P A R T C D e c i s i o n u n d e r A p p e a l T h e d e c i s i o n u n d e r a p p e a l i s t h e r e c o n s i d e r a t i o n d e c i s i o I n n o v a t i o n ( m i n i s t r y ) d a t e d M a r c h 6 , 2 0 1 4 i n w h i c h t h e m e q u i p m e n t a n d d e v i c e s , n a m e l y a h o s p i t a l b e d m a t t r e s s m a t t r e s s c o v e r i n g a n d a r e p l a c e m e n t h a n d h e l d p e n d a n r e s p e c t t o t h e m a t t r e s s a n d m a t t r e s s c o v e r i n g s , t h e f i v e i t e m s u n d e r s e c t i o n 3 . 7 ( 2 ) o f S c h e d u l e C , E A P W D R h a s r e p l a c e m e n t s u n t i l A p r i l , 2 0 1 6 . T h e m i n i s t r y w a s n o t s a c o v e r i n g a r e m e d i c a l l y e s s e n t i a l t o p r e v e n t s k i n b r e a k d o s e c t i o n 3 . 7 ( 1 ) o f S c h e d u l e C , E A P W D R o r t h a t a n o c c u p t h a t t h e i t e m s a r e m e d i c a l l y e s s e n t i a l , a s r e q u i r e d b y s e t h e h a n d h e l d p e n d a n t , t h e m i n i s t r y h e l d t h a t t h e A p p e l l a t h e r e f o r e s h e i s n o t e l i g i b l e u n d e r s e c t i o n 3 ( 1 ) ( b ) ( i i ) o f S r e p l a c e m e n t u n d e r s e c t i o n 3 . 6 ( 2 ) o f S c h e d u l e C , E A P W P A R T D R e l e v a n t L e g i s l a t i o n E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t h D i s a b i l i t i e s s e c t i o n s 3 ( 1 ) ( b ) ( i i ) , 3 ( 2 ) , 3 ( 3 ) ( b ) , 3 . 7 ( 1 ) a n d ( 2 ) , 3 . 6 ( 2 ) E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L # I n o f t h e M i n i s t r y o f S o c i a l D e v e l o p m e n t a n d S o c i a l i n i s t r y d e n i e d t h e a p p e l l a n t ' s r e q u e s t f o r m e d i c a l , a n i n c o n t i n e n c e m a t t r e s s c o v e r i n g , a n e l a s t i c i z e d t f o r a h o s p i t a l b e d . T h e m i n i s t r y h e l d t h a t w i t h y e a r l e g i s l a t e d p e r i o d o f t i m e f o r r e p l a c e m e n t o f t h e s e n o t e l a p s e d , a n d t h e A p p e l l a n t i s n o t e l i g i b l e f o r t i s f i e d t h a t t h e m a t t r e s s o r t h e i n c o n t i n e n c e m a t t r e s s w n a n d m a i n t a i n s k i n i n t e g r i t y a s r e q u i r e d u n d e r a t i o n a l t h e r a p i s t o r p h y s i c a l t h e r a p i s t h a s c o n f i r m e d c t i o n 3 ( 2 ) ( b ) o f S c h e d u l e C , E A P W D R . W i t h r e s p e c t t o n t h a s s u f f i c i e n t f u n d s t o p u r c h a s e t h i s i t e m a n d c h e d u l e C , E A P W D R , a n d t h a t s h e i s n o t e l i g i b l e f o r a D R u n t i l O c t o b e r , 2 0 1 7 . R e g u l a t i o n ( E A P W D R ) s e c t i o n 6 2 ; S c h e d u l e C ,
I APPEAL# PART E -Summary of Facts Information before the ministry at Reconsideration included: Ministry file notes on the Appellant dated October 26, 2012 to July 25, 2013. A ministry telephone log for March 6, 2014, summarizing conversations with a mobility products supplier. A copy of a sales quotation for a mattress and two coverings requested by the Appellant dated December 16, 2013 in the amount of $1,590.30. A copy of a sales quotation for emergency repairs to an electric hospital bed and replacement pendant dated January 8, 2014 in the amount of $227.67. The Appellant's Request for Reconsideration, stamped as received by the ministry February 18, 2014, with attachments: • A copy of a letter from an Occupational Therapist (OT), signed by a physician, dated January 13, 2014, stating that the Appellant spends 24 hours a day in bed, that she requires total care with the exception of feeding, and that she is at great risk for skin breakdown, of which there has been no evidence since she received a mattress in April, 2011. The OT stated that there is a large tear in the mattress bottom and asked that a replacement pressure mattress be considered. The physician acknowledged that he had read the letter and agreed with the recommendation. • A copy of the ministry's letter dated January 16, 2013, stating that the ministry requires a financial review to determine her eligibility for financial assistance with repairs to her bed because the ministry determined that the Appellant has sufficient income to meet many general health supplement costs through her own income. • A copy of a letter