What do Occupational Therapists do in seating and mobility interventions…

woman in grey and beige suit using a manual wheelchair. She has a laptop on her lap. She is in a brick building.

I’m an Occupational Therapist and Assistive Technology Professional, working in New York City.  I work for Independence Care System’s On A Roll programme, a freestanding specialty clinic providing comprehensive and specialised mobility evaluations.  We provide complex rehab technology solutions for people with physical disabilities as we believe a well fitted wheelchair promotes health and independence.

We have two purpose built locations, one in the Bronx and the other in Brooklyn.  In determining clinic locations, we carefully considered public transit access and the accessibility of the commercial buildings in which we are located to ensure fair access. Both Clinics are fully accessible: doorways are at least 32” wide, bathrooms are accessible, we have ceiling lifts (rated to 650 lbs. in Brooklyn, and 1000 lbs. in the Bronx) for transfers if needed, high-low mats for full postural and ROM assessments, and access to demo/trial equipment. We have both floor scales and integrated scales in the lift to capture a person’s weight.  You would be surprised how many wheelchair users do not have accurate weights because many facilities are not equipped to weight them.  This can be crucial when considering medication management, wound healing, or simply nutrition and overall health.

We provide individualised assessments and work in partnership with our clients to provide a customised wheelchair configured to meet our patient’s needs and maximise health and mobility.  We also assess for and recommend custom bathroom equipment for bathing/toileting needs.  Our evaluations consider physical presentation including a full postural and ROM assessment, functional abilities, environment(s) of use, cognition and visual perceptual skills, lifestyle, roles, skin assessment, pain etc.

Historically, our primary population served was low income New Yorkers with physical disabilities but we are now accepting private and commercial insurance plans.  We work with people from assessment, through insurance funding to delivery and training.  

We are affiliated with Independence Care System whose mission is helping people with disabilities and chronic conditions remain healthy and independent, at home, in their communities.  We value partnership, respect, advocacy and collaboration. To this end, staff are trained in disability competence and recognise the unique challenges a person with physical disabilities can face.

I love my job.  It can be extraordinarily frustrating to navigate the ever-changing world of insurance coverage.  And the implicit bias built into the coverage system is staggering.  Most coverage criteria are based around Medicare policy which was developed to meet the needs of senior citizens aging in place, and not the needs of people with disabilities active in their communities who are going to school, or working, or participating in other activities outside of their home. But my job is also tremendously rewarding.  What I do matters and it makes a difference to people.  I’ve worked here for 14 years and the relationships I’ve built with my colleagues, other providers and the population we serve are truly rewarding.

Author: Rachel Spiers

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