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Submitting EMS requests during COVID-19 Alert Level 4

We appreciate your patience in waiting to hear from us about how our services will be operating during this level 4 national lockdown.

Thank you for collaborating with us during the recent Zoom sessions and providing us with feedback, concerns and things to consider as we navigated this unprecedented situation in which we find ourselves.

As you will be aware, the Ministry of Health has released criteria by which essential services can define their operations during this time, and we are now establishing new processes and pipelines to ensure that we are operating within that remit.

For Enable New Zealand, we will continue to provide services which ‘prevent a risk of serious harm or hospitalisation or support a person’s discharge from hospital.’ The main focus is keeping people safe at home.

This document provides guidance as to how our services and processes will be adapted during this time. We appreciate your understanding that we’re operating in a fast-paced and constantly changing environment at the moment, where things are changing daily. We will continue to assess our services, the supply chains that support them and the roles and capabilities of all our stakeholders and may need to make changes when necessary.

Please ensure you read any updates sent to you by Enable New Zealand so you can be confident you are up to date with the latest developments and process requirements.

Band 1 equipment requests

Band 1 equipment request process will remain the same during this time. However, in line with the agreed Ministry of Health definition of essential equipment, only equipment deemed essential based on ‘prevention of risk of harm or hospitalisation, or that supports a person’s discharge from hospital’ should be requested during this time.

Non-essential equipment requests

Requests for non-essential equipment may still be submitted, but these will remain in our system for processing until such time as the level 4 lockdown is lifted and normal business operations allow.

We have liaised with our suppliers to ensure they are aware of the process.

Delivery of equipment

  • If the equipment is being delivered directly to the client, the courier with leave at the door without contact with the client.
  • If the equipment is being delivered to you to pass on to your client, we ask that you align with your organisation’s practice around contact with clients and follow your agreed infection prevention protocols. Please also be aware that there may be delays in deliveries as freight companies need to prioritise other essential transportation requirements.

Band 2 & 3 equipment requests

Band 2 & 3 equipment requests will be subject to the essential criteria – only requests for equipment that help ‘prevent risk of serious harm or hospitalisation or supports a person’s discharge from hospital’ should be submitted during this time.

Please indicate in the notes of your request (preferably on page one) why you believe your request matches the criteria. If further clarification is needed on a request for essential equipment, our team will contact you to discuss this in more detail.

At this time, Hearing Assistive technology (HAT) equipment requests are not considered urgent requests.

Some aspects of Communication Assistive Technology (CAT) are considered urgent, when it meets the above criteria – at this time EMS Advice is not required.

Requests which are classified as non-urgent will be kept in our system to be revisited at a later date, however we would request that you keep non-urgent requests to a minimum at this stage to allow for streamlining in our review process.

We are currently working through a process for delivery of larger pieces of equipment i.e. beds and will confirm with you shortly once a solution has been found.

EMS advice requests

The EMS Advisory Service is functioning as normal, whilst complying with all protocols around working remotely.

We are working through all your current requests and prioritising them.

If you have an urgent request - it meets the criteria of supporting discharge or will prevent hospitalisation or re-entry into hospital - and meets MOH eligibility and access criteria, going forward we will waver EMS advice during this time but the request may still be reviewed.

Please include on the notes section of the equipment request and in the EMS Portal document why you consider your request meets the definition of Urgent. Mandatory consultation guidelines still need to be adhered to for non-urgent, wheelchairs/ seating and Housing modifications. We will monitor this weekly.

EMS Portal

You still need to come through the EMS portal and provide your clinical rationale. Please ensure the information is robust and sufficient – this will enable our teams to understand your request without further communication with the EMS Assessor and therefore avoid delays.

If you submit a non-urgent request please make sure this is noted on the request. We will be working through our equipment back log during this time, and we will include a text line on each purchase order that this is a non-essential piece of equipment and therefore not required for dispatch until the level 4 is lifted.

Requests that have already been submitted

Equipment requests that have already been submitted will be triaged by our review team in line with current criteria. We may be in touch with assessors to clarify whether requests meet the current criteria.

