Establishing an Adaptive Needs Fitting Station: Overcoming Challenges, Pursuing Funding

Sheryl Williams, BSN, RN, CCM
Adrienne Gallardo, BSW, MAOM, CPST-I

One hospital is revolutionizing adaptive car seat assessments and funding. The most vulnerable members of our population were overlooked during the pandemic due to limiting community contact. During this time, DME providers took over the adaptive car seat demands which led to incorrect use and compatibility concerns both with the vehicle and child fit. After multiple incompatibilities were found, we connected with the DME providers and began establishing relationships. This program is now the program that medical providers, therapist, and DMEs are referring all adaptive car seat requests to.

Prior to establishing the Adaptive Needs Fitting Station, the assessments were a team effort by all special needs trained technicians. A family would work with a Child Passenger Safety Technician (CPST), find an appropriate car seat, and the CPST would provide a letter of medical necessity for the family to share with their case manager to pursue funding. This resulted in adaptive car seats not being funded.

To solve this issue for these valuable members, we streamlined the process to one CPST. To fund the position, we tracked the number of families being seen, how many hours spent from start to finish with one family, and proved the increase in funding from 0% to 66% to leadership.

Due to the established fitting station, successful funding, and relationships being built with key stakeholders, we are the point-team for all adaptive car seat request and have limited misuse, incompatibilities, and increased funding and most importantly a safe way for children with disabilities to travel in their vehicle.

Throughout 2020-2021 we began seeing most of the adaptive seating needs in a large city, and in 2021 we helped 81 families with adaptive car seats and closed 35 with a funding rate of 43%. In 2022 we established a .5 FTE position to allow one person to establish relationships with DME and insurance plans and oversee the adaptive car seat assessments. Averaging 12 – 20 hours a week, this one person helped 101 children with special healthcare needs in Oregon, Washington, and Idaho with a funding rate of 66%. To date in 2023, 34 assessments have been conducted and have competed 19 with a funding rate of 56%

We are establishing relationships with Medicaid and funding sources and leveraging key stakeholders to change how adaptive car seats are obtained. Through our trials, errors, and successes, we want to share what we have learned and set a pathway for other agencies and states to find the same success.

1. How to meet community adaptive seating demands and the costs to main program
2. How to leverage key stakeholders and establish relationships with DME providers
3. Tips and tricks navigating Medicaid and private insurance plans