Assistive Devices Program Ministry of Health & Long-Term Care

1. Assistive Devices ProgramMinistry of Health & Long-Term Care Wheelchairs, Positioning Devices (Seating) & Ambulation Aids Central Equipment Pool for High Technology Wheelchairs

2. Today’s Presentation: • The Program • What is the Central Equipment Pool for High Technology Wheelchairs? • Eligibility • What are the eligibility criteria? • Application Process • Roles and Responsibilities • Accessing CEP • Funding Application • Changes/Modifications to current applications

3. What is the Central Equipment Pool for High Technology Wheelchairs (CEP)? • CEP provides ADP clients throughout Ontario with high quality new and recycled power wheelchairs with power tilt/recline units at discounted prices and provides a rebate on the client's costs once the equipment is returned to the pool. • For the purpose of ADP funding assistance, a high technology wheelchair is defined as a power wheelchair and/or power base that includes a power dynamic positioning device – tilt and/or recline – as a component • In addition to the opportunity to purchase recycled equipment, a consistent level of service to ADP clients across the province has been established by consolidating all high-technology services in one responsibility centre.

4. What is CEP? (Continued) • This is a recycling pool and as such, clients will be provided with quality reconditioned equipment that meets their individual requirements when available. All routine maintenance and repair costs are provided free of charge, for the 3 year warranty period to CEP clients. • ADP funding assistance, for all components of a high technology wheelchair, including positioning devices (seating) must be obtained through the Central Equipment Pool.

5. Equipment Provided • Equipment (including seating) is provided by CEP based on the authorizer’s prescription and ADP approval. This may include • Base • Power Dynamic Positioning Devices • Custom molded seating • Specialty controls • Only those items listed in the ADP Product Manual are eligible for funding assistance through the ADP CEP program.

6. The Central Equipment Pool • Is an essential resource for the ADP applicant and/or agent and the ADP registered authorizer regarding CEP equipment policies and procedures • Works cooperatively with the ADP applicant and authorizer to ensure that the choice of equipment is appropriate to meet the individual's basic mobility requirements • Is an agent of the Program and as such must comply with the Freedom of information and Protection of Privacy Act, Personal information Protection and Electronic Documents Act and the Personal Health Information Protection Act. (section 535 – Policy and Procedures Manual ADP Program) Please provide a copy of the ADP application form to CEP

7. Key Concepts • CEP is a recycling program – recycled equipment will be provided where it meets the clinical prescription • Equipment is provided for assessment and trial purposes to determine the appropriate mobility prescription • Clients are responsible for their portion of the costs • Assessment times must be reasonable • Rebates may be available if equipment is no longer required

8. Administration Manual for “Mobility” CategoryWheelchairs, Positioning Devices (Seating) & Ambulation Aids • Applicant Eligibility – Section 3 • Not eligible for WSIB or Veteran's Affairs Canada for same condition • Valid health card • Permanent residency • Physical disability • Applicant Eligibility Criteria for Mobility Devices – Section 4 • Functional status requirements • Basic Mobility Requirement is defined by ADP for funding purposes • Device must be required and used on an ongoing daily basis within the applicant’s place of residence and to gain entry/exit from the residence • Place of residence may be a home, apartment building, long-term care home etc.

9. Administration Manual for “Mobility” CategoryWheelchairs, Positioning Devices (Seating) & Ambulation Aids • Confirmation of Eligibility for Equipment Required – Section 5 • Assessment process and equipment trials • Move from the most basic to the more complex equipment • Ambulation Aid to Manual Wheelchair to Power Mobility • Central Equipment Pool for High Technology Wheelchairs – Section 6 • Funding Periods and Replacement Policies – Section 7

10. Eligibility Criteria CEP specific applicant eligibility The applicant must require the authorized equipment to support posture to facilitate mobility Applicant must be able to operate the authorized equipment independently Required and intended use of the equipment must be to provide mobility Meet the applicant’s basic mobility needs on an ongoing daily basis Client is a permanent Ontario Resident with a valid Health card Client is not eligible for WSIB or Veterans Affairs for the same medical condition or device

11. CEP Specific Eligibility Criteria (Section 6) • Power Tilt and/or recline: • Maintain skin integrity where there is a high risk of tissue trauma and a loss of ability to effectively weight shift independently; • Maximize respiratory function where there are measurable limitations, and objective data can be provided to show improvements with power tilt/power recline; • Maintain independent mobility through increased sitting tolerance, where there is an inability to maintain a functional sitting position due to abnormal tone/reflex activity, postural instability, and/or joint/spinal contractures/deformities.

