ALS Canada ALS Equipment Program Overview & Information ALS Canada is dedicated to assisting individuals diagnosed with ALS to cope with the daily challenges of decreasing mobility, communication ability and retaining independence. To be eligible for the ALS Equipment Program the applicant must: Have proof of diagnosis of ALS, PLS and/or Motor Neuron Disease Be registered with ALS Canada Have accessed all other sources of financial assistance through private insurance Have accessed Assistive Devices Program (ADP) and other government and nongovernment sources before applying for this program; if applicable to equipment The ALS Equipment Program provides access to basic and essential assistive equipment through: Loan Equipment Pool Program Purchase Funding Program Lease Funding Program Rental Funding Program Loan Equipment Pool Program: Assessment to be performed by a registered healthcare professional (Occupational Therapist, Physiotherapist or Registered Nurse) Complete and return the ALS Equipment Request Form with as much detail about the equipment requested and the Wheelchair Specifications Page; if applicable. Please ensure that your fax has been transmitted successfully. Our fax number is: 905-248-2019 All clients can access the loan pool regardless of income Financial information not required for accessing the equipment loan pool program Please note Delivery costs are the client s responsibility in most regions Purchase Funding Program (if not available in Loan Pool): Assessment to be performed by a registered healthcare professional (Occupational Therapist, Physiotherapist or Physician) Complete and return the ALS Equipment Request Form with as much detail about the equipment requested and the Wheelchair Specifications Page; if applicable. Please ensure that your fax has been transmitted successfully. o Our fax number is: 905-248-2019 Page 1 of 5
Submit most recent Notice of Assessment 1,may be faxed to above number. Check with your insurance provider to determine whether you have coverage Healthcare practitioners to determine if ADP is applicable to this equipment request After ADP and/or insurance funding the ALS Ontario will cost share the client s portion; if eligible (refer to Cost Sharing Funding and Income Criteria) Lease Funding Program: Central Equipment Pool (CEP) Communication Devices This program is run by the government of Ontario and provides communication equipment on a lease basis to clients. The government provides funding towards the purchase and repairs of devices through CEP. The client is responsible for a yearly lease fee of up to $800.00. ALS Canada may cost share the client s portion (refer to Cost Sharing Funding and Income Criteria) To access this program contact a speech language pathologist (SLP) in your community or at the ALS clinic you attend Speech Language Pathologist to complete and return the ALS Equipment Request Form including a quote from CEP. Please ensure that your fax has been transmitted successfully. Our fax number is: 905-248-2019 After ADP and/or insurance funding ALS Ontario will cost share the client s portion; if eligible (refer to Cost Sharing Funding and Income Criteria) For cost sharing funding, submit most recent Notice of Assessment, may be faxed to above number RENEWAL: Statement of account for yearly renewal to be provided to ALS Canada by the Speech Language Pathologist, Assistive Technology Clinic (ATC) or client. Central Equipment Pool (CEP) Power wheelchairs Assessment to be performed by Occupational Therapist or Physiotherapist for funding consideration recycled power bases are to be requested by assessing therapists Please contact ALS Canada to determine whether the wheelchair requested is available in our loan pool Investigate personal insurance coverage. If coverage is not available, complete and fax Equipment Request Form including a quote (required) to ALS Ontario. Please ensure that your fax has been transmitted successfully. o Our fax number is: 905-248-2019 ALS Canada will cost share the client s portion; if eligible (refer to Cost Sharing Funding and Income Criteria) For consideration of cost sharing funding, submit most recent Notice of Assessment, may be faxed to above number. 1 Canada Revenue Agency form sent annually to all persons who submit income tax returns Page 2 of 5
