“This is almost too large to plan for,” said Mike Hamilton, executive director of the Alabama Durable Medical Equipment Dealers Association (ADMEA). “This is like Katrina, and most providers’ emergency preparedness plans have been overwhelmed because the storms covered such a huge area.”

With thousands injured and without power, HME companies throughout the South were left scrambling to take care of patients. Leigh Ann Matthews, owner of Complete Care, with locations in Fort Payne and Scottsboro, Ala., swung into action to help patients in devastated areas.

“We are now trying to go in and replace backup systems for our oxygen patients,” said Matthews, who also serves as president of ADMEA. “Some of those areas are almost impassable. We are just trying to get to them by whatever route possible. We have also had patients who have completely lost their homes and had to relocate.”

The last set of storms came through about five miles from Matthews’ Fort Payne location, a town that saw widespread destruction and more than 30 fatalities. Officials told Fort Payne residents they might not have power until some time during the week of May 2, and Matthews was preparing for that situation.

As soon as the storms broke April 27, Matthews directed delivery personnel to hit the road, and they went non-stop all day. These efforts are mostly not reimbursable under Medicare guidelines, and providers across the region will likely feel the hit.

“It will be a financial burden,” acknowledged Matthews. “And we have no idea how much equipment we have actually lost, because there are some areas we have not been able to get into,” she said Friday. “If it was one small area that was hit, you could handle it, but when every oxygen patient you have does not have power, it makes it very difficult.”

The full measure of the storms’ impact will continue to be revealed in the days ahead. For some, it could end up as a double whammy of damage to both business and home.

“I talked to one supplier this morning, and he had locations in Tuscaloosa, Birmingham and Huntsville,” said Matthews. “His home had been damaged, and he said, ‘I don’t even know if I have any businesses standing.'”

Joe Bryant, owner of Happy Home Health, escaped damage to his business in Pelham, Ala., and his home in Alabaster, Ala. However, many of the patients he serves in Bibb, Blount, Chilton, Jefferson, Shelby, St. Clair, Talladega, Tuscaloosa and Walker counties were not so fortunate.

“The biggest problem is electrical power disruption,” said Bryant. “Patients on oxygen who are without power have been handled in one of two ways. First, LOX systems do not require electricity, so we made these systems available to as many of our patients as possible. Second, some years ago we purchased portable gasoline-powered generators, and we have made these available as needed.”

Bryant faced a similar situation years ago with Hurricane Opal (1995). At the time, he had to supply rural patients with oxygen cylinders, since he was not heavily involved in LOX.

“Following that hurricane, we swore we would not go through that many oxygen cylinders again and the headaches associated with the logistics of refills and delivery,” said Bryant. “So far, we have met all of our patients’ needs and are operating under our emergency preparedness plan.”

All these secondary devices — LOX systems and generators — are not subject to reimbursement because they are considered backup systems. “The costs have to be absorbed by the DME provider,” said Bryant, echoing the sentiments of Matthews. “I know of no other industry that does this. This is non-reimbursement as mandated by Medicare, Medicaid and other insurance carriers, including Blue Cross Blue Shield.

“Wouldn’t it be nice if banks and mortgage companies had to supply you with a house at no cost until you replaced your lost or damaged home?”

The disaster sparked industry advocates to question again the wisdom of nationwide competitive bidding and how it might affect patients in times of dire need.

“The fewer suppliers you have,” said Hamilton, “the less likely it is that you will be able to respond properly to a disaster like this.”

Bill Hewlett, a VGM member and vice president of the Kentucky Medical Equipment Suppliers Association (KMESA), wrote that a lack of providers — especially in rural areas — would surely be felt once competitive bidding spreads.

“When competitive bidding comes to this rural area, will we all still be around to make sure patients are cared for in a proper way? Probably not,” said Hewlett.