7.8 Assistive devices
Sections 2, 3, 55(1), 59(1) of Regulation 134/98.
Adequate documentation is on file to support decisions and level of benefit issued.
Random file reviews are completed to ensure that all requirements are met.
Application of policy
The Assistive Devices Program (ADP) of the Ministry of Health and Long-Term Care provides funding to people with long-term physical disabilities to obtain personalized assistive devices appropriate to their basic needs. Assistive aids and devices are used to replace, compensate for, or improve the functional abilities of people with disabilities.
The ADP provides assistive devices under the following categories:
- communication devices
- diabetic supplies
- enteral feeding equipment and supplies
- hearing aids
- orthotic devices
- ostomy supplies
- pressure modification devices
- prosthetic devices
- respiratory equipment and supplies
- visual aids
- wheelchairs, positioning and ambulation aids
For a full inventory of the devices covered by the ADP under each category, visit: http://www.health.gov.on.ca/en/public/programs/adp/categories.aspx
The ADP establishes funding maximums for certain devices but in most cases does not list individual prices. Where the ADP does not list individual prices, the vendor may charge the retail cost of the device. The client must purchase the device from an ADP-registered vendor who invoices the ADP for the amount of the device. This method of payment is used for the following categories: respiratory, wheelchairs, positioning and ambulation aids, communication aids, hearing aids, visual aids, and some prosthetics.
For devices under this funding method, the ADP will pay 75% of the vendor's selling price up to a maximum limit. For social assistance recipients, the remaining 25% of the cost of the device is paid directly by the Ministry (ADP bills the Ministry for this payment). However, if the total cost of the device exceeds the maximum limit set by the ADP, the recipient is responsible for paying the difference.
An exception to this billing process occurs in the case of hearing aids and personal FM systems where the 25% contribution is not covered by the Ministry. If any member of a benefit unit is required to pay the 25% consumer contribution for an assistive device, this payment is covered as a mandatory benefit.
If an assessment is required to determine eligibility for an assistive device under the ADP and there is no other source of funding for the assessment, the cost of the assessment is covered as a mandatory benefit up to an amount approved by the Administrator.
The ADP does not cover costs associated with the maintenance of and repairs to assistive devices. The cost of batteries and repairs for mobility devices such as wheelchairs are covered as a mandatory benefit if these costs are not otherwise reimbursed by another source.
Most devices must be authorized by a qualified health care professional who is a registered authorizer. This includes persons who work in hospitals, homecare agencies or private practice. The type of professional qualification may vary with the device category.
Members of the benefit unit are advised that gifts from family, friends or charitable or benevolent organizations for disability-related purposes can be applied against the cost of devices or supplies not covered by the ADP and are exempt as income.
If a device is purchased before being authorized for ADP funding, funding assistance under the ADP will not be provided. Applicants or recipients are responsible for such costs if the device is purchased before being authorized for ADP funding.