Medical Supplies – General (POC 7)

This policy replaces the following policies: Equipment Ownership; Equipment or Supplies in Health Care Facilities; and Purchase or Rental (Equipment).

Purpose

This policy describes medical supplies, which includes durable medical equipment and consumable medical supplies, and outlines the conditions governing their approval for individuals eligible to receive treatment benefits under the Veterans Health Care Regulations.

Policy

General

1. For the purpose of this policy, a reference to the term “Veteran” is interpreted to include all individuals eligible for medical supplies and equipment, as well as their duly authorized representatives, if applicable.
2. If a Veteran satisfies the applicable eligibility criteria (see Eligibility for Health Care Programs – Eligible Client Groups), medical supplies and equipment may be approved in accordance with this policy.
3. Medical supplies are those items that are:
   1. essential to effectively monitor or treat an illness or injury; and,
   2. primarily used to serve a medical purpose, and, generally, not useful to a person in the absence of an illness or injury.
4. Medical supplies fall into two categories:
   1. Durable Medical Equipment which:
      1. can withstand repeated use; 
      2. is appropriate for use in the home; and
      3. is prescribed by a health professional.

Examples include items such as: glucose meters, transcutaneous electrical nerve stimulators, and nebulizer compressors.

Durable medical equipment differs from special equipment authorized under POC 13 in that it is used to treat or monitor an illness or injury. Special equipment (e.g. wheelchairs, walkers, transfer/lift devices, etc.) enables an individual to carrying out activities of daily living such as feeding, bathing, toileting, etc.

Note: Prescription drugs required for use in durable medical equipment (i.e. salbutamol, commonly known as Ventolin or Aerolin) are authorized under POC 10.

1. 2. Consumable Medical Supplies (non-durable items) which:
      1. are often disposable in nature;
      2. cannot withstand repeated use by more than one individual; and
      3. are prescribed by a health professional.

Examples include items such as: bandages, disposable gloves, diabetic test strips, colostomy bags, catheter and catheter supplies, syringes and needles, and splints and slings.

Consumable medical supplies may be approved when they are prescribed to prevent further injury. An example is bandages prescribed to prevent bed-sores.
Consumable medical supplies also include items necessary for the effective use of durable medical equipment, such as non-prescription items (i.e. nebulizer filters, masks, tubing, etc.).

Approval of Items on Benefit Grids

5. When a health professional has prescribed a benefit that appears on the benefit grids, this is generally sufficient evidence for a decision-maker to approve the benefit.

Approval of Items Not Appearing on Benefit Grids

6. Medical equipment and supplies not listed in the benefit grids may be approved based on information and medical evidence that:
   1. the benefit has been prescribed by a health professional and is essential to effectively monitor or treat an illness or injury; and/or
   2. the Veteran's condition and/or general health would be negatively affected in the absence of this particular benefit.

Purchase, Rental, or Lease to Purchase of Durable Medical Equipment

7. Durable medical equipment may be acquired via purchase, rent, or lease to purchase. The decision to purchase, rent, or lease to purchase is made at the discretion of the VAC decision maker, using the most economical option available.
8. Durable medical equipment that is purchased or acquired through a completed lease to purchase agreement is considered the property of the Veteran. Equipment that is rented from a third party remains the property of the third party.

Durable Medical Equipment in Health Care Facilities

9. Funding for durable medical equipment that is normally provided by a health care facility should not be approved as an additional expense to Veterans Affairs Canada.
10. Funding for durable medical equipment that is not normally provided by a health care facility may be approved, as outlined in the relevant benefit grid, as an additional expense to Veterans Affairs Canada if the item is:
    1. a replacement of a similar item previously provided by Veterans Affairs Canada prior to admission; or
    2. an effective response to the Veteran’s health-related needs which has been prescribed by the treating physician, medical specialist, or other approved health professional; and approved by the delegated decision maker (see Business Processes for POC 13 ).
11. The health care facility must agree in writing that the item may be placed/installed in the facility, and that it will be used exclusively by the Veteran for whom it was purchased.
12. Prior to approving an item for a Veteran in a health care facility, the delegated decision maker should take into consideration whether or not the item meets the current needs of the Veteran; and whether or not the item will meet future needs, if a Veteran’s discharge from a health care facility is anticipated.
13. When a Veteran is discharged, the delegated decision maker must be satisfied that adequate supervision will be available to the Veteran in using the item. In making this determination, an on-site visit to the new place of residence may be required.

References

Veterans Health Care Regulations

Medical Supplies (POC 7) - Benefit Grid

Guide to Treatment Benefits, Health-related Travel and VIP (Blue Cross)