Philanthropy in O&P: Giving Back in O&P Comes in Countless Ways

EVEN THE SMALLEST philanthropic deed can do wonders for the beneficiary. A philanthropist doesn't need to be wealthy; a generous nature and a heart filled with compassion and empathy will do. Philanthropic efforts of planned and spontaneous giving can come in many forms: monetary contributions or volunteering time to a worthy cause or donating canned goods to a local food bank.

In O&P, acts of goodness and mercy are demonstrated by clinicians donating their efforts, time, and talent to provide devices to clients at little to no cost or helping them in other ways.

"We always need to make sure we remember why we chose our profession," says Jimmy Colson, CO, CEO of POP Prosthetics, Las Vegas. "We are here to aid others in living their best possible lives."

It Takes a Village Coincidence and social media led Shawnna, a 46-year-old Bonifay, Florida, resident with a left transfemoral amputation, to Mike Bugg, CPO, owner of Orthotech Prosthetics & Orthotics in West Branch, Michigan. Shawnna was experiencing complications with the prosthesis she had received after her amputation due to peripheral artery disease in 2018, and the practice that was providing her care could no longer help her because her insurance would not pay for a new socket.

When Bugg learned of Shawnna's dilemma through one of his patients, he said, "Get her up here." Kathy Sauvola, Orthotech's marketing director reached out to Shawnna to arrange for her travel to Michigan. From there, Orthotech's philanthropic efforts came in a torrent. Sauvola contacted College Park Industries, Warren, Michigan, who donated a prosthetic foot and knee, a car rental agency gave Shawnna a discount, and a local hotel donated a room. Sauvola also opened her home to Shawnna for part of her stay.

Shawnna was involved in the entire process of getting her new prosthesis at Orthotech, from casting to watching the fabrication to fitting, Sauvola says. When Shawnna cried as she took her first steps on her new device, nearly everyone in the office was affected, Sauvola says.

"Mike knows he can't change the outcome for every patient, but Shawnna's story deeply moved him and his staff," Sauvola says. "Mike is unable to bill Shawnna's insurance nor is it in Orthotech's budget to bring her to Michigan, but if her story can bring awareness to the struggles and roadblocks many amputees face, then it's worth it."

Shawnna's story and the help she received from her clinicians is not unusual in O&P.

Clinicians in most facilities nationwide will readily treat individuals with challenging limb conditions or multiple limb amputations who are struggling to incorporate their prostheses into their daily lives, practitioners say. A good portion of these clients reside in other countries and do not have the means to travel internationally to clinics in the United States, they say. Many also do not have the financial ability to pay for prosthetic care.

When it comes to providing a service, it doesn't just have to be for a prosthetic device.

[caption id="attachment_249329" align="alignright" width="454"] Dream Team Prosthetics’ annual Bilateral Life Camp, a hands-on experience on how to thrive with limb loss, is free to attendees. Photograph courtesy of Dream Team Prosthetics.[/caption] Every summer, Dream Team Prosthetics, Duncan, Oklahoma, hosts its Bilateral Life Camp at no cost to those who attend, says Chad Simpson, BS, BOCP/LP, clinical director at Dream Team. Food and drink are provided by Dream Team during camp sessions, and it also arranges for special rates at local hotels for participants who attend from out of town. "We even have connected attendees with individuals who have asked to remain anonymous and have donated airline travel," Simpson says.

The annual camps have been a blessing to many, he says, particularly to one individual with transfemoral amputations from Guatemala. "He was doing very well but was limited in his function by the mechanical knees he was using that were also worn out and not functioning properly," Simpson says.

Dream Team provided him with microprocessor knees and within a few hours of instruction during the camp, he was able to eliminate using his cane and walk independently, Simpson says. "He worked very hard during the sessions each day and when he was finally able to walk down a steep ramp independently, he was moved to tears."

The man returned to Guatemala and was also able to return to work due in part to the function and support the microprocessor knees provide him during his daily life, Simpson says.

At POP Prosthetics, clinicians treated a young woman who had lost her leg above the knee to cancer. "We called our vendors and asked them to pitch in parts," Colson says. Össur, Reykjavik, Iceland, donated the knee and liners; Fillauer Companies, Chattanooga, Tennessee, donated an AllPro foot; and SPS contributed componentry, he says. "It all came together from them to help us make this awesome young lady a prosthesis," Colson says.

Ropp Orthopedic Clinic in Commerce Township, Michigan, has also connected with its vendors—ALPS South; College Park Industries; Martin Bionics Innovations, Oklahoma City; Ottobock, Duderstadt, Germany; and Blatchford, Basingstoke, England—when they've needed help with a specific patient, says Jeffrey Ropp, CP. "Many times, they have given away components for causes for patients who cannot pay or needed something special," he says.

