<p> Version 1.0 Date of version 23/10/2009 All prescribers to the DCSI Applies to Equipment Program Issued by DCSI equipment Program Matthew Massy-Westropp Manager Delegated authority DES Belinda Carpenter Manager Procedure custodian Specilaised Equipment DES Equipment Program Date Published 23/10/2009 Due for review 23/10/2010 Confidentiality Public Determining eligibility for equipment DCSI strategic objective items SA Strategic Plan</p><p>Printed versions of this document may have been superseded. See the DCSI EP supporting documents public access list or DCSI Equipment Program site for latest version. </p><p>Overview</p><p>This procedure outlines how a clinician determines eligibility for provision of equipment item(s) to Department for Communities and Social Inclusion (DCSI) clients using the Key Approval Criteria for Equipment for provision of all equipment items) the eligibility Criteria and Criteria Screening Tools for specific items of equipment. </p><p>The key approval criteria guide provision of all equipment items to DCSI clients and clinicians should consider these criteria when prescribing items for all clients. </p><p>Specific eligibility Criteria are used by clinicians and delegates to guide consistent and equitable eligibility decision making for approval and provision of equipment items to Disability and Domiciliary Care SA clients. </p><p>See all the “Crieria” documents listed under “Equipment documents/Document type” at the Public access Equipment Program documents locations: EP supporting documents public access or SA government DCSI and Health staff can access EP documents and selected Novita documents from the DCSI Equipment Program site</p><p>Criteria Screening Tools are used to determine eligibility for provision of a scooter, electric bed, electric riser recliner, ceiling hoist, wheelchair carrier / car hoist and modified driving controls. See the Completing eligibility assessment using screening tool procedure.</p><p>The DCSI Operational policy on equipment states clients will be assured of appropriate clinical assessment for equipment need, and where applicable, recommendation for that equipment. Clinical assessment will be conducted by an approved health professional who, in conjunction with the client and / or other relevant parties, will define initial priority of need. Procedure detail</p><p>Step Description</p><p>1 To determine eligibility for all equipment item(s)</p><p>The need for an equipment item is identified at the clinical assessment or is requested on the referral information for the equipment only group of clients.</p><p>Does the client meet the Key Approval Criteria for Equipment for provision of an equipment item?</p><p>If yes, go to step 2 If no, go to step 4</p><p>2 To determine eligibility for a specific equipment item listed  Refer to the criteria for the specific equipment item.  Complete the eligibility Criteria screening tool if the request is for a: </p><p> o Scooter Eligibility Screen o Electrically Operated Bed Eligibility Screen o Electric Riser Recliner Chair Eligibility Screen o Ceiling Hoist Eligibility Screen o Wheelchair Carrier Eligibility Screen o Modified Driving Controls Eligibility Screen</p><p>Note: refer to procedure Completing eligibility assessment using screening tool</p><p>Does the client meet the clinical criteria for the specific equipment item?</p><p>If yes, go to step 3 If no, go to step 4</p><p>3 To seek delegate approval  Delegate approval is required for all of the above equipment items apart from a manual wheelchair or electric bed. </p><p> Forward the clinical assessment report to the delegate for approval / non approval. Refer to procedure Seeking delegate approval for an equipment prescription</p><p>Has delegate approval been given for the provision of the item?</p><p>If yes, complete prescription of equipment items, refer to procedures Completing online prescriptions , Completing online prescriptions, Completing paper prescriptions, and Clinical considerations for prescribers and assessment forms for specific items. If no, go to step 4</p><p>4 To advise client of non approval of equipment request</p><p>Complete the advice letter for clients for delegate to sign (Letter template - Not eligible equipment Flowchart</p><p>Clinician determines eligibility for equipment</p><p>Client meets Key approval criteria for provision of an NO equipment item?</p><p>YES</p><p>Clinician determines eligibility for a specific equipment item</p><p>Client Clinician advises client of non meets specific approval of equipment request, NO eligibility criteria for using the Letter Template - Not item? Eligible Equipment</p><p>YES</p><p>Clinician seeks delegate approval</p><p>Delegate approval NO for provision of item?</p><p>YES</p><p>Complete prescription of items</p><p>Overarching legislation and policy</p><p>The guiding policy for this procedure is the DCSI operational policy on equipment. Related procedures, standards and guidelines</p><p>Procedures Completing eligibility assessment using screening tool Seeking delegate approval for an equipment prescription Completing online prescriptions Completing paper prescriptions</p><p>Forms and templates Adult postural chair assessment form Bed pressure management device assessment Electric recliner lift chair assessment form Hoist Assessment Form</p><p>Supporting documents and references </p><p>Supporting documents Key Approval Criteria for Equipment Letter template - Not eligible equipment </p><p>Clinical considerations for prescribers / Criteria / Criteria Screening Tools See listed under “Equipment documents /Document type” at access locations described below</p><p>Other</p><p>DES website catalogue (for external prescribers)</p><p>DES online ordering system (for internal prescribers)</p><p>For access to all forms / supporting documents and procedures: </p><p>Check for latest e-version, photocopies may be out of date</p><p>Public access Equipment Program documents are available from EP supporting documents public access </p><p>SA government DCSI and Health staff can access EP documents and selected Novita documents from the DCSI Equipment Program site</p><p>For further information or feedback: </p><p>Phone: 1300 295 786 Fax: 1300 295 839 Email:[email protected]</p>