DISCOVERING HIDDEN RESOURCES
Assistive Technology Recycling, Refurbishing, and Redistribution
Technical Assistance Project
The Benefits of Recycling and Reusing Assistive Technology
Our nation continues to struggle with meeting long-term health care needs in an environment of reduced federal support in the Medicare and Medicaid programs. An aging U.S. population combined with the fiscal realities of balancing the federal budget, which has resulted in reductions in entitlement programs, make efforts to change long-term care policy more difficult. Studies have shown that the development of community support systems to reduce or eliminate the need for costly institutional care increases a person's quality of life and produces cost savings. However, a medical model currently dominates long-term care planning.
For those who are older or who have disabilities, assistive technology (AT) makes it possible to maintain community involvement and avoid the need for institutional care. Assistive technology includes items such as wheelchairs, hospital beds, augmentative communication systems, environmental control systems, ramps, and computers. While access to AT has been enhanced through the federal Technology-Related Assistance for Individuals with Disabilities Act (P.L. 103-250) (Tech Act), many barriers remain, particularly related to funding. Although AT, a multi-million dollar business, is only a small part of the total national health care budget, it can be essential in reducing the need for expensive institutional care. Unfortunately, coverage for devices has continued to become more restrictive as government health care and managed care programs reduce costs.
One means to address the reduced resources available for the purchase of AT is through the reutilization of existing assistive technology. An estimated 20% to 40% of assistive technology goes unused for a variety of reasons, such as changes in medical needs, an individual grows out of the equipment, or the equipment selected was not the appropriate piece of equipment for the individual. This unused equipment creates a potential resource that could meet the needs of many individuals.
Definitions Used in Recycling AT Equipment
In waste management and product recovery, the term "recycle" is actually the last level in a hierarchy. The first level is "reduce," such as when a company reduces its inventory, and gets rid of extra stock. The second level is "reuse," which means to use again and again, to put a piece of equipment back in circulation. The third level is "recycle," which means taking something that was discarded and transforming it into some other kind of product.
In this document, the term "recycled" means to reuse an AT item. Recycled assistive technology equipment is any piece of used equipment, device, or aid that is now capable of being reused by someone else. The recyling programs featured have various names for this: reutilization, refurbishing, or redistribution.
How Recycled AT Benefits Suppliers, Students, and Consumers
Suppliers. The availability of refurbished equipment fills a void; it provides another tool for suppliers to satisfy the needs of consumers. Often, third party reimbursement systems establish caps, or limits, on payments for certain categories of equipment. Suppliers can offer recycled equipment as a less expensive alternative to allow consumers to stay within their financial limits. Reused equipment, compared with new equipment, also incurs a lesser co-payment amount when the consumer pays a percentage of the total cost. Since AT often is paid from consumers' own funds, recycled equipment allows consumers to reduce out-of-pocket expenses. Suppliers also can use recycled devices for rental requests to fill temporary needs.
Students. Currently, public schools do not have enough computers for all students, including students with disabilities. Students with disabilities use computers to complete classwork, take tests, conduct research, and improve their computer skills. Teachers find that course work completed on the computer is often easier to read, better organized, and easier to correct. Computer use often builds students' confidence and self-esteem.
Recycled technology can fill the need for more computers for students with disabilities. It can provide vital equipment for class use. It also can provide the extra devices that students take home to do their homework and get more comfortable with the technology. The less sophisticated computers that are available as used equipment usually are less intimidating for students and can be modified to perform specialized tasks for individuals.
Consumers. Reused equipment is less expensive than new equipment, which is especially important if consumers must pay for devices out of their own funds. Moreover, consumers can afford to purchase second pieces of equipment, such as a second wheelchair, for convenience. Recycled, adapted recreational devices also offer more affordability than new devices.
Reused equipment can provide temporary access to devices when consumers are waiting for their newly purchased items to arrive. For example, consumers who are discharged from nursing homes, and who cannot take the equipment that they were using in the facility, can borrow recycled equipment until their new equipment arrives.
Being able to use a recycled computer in the home allows consumers to shop on-line, pay bills, and write checks more easily. Computers can provide an avenue of communication via e-mail, especially important for people with disabilities who may spend a considerable amount of time in their homes. Computers can help with employment, by providing a means to conduct a job search on-line or to telecommute.
A Supplier's View
All-Ways Accessible, Inc.
Jeff Lavoie, President of All-Ways Accessible, Inc., in Concord, New Hampshire, had some initial concerns about a statewide recycling program. "When the REM (the state's recycling program) started, I had some reservations as to how the program would work and what it would mean to me. How would this affect my profit margin? Would a used equipment program flood the marketplace and then make the sale of new equipment more difficult? What if consumers purchased less expensive used equipment from the recycling program and caused me to lose out on sales?"
None of these initial concerns have come to fruition. The REM recycling program was designed with the dealer in mind. It involved the business community from the beginning so an antagonistic relationship did not develop and the state's recycling program relied on dealer knowledge and expertise to make the program successful.
"The idea that used equipment would flood the market and decrease the sale of new equipment did not happen," said Lavoie. "Used equipment fills a void that new equipment cannot fill. When a consumer needs a piece of equipment and has funding issues, sometimes the only answer is to provide a good quality, less expensive piece of used equipment. If I did not have the option to sell the used product, then I would not have been able to satisfy the customer's need and I would not have made any sale at all."
"As a result of the New Hampshire recycling program, I am able to have another resource to quickly satisfy the customer's need. For me, this means that I have a happy customer who will continue to do business with me. I am able to quickly solve a problem by using recycled equipment and then move on to other sales that are more revenue generating."
"With HMO caps, many times customers will face the dilemma of purchasing a new piece of equipment with a large co-payment versus buying a piece of good, used equipment with a smaller co-payment. Obviously, the used equipment becomes the product of choice. Many times, this is the difference between making the sale or not making the sale."
"The recycled equipment program also serves as a great referral source. Many customers call the REM and they tell the customer to call me to make arrangements to purchase the used equipment, or for new equipment if used is not available. I also am able to service my other referral sources better by helping them out of difficult situations for minimal expense."
All-Ways Accessible, Inc.
Jeff Lavoie, President
128F Hall St.
Concord, NH 03301
RESNA Technical Assistance Project
1700 North Moore Street, Suite 1540
Arlington, VA 22209-1903
703-524-6686 (V), 703-524-6639 (TTY)
This publication is available in alternative formats.
The RESNA Technical Assistance Project, Grant #H224A50006, is an activity funded by the National Institute on Disability and Rehabilitation Research (NIDRR), U.S. Department of Education (ED), under the Technology-Related Assistance for Individuals with Disabilities Act of 1988, as amended. The information contained herein does not necessarily reflect the position or policy of NIDRR/ED or the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA), and no official endorsement of the materials should be inferred.
RESNA is an interdisciplinary association of people with a common interest in technology and disability. RESNA is the grantee funded under the Tech Act to provide technical assistance and information to the Tech Act projects.