Arda Abbott desperately needs a hospital bed. She suffers from arthritis and the first stages of dementia. She’s had three strokes and surgery to remove a tumor from her thyroid gland.
Medicare covers Abbott’s doctor visits and hospital stays and prescriptions, but not a hospital bed. Renting one without the benefit of insurance can cost as much as $1,500 a year at a medical equipment retailer such as Boise-based Norco. The 84-year-old doesn’t have a penny to spare. No one in her family does.
Which is why Abbott’s daughter and son-in-law showed up at the Knights of Columbus Medical Equipment Loan Program in Meridian shortly after its doors opened. On a recent Thursday morning, the organization had three hospital beds to lend, but no mattresses.
“We’re retired, and we’re on a fixed income,” said Cathy Owings of Boise, Abbott’s daughter. Their situation is simple and painful: “Your life changes, and you need something now, and you can’t afford it.”
As Idaho grows and grays, more families like Abbott’s are finding themselves in similar predicaments. So-called durable medical equipment is necessary and expensive. The U.S. market alone is expected to reach around $75 billion by 2026, up from around $38 billion in 2014, according to Polaris Market Research.
But federal programs such as Medicare and Medicaid do not always cover the costs of wheelchairs and walkers, lifts and bath chairs and bedside commodes. Families — often with limited incomes — are left to pick up the slack.
HELP IN THE TREASURE VALLEY
Here in the Treasure Valley, however, there is some help. Nonprofit organizations such as the Knights of Columbus’ Risen Christ Council, Hands of Hope Northwest and LINC Idaho have created lending libraries for expensive equipment, collecting used items from hospitals and individuals, cleaning it, repairing it and offering it for free.
In addition, the Idaho Assistive Technology Project set up a website called idaho.at4all.com that supports the reuse and loan of equipment to help people with disabilities and the elderly function better.
These services’ own growth — and strained circumstances — are evidence of the region’s increasing need. LINC Idaho’s Boise office had seven motorized wheelchairs available in early March and seven families that needed them. But the devices sat in the organization’s office, because there was no money to pay for pricey batteries, which can run upwards of $200 a pop.
“Most of the people we serve are on Social Security, a limited income,” said Christa Nuxoll, disability advocate for LINC Idaho. “Those motorized chairs are thousands of dollars to buy. A walker may be $25, but, if you’re living on $700 a month, that’s a huge amount.”
Hands of Hope Northwest, based in Nampa, has a lending library of 1,000 items for the Treasure Valley region — and a waiting list for many of them. Executive Director Debbie Wheeler said her organization does not handle power wheelchairs because the batteries are so expensive.
“People come from all over the Valley to borrow from us,” Wheeler said. “With the baby boomers aging, it’s getting to be a bigger issue. Demand is growing ... Wheelchairs are the most requested item.”
Hands of Hope lends medical equipment including wheelchairs, bath chairs, crutches and walkers to people of all ages, although the elderly make up a significant part of the group’s local clientele. The organization started sending donated medical equipment overseas and added the Treasure Valley in 2005.
Wheeler said her group measures demand by figuring how many days a client has a piece of equipment on loan and what it would cost to rent the item for that period. They call that dollar figure the “benefit to the community.”
“In 2005, we figured the benefit to the community was $38,152,” Wheeler said. “In 2017, we figured the benefit to community was $679,446.”
CRITICAL CARE AT HOME
Durable medical equipment is a critical part of the health care industry, because it allows people with chronic illnesses, elderly people and those with disabilities to be cared for at home.
“Home care is much less expensive than admitting someone to the hospital,” said Jim Kissler, president and chief executive of Norco, which has 75 retail stores in seven Western states. “If we can set up a hospital environment, the bill might be hundreds of dollars a month to rent the equipment instead of thousands of dollars a day in the hospital.”
Kissler said his company is handling many more customers, but medical sales have been flat for the last two to three years. In the health care industry, he said, “everyone’s being reimbursed at lower numbers, including doctors and hospitals. We’re all getting more patients but dealing with less topline revenue.”
Norco is a privately held company and does not disclose its sales figures. Much of its business comes by prescription and is covered by private insurance, Medicare or Medicaid. But about 5 percent of Norco’s total revenue, Kissler said, is “written off for people who are unable to pay.”
Elder care consultant Dee Childers, owner of an Eagle-based company called Life Changes, suggests that people shopping for medical equipment at a retailer such as Norco ask what the cash price is for an item, because it’s generally much lower than what an insurer would pay.
She points those with more need than resources to thrift stores such as Idaho Youth Ranch and Goodwill, which often carry used equipment. She recommends Walgreens for basic items such as walkers and canes.
The Idaho Lions Foundation is a good destination for glasses and refurbished hearing aids, she said, and the Idaho Commission for the Blind & Visually Impaired for assistive technology such as audio book readers and talking watches. She recommends the Knights of Columbus “for nearly everything.”
KNIGHTS ‘OF NEARLY EVERYTHING’
Dale Anderson and Dick DeLeonard founded the Knights of Columbus Medical Equipment Loan Program 16 years ago in an outbuilding on Anderson’s Meridian property that Anderson originally built for his hobbies: the boat, the truck.
These days it is crammed with donated equipment that a small army of volunteers cleans and repairs. Walls are hung with crutches and walkers. An anteroom is jammed with wheelchairs. On a recent Thursday in early March, four hospital beds were lined up in the driveway, each one claimed and waiting to be picked up.
No one is turned away. Everything is free. The only request is that, once clients no longer need the walkers or wheelchairs or hospital beds, they return them so someone else can make use of them. In 2016, Anderson said, the organization helped 4,144 people. In 2017 that number jumped nearly 25 percent, to 5,145. This year the program is on track to help around 6,000.
“We don’t set a time limit on how long people can use things,” Anderson said. “I figure if I deal with a senior citizen, they might need it for the rest of their life.”
DeLeonard knows first hand why that policy is so important. Several years after co-founding the exchange, his wife was diagnosed with Alzheimer’s disease.
“For eight years, I kept her at home,” DeLeonard said, misty eyed. “Everything she needed, we got here. A wheelchair, a transport chair, a bed, a knee walker, the full bailiwick. She became bedridden after six years. She passed this last August.”
Her name was Shirley. They’d been married for 68 years. She didn’t quite make it to her 88th birthday.
On this chilly Thursday, a physical therapy assistant named Shawna Botos, who works for a home health care agency, picked up a bedside commode from Knights of Columbus for a client.
“Insurance doesn’t cover the cost of things like bedside commodes and reachers” if they are not considered medical necessities, she said. “Without Knights of Columbus, people would have to buy these things themselves, and oftentimes they’re on a limited income.”
Ted Ayers came by to get an updated wheelchair for his ailing wife, Peggy. She fell recently and broke her foot, and she needs a model that can elevate her leg. Norco supplies her oxygen, the Boise man said, but the company’s wheelchairs are beyond his means.
“These people have helped us for six or seven years,” Ayers said. “She’s gone downhill ... When I get in trouble, they’re here to help. God bless them, as He does us all.”