to whom it may concern from a physician, dated February 2, 2014, stating that the Appellant must purchase a new mattress because her current mattress is worn out and she does not have the funds to do so. • A copy of a Medical Equipment Request and Justification signed by the Appellant October 1, 2013. • Copies of receipts for various purchases made in the month of December, 2013. • A copy of a Monthly Household Budget, undated, stating total income as $1,465.13, total home expenses as $923.57, daily living expenses as $396.60 and health costs as $123.02, with a note stating that extra expenses occur from time to time, as an example, a water cooler costing $232.90. • A copy of a rent receipt dated January 1, 2014 in the amount of $850.00. • A copy of a receipt from a chiropractic clinic dated December 23, 2013, in the amount of $25.00. • A copy of a statement from a chiropractic clinic for the period January 4 to December 23, 2013. • A copy of a bill from Telus dated January 19, 2014 in the amount of $73.57. • A copy of a bank statement dated February 18, 2014, for the period January 3 to January 14, 2014, showing an opening balance of $126.20 and a closing balance of $3.81. • A letter from the Appellant's caregiver dated February 15, 2014, stating that the Appellant's mattress is in poor condition, causing her discomfort and affecting her sleep, and stating that the bed control device also needs replacement. The Appellant submitted a note from a chiropractor dated March 25, 2014 with her Notice of Appeal. The note states that the Appellant has been treated by the chiropractor for a number of years, that she has severe rheumatoid arthritis and is confined to bed and that it appears her mattress is breaking down and he has suggested that it is time to look for a replacement. The Panel admits the statements in the Notice of Appeal under section 22(4)(b) of the Employment and Assistance Act as testimony in support of information that was before the ministrv at the time the decision beina appealed was made, as it confirms information previouslv EAA T003(10/06/01)
p r o v i d e d b y h e a l t h p r o f e s s i o n a l s . T h e m i n i s t r y h a d n o o P r i o r t o t h e h e a r i n g , t h e A p p e l l a n t s u b m i t t e d t h r e e p h o t o p r o v i d e d t o t h e m i n i s t r y b y f a x o n A p r i l 1 4 , 2 0 1 4 , t h e m i n n o t r e c e i v e d t h e m a n d o b j e c t e d t o t h e i r a d m i s s i o n b y t h e v i d e n c e o f t h e A p p e l l a n t ' s b e d r i d d e n s t a t e . I n h e r N o t i c e o f A p p e a l , t h e A p p e l l a n t s t a t e d t h a t a c c o r d s i n c e i t i s a f f e c t i n g h e r h e a l t h a n d t h a t s h e i s c o n f i n e d t o t h e r e f o r e a b e d d o e s n o t l a s t t h e s t a n d a r d l e n g t h o f y e a A t t h e h e a r i n g , t h e A p p e l l a n t ' s w i t n e s s s t a t e d t h a t s h e h s t a t e d t h a t t h e A p p e l l a n t l i v e s s i m p l y , w i t h n o l u x u r i e s . S s w a b s a n d T y l e n o l t h a t s h e m u s t p a y f o r , a n d s h e u s e s s c r a t c h d u e t o i m m u n e d e f i c i e n c y . W i t h r e s p e c t t o t h e m i t i s c o n c a v e , w h i c h c a u s e s p a i n w h e n t h e A p p e l l a n t h a s T h e A p p e l l a n t s t a t e d t h a t w i t h r e s p e c t t o h e r b u d g e t , s h e u p t o f i v e o r s i x t i m e s a m o n t h , a n d t h e m i n i s t r y ' s c a l c u l a e x p e n s e s s u c h a s s u p p l e m e n t s , w a t e r , e n t e r t a i n m e n t o r t h e e n d o f t h e m o n t h , a n d n o e x c e s s i n c o m e . S h e s t a t e S h e s t a t e d t h a t t h e r e i s n o d i f f e r e n c e i n h e r s p e n d i n g i n W i t h r e s p e c t t o t h e n e e d f o r a r e p l a c e m e n t m a t t r e s s , t h e m a t t r e s s f o r t h r e e y e a r s , a n d i t h a s a g r e a t d e a l o f w e a r d a y , s e v e n d a y s a w e e k . I n r e s p o n s e t o a q u e s t i o n f r o m t h e m i n i s t r y , t h e A p p e l l a n w a r r a n t y . I n r e s p o n s e t o q u e s t i o n s f r o m t h e P a n e l , t h e A p p e l l a n t s h a s n o t h i n g t o d o w i t h t h e h o l e i n t h e m a t t r e s s ; t h e o r i g i n m o i s t u r e c a n c a u s e b e