Specialized Equipment and Supplies 525-05-30-60

(Revised 8/1/07 ML #3106)

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Purpose

Specialized Equipment and Supplies Service includes the purchase of equipment and supplies that will facilitate or promote a recipient's independent functioning within his or her home. The service is not physician driven nor is the allowable equipment and supplies authorized for purchase under this service chapter to primarily serve medical needs, although, the products may indirectly assist with medical needs. Specialized Equipment and Supplies Service is a service to purchase adaptive devices and supplies that can assist an individual to function safely in their own home.

Service Eligibility, Criteria for

The individual receiving Specialized Equipment and Supplies Services must meet the following criteria:

1. Must be eligible for the programs of Medicaid Waiver for Home and Community Services.
2. The basis of need for the equipment is established through the assessment process and must include an adaptive assessment completed by a professional with expertise in the equipment requested, (e.g. PT/OT, Speech and Hearing). Prior approval is required for the purchase of specialized equipment or supplies.

3. The equipment purchased is of significant benefit to the applicant/recipient in the performance of personal cares and/or household tasks in their home.
4. The recipient does not already have access to a product that serves essentially the same purpose.
5. The need for the equipment is expected to extend indefinitely.
6. The individual is motivated to use the equipment.
7. The equipment is a non-covered item under the Title XIX State Medicaid Plan or unavailable  through other funding sources.
8. The informal network (family members, friends, or neighbors) is not willing or able to purchase the equipment for the individual.
9. Pre approval from the Department of Human Services is required before this service can be authorized.

Limits

The costs are limited to what is budgeted per person for Specialized Equipment and Supplies in the federally approved in the Medicaid Waiver(s).

Specialized Equipment and Supplies, Scope of

The products covered under this Service Chapter are ADL/IADL related products that are not covered under the Title XIX Medicaid State Plan. Examples of such specialized equipment and supplies may include but are not limited to the following:

1. Communication Board
2. Remote control device to safely operate electronic appliances such as microwave, garbage disposal, blender, toaster, television, etc.
3. Special designed wheelchair lap tray
4. Specialized positioning devices(s)
5. Safety devices and equipment

Specialized Equipment and Supplies, Delivery Of

When it has been determined that a specific item(s) (applicable to this service chapter) will be of benefit to the applicant/recipient, the following procedure is followed:

1. The HCBS Case Manager will contact a supplier of the specialized equipment and/or supplies enrolled as a Qualified Service Provider.  The purpose of the contact is to authorize purchase of the approved item and to verify the cost.
2. The supplier will ship/mail the item only upon receipt of the Authorization to Provide Service, SFN 1699.  The Qualified Service Provider will request payment from the Department of Human Services using the QSP payment system.
3. The supplier is responsible to arrange for or provide any instruction the recipient may need to use the specialized equipment.
4. One month following delivery, the HCBS Case Manager is to contact the recipient to monitor the effectiveness of the specialized equipment.  The results of this monitoring contact are documented in the case file.  It is at this point that Specialized Equipment and Supplies Service should be deleted from the Individual Care Plan if no further need exists for the reimbursable items of this service chapter.