Requests which are classified as non-urgent will be kept in our system to be revisited at a later date. This may include requests that have already been approved if they involve follow-up that is not possible under current criteria.

Collections

There will be no equipment collections performed at this time. The form to request collections has been disabled on our website for the time being.

Equipment trials

Updated on 6/4/20: Only trials for pieces of equipment that are deemed essential will be approved and commenced during this time. We will work with Assessors where necessary on a case by case basis. More information about arrangements for EMS equipment trials can be found on our DFI notice

All outstanding trials will be purchased and the equipment can remain with the client during this time.

Equipment Repairs (Equipment subcontractors)

During this time, only repairs for essential equipment will be carried out. In line with the definition of essential services, only repairs that help ‘prevent the risk of serious harm or hospitalisation, or that support a person’s discharge from hospital’ will be considered. Our sub-contractors have been informed of this change in process, and have been advised to contact us should they need assistance in defining an essential repair.

Housing modifications

Limited housing modifications or installations will still be carried out in cases where they match the essential services criteria. Where modifications are part-finished modifications work will be continued to ensure homes are habitable (with access to standard gas, water, electricity and similar essential utilities). Access is also being prioritised.

Requests which are classified as non-urgent will be kept in our system to be revisited at a later date. This may include requests that have already been approved if they involve follow-up that is not possible under current criteria.

Accreditation

We will review dates of credentialing expiry over this period of time and extend them out.

Reissue Equipment

If you choose to reissue equipment, the equipment cleaning must meet your DHB infection control process for equipment.

Housing and Wheelchair and Seating clinics

Until further notice, face to face wheelchair/seating or housing outreach clinics will no longer occur.

An EMS Wheelchair & Seating or Housing Outreach Advisor is available to offer Zoom or FaceTime appointments as an alternative option to outreach clinics for clients whom you have prioritised as urgent. Please email ppa@enable.co.nz if this is required.

FAQs from Assessor Zoom sessions

With regards to making a note on request; can I ask if HAT Band 1 for smoke alarms be covered under new urgent criteria with regarding to safety in home? As it does not assist with discharge generally and readmission into hospital.

Band 1 equipment is still available currently, however requests need to meet the definition of essential equipment in terms of preventing risk of serious harm or hospitalisation or supporting a person’s discharge from hospital.

Will housing mods that have been approved still go ahead?

Only urgent housing modifications will occur in next 4 weeks to support discharge and safety at home. This is likely to only be centred around access solutions. Your request will still go ahead but will not be processed until we are back up and running. Any mods that are part way through but not deemed essential will be made safe and habitable, with access to all essential services such as water, gas, electricity etc.

Can we still send through trial successful forms for purchase?

At this point we are suspending the commencements of new trials and all existing trials will be purchased.

Are 20-day trials suspended or extended?

All existing trials will be purchased and the equipment can stay with the client.

What about the specific increased risk with children with challenging behaviours, now being within homes 24/7 for 4 weeks plus?

If you believe your request will prevent hospitalisation or is for safe discharge then please submit it will clear rationale. We will continue to look at requests on a case by case basis where required and seek further clarification from the assessor if needed.

Just wondering if we can continue to make service requests into the system despite the fact that they won't be urgent?

We understand that you may want to continue sending through non-urgent service requests in order to help clear work back-logs at the moment and that is fine. However please be aware that these requests will remain in our system and will not be processed until such time as we are back up and running as usual.

CDHB have advised that community providers will not be making showering/bathing essential meaning potentially I will have clients that will be showering themselves (regardless of me telling them to sponge wash)- toilet transfers and safety - with view of this will Enable contractors still be able to install with view of reducing falls risk and preventing hospital admission?

At this time, showering and bathing is not deemed essential based on Ministry of Health criteria. We would encourage discussions with your client around personal responsibility for maintaining their own safety during this time and finding alternative options to issues such as this, for example sponge washing versus showering.

We are an Enable sub-contractor but are unable to get PPE equipment as we’ve been told it is only for DHBs and GP Practices. How can we get the PPE equipment?