d s o r e s . S h e s t a t e d t h a t h e r f a m i l y b y t h e m i n i s t r y c o v e r e d o n e m o n t h , w h i c h w a s n o t n e c e s e x p e n s e s w h e n q u e s t i o n e d b y t h e m i n i s t r y . S h e s t a t e d t b e c a u s e h e r b e d d o e s n o t h a v e a b o x s p r i n g , a n d t h i s w a c o r e o f h e r p e n d a n t , w h i c h i s a c o n t r o l f o r t h e r a i s i n g a n d s e v e r e d d u e t o i n c o r r e c t i n s t a l l a t i o n , a n d t h a t s h e h a s a l r T h e M i n i s t r y , i n t h e i r s u b m i s s i o n , r e f e r r e d t o t h e R e c o n s i " M S O " ( m e d i c a l s e r v i c e s o n l y ) c l i e n t . T h e m i n i s t r y s t a t e d m a t t r e s s i s 2 0 1 6 ; f i v e y e a r s f r o m t h e d a t e w h e n i t w a s p r l e g i s l a t i o n . T h e m i n i s t r y s t a t e d t h a t t h e r e i s n o o c c u p a t i o a s s e s s m e n t p r o v i d e d w i t h t h e r e q u e s t f o r a r e p l a c e m e n t r e g a r d i n g s k i n b r e a k d o w n . W i t h r e s p e c t t o t h e f i n a n c i a l r e v i e w c o n d u c t e d , t h e m i n i s t d o c u m e n t s p r o v i d e d b y t h e A p p e l l a n t . I n t h e R e c o n s i d e r m o n t h l y e x p e n s e s t h e A p p e l l a n t h a d a p p r o x i m a t e l y $ 2 7 5 o r o v i d e d e x o e n s e s f o r t h e m o n t h o f D e c e m b e r , w h i c h i s E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # b j e c t i o n t o t h e a d m i s s i o n o f t h i s d o c u m e n t . g r a p h s o f h e r s e l f i n b e d . A l t h o u g h t h i s m a t e r i a l w a s i s t r y r e p r e s e n t a t i v e a t t h e h e a r i n g s t a t e d t h a t s h e h a d e P a n e l . T h e P a n e l a d m i t t e d t h e p h o t o g r a p h s a s i n g t o h e r d o c t o r a n e w b e d i s r e q u i r e d i m m e d i a t e l y h e r b e d 2 4 h o u r s a d a y , s e v e n d a y s a w e e k , r s . a s b e e n t h e A p p e l l a n t ' s c a r e g i v e r f o r 1 ½ y e a r s . S h e h e s t a t e d t h a t t h e A p p e l l a n t r e q u i r e s i t e m s s u c h a s t h e f o o d b a n k . H e r f o o d h a s t o b e p r e p a r e d f r o m a t t r e s s , s h e s t a t e d t h a t i t h a s s p o n g e c o m i n g o u t a n d t o r o l l o v e r . s o m e t i m e s n e e d s c h i r o p r a c t i c t r e a t m e n t m o r e o f t e n , t i o n s o f h e r e x p e n s e s d o n o t a l l o w f o r t h i s o r o t h e r p r e s c r i p t i o n s . S h e s t a t e d t h a t t h e r e i s n o m o n e y l e f t a t d t h a t s h e m u s t u s e t h e l o c a l f o o d b a n k e v e r y m o n t h . D e c e m b e r f r o m a n y o t h e r m o n t h . A p p e l l a n t s t a t e d t h a t s h e h a s h a d t h e c u r r e n t a n d t e a r d u e t o t h e f a c t t h a t s h e i s i n b e d 2 4 h o u r s a t s t a t e d t h a t s h e b e l i e v e s t h e m a t t r e s s h a d a o n e y e a r t a t e d t h a t t h e n e w b e d c o v e r p r o v i d e d b y t h e s u p p l i e r a l c o v e r w a s r e m o v e d b e c a u s e i t w a s p l a s t i c a n d s h o p s f o r h e r a n d t h a t t h e f i n a n c i a l r e v i e w c o n d u c t e d s a r i l y t y p i c a l , a n d s h e c o u l d n o t b e p r e c i s e a b o u t h e r h a t s h e p l a c e d t h e n e w m a t t r e s s o n t o p o f t h e o l d o n e s m o r e c o m f o r t a b l e . T h e A p p e l l a n t s t a t e d t h a t t h e l o w e r i n g o f t h e h e a d a n d f o o t o f t h e b e d , w a s e a d y r e p l a c e d i t h e r s e l f . d e r a t i o n D e c i s i o n a n d s t a t e d t h a t t h e A p p e l l a n t i s a n t h a t t h e r e p l a c e m e n t d a t e f o r t h e A p p e l l a n t ' s o v i d e d , w h i c h i s t h e p e r i o d p r e s c r i b e d i n t h e n a l t h e r a p i s t ( O T ) o r p h y s i c a l t h e r a p i s t ( P T ) m a t t r e s s a n d n o e v i d e n c e h a s b e e n p r o v i d e d r y s t a t e d t h a t i t w a s d o n e b y t e l e p h o n e b a s e d o n t h e a t i o n D e c i s i o n , t h e m i n i s t r y c a l c u l a t e d t h a t a f t e r . 0 0 a v a i l a b l e . T h e m i n i s t r y s t a t e d t h a t t h e A p p e l l a n t t v n i c a l l v h i a h e r f o r m o s t o e o o l e .
