Recycle for Life Program

An individual in need is defined as someone who has exhausted all other avenues for financial support in their efforts to obtain medical equipment. They have fallen through the cracks of the traditional healthcare system and have no where else to turn. For individuals with disabilities, gaining access to costly medical equipment is difficult and sometimes impossible in the current health care delivery system. A person's ability to stay active is important for their mental and physical wellbeing. When a person cannot obtain much needed durable medical equipment, their life is often jeopardized and independence is severely compromised.

The major obstacles facing people who need medical equipment include:

• People between the ages of 18 and 65 do not qualify for Medicare, and many do not qualify for Medicaid. For those that do qualify, Medicare does not cover the cost of bathroom equipment.
• Many of these people have either inadequate or no health insurance, leaving them with limited or no access to medical equipment. Often the insurers do not cover assistive devices such as shower chairs, toilet safety frames, grab bars, crutches, commodes, toilet risers, hand held showers or bathtub transfer benches because they are not deemed "medically necessary".
• Pre-existing condition exclusions in medical insurance policies often place limits on the number of pieces of medical equipment an insurer will provide and few provisions for maintenance, repair or replacement exist.
• The typical lengthy review and prior authorization process by which insurance systems provide equipment is also a barrier for people with little education.

People with disabilities living in rural areas may be able to receive basic health care from a local rural community health clinic, but medical equipment is not available at these health clinics and must be obtained in a larger city. This results in having to travel long distances to purchase the medical equipment which increases their difficulty and the cost to secure assistive devices from health care providers.

Some obstacles the project overcame were:

• Labor costs: To process the equipment from the initial equipment donation to distribution to those in need is very labor intensive. Volunteers and teenagers with community service hours were used as much as possible.
• Travel costs: Delivering the equipment to the rural areas was very expensive. Every effort was made to send equipment with individuals or companies who were traveling that direction such as moving companies, furniture companies, state workers, all kinds of truckers.
• Lack of sustainable revenue: The program must rely on donations or grants as the people who need the equipment have already reached their financial limit before they call us. The donations received for using the equipment will never earn enough to sustain the program.
• Lack of knowledge: Finding volunteers with basic knowledge concerning medical equipment was difficult. Because of the liability issues, it was a high risk to have equipment distributed by someone who did not understand the basics of geriatrics or physical therapy.
• Medicare does not cover the cost of used medical equipment.

Yes, the program will be sustainable. The program has been downsized and only active in six locations at this time (not including the Rural Health Clinics).

Challenges and corresponding changes to the program include:

• The program is labor intensive and expensive. Two main locations have been designated that have South Dakota CARES staff who can fit the program into their current daily work schedules. These locations also have the most potential for people who may need the equipment. In one of these locations, at least one person per day walks into the office for a piece of equipment. The other locations have volunteers distributing equipment approximately 20 times a year.
• The biggest challenge was to serve the rural areas as travel costs are high. Therefore, equipment is no longer delivered. People served must pick up the equipment at one of the 6 distribution centers.