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Summary
In this episode of CareLab, hosts Emilia Bourland and Brandy Archie speak with Justin Oakley, co-founder of Oakley Home Access and an occupational therapist. They discuss the importance of proactive home modifications to support aging in place, highlighting how accessibility solutions can prevent falls, reduce healthcare costs, and improve quality of life. Justin shares insights on the intersection of occupational therapy and home construction, the financial burden of reactive modifications, and strategies for securing funding and legislative support.
Key Takeaway
- Proactive home modifications (e.g., grab bars, ramps) cost significantly less than reactive modifications after an injury.
- Falls are costly—a single hospitalization can cost $35,000, while preventative measures may cost as little as $1,200.
- Funding sources exist but vary by state—Centers for Independent Living and disease-specific organizations often provide grants.
- Legislative advocacy is crucial to expanding financial support for home modifications through Medicare and state programs.
-
Collaboration between OTs and contractors ensures that home modifications meet both medical and structural needs.
Transcript
Emilia Bourland
Hey everyone, welcome to Care Lab.
Brandy Archie, OTD, OTR/L, CLIPP
am so excited that we are here today and we have Justin Oakley with us. This is gonna be so full of good information for you guys. Justin is the founder of Oakley Home Access, which is a fuel service home accessibility equipment company. You know I love that. It specializes in installation of products including, but definitely not limited to things like grab bars and ramps and stair lifts and barrier free showers and elevators. Yes, you can have elevator in your house.
Their core values include a jam place and fall prevention and increasing accessibility and an in-house occupational therapist begins this process with a free home safety assessment and then their in-house certified installation technician is completely agreed upon projects in a timely fashion, which is really key because sometimes contractors use lot of subcontractors, which means it might be challenging to make sure you're getting
repeatable high quality across all the jobs. And so they also know that funding is a challenge sometimes and have some funding programs and some financing options available. so Justin is also an occupational therapist and a wealth of knowledge. And so since he's a mashup of OTA and contractor, we're so excited to have you on the show today. Thanks for joining us.
Justin Oakley
Thank you so much, Brandy and Amelia. I appreciate you guys.
Emilia Bourland
Yeah, we're really, really always pumped to have another occupational therapist on the show. And I think I'm very excited in particular to hear what you have to say and really pick your brain about, you know, what you're doing and how you're doing it, because I think you're solving a bunch of problems in a really, really unique way. So can't wait to can't wait to pick your brain on that. But first, we always start with an icebreaker question. And Justin, we didn't tell you this earlier, because I forgot to. But
Justin Oakley
Okay.
Emilia Bourland
you have to go first for the question. So, but this one's it's not too bad. It's kind of a softball. Are you ready for it? Okay, so what is one thing that you do every day that helps you to like relax or wind down or just like draw the day to a close?
Justin Oakley
I'm ready, I'm ready, yeah.
Justin Oakley
That's a great question. We got some long days in this business. I would say it sounds a little silly and simple, but breathing is what works for me the most. So like deep belly breaths, the Wim Ham breathing techniques, super deep breathing, belly breathing, inhaling, exhaling for longer.
getting all that carbon dioxide out is just a great way for me to kind of focus. It's usually, you know, on my drive home, you know, before I go to the wildness of the family and the great wildness of the family. But just like a sense of calm, you know, before I get out of the truck to enter the circus is just really something that I try to do every single day to get myself focused. yeah, and then chase the kids around at basketball practice is always fun too.
Brandy Archie, OTD, OTR/L, CLIPP
Mm.
Brandy Archie, OTD, OTR/L, CLIPP
you
Justin Oakley
Okay
Brandy Archie, OTD, OTR/L, CLIPP
Boom, exactly. We just started basketball practice too in our house with my five-year-old and my seven-year-old. So it's the first season playing.
Justin Oakley
Nah.
Justin Oakley
Nice, I am steamy!
Emilia Bourland
that's so exciting. they having fun?
Brandy Archie, OTD, OTR/L, CLIPP
They're having a blast. We have our first game on Saturday. So yeah, they're having a good time. That is a awesome way to transition. I like to do that too in between sections of the day. you know, we're in the same trenches right now, Justin. So work and then morning time, get them to school, breathing, work, breathing, get the kids back. But the thing I'll focus on is, cause you kind of mentioned like end of the day. And I like to make sure that
Emilia Bourland
That's awesome.
Justin Oakley
Yep, yep.
Emilia Bourland
Hahaha.
Brandy Archie, OTD, OTR/L, CLIPP
I don't go to bed right after the kids go to bed. So no matter what it is I do in that little bit of time, I need my little bit of time to just like do something that only I need to do for myself and then go to sleep. So yeah.
Justin Oakley
yeah.
Justin Oakley
I like it. I've been trying to teach myself how to play the guitar and although it's not the greatest, it's something and that helps keep my mind at ease too and calm me down after the kids are asleep, for sure.
Brandy Archie, OTD, OTR/L, CLIPP
Hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland
I think it's so good to just have something that is not work or stress related that you can focus on. Like learning to play an instrument is such a good example of that. It's not even necessarily about like, I mean, obviously you wanna be good, but it's not even about being good in that moment, but you have to be like deeply focused on it. And I think that that is super, super helpful for de-stressing. That said, that's...
Justin Oakley
Yeah.
Justin Oakley
Yeah. Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland
I think that's wonderful. I wish I were learning to an instrument. I'm not. That's not my answer.
