 or visit www.ottobockus.com

Otto Bock’s 3C86/3C96 Compact Microprocessor Knee 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.

marketplace

Introducing the KISS Superhero Reusable Test Socket Plate.

n

marketplace

Redesigned StepLock Handle from OTS Corp.

OTS Corp. has redesigned the StepLock handle to allow the use of a special bail kit. In the past, a stiff connection between Redesigned StepLock the two joints Handle risked one side locking, while the other was not completely locked, causing the last ratchet tooth to be worn away.

The new bail kit has rubber grommets inside the connection, allowing some play between the two sides.

The kit attaches through two spaces in the redesigned handle, which also allows for a better lever release kit connection. The new handle also is less obtrusive and less likely to catch on clothing. It is now standard on all StepLocks ordered.

For more information, call 800/2214769 or visit www.ots-corp.com.

New ALPS Extreme Liner Available from PEL Supply

The new ALPS AK Extreme Liner, available from PEL Supply, has been specifically designed for both transfemoral (AK) or transtibial (BK) amputees. This makes it an exceptional value by reducing your on-hand inventory costs and space requirements. As compared to other ALPS gel liners, the Extreme Liner eliminates 80 percent of vertical stretch, resulting in demonstratively increased contact while reducing movement of redundant tissue and substantially eliminating pistoning.

This unique liner also features Alps’ new GripGEL which is more tactile than EZGel to gently but firmly support the residual limb and sensitive tissues. Available in 3mm and 6mm uniform thicknesses in eight sizes, the liner’s distal ends are proportionate to the size of the liner.

Other benefits: • Limited vertical stretch reduces movement of redundant tissue • High circumferential stretch to assist with form fitting • Wider distal end for ease of donning • Provides more control and stability • One-year warranty, two-year on two liners.

PEL Supply stocks over 45,000 products, components, tools and accessories, with most available for same day shipment. For information on the new Alps AK Extreme Liner, the General Purpose Gel Liner or other fine Alps products, contact any helpful PEL customer service specialist at 800/321-1264, by fax 800/222-6176, or e-mail customerservice@pelsupply.com.

Visit www.pelsupply.com.

40

O&P Almanac OCTOBER 2009

New Element Foot System from PEL Supply The Element Foot, from Fillauer, sets itself apart from two-spring prosthetic foot designs by adding an innovative 3rd element.

Emotis has designed the Element to support each phase of foot function in the gait cycle-from heel strike, to mid-stance, to toe off. The result is a foot with unsurpassed smoothness, stability and performance throughout the gait cycle. The system kit includes foot, heel bands and elastomers, Spectra sock and instruction manual.

The new prosthetic foot features a composite construction primarily of carbon fiber, creating a form consisting of smooth, continual contours with light weight, low profile height and high durability.

Key design elements which differentiate the Element Foot System from other prosthetic feet include: • Unique 3rd element technology • Smooth rollover and superior stability • Natural gait cycle and fluid rollover • Interchangeable heel elastomers for fine tuning heel stiffness • Modular design with superior flexibility • Low profile design requires only 3.75 in. clearance (9.5 cm) • Incredibly lightweight only 310 grams.

PEL Supply stocks the most popular, best performing products, components, tools and accessories from hundreds of O&P manufacturers with many available for same day shipment. For information on the Element Foot System, or any of the outstanding products from The Fillauer Companies, contact PEL at 800/321-1264, by fax 800/222-6176, or e-mail customerservice@pelsupply.com.

Visit www.pelsupply.com. a

n

jobs

run your ad in the O&P Almanac and on jobs.AOPAnet.org.

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:

- Northeast - Mid-Atlantic - Southeast - North Central

O&P Ad 25356, O&P Almanac 330 John carlyle st., ste. 200 Alexandria, VA 22314 fax: 571/431-0899

- Inter-Mountain - Pacific Use our map to find which region you fit into!

Inter-Mountain

cPO, cO, Assistants, technicians San Antonio, Texas Now is your chance to work with a dynamic private practice, with multiple locations, in San Antonio. We are seeking experienced, self-motivated practitioners, assistants, and technicians. Three years’ experience preferred; pediatrics a plus. We offer a competitive salary with full benefits package, and an excellent bonus structure commensurate with productivity. Practitioners must be eligible for Texas licensure and have current certification with ABC. All inquiries will be kept strictly confidential.

