Meet the most important room - The Bathroom

When designing for accessibility, in accordance with individual functional capabilities, no location in the home is more important than the bathroom. It is often the first or the only room to need modification. The bathroom is the common denominator for all of the members of the family since independent maintenance of personal hygiene is important to every member's sense of privacy, self- esteem and personal hygiene. Family members and guests do not need constant reminders of the client's disability. A person with a disability is not a patient, and therefore, institutional precedents are not appropriate. The appropriate goal is to provide, as unobtrusively as possible, precisely what is needed in order to function by including design considerations that provide adaptability to future circumstances.

"If we are to truly pursue the principles of Universal Design for our built environment, then we should be forward thinking in terms of how we design new homes or modifications of existing ones". Wally Dutcher, Universal Design Consultant and specialist.

Layout Considerations The choice of fixtures, locations, and architectural solutions will be influenced by such non-physical factors as family constraints, what changes landlords will allow, and the client's personal habits or preferences. Physical factors include the type of disability the client's range of motion, and the physical context of the building. The bathroom is a prime location for household accidents. The combination of water and soap can easily create conditions that are hazardous to the frail, the elderly or the wheelchair user in the midst of a transfer. All surfaces and handholds should be non-slip. Water temperature should be regulated by thermostatic controls or pressure compensation devices, and the water heater should be preset at a limit of 109°F (43°C). Provide an emergency call system and emergency hardware for the door so that if an accident does occur the occupant can summon help and the helpers can get into the room. Safety must be kept firmly in mind at all stages of the design process. Accessibility is for all, so your design should suit the needs of everyone!

Posted by Ronnie Wiskin of Barrier Free Living

Medicare: What you don't know WILL make you sick

The most serious issue facing the home medical equipment industry right now is competitive bidding. In its current form, it will have a devastating effect on both medical equipment providers and their patients -- our parents, grandparents and other loved ones.

A study commissioned by VGM concluded that CB will have a horrible effect on rural areas, which is the opposite of what CMS has been telling lawmakers and the medical equipment industry.
This study, as well as some interviews with individuals who use HME and related services, is the basis for VGM TV’s first show, “Medicare: What You Don’t Know WILL Make You Sick."


View Part 3 of this series to learn more about the serious service access issues that could result from competitive bidding.

Medicare: What you don't know WILL make you sick Part 3

The most serious issue facing the home medical equipment industry right now is competitive bidding. In its current form, it will have a devastating effect on both medical equipment providers and their patients -- our parents, grandparents and other loved ones. A study commissioned by VGM concluded that CB will have a horrible effect on rural areas, which is the opposite of what CMS has been telling lawmakers and the medical equipment industry. This study, as well as some interviews with individuals who use HME and related services, is the basis for VGM TV's first show, "Medicare: What You Don't Know WILL Make You Sick." View Part 3 of Medicare: What you don' t know WILL make you sick to learn more about service access issues that could arise as a result of competitive bidding.

Medicare: What you don't know WILL make you sick Part 2

The most serious issue facing the home medical equipment industry right now is competitive bidding. In its current form, it will have a devastating effect on both medical equipment providers and their patients -- our parents, grandparents and other loved ones.

A study commissioned by VGM concluded that CB will have a horrible effect on rural areas, which is the opposite of what CMS has been telling lawmakers and the medical equipment industry.
This study, as well as some interviews with individuals who use HME and related services, is the basis for VGM TV’s first show, “Medicare: What You Don’t Know WILL Make You Sick."

Click here to view Part 2 and learn the potential impact Competitive Bidding could have on our rural communities.

Medicare: What you don't know WILL make you sick Part 1

 The most serious issue facing the home medical equipment industry right now is competitive bidding. In its current form, it will have a devastating effect on both medical equipment providers and their patients -- our parents, grandparents and other loved ones.  A study commissioned by VGM concluded that CB will have a horrible effect on rural areas, which is the opposite of what CMS has been telling lawmakers and the medical equipment  industry. This study, as well as some interviews with individuals who use HME and related services, is the basis for VGM TV's first show, "Medicare: What You Don't Know WILL Make You Sick," View part 1 of VGM TV's Medicare: What You Don't Know WILL Make You Sick.