Justin Oakley
I never thought I would. I don't have that type of brain, but it's like you said, if you really focus, it allows yourself to kind of free your mind almost and just free everything else. And then once you are attacking everything else, it's with a clearer mind, I find.
Emilia Bourland
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland
And I think like, same thing as breathing, when you're doing something that requires both your mental focus and your physical focus, it like doubles those effects, I really think. Mine is really simple. just, right before I go to bed, I have to have a cup of tea every day. And it's like making the tea and then like I'll sit and drink the tea in bed. And sometimes I'll only have honestly, like four or five sips. then I, but it's the-
Justin Oakley
But it's process. It's the process.
Emilia Bourland
It's exactly it's like that sleep hygiene process for me that just tells me that, okay, it's, it's okay to let everything go, it's time to relax. And there's also just something that's so comforting about a nice hot cup of tea. I don't know. Just does it. Totally, totally. Okay, so let's dive in here with the important questions though.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
Yeah, it gives the body permission to relax, you know? Yeah, I love it.
Brandy Archie, OTD, OTR/L, CLIPP
That's true.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Emilia Bourland
I'm gonna start because I have many questions burning on my mind, but the first one that I have for you, Justin, is which came first? Were you an OT first or a contractor first?
Justin Oakley
So certainly OT, no question about it. To polish my title a little bit, I'm a co-founder is what I'd rather say. It's really a yin and a yang relationship. Our organization is literally nothing without my partner, Michael Vieira, who at the core of it and foundation of everything is the contractor. So.
When, so that's the answer. Certainly OT, when we created the company, the need was identified because I was practicing as an occupational therapist in a skilled nursing facility right down the street from our now showroom. And we would work so tirelessly with all the other disciplines and providers to get folks home. That was the goal. We'd create intimate relationships with folks.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland
Mm-hmm.
Justin Oakley
And the main goal would be to say goodbye and to not see them again. It would be bittersweet. Folks would come in on a stretcher and we'd be watching them walk out teary-eyed for the best. And you never know if someone was gonna be there for a couple days. Someone our age with a nasty knee replacement turned infection and no help at home. They're there for a few days and we're working them to get home and they wanna...
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
fight like heck to get out of there. And then you have folks that roll in in there on a stretcher and you know someone still could be our age and nasty CVA and they're going to fight like heck, but they're probably going to be there their entire hundred days. they may be meeting goals and progressing hundred days, but the main goal always for those folks was to get them home. We knew sometimes they did move to the other side of the building into long-term care.
Emilia Bourland
Mm-hmm.
Emilia Bourland
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
And that's okay for some folks, but most folks coming into that short-term side, their goal is home. And we would provide home evaluations through Medicare. And we would take, that opened my eyes to this entire company, this entire opportunity in the community. We would take folks home, they'd have to promise to return to the facility. And that's That's a challenge. They get back into command central and in that
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland
you
Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
They don't want to go back to the facility. So we take them through the processes up and down from all the seated areas. Where are you going to perform your ADLs? Where are you going to perform your leisure activities? We would get valuable information from those. I would write prettiest reports. I got really good at writing reports. I'd make it rain with recommendations. Social services would have recommendations. The family would have...
Emilia Bourland
.
Emilia Bourland
you
I you.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
recommendations, the patient and herself, his self would have recommendations. And it was about a year going into this of just really getting good at telling folks what they could do, should do, or unfortunately sometimes needed to do to take a safe transition home. So after about a year of getting really good at these and really encouraging our facility to perform these as much as possible, I went to my social service director and I said,
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
You know, I've never I haven't thought enough about it. What happens with all these recommendations? I write beautiful words. And, know, we I don't want to minimize the results of them because we would bring the reports back and set the therapy mat to the right height of that the bed was going to be. We would simulate a grab bar being where they could put a grab bar next to the toilet. We could do some things and have some fun, set up a.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-mm.
Emilia Bourland
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Yep.
Justin Oakley
tub transfer bench situation where they could see if they can get over the tub wall. Some fun stuff could emerge. We'd know how many stairs they'd have to navigate. So the faux stairwell could work. But aside from that, it was the how is this stuff gonna get done? So her answer is why I'm here. It's why you've invited me onto this show today. And I'm blessed and honored to be on the show and to be involved in this industry. She said,
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
We kind of hope they have someone handy in their family. And I got the shivers right now. It's a hundred percent hit rate for me. My jaw dropped. It was the aha moment. And I said, why haven't I not thought of this before? That service. And I said, to no fault of your own, Christine, I said to her, there's just, it seems to not be resources out there to do this. Not only make the recommendations like,
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
The three of us in this room can make very well and targeted, but we can't either liability wise, which was the case in the nursing home for me. And more importantly, skill wise, I didn't have the skills. You may, you may, but I did not have the skills. No, I wasn't allowed to start working on folks as homes that were my patients. So.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Mm-hmm.
Emilia Bourland
Thank
Emilia Bourland
No, I don't have those skills.
Brandy Archie, OTD, OTR/L, CLIPP
Hahaha!
Justin Oakley
It just, was the aha moment. And I said, that's a disservice to no fault of your own. I want to change that. I want to create an organization that not only makes the recommendations, but is actually able to do the work. Now it started off with the grab bar on the shower wet wall, the plumbing wall, which is the transfer grab bar is what we call in and out of the space was the thing that everyone asked us the most during the evaluations when they entered the facility.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
It's on our report. We'd have to check the box. Do you have grab bars in your bathroom? Folks would say, no, how do I get one? I don't know. Would be for a long time, but I'd tell them they need one. Yep. So it was just a disservice. There was one person in my life and my network that I knew was the only person I could reach out to for this. Cause it's the person in my network, my life since we were in, I point because it's
Brandy Archie, OTD, OTR/L, CLIPP
But you need one.