12. CEP Specific Eligibility Criteria • Power Tilt and Recline • Clinical equipment results demonstrate that power tilt or power recline alone is not an adequate solution to achieve previous goals. • Power Elevating Leg Rests • Decrease in swelling due to chronic edema in the lower extremities, where power tilt and/or recline is prescribed. Objective trial data must be provided. • Repositioning of the lower extremities where power recline is prescribed and self elevating leg rests are not effective to regain a functional position.

13. CEP Specific Eligibility Criteria • Assistance towards the purchase of power tilt, power recline and/or power elevating leg rests should not be considered where the purpose is solely for pain management, to facilitate transfers, toilet activities, swallowing, and/or rest. • Factors that will influence the prescription details include the applicant's medical condition and prognosis, and mobility needs now, and in the foreseeable future.

14. Eligibility Criteria CEP specific applicant eligibility The applicant must require the authorized equipment to support posture to facilitate mobility Applicant must be able to operate the authorized equipment independently Required and intended use of the equipment must be to provide mobility Meet the applicant’s basic mobility needs on an ongoing daily basis Client is not eligible for CEP equipment Client is a permanent Ontario Resident with a valid Health card Client is not eligible for WSIB or Veterans Affairs for the same medical condition or device

15. Key Points: Eligibility Criteria • Applicants must meet basic ADP eligibility criteria before being considered for CEP (including being independent and safe using a power wheelchair) • Power elevating leg rests are funded only in conjunction with tilt and/or recline

16. Accessing the Program: Roles and Responsibilities • Authorizer • Applicant • CEP representative (local) • CEP Operations

17. Role of the Authorizer (section 120) • Is the gatekeeper to the Program and assumes the leadership role in the assessment process, confirmation of the applicant’s eligibility, and completion of the ADP application form in a timely fashion. • Inform their client and/or legal representative about ADP eligibility criteria, policies and procedures so that the applicant/client can make an informed decision regarding submitting an application to the program. • Complete a comprehensive clinical assessment • Identify the need for mobility equipment • Work with CEP to provide trial equipment

18. Role of the Authorizer (Cont) (section 120) • Will work with client’s vendor to enhance his/her own knowledge of ADP funded equipment by discussing the client’s equipment needs and technical support requirements with the ADP Registered Vendor. • The ADP authorizer must provide a complete prescription that includes all the components of the system (power wheelchair/base, positioning devices (seating), and the power positioning devices (tilt and /or recline) that the client requires and that meet the ADP eligibility criteria. • Determine ADP eligibility and complete the application form • Follow up to ensure prescribed equipment continues to meet the client’s needs

19. The Role of the Applicant • In order to be eligible for ADP funding assistance the client must: • Participate in a clinical assessment with an ADP Registered Authorizer • Provide personal health information required by the program to determine eligibility - Individuals have the right to disqualify themselves from the funding program • Is responsible for paying his/her 25 per cent portion of the ADP approved amount for the mobility equipment directly to CEP in a timely manner

20. Role of the CEP • Information Resource • Provide equipment for clinical trials • Provide quotes as required • Follows up to ensure a smooth process and completed documentation

21. CEP Rep Checklist • Completed at the initial assessment. • Ensures the client is well informed and able to ask questions at the beginning of the process • Ensures the client has key contact numbers for the sales representative and service departments • An information pamphlet is also available

22. Role of CEP – (Cont) • Provide new and/or recycled high technology wheelchairs according to the contractual agreement • Deliver high quality product • Maintain a high quality service delivery system throughout the province • Works with the authorizer and client to determine the most appropriate equipment • Provide warranty and service for all CEP (MOHLTC owned items) • Provide education and support to ADP authorizers, clients and caregivers • Provides feedback to manufacturers on products

23. Application process – Electronic Application Form http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/FormDetail?openform&ENV=WWE&NO=014-2196-67

24. Application Process • Complete the application form and provide a copy to the CEP representative • Vendor Number -- leave this section for the CEP representative to complete • Only CEP can be listed as a vendor in this section

25. Prescription Changes • How do I make changes or corrections on an ADP application form that has been submitted to, or approved by the Program? • Authorizers must make the correction on the appropriate page of the application form and submit it by fax (416-327-8192) or mail, with a covering page explaining why the change(s) are required. Do not send in a new application form.

26. Website Access the ADP Web Site for further information at: http://www.health.gov.on.ca/english/providers/program/adp/adp_mn.html

27. ADP Contact Ian Lowe, Senior Program Coordinator • Tel: 416-327-8148 Toll Free: 1-800-268-6021 • Fax: 416-327-8192 • E-mail: ian.lowe@ontario.ca