Medicare Patient Responds to Orlando Sentinel

Medicare Patient Responds to Orlando Sentinel By Aaron Thomas Mike Thomas' recent column on Medicare's competitive bidding program for home equipment and services was biased and laden with problems. It is based upon the flawed premise that medical equipment and related services (oxygen therapy , wheelchairs, etc.) delivered to Medicare beneficiaries in their homes should be reimbursed based on what one would pay on the Internet or at a retailer for the equipment alone. As someone who has used a wheelchair since the age of 4 due to a form of muscular dystrophy , I can tell you that a power wheelchair, specifically fitted for my disability, cannot be acquired over the Internet. Even oxygen, as a regulated prescription drug, can't just be picked up at a local Walmart. Should a user who depends on supplemental oxygen to stay alive pick it up at Walmart, adjust the flow rate, and maintain this system, plus a back-up, on their own? Will Walmart provide emergency supplies of oxygen after a hurricane when the power's out? What some don't understand is that getting the cheapest reimbursement for a medically required device for home use is not in the patient's or taxpayer's best interest. Quality home medical equipment and services help keep seniors and people with disabilities safe and independent in the most cost-effective setting for care -their own homes. Medicare currently pays under $7 per day to provide oxygen therapy in the homes of people with lung disease or heart failure. Compare that to more than $7,000 on average that Medicare pays for a short hospital stay. Bottom line: quality equipment and services provided to Medicare beneficiaries in their homes is part of the answer -not the problem -to Medicare's financial crisis. This poorly designed Medicare bidding was implemented for two weeks in 2008. The program excluded 90 percent of local area providers, excluded qualified applications, and awarded contracts to unqualified providers with no experience in this area. Had the program continued, patient choice, access to care, and quality competition would have suffered. Unfortunately , the flaws in this program remain. It's due to resume in Orlando and Miami in 2011. There is no way to predict the detrimental impact on Florida beneficiaries. A bipartisan bill to repeal Medicare bidding is supported by 255 members of Congress and designed to be budget neutral. The bill would cut payments to home medical equipment to make up for the savings the bid program would have reaped -without dismantling the existing network of home medical providers. Aaron C. Bates lives in Orlando.

Medicare Patient Responds to Orlando Sentinal

Medicare Patient Responds to Orlando Sentinel
By Aaron Thomas

Mike Thomas' recent column on Medicare's competitive bidding program for home equipment and services was biased and laden with problems.



It is based upon the flawed premise that medical equipment and related services (oxygen therapy , wheelchairs, etc.) delivered to Medicare beneficiaries in their homes should be reimbursed based on what one would pay on the Internet or at a retailer for the equipment alone.

As someone who has used a wheelchair since the age of 4 due to a form of muscular dystrophy , I can tell you that a power wheelchair, specifically fitted for my disability, cannot be acquired over the Internet.

Even oxygen, as a regulated prescription drug, can't just be picked up at a local Walmart. Should a user who depends on supplemental oxygen to stay alive pick it up at Walmart, adjust the flow rate, and maintain this system, plus a back-up, on their own? Will Walmart provide emergency supplies of oxygen after a hurricane when the power's out?

What some don't understand is that getting the cheapest reimbursement for a medically required device for home use is not in the patient's or taxpayer's best interest. Quality home medical equipment and services help keep seniors and people with disabilities safe and independent in the most cost-effective setting for care -their own homes.

Medicare currently pays under $7 per day to provide oxygen therapy in the homes of people with lung disease or heart failure. Compare that to more than $7,000 on average that Medicare pays for a short hospital stay.

Bottom line: quality equipment and services provided to Medicare beneficiaries in their homes is part of the answer -not the problem -to Medicare's financial crisis.

This poorly designed Medicare bidding was implemented for two weeks in 2008. The program excluded 90 percent of local area providers, excluded qualified applications, and awarded contracts to unqualified providers with no experience in this area. Had the program continued, patient choice, access to care, and quality competition would have suffered.

Unfortunately , the flaws in this program remain. It's due to resume in Orlando and Miami in 2011. There is no way to predict the detrimental impact on Florida beneficiaries. A bipartisan bill to repeal Medicare bidding is supported by 255 members of Congress and designed to be budget neutral.

The bill would cut payments to home medical equipment to make up for the savings the bid program would have reaped -without dismantling the existing network of home medical providers.

Aaron C. Bates lives in Orlando.