Oregon Expands Access to Motorized Wheelchairs After Patients Describe ‘Dehumanizing’ Delays

Oregon’s 1.4 million Medicaid members will now have easier access to motorized wheelchairs and Durable Medical Equipment (DME) such as prosthetic limbs, infusion pumps, and blood sugar monitors, after collaborations between the state’s Health Authority (OHA) and its Ombud’s Program.

Problems encountered by more than 80 Medicaid and Oregon Health Plan (OHP) members were brought to the attention of the Ombud’s Program, whose annual report revealed the problems patients encounter when trying to obtain motorized wheelchairs and DMEs.

During Think Tank sessions, the OHA and Ombud’s Program heard from a young woman with intellectual and developmental disabilities whose seven-year-old motorized wheelchair was beyond repair.

Her local Medicaid network denied her request for a replacement, saying staff at her group home could instead push her in a manual wheelchair. Unable to move on her own, the young woman could no longer interact with her neighbors or contribute to her household by collecting the mail every day.

A Paralyzed Young Man Felt Dehumanized By the Struggle to Obtain a Mobility Device

Another encounter was from a young man, paralyzed after an accident. The report notes that he felt ‘dehumanized’ by the year-long struggle to obtain a mobility device to enable him to navigate from his bed to the bathroom.

The OHA and Ombud’s Program partnered with the state’s Department of Human Services, and the Oregon Disability Commission, among others, to organize the DME Think Tank.

The group included 12 Medicaid members, caregivers, providers, and representatives of advocacy groups, who shared their personal experiences with OHA Medicaid policy and program staff.

As a result of member feedback, the OHA took several actions, including the clarification of Medicaid policy that having a caregiver is not a reason to deny motorized wheelchairs. The OHA will also continually update its rules improvement process, based on the experiences of Medicaid members.

After three meetings with the Oregon Disabilities Commission and the Disability Services Advisory Councils, the Think Tank has recommended that the following improvements be instituted by the OHA:

• Formalize member involvement in a DME advisory work group;
• Collaborate with community members to discuss Medicaid member complaints and grievances;
• Evaluate Medicaid policies and rules to identify opportunities to advance health equity.

Last year, the OHA Ombud’s Program worked with 1,939 people who raised 2,085 concerns about Medicaid. About 37% of those concerns were related to care access, and behavioral health was the focus of most concerns.

OHP members who are not able to receive the support they need from OHA can email the Ombud’s Program at: [email protected] or call 1-877-642-0450.