DME

Blog posts of '2020' 'December'

When Do We Consider Renting AT Equipment?

Today we will discuss some situations where rental may be a beneficial option to consider. Over the years I have been contacted frequently about renting Assistive Technology (AT) for mobility and seating, from basic entry level through to complex solutions.


Interim Use

Interim use often refers to short term use whilst waiting for your regular equipment to be funded or repaired. In these situations, someone needs something and needs it now, How would you get about your day, complete all the activities and tasks that you need to do if your mobility was suddenly taken away? Could you sustain your daily activities of life? How would you be impacted not being able to go to school, to work, to the supermarket, out to see friends or attend appointments? Whilst there are various funding models, each of these works in slightly different ways and have different processes.

There are also different waiting times within each model and whilst most will offer funding or a means of repairing equipment how can someone continue with their day to day life without access to equipment to support their mobility?

Some disability service providers, hospitals or community groups may have loan pools where members or clients can access various AT for short term use. These vary and often include donated equipment so may have limitations in sizes and features. Whilst they may include equipment that is adjustable, they don’t always have someone available to reconfigure to a user’s specific needs.

This can be a great solution if you can match the users essential short term needs to equipment available however the more specific the users needs the more difficult this can be due to resources and availability of complex equipment. As seating therapists, we are usually striving to fit the equipment to the individual and their needs, rather than fit the individual to the equipment. Let’s consider scenarios where someone may want or need to rent for interim use.

 


Repairs and Maintenance

Whilst we don’t like to compare a mobility base to a motor vehicle in terms of functional use, when we look at the mobility base independently it also requires ongoing servicing and maintenance and can require mechanical repairs. Just like a car, maintenance may require waits for parts or completion of work to ensure it continues to be reliable and to meets client requirements. The service provider completing repairs and maintenance may have a mobility base that can be borrowed however if the user’s mobility base has certain features or specific configuration, a non-complex loaner may not meet their functional needs.

In this situation a user may want to consider renting a chair that is more specifically suited to their needs. Seat-to-floor height or seat elevate, for example, may be essential for the user to maintain independent transfers, the user then may require additional support not usually required. The impact of not having access to a mobility base that meets their needs is potentially not only affecting their mobility, but on them getting into or out of bed which could additional support and resources.

It is important to have a plan for what happens if the user doesn’t have access to their essential equipment as breakages and mechanical repairs are not always predictable! Do you have a plan for your clients if things go wrong?


Waiting for the Funded Solution

As discussed earlier there are different funding processes and the biggest difference between Australia and New Zealand’s government funding for disability is the order that the process takes when applying for equipment; In Australia an assessment is completed, equipment trialled and then an application is made for funding. Once funding is approved the equipment is ordered and an average of 6-8 weeks later, the equipment is delivered. In New Zealand the assessment takes place and the application to trial specific options is submitted, once approval is given a trial will be set up and there is an opportunity to keep the trial chair if it is successful.

As such the wait times and where the wait times occur do differ. An interim use chair may be required based on the users needs while they await assessment, funding or delivery of new equipment.

Renting equipment can also assist therapists and users identify how certain features or configurations can impact on function and assist in identification of potential solutions to trial. In Australia the trial time is limited to an appointment with the supplier which only provides a small snapshot of the user’s life and function. It may be appropriate to consider options for a longer trial period to fully identify what works and doesn’t work for a user.

We are aware of several users that have rented complex mobility bases before proceeding with funding as they wanted to ensure certain features where used or considered in multiple environments.


Short Term Use

Short term use is when the user doesn’t need their equipment long term, it may be part of rehab or assist someone in getting home from hospital post-surgery. This equipment is usually less complex and if required for hospital discharge is often loaned or rented from the hospital or arranged by the hospital staff. Short term rental is often considered when it is more cost effective than purchasing equipment that won’t be needed in the future.

Short term rental can also be an option when someone is travelling and not wanting or able to take their equipment with them. Travelling and resources may mean that someone takes a manual chair but wants a powered chair to explore and independently access the locations as they would normally at home in their power chair. 


Intermittent or Occasional Use 

Off road or all terrain chairs and beach chairs are often essential to access certain locations. How frequently will they be used? These chairs will not usually be practical for everyday use, so can be a large cost for occasional use that don’t meet some funders’ criteria. What will be the most cost-effective solution? If someone lives on a farm or rural location, they will potentially be using the equipment daily. But if it’s for an annual holiday to the beach or to the farm, renting may be an option to consider.

How can I rent mobility and seating solutions? 