Emilia Bourland
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
A quarter mile down the road is Adventureland, which is a family fun center with go-karts and mini golf and batting cages. Michael and I worked there together. It's where I met him when we were 15 years old. And he was the that fixed the go-karts and made them work even at that young age. And I was the guy that messed around on the megaphone and messed with the safety talk at the beginning and had fun with all the clients.
Brandy Archie, OTD, OTR/L, CLIPP
wow.
Emilia Bourland
Thank
Brandy Archie, OTD, OTR/L, CLIPP
You
Justin Oakley
Now here we are. What's 15 and so on? Yeah, so 15 minus 43, know, 20 odd something years ago, here he is leading our team of 20 individuals that are actually doing the things and installing, putting things in the community. And here I am talking about it.
Emilia Bourland
You were already comfortable in your roles advising and making safety recommendations and hands on fixing things.
Brandy Archie, OTD, OTR/L, CLIPP
Eh.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
And I say that lightly, we educate and we create a lot of relationships and we share with solutions to problems that they didn't realize they had or didn't realize they were a solution to. Every day, folks say to our assessors, they say, why didn't I think of that? Builders, adult children, why would you? Exactly. You didn't need to. It didn't matter how many stairs you had, two, three, four, six, who cares?
Brandy Archie, OTD, OTR/L, CLIPP
You ain't never had needed to. Yeah.
Emilia Bourland
Okay.
Brandy Archie, OTD, OTR/L, CLIPP
You can do them!
Justin Oakley
You're going up like blindfolded with three things in your hands until you fracture your hip, until you become 89 instead of 79, and you're grabbing on to the hedges on your way up the stairs. And you realize you don't have a railing. So we created a company that we based it, the foundation of it is all that free evaluation that Medicare allows for the
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland
you
Justin Oakley
skilled nursing facility or hospital setting. Checking out the home, full assessment. We don't charge a penny for it because we know if we charged one dollar, we'd be in less bathrooms. And I want to be in every bathroom. I want to see every toilet. When you look at my phone and you search, can search the photos based on words now. You see toilet. There's 5,000 photos of toilet.
Emilia Bourland
Thank
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland
So, thank you.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
We want to see every toilet. The only thing folks pay for is the work that's actually done. know, folks will take our assessment and have their loved ones do some of the work. They can take our assessment, go get the tub transfer bench. I'll show them the link on Amazon, how they can save money, get it themselves. I've educated you about it. I know you can't get the modular ramp yourself or the stair lift yourself. Go get the tub bench yourself.
Emilia Bourland
Yeah.
Emilia Bourland
Thank
Emilia Bourland
Thank you.
Justin Oakley
Get the mobile showerhead yourself if you can install it. Some people can't, so we offer full service, of course. But the main thing in the model that we love is that, like you are so excited to talk to me as an OT, we are so excited to talk to you as OT. We speak the same language. We are on the same page about the plight and the journey. At any time when someone calls us or a loved one calls on behalf of someone, we know.
Emilia Bourland
you
Justin Oakley
the healthcare journey that they may have been on. You we educate our whole team about the different roles in healthcare and the different journey that an individual may be on until they found our way. Maybe their primary care told us about us, that's the best, or senior center because they go and play bingo there. That's ideal. Unfortunately, oftentimes it's the hospital skilled nursing facility that's discharging someone's home and something's already happened. So more productive.
Emilia Bourland
and that's what we're going do.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
But that's why we created it as the reactive stuff. Now we might be up to around 10 plus percent of proactive calls. Folks looking for... It's really good because it's because of outlets like this. It's education, making grab bars cool. You know, I want to make grab bar stairless ramps a commodity like a refrigerator, a microwave.
Emilia Bourland
Okay.
Brandy Archie, OTD, OTR/L, CLIPP
that's really good.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Justin Oakley
and good pair of sneakers.
Emilia Bourland
Stop making accessibility cool, making accessibility the norm instead of the exception.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah!
Justin Oakley
What you want? Yep. I don't want to be picking up on Johnson. I want Mr. Smith to say, yeah, yeah, neighbor, yeah, I got a stairlift because I'm staying here. I'm not moving to a facility like you might. I got a stairlift. Not, oh, I have to have a stairlift. That means I'm less than now. You're
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland
Mm-hmm. Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah. Yeah.
Justin Oakley
You got yourself, you know a guy who knows a guy who knows a girl who got you this little chair that lets you stay at home. That's the win.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm, and look how it looks and I got the top of the line what you got over there This is what we need to be doing comparing those kinds of things not just our lawns
Justin Oakley
Good to myself.
Emilia Bourland
Mm-hmm.
Justin Oakley
We've been not hiding this stuff from the Johnson's. So we work all day to talk to health care providers and to talk to adult children on how to talk to their loved ones and their patients. Not you need this. It's this could help you live more comfortably and convenient here in this hall. You know, mom, what's a
Brandy Archie, OTD, OTR/L, CLIPP
Yep.
Justin Oakley
What's big, I know the chair in the hallway is a change. What's the bigger change? Putting that chair there or moving everything you own, everything you have here and going to another facility? What's the bigger change? And then we say, tell them this, use strategies. Tell them it's not for you, mom. I know you're fine. It's for me. Give me peace.
