Alberta Health
Alberta Health Alberta Aids to Daily Living Pediatric Bathing and Toileting Aids Feeding, Standing and Walking Aids Recycle Equipment Policy & Procedures Manual July 1, 2014 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Revision History Description Date Policy K-04: Updated information about submitting QFRs and minor wording changes. July 1, 2014 Policy K-05: added policy on Pediatric Client Growth July 1, 2014 APL K17 and K18: removed July 1, 2014 APL K-37: added components July 1, 2014 APL K-255: added accessories July 1, 2014 APL K-275: removed July 1, 2014 Revised by combining policies, partial removal of recycling provisions, and reformatting. January 1, 2014 Overall manual formatting revisions, including updating of all policy numbers. April 1, 2013 Policy K-01: Additional information on chart for clarification. April 1, 2013 Policies K-03 to K-14: Minor wording changes to be consistent with “B”, “C” and “G” policies. April 1, 2013 Policy K-15: Product information and specifications: all “K” benefits placed in this section (some were previously in “G” manual. Products placed in numerical order. April 1, 2013 © 2014 Government of Alberta 2 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Table of Contents Policy K – 01 ..................................................................................................................4 Process to Obtain Recycled Equipment ..................................................................................... 4 Policy K – 02 ..................................................................................................................5 Authorizing Benefits .................................................................................................................... 5 Policy Statement.................................................................................................................................... 5 Procedure .............................................................................................................................................. 5 Policy K – 03 ..................................................................................................................7 Eligibility Criteria for Pediatric Benefits ....................................................................................... 7 Policy Statement.................................................................................................................................... 7 Procedure .............................................................................................................................................. 7 Policy K – 04 ..................................................................................................................8 Quantity and Frequency Limits ................................................................................................... 8 Policy Statement.................................................................................................................................... 8 Procedure .............................................................................................................................................. 8 Policy K – 05 ................................................................................................................10 Pediatric Client Growth ............................................................................................................. 10 Policy Statement...................................................................................................................................10 Procedure .............................................................................................................................................10 Policy K – 06 ................................................................................................................11 Care and Maintenance of Equipment ....................................................................................... 11 Policy Statement...................................................................................................................................11 Procedure .............................................................................................................................................11 Policy K – 07 ................................................................................................................13 Trial and Rental Equipment....................................................................................................... 13 Policy Statement...................................................................................................................................13 Procedure .............................................................................................................................................13 Policy K – 08 ................................................................................................................14 Internal Transfers ...................................................................................................................... 