In re sponse t o questi ons from the Panel, t he mini s t ry stated 2008, 2009 and a mattress was provided in 2011, but no whether the legislated time limits, if any wer e in effect, were f The Panel ma k es the following findings of fact: The Appellant is an MSO minist ry client. A mattr e ss was pro vi d ed to the Appellant i n 20 11. The A p pell an t purchased a replacemen t pend ant The OT's ass essment does not sp eci fically state that a replace EAA T003(1 0/06/01) I APPEAL# that bed s wer e provided to the Appellant in 200 5 , informat i o n wa s available to explain the reasons or o l lo wed. with her own fund s. ment m at tress is med i cally essen ti al.
P A R T F R e a s o n s f o r P a n e l D e c i s i o n T h e i s s u e b e f o r e t h e p a n e l i s t h e r e a s o n a b l e n e s s o f t h e i n w h i c h t h e m i n i s t r y d e n i e d t h e a p p e l l a n t ' s r e q u e s t f o r m m a t t r e s s , a n i n c o n t i n e n c e m a t t r e s s c o v e r i n g , a n e l a s t i c i p e n d a n t f o r a h o s p i t a l b e d . T h e m i n i s t r y h e l d t h a t w i t h r y e a r l e g i s l a t e d p e r i o d o f t i m e f o r r e p l a c e m e n t o f t h e s e i t h a s n o t e l a p s e d , a n d t h e A p p e l l a n t i s n o t e l i g i b l e f o r r e p s a t i s f i e d t h a t t h e m a t t r e s s a n d t h e i n c o n t i n e n c e m a t t r e s s b r e a k d o w n a n d m a i n t a i n s k i n i n t e g r i t y a s r e q u i r e d u n d e r o c c u p a t i o n a l t h e r a p i s t o r p h y s i c a l t h e r a p i s t h a s c o n f i r m e s e c t i o n 3 ( 2 ) ( b ) o f S c h e d u l e C , E A P W D R . W i t h r e s p e c t t A p p e l l a n t h a s s u f f i c i e n t f u n d s t o p u r c h a s e t h i s i t e m a n d S c h e d u l e C , E A P W D R , a n d t h a t s h e i s n o t e l i g i b l e f o r a E A P W D R u n t i l O c t o b e r , 2 0 1 7 . L e g i s l a t i o n E A P W D R G e n e r a l h e a l t h s u p p l e m e n t s 6 2 ( 1 ) S u b j e c t t o s u b s e c t i o n s ( 1 . 1 ) a n d ( 1 . 2 ) , t h e m i n i s t e s e c t i o n 2 [ g e n e r a l h e a l t h s u p p l e m e n t s ] o r 3 [ m e d f a m i l y u n i t i f t h e h e a l t h s u p p l e m e n t i s p r o v i d e d t o ( a ) a r e c i p i e n t o f d i s a b i l i t y a s s i s t a n c e , ( b ) a p e r s o n w i t h d i s a b i l i t i e s w h o h a s n o t e l i g i b l e f o r d i s a b i l i t y a s s i s t a n c e b e c a u s e o ( i ) e m p l o y m e n t i n c o m e e a r n e d b y p e r s o n o r t h e p e r s o n ' s s p o u s e ( A ) i s u n d e r a g e 6 5 a n d t h t h e M e d i c a r e P r o t e c t i o n A c ( B ) i s a g e d 6 5 o r m o r e a n d s p o u s e ' s a l l o w a n c e o r t h e f ( i i ) a p e n s i o n o r o t h e r p a y m e n t u n ( i i i ) m o n e y r e c e i v e d b y t h e p e r s o n a g r e e m e n t a p p r o v e d b y t h e S u p r e ( i v ) m o n e y o r v a l u e r e c e i v e d b y t h u n d e r a m a i n t e n a n c e o r d e r , m a i n t e p e r s o n o r t h e p e r s o n ' s s p o u s e ( A ) i s u n d e r a g e 6 5 a n d t h t h e M e d i c a r e P r o t e c t i o n A c ( B ) i s a g e d 6 5 o r m o r e a n d s p o u s e ' s a l l o w a n c e o r t h e f S c h e d u l e C M e d i c a l e a u i o m e n t a n d d e v i c e s E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # m i n i s t r y ' s r e c o n s i d e r a t i o n d e c i s i o n o f M a r c h 6 , 2 0 1 4 , e d i c a l e q u i p m e n t a n d d e v i c e s , n a m e l y a h o s p i t a l b e d z e d m a t t r e s s c o v e r i n g a n d a r e p l a c e m e n t h a n d h e l d e s p e c t t o t h e m a t t r e s s a n d m a t t r e s s c o v e r i n g s , t h e f i v e e m s u n d e r s e c t i o n 3 . 