Moving Forward, Making a Difference

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By Laura Hochnadel

To speak up for what you believe in and affect change at any level of government—local, state, or national—is one of our country's foundational principles. Participation takes various forms, from voting to rallying support for a variety of issues and bringing them to the attention of decision-makers all the way to campaigning. No matter how one chooses to participate, the driving factor is the desire to make a difference. There are a number of efforts currently under way to protect the interests of O&P professionals and the patients they serve. There seems to be an increasing number of patients with amputation who are spearheading efforts to move legislation forward, particularly in the O&P arena. The O&P EDGE talked with four people who are doing just that.

John Kriesel (R-MN District 57A)

Vice Chair: Veterans Services Divisions
Committee Assignments: Capital Investment; Judiciary Policy and Finance;
Public Safety and Crime Prevention Policy and Finance

John Kriesel

On January 4, 2011—with his wife Katie and their four sons at his side—John Kriesel (R) 57A, was sworn into office as a member of the Minnesota House of Representatives. It was a hard-won battle; the victory was possible, in large part, because Kriesel knocked on "thousands of doors and [talked] to thousands and thousands of people," he says. Door-to-door campaigning at any level is physically demanding. What differentiated Kriesel's campaign from others is that he has the additional challenge of being a bilateral amputee.

"They told me, 'hey, it's going to be tough,'" he says. "I'm not going to be shy about saying that I guarantee that it was tougher for me than for anybody else." Kriesel says he used a Segway to maneuver neighborhoods and paths, but he walked the final steps to each front door unassisted.

Kriesel's amputations are the result of injuries sustained while fighting in Iraq as a member of the Minnesota National Guard. On December 2, 2006, the Humvee in which Kriesel and four other soldiers were traveling struck a 200-pound improvised explosive device (IED). Kriesel and two others were thrown from the vehicle. "Two of my best friends died in that blast," he says. That same explosion claimed his left leg above the knee and his right leg a few inches below the knee, severely damaged his pelvis and both arms, crushed his lower back, and delivered shrapnel wounds to his face and abdomen. He died and was revived three times while on the operating room table.

Kriesel got his first taste of politics during his nine-month recuperation, when he spent two months interning for the now former Senator Norm Coleman (R-MN), helping with constituent services. He returned to Minnesota in August 2007 to take a civilian position, offered through the armed services, working for a firm that markets and advertises for the Minnesota National Guard. "I get to market something I love...," he says. "I love the National Guard. It's made me who I am today...."

Kriesel ran for office at the suggestion of a legislator from a neighboring district. He says he brings to his position a blue-collar and a military work ethic. "No matter what our mission was...we worked together to get it done," he says. "The values I've learned in the military of doing what's right, that's the...advice that's stuck with me my entire life [and that] I use now and here more often than not...."

Kriesel has been active in his new position; so far he has authored 12 bills on a variety of topics and coauthored many more. On February 24, his first bill, HF 57, was passed—a measure that would prohibit the sale or possession of synthetic marijuana. His second bill to pass was HF 361, a measure to modify the crime of fleeing a peace officer. His "baby," however, is HF 847—a measure requiring health plans to "provide coverage for orthotic and prosthetic devices, supplies, and services, including repair and replacement, to the extent that coverage is provided under federal law for health insurance for the aged and disabled...," the bill states.

"This bill will do nothing to help me because I was strangely fortunate enough to be wounded in the line of duty [and am covered by the Department of Veterans Affairs]...," he explains. "I know that there are people out there that aren't so fortunate and really they just want to get back to work and be productive.... I think...there are many insurance companies that do the right thing and I don't like mandates,...[but sometimes] mandates are necessary because someone refuses to do the right thing. That's what this is about...[and] ultimately this is going to get people off of state-funded programs, federally funded programs, and most of all it's going to improve their quality of life.

"Like I've said before, I just focus on doing what I know is right."

Sam Kliewe

Sam Kliewe

Regardless of age, a person can still have a voice in government. Sam Kliewe is a 17-year-old high school student in Stamford, Connecticut, and a Symes amputee. He has attended the Amputee Coalition's Paddy Rossbach Youth Camp every year since 2004.

Kliewe's first foray into the political arena was a letter-writing campaign—part of an Amputee Coalition-sponsored crusade to declare April as Limb Loss Awareness Month in his state. Not even of legal voting age, he was able to experience the machinery of government in operation.

"I wrote a letter and I sent it probably mid-March, and by the end of the month I got something back [from Governor Dannel Malloy] that had the statement [declaring April as Limb Loss Awareness Month] signed," Kliewe said. "It wasn't hard. Anyone can do it."

Kliewe says, "It is important for people to be aware [of] limb loss...[because] it is something that many people face...." He adds, "I think other amputees should get involved. I sent a letter to the governor, and...if others did the same as me, then it could be official throughout the country."

Jennifer Latham Robinson

"The place was electric," Jennifer Latham Robinson says of her 2009 trip to Washington DC, where she lobbied for fair insurance coverage for artificial limbs. "There was a large group of amputees from across the nation, and our goal was to systematically meet with representatives and senators to make a profound impact. With close guidance from the [Amputee Coalition] and AOPA [American Orthotic & Prosthetic Association], we were briefed and disbanded upon them!"

Robinson, 34, impacts her surroundings in a variety of ways: As a singer/songwriter with her lyrics; as an artist whose favorite theme is to portray the "disabled" body in a positive, fun way for children; as a blogger who writes about O&P and related issues; as an amputee case manager at Westcoast Brace & Limb, Tampa, Florida; and as a congenital transfemoral amputee involved in the facility's amputee support group, Amputees Together of Florida. "I enjoy engaging myself in the world around me," she says, adding, "It's easy to just tune-out sometimes and run things on auto-pilot. But it's more interesting to actually fly the plane."