14 Policy Statement...................................................................................................................................14 Policy K – 09 ................................................................................................................15 Approved Product List (APL)..................................................................................................... 15 Policy Statement...................................................................................................................................15 Policy K – 10 ................................................................................................................17 Refusal of the Equipment .......................................................................................................... 17 Policy Statement...................................................................................................................................17 Procedure .............................................................................................................................................17 Policy K – 11 ................................................................................................................18 Formal Recycle and Community Recycle ................................................................................. 18 Policy Statement...................................................................................................................................18 Procedure .............................................................................................................................................18 Policy K – 12 ................................................................................................................19 Product Information and Specifications .................................................................................... 19 Appendix A: Glossary of Terms ............................................................................................ 30 © 2014 Government of Alberta 3 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Policy K – 01 Process to Obtain Recycled Equipment Client needs identified Client assessed by authorizer, decision on equipment eligibility Authorizer organizes equipment trial Identifies correct equipment Completion of 1250 order form 1250 form distributed as indicated on bottom of form AADL confirms eligibility AADL determines if available in Recycle Available in Recycle Pool Not available in Recycle Equipment shipped to preferred vendor Item recycled out from vendor AADL orders from Vendor of choice Client pays cost share (if applicable) Vendor arranges delivery Vendor invoices AADL for appropriate amount after client receives benefit Equipment returned to vendor or community once according to label on equipment once client no longer needs it © 2014 Government of Alberta 4 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Policy K – 02 Authorizing Benefits Policy Statement An OT , PT, or RN must be trained and registered as an AADL program authorizer to authorize for large equipment. Authorizers: • Assess client’s equipment needs in their home environment. • Confirm client eligibility including residence and past benefit consumption. • Provide client choice of vendor according to Approved Product List (APL). • Trial equipment to ensure it is appropriate for client in their environment. • Complete the AADL Authorization form including benefit number and model/brand of product if necessary. • Address Need for Prior Approval if required: add clinical information to the Authorization Form to justify the request. Do not phone the AADL office for prior approvals. • Some equipment, is labeled “Recycle” in the APL, is formally recycled and is ordered and purchased by AADL. Equipment, which is labeled “Community”, is community recycled and ordered by the authorizer in the same manner as a “B”, “C”, or “V’ benefit. Authorization forms are mailed in to AADL with the exception of equipment orders for palliative clients. These may be faxed to AADL and will be processed within a day. Procedure Authorizers/Clients/Vendors/AADL: 1. Follow process to obtain large equipment on page 4. Clients: 1. Sign client declaration. 2. Pay cost-share contribution, if applicable. © 2014 Government of Alberta 5 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 AADL: 1. Process authorizations. 2. Pays claims. © 2014 Government of Alberta 6 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Policy K – 03 Eligibility Criteria for Pediatric Benefits Policy Statement This section contains special equipment for children under the age of 18 years including: feeder seats, floor sitters, adaptive standers and pediatric walkers Benefits are not provided to persons who are in a general hospital or a long-term care facility except as part of a definitive discharge plan. These benefits are only for children under the age of 18 years. AADL equipment is not to be ordered for short-term use. AADL defines short-term use as when equipment is needed for less than six months. Procedure Authorizers/Vendors: 1. Determine if client is eligible for benefits. 2. Follow the process outlined on page 4. 3. Advise clients that equipment is not authorized for short-term use and that short term use loans are often available through regional community loaner pools or the Red Cross equipment loaner programs. Clients: 1. Pay cost-share contribution, if applicable. Vendors: 1. Provide trial equipment. 