Kiley Connealy, OTR/L and Practice Council member with Infinity Rehab, completed the company’s Leadership Academy in 2019 by helping patients get much-needed wheelchairs.
But her journey started before she even joined Leadership Academy.
Identifying a need
Myron* suffered a stroke in his 40s, leaving him unable to walk without assistance or complete daily activities on his own.
He came to Infinity Rehab after being in inpatient rehab for about two months. Kiley knew right away that Myron needed a wheelchair, so she began the process of obtaining one.
One denial after another
The first denial came from Medicaid, because they said he could walk. Kiley submitted documentation that proved he can only walk with assistance.
The second denial came, this time because Medicaid said he can’t wheel himself independently. Kiley submitted documentation proving Myron was able to operate a wheelchair.
The third denial came. This is when Kiley took additional action. She got a local attorney involved – her own husband. During the appeal, she thought there was no way they could deny this man a chair.
Less than a week later, they received the final denial.
It was at this time that she joined Infinity Rehab’s Leadership Academy.
“It began my journey with advocacy and knowing that I needed to challenge this process – that I needed to create a change for others in the future.”
Kiley contacted the American Occupational Therapy Association (AOTA) and the Nebraska Occupational Therapy Association (NOTA), the local OTOA chapter where she resides.
She received no response from AOTA and little response from NOTA.
This changed in June 2019 when a new lobbyist joined NOTA, who happened to be a former teacher Kiley knew for many years, Melissa Kimmerling, Vice President of Policy and Advocacy.
“Together, we were persistent,” Kiley shared during her Leadership Academy presentation.
They gathered research, discussed how to implement the change, and knew they would have power in numbers to make a difference.
More than what it seemed
Clinicians across physical therapy and speech-language therapy were experiencing Medicaid denials as well.
The team of two inspired a shared vision together by reaching out to fellow occupational therapists and compiling documentation of denials within Medicaid.
They discovered this was more than just wheelchairs and even impacting more than only occupational therapists.
Through their efforts, the Medicaid director agreed to monthly meetings. He and NOTA representatives met monthly beginning in August 2019, and Kiley stayed involved through Melissa.
Results from advocacy
A bill is now in the senate to increase services covered by occupational therapy, physical therapy, and speech-language pathology and wheelchair products for Medicaid patients in Nebraska. This includes changing the pre-authorization process for therapies and decreasing denials of durable medical equipment and wheelchair products.
Even now, Kiley is seeing a difference in wheelchair approvals from 25% to 80%, but her advocacy didn’t stop there. She saw a need to help fellow clinicians across Nebraska. The wheelchair approval process and navigating insurance is intimidating, so she created a handy list of steps to follow.
“This leadership journey came to me at the exact right time,” Kiley shared. “Without this journey, I probably never would have pursued going further to create this change, to challenge the process, to enable others around me, to jump in and create this change.”
Kiley is truly a mentor and resource to her peers with the wheelchair application and denials management process. Alongside NOTA and other professional organizations, her next steps are to tackle other therapy-related services and equipment that are being denied and lead the way by advocating for the therapy services patients need.
Infinity Rehab is made of clinicians and leaders just like Kiley who advocate for change. Find out more about Infinity Rehab at InfinityRehab.com.
*Name changed to protect the patient’s identity