E-mail resume to:

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 rate non-member 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 $482 $678 1/2 page, color $634 $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.

e-mail: hr@mkprosthetics.com

Prosthetic technician Houston, Texas Hermann Medical is seeking a well experienced prosthetic technician (orthotics experience a plus). Pleasant working environment allowing you to be your own persona and freely express your complete range of experience. Competitive salary and benefits.

Responses to O&P box numbers are forwarded free of charge.

Company logos are placed free of charge.

Job board rates

Phone: 281/580-1992 fax resume to: 281/580-1943

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 running your ad both in the O&P Almanac and on the O&P Job Board, online at jobs.AOPAnet.org.

42

O&P AlmAnAc OCTOBER 2009

n

Yankee Medical has immediate openings available in one of our six locations. We are a “family friendly,” privately owned company with a 58-year history of providing high-quality patient care throughout Vermont and its border communities.

Bulow BioTech Prosthetics, based in Nashville, TN with satellite practices in Cookeville and Clarksville, TN, is expanding to other locations. We are currently seeking energetic, caring, and talented prosthetists to open facilities in selected cities in the southeastern United States. A successful candidate will work under the clinical direction of our founder, Matt Bulow, a 1991 graduate of the Northwestern Prosthetic Certificate Program with over 18 years of clinical experience. Matt is a BK amputee, 3 time paralympian, and former long-jump world record holder. A minimum of 3 years experience and a passion for prosthetic patient care excellence is required. Prior management experience and / or the ability to market and develop new areas is required. Our company is unique in that we specialize in prosthetic patient care services only, allowing us to provide customized, one-onone care for each of our amputee patients. Position includes excellent benefits and pay based on salary plus performance. For more information on our company please visit www.bulowbiotech.com.

We are looking for an experienced practitioner who desires a long-term relationship with our progressive company. We would also consider a motivated resident with prior O&P work experience.

Yankee Medical offers a generous benefit package, including fully paid health insurance, 401K matching, profit sharing, bonuses, life insurance, short- and long-term disability insurance, as well as remuneration for your required education credits and help with relocation expenses.

Come join the family of lifelong Yankee Medical people.

Call, fax, or e-mail inquiries to:

Linda Wells, Operations Manager Yankee Medical Inc. 276 North Avenue Burlington, VT 05401 Phone: 802.863.4591  Fax: 802.658.3101 E-mail: ljw@yankeemedical.com

Interested individuals please e-mail resume to info@bulowbiotech.com

AVAILABLE POSITIONS

Why do I work at Hanger?

Orthotist Phoenix, AZ

Evansville, IN

Folsom, CA

Jackson, MI

Murrieta, CA

Akron, OH

practice. I also have access to the depth of knowledge that

Pasadena, CA

Cincinnati, OH

comes with being part of a national network of skilled practitioners.

Waterbury, CT

Tahlequah, OK

Tampa, FL

Harrisburg, PA

Springfield, IL

Memphis, TN

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

In today’s uncertain economy, I have job security. I benefit from the strength of an established company, and at the same time,

Thomasville, GA

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

Orthotist/Prosthetist Havertown, PA

For more information visit www.hanger.com/careers

El Paso, TX Dallas, TX

Prosthetist Denver, CO

Memphis, TN

Prosthetist/Orthotist

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

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 • Fax 860.667.1719

43

O&P Almanac OCTOBER 2009

Beverly Hills, CA

Jackson, TN

Cameron Park, CA

Nashville, TN

Ashland, KY

Oak Ridge, TN

W. Monroe, LA

Fort Worth, TX

Meridian, MS

Alexandria, VA

Nashua, NH

Olympia, WA

Central PA

Seattle, WA

jobs

ABC – BOC Orthotist/Prosthetist For Multiple Facility Locations

n

jobs

Inter-Mountain

Southeast

Prothetist/Prosthetic Technician

Certified Orthotist and/or Orthotist/ Prosthetist (licensed or eligible)

Louisiana Louisiana based company seeking certified prosthetist and prosthetic technician. Prosthetist must have the clinical experience, rehabs and hospital settings. Marketing skills would be appreciated. Prosthetic technician requires good fabrication skills. Salary commensurate with experience.

Employee benefits, paid continuing education and other opportunities. Send resumes to:

Texas Dallas: big D offers it all! Anchored by Downtown, the center of the city is the epicenter of urban revival along with shopping, barbecue, authentic Mexican and Tex-Mex cuisine. Dallas has its share of football, basketball and hockey teams. Don’t forget NASCAR, the parks and lakes and the massive State Fair of Texas.