7 ( 2 ) o f S c h e d u l e C , E A P W D R l a c e m e n t s u n t i l A p r i l , 2 0 1 6 . T h e m i n i s t r y w a s n o t c o v e r i n g a r e m e d i c a l l y e s s e n t i a l t o p r e v e n t s k i n s e c t i o n 3 . 7 ( 1 ) o f S c h e d u l e C , E A P W D R o r t h a t a n d t h a t t h e i t e m s a r e m e d i c a l l y e s s e n t i a l , a s r e q u i r e d b y o t h e h a n d h e l d p e n d a n t , t h e m i n i s t r y h e l d t h a t t h e t h e r e f o r e s h e i s n o t e l i g i b l e u n d e r s e c t i o n 3 ( 1 ) ( b ) ( i i ) o f r e p l a c e m e n t u n d e r s e c t i o n 3 . 6 ( 2 ) o f S c h e d u l e C , r m a y p r o v i d e a n y h e a l t h s u p p l e m e n t s e t o u t i n i c a l e q u i p m e n t a n d d e v i c e s ] o f S c h e d u l e C t o o r f o r a o r f o r a p e r s o n i n t h e f a m i l y u n i t w h o i s r e a c h e d 6 5 y e a r s o f a g e a n d w h o h a s c e a s e d t o b e f t h e p e r s o n o r t h e p e r s o n ' s s p o u s e , i f e i t h e r t h e e f a m i l y u n i t i s r e c e i v i n g p r e m i u m a s s i s t a n c e u n d e r t , o r a p e r s o n i n t h e f a m i l y u n i t i s r e c e i v i n g t h e f e d e r a l e d e r a l g u a r a n t e e d i n c o m e s u p p l e m e n t , d e r t h e C a n a d a P e n s i o n P l a n ( C a n a d a ) , o r t h e p e r s o n ' s s p o u s e u n d e r t h e s e t t l e m e n t m e C o u r t i n A c t i o n N o . 8 5 0 8 0 8 , K e l o w n a R e g i s t r y , o r e p e r s o n o r t h e p e r s o n ' s s p o u s e t h a t i s m a i n t e n a n c e n a n c e a g r e e m e n t o r o t h e r a g r e e m e n t , i f e i t h e r t h e e f a m i l y u n i t i s r e c e i v i n g p r e m i u m a s s i s t a n c e u n d e r t , o r a n y p e r s o n i n t h e f a m i l y u n i t i s r e c e i v i n g t h e f e d e r a l e d e r a l g u a r a n t e e d i n c o m e s u p p l e m e n t ,
3 ( 1 ) S u b j e c t t o s u b s e c t i o n s ( 2 ) t o ( 5 ) o f t h i s s e c t i o n , t h e 3 . 1 t o 3 . 1 2 o f t h i s S c h e d u l e a r e t h e h e a l t h s u p p l e m ( a ) t h e s u p p l e m e n t s a r e p r o v i d e d t o a f a m i l y u n i t s u p p l e m e n t s ] o f t h i s r e g u l a t i o n , a n d ( b ) a l l o f t h e f o l l o w i n g r e q u i r e m e n t s a r e m e t : ( i ) t h e f a m i l y u n i t h a s r e c e i v e d t h e p r e a o r d e v i c e r e q u e s t e d ; ( i i ) t h e r e a r e n o r e s o u r c e s a v a i l a b l e t o t h e q u i p m e n t o r d e v i c e ; ( i i i ) t h e m e d i c a l e q u i p m e n t o r d e v i c e i s t d e v i c e . ( 2 ) F o r m e d i c a l e q u i p m e n t o r d e v i c e s r e f e r r e d t h e r e q u i r e m e n t s i n t h o s e s e c t i o n s a n d s p r o v i d e t o t h e m i n i s t e r o n e o r b o t h o f t h e ( a ) a p r e s c r i p t i o n o f a m e d i c a l p r a c t i t i o n e d e v i c e ; ( b ) a n a s s e s s m e n t b y a n o c c u p a t i o n a l t h n e e d f o r t h e m e d i c a l e q u i p m e n t o r d e v i c ( 2 . 