Research in Action – How NIDILRR-Funded Research and Development Shape Policy

On February 15^th, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a memo proposing that power seat elevation equipment on certain powered wheelchairs be covered under Medicare benefits as Durable Medical Equipment. The public is invited to comment on the proposal through March 17th. The proposal comes after significant research by CMS as well as public comments on the benefits of this type of equipment for people who use powered wheelchairs, including reducing shoulder injury and fall risk from transferring in and out of a chair. That research included significant contributions from several NIDILRR-funded centers and projects, which are cited throughout the memo. Studies, reports, and reviews from the NIDILRR-funded University of Pittsburgh Model Center on Spinal Cord Injury, the Northwest Regional Spinal Cord Injury System, the Rehabilitation Engineering Research Center on Spinal Cord Injury, the Rehabilitation Research and Training Center on Secondary Conditions in Spinal Cord Injury, and the fellowship on Enhanced Remote Data Logging for Electric Powered Wheelchairs were all cited to support the proposed change.

NIDILRR-funded research and development has provided the evidence base for several policies, guidelines, and regulations over the years:

• Research from the Rehabilitation Engineering Research Center on Accessible Medical Instrumentation became part of the Accessibility standards for medical diagnostic equipment. These standards address barriers to exams, screenings, tests, and other medical care, including setting the height of adjustable transfer surfaces and specifying grab bars and grip surfaces.
• The Web Accessibility Initiative was funded in part by NIDILRR beginning in 2000, and their work has significantly influenced laws and policies ensuring the accessibility of websites, kiosks, multimedia, and much more. These include Section 508 of the Rehab Act, which requires Federal agencies to provide individuals with disabilities equal access to electronic information and data comparable to those who do not have disabilities, unless an undue burden would be imposed on the agency.  
• The Rehabilitation Engineering Research Center on Interactive Exercise Technologies and Exercise Physiology for People with Disabilities (RecTech) worked with industry to develop Universal Design of Fitness Equipment Standards which establishes requirements for the design and manufacture of fitness equipment intended for use by people with disabilities to exercise safely. RecTech continues to study barriers and solutions to implementation of these standards with industry.
• Research from the project Making In-Flight Communications and Entertainment Accessible resulted in recommendations for standards integrating closed captioning for video and audio, descriptive narration, and audio navigation for the entertainment systems and announcement systems on board aircraft.
• The Rehabilitation Engineering Research Center for Inclusive Wireless Technologies regularly provided evidence-based input to the Federal Communications Commission and other regulating agencies on policies and standards for wireless communications, including into its Wireless Emergency Alert Second Report and Order (PDF), specifically requirements to preserve alert messages on mobile devices.

These are just a few examples where NIDILRR-funded research and development have impacted policy, guidelines, and standards which support the full participation of people with disabilities in the community. In many cases, comments and research were submitted during public comment periods, like the one currently open for the power seat elevation coverage. We previously wrote about sharing both professional and lived experience in advocating for policy change in our Spotlight blog. Have you sent in public comments, contacted your policy makers, or participated in other advocacy efforts? Share your experience and tips in the comments below!