Rental Funding Program (Straight Stair Glide/Lift only): Funding for rentals is only provided for straight stair glide/lift Funding for curved stair glide/lift is not provided by ALS Canada. You may wish to contact the Ontario March of Dimes or pursue other means of funding Funding is only provided for one straight stair glide/lift The healthcare providers must complete and submit the ALS Equipment Request Form by fax to our office. Please ensure that your fax has been transmitted successfully. Our fax number is: 905-248-2019 ALS Canada will cost share the client s portion; if eligible (refer to Cost Sharing Funding and Income Criteria) For cost sharing funding, submit most recent Notice of Assessment, may be faxed to above number Please note that Installation & Removal Costs are the client s responsibility Please note that the ALS Canada does not trial equipment. ALS Canada Designated Equipment List Equipment Available for Loan, Rental/Lease or Purchase Assistance: The following items may be available for loan from the ALS Loan Equipment Pool. If an item from this list is not available and is considered basic and essential, ALS Canada may provide funding assistance for purchase/lease/rental cost of the requested item. Major categories Bathroom Aids Mobility Aids Patient Lifts 2 Miscellaneous Communication Items covered includes but not restricted to the following: Shower Commodes, Bath lifts. Wheelchairs (manual and power driven), Scooters Transfer systems like Mechanical/Power 'Hoyer type' lifts, Ceiling track lifts Lift chairs, hospital beds, pressure relief surfaces, portable ramps, stair glide/lift 3 etc. Most types of communication devices are available on lease through the Assistive Devices Program (ADP) 2 Patient elevating devices such as Porch Lifts and elevators will not be funded under the program. 3 Funding is available for monthly rental of one (1) Straight Stair Glide/Lift only. Page 3 of 5
Program Limitations Cost Sharing Funding and Income Criteria: Income Funding Eligibility 4 Funding Limit Cap Individual Combined Household Notice of assessment 5 < $30,000 Determine ODSP eligibility 100% < $20,000 100% ALS $6,000 of which a maximum of $4,000 can $20,001 $ 40,000 65% ALS 35% Client $30,001-$60,000 65% ALS 35% Client Notice of assessment Determine ODSP eligibility $5,000 of which a maximum of $3,000 can $40,000 - $60,000 35% ALS 65% Client $60,001-$80,000 35% ALS 65% Client Notice of assessment $4,000 of which a maximum of $2,000 can > $60,001 > $80,001 No Funding When any equipment is loaned from the ALS Canada equipment pool, the client will pay the entire delivery cost directly to the vendor who has delivered the equipment. The cost sharing funding formula is applicable to the client's share of the cost of purchase or lease, after ADP funding or private insurance (if any). Funding requests from all applicants for items when ALS Canada s portion is less than $250 (Canadian) will not be considered. Funding for the following equipment is not provided by ALS Canada, including but not limited to, the following: walkers, transport chairs, bath chairs, transfer bench, over bed table, versa frame, raised toilet seats, etc. Any installation costs associated with ALS Canada equipment or funded equipment must be paid in full by the client The Client Services Coordinator can arrange for you to pickup equipment directly from the vendor when equipment does not require installation ALS Canada will provide funding for one set of batteries per motorized device per applicant ALS Canada will cover the costs of repairs to any equipment that the Society owns, unless the repair has been necessitated by client's neglect or abuse of the equipment. ALS Canada will also cover the cost of returning ALS equipment to the loan pool, when required. ALS Canada does not fund, including by not limited to, the following: transportation, 4 In extenuating circumstances eligibility criteria may be waived or altered, completion and return of a needs assessment (can be downloaded from www.als.ca) may be required to support the request. 5 For the initial equipment funding request, a copy of the prior year s Canada Revenue Agency - Notice of Assessment is required. For consideration of exception to eligibility criteria on future requests, an updated notice of assessment may be required. If there is a significant change in income within the previous year which would not be reflected on the most recent Canada Revenue Agency Notice of Assessment, substantiating documents may be requested for consideration of an exception. Page 4 of 5
homecare, medical equipment (i.e. feeding equipment - feeding pumps, respiratory equipment - bi-pap machines, medical supplies etc.), home and vehicle modifications, etc. Ownership of equipment ALS Canada retains ownership of the equipment when: The equipment is on loan from ALS Canada equipment pool. The ALS Canada has contributed to the client portion of the cost (remaining after contribution from ADP and insurance) of the purchase of the equipment. Acknowledgement of client contribution to the cost of equipment is recognized by a tax receipt following acceptance of equipment donation. Equipment should be returned to ALS Canada when no longer required. All equipment on lease must be returned to the leasing agency. For further information, please contact the Client Services Coordinators at the ALS Society at 905-248-2052 or 1-800-267-4257 x211 or x222 Page 5 of 5