Power Mobility Equipment (POC 13)

This policy replaces the following VPPM 2 policy: 2.2.22.x Power Mobility.

Purpose

This policy provides direction on the consideration of applications for power mobility devices for clients.

Policy

Definitions

1. Ambulation: for purposes of this policy, the activity of walking normal distances by a person without a mobility impairment. Ambulation is not considered to include walking distances that would normally be travelled by the use of a motor vehicle or public transportation.  

General

2. The objective of the health care benefits program is to ensure that clients, in accordance with their treatment eligibility, are provided with reasonable and timely health care benefits which the Department considers to be an appropriate response to their assessed health need.
3. Power mobility devices are to be authorized primarily for the purpose of performing activities of daily living (ADL’s); however, aspects of instrumental activities of daily living (IADL’s) requiring ambulation (as defined above) may also be factored in.
4. It is important to note that power mobility devices are provided as a means to compensate for loss of ability to ambulate, not as a replacement for vehicle transportation.
5. Applications for transportation of the power mobility device outside the home (when the client needs to travel over longer distances than are sanctioned by this policy) are to be considered in accordance with the Vehicle Modifications (POC 13) policy.

Approval Requirements

6. A power mobility device may be authorized only for those clients who:
   1. have been assessed against established health requirements and cannot have their mobility needs reasonably met by other mobility aids in an ascending order as follows: cane, walker, wheeled walker with seat, or manual wheelchair; and                  
   2. are able to demonstrate that a power mobility device would be of clear benefit in allowing independent and safe mobility for activities of daily living in the home and for ambulation outside the home.
7. Caution should be exercised when authorizing a power mobility device to ensure that approval of the device does not unduly result in a potentially avoidable further deterioration of any remaining ability for unassisted ambulation (i.e., the potential for development of dependency on the device, and further loss of ambulatory ability as a result of diminished use).
8. A power mobility device is not to be authorized or continued for a client if there is a reasonable probability that the device will be operated in a manner or environment that creates a risk of injury to the client or other persons. This would include, for example, a client with visual, cognitive or physical disabilities that would reasonably impact safe operation.

Home Accessibility

9. The main living areas of the client’s home, including the entryway, bathroom, bedroom, kitchen and dining area, should be accessible by the power mobility device, if the device was approved for use in the home. If minor home modifications are required, i.e. widening a doorway, building a ramp, installation of in-home transportation or lifting devices, the request must be considered as part of the request for the power mobility device, as per the Home Adaptations policy.

Equipment Acquisition and Payment

10. The purchase, rental or leasing of equipment should be considered when deemed appropriate in the circumstances (e.g., a rental or lease arrangement may be appropriate where the client’s expected need is time limited).
11. Payment is limited to the cost associated with the type and model of power mobility device that most reasonably addresses the client's mobility needs as identified through a health assessment. In addition, a power mobility device should be chosen that is most reasonably expected to meet the power mobility needs of the client for most of the replacement period (i.e. not less than three years; normal replacement is every four to five years).

Care, Maintenance and Repairs

12. The client, a caregiver, or some other responsible person must be able to provide reasonable care of a power mobility device, such as ensuring that the device is properly stored, protected from the elements, charged, etc.
13. The initial assessment must identify whether the client has access to proper storage facilities to house the power mobility device. The Department will not fund storage requirements; however, if minor home modifications are required to facilitate usage or storage of the device, they must be considered as part of the request for the device. While the Department will not pay for the construction of a storage facility, consideration may be given to approving modifications of an existing facility (widening doorway, building a ramp) under the home adaptations policy.
14. Payment for maintenance and repairs will only be made for items which are no longer covered by a manufacturer's warranty. Consideration may be given to paying reasonable service charges where extensive travel is involved in repairing a power mobility device under warranty, where those charges are not covered under the warranty.
15. Pre-authorization is required by the Department for purchase, repairs, maintenance and replacement of power mobility devices. 
16. If there is a requirement for modifications of the power mobility device, these must be included as part of the original request, unless the client has had a change in medical condition or functional status following initial issue.

Restrictions

17. A client is normally limited to one power mobility device. A backup device should normally be a non-power intervention such as a manual wheelchair. As well, clients would not normally receive both a power wheelchair and a power scooter (any such requests could only be considered on an exceptional basis).
18. As a safety consideration, when scooters are recommended as a power mobility device, only four-wheeled models will normally be approved. Three-wheeled scooters will only be considered in exceptional circumstances.

References

Veterans Health Care Regulations, section 4(b)

Vehicle Modifications (POC 13)

Home Adaptations

Equipment (POC 13)