1 ) F o r m e d i c a l e q u i p m e n t o r d e v i c e s r e f e r r e r e q u i r e m e n t s i n t h a t s e c t i o n a n d s u b s e c t h e m i n i s t e r o n e o r b o t h o f t h e f o l l o w i n g , ( a ) a p r e s c r i p t i o n o f a m e d i c a l p r a c t i t i o n e d e v i c e ; ( b ) a n a s s e s s m e n t b y a r e s p i r a t o r y t h e r a c o n f i r m i n g t h e m e d i c a l n e e d f o r t h e m e d ( 3 ) S u b j e c t t o s u b s e c t i o n ( 6 ) , t h e m i n i s t e r m a y m e d i c a l e q u i p m e n t o r a m e d i c a l d e v i c e , t h a t i s d a m a g e d , w o r n o u t o r n o t f u n c t i o n ( a ) i t i s m o r e e c o n o m i c a l t o r e p l a c e t h a n p r o v i d e d b y t h e m i n i s t e r , a n d ( b ) t h e p e r i o d o f t i m e , i f a n y , s e t o u t i n s e t h e p u r p o s e s o f t h i s p a r a g r a p h , h a s p a s s ( 4 ) S u b j e c t t o s u b s e c t i o n ( 6 ) , t h e m i n i s t e r m a y e q u i p m e n t o r a m e d i c a l d e v i c e t h a t w a s e c o n o m i c a l t o r e p a i r t h e m e d i c a l e q u i p m ( 5 ) S u b j e c t t o s u b s e c t i o n ( 6 ) , t h e m i n i s t e r m a y e q u i p m e n t o r a m e d i c a l d e v i c e t h a t w a s n ( a ) a t t h e t i m e o f t h e r e p a i r s t h e r e q u i r e m S c h e d u l e , a s a p p l i c a b l e , a r e m e t i n r e s p e a n d E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # m e d i c a l e q u i p m e n t a n d d e v i c e s d e s c r i b e d i n s e c t i o n s e n t s t h a t m a y b e p r o v i d e d b y t h e m i n i s t e r i f t h a t i s e l i g i b l e u n d e r s e c t i o n 6 2 [ g e n e r a l h e a l t h u t h o r i z a t i o n o f t h e m i n i s t e r f o r t h e m e d i c a l e q u i p m e n t e f a m i l y u n i t t o p a y t h e c o s t o f o r o b t a i n t h e m e d i c a l h e l e a s t e x p e n s i v e a p p r o p r i a t e m e d i c a l e q u i p m e n t o r t o i n s e c t i o n s 3 . 1 t o 3 . 8 o r s e c t i o n 3 . 1 2 , i n a d d i t i o n t o u b s e c t i o n ( 1 ) o f t h i s s e c t i o n , t h e f a m i l y u n i t m u s t f o l l o w i n g , a s r e q u e s t e d b y t h e m i n i s t e r : r o r n u r s e p r a c t i t i o n e r f o r t h e m e d i c a l e q u i p m e n t o r e r a p i s t o r p h y s i c a l t h e r a p i s t c o n f i r m i n g t h e m e d i c a l e . d t o i n s e c t i o n 3 . 9 ( 1 ) ( b ) t o ( g ) , i n a d d i t i o n t o t h e t i o n ( 1 ) o f t h i s s e c t i o n , t h e f a m i l y u n i t m u s t p r o v i d e t o a s r e q u e s t e d b y t h e m i n i s t e r : r o r n u r s e p r a c t i t i o n e r f o r t h e m e d i c a l e q u i p m e n t o r p i s t , o c c u p a t i o n a l t h e r a p i s t o r p h y s i c a l t h e r a p i s t i c a l e q u i p m e n t o r d e v i c e . p r o v i d e a s a h e a l t h s u p p l e m e n t a r e p l a c e m e n t o f p r e v i o u s l y p r o v i d e d b y t h e m i n i s t e r u n d e r t h i s s e c t i o n , i n g i f t o r e p a i r t h e m e d i c a l e q u i p m e n t o r d e v i c e p r e v i o u s l y c t i o n s 3 . 1 t o 3 . 1 2 o f t h i s S c h e d u l e , a s a p p l i c a b l e , f o r e d . p r o v i d e a s a h e a l t h s u p p l e m e n t r e p a i r s o f m e d i c a l p r e v i o u s l y p r o v i d e d b y t h e m i n i s t e r i f i t i s m o r e e n t o r d e v i c e t h a n t o r e p l a c e i t . p r o v i d e a s a h e a l t h s u p p l e m e n t r e p a i r s o f m e d i c a l o t p r e v i o u s l y p r o v i d e d b y t h e m i n i s t e r i f e n t s i n t h i s s e c t i o n a n d s e c t i o n s 3 . 1 t o 3 . 1 2 o f t h i s c t o f t h e m e d i c a l e q u i p m e n t o r d e v i c e b e i n g r e p a i r e d ,