Brandy Archie, OTD, OTR/L, CLIPP
Yep, gotta put it in those terms.
Emilia Bourland
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
So I can sleep at night if let these guys put in these few grab bars. I'll sleep at night much better. I know you don't need them Do it for me mom and that's
Emilia Bourland
love that. I love that.
Brandy Archie, OTD, OTR/L, CLIPP
That is such a good strategy.
Justin Oakley
Yep. Yep. And we tell folks, you're not alone. Mom doesn't want the stuff because she's grown up in an age where that is a stigma. And your goal and your goal is to break that down with me. So kudos for having these outlets because these outlets are what is going to change, change things.
Brandy Archie, OTD, OTR/L, CLIPP
You said something really important. We said a lot of really important things, let's start there. something that I think is interesting, I have ideas about, but let me, if you compare the job that you do for somebody who's leaving a skilled nursing facility to the job that you do for somebody that's one of those 10 % proactive, what differences do you notice? Is one cheaper than the other? Do you end up doing less on one thing than the other? Talk about how that is.
Emilia Bourland
my gosh, that's such a good question.
Justin Oakley
You're talking easily, depending on what happened and baseline, that same individual proactive call, cause they called us cause they saw our rat card at the senior center or saw us talk at the center versus the OT or PT at the nursing home gave us the card because of the fall and the fracture.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
You're talking about a $1,200 experience versus a $12,000 experience. Easy. That proactive call, we're talking about two grab bars in the shower and one next to the toilet. We're talking about a mobile shower head and maybe just the fact that a tub transfer bench exists, but like those grab bars are going to get them over if they're calling us in a proactive situation. There's also very simple shower chairs.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
that can be waiting for the individual in the space. There's now, and now everything I just mentioned is what we had called, we still call it the conservative approach, a conservative remodel. It will look all different space. another couple hundred dollar thing. Removing the glass shower doors and putting a curtain. Yeah, that gets me excited too. Curved curtain rod. They're not the plastic moldy shower curtains.
Emilia Bourland
yeah.
Brandy Archie, OTD, OTR/L, CLIPP
Woo, yes.
Emilia Bourland
Yeah.
Justin Oakley
that you remember that everyone pictures when they... When you say, I'm saying, no, no, don't picture the moldy shower curtain that you have to throw away every two weeks. They're now polyester that you can put in the washer and dryer if you don't like the soap buildup. They're fabric-y now. And of course on the outside you can get any pattern, any beautiful thing you'd like. Curved mounted rod gives you that hotel swanky feel look. It's... When that curtain...
Emilia Bourland
No, you have to get beautiful shower curtains now. Beautiful.
Brandy Archie, OTD, OTR/L, CLIPP
That could be beautiful, yes!
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Yep.
Justin Oakley
goes to the side though, it's that for accessibility. It's wide open. I could talk all day. We could do a whole show about glass doors. It's every month we look at our traction on our website. For some reason, it's our blog post about the dangers of glass shower doors that just hits way harder than anyone. I feel like therapists might direct patients to that.
Emilia Bourland
Okay.
Emilia Bourland
We honestly could, maybe we should sometime because...
Justin Oakley
they're talking about. So that being said, that conservative approach I just mentioned, re-grab bars, mobile shower head, seat, and a curtain replacing the grass door, you're looking at less than a thousand dollars, plus we were talking about funding. Now, say there's a nasty fall, and also if you want to add on that conservative approach a tub cut to drop it into a walk-in shower, another thousand dollars, now you have a walk-in shower six inches high instead of
15 inches high. So let's generally the proactive calls, they're done. They'll have options for down the line if they, and then handrails on the stairs to get a couple hundred bucks complimenting the banister that they already have. We see the fingerprints on the wall. those are the clues. They do my job for me. A couple hundred dollar handrail. Okay. That's now that's the silver sneaker proactive found out about us at the YMCA.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
on the stairs.
Emilia Bourland
Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
Yes.
Justin Oakley
or primary care provider. Awesome. During an annual checkup. Now, the majority of our clients tell that same individual, but didn't make the call. And then they fell. They're at home or in the community. Fracture, emergency room, surgery, rehab, hopefully home. Right?
Brandy Archie, OTD, OTR/L, CLIPP
That's so key. Hopefully home. You already have the risk of not even being able to go home. Mm-hmm.
Justin Oakley
Hopefully.
Emilia Bourland
Yeah.
Justin Oakley
During that rehab process where I was there, I lived it, we're engaging with the family, looking at the home, getting information, sharing information with the rehab team. So it's more of a process. We don't see the person function. So we rely and it's no problem. It's great collaboration because we speak the language. We talk to the either adult child, spouse, neighbor, best friend that
welcomes to the slum and shows us around. We then create targeted questions to bring back to rehab.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
How wide is the wheelchair rim to rim?
Emilia Bourland
Mm-hmm.
Justin Oakley
device are they going to be using? What supervision or assist level are they going to be for transfers? It all matters. Now, to get that person home, potentially a ramp, that could be, if there's one step, it could be a thousand. If there's five steps, it could be a $10,000 ramp, depending on where it needed to go. The beauty of our aluminum equipment is we can make it work anywhere and customize it. But you could, let's call it an average $5,000 ramp.
Emilia Bourland
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
Stair lift once you get inside to get up to the bathroom that we had put for the proactive gal, we put $150 handrail. This is going to be a $3,500 stair lift. Up to $4,500 if they want the stair lift. If it's a stair lift, thank you.