  • Funding for rental may be available in some situations, this is best to addresses with your specific funding body
  • Talk to your therapist or service provider about potential options 

If you want to discuss any essential clinical features and options you feel are essential in an interim or short-term mobility or seating base, contact us at education.au@permobil.com. If you are looking at renting any Permobil products you can find more information on our Rental page.


Tracee-Lee Maginnity
Clinical Education Specialist

Tracee-Lee Maginnity joined Permobil Australia in July 2019, as a Clinical Education Specialist. She graduated Auckland University of Technology with a BHSc (Occupational Therapy) in 2003 and has since worked in various roles related to seating and mobility including assessing, prescribing and educating. 

Tracee-Lee is passionate about maximising functional outcomes with end users and the importance of education within the industry.

Alternative Funding Options 


It is important that as prescribers we understand the funding criteria and can articulate both the clinical justifications and how these can or cannot be met within the funding framework. Why do some applications fail to get approved and what are the options in these circumstances? Sometimes a person’s equipment needs may not fit within the funding requirements. In other cases it’s that a clear picture of the needs hasn’t been articulated. 

Either way, not getting funding approval for Assistive Technology (AT) doesn’t mean it’s not needed. In fact, if we have assessed and identified a specific need and identified a feature as a necessary part of a solution, we need to ensure that the end user understands the why’s and how to’s to inform future decision making. Today’s blog discusses some of these options and challenges. 

Funding not approved for essential equipment needs 

If a funding application has been declined and you feel it fits within the funder’s criteria and has been clinically justified through assessment, most funding processes have ways to appeal and this should be considered. In these situations, we initially need to understand why. Is it a mis interpretation of the criteria or has the justification not been clearly articulated? Consider what reasoning and feedback was provided by the funding body. 

Not meeting funding criteria 

Both New Zealand and Australia have really good funding systems. In fact, when compared to other countries around the world we could say we have some of the best funding opportunities for AT internationally. But funds are not infinite and to ensure that essential needs for more people are met there are certain limitations within each system. This can be difficult for someone to understand who has needs and requirements viewed from the perspective of their lived experience. As such we do need to be able to have clear, open communication around what can be funded. Whilst we may still identify a need there may be an ethical requirement to seek alternative options.

When prescribing AT it is important that we understand the criteria of the funding body. If someone is not going to meet the criteria, then we need to have the discussion early on and support the user to make an informed decision about their options. There are often options in this scenario such as co-funding where certain features are not fundable. But if the provision of the AT or a feature is essential to the user you may need to seek alternative funding.

Self Funding

In communities where equipment is routinely funded it is sometimes hard to have conversations around self funding. We shouldn’t assume that someone doesn’t want or can’t financially contribute to their equipment. If a colour choice or accessory is not within the criteria but important to the user they may wish to self fund the up charges. It is important they are aware of the options and choices around this. As a mum I would have definitely considered paying for light up castors for my child’s wheelchair for the annual school disco, but as a therapist this would have been something I potentially wouldn’t have felt comfortable justifying.

Crowd Funding and Fundraising

Self funding also doesn’t necessarily mean someone has the financial means to pay themselves. A popular fundraising movement of crowd funding has seen communities come together to help raise funds through online and digital platforms which often reach beyond a person’s community. Others may opt with more conventional fundraising through local events, family and friends.

Charities

There are many charities that contribute to assisting people financially. These also often have criteria and some prioritise equipment needs not funded by government funding agencies. Knowing these organisations and requirements can help us to identify potential options. Most require a supporting letter or application from the therapist involved. Is the user involved in any local organisations that may have funding or sponsorship opportunities?

Local support groups and associations for specific disabilities or impairments may also be an avenue to consider as a resource of financial support and advice in relation to equipment needs.

As mentioned earlier we are fortunate with our funding systems across Australia and New Zealand. The take home message is that if something is assessed and will assist someone in living their best life we should consider all options and know the funding parameters and alternative options available.

If you are wanting to know more about funding in AU and NZ, we are currently running a webinar series on this topic. The feedback and response shows how important a part of the AT prescription process this is! Part 3 is live next Thursday, 10th December – don’t forget to register here. If you missed Part 1 and 2, don’t panic! These were recorded so you can keep an eye out on the replay schedule here. 


 

Tracee-Lee Maginnity
Clinical Education Specialist

Tracee-Lee Maginnity joined Permobil Australia in July 2019, as a Clinical Education Specialist. She graduated Auckland University of Technology with a BHSc (Occupational Therapy) in 2003 and has since worked in various roles related to seating and mobility including assessing, prescribing and educating.

Tracee-Lee is passionate about maximising functional outcomes with end users and the importance of education within the industry.