Enable New Zealand has been able to secure two PPE kits per sub-contractor which is to be used only after prior communication with Enable New Zealand. All sub-contractors have been sent detailed information with regards to our process for preliminary screening before commencing a job.

Regarding housing applications that have been approved for children who are a flight risk and require fencing – will this considered to be essential and builders allowed to complete the work?

We can start to process the request, but as per usual timeframes it is very unlikely the solution will be in place in 4 weeks. We’d recommend you look into other alternatives to support the family during this time.

We also have a retail and hire side of our business. Can we continue this, in view we are preventing a burden on the health system?

Each individual business needs to make that call based on criteria set out by MoH on what is an essential service. Unfortunately, we are unable to make that call for you.

If you are unsure if your business is considered essential, email essential@mbie.govt.nz or call 0508 377 388 for guidance.

Our ward has enquired about getting 3-in-1 commodes for use with COVID patients so they can toilet in their rooms - so far I've gone to using short term loan commodes - is there any option of being provided 3-in-1 commodes through Enable or do wards/hospitals have to purchase these?

Purchasing is an option, but also if the need meets urgent criteria and person is eligible for EMS we will consider the request. We are currently working through arrangements by which we can further support DHBs.

Will there be any priority for families who need equipment for children to reduce the stress within the family (significant risk of mental health issues)?

If the person is likely to be at risk of serious harm or likely be admitted to hospital and the solution will prevent this, then we would consider it on a case by case basis and may need further rationale from the assessor. If there is any concern you may wish to consider supports around the family and Enable New Zealand can offer advice on a case by case basis.

Can we send applications to provide equipment that will release hospital loan equipment back? We are short of equipment in our pool.

We will consider solutions if they are for safe discharge. We are working with DHBs around how we can support loan pools.

Does Enable have any guidelines re: cleaning of equipment used by COVID patients? i.e. short-term loan equipment.

You will need to follow the processes and guidelines of your DHB for effective cleaning and infection control. We have our own practices in place for cleaning equipment that comes back to us.

In Auckland we use Accessable - are they using the same urgent criteria as Enable?

Yes, this criteria came from the MOH. We are collaborating with Accessable to ensure we are being as consistent as possible when it comes to definitions and decisions around essential vs. non essential.

What about modifications for children with challenging behaviours?

If the solution prevents likely admission to hospital we will consider it.  However, in reality these solutions will not be in place immediately due to existing process and contractor availability so we would urge you to explore alternative solutions for the family in the interim period. Enable New Zealand can offer advice on a case by case basis.

Will things like over toilet surrounds be delivered set up or in several pieces? If not, please can they be sent with instructions so families can put them together?

Where possible we are advising couriers and repair sub-contractors to limit contact with clients so set up will be very unlikely.  We would encourage the assessor community to provide as much information about set up and use to clients as possible and we will send out instructions as well.

Will there be another zoom update next week as the situation develops?

Yes we’re keen to keep communicating with you as much as is required. This is a fast moving situation and plans and decisions could change frequently. We’d urge you to read any updates we send through and let us know of issues or considerations you think of as things progress.

To clarify – access is seen as a priority only if it’s for facilitating discharge and not in general referrals?

Yes this is correct, and also a priority where it prevents possible admission to hospital.

Regarding deliveries where the plan is to drop off at the door - what about hospital bed and mattresses?

Where larger pieces of equipment such as beds are deemed as essential, we are still able to get these out to clients but it may take longer than normal. We will need to manage each delivery on a case by case basis, and work with our sub-contractors to determine the safest way forward. For every case we will keep in contact with the assessor to ensure they’re kept in the loop.

Is it to possible to have a stock of equipment such as walking frames to issue from source i.e. hospital?

Enable New Zealand has been authorised by the Ministry of Health to support DHB Short Term Loan (STL) inventory by providing MoH Long Term Loan equipment where we are able to source such equipment. We have been in contact with key DHB Short Term Loan managers regarding this. Due to expected demand, requests will be limited to a small number of authorised DHB staff and we will be sending out further information to STL managers regarding the process for this once we have finalised details.

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