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ADP Today


									ADP Today
A Newsletter from the Assistive Devices Program

Winter Issue – December 2004

Measuring Performance                           providers and consumers through the
                                                standing committees to analyze current
                                                                                              A Report from the
Karen Gansel,                                   service delivery models and identify          Medical Device Teams
Senior Manager                                  improvements in policy and process.
                                                Staff will continue to use clinically
                                                                                              Respiratory Category
    he Ministry of Health and Long-Term
T   Care has made a firm commitment to
accountability as well as providing a more
                                                based evidence and best practices when
                                                evaluating new products for listing
                                                                                              Revised CPAP pricing
                                                                                              On August 1, 2004, a new ADP approved
                                                and when making changes to current            price of $978.00 was introduced for
transparent and cost effective use of           eligibility criteria.                         Continuous Positive Airway Pressure
healthcare funding, through monitoring,                                                       (CPAP) Systems. As well, the ADP
performance measures and reporting to           The focus during the next fiscal year
                                                                                              now provides funding assistance for
stakeholders on results.                        will be to continue to implement the
                                                                                              Auto-titrating Positive Airway Pressure
                                                new pricing framework and monitoring
The Assistive Devices Program (ADP)                                                           (APAP) Systems.
                                                the results to make adjustments as
has an ongoing process of establishing          required. Through this mechanism, staff       In response to concerns voiced by vendors
performance targets and ensuring they           will provide residents with fair and          about the new price not reflecting a fair
are met on a consistent basis. Quality          affordable access to a range of devices       margin, staff have completed another
improvements have been identified               and provide vendors with a fair and           analysis. Recognizing that small vendors
in service delivery areas and new               predictable return on their investment.       have less ability to negotiate discounts
processes designed and implemented                                                            with manufacturers, the second analysis
through advice from our four standing                                                         used only small vendor costs. It has been
committees for wheelchairs and                  Changes to the ADP                            determined that to ensure a fair margin,
positioning, sensory, prosthetics and           Vendor Contract                               the ADP approved price for CPAP
orthotics and respiratory services.                                                           and APAP systems has been increased
                                                Implementation of the fixed pricing
The ministry has made a commitment                                                            from $978.00 to $1,040.00 effective
                                                funding model on August 1, 2004, required
to a health system that is easier for the                                                     August 1, 2004.
                                                the ADP to send out an amendment to
client to understand and to navigate.           the ADP contracts to all vendors affected     In order to ensure that applications signed
To reach this objective, staff will enhance     by this change. Staff have taken this         by a physician on or after August 1, 2004
the ADP website so that clients have            opportunity to review all current             are processed at the new price, the ADP
easier access to information on what            contracts. ADP staff have met with the        automatically adjusted the price from
products are funded and how to access           ministry’s Legal Services Branch and          $978.00 to $1,040.00 until October 31, 2004.
this support. Furthermore, the ministry         all ADP registered vendors will be asked      After October 31, 2004, applications that
has committed to providing easier               to sign new updated vendor contract           indicate a price of $978.00 are being
access for clients to the right services.       before the end of 2004. The new contract      returned to the vendor for correction.
Staff have also committed to initiate           will incorporate the ADP Policies and
a customer satisfaction survey with                                                           What is a complete CPAP or
                                                Procedures Manual as well as device-
recent clients to assess the service they                                                     APAP system?
                                                specific manuals. It is hoped that the new
received and to design improvements                                                           The ADP provides funding assistance
                                                contract will assist ADP registered vendors
to address any barriers.                                                                      for a complete CPAP or APAP system.
                                                to better understand their contractual
                                                                                              For ADP purposes, a CPAP or APAP
The ministry is committed to a health           requirements with the ministry.
                                                                                              system consists of a CPAP/APAP device,
system that delivers quality results,                                                         heated humidifier, basic mask and
efficiently and effectively. As a result, ADP                                                 headgear, carrying case, six ft. tubing,
staff are working with key healthcare                                                         all necessary caps and filters, power
                                                                                              cord and patient instruction manual.