Emilia Bourland
if it's a straight lift. And that's if it's a straight lift. If it's not a straight lift, if you have a landing or a curve that you got to get around like all bets are off.
Brandy Archie, OTD, OTR/L, CLIPP
Yes.
Justin Oakley
Now you're starting at 15,000 and we make the track like DNA. We take the survey, it goes to manufacturing. In the first case with a straight, like you said, Amelia, that was great, great point. Straight, we're there the next week installing it. No problem, we're there for three hours, no problem. We do it all day every day. We have 20 of them right here in the warehouse. But if it's curved, Amelia, to your point, we come back in four to six weeks.
Emilia Bourland
huh.
Justin Oakley
when the manufacturer creates that lift. So that's very often, but let's call it a straight lift to go easy on this reactive consumer. I mean, she just had a stroke, so let's go easy on her, So wheelchair ramp, stair lift, we're at $9,000 now. That doesn't even get you into the bathroom. Now we start talking about the bathroom.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
you
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
Definitely you're talking tub transfer benches that there's a wide variety of them They're up to from $100 on Amazon to we have $600 tub benches that you know swivel Mechanical nature do the sliding for you We can remove the tub listen that tubs not happening we need to roll in we are now doing Hoyer transfers patient lift transfers We need barrier free
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Mm-hmm.
Justin Oakley
Sorry, that tub cut, it's not cutting it. Some folks had no pun intended. Some, it will, some it won't. So let's just go pure CVA, maybe right side hemiparesis for indefinite amount of time, right? Working on it, working on it at home, plateaued in therapy after a hundred days, you know? So barrier free shower, $14,000.
Brandy Archie, OTD, OTR/L, CLIPP
Ain't gonna cut it.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
So say we just did the conservative approach because the tub cut was enough grab bar. So that's a thousand dollars in the bathroom. You're at there's your ten thousand right there. We didn't talk about the bedroom, the hospital bed, maybe the railing. We didn't talk about the maybe power lift chair that they need recliner in the living room. So that that's easily a ten thousand dollar project without even going into the bedroom or the living room.
Emilia Bourland
Okay.
Justin Oakley
and then being conservative in the bathroom.
Emilia Bourland
And then can I also add on to that though? Let's say that the reason for this hospitalization and rehab stay was a fault or something preventable. It's not just a matter of the cost of the original preventative equipment versus the cost of what you're gonna pay afterwards. You also have to think about the cost of that hospital stay, the cost of that rehab.
Justin Oakley
Yeah. Yup.
Justin Oakley
course.
Justin Oakley
Yeah.
Emilia Bourland
And not just the financial cost, the cost to your welfare, your health, your quality of life. Like these are things that we can't actually put a price tag on. And so is 1200 bucks worth it to help prevent you having to go down that path at all in the first place? It's gotta be. We spent 1200 bucks on iPhones, man.
Justin Oakley
Right. Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
Yeah.
Justin Oakley
That's what we want Medicare to understand that 1200 bucks is worth it for their people. We've been told from our national membership organizations, oh, Brandy, VGM. We've been told by VGM for the viewers and listeners, a membership-based organization that advocates for our industry, home modifications. Is that fair to say, Brandy?
Brandy Archie, OTD, OTR/L, CLIPP
Exactly.
Emilia Bourland
Yep.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah, home access professionals. It's like a great resource for very qualified embedded home access professionals of which you can access through Ask Sammy.
Justin Oakley
Yes, of course. Now that group has educated us. They've helped us advocate on state levels for funding, and they've educated us that that's how we're going to get Medicare to listen. The more and more states that we check off that create funding programs that are saving the state millions and potentially billions of dollars is when Medicare will finally listen.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
So they think it's a waste of my time to go straight to Medicare. So I play on the state level now very, very hard. play on the state level. So that's our goal for funding. that $1,200 point, yeah, we think it's well worth the prevention of potential and the peace of mind. Gosh, Amelia, you brought up a lot with that, the more than the monetary value.
The statistics on falling are ridiculous, even past money. I mean, the money ones are a single fall that results in an emergency room visit is out of pocket around $7,000. But Medicare, it's around 35,000 that Medicare pays on average. Now, other than that, yeah.
Emilia Bourland
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland
So if any Medicare officials are listening right now, I just, feel like this is a pretty easy price comparison between 1200 versus 35,000. I feel like that's easy. Just if you're listening, sorry, continue Justin.
Justin Oakley
Slow hanging fruit.
Justin Oakley
Yes.
We can eliminate. No, if you can prevent a small percentage of that, it saves million, potentially billions of dollars. Commercial insurance companies are starting to see it was Blue Cross. I was fortunate enough to have a high level conversations with a benefit creator, meaning like a product creator for Blue Cross.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Justin Oakley
And he brought it to the finish line. said, he said it's not going to happen in 2024, meaning funding for stair lifts and ramps and things like that. He said it was close. He had some ears listening, but it didn't pass. It didn't finish. So he said it's a long term goal. So we're not going to stop. We're going to we're going to keep fighting and advocating. But as from a private pay standpoint, yeah.
It's quite the investment, small investment for what it could save. Emotional, you know, cost of falling. Folks are half as likely to enter a room or a space if they've fallen there. So that means they're likely to bathe if they've fallen in the bathroom. Half as likely to leave and go to parcheasy in the community if they fell leaving the house. Half as likely to go to doctor's appointments.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Yep.
Justin Oakley
because they fell leaving once and it's 20 minutes preparation to go down the stairs. So I mean we.
