Alberta Aids to Daily Living Primary Module B Part 3 OT/PT/RN. Module B Part 3 Outline. Overview:

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1 Alberta Aids to Daily Living Primary Module B Part 3 OT/PT/RN Patient Lifters and Slings Homecare Beds and Accessories Two APL s (L) and (BL) 1250 Form(s) Module B Part 3 Outline Overview: Patient Lifters Homecare Beds and Accessories Formal Recycle versus Non-Recycle Authorizers Vendors Eligibility criteria Forms and Processes Examples 2 Overview: Patient Lifters and Slings (L) Overhead and Floor Patient Lifters Slings Homecare Beds and Accessories (BL) Bed Frames and Accessories Overbed Table, Trapeze, Bedrails Mattress standard or pressure redistribution 3 1

2 Formal Recycle versus Non-recyclable Benefits Formal Recycle Program Overhead and Floor Patient Lifters (AADL Recycled) Homecare Beds and accessories (AADL Recycled) Homecare Pressure reduction mattresses Non-recycle Standard mattresses for use under pressure reduction overlays Slings 4 Formal Recycle versus Non-Recycle Process Formal Recycle Authorization form required AADL orders equipment Tracked and repaired by AADL Client returns equipment to AADL vendor for recycle to another AADL client Non-recycle Separate Authorization form required from recycle benefit AADL does not order the equipment the authorization is sent to the vendor. Slings may be recycled in the community at your risk/discretion may not always be appropriate. Not to be sold. 5 Authorizers Lifters and homecare beds/accessories Occupational Therapists, Physiotherapists and Registered Nurses Competency expectations Knowledge and skills in the use of pressure redistribution for the management of chronic wounds. Need to know when to order the regular pressure reduction mattress that comes with the homecare bed or when a pressure reduction overlay is more appropriate. Ability to assess the client s environment. 6 2

3 AADL Program Vendors Lifters Multiple recycle vendors for lifters see (L) Vendor List Client chooses vendor, authorizer indicates vendor on authorization form. Homecare Beds and Accessories Single vendor for homecare beds - awarded contract through tender process current award to Eco Medical Equipment. Client deals directly with Eco Medical Equipment Vendor for returning bed, dealing with repairs, paying cost share. 7 Eligibility Criteria for Homecare Beds (BL) and Patient Lifters (L) Must meet general AADL eligibility and benefit specific eligibility Intended for clients who want to remain in their home yet do not require the higher level of support provided at level SL3/4. Type of residence affects eligibility for (L)& (BL) benefits Funded in private homes, apartments, lodges and group homes. Higher Levels of Assisted Living/Long term care not covered. 8 Eligibility Criteria - Lifters Ceiling Track Lifters Must have Ceiling Track in place or funding in place On 1250 Authorization form indicate: Client has a quote for whole track package and funding is in place for track and installation. Homecare Beds & Accessories Portable Floor Lifters Folding feature requires justification Only one type of lifter funded per client 9 3

4 Benefit Specific Eligibility (BL) Homecare beds and Accessories Client must be palliative and/or remain in bed 80% of the day for the homecare bed and/or accessories. Criteria must be written on the authorization. Homecare beds are not provided to clients with power wheelchairs. Maximum of one of each type of accessory per client: overbed table, trapeze bar and floor stand for trapeze. 10 Benefit Specific Eligibility (BL) Homecare beds and Accessories Pressure relief mattress (L210) used with homecare beds and are the default mattress provided. Order a Standard mattress (L206) if client has a pressure ulcer and the plan is to obtain an overlay which has higher pressure relief properties. 11 Authorization Process Need: (L) APL - Lifters 12 4

5 Authorization Process (Steps) Lifters, Pressure Redistribution Overlays & Homecare Beds Assessment QFR Clinical assessment of need and eligibility. Assessment date is when you have completed the assessment including eligibility confirmation and home assessment. QFR? Do you submit authorization form if QFR needed? Trial Authorization Form submitted Trials are necessary for all equipment except the homecare beds. Need to discuss the room/space required to house the bed within the home. Provide handout for homecare beds. Authorization forms are required. Check rationale requirements. Add QFR # if appropriate. If you are authorizing an AADL recyclable benefit, AADL orders the item from the vendor you list on the form. You can still forward a copy of the form. 13 Authorization Completion Complete 1250 Authorization form. Use separate 1250 for non-recycle benefits. Always use separate form for homecare bed/accessories Must use separate form for each vendor. Do not combine recycle with non-recycle e.g., slings (not recycled) should be on a separate 1250 from the lifter (formally recycled) Include all additional rationale/information required as listed on APL to avoid delays. HD equipment, folding feature, overhead lifter See APLs e.g. Lifters and Slings 14 Approved Product Lists LIFTERS AND ACCESSORIES Recycle Patient Lifters are provided through the AADL Recycle Program and must be returned to an AADL vendor when the client no longer needs it. Slings are considered benchmark benefits and are not recycled by AADL. Eligibility: Must indicate on the 1250 that client has funding in place for overhead track including installation (client responsibility) Clinical rationale for Heavy Duty models includes the client's weight. Quantity and Frequency Requests are required if replacing lifters within 4 years. One type of lifter provided either an overhead track lifter or portable floor lifter. Manufacturer and model must be indicated on Minimum Standards for Lifters Minimum 3 year warranty on lifter, one year on battery, one year on hand pendant and one year on charger. Must have safety mechanisms emergency lowering & stop, slack strap switch, over-speed governor. Manufacturers must have an active representative in the province available for consult. Distribution of equipment is through AADL Approved Vendors with a facility maintained in Alberta. Parts/components must be available from a Canadian Distributor/Warehouse. Vendor to carry common maintenance parts. Costs: AADL Prices are based on MSRP minus vendor discount unless otherwise indicated. Clients are responsible for any upcharges indicated. OVERHEAD LIFTERS AADL Cat # Manufacturer/Model Description Wt.Cap Lifting AADL Upgrade (lbs.) range price cost (Client) ArjoHuntleigh Overhead Lifter L Up to 48 $ $0.00 Voyageur L312 Humancare Durable metal parts, weighs 22 lbs. Carriage adapter available to accommodate other 480 Up to 66 $ Altair HD $ manufacturer s overhead track systems. Straps - size 3.9 to 17.7 $59.40 Straps - size 19.7 to 29.6 $83.10 Straps size 31/5 to 39.3 $ D-Ring adaptor $38.40 L316 Humancare For clients under 300 lbs. See L312 for HD model 330 Up to 66 $ Durable metal parts, weighs 22 lbs. Altair 150 Straps - size 3.9 to 17.7 $59.40 Straps - size 19.7 to 29.6 $83.10 Straps size 31/5 to 39.3 $ D-Ring adaptor $38.40 Molift Overhead lifter L Up to 78 $ Nomad 15 5