If a client requires items that are not     Orthotics category                            Wheelchair, Positioning
part of the basic CPAP or APAP system,      On October 1, 2004, service delivery
the respiratory vendor may invoice the      changes were implemented in the               and Ambulation
client for 100 per cent of the cost of      Orthotics category. All registered vendors,   Aids Category
these items.                                authorizers and rehabilitation assessors
                                            received a new Policy Manual at that          New ADP pricing framework
Vendors who offer ADP clients a service                                                   effective August 1, 2004
                                            time. The two main changes to ease
package, must provide the client with the
                                            client access to ADP funding were the         Updated prices and revised device codes
option to purchase the service package
                                            removal of the clinic assessment              for mobility devices are now in effect.
separately and not as a mandatory
                                            requirement and the inclusion of family       ADP policies and procedures related to
service when purchasing the CPAP or
                                            physicians as prescribers for most            eligibility criteria for funding assistance,
APAP device.
                                            orthotic devices. These changes were          application submission and equipment
The ADP expects all respiratory             recommended by an Orthotics Task              listing, remain unchanged.
vendors registered with the ADP to          Force. More details can be found in the
ensure that their clients are instructed    Orthotics Administration Manual. The          ADP authorizer date
in the appropriate and safe use of the      client fact sheet has also been revised       The authorizer date on the ADP
equipment. Respiratory vendors may          to reflect these changes. The fact sheet      application form is the day that the
provide additional services such as an      can be printed from the ADP web page.         prescribing therapist (ADP authorizer)
extended warranty, yearly pressure                                                        completes the clinical assessment and
                                            Pressure Modification Devices/                finalizes the equipment prescription
checks and calibrations or pressure
                                            Limb Prosthetics                              for the ADP applicant. This date may
adjustments. The vendor may offer
                                            The ADP continues to work with the            not be changed. The old ADP device
these services to the client at a cost
                                            P&O Standing Committee and task               codes and pricing format must be used
separate from the funding support
                                            forces to identify changes in service         when the authorizer date was prior
provided by the ADP.
                                            delivery. These changes will ensure           to August 1, 2004. The new device
Enteral feeding category                    improved client access to the funding         codes and pricing format must be used
When submitting a request for funding       of compression garments and devices           for all authorizer dates commencing
assistance for enteral feeding pumps        in these categories.                          August 1, 2004. If any changes are
and supplies, two ADP Equipment                                                           required to an application form that was
                                            Pressure modification devices
Supply Authorization (ESA) forms must                                                     submitted with the authorizer date prior
                                            Updated pricing was implemented on
be completed and submitted to the ADP.                                                    to August 1, 2004, the old device codes
                                            August 1, 2004. The device listings are
One ESA form will list the enteral feed-                                                  and pricing format must be used.
                                            now organized and written generically.
ing pump and one ESA form will list the                                                   Application forms that are submitted
                                            This is intended to allow more flexibility
required enteral feeding supplies. This                                                   with incorrect codes will be sent back
                                            for the authorizer and certified fitter in
ensures that the ADP approved amount                                                      to the authorizer for correction.
                                            determining the best garment for the
for enteral feeding pumps is not included
                                            individual client. It will also eliminate     Custom Fabricated device codes and
in the approved amount for the supplies.
                                            the need for an approved and listed           Non-Designated device codes
                                            manufacturer to apply to have a described     ADP authorizers may prescribe positioning
Prosthetics and Orthotics                   type of garment listed with the ADP.          devices (seating) that must be fabricated
Program staff are meeting with stake-       The latter benefit will help to ensure        using raw materials using coding from
holders to help establish an up-to-date     that some new products are made               the Custom Fabricated (CF) device codes.
funding model to help revise pricing        available immediately for those clients       All commercially available modular
in prosthetics and orthotics, beginning     who need them.                                seating devices must be coded using
in 2005.                                                                                  the Non-Designated (ND) device codes.
                                                                                          When custom modifications are required
Prosthetics and Orthotics Standing                                                        to an ADP listed modular seating device,
Committee                                                                                 authorizers may use code SEMND2005.
The P&O Standing Committee welcomes                                                       The CF codes and ND codes are not
back Karen Litman. The committee will                                                     interchangeable.
be meeting in the Fall of 2004.

