Frequently asked Questions
General
Q. Who do I go to if funding is not available?
Response:
Talk to your supervisor to provide confidence around your clinical reasoning in relation to the ‘Risk’ and ‘Ability to Benefit’ questions. Remember that the Tool determines availability of funding based on need and ability to benefit. Some people will miss out and other options will need to be considered. If the demand for, and the cost of, equipment and modifications continues to grow then more people will miss out on funding. There is a capped EMS budget.
Q. How does the person/family complete the Impact on Life questionnaire when their current wheelchair no longer meets their needs e.g. they have outgrown it or the wheelchair is on short term loan from their DHB?
Response:
It is important that the Assessor explains to the person/family that they need to complete the Impact on Life questionnaire knowing that their current wheelchair is no longer of use or available to them, picturing their daily life without the use of that piece of equipment.
This is not a like for like replacement, and therefore needs to go through the Prioritisation Tool, as there has been a change in the person's needs (growth