2. Collect cost-share contribution if applicable prior to delivery of equipment. 3. Deliver equipment to client within a period specified on the vendor contract. © 2014 Government of Alberta 7 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Policy K – 04 Quantity and Frequency Limits Policy Statement The quantity and frequency limit for sitters, commodes, shower/commodes, walkers and bath equipment is one per four year period. The quantity and frequency limit for standers and walkers is one per six year period. Benefits are provided to eligible clients based on need. Equipment should only be replaced when it is no longer suitable to meet the client’s needs due to a change in medical condition, or the equipment cannot be cost effectively repaired. No QFR is required if equipment needs to be replaced due to growth one size or greater for pediatric clients. The Authorizer must indicate growth has occurred on section three of the 1250 form. When a need to replace the equipment has been identified, the client must arrange for a large recyclable benefits vendor to assess the equipment’s condition. The vendor will advise the AADL with a work order, and will obtain direction regarding repair or replacement. The authorizer/client will be advised by the vendor. When considering quantity limits, take into account that pediatric needs may be met by the benefits found in the “B” and “C” section and some products are in the same benefit group as some of the specialized pediatric equipment found in section “K”. A client cannot have more than one item in the benefit group or have more than one benefit for a function. For example: A client may have one walking aid. If the client has a specialized pediatric walker, they may not also have forearm crutches (“C” benefit). Similarly, if the client has an AADL-supplied standing frame for use at home, they may not have a second AADL-supplied standing frame for use at school. Procedure Authorizers: 1. Advise clients of quantity and frequency limits. © 2014 Government of Alberta 8 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 2. Follow the Quantity and Frequency Review (QFR) process, if the client is over-quantity. 3. Submit QFR to AADL for approval. 4. Submit 1250 form to AADL once QFR is approved. 5. When equipment is replaced, the previous equipment should be informally recycled to a different client. Clients: 1. Ensure proper use, care and maintenance of equipment. 2. Obtain insurance to replace equipment in the event the equipment is lost, stolen or damaged 3. Pay for repairs and maintenance to equipment that is outside of the warranty terms. 4. Seek other funding options for equipment needs that fall outside the quantity and frequency limits. Vendors: 1. Confirm client’s previous consumption for the requested benefit. 2. Advise authorizer if client is over-quantity for requested benefit. 3. Do not provide benefit to client unless an approved QFR request has been received. 4. Do not bill clients or AADL for vendor errors. © 2014 Government of Alberta 9 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Policy K – 05 Pediatric Client Growth Policy Statement Growth is expected to occur in pediatric clients. Therefore, no Quantity and Frequency Review (QFR) is required if the client’s equipment needs to be replaced due to growth. Growth must require a change in one full size of the equipment. Procedure Authorizers/Vendors: 1. Determine if client is eligible for benefits. 2. Follow the process outlined on page 4. 3. Advise clients that equipment is not authorized for short-term use and that short term use loans are often available through regional community loaner pools or the Red Cross equipment loaner programs. 4. Put client growth as reason for replacement in Section 5 of the 1250 form. © 2014 Government of Alberta 10 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Policy K – 06 Care and Maintenance of Equipment Policy Statement The client (their family, trustee/guardian) is responsible to ensure reasonable care and maintenance of AADL-supplied equipment. AADL does not replace equipment that has been lost, stolen, abused or damaged. Clients should purchase insurance to cover the cost of replacement should the equipment be lost, stolen or damaged. AADL will fund repairs and maintenance to formally recycled equipment (see “Z” benefits). AADL will fund repairs to bathing and toileting equipment if it is cost-effective and is being utilized by the client that was originally assessed and authorized the equipment. AADL does not pay to repair or maintain privately owned equipment. This is the client’s financial responsibility. Procedure Authorizers: 1. Advise clients of their responsibility regarding AADL funded equipment. Clients: 1. Maintain private insurance if required. 2. Take AADL purchased equipment to an AADL approved large equipment vendor for repair as needed. Vendors: 1. Determine if client was issued benefit through Interactive Voice Response (IVR) system. 2. Advise if equipment is eligible for repairs to be funded by AADL 3. Create work order for repairs if the client was authorized the equipment. 4. Submit on E-business. © 2014 Government of Alberta 11 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 AADL: 1. Determines if it is cost effective to repair the equipment. 