Wheeled walkers: clarification of           clinics and individual authorizers working   who are specialist teachers of the
ADP policy                                  in the community. There is also academic     blind or rehab teachers as well as ADP
ADP eligible individuals may receive        representation and other representation      registered High Technology Visual Aids
funding assistance towards the purchase     from the field of augmentative and           Sight Substitution authorizers.
of an Adult Wheeled Walker Type 1 (MW1)     alternative communication. The target
                                                                                         What’s on the ADP web page:
or an Adult Wheeled Walker Type 2 (MW2)     date for the task force to complete its
and a wheelchair at the same time.          work is December 2004.
Type 1 (MW1) and Type 2 (MW2) replace                                                    •   Previous issues of the “ADP Today”
                                            Voice entry hardware and software
the previous Category 1 (MWA) wheeled                                                        newsletter
                                            For any voice entry hardware and
walkers. Adult Wheeled Walkers Type 3                                                    •   List of assistive devices covered and
                                            software, please use ADP catalogue
(MW3) replaces the previous Category 2                                                       not covered
                                            number/code CWAND800P (MS-DOS
(MWB) wheeled walkers. ADP funding                                                       •   Contacting ADP
                                            voice entry hardware and software)
assistance is not provided towards the                                                   •   Fact sheets
                                            and for voice entry software only, use
purchase of a Type 3 (MW3) wheeled                                                       •   Forms (ADP Applications) – View only
                                            catalogue number/code CWCND960P
walker and a manual or power wheelchair.                                                 •   Program information
                                            (Dictate – French). Catalogue number/        •   Questions and answers
Upgrades                                    code, descriptions and prices will           •   Links
When the intent is to fulfill mobility      be updated during Phase 2 of the
requirements beyond the scope of ADP        implementation of the new pricing            Health Care Providers
funding guidelines, the applicant may       framework.                                   • Contacting ADP
request to use their ADP funding towards                                                 • Standing Committee Members
                                            Writing with symbols
the purchase of another device (Section                                                  • ADP Policies and Procedures Manual
                                            For “Writing With Symbols” use ADP
1. 2. 6 Policy and Procedures Manual).                                                   • Forms (ADP Applications) – View only
                                            catalogue number/code CWSM1302L
The ADP portion will be for the basic                                                    • Previous issues of the “ADP Today”
                                            (for lease) or CWSM1302P (for purchase).
device prescribed, excluding options                                                       newsletter
                                            Please note that CWSDJ300L and
and accessories. The vendor may charge
                                            CWSDJ300P no longer exist in the ADP
the client no more than the ADP price
for the upgraded device.
                                            approved list of communication aids.         About the Assistive
Product Manuals
                                            New price for the Servox Electronic          Devices Program
                                            Speech Aid                                   The Health Services Division of the
The product manuals for ambulation
                                            The new ADP approved price for               Ministry of Health and Long-Term Care
aids and pediatric standers (Section 3),
                                            the Servox Electronic Speech Aid             administers the Assistive Devices
wheelchairs (Section 4), and positioning
                                            (CSLSM0002) is $909 and the ADP              Program (ADP). Through the ADP, the
devices (Section 5) are updated regularly
                                            contribution of (75 per cent) is $681.75.    ministry provides consumer centered
and include all newly listed devices.
                                            The price is effective August 2004.          support and funding to Ontario residents
To receive a copy of an updated manual,
please fax a request to the ADP office,                                                  who have long-term physical disabilities
including your ADP authorizer/vendor        Visual Aids                                  to provide access to personalized assistive
registration number and your full mailing                                                devices appropriate for the individual’s
                                            Who can authorize audio book
address or e-mail address.                                                               basic needs.
                                            playback machines?
                                            Audio book playback machines can be
Communication                               authorized by ADP registered authorizers
                                            who may be vision rehab workers,
Aids Category                               specialist teachers of the blind,
Eligibility criteria task force             rehabilitation teachers as well as ADP
A task force has been assembled to          registered High Technology Visual Aids
make recommendations to the ADP             Sight Enhancement authorizers or sight
regarding eligibility criteria for the      substitution authorizers.
Communication Aids category. Members
                                            Who can authorize low-tech
include ADP registered speech-language
                                            writing aids?
pathologists and occupational therapists
                                            Low-tech writing aids such as the Perkins
from across the province including
                                            Brailler, ID Mate or VoiceMate, may be
authorizers working at ADP designated
                                            authorized by ADP registered authorizers

Assistive Devices Program
Operational Support Branch
Ministry of Health and Long-Term Care
5700 Yonge Street, 7th Floor
Toronto, Ontario M2M 4K5

How to Contact Us
Assistive Devices Program
Operational Support Branch
Ministry of Health and Long-Term Care
5700 Yonge Street, 7th Floor
Toronto, Ontario M2M 4K5

General Inquiry Telephone #: In Toronto, call (416) 327-8804
Toll-Free in Ontario Only: 1-800-268-6021
TTY: 1-800-387-5559
Fax Number: (416) 327-8192

Detach this form and mail or fax it back to the address above.


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