[caption id="attachment_249331" align="alignright" width="367"] From left: Zoila and Caty help Marco with gait training at a ROMP clinic in Guatemala in June. Photographs courtesy of ROMP Global.[/caption] Ropp and his staff helped a man with an amputation in Senegal, West Africa, who has a family member in Michigan. Ropp worked with the patient's physician in Africa to get measurements, then contacted vendors for assistance. "They helped with the project, and when we were finished and had the final prosthetic components and prosthesis, [the family member] took it to Senegal, and from what we understand everything went very well." LFL clients receive prosthetic care through a nationwide network of clinics, says Lucy Fraser, executive director for the nonprofit, which receives and recycles donated prosthetic components that have been dismantled by volunteers. LFL is able to do the work it does because of the donations it receives from O&P suppliers such as ALPS South, St. Petersburg, Florida, and WillowWood, Mount Sterling, Ohio, who regularly replenish LFL's stock with donated liners, Fraser says. In 2018, LFL received more than 7,800 prosthetic parts from 283 donors in 41 states. Parts were distributed to people with amputations in 28 states and 23 countries. One of those beneficiaries was the Mongolian sitting volleyball team, which was part of a United States Department of State initiative to empower women around the world, Fraser says. "Five of the 11 team members were amputees," she says. "Through translators, we realized that most of our prosthetic components were a vast improvement over what the women were wearing. With the help of a volunteer prosthetist, each amputee left with the parts needed to assemble a new limb." ROMP is an international nonprofit with a mission to provide high-quality prosthetic care to people with amputations in the Western Hemisphere who face barriers to accessing this human right, says Jonathan Naber, chief program officer. In the 15 years since ROMP was founded, nearly 3,000 prosthetic devices have been delivered to people with amputations in Guatemala, Ecuador, Honduras, El Salvador, Mexico, and Belize, among others, Naber says. Through its Components for a Cause (C4C) program, ROMP works with numerous prosthetic companies nationwide to collect new and gently used components that keep its clinical operations in Guatemala and Ecuador well stocked to provide care on a continuous basis, Naber says. Some of its key C4C contributors include Ability Prosthetics & Orthotics, Exton, Pennsylvania; Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan; Bulow Orthotics & Prosthetics Solutions, Nashville, Tennessee; and Scheck & Siress, Oakbrook Terrace, Illinois. "ROMP also works with these companies as well as nearly all of the O&P schools in the United States to bring clinicians to the field to serve with ROMP through it many volunteer programs throughout the year," Naber says. No Secret Formula Most practitioners say they don't use a sliding scale when it comes to charging a patient for prosthetic care, but they will work with them based on their ability to pay. Almost any client who doesn't have the ability to pay is considered for care on an individual basis, clinicians say.

"If we are at a point where we can assist someone who needs prosthetic-related help, we would thoroughly evaluate their situation and speak to them to understand their physical condition and potential to use a prosthesis if they are not already using one," Simpson says. "We also try to evaluate them to see if they are ready to make the commitment to put in the work necessary to become a successful prosthetic user. We try to determine if they have all the necessary attributes to help ensure a good outcome."

Randall Alley, BSc, CP, CEO, biodesigns, Westlake Village, California, says some components may be chosen more carefully with an eye on a patient's cost and capability for care, however, "our level of attention to detail on everything else remains the same.

"We do not downgrade our service level based on our patient's ability to pay," Alley says.

Orthotech will set up payment plans for its patients, Sauvola says. "Mike considers each request on a case-by-case basis and if for some reason we are not able to help them, then we reach out to our other partners."

Kevin Burton, CPO, Prosthetic & Orthotic Group of Northern Colorado, Fort Collins, says he will often discount a device if there is no insurance or insurance doesn't cover the device. "It's an option," he says. "It allows the person or family to be able to purchase a custom device that they may not otherwise have afforded."

[caption id="attachment_249332" align="alignright" width="383"] Sergio shows the homemade prosthesis he used prior to receiving a prosthesis from ROMP.[/caption] POP Prosthetics tries to help as many patients as possible. "There's no secret formula other than a patient being nice," Colson says.

Ropp Orthopedic will often supply components to patients who can't afford them. "It's when they're on a lower paying insurance but are active enough that they really need more than what the insurance will pay," Ropp says. "In these cases, we inform the patient and receive a prescription for the better item, then give them the components they need." Ropp says this happens primarily with Medicaid patients and his younger patients who can't be highly active with the lower cost Medicaid-paid components.

When to Say No (or Not) About the only time practitioners will decline a philanthropic request is when the patient's health or diagnosis would inhibit him or her from moving forward.

"I can't fulfill a client's request if I feel it's an inappropriate request, or I don't feel comfortable working on a device that might not be safe for that person," Burton says. "Today, liability is an issue. I do not want to put anyone in a position that they might get hurt or injured because of something I did."

Ropp concurs when it comes to legal issues. "There are some things we will not do because of the legal situation," he says. "The other problems are when they ask for something that may do harm to themselves or others from what we could make for them. That's when we say we just cannot help."

For Colson, it comes down to a patient's demeanor and sincerity. "Honestly, if someone is nice and sincere, we'll do our best to fill most requests," he says.