2. Advises vendor about whether or not to proceed with repairs. © 2014 Government of Alberta 12 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Policy K – 07 Trial and Rental Equipment Policy Statement Large equipment vendors will provide equipment for a trial period not to exceed three days. At the end of the trial period, the authorizer must arrange to have equipment returned. The client may not keep the trial equipment. A client may enter a rental agreement with a large equipment vendor for temporary or shortterm use of this type of equipment. AADL does not reimburse clients for any rental charges they may incur. Procedure Authorizers: 1. Policies for the use of trial equipment should be explained to the client. See the form for client use: “AADL Train Equipment Use” on the AADL website. 2. Arrange for any trial equipment to be returned to the vendor. 3. Advise client that AADL will not reimburse clients for any rental charges if the client chooses to rent equipment from the vendor. Vendors: 1. Provide trial equipment as requested by the Authorizer. Clients: 1. Return equipment to AADL approved vendor after trial period is over. 2. Comply with trialing protocol ie, dry run only, does not sit on bathing/toileting aid with exposed skin. © 2014 Government of Alberta 13 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Policy K – 08 Internal Transfers Policy Statement An authorizer may transfer a piece of “K” large recyclable equipment from a client who no longer needs it to one who does. Please see the “Z” manual for an example of the internal transfer documentation. Only standard benefits can be internally transferred. Standard-plus benefits must be returned to the recycle vendor and cannot be internally transferred. The item being internally transferred must be in good repair, be a good fit, and not need any parts changes. If this is not the case, the equipment should be recycled in and an appropriate one ordered for the client. Items marked community recycle in the APL are not required to follow this process and can be transferred without advising AADL. © 2014 Government of Alberta 14 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Policy K – 09 Approved Product List (APL) Policy Statement Only products on the Approved Product List (APL) are eligible for AADL funding. The effective dates of the APL are on the cover page. “Benefit Status” column indicates whether AADL will pay for the full cost of the benefit (S = Standard), or if the client will have to pay some extra above the AADL maximum contribution (SP = Standard Plus). Standard Benefits designated on the APL as “S” are fully funded by AADL (subject to cost sharing). All clients are eligible for these benefits if they have an assessed need. The items identified under “Return Equipment” as “Recycle” are owned and maintained by AADL. Standard Plus Benefits designated on the APL as “SP” are funded by AADL to a stated maximum contribution level (subject to cost sharing). There are generally similar items available on the APL that are available as standard benefits. A client may choose a Standard-Plus model, but will have to pay the amount that exceeds the AADL maximum contribution and is indicated as a “Client Upcharge”. This extra amount is less than the AADL maximum contribution and is not considered a cost-share payment. The “SP” items identified under “Return Equipment” as “Recycle” are owned and maintained by AADL. Upgrade Upgrade benefits are rarely listed on the APL, but might be offered as a choice for clients. If a client chooses an item designated as “U” on the APL, the program will pay a maximum contribution (subject to cost sharing) towards the purchase. The amount that is the client’s responsibility to pay is greater than the AADL maximum contribution. In this case, the client will own the equipment and will be responsible for its ongoing maintenance and repair costs “Return Equipment” column indicates whether AADL formally recycles the equipment, and where the equipment is returned to when it is no longer needed. It also advises who is to actually order the equipment. The more expensive equipment, which is labeled “Recycle”, is formally recycled and is ordered and purchased by AADL office staff. The less expensive equipment, which is labeled “Community”, is community recycled and ordered by the authorizer in the same manner as a “B”, “C”, or “V’ benefit. © 2014 Government of Alberta 15 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 “AADL Price after Discount” column indicates the amount AADL will pay towards the benefit. This amount is fixed for the duration of the purchase agreement term. “Comments/Client Upcharge” column contains any extra information that is needed when authorizing the benefit. It includes information such as when clinical information must be added to the 1250 form, that a prior approval is required, when the item is priced in American dollars, any extra amount the client needs to pay, and any eligibility restrictions. Authorizers: 1. Use the APL to complete the 1250 form. 2. Advise the client of cost-share and upgrade charges. Vendors: 1. Only provide AADL clients with equipment that is listed on the APL. 2. Advise the client of cost-share and upgrade charges. © 2014 Government of Alberta 16 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Policy K – 10 Refusal of the Equipment Policy Statement By signing the Declaration form the client is acknowledging that they are prepared to accept the equipment that has been authorized and ordered for them. During the authorization process the client has the opportunity to trial the equipment and ensures their home and living situation can accommodate the equipment. Procedure Authorizers: If the client/family refuses to accept equipment that has been ordered for them, the authorizer should advise them of the following: 1. Clients are not eligible to be re-authorized until six months has elapsed. 