Richardson: You serve as the Director of Advocacy and Communications for NCART, the National Coalition for Assistive and Rehab Technology. How has your career evolved and what led you to this role?
Lee: My career in the CRT industry got its start back in 2007. At that time, I began as a customer service representative for Monroe Wheelchair (now part of Numotion) in Rochester, New York . I didn’t expect to stay there long but I found myself falling deeper and deeper into the rabbit hole of CRT, document review, billing, Medicare appeals, and eventually got involved with NCART through the annual CRT Leadership and Advocacy Conference. Advocacy really struck a chord with me; I went full-time with NCART in 2012 and have been there ever since.

Richardson: For those who may not be aware, what is the purpose of NCART and who are its members?
Lee: NCART is the non-profit industry association that ensures coverage and reimbursement policies allow appropriate access to CRT. We work with federal, state, and private policy makers on behalf of the CRT industry to establish and protect appropriate coverage, coding, supplier standards, and funding policies. Our members are the leading suppliers and manufacturers of CRT who are dedicated to protecting access for people with disabilities.

Richardson: How has industry consolidation affected NCART operations and how are you responding to those changes?
Lee: The industry has certainly been fluid and consolidation has had its impact. However, NCART has always operated with a “lean and mean” staff under the guidance of our Board of Directors, who are industry veterans with decades of combined experience. As a result, consolidation and other changes within the industry haven’t had any negative impacts on the legislative and regulatory work we’re able to carry out. We’re incredibly grateful for the many dedicated individuals who are involved in those efforts.

Richardson: For many outside of the bubble of the disability and mobility space, Complex Rehab Technology is often unfortunately “out of sight, out of mind.” What are the best ways for our readers to help raise awareness of CRT?
Lee: There is a range of possible answers for this because everyone has their own level of comfort and available time when it comes to raising awareness. The good news is that there truly is a way for everyone to get involved if they want to.  It can be something as simple as sharing information on social media and, on the other end of the spectrum, something as involved as directly communicating with state and federal legislators about matters that involve CRT. NCART is there to provide resources for any level of involvement, so getting signed up for our timely updates and newsletters is a great place to start. (www.ncart.us)

Richardson: Due to COVID-19, remote telehealth evaluation capability has been critical to the continuation of mobility services. What is NCART’s position on remote telehealth and what, if anything, is being done to ensure its role in the future?
Lee: Telehealth and Remote Service options have been a crucial part of keeping individuals who utilize CRT safe and healthy during the course of the Public Health Emergency. We are currently working to see those options become permanent in Medicare, Medicaid, and commercial payer policy.  We’ve created a Remote Services and Telehealth Consortium with impacted stakeholders to determine best practices, recommended policy, and develop safeguards that can be shared with these policy makers.  We are also communicating with Congress about how best to ensure these policies stay in place.

Richardson: With state budgets compromised due to significantly reduced tax revenues and the added expenses required to combat the COVID-19 pandemic, do you expect CRT reimbursement within Medicaid programs to be affected and if so, how?
Lee: This is a real risk for CRT access. Most states have their enacted budgets in place for fiscal year 2021. For states who were in their budget processes earlier this year, we monitored closely through May, June, and July to track any potential rate reductions that would impact CRT. While there were a handful of state Medicaid agencies that did make cuts, we were able to confirm that the vast majority of states weren’t implementing any significant changes affecting CRT, at least for now. We’ve begun discussions with states who are currently making adjustments and continue to monitor budget changes across the country so we’re able to address any future cuts.

Richardson: In addition to the work being done to mitigate the negative effects of COVID-19 on our industry and those we serve, non-COVID efforts are ongoing. Where do things stand with the push to ensure coverage for power seat elevation and standing?
Lee: I’m so glad you asked about this because it’s such an important initiative that the industry is currently pursuing. We’ve been collaborating with the ITEM Coalition and others to develop the data and documentation needed to formally make this request. The final packet of information will be submitted to CMS soon in the form of a “Request for Reconsideration of the National Coverage Determination for Mobility Assistive Equipment”. Once this is submitted, CMS will begin the formal review process. We should have updates to share later this month.

Richardson: Many of the CRT “victories” our industry has experienced in the past few years have occurred at the administrative level. Is grassroots activism still effective or does real change only occur in high level negotiations?
Lee: Grassroots advocacy is absolutely still effective. The industry’s federal legislative win in December 2019, when CRT Manual Wheelchairs were permanently excluded from the Competitive Bidding Program (CBP) and their accessories/components were exempted from the application of CBP pricing for 18 months, proves that. The legislative action and Congressional support were a direct response to outreach from constituents in the CRT community and that got us across the finish line. We’ve got some new CRT grassroots advocacy opportunities ahead, so folks can be keeping an eye out for that!

Richardson: What is the current state of cooperation between the major disability consumer groups when it comes to CRT advocacy?
Lee: As always, the disability consumer groups remain plugged in and ready to coordinate advocacy efforts whenever there is an opportunity to improve or protect access to CRT for their members.  The work to secure Medicare coverage of power seat elevating and standing features is a great example. These organizations have been a steady support over the years and have contributed much to the victories that CRT has seen. We’re very thankful to have the support of these important partners in advocacy.

Richardson: Our nation recently marked the 30th anniversary of the signing of the Americans with Disabilities Act. What role do you believe CRT has played in the disabled community’s ability to achieve the quality of life and equality goals promoted by the ADA?
Lee: I truly believe that the ADA and CRT go hand-in-hand. In 1990, the ADA determined that no individual should be singled out or discriminated against because of a disability. The disability community was finally recognized and given the respect deserved; opportunities for work, school, business, and more became a reality.  In that context, CRT is an important tool that supports and allows many individuals to pursue those possibilities. Without the right CRT, the promise of the ADA cannot be fulfilled.  NCART’s work to establish and maintain access to it is our way of keeping that door open for anyone that wants to go through it.

Richardson: What are the most frustrating parts of your daily work to help guarantee continued access to CRT for those living with disabilities?
Lee: Every job has its frustrating moments, I’m sure. When you work in the CRT industry, you come to understand that there are going to be plenty of challenges along the way. Some days you’ve got to dig a little deeper than others to send another follow up email or read through another list of proposed policy changes but I consider myself blessed to genuinely have a passion for what I do. 

Richardson: On a positive note, what are the most rewarding parts of your job?
Lee: There are so many rewarding aspects of working to protect access to CRT, I couldn’t possibly list them all.  Knowing that the work we’re doing today not only continues the mission of so many advocates like Judith Heumann or the late Mark Smith who labored for access before us, but also lays the groundwork for maintaining and improving access for individuals in the future is definitely at the top of that list for me.

Richardson: When you aren’t focused on fighting the good fight for people with mobility-related disabilities, how do you spend your free time?
Lee: I spend a lot of time drinking coffee and trying not to kill my houseplants. I also love hanging out with my son and attempting whatever culinary creation I last saw on the Great British Baking Show.

Richardson: What would be the best channels through which our readers can follow both your work and the work of NCART?
Lee: We post a lot of our updates to our social media sites (Facebook, Linked In, Twitter) but the best way, hands down, to stay in the loop on matters affecting CRT is to subscribe to our email updates. We know that inboxes fill up quickly so we summarize our work in a monthly newsletter to keep things simple. Unless, of course, there is something urgent or important that needs to be shared as quickly as possible.  We’re also co-hosting monthly CRT Industry Webinars with NRRTS, U.S. Rehab, and the Clinician Task Force which is another great way to get the latest CRT news. Recordings of past webinars, registration links for future webinars, and the link to subscribe to our emails can all be found on the NCART website (www.ncart.us).