LFL wants a no to be the last option for those with amputations, Fraser says. "Rather than saying no, we provide information and referral to those amputees who may have access to prosthetic services through a state or private agency in their geographic area." In 2018, LFL responded to more than 1,400 information and referral requests from those with amputations nationwide, Fraser says.

One of the services that biodesigns is unable to provide revolves around standard of care (SOC) sockets, Alley says. "Because I feel strongly that such designs are damaging to patients over the long term, I have turned several patients away who were interested in traditional, ischial containment sockets," he says. "For those requesting SOC sockets that answer is simple: I care too much for their quality of life and well-being."

Dream Team Prosthetics will refer patients to other organizations and foundations that are established to help fund such prosthetic needs, Simpson says. "We've also had clients use GoFundMe and crowdfunding to raise funds to be able to acquire high-tech prosthetic devices," he says.

The Little Things It's not always about the money.

For a patient, almost nothing can top receiving a device for little to no cost. The outcome is also often immeasurable for practitioners.

Burton once made a protective mask for a young soccer player. "At the time I didn't think much about it, only that it was made properly," he says. "Afterward I received a thank you note from her stating how well it worked and that she was able to play because of it. I was just doing my job, but to her it was the chance to play in the championship game."

Ropp has made prosthetic devices for patients who can't afford shoes to go with them. "We'll buy shoes for them and bring them along," he says. "They like the prosthesis because they can walk again, but they love the shoes because they look great."

Alley once made a bilateral cable-driven humeral device for a young man in Vietnam. "I took the case because I was so inspired not only by this young man, but also by the individual in the United States who was sponsoring him," says Alley, who made the prostheses, a unique design that included an open-framed interface that maximized the heat dissipation to accommodate the tropical weather and would also allow the man the ability to grow into them over several years. "Months later, I was sent a picture of him riding his bicycle through the village with such a big smile on his face that it absolutely melted my heart," Alley says. "What I saw still affects me to this day."

For Bugg, taking the time to respond to patients after hours as well as celebrating their milestones is one way to support them. "I remember once receiving a text from a bilateral amputee at nine on a Saturday evening telling me she had gone up and down her stairs for the first time in three years," he says. "Philanthropy isn't always about giving something away of monetary value. You can't put a price tag on listening or your time."

Getting Involved Getting involved can make the biggest difference for someone with an amputation—and it may be as easy as looking in the stock room.

"Send us your inventory overstock," Fraser says. "The old prostheses patients leave behind, that supply of short three-ply socks that are abandoned in your stock room. When you give a little, it can make a big difference in an amputee's life."

Help when you can, Ropp says. "We have all needed a little extra from time to time," he says. "And when you do, it may make a difference for not only that person, but for all those who are part of their world."

NONPROFITS O&P businesses and facilities also partner with nonprofit organizations such as the Range of Motion Project (ROMP) and Limbs for Life Foundation (LFL) to provide prosthetic componentry to those in need in the United States as well as in less resourced countries.

LFL clients receive prosthetic care through a nationwide network of clinics, says Lucy Fraser, executive director for the nonprofit, which receives and recycles donated prosthetic components that have been dismantled by volunteers. LFL is able to do the work it does because of the donations it receives from O&P suppliers such as ALPS South, St. Petersburg, Florida, and WillowWood, Mount Sterling, Ohio, who regularly replenish LFL's stock with donated liners, Fraser says.

In 2018, LFL received more than 7,800 prosthetic parts from 283 donors in 41 states. Parts were distributed to people with amputations in 28 states and 23 countries. One of those beneficiaries was the Mongolian sitting volleyball team, which was part of a United States Department of State initiative to empower women around the world, Fraser says. "Five of the 11 team members were amputees," she says. "Through translators, we realized that most of our prosthetic components were a vast improvement over what the women were wearing. With the help of a volunteer prosthetist, each amputee left with the parts needed to assemble a new limb."

ROMP is an international nonprofit with a mission to provide high-quality prosthetic care to people with amputations in the Western Hemisphere who face barriers to accessing this human right, says Jonathan Naber, chief program officer. In the 15 years since ROMP was founded, nearly 3,000 prosthetic devices have been delivered to people with amputations in Guatemala, Ecuador, Honduras, El Salvador, Mexico, and Belize, among others, Naber says.

Through its Components for a Cause (C4C) program, ROMP works with numerous prosthetic companies nationwide to collect new and gently used components that keep its clinical operations in Guatemala and Ecuador well stocked to provide care on a continuous basis, Naber says. Some of its key C4C contributors include Ability Prosthetics & Orthotics, Exton, Pennsylvania; Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan; Bulow Orthotics & Prosthetics Solutions, Nashville, Tennessee; and Scheck & Siress, Oakbrook Terrace, Illinois. "ROMP also works with these companies as well as nearly all of the O&P schools in the United States to bring clinicians to the field to serve with ROMP through it many volunteer programs throughout the year," Naber says.

Betta Ferrendelli can be contacted at betta@opedge.com .

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