2. If the family wants the equipment re-authorized they must send in a letter to AADL for consideration. 3. If the client refuses to accept equipment a second time, the client will not be eligible again. AADL: 1. Reviews the circumstances around the refusal of the equipment and considers the request. © 2014 Government of Alberta 17 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Policy K – 11 Formal Recycle and Community Recycle Policy Statement The AADL program retains full ownership of all formally recycled equipment. The equipment is not for resale and must be returned to a recycle benefits vendor when the client no longer needs it, or when it has been replaced by AADL, or when the client moves out of Alberta or if for any other reason becomes ineligible for the benefit. AADL-purchased equipment identified on the APL as “return to community” is still the property of the Crown. Although AADL does not formally recycle it, the client is expected to return the equipment to a local community recycle pool once it is no longer needed. It should not be resold. Procedure Authorizers/Clients: 1. If the equipment is recycled return the equipment to an AADL approved recycle vendor when it is no longer required by the client. 2. If the equipment is community recycle, cycle the equipment in the community. 3. If the client resides in a facility or continuing care centre, the facility can re-allocate that piece of equipment to another resident. © 2014 Government of Alberta 18 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Policy K – 12 Product Information and Specifications Toileting/Bathing Equipment K015 Child’s High Back Toilet Support Contoured ABS plastic, height adjustable back. Powder coated steel base mounts to toilet. High back support with harness for trunk and head support. Back can be removed easily so others can use the toilet. Includes seat reducer ring and splashguard. Base of back width 14.5”, back height adjustment 18” - 24” Columbia 4700 Small Columbia 4800 Large Accessory: Armrest/footrest assembly - Columbia 4925 Armrest/Footrest Assembly K016 Pediatric Commode Otto Bock Aquanaut (Variety Ability System) Contoured seat and back, removable anterior support, independent foot support. Includes contoured sitting support, bi-level foot support, side laterals, and front trunk support. Removable hip pads accommodate growth. Holds 120 lbs. max. © 2014 Government of Alberta 19 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 K019 Pediatric Commode / Shower Chair with Tilt Client must have wheel-in shower R82 the Swan Contoured fibreglass shell, with pommel and deep walls that provide lateral support. Stainless steel frame, tilts 15 - 30 degrees, adjustable height. Includes headrest, footrest, footrest rod, and pan. Other options available but not listed on APL. Size 5 only: Seat 15” x 13”, back height 29”, seat to floor height 18.5” - 25” Holds 176 lbs. K023 Pediatric Commode / Shower Chair with Tilt Client must have wheel-in shower R83 Flamingo Several positioning options (tilt, recline). Use over toilet, tilted over sink or tub, wheeled into shower, or as bath seat (with suction cups). Adjustable seat to floor height 19.5” - 23.5”, angle adjustable footrest, casters, aluminum frame folds, seat white molded plastic. Removable seat can be used as a bath seat. Includes mobile base. Size 1 Size 2 Size 3 Size 4 10” x 10”, back height 14”, holds 77 lbs. 11” x 11.5”, back height 15.5” seat, holds 110 lbs. 12.75” x 13.5”, back height 17” seat, holds 132 lbs. 13.5” x 16.5”, back height 18.5” seat, holds 154 lbs. Accessories available on APL: Side extenders (without back upholstery) Mounting hardware Suction cups K025 Pediatric Tilt Commode with 5” caster Maple Leaf Junior Tilt Commode Nickel plated epoxy coated frame, height adjustable base (21-23”), 5” castors (three directional casters lock and one directional lock), adjustable headrest, mesh back, drop arms, removable seat, gas struts for tilting, push handles, holds 180 lbs; available in two sizes only (12” x 14” or 14” x 14”). Can be ordered with wheelchair wheels for self -propelling. Accessories: Side laterals included in 2014. 