Emilia Bourland
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
It makes your life smaller. you know, like, think we skipped over something that I really want to highlight because we kind of already know this, but most people that I encounter think that this stuff is covered by insurance, even at least a shower chair or like, well, my insurance will give me a grab bar or something. And we're talking about this in terms of money because it is not covered by your insurance. It is not. I mean, you might have a few Medicare Advantage plans, like you said, that have a...
Justin Oakley
Yeah. Yes.
Justin Oakley
Right. First question.
Brandy Archie, OTD, OTR/L, CLIPP
a way to get a few pieces of equipment maybe, but overall stair lifts, lift chairs, these remodeled are not covered by 90 % of the insurance providers that exist in our country. And so that's why you really need to consider starting early. And the other thing, I wanted you to dive into a little bit about how you find some ways in your community to help with funding some of this. Cause I know people who can't really handle $1,200 to do the preventative stuff, right?
Justin Oakley
Totally.
Emilia Bourland
Mm-hmm. Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
And so, but if you knew that you could keep safe in your home by having this kind of equipment, you could start looking at what's available in your community to maybe pay for that because they're great services, but they often have long wait lists. so knowing now and being proactive and not waiting until something happens means that you can sign up for those wait lists and get into those programs. And you know,
Justin Oakley
Yeah.
Justin Oakley
Yes.
Brandy Archie, OTD, OTR/L, CLIPP
Use your $25 thing from your insurance company to get a grab bar out of that book and then find a son or somebody to put it in. You just need to know what you need to do though. That's the first thing you need to do.
Justin Oakley
Yep. listening to health care providers that are encouraging to simply learn about what options are out there really helps break down that barrier. Yeah, the funding source is big. We find it's on a state level and it's state by state, but we start with the Centers for Independent Living's have some programs, a lot of it's income based, but the folks that
are needing help with the 1200, they oftentimes will qualify. In Rhode Island, we're so fortunate to have a state grant that was in a pilot situation six years ago now, and it offers 50 % back for all the stuff we do. And when I found out about it, I screamed it from the rooftops. Like it's on us as healthcare providers to share it.
I went on a pilgrimage and shared it with all 100 facilities in the state, and I think three therapists had heard about it before out of the 100 I engaged with. So now it's a permanent part of our state budget. We believe we put a proposal in for them to use ARPA funds. So historically, every year, halfway through the fiscal year, they'd say, sorry, you used up the entire $500,000 budget.
Brandy Archie, OTD, OTR/L, CLIPP
That's great.
Justin Oakley
Well, that's great because we used the budget and we helped a lot of people, but there should be more money for it. We wrote a proposal for the ARPA fund money, which was, think Rhode Island had like two billion, which is small compared to other states, but it was plenty for us to use. I think they used a million or so of that fund to put towards our grant because two years in now since that we've never been told that we ran out of money and we use it.
way more than we ever have because we have more volume. So we're so happy with that. We encourage providers, healthcare professionals and home access professionals alike to seek funding through the state. All state government websites should have things listed on funding. Our website does a decent job of highlighting national organizations as well. Things like the MS Society, Parkinson's associations.
ALS United just rebranded. They used to be ALS Association. Now it's ALS United. Most chapters have funding, have ramp programs. In Rhode Island, it happens to be $1,500 they'll give you. For multiple sclerosis, it happens to be around $4,000 they'll give you. So we do a lot of work to ask a lot of questions about the individual to find funding from there. And anytime we find funding, we grab onto it and we find out how to access it.
how to apply, who to contact, and what you get out of it. That's the first thing we do when we find out about any organization. And it's healthcare providers like you that bring to our attention a lot of funding sources. So it's, we're all in it together type thing.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
So the moral of the story is, this is another really good reason why you should start now, because it might take you some time to find an organization that matches with what your needs, income level, diagnosis or whatever. But once you find it, you might be able to get some of those resources. And then like you mentioned Centers for Independent Living, there's one in everybody, no, there's multiple in everybody's state. There should be one in your community.
Justin Oakley
Well, where I guarantee, I guarantee we're the only ones with one in Rhode Island. Where this is. Well, even Massachusetts has about 10 of them. know, plant, you know, I'm sure in Missouri you've got to have handfuls now.
Emilia Bourland
Mm-hmm. Yeah, there should be one.
Brandy Archie, OTD, OTR/L, CLIPP
Right, Roller is not that big, but everybody else is staying.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah, we do have a handful in Missouri. So these resources do exist. It just takes work in order to be able to access them. And, you know, lots of different organizations are trying to simplify that. ASAMI is Oklahoma Access, which is not just in New Hampshire or in Rhode Island. It's also in Massachusetts and Connecticut are doing it. But this is just another push to tell you caregiver to try to take a look at what's available and starting with your state's website is great.
Justin Oakley
Massachusetts and Connecticut as well.
Justin Oakley
Absolutely, absolutely.
Emilia Bourland
And the only thing that I would add to that, because y'all have done like an incredible and comprehensive job talking about these things, is that if you're listening to this conversation and you're someone who, let's face it, we are all people who will need these things or benefit from these things in the future, call your elected representatives, like talk to them about these issues. Let them know that you care because you have power as a constituent to
Brandy Archie, OTD, OTR/L, CLIPP
Yes.
Emilia Bourland
you should have power to happens in legislation. And hearing this thinking wh or $35,000 for this. And I money going to waste or, it is that motivates you c and tell them what you th know and what you want. R are powerful things that
Justin Oakley
us.