Bias Orthotics & Prosthetics P.O. Box 4571 Lake Charles, LA 70606 E-mail: lapobias@suddenlink.net

Ft. Worth: sister to Dallas, is the 5th largest city in Texas boasts art deco style buildings, multiple theatres, museums and who could forget Billy Bob’s, the Metroplex and golf’s “Fifth Major.”

Certified Orthotist and/or Orthotist/ Prosthetist (licensed or eligible)

El Paso: the sixth largest city in Texas and stands on the Rio Grande with the Juarez Mountains as its skyline. It has 13 hospitals, multiple parks, museums and has been the filming site for 20+ movies.

Tennessee Ready for a Change…Come to Tennessee! If you are looking for the Appalachian Trail, the Great Smoky and Blue Ridge Mountains, state parks, no state salary income tax, famous universities, NASCAR, Blues, Gospel and Rock n’ Roll music, Tennessee is the place for you. It is the 14th fastest growing state in the US!

We offer a very competitive salary and benefit package accompanied by sign on bonus and relocation assistance.

If you are ready to make a change and desire the security of working for the oldest orthotic and prosthetic patient care company in the world, contact, in confidence:

• • • •

Jackson, TN: CPO* Memphis, TN: CO* Nashville, TN: CPO* Oak Ridge, TN: CPO*

• Nashville, TN: Orthotic Technician

Sharon King Director, Recruitment Hanger Prosthetics & Orthotics, Inc. 678/455-8865 678/455-8885 Fax E-mail: Sking@hanger.com www.hanger.com/careers

* licensed or eligible We offer a very competitive salary and benefit package accompanied by relocation assistance, sign on bonus and much more. If, interested, please contact, in confidence:

Sharon King Director, Recruitment Hanger Prosthetics & Orthotics, Inc. 678/455-8865 678/455-8885 Fax E-mail: Sking@hanger.com www.hanger.com/careers

44

O&P Almanac OCTOBER 2009

Are you paying too much?

On

Foot Impression Foam Apis Footwear may save 50% or more for you!

Being a manufacturer, we want to save you money & win your business.

Cost to you if you buy: 1-10 pairs @ $2.95/pair (box); 11-50 pairs @ $2.85/pair (box); TM 51-100 pairs @ $2.75/pair (box); foot impression box 110-500 pairs @ $2.65/pair (box); 510-3,500 pairs @ $2.55/pair (box), and we will print your own logo and box for you at NO additional cost 3,510 pairs or more, please call us to negotiate our container load price.

Item#: 18 (in Light Yellow & Sky Blue color, Flat for special order double only) tray

Footwear Co.

Item#: 16 (in Light Yellow & Sky Blue)

Foldable double tray

2239 Tyler Avenue, South El Monte, California 91733 Tel: 888-937-2747; 626-448-8905 Fax: 888-990-2245; 626-448-8783 B2B www.apisfootwear.com, Tech. web: www.bignwideshoes.com

n

calendar

New calendar additions appear in color AOPA-sponsored activities appear in a color box

2009 OctOBer 9-10:

Foot/Ankle Complex for Tone-Involved Pediatrics; Mold-To-Patient Custom Orthotics. Approved for 18 CEUs. Call 888/678-6548, e-mail info@allardusa.com.

deficits with the new Adjustable Dynamic Response (ADR) technology. Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems.com, 800/220-6670.

Annual Fall Scientifi c Meeting. Doubletree Hotel, Columbus, OH. Contact Richard W. Butchko 614/659-0197 or butchko1@ columbus.rr.com or go to www.ohiochapteraaop.com.

OctOBer 16

OctOBer 27

OctOBer 14-16

American Academy of Orthotists & Prosthetists One-Day Seminars.

Hyatt Regency O’Hare, Chicago. Visit www.oandp. org/education/seminars/ one-day/ for details.

Contact: Matt Beierschmitt at 202/380-3663, ext. 206 or mbeierschmitt@oandp.org.

New England Chapter of AAOP Annual Meeting, Manchester, NH. Radisson Hotel. Contact Szeller@ Bostonbrace.com or Erin Cammarata at 978/835-3084.

To register online visit www.regonline.com/707308.

