November 25 2004 - Process Change
Customisation/Modification of Equipment
This updates the Specialised Assessor Equipment Manual Section E1.10.1. Includes process, definitions and examples of what is considered to be modification compared to an equipment application
All modifications and/or customisation including any part or accessory that is attached to or added onto Ministry of Health owned equipment must be undertaken by an Enable New Zealand Technician or Enable New Zealand approved subcontractor.
Accredited Specialised Assessors are required to submit a written request to their local Enable New Zealand technician or Enable New Zealand approved subcontractor for any alterations/modifications required.
Enable New Zealand subcontractors have the authority to complete all alterations/modifications up to a value of $250. Approval must be sought from the Enable New Zealand Technicians for any work expected to exceed $250.
Where there are economical or practical concerns regarding the cost effectiveness of the alteration/modification requested, Enable New Zealand Technicians may consult the Policy and Professional Advice Team. The Policy and Professional Advice Team will liase with the Specialised Assessor to establish whether an equipment application should be submitted to Enable New Zealand.
Enable New Zealand Technicians and Enable New Zealand approved subcontractors have the authority to outsource work they do not have the capacity to do.
Modification: A modification is viewed as any change or alteration required to an equipment solution that is not achievable through the normal methods of adjustment available on that piece of equipment.
The intent of the modification service relates to existing Ministry of Health owned equipment and seating components and the changes that are made directly to that equipment.
It is expected that Specialised Assessors will have determined the modifications required through a process of assessment and trial if appropriate.
Any alteration to a seating system that involves changing existing componentry is considered to be a modification eg. Changing from curved lateral pads to straight pads, cutting a solid seat board for leg length discrepancy, changing the existing solid seat to a drop seat base and modifying the seating to fit. If new parts are required eg. Offset brackets for a seating system or a growth kit, then this would be a modification.
Normal Methods of Adjustment: Any alterations for growth or changing needs that can be met by using the adjustability available through existing adjustment mechanisms eg. seating bracketry or wheelchair axle and frame adjustments. Cutting of a Jay base cushion for leg length discrepancy would be viewed as a normal method of adjustment for that product.
Equipment applications vs Modifications:
An equipment application is only required where the item is not a modification AND requires an asset number.
Requests to fabricate whole items or provide seating components to be utilised within a funded mobility base are not modifications and should be treated as an equipment application. Eg. Where a child has a buggy and requires seating or fabrication of a seating insert for appropriate positioning these are treated as separate assets and therefore would be a seating equipment application, not a modification.
Any change to a funded wheelchair that involves an item/component that would normally appear on a wheelchair prescription form would be processed by Enable New Zealand as a modification (this does not include seating products, which appear on some supplier prescription forms) eg. Changing from standard legrests to elevating legrests, altering castor style, changing to height adjustable armrests, adding a safety belt or calf strap. Low cost items that are permanently attached to the wheelchair would also be processed as a modification eg. ankle huggers, shoe holders.
Items that are part of a wheelchair/seating solution eg. head rests, armrests, and trays are items which do not need to be tracked with an asset number (while they are recycled , they are not re-issued). An equipment application for these items is not necessary as Ministry of Health access and eligibility criteria will have already been considered and met in order for the client to have received their existing wheelchair/seating solution, and these items do not require an asset number.
Modifications to custom fabricated seating
Given the complex nature of many custom fabricated seating systems, it is often preferable to utilise the original custom fabricator to make major changes to the seating system eg. re contouring a backrest after spinal surgery. This would be processed as an equipment application, however the existing asset number for that piece of equipment should be quoted in the application.
Standard wheelchair pelvic positioning belts are processed as a modification. Where the client requires a specific style of positioning belt for postural control, this is considered part of the existing wheelchair/seating solution. Access and eligibility criteria have already been determined and approval for funding given, and because no asset number is issued an equipment application is not required. This is a modification that can be initiated via the Enable New Zealand Technician or Enable New Zealand approved subcontractor.
The following would be classified as a Modification:
Wheelchair pelvic positioning belt
4 point rear pull hip belt
Change to pneumatic castors
Change of flush mounted seat pan to drop seat base
Customise existing tray shape
Re- contouring of custom fabricated system
Drop base to replace standard upholstery
Seating inserts for car seat or buggy