Sophie Hardesty learned to walk on custom-built braces and a walker with a seat that held her while her legs grew strong enough to support her long, thin frame.
The Germantown 5-year-old is developmentally delayed and talks with pictures, pointing at what she wants to express in a book full of images or on a special electronic device that announces her needs with the push of a button. She wears specially-designed glasses that help her see and protect her sensitive eyes from bright lights.
Her mother, Angelica Forero, 25, also of Germantown, typically spends the time she’s not in school either putting these devices to use or trying to obtain new ones after Sophie outgrows them. Because her daughter has cerebral palsy and was born with a clubfoot and relies on state-administered Medical Assistance for health coverage, that is often a full-time job, with regular visits to the neurologist, physician and physical therapist followed by plenty of paperwork.
“It usually takes six months once I know she needs it,” Forero said. “And that’s calling like every day to keep it moving.”
So when her physical therapist offered her a free specially-built tricycle for her daughter without the hassle of paperwork, Forero said she was taken aback. She could finally get something for Sophie without weeks or months of calling doctors, hospitals, medical vendors, and her Medicaid administrators.
“It meant a lot not have to go through all that,” she said.
The tricycle was one of 39 pieces of adaptive equipment given to families with children living with disabilities by Equipment Connections for Children Inc. of Germantown last year, said president and founder Claire Wong, who is Forero’s physical therapist. The group collects used adaptive equipment for children — walking aides, adjustable seats and exercise equipment — cleans and repairs it, then donates it to families in need.
Equipment Connections is one of a few nonprofits of its kind that reuses medical equipment for low-income families, the uninsured and the under-insured in Montgomery County despite a growing demand for it. Usually called “loan closets,” the state’s Department of Disabilities lists the Germantown group as one of three operating in the county and the about 17 in the state.
More and more with less and less
While 64 percent of the total U.S. population was covered by a private health plan in 2010, 11.2 percent, like Forero, relied on Medicaid alone, according to the latest data from the U.S. Census Bureau. Reliance on government health insurance has steadily increased nationwide; from the 80.2 million people covered by Medicaid, Medicare or military health care in 2005 to the 95 million in 2010, or 31 percent of the total U.S. population, both all-time highs.
In Maryland, there were roughly 710,000 people living without health insurance in 2010, based on a three-year averaging of census data. Two-year averages show the percentage of the population living uninsured in Maryland has risen slightly, from 12.1 percent between 2007 and 2008 to 13.2 percent between 2009 and 2010, the most available data.
According to state budget figures, Medicaid enrollment in fiscal 2010 stood at 676,187. It was estimated to have reached 815,000 in fiscal 2012.
The state of Maryland is one of the largest providers of assistance for disabled persons seeking financial assistance and equipment loans, spending more than $600,000 each year on such efforts, according to the state Department of Budget and Management. In 2011, the state’s Department of Disabilities estimated it processed 190 loans to persons with disabilities for assistive technologies, up from 127 in 2009 and 158 in 2010.
Little rooms, big change
Although nonprofit loan closests in Montgomery County are small operations run by a handful of people, they serve a population that often struggles with the cost of what it needs.
Assistive medical equipment generally costs between $1,000 and $3,000 apiece, and the 39 pieces Equipment Connections gave out between August of 2010 and July of 2011 are worth about $56,000, Wong wrote in an email. During that time the group had 91 requests for equipment.
How much those with private or public insurance pay varies wildly on their individual plan and needs, Wong said.
Since July of 2011, Equipment Connections has had 69 requests for equipment and given out 34 pieces.
Wong is one of three people who runs Equipment Connections, headquartered in her Germantown home. It has a budget of less than $14,000 per year, spent mostly on salaries and the rent for a 100-square-foot storage space to hold its donations.
Paul Holland is president of the Washington Area Wheelchair Society in Silver Spring, another loan closet program dedicating to salvaging and reusing adaptive equipment for the elderly. Working out of a 900-square-foot warehouse, the society has for 30 years specialized in collecting, repairing and distributing used wheelchairs and powerchairs.
Holland said the group uses its $24,000 a year budget mostly on rent and parts for the 500 manual wheelchairs and 150 power chairs they give out each year. The group also reuses walkers and in-home equipment as well.
Most of the work is done by Holland or student volunteers, he said. He relies mainly on word-of-mouth for donations and referrals because he can’t afford to maintain a website.
“Our goal is to salvage as much as possible to help as many as possible,” he said.
The Foundation for Rehabilitation Equipment and Endowment is one of the largest donators of medical equipment in Virginia and one of few groups of its kind to try and estimate its impact. Executive Director Sonja K. Schaible said the impact comes in how the equipment improved the recovery rate of people who recently underwent surgery or the mobility of elderly persons who would have otherwise lived without.
“If someone can’t afford it, they’ll try to live without it,” she said.
In 2007, the group surveyed 136 people who received equipment the year before and estimated that for every 100 people who they served, 26 hospital stays and 29 emergency rooms trips were avoided that year among those surveyed. For every 100 people they serve, $465,585 is saved avoided medical expenses of hospital trips, moves to assisted living facilities, or loss of employment.
For Holland, the benefit comes whenever he helps someone reclaim a little bit of mobility or comfort in their life.
“Maybe it’s just a wheelchair to get them around or a bedside commode to give them a little dignity in the night, but that’s usually enough to make a difference somewhere,” he said.