Social Policy in Ontario

The Assistive Devices Program (ADP), which provides 75 per cent of the cost of critical equipment such as power wheelchairs, portable oxygen, prostheses and insulin pumps, was declared a non-essential workplace March 24 due to the COVID-19 crisis.

And yet equipment vendors, who continue to receive government funding, have been deemed essential and are still open, causing confusion among people with disabilities who struggle to pay for equipment without ADP approvals.

The situation highlights the urgency to “to modernize the ADP system and to move to more digital solutions to support eligibility reviews and funding approvals,” said Christine Brenchley, executive director of the Ontario Society of Occupational Therapists.

“It is unclear why some elements of application review processes cannot proceed with safe practices of social distancing as in other areas of essential service,” she wrote in a letter to ministry officials March 27, in which she raised concerns about the government’s decision to close ADP.

Barrie-area mother Heather Morgan, a disability activist who has a rare neuromuscular condition, said she has also been raising the alarm with ministry officials and her local MPP.

“Many people with disabilities in the community rely on specialized equipment to remain in their homes safely while they self-isolate,” said Morgan, whose 16-year-old daughter, Ten, has an acute form of the condition that makes it difficult for her to even sit up and has been bedridden for the last year.

After months of waiting, an error in Ten’s application for a motorized wheelchair was sorted out last month, just as the ADP program was closed, Morgan said.

“My daughter has already missed a year of school because of this, and now we don’t know when the funding will come through,” she said.

“But this isn’t just about my family,” Morgan said. “I have heard from someone who is taping their prosthetic leg together because they cannot get it fixed and can’t function without it. I have heard from someone whose elderly relative needs a rollator (a type of walker that helps prevent falls) and can’t access one but lives alone. On and on the stories go.”

A spokesperson for Health Minister Christine Elliott said the government is aware of the uncertainty around the ADP program.

“We’re currently evaluating options to provide greater continuity of services under the Assisted Devices Program during the COVID-19 pandemic,” Hayley Chazan said in an email.

In 2017-18, the health ministry spent about $514 million to provide mobility and medical devices for more than 400,000 Ontario residents, an increase of about 48 per cent in the last 10 years, according to a 2018 provincial auditor’s report. More than 8,000 devices are covered under the program.

Since the program closed, the ministry has continued to fund equipment vendors based on an average of their monthly billings for the past six months. But some vendors are reluctant to offer equipment without ADP funding approval, Morgan said.

Others have said they will provide equipment if clients pay the 25 per cent co-payment. But for her daughter’s motorized wheelchair, that amounts to $10,000, she said.

Many people rely on insurance to cover co-payments. But insurers won’t cover the cost without an ADP approval, she said. “So it is a Catch-22 situation.”

In her letter to the ministry, Brenchley expressed grave concerns about the province’s decision to close ADP services during the pandemic.

She said many hospital patients are unable to return home or move to long-term care without access to appropriate seating and mobility systems.

Closing ADP will delay timely discharges that are critical as hospitals prepare for a surge in COVID-19 patients, warned Brenchley, whose society represents the province’s 4,300 registered occupational therapists.

Those living in the community who need mobility equipment repairs, upgrades or new equipment will be put at increased risk of falls, pressure injuries and other loss of independence if they can’t access ADP financial support, she said in the letter.

Some people will end up in emergency departments and put increased demands on home care during a time when the health-care system is already struggling to fight the pandemic, she noted.

ADP is already experiencing a three-to-seven-month backlog, Brenchley said, adding the situation will only worsen if the program remains shuttered during the health crisis.

In an email Thursday, Brenchley said the ministry has been working to ensure “expedited” funding approval for patients being discharged from hospital who need seating and mobility equipment.

“While not perfect, the ministry has addressed a workaround for essential services,” she said. “At this time we’re monitoring impacts.”

Double amputee Aristotle Domingo, founder of the Amputee Coalition of Toronto, is not aware of any local members who were awaiting ADP funding approval when the office closed last month.

“What I can share, however, is the level of anxiety that we feel while we wait for an approval from ADP even on a regular day,” he said this week. “In the amputee community, getting approval for a prosthesis or wheelchair is a game changer.”

Without funding support, mobility is severely limited, resulting in “less than ideal healthy outcomes both physically and mentally,” he added.

https://www.thestar.com/news/gta/2020/04/13/activists-fear-for-safety-of-people-with-disabilities-after-funding-for-mobility-and-medical-devices-deemed-non-essential.html