Brandy Archie, OTD, OTR/L, CLIPP
Yes.
Emilia Bourland
whether or not you're a healthcare provider, like we can all do these things as Americans. So like let's get on the phone, send some emails, let's do some stuff people.
Justin Oakley
I love that. That is incredible advice because so often constituents think that they don't have a voice. But I'll tell you why the representatives and the senators care. They care because the constituent cares. Because the constituent votes and they like their spot in office. And especially a real pro tip that we found, it's the newly elected.
Brandy Archie, OTD, OTR/L, CLIPP
Yes.
Justin Oakley
official that want something to grab onto.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
sink their teeth into. Yes, that they can champion.
Emilia Bourland
Mmm. They want to make it an issue for them,
Justin Oakley
Champion it. Champion it. Be the voice. Add it to your platform that you care about the seniors. It's bipartisan. It's what's awesome about the grant that now it's sitting in for Massachusetts. This grant we were able to find a senator to have her legal team create verbatim the Rhode Island bill for Massachusetts. They switched out Rhode Island with Massachusetts. This was four years in the making.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
And this shows the power of senators and representatives that care. She cared enough to get it going, but it has not cared enough to champion it. She ended up looking back, she sponsored hundreds of bills, nothing against her, but it's sitting now in the ways and means committee. It's the last step, but it's sitting there because it needs someone to grab it and champion it and use it. And
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
be like.
Justin Oakley
It's the power of the people saying, hey, I care about this. I care about this. If you care about it, then they'll care about it. So that's how things change. When I was able to work through some, some very big roadblocks with Medicaid because Medicaid just doesn't understand our equipment and our, they want to reimburse us like we're dropping off shower chairs. They're giving us prior authorizations for installing hundred foot ramps.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
It's the same code as a general. Because I hadn't paved the way. I had to create it and get very, very close with the payers to say, hey, listen, this is DME. Let this be called DME, even though we know it's not. So state officials were very integral in getting me to the right table to say, hey, this is what we need the reimbursement rates to be, or else no business will be equal
Emilia Bourland
yikes.
Brandy Archie, OTD, OTR/L, CLIPP
Nobody's gonna get, yeah.
Justin Oakley
We physically won't be able to pay our payroll if we don't get reimbursed X for these jobs.
Emilia Bourland
And we rely on businesses in this country. We're a capitalistic society. like private industry is what steps in to do these things. It's not publicly done. So we have to make it feasible for people who are running businesses to do it.
Justin Oakley
Yep.
Justin Oakley
Yes, and we.
Brandy Archie, OTD, OTR/L, CLIPP
And can I give y'all a concrete example too of this? Like this just happened. Here's a, here's a, cause I know that everybody always says call your legislator and like, what does one voice do? Okay. Let me tell you literally just just happened. So in Kansas city, there's multiple counties that are in our metro area. Every county around the main county, which is Jackson County for Kansas city has a senior fund in which they've taken a little bit of property tax money and pulled it aside for seniors.
And they created an organization so that that org can decide how that needs to be best used for seniors. So seniors can then apply and they have varying levels of income restrictions. And then they can get varying levels of money to do home modifications and get transportation and have caregiving. Right. But Jackson County didn't have one. And in a matter of six months, a group of people, I'm talking like some business owners, some nonprofit owners and seniors.
got together to make a committee to push this effort. We got it on the ballot, the November ballot, the people voted for it, and it got passed. And that happened in a very short amount of time. And it didn't take a massive amount of people, and it was very collaborative amongst the kinds of people there. And the people who really pushed it to the finish line were the seniors that came to the hearing.
to say why this was important to have and to put onto the ballot so the people could vote on it. And then the people voted on it and they passed it, right? Because everybody has a senior, everybody's gonna be a senior. People wanna be supported when they get to that level. And so in a relatively short amount of time for politics, we were able to create funding in our county that is now going to be able to be used for Jackson County residents. So this is doable. And you could take that same playbook and use it. You should take that same playbook and use it in your own community.
Justin Oakley
thoughts.
Emilia Bourland
That's awesome.
Brandy Archie, OTD, OTR/L, CLIPP
Because you can say, at all these other counties that do this. This is how they do this, the people voted for it. Let's do it here.
Emilia Bourland
Yeah, that's awesome.
Justin Oakley
That's the power of politics if you know how to use it. Absolutely. I love it.
Emilia Bourland
So I know we're coming up to the end of our time. I have one more question that I really, really, and it's kind of a pivot, but I really wanted to ask you this, Justin, before we wrap up here today. And that is, I know you said like, so essentially you don't charge for the OT portion of what you do. However, it is really important that both an OT and a contractor be involved. And I would love for you to talk a little bit about like, why is that? Why do you need both?
of these particular parties to have an effective solution.
Brandy Archie, OTD, OTR/L, CLIPP
Mm.
Justin Oakley
From a business standpoint, the business climate, it's our differentiator. To be honest, it's what separates us from any equipment company. There are national ramp dealers. There is 1-800-STARELIFT. There are big corporate enterprises out there. It's the relationships.
with you Amelia and you Brandy. It's the healthcare piece that allows us to look at the whole picture. It's holistic. You're gonna love this. We'll never go into a home and look at a stairwell and say, ooh, look at how wide and straight that is. This is a perfect place for a stairlift. Wow, you got a power outlet right there too? Awesome, easy sale.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Justin Oakley
No, no, no. It's all about the person. The person wants to go upstairs. Does the person transfer from one chair to another? Does the person have upright sitting balance with a little motion? Let's call it dynamic because they're moving. I don't know. Are they home alone? And do they have the cognition level to operate a machine, a computer? I don't know.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland
Mm-hmm.