OctOBer 14-15

OctOBer 15

ALLARD USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Ft. Lauderdale, FL. Three courses: Gait Biomechanics and Orthotic Applications: Management of Hip and

Ultrafl ex: Pediatric UltraSafeGait Continuing Education Course, via WebEx, 10:00 – 11:00 am ET course covers clinical assessment and compensating for pediatric gait

OPGA: Bioness Training Course, Orlando, FL. One-day course covers the NESS L300 system evaluation and hands-on training. Instructed by Keith McBride, MPT, DPT and John Michael, MEd, CPO/L, FAAOP, FISPO. The NESS L300 is a userfriendly neuroprosthetic designed to improve gait for individuals experiencing foot drop. 7 CEUs. Register at 800/214-6742 or www.opga.com.

OctOBer 19-23

list eVents in the O&P ALMANAC

Trulife Fitters Course 2009.

Trulife Institute of Applied Technology (TIAT) St. Petersburg College. St. Petersburg, FL. To register contact Emily Swain at 800/248-6463 or www.spcollege.edu/ac/ce.

Telephone and fax numbers, e-mail addresses and Websites are counted as single words.

Refer to www.AOPAnet.org for content deadlines.

Words

Member rate

25 or less $40 26-50 $50 51+ $2.25 per word Specials: 1/4 page, color 1/2 page, color

$482 $634

Non-member rate

$50 $60 $3.00 per word

OctOBer 23

$678 $830

Ohio Orthotics and Prosthetics Association Annual Fall Meeting. Doubletree Hotel, Columbus, OH. Contact Dianne Farabi 614/659-0197 or dfarabi@ columbus.rr.com.

Listings will be placed free of charge on the Attend O&P Events section of www.AOPAnet.org.

Make checks payable in U.S. currency to:

American Orthotic & Prosthetic Association Send announcement and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 223340711, fax 571/431-0899, or E-mail srybicki@AOPAnet.org. along with VISA or MasterCard number, the name on the card, and expiration date.

For information on continuing education credits, contact the sponsor. Questions? E-mail srybicki@AOPAnet.org.

OctOBer 24 Ohio Chapter, American Academy of Orthotists and Prosthetists (AAOP)

46

O&P AlmAnAc OCTOBER 2009

Ultrafl ex: 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, 800/220-6670.

OctOBer 29-31 Annual North & South Carolina AAOP Meeting.

Ballantyne Golf Resort, Charlotte NC, 13 CEUs. For hotel/meeting reservations and information go to www.ncaaop.com. nOVemBer 4-5 ALLARD USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Detroit. Three courses: Gait Biomechanics and Orthotic Applications: Management of Hip and Foot/Ankle Complex for Tone-Involved Pediatrics; Mold-To-Patient Custom Orthotics. Approved for 18 CEUs. Call 888/678-6548, e-mail info@allardusa.com.

November 16-17

AOPAversity Mastering Medicare: Advanced Coding and Billing Techniques. Las Vegas.

Mandalay Bay Hotel. To attend, contact Erin Kennedy at 571/431-0876 or e-mail ekennedy@AOPAnet.org.

November 19 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, 800/220-6670.

DECEMBER 2 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

DECEMBER 3-4 ALLARD USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Denville, NJ. Three courses: Gait Biomechanics and Orthotic Applications: Management of Hip and Foot/Ankle Complex for Tone-Involved Pediatrics; Mold-To-Patient Custom Orthotics. Approved for 18 CEUs. Call 888/678-6548, e-mail info@allardusa.com.

DECEMBER 10-12 Rehabilitation Institute of Chicago: Pediatric Gait Analysis and Orthotic featuring Elaine Owen.

Chicago. 23 ABC Credits.

For more information visit www.ric.org/education or contact Melissa Kolski at 312/238-7731.

DECEMBER 15 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, 800/220-6670.

2010 January 12-17 OPGA/POINT Premier Conference, Dreams Resort, Cancun, Mexico.

Premier Members and Suppliers will meet with leading speakers from the orthotic and prosthetic community for a week of education, networking and relaxation. For more information, go to www.opga.com or contact OPGA at info@ opga.com or 800/214-6742.

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.

Clearwater, FL. Sheraton Sand Key Resort. For more information contact call 847/698-1637 or e-mail acpoc@aaos.org or visit www.acpoc.org.

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

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.

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

208 or dragusa@oandp.org.

MAY 12-15 International Trade Show for Prosthetics, Orthotics and Rehabilitation Technology: “Orthopadie + Reha-Technik 2010” Leipzig, Germany. www.ispo-2010-leipzig.de.

JUNE 2-5 Association of Children’s Prosthetic-Orthotic Clinics 2010 Annual Meeting.

47

O&P Almanac OCTOBER 2009

SEPTEMBER 29OCTOBER 2 AOPA National Assembly.