( b ) i t i s m o r e e c o n o m i c a l t o r e p a i r t h e m ( 6 ) T h e m i n i s t e r m a y n o t p r o v i d e a r e p l a c e m e s u b s e c t i o n ( 3 ) o r r e p a i r s o f m e d i c a l e q u i f t h e m i n i s t e r c o n s i d e r s t h a t t h e m e d i c a M e d i c a l e q u i p m e n t a n d d e v i c e s h o s p i t a l b e d 3 . 6 ( 1 ) S u b j e c t t o s u b s e c t i o n ( 3 ) o f t h i s s e c t i o n , t h e f o l l o s e c t i o n 3 o f t h i s S c h e d u l e i f t h e m i n i s t e r i s s a t i s f i t r a n s f e r s o f a p e r s o n t o a n d f r o m b e d o r t o a d j u s ( a ) a h o s p i t a l b e d ; ( b ) a n u p g r a d e d c o m p o n e n t o f a h o s p i t a l ( c ) a n a c c e s s o r y a t t a c h e d t o a h o s p i t a l b e ( d ) a p o s i t i o n i n g i t e m o n a h o s p i t a l b e d . ( 2 ) T h e p e r i o d o f t i m e r e f e r r e d t o i n s e c t i o n 3 ( 3 ) ( i t e m d e s c r i b e d i n s u b s e c t i o n ( 1 ) o f t h i s s e c t i o p r o v i d e d t h e i t e m b e i n g r e p l a c e d . ( 3 ) T h e f o l l o w i n g i t e m s a r e n o t h e a l t h s u p p l e m e n t ( a ) a n a u t o m a t i c t u r n i n g b e d ; ( b } a c o n t a i n m e n t t y p e b e d . M e d i c a l e q u i p m e n t a n d d e v i c e s p r e s s u r e r e l i e f m a 3 . 7 ( 1 ) A p r e s s u r e r e l i e f m a t t r e s s i s a h e a l t h s u p p l e m e n m i n i s t e r i s s a t i s f i e d t h a t t h e p r e s s u r e r e l i e f m a t t r e a n d m a i n t a i n s k i n i n t e g r i t y . ( 2 ) T h e p e r i o d o f t i m e r e f e r r e d t o i n s e c t i o n 3 ( 3 ) ( b i t e m d e s c r i b e d i n s u b s e c t i o n ( 1 ) o f t h i s s e c t i o p r o v i d e d t h e i t e m b e i n g r e p l a c e d . T h e A p p e l l a n t ' s p o s i t i o n i s t h a t s h e i s e n t i t l e d t o f u n d i n g m i n i s t r y i n 2 0 1 1 b e c a u s e i t i s n o l o n g e r u s e a b l e b e c a u s e u s e f u l l t i m e . T h e A p p e l l a n t a l s o a r g u e s t h a t t h e m i n i s t r y r e p l a c e m e n t m e d i c a l e q u i p m e n t a n d s u p p l i e s . T h e m i n i s t r y ' s p o s i t i o n i s t h a t t h e A p p e l l a n t d o e s n o t m e e b e c a u s e t h e l e g i s l a t e d t i m e p e r i o d f o r r e p l a c e m e n t , f i v e y t h a t t h e O T d i d n o t c o n d u c t a n a s s e s s m e n t t h a t e s t a b l i s h W i t h r e s p e c t t o t h e h a n d h e l d p e n d a n t r e q u e s t e d , t h e m i p a y f o r a r e p l a c e m e n t a n d t h e l e g i s l a t e d t i m e p e r i o d f o r r e l a p s e d . W i t h r e s p e c t t o t h e A n n e l l a n t ' s r e a u e s t f o r a r e p l a c e m e n E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # e d i c a l e q u i p m e n t o r d e v i c e t h a n t o r e p l a c e i t . n t o f m e d i c a l e q u i p m e n t o r a m e d i c a l d e v i c e u n d e r i p m e n t o r a m e d i c a l d e v i c e