6 Approved Product Lists Patient Lifter Slings SLINGS (Benchmark/non-recycle) Recycle Patient Lifters are provided through the AADL Recycle Program and must be returned to an AADL vendor when the client no longer needs it. Slings are considered benchmark benefits and are not recycled by AADL. Eligibility: Must indicate client's weight on all authorizations to support choice of product. Quantity and Frequency Requests are required if replacing slings within 2 years. Slings must be compatible with the lifter either same manufacturer or accepted as compatible by manufacturer. Minimum Standards for Slings Minimum 2 year warranty on slings. Manufacturers must have an active representative in the province available for consult. Distribution of equipment is through AADL Approved Vendors with a facility maintained in Alberta. Costs: AADL Prices are based on MSRP minus vendor discount quoted on matching lifter. Pricing is based on the maximum price funded for a sling and is not intended as the price for all types of slings under that manufacturer. Consult with the vendor for individual prices as these will vary according to type. Manufacturer and Model of the client s lifter must be indicated on the authorization form. AADL Cat # Manufacturer Description Sizes MSRP Maximum AADL price XXS-L 5% $ L313 ArjoHuntleigh Slings Oversize 5% $ XS-L 5% $ L315 Handicare Slings Oversize 5% $ Deluxe slings S-XL 5% $ L320 Hoyer Advance E slings S-XL 5% $ L321 Invacare Slings S-XL 5% $ L326 Prism Slings S-XL 5% $ S-L 5% $ L328 Humancare Slings Oversize 5% $ S-M $ L318 Molift Slings L-XXL $ Authorization informing client Alberta Aids to Daily Living Review 1250 Authorization form with client Provide handouts, information sheets if appropriate Ensure client is aware of cost upgrades and vendor expectations Vendors require payment before providing equipment Client timely payment prevents delays Homecare beds and accessories AADL provides eligible Albertans with homecare beds, mattresses, rails, over-the-bed tables, and trapeze bars through Eco Medical Equipment. Beds and accessories are provided as a package or individual items. A bed package includes a homecare bed (power), a pressure reduction mattress, and bed rails. This equipment is not provided to persons in acute care facilities or continuing care centres. Equipment may be new or recycled. Eligibility requirements The recipient must be an Alberta resident with a valid Alberta Health Care Insurance Plan card and: requires equipment due to a long-term disability, chronic illness or terminal illness, spends 80% of their time in bed and/or are end-stage palliative, and has been assessed by an AADL Authorizer. Steps to obtain a bed 1. The individual is assessed by an AADL Authorizer and eligibility for equipment is determined. 2. Correct equipment is identified. 3. Client signs declaration form. 4. Client pays cost-share portion, if appropriate. 5. Equipment is delivered. Client responsibility The client (their family, trustee/guardian) is responsible to ensure reasonable care and maintenance of AADL-supplied equipment. The client is responsible for replacing equipment that is lost, stolen or damaged due to misuse. Ownership The AADL program retains full ownership of the equipment. The equipment is not for resale and must be returned to the vendor, Eco Medical Equipment, in the following circumstances: 1. The equipment is no longer required, for whatever reason. 2. The equipment needs to be replaced by AADL. 3. The person using the equipment moves out of Alberta. 4. If, for any reason, the person becomes ineligible for the benefit. 17 Authorization Completion All additional rationale/information provided. HD equipment, folding feature, overhead lifter tracking in place No expiry date entered. Authorizations automatically expire once the equipment is provided and the vendor has made a claim. Submit to AADL. AADL orders the equipment may be from recycle pool or purchased new. 18 6

7 Equipment Provided Now what What if it needs repairs? What if client no longer needs it? Patient Lifters AADL will fund repairs and ongoing maintenance Client no longer requires equipment Contact AADL equipment vendor to arrange to return equipment. May do an internal transfer if equipment meets another eligible clients needs. Equipment is refurbished and recycled out to a new AADL client AADL continues to fund repairs and maintenance Beds and accessories Client no longer requires equipment Bed is refurbished and recycled out to a new AADL client AADL will fund repairs and ongoing maintenance. Contact AADL vendor to arrange to return bed/accessory Internal transfers are rare AADL continues to fund repairs and maintenance. May replace pressure relief mattress when worn out. 19 7