John Prosser II: I am interviewing Erica
Coulston, president and co-owner of
Walk the Line to SCI Recovery, Inc.
Erica, can you share the story of your
life, centered on your injury and how
you’ve worked through that to be
where you are today? My first question
is, ‘what is your involvement in the
treatment of brain and/or spinal cord
Erica Coulston: I am president and co-owner
of Walk the Line to SCI Recovery,
which is an outpatient physical therapy
recovery program for individuals
with brain and spinal cord injuries in
Southfield, Michigan. We focus on
physical recovery, working on the areas
of the body that were affected by injury.
JP: And yours is a pretty unique
approach to that process, correct?
EC: It is. Our protocol is definitely
unique, as well as our hands-on
approach. Our staffing approach is also
pretty unique in that way…definitely.
JP: What percentage of your clients
were injured in automobile accidents?
EC: I would say between 65 and 70
percent of our clients were injured in
automobile accidents, most of them in
Michigan. Although we do have a few
clients who were injured in automobile
accidents outside Michigan. And we
also have clients who have private health
insurance, workman’s compensation,
Medicare, or are self-pay.
JP: What is the proportion of men to
EC: I would say we have a pretty good
mix; the slight majority is male.
JP: What is your experience working
with patients covered by the Michigan
auto no-fault insurance system?
EC: I am not only speaking from the
perspective of our clients, but myself. I
think that the largest benefit to having
or being covered under Michigan’s
no-fault system is really the access to
ongoing treatment, as well as the full
continuum of care.
It’s not just being able to go to therapy
continually throughout the year, without
the limitation of a certain number of
visits or a monetary cap, but it’s also
having the support with transportation
and having attendant care. It’s having
the support of other therapies like
speech or occupational or vocational,
cognitive therapies. It’s having that full
spectrum of care that I see as one of
the biggest differences, as well as the
access to ongoing care throughout
the years, year after year. Those are
the biggest differences, and it leads to
better outcomes for people.
JP: Can you share a little bit about
your personal experience with your
EC: I was injured in a car accident in
October 2001. I was not living in the
state at the time, but I was injured with
my brother. He was driving while I was
visiting my parents in Michigan, so I was
covered under his auto no-fault policy.
Very early on, I decided to pursue
physical recovery from my injury. I
have a c6/c7 spinal cord injury, and I
really started looking elsewhere. At the
time, in 2001, spinal cord injury and
recovery therapy were not really words
or phrases that were put together in
Michigan or elsewhere. We started
looking outside of Michigan and
outside of the United States, and I spent
a few years pursuing other therapies in
California, as well as other parts of the
I eventually came back to Michigan in
2004, where we helped to start another
recovery program at another facility. I
left there in 2007 to start Walk the Line.
We really put together the things, both
good and bad, that we had learned
from the experiences I had at other
programs to create sort of the ultimate
program, which was something I had
envisioned from the beginning.
JP: I am biased, and I don’t mind my
audience knowing that. I’ve known you
and your family for a very long time,
and I very much admire Walk the Line
to SCI Recovery!It is a great program.
I’d like you to speak a little bit about
how your clients’ treatment experiences
differ if they have Michigan auto no-fault
versus other coverage such as
private health insurance, Medicare or
EC: We don’t take Medicaid. We do
take Medicare; we take most private
health insurances. We have some clients
who self-pay, and we have a few clients
who have, or have had, workman’s
JP: You mentioned that you don’t take
Medicaid. Why is that?
EC: It doesn’t pay, basically. It doesn’t
even pay enough to cover the expense.
Medicare or Blue Cross, which pays the
least, at least covers the expenses of
the cost of a session for us.
JP: But you are capped at $1900 worth
of therapy a year under Medicare,
EC: We use a modifier, so we’re capped
JP: Oh, that’s a vast improvement,
compared to most souls who are stuck
at the $1900.
EC: Yes and that $3700 still is about five
weeks of therapy for most individuals
JP: On that note, how long have you
been getting therapy, yourself?
EC: I’ve had continuous therapy since I
was injured, so more than 15 years.
JP: You were mentioning details of
health insurance. How is that similar or
dissimilar to Medicaid?
EC: The only difference in treatment
that any of our clients receive, whether
they have no-fault or another form of
insurance, is really the duration of time
that they’re able to be with us.
So clients who have no-fault versus
our clients who have Medicare or Blue
Cross or self-pay all receive the same