u n d e r s u b s e c t i o n ( 4 ) o r ( 5 ) l e q u i p m e n t o r d e v i c e w a s d a m a g e d t h r o u g h m i s u s e . w i n g i t e m s a r e h e a l t h s u p p l e m e n t s f o r t h e p u r p o s e s o f e d t h a t t h e i t e m i s m e d i c a l l y e s s e n t i a l t o f a c i l i t a t e t o r m a i n t a i n a p e r s o n ' s p o s i t i o n i n g i n b e d : b e d ; d ; b ) o f t h i s S c h e d u l e w i t h r e s p e c t t o r e p l a c e m e n t o f a n n i s 5 y e a r s f r o m t h e d a t e o n w h i c h t h e m i n i s t e r s f o r t h e p u r p o s e s o f s e c t i o n 3 o f t h i s S c h e d u l e : t t r e s s e s t f o r t h e p u r p o s e s o f s e c t i o n 3 o f t h i s S c h e d u l e i f t h e s s i s m e d i c a l l y e s s e n t i a l t o p r e v e n t s k i n b r e a k d o w n ) o f t h i s S c h e d u l e w i t h r e s p e c t t o r e p l a c e m e n t o f a n n i s 5 y e a r s f r o m t h e d a t e o n w h i c h t h e m i n i s t e r f o r r e p l a c e m e n t o f t h e m a t t r e s s p r o v i d e d b y t h e i t i s w o r n o u t a n d d a m a g e d d u e t o t h e f a c t t h a t i t i s i n i n c o r r e c t l y a s s e s s e d h e r a b i l i t y t o p a y f o r t t h e r e q u i r e m e n t f o r a r e p l a c e m e n t m a t t r e s s e a r s , h a s n o t e l a p s e d . I n a d d i t i o n , t h e m i n i s t r y h o l d s e s t h a t t h e r e q u e s t e d i t e m i s m e d i c a l l y e s s e n t i a l . n i s t r y h o l d s t h a t t h e A p p e l l a n t h a s s u f f i c i e n t f u n d s t o e p l a c e m e n t b y t h e m i n i s t r y , f i v e y e a r s , h a s n o t t h a n d h e l d o e n d a n t f o r h e r h o s o i t a l b e d , t h e P a n e l
I APPEAL# finds that the ministry reasonably concluded that the legislated time period of five years, pursuant 3(3)(b) and 3.6(2) of Schedule C, EAPWDR for replacement has not elapsed since October, 2012 when the Appellant was provided with a pendant. Also, since the Appellant has paid for a replacement, the Panel finds that the ministry reasonably concluded that the Appellant had the financial resources to do so. With respect to the ministry's denial of a replacement hospital bed mattress, an incontinence mattress covering and an elasticized mattress covering, the Panel finds that the ministry reasonably concluded that the OT's assessment did not establish that these items are medically essential as required under section 3(2)(b) of Schedule C, EAPWDR, as there is no evidence of skin breakdown and the OT has not confirmed that the items are medically essential. The Panel finds that the ministry reasonably determined that there is no evidence that the items are medically essential to prevent skin breakdown as required by section 3.7(1) of Schedule C, EAPWDR. The Panel notes that the ministry previously supplied hospital beds to the Appellant in 2005, 2008 and 2009, and a pressure relief mattress in 2011. The Panel finds that the ministry reasonably determined that the legislated time limit for replacement of the Appellant's current mattress has not passed, and that the replacement date is April, 2016. The Panel therefore confirms the ministry's decision as reasonably supported by the evidence. EAAT 003( 10/06/01)
You are being directed to the most recent version of the statute which may not be the version considered at the time of the judgment.