Jennifer Latham Robinson

As an amputee case manager, Robinson says she grew increasingly frustrated with insurance companies over the years. "Higher deductibles, larger co-insurances, larger out-of-pocket maximums—people can almost swallow that," she says. "But then you have to sit there and explain to someone who has a job, pays his or her insurance premium, and has a family, that the insurance company will only pay $2,500 a year for a prosthetic limb.... Instead of just brewing over it, I decided to do something."

In addition to lobbying in Washington DC, she decided to encourage her clients to get involved and write letters to their state representatives with the goal of offering "legislators practical information: here is this situation, here is the effect on an individual's life, here is the effect on society, and here is how we can fix it...." The effort involved rallying the amputee support group she attends to address the need for legislation in Florida that promotes insurance fairness for amputees. "I simply made an announcement at our amputee support group meeting," she says, noting that "not everyone wanted to be personally involved with the actual nuts and bolts of the issue, but everyone was incredibly supportive."

Robinson says the Amputee Coalition educated the group on how other states had approached the issue and how to take action. "We met with several representatives and senators over the last two years and even attended a town hall meeting as a group," she explains. "The town meeting was really an eye-opener. Person after person would get up and bring attention to these significant issues, and then it was our turn. We sat in the front row so that everyone could see that we were wearing prostheses. We explained our concerns and then...we met privately with our target to explain our needs and propose our solution in greater detail. We also met with insiders in the insurance industry so that we would have a better understanding of what we were going against."

Aside from the fun and frustration of learning about the legislative process, Robinson says the opportunity afforded her group a sense of empowerment. "We brought awareness to legislators and, hopefully, we were one of many groups that pushed this issue along." The awareness Robinson and her group imparted on state legislators resulted in Florida HB 5, a bill that supports insurance fairness for amputees. The bill is currently making its way through the state legislature.

"What we did really wasn't so unbelievable or difficult," she says. "The fact is amputees everywhere are doing it.... The people who are continuing with this issue until it's resolved, those people should be applauded."

Jim Young, CP, LP, FAAOP

"Everybody has an opportunity to make a difference," says Jim Young, CP, LP, FAAOP. "And if you don't give money, give of your time."

Jim Young

As a current member and past president of the Georgia Society of Orthotists and Prosthetists (GSOP), and as a member of AOPA and the American Academy of Orthotists and Prosthetists (the Academy), Young heeds his own advice. He donates money to O&P political action committees and politicians who support his interests. He worked on the medical device tax in Georgia—kept in contact with Georgia's legislative advisor, and monitored versions of bills and tax-code proposals. This past April he attended his fourth AOPA Policy Forum, where he says he met with Georgia senators and representatives to discuss the Medicare Improvements Act, the Insurance Fairness for Amputees Act, O&P being included in the essential health benefits package of the Patient Protection and Affordable Care Act (PPACA), the medical device excise tax, and the Veterans Bill of Rights as it pertains specifically to amputee vets. He also discussed the topic of outcomes research and the need for more O&P educational programs.

Young says he's always had political inclinations. In 1991, he ran for city council in his hometown of South Charleston, West Virginia, but had to pull out of the campaign to undergo a transfemoral amputation of his left leg—the final blow after having undergone 28 limb-salvage surgeries following injuries sustained in a motorcycle crash three years earlier. While his political aspirations were cut short, he found his life's calling and another way to stay plugged in to the political scene.

"I started working [as a] prosthetics [assistant] right after I had my amputation...," he says. Young supported himself in this manner for the eight years it took him to earn a bachelor of science degree in sports medicine and athletic training from the University of Charleston, West Virginia, and his prosthetics certificate from Northwestern University, Chicago, Illinois. He became a certified prosthetist in 2001, and on June 15, 2005, he and his wife founded the Amputee Prosthetic Clinic, headquartered in Macon, Georgia.

As a small business owner and an amputee, Young has a vested interest in the O&P political arena and says he doesn't want to blindly be told what's going to happen to him. That's why, among other issues, he was actively involved with Georgia HB 385, which revises the state's revenue structure, a measure that has since been struck down. Buried deep in this 127-page document was a two-line reference to the medical device tax that Young quotes: "The sales and use taxes levied or imposed by this article shall not apply to: The sale or use of any durable medical equipment or prosthetic device prescribed by a physician.

"Our consultant here at the state level told our [GSOP] liaison...'it's nothing you gotta worry about this year,'" Young notes, adding, "[however]...the next line under that exemption says, 'This paragraph shall stand repealed in its entirety on July 1, 2012.' So it's true. You don't have to worry about it this year; next year you lose that exemption, [which]...is the same as raising the tax because now you have to pay a tax that you haven't been paying."

It's the fine print and "no worries" attitude that concerns Young and prompts him to take action. "I wear [a prosthesis] and I make them," he says. "So I really, really care about this stuff. It affects not only my life, it affects my livelihood."

"I stay active," he continues. "I try to know my representatives. I support the ones I think are working for me and the people I care for and hang out with. When you're not running [for office] you can be the green party—the guy that gives them a little something-something for their campaign efforts."

"Everybody [who works in O&P] should care," Young says, explaining that whatever affects the facility owner ultimately trickles down to employees and patients. And because the profession is so small, he thinks forming partnerships are important—whether with national organizations such as the Easter Seals or competing facilities in order to join forces for the common good.

"We all need to be pulling on the same rope together, try to speak with one voice," he says. "That's the only way we can be effective...."

Laura Hochnadel can be reached at