Emilia Bourland
Mm-hmm. Yeah.
Justin Oakley
I collaborate. speak the same all the time when I'm talking about our model and the why are you spending the time with a health care professional in the home? It's we speak the same language. We are telling the loved one, let's call it the spouse. It's often the spouse we're engaging with. Tell health care provider to call us and take the report itemized and call us out on that. They don't, he won't need this side.
grab bar on this side. Great. We want to prioritize what's on this list, not complicate it. We're trying to sell anything. We're trying to educate about what exists. We used to say for when we created the company, because it was, was, my mind was in the, the clinical field recommendations. We always said recommendations, recommendations. We've pivoted. We're providing options.
Emilia Bourland
Mm-hmm.
Justin Oakley
based on what we know about the person, what we've shared, what we've learned about the individual and how they operate. And we know for a fact on the equipment side, when we're giving it as an option that it will fit and that it will work structurally, then it's a collaboration piece. We're never gonna say you should have a stair lift versus a ramp. It's what do you think? These are the options based on what I know about you.
Emilia Bourland
Hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm.
Justin Oakley
And let's all talk about it. Let the family care, let the healthcare providers care. That's why we think it's imperative to have a CODA or an OTR in the home, engaging with the individuals, looking at the whole picture and identifying solutions that could potentially help them. It's imperative. I don't care if it's a single grab bar.
or a full home and it turns into an elevator. That first touch, that first education has to be a healthcare provider in our model because it's the yin and the yang. We're nothing without the other side. We're merely a construction company without the OT portion and we're merely, with nothing against it, but we're merely a consulting company without the construction side, but we're not.
We're all of it. And that's our power. And that's our differentiator against any other equipment company. That being said, outside of our territories, we'll refer those equipment companies because it's a good start. Great equipment. All of our competitors, great equipment. Good stuff. Good end result oftentimes. you're outside, I would send family. I've sent family members through VGM, vetted through VGM.
Atlanta was one of my aunt's move to Atlanta. Found them a contractor through VGM who did stair lifts. Now I don't know. They probably didn't have an OT at the house. Probably wasn't the same experience as us, but she got a stair lift because someone was unable to identify that she needed it. So it's a team effort. There's no right or wrong answer. Nothing against any company not using OTs, but I think it's pretty imperative. I think all the work you guys do is to show that
Us as clinicians are leaders in the construction space. And all of us leaders out here, I love LinkedIn because everyone, the Janet Ingalls of the world, the Brandy Archers of the world, from the roof, Cindy Petito's of the world, screaming about, educating about how, hey, we're here, we make a difference, we'll help you. We're making a big campaign to developers and builders because
Justin Oakley
on multiple occasions last year, we were brought into situations when if they had brought us in before the concrete was poured for the foundation or even before the walls were up in the framing, then let's just call it pure monetary, pure money. The developers would have had six places to offer elevators for their incoming clients.
Emilia Bourland
Mm-hmm.
Justin Oakley
Now those can be considered in the developer work add-ons like the $40,000 awning. They would have had six opportunities to sell elevators within the footprint. Now that we're introduced at this stage of development, they have one place. Each of those units, 60 units. And this is one example, one little developer. There's 60 units that they've built and where we've been introduced into the situation, now they have one spot in every unit that they can offer elevator. And if that purchaser doesn't want it there, they lost out on a $40,000 upcharge is how developers look at it. They want to sell them all the awning package. Now with us, they would have been able to have six spots for that thing, tucked away here, tucked away there. So we're making a big campaign for architects, developers, builders, designers to contact the OT. We don't cover everywhere. So the OT, in OT.
Emilia Bourland
Mm-hmm.
Justin Oakley
involved with home modifications before it's okay to have blueprints because you can change blueprints but before you start pouring or break ground let's say talk to us meaning not Oakley home access meaning in OT in ECHMP you know a clip a caps talk to somebody that that that lives it even though they don't have a hammers in their tool belt they get it you know you guys get it
So that's our push, that's our education. builders have been like, why didn't we reach out to you before we poured this foundation? I don't know, because you didn't know. And then the families say, when the homes, they say, why didn't we call you before mom had the stroke? Well, you didn't know, and we can only move forward. So let's move forward together. And platforms like this educate, educate, educate.
and help folks be more proactive. again, kudos for what you guys are doing here.
Emilia Bourland
We heard it here, folks. Call an OT first. Thank you so much for being on this episode of Pure Lab, Justin. It was such a pleasure. I hope that we can have you back again sometime, because clearly there are 100 million things that I think that we could all talk about and soapbox on and dig into and have a real good time. Listener, if you made it to the end of this episode, please make sure to...
Justin Oakley
Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
Colin O.T. where's screaming from the rooftops?
Justin Oakley
Yes.
Brandy Archie, OTD, OTR/L, CLIPP
Dig into.
Emilia Bourland
like, subscribe and follow. That's gonna make it easier for more people to find this kind of valuable information that we're trying to bring you here on CareLab. Don't forget to leave a comment. And if you have a question, if there's something that you want us to cover, put it in the comments. We will do our darndest to make sure that we are covering what you want to hear about. Until next time, we'll see you right here on CareLab. Bye.
Brandy Archie, OTD, OTR/L, CLIPP
Bye guys.
Justin Oakley
Thanks guys.
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