SANDY — Most insurance plans will cover 20 to 30 one-hour therapy visits a year for a patient, regardless of how much therapy the patient might need.
But data shows that more intense and more frequent therapy can help survivors of a traumatic spinal cord or brain injury get back to function sooner, and it will cost less to care for that person in the long run.
"If we make people more independent — helping them be able to transfer in and out of cars, getting themselves dressed and showered … doing the things we all take for granted — it will lead to a quantum change in those individual lives," said Dale Hull, co-founder and executive director at Neuroworx, a nonprofit facility that contracts with the state to provide therapy services to patients of all ages, regardless of their ability to pay.
He said finances are often a barrier for people needing the rehabilitation services his state-of-the-art facility offers, which is why he and Neuroworx medical director Jan Clark founded the clinic 15 years ago.
Nationally, Hull said, roughly 30% of survivors end up going back to school or work even 20 years after their accidents. In Utah, however, that rate is 72%, and it happens within the first five years following a spinal cord or brain injury.
"We now know that people can get better with the necessary therapy," he said.
Utah lawmakers believed the upfront investment made sense, so during the 2012 legislative session, they appropriated $200,000 for the first year, and established the Utah Spinal Cord Injury and Brain Injury Rehabilitation Fund. The restricted special revenue fund, which includes donations and gifts from private sources, helps cover the cost of rehabilitation services should a patient have no way to pay for it themselves.
Thousands of adult Utah patients have benefited from the fund since its inception, but Rep. Eric Hutchings, R-Kearns, says its not enough.
He was gunning for more funding during this year's session, but the state's finances got tied up in discussions about tax. Hutchings said he won't stop asking.
"It's my crusade to 10-times that fund," he said Thursday during a quarterly meeting of Utah's Spinal Cord and Brain Injury Rehabilitation Fund Advisory Committee, of which he is a member.
"Without this program, these treatments don't happen," he said. Hutchings sponsored the original legislation that established the fund in 2012.
He and the committee are working on a way to grow the fund to also help cover services for certain children with non-progressive neurological conditions who have experienced an acute change in functional status, for example, after surgery to reduce spasticity in their legs, or other helps.
Hutchings backed legislation earlier this year to establish the Pediatric Neuro-Rehabilitation Fund, which was not funded, but could be in the coming year. He says it is a no-brainer for lawmakers and will save the state money down the road, not having to institutionalize people whose lives could've been made better with enough therapy.
"It might be the advocate, the mother and the grandmother in me speaking — I want every kid to get everything they need," said committee Chairwoman Nita Smith, whose daughter suffered a traumatic brain injury when she fell off a swing at a day care at 18 months old.
That was decades ago, but it forever changed her daughter's life, as well as her own.
"There is this assumption that if something horrible and devastating happens to us, there is a government program that will help us," Smith said. "It's just not that way."
Fewer than 8% of survivors of traumatic brain injuries, she said, typically get the help they need to recover enough to enter the workforce or return to school where they have the opportunity to better their own lives. Many of them end up in institutions, which cost their families and/or state governments tremendously.
"It's not the ideal happy ending," Smith said, adding that changing the prospect for patients is "a matter of convincing our culture that we can and should help —when we can."
The committee and its funding mechanism are getting noticed across the nation, as Utah is the first to proactively establish a method to help people get back into society after catastrophic events in their lives.
Hull said that when he and Clark started Neuroworx in a small, rented room with "a set of weights, a floor mat and a ball," he had no idea of the overwhelming need there was for it. In just 15 years, Neuroworx has grown to fill a 24,500-square-foot facility, where staff serves a combination of insured and self-pay patients, as well as people funded with donations and the state rehabilitation fund.
The Utah Department of Health estimates that use of the fund to provide physical, occupational and speech therapy throughout fiscal year 2018 saved the state more than $4 million.
"People with spinal cord and brain injuries are being released from the hospital much earlier than ever before," Hull said. The prospect of spending an average of eight days in the hospital means more outpatient therapy is necessary, and patients max out on their health care plan limits more quickly.
In 2013, Neuroworx started an aggressive neurological rehabilitation program for kids, which has grown exponentially since then.
"We can't treat every kid," said Rick Reigle, a pediatric physical therapist at Neuroworx and Utah's representative for the Academy of Pediatric Physical Therapy, but there is data to back up intense focus at a young age.
In addition to Neuroworx, Primary Children's Hospital and the local Shriners Hospitals for Children also provide therapy to young patients, depending on their needs. University of Utah Health Care serves adults at its outpatient clinic in Sugar House, and is also a contracted provider for patients selected for help from the state rehabilitation fund.