24” Wheelchair wheels © 2014 Government of Alberta 20 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 K026 Pediatric Folding Commode with 5” casters Maple Leaf Junior Escape Commode Nickel plated epoxy coated frame, 5” castors (three directional casters lock and one directional lock), adjustable headrest, mesh back, drop arms, removable seat, holds 180 lbs; available in two sizes only (12” x 14” or 14” x 14”). Can be ordered with wheelchair wheels for self propelling. Commode folds like a wheelchair. Accessories: 24” wheels K037 Pediatric Tilt Commode / Shower Commode / Toileting System Client must have wheel-in shower Rifton HTS Can be used as free standing shower/commode, or over the toilet commode, or on the toilet. Comes in two sizes – small and medium. Specify Components Needed: Z112 Small mobile base comes with tilt Z113 Small mobile base with no tilt Z115 Mounting bar round toilet Z125 Mounting bar elongated toilet Z101 Low armrest Z102 Medium armrest Z153 Open seat pad Z154 Closed seat pad Z104 Headrest Z116 Small butterfly harness Z145 Small anterior support (tray) Z105 Small laterals Z117 Small pan Z118 Standard deflection Z119 Splash guard Z124 Abductor © 2014 Government of Alberta Small 30”-50” tall Large 48”-72” tall 21 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 K046 Child’s Bath Support Seat supports trunk to allow child to be seated upright in bathtub. Adjustable height yoke support for back, mesh sling for seat is bacteria and fungal resistant, adjustable belt. Child sits on mesh sling on floor of tub. Priced in US $, price converted to CDN $ on day of purchase. Columbia Wraparound 7200 Small (low back) Back width 8.5”, height 9” - 14” Small & Medium Columbia Wraparound 7300 Medium (low back) Back width 12”, height 10” - 14” Columbia Hi-Back 7700 Medium High back width 14”, height 19” - 23.5” Columbia Hi-Back 7900 Large High back width 14”, height 19” - 23.5” Medium & Large High Back K047 Child’s Adjustable Reclining Bath Chair Columbia Features: adjustable height, adjustable reclining back 30-70 degrees, frame rust proof, rip proof bacteria and fungal resistant mesh fabric, high back supports trunk and head. Two safety straps. Columbia 8500 Small – Holds 100 lbs. max. Seat 12” x 10”, back height 21”, overall width 17”, height 2” - 4.5” Columbia 8600 Medium – Holds 130 lbs. max. Seat 12” x 14”, back height 28”, overall width 17”, height 2” - 4” Columbia 8700 Large – Holds 180 lbs. max. Seat 17” x 17”, back height 31”, overall width 19”, height 6” - 9” Otto Bock Robby Reclining Bath Chair Low height, compact and transportable. Independently adjustable head, back, seat and leg sections. Telescoping tubes for growth. Removable and washable net upholstery. Head section folds down. Size 1 overall length 115 - 133 cm, width 38 cm, weight 3.8 kg Size 2 overall length 147 - 173 cm, width 38 cm, weight 4.3 kg Accessory: Headrest © 2014 Government of Alberta 22 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 K047 Child’s Adjustable Reclining Bath Chair (continued) Rifton Blue Wave Mesh seat, seat removable so child can sit on tub and lean on back, adjustable legs lift seat from 5-18 cm, leg straps, reclines to flat. E514 Small 37 cm x 33 cm, back height 46 cm, holds 60 lbs. max. E524 Medium 37 cm x 33 cm, back ht. 64 cm, holds 120 lbs. max. E534 Large 37 cm x 42 cm, back height 81 cm, holds 160 lbs. max Snug Seat Manatee Bath Seat Bath seat with mesh cover, reclines in 4 positions, legs adjust to 4 height positions 5” - 17”. Adjustable frame accommodates growth in depth. Comes with waist strap, headrest and lateral cushions. Colour: Blue mesh and blue straps only. Width 16” Seat holds 165 lbs. Size 1 882015 Seat depth 10” - 13”, back ht. 17”, lower leg 11” Size 2 882025 Seat depth 13” - 16”, back ht. 23”, lower leg 14.4” Other accessories available but not purchased by AADL. Drive Medical Dolphin Bath Chair Seat and back angle adjust indepencently Fits all standards tubs. Includes two adjustable position belts and headrest for safety Drive Medical Otter Bath Chair Lightweight folding bath chair, height adjustable. Features adjustable slip resistant legs that raise the chair up to 7”. Fabric is removable and machine-washable. Size 1 - 60 lbs max Size 2 -120 lbs max Size 3 -160 lbs. max © 2014 Government of Alberta 23 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Feeder Seats K252 Sammons Preston Tumble Forms 2 Feeder Seat The seat portion (only) of the Tumbleform feeder seat system. If child already has the base wedge and has outgrown the seat, then this item is to be ordered to replace the seat. Comes with harness. Comes in colors blue (B), red (R), Teal (T) and Purple (P). Options are available but are not listed on APL as a benefit. Note: If child needs an extra large feeder seat, you must order the deluxe floor sitter to get the wedge that fits. 2795N Small - inside seat 7.75” x 8”, child height to 36” 2795M Medium - inside seat 9 “x 9.5”, child height to 48” 2795X Large - inside seat 12.25” x 13.25”, child height to 60” K254 Sammons Preston Tumble Forms 2 Deluxe Floor Sitter The deluxe floor sitter includes both the feeder seat and the wedge base. The wedge base allows child to be in an upright or reclined position. Comes with harness. Comes in colors blue (B), red (R), Teal (T) and Purple (P), and wedge and feeder seat can be in different colors. Options are available but are not listed on APL as a benefit. 