Rosen Shingle Creek Resort. Orlando, FL. 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 or e-mail acpoc@aaos.org or visit www.acpoc.org. a

calendar

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, 800/220-6670.

Adjustable Dynamic Response (ADR) technology. Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems.com, 800/220-6670.

n

NOVEMBER 6

n

AOPA membership applications

T

he officers and directors of the American Orthotic & Prosthetic Association (AOPA) are pleased to present these applicants for membership. Each company will become an official member of AOPA if, within 30 days of publication, no objections are made regarding the company’s ability to meet the qualifications and requirements of membership.

At the end of each new facility listing is the name of the certified or state-licensed practitioner who qualifies that patient-care facility for membership according to AOPA’s bylaws. Affiliate members do not require a certified or statelicensed practitioner to be eligible for membership.

At the end of each new supplier member listing is the supplier level associated with that company.

Supplier levels are based on annual gross sales volume: Level 1: equal to or less than $1 million Level 2: $1 million to $1,999,999 Level 3: $2 million to $4,999,999 Level 4: more than $5 million

Core Prosthetics Lab Inc.

Handicapped Mobility Inc.

29723 New Hub Dr., Ste. A Moreno Valley, CA 92551 951/246-8888 Fax: 951/246-8675 Category: Patient Care Facility Benjamin Phillips, CO

2627 Courthouse Cir. Flowood, MS 39232 601/936-7747 Fax: 601/936-7252 Category: Patient Care Facility Allen Ray Walker, Sr., CP

Freedom Prosthetics LLC

Orthotic Care Services

8369 Florida Blvd.

Denham Springs, LA 70726 225/665-0323 Fax: 225/665-0319 Category: Patient Care Facility David R. Bryan, RTP

360 Sherman St., Ste. 299 Saint Paul, MN 55102 651/291-9000 Fax: 651/291-8894 Category: Patient Care Facility Kristyn Hubel a

n

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

ad index

Company

Page

Phone

Web site or E-mail

Allard USA Inc.

31

888/678-6548

www.allardusa.com

ALPS

11, 33

800/574-5426

www.easyliner.com

Orthotics, Prosthetics & Orthotics

29

703/836-7114

www.abcop.org

Apis Footwear

9, 45

888/937-2747

www.bigwideshoes.com

College Park Industries Inc.

19, 37

800/728-7950

www.college-park.com

Daw Industries

1, 41

800/252-2828

www.daw-usa.com

Dr. Comfort

15, C3

800/556-5572

www.drcomfortdpm.com

Fillauer Companies Inc.

17

800/251-6398

www.fillauercompanies.com

KISS Technologies LLC

23

410/663-5477

www.kiss-suspension.com

Ohio Willow Wood

2

800/848-4930

www.owwco.com

OPTEC

25

888/982-8181

www.optecusa.com

Ossur® Americas Inc.

C4

800/233-6263

www.ossur.com

OTS Corp.

7

800/221-4769

www.ots-corp.com

Otto Bock HealthCare

C2, 35

800/328-4058

www.ottobockus.com

PEL Supply Company

27

800/321-1264

www.pelsupply.com

Spinal Technology Inc.

5

800/253-7868

www.spinaltech.com

Wear Ease

26

208/424-0512

www.wearease.com

American Board for Certification in

48

O&P AlmAnAc OCTOBER 2009

2XU 0LVVLRQ LV 4XDOLW\

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

<PM .QVM[\ 9]ITQ\a +WUNWZ\ .WW\_MIZ IVL 1V[MZ\[ 8MZQWL

^^^ KYJVTMVY[ZOVLZ JVT Â&#x2039; 'U &RPIRUW 6KRHV $OO 5LJKWV 5HVHUYHG

THE NEW VARI-FLEX, NOW WITH EVO.™ FEEL THE DIFFERENCE FROM THE VERY FIRST STEP. ®

The redesigned Vari-Flex with Energy Vector Optimization (EVO) is the first fully-integrated mechanical foot and shell system. Featuring full-length, intimate contact between the foot and shell, Vari-Flex with EVO closely mimics the fluid rollover, from heel-strike to toe-off, of the human foot. The result is a more natural gait and reduced impact on both the residual limb and sound side.

“I’ve always loved my Vari-Flex. But I felt the difference in this foot right away. It is smoother and more comfortable, so I have more energy at the end of the day.”

— Andy Bailey, 72 Retired Social Service Supervisor

VISIT OSSUR.COM TO LEARN MORE.