Traveling with Oxygen:Traveling with Oxygen:It’s Getting Better All the It’s Getting Better All the

TimeTimeCurrent Status of POC Use for Current Status of POC Use for

TravelTravel

AARC Congress, Las Vegas, NVAARC Congress, Las Vegas, NVBob Fary, RRTBob Fary, RRT

Traveling with POC’sTraveling with POC’s

Air TravelAir Travel Train TravelTrain Travel Cruise ShipsCruise Ships Private AutomobilePrivate Automobile Travel-Specific ProvidersTravel-Specific Providers

History of Airline OxygenHistory of Airline Oxygen

Pressurized CabinsPressurized Cabins• 8,000-10,000 feet8,000-10,000 feet

Less Oxygen AvailableLess Oxygen Available• Sleepy? You PO2 is lower!Sleepy? You PO2 is lower!• Lung disease? Supplementary oxygen is Lung disease? Supplementary oxygen is

requiredrequired DOT HazMat ClassificationDOT HazMat Classification

• Requires exemptionRequires exemption• Mainline carriers onlyMainline carriers only

History of Airline Oxygen-ProvidersHistory of Airline Oxygen-Providers

Homecare Providers Travel ProgramsHomecare Providers Travel Programs• National providersNational providers• Alliances of independentsAlliances of independents• Oxygen users travel guideOxygen users travel guide• Logistical and economic challenge-many Logistical and economic challenge-many

opportunities for failuresopportunities for failures Service coordinationService coordination Reimbursement/compensation issuesReimbursement/compensation issues

• Costs passed on to oxygen usersCosts passed on to oxygen users

History of Airline Oxygen-UsersHistory of Airline Oxygen-Users

Find a Willing ProviderFind a Willing Provider• Local provider abilityLocal provider ability• Switch providers?Switch providers?

Make Arrangements with AirlineMake Arrangements with Airline• 60 day planning60 day planning• Medical historyMedical history• Flight availabilityFlight availability

Pay Up!Pay Up!

History of Airline Oxygen-AirlinesHistory of Airline Oxygen-Airlines

Hazardous Materials ExemptionHazardous Materials Exemption• Large paperwork burdenLarge paperwork burden

Logistical ChallengesLogistical Challenges• Oxygen on the correct flightOxygen on the correct flight• Regulations regarding tanksRegulations regarding tanks• Training issuesTraining issues

Money-Losing ServiceMoney-Losing Service• Carrier bankruptciesCarrier bankruptcies• Fees cover some costsFees cover some costs

Advocacy Efforts Advocacy Efforts

NHOPANHOPA• Pioneered efforts to change onboard oxygen Pioneered efforts to change onboard oxygen

rulesrules• More than 8 years of lobbying activityMore than 8 years of lobbying activity

ATSATS AARCAARC ACCPACCP NAMDRCNAMDRC A A HomecareA A Homecare

• HME/RT CommitteeHME/RT Committee

DOT Rule-SFAR-106DOT Rule-SFAR-106

Allows Use of Portable Oxygen Allows Use of Portable Oxygen Concentrators Onboard Commercial Concentrators Onboard Commercial AircraftAircraft• At discretion of individual carriersAt discretion of individual carriers• 4 devices have been approved for this 4 devices have been approved for this

useuse• Enables oxygen users to carry-on and Enables oxygen users to carry-on and

use their own personal oxygen use their own personal oxygen concentratorconcentrator

SFAR-106, ContinuedSFAR-106, Continued

• Requires user to carry a letter from their Requires user to carry a letter from their physicianphysician

• No 60 day notice requirementNo 60 day notice requirement• No longer requires airline to have HazMat No longer requires airline to have HazMat

exemption to allow oxygen useexemption to allow oxygen use• Allows users to be self-responsible for their Allows users to be self-responsible for their

oxygen needsoxygen needs• Removes logistical hurdles for providers and Removes logistical hurdles for providers and

airlinesairlines• Saves users money-no more fees from provider Saves users money-no more fees from provider

or airlineor airline

When? How? Who?When? How? Who?

AirSep, SeQual, Respironics and AirSep, SeQual, Respironics and Inogen Approved by FAAInogen Approved by FAA

Most Airlines Have Approved POC Most Airlines Have Approved POC UseUse• Independent testingIndependent testing• Policies and proceduresPolicies and procedures• Training of employeesTraining of employees

Check Airline and POC Manufacturer Check Airline and POC Manufacturer Web Sites for Current ApprovalsWeb Sites for Current Approvals

Approvals as of November, 2006Approvals as of November, 2006

NorthwestNorthwest America WestAmerica West US AirwaysUS Airways MidwestMidwest DeltaDelta FrontierFrontier AlaskaAlaska ATAATA MidwestMidwest

LufthansaLufthansa Royal JordanianRoyal Jordanian Air FranceAir France HawaiianHawaiian QuantasQuantas SouthwestSouthwest Sun CountrySun Country American American ContinentalContinental jetBluejetBlue

Approvals Still PendingApprovals Still Pending

United AirlinesUnited Airlines• Concerns on pilot notification Concerns on pilot notification

requirementrequirement• Concerns about seating requirementsConcerns about seating requirements

What’s Next?What’s Next?

DOT NPRM Docket OST-2005-22298, DOT NPRM Docket OST-2005-22298, Issued September 7, 2005Issued September 7, 2005• Federal register vol. 70 no. 172Federal register vol. 70 no. 172

Requires Airlines to Allow POC’s Requires Airlines to Allow POC’s Onboard as Personal Assistive DeviceOnboard as Personal Assistive Device• Places use under Air Carrier Access ActPlaces use under Air Carrier Access Act

Comments Accepted and Available Comments Accepted and Available for Reviewfor Review• www.dms.dot.govwww.dms.dot.gov

SummarySummary

POC’s are Welcomed on Most AirlinesPOC’s are Welcomed on Most Airlines Freedom for Oxygen UsersFreedom for Oxygen Users Financial Benefit for UsersFinancial Benefit for Users Financial Benefit for Homecare Financial Benefit for Homecare

ProvidersProviders More Active PatientsMore Active Patients Subsequent DOT Ruling to FollowSubsequent DOT Ruling to Follow