4542B Small - inside seat 7.75” x 8”, child height to 36” 4542A Medium -inside seat 9” x 9.5”, child height to 48” 4542D Large - inside seat 12.25” x 13.25”, child height to 60” 4542E X-Large - inside seat 15” x 16.25”, child height to 72” © 2014 Government of Alberta 24 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Standing Frames K255 Adaptive Standers – on 1250 form explain plans for standing Buffalo Standing Frame R82 Prior approval needed. Please describe intended usage, and describe success of trial. Can be used for both prone and supine standing, manually controlled tilt, height adjustable for growth, powder coat finish on steel frame, vinyl upholstery, casters lock, adjustable footrests, belts, frame 21” x 34” Size 1 –width 19”, Holds 110 lbs. Size 2 – width 21”, Holds 154 lbs. Size 3 – width 24”, Holds 220 lbs. Accessories: Trunk Extension 86105-48 or 86106-48 size 1 86124-59 or 86111-59 size 2 86131-58 or 86133-58 size 3 Laterals supports set - size 1, 2, and 3, Pommel size 1, 2, and 3, Knee Supports size 1, 2, and 3 Tray PVC size 1, 2, and 3 Giraffe Standing Frame Models V2 #307-1000 or #807-1000E1 Prior approval needed. Please describe intended usage, and describe success of trial. Can be used for prone, supine, and upright standing. Locking casters, belts, highly adjustable for child height of 18” - 60” with 36”center spar. Largest base dimensions 34” x 41.5”. Holds 90 lbs. Accessories: Clear Acrylic Tray Center Spar Replacement (24", 36", or 48" length) Snug Seat Gecko Upright Stander Includes 4 locking casters, height and width adjustable trunk support, combined hip/sacral support, multi-adjustable knee supports, swing away pelvic stabilizer, standing platform, depth and width adjustable foot positioners. Size 1 – Length 27”, width 23.5”, fits to child 20” – 42” tall. Size 2 – Length 33”, width 33”, fits to child 41” – 56” tall. Accessories: Tray - Size 1 Tray - Size 2 Trunk Pad Assembly - Size 1 Trunk Pad Assembly - Size 2 © 2014 Government of Alberta 25 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Sitters K259 Otto Bock Flip2Sit Floor Sitter Works two ways – as floor-level positioner and also a stable seat for table height activities. Two-way belt, cushioned seat, anti-slip pads, strap secures to chair. Normal age range 2-5 years old. Seat 10" x 9.5". Holds 50 lbs. max. K260 Tumble Form Universal Corner Sitter Maintains leg extension, reduces extensor thrust. Padded. Broad base to prevent tipping, integral abductor blocks support removable tray, hip positioning belt and adjustable H harness, weight capability 125 lbs. C4590U Sammons Preston Tumble Forms 2 Universal Corner Sitter K268 Special Tomato Soft Touch Sitter (Includes Wood Tilt Wedge Kit) • • • • Included with the Soft-Touch Sitter Tilt Wedge Kit are: - Soft contoured seat with anti-thrust seating surface - Built in abductor - Contoured head and lateral supports - Adjustable 5-point positioning harness - Attachment straps for securing to a standard chair or tilt wedge - Wooden Tilt Wedge Base with 25 degree tilt capability 90-200 pound weight capacity 54-74" Height Range 5-Year Warranty © 2014 Government of Alberta 26 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Walking Aids K275 Pediatric Walkers R82 Pony Padded seat, brakes on 3 wheels, directional locks on rear wheels, very adjustable for support and handle bars, some options available which are not on the APL. Size 0 – 23.25” x 26.25”, seat height 9” - 15”, holds 66 lbs., suggested user age to 3 years. Size 1 – 27” x 28.25”, seat height 15” - 19.5”, holds 88 lbs., suggested user age 3 to 6 years. Size 2 – 30.25” x 41”, seat height 19” - 25”, holds 110 lbs., suggested user age 6 to 9 years. Size 3 – 42” x 52”, seat height 21” - 36”, holds 155 lbs., suggested user age to 7 to 12 years. R82 Bronco Similar to the Pony walker, but more robust for heavy outdoor use. Has 8” x 2” locking wheels with directional stabilizers, highly adjustable. Size 0 – 23” x 37.5”, seat height 10” - 14.5”, holds 66 lbs., suggested user age to 3 years. Size 1 – 26” x 42”, seat height 13” - 20”, holds 88 lbs., suggested user age 3 to 6 years. Size 2 – 29” x 49”, seat height 17” - 24”, holds 110 lbs., suggested user age 6 to 9 years. Cricket Gait Trainer Easily adjustable steel frame, tension adjustable rear wheels to add or reduce resistance for ambulation, support ring around the waist, some accessories are not included on the APL. C1745S Small - Child maximum height 43”, holds 77 lbs. C1745L Large - Child maximum height 53”, holds 77 lbs. Accessories: C1746TS Trunk Support Small C1746T Trunk Support Large C1747-03 Handle Bar (Griprail) C1746S Saddle C1746C Banana Seat C1746SC Seat Cushion © 2014 Government of Alberta 27 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Rifton Gait Trainer Frame folds for easy transport. Swivel casters have one-way ratchet to prevent backward movement. Variable brake drag slows forward movement. AADL purchases this walker in metallic blue. Other options are available, but are the client’s financial responsibility. Frame size: K511 Small - elbow height 44 - 66 cm, holds 75 lbs. K521 Medium - elbow height 61 - 86 cm, holds 150 lbs. K531 Large - elbow height 81 - 119 cm, holds 200 lbs. Accessories: K512 Arm Prompt Small K532 Arm Prompt Large K514 Chest Prompt Small K524 Chest Prompt Medium K534 Chest Prompt Large K513 Hip Positioner Small (with handholds) K533 Hip Positioner Large (with handholds) K519 Handholds Snug Seat Crocodile Gait Trainer Lightweight folding aluminium frame, width/height adjustable rotational handles with handgrips, directional lockout, on/off anti-reverse wheel stops, friction adjustable rear drag wheels, swivel front casters, padded rear stabilizer bar with tool kit. Size 1 – yellow, length 28.75”, width 24.5”, handle height 16” – 29.5”, handle width 8” – 20.5”, weight 11 lbs., user height to 45”, holds 66 lbs. Size 2 – orange, length 33.5”, width 26”, handle height 20” – 34”, handle width 9” – 22”, weight 14.3 lbs., user height to 59”, holds 99 lbs. Accessories: 86810 Forearm Support Set with grip – Size 1 86811 Forearm Support Set with grip – Size 2 Solid Seat Size1 or Size 2 Other accessories available, but not purchased by AADL. © 2014 Government of Alberta 28 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Snug Seat Gator Gait Trainer Folding steel frame, width and height adjustable rotational handles, choice of handgrips, on/off anti-reverse wheel stops, swivel front casters with removable caster pin locks (straight or variable tracking), four 6” x 1.66” tires, padded rear stabilizer bar, length 27.5”, width 23”, handle width 10” – 18”, handle height 13.5” – 27”, weight 22 lbs. Fits 45” – 75” tall child. Accessories: 4800-L Forearm Support Left 4800-R Forearm Support Right Other accessories available, but not purchased by AADL. Otto Bock Nurmi Neo Walker Comes with continuous height and depth adjustable grip bar, 5-year limited warranty, front wheels swivel, reverse-roll wheel locks, foldable. Color: green only. HR24161800 Size 1 – width 25”, weighs 12 lbs., 6” wheels, holds 55 lbs. HR24261800 Size 2 – width 26.75”, weighs 13 lbs., 6” wheels on front, 8” wheels on rear, holds 88 lbs. HR24361800 Size 3 – width 28”, weighs 14 lbs., 6” wheels on front 8” wheels on rear, holds 121 lbs. Accessories: (Must be put on at time of order) Standard Grip Bar Size 1, Size 2, Size 3 Grip bar with Universal Grip Size 1, Size 2, Size 3 Extra High Grip bar w Forearm Support Size 1, 2, or Size 3 Fold up Seat Size 1, Size 2, Size 3 Caster Swivel Wheel Locks HR24167200 Anti-tippers (Blue 306) Size 1 HR24267200 Anti-tippers (Blue 306) Size 2/3 HR24167200 Friction Brake Other accessories available for private purchase. © 2014 Government of Alberta 29 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 Appendix A: Glossary of Terms Please review the glossary of terms included in the large equipment (“G” and “L”) and wheelchair (“W”) sections of the manual. Community Recycle AADL purchased equipment that is identified as “return to community” on the Approved Product Listing (APL). This equipment can be reused in the community and does not need to be returned to an AADL vendor for recycling. Equipment Trial It is required that the client and caregiver try the equipment in the client’s home before it is authorized. Vendors assist with the provision of trial equipment. Trial must include access to rooms in home. Bathroom equipment is to be tried “dry”, not “wet”. Clients who soil trial equipment will be responsible for purchasing the equipment. Formal Recycle All AADL owned equipment is formally recycled by AADL. When the client no longer needs the equipment, it is returned to a recycle vendor. When an authorizer requests large equipment for a client, AADL looks for it in the Recycle pool. When there is no suitable recycle equipment available in the recycle pool, then the program buys new from the preferred vendor. Internal Transfer An authorizer may reassign large equipment from a client who no longer needs it to one who does. Some restrictions apply. “Standard-plus” equipment may not be internally transferred without prior approval from AADL. See “Z” section for instructions and sample of internal transfer documentation. Palliative Clients A client is deemed palliative if in the end stage of a terminal illness when care is focused on symptom relief and not cure. Palliative equipment orders receive priority when they are received in AADL. Recycle In The process that occurs when a large piece of equipment is returned to a recycle vendor. See “Z” section. Recycle Out © 2014 Government of Alberta 30 Alberta Health, Alberta Aids to Daily Living Program Manual, Manual G, Adult Bathing and Toileting Recycle Program Benefits, Policy and Procedures Manual July 1, 2014 The process that occurs when AADL assigns a piece of equipment from the recycle pool to a client. The equipment is refurbished, and sent out to the client. See “Z” section. Recycle Pool The equipment inventory owned by AADL and stored at various recycle vendor locations in the province. Recycle Vendor A recycle vendor is an AADL registered vendor who holds a contract for the supply, maintenance, storage, and recycle of Large Recyclable Equipment. Recyclable Benefits AADL purchased equipment that remains the property of the Government of Alberta and is loaned to clients for their use. When returned to AADL by the client, these items are refurbished and reused. Standard-Plus The term describing a situation when the client pays extra towards the cost of the equipment. It is owned by AADL because AADL contributes more than half the cost. Upgrade The term describing a situation when the client pays more than AADL towards the purchase of the equipment. It becomes the client’s property because they contributed more than half of the cost of the item. AADL does not pay for parts or repairs for Upgrade equipment. There is rarely an Upgrade opportunity in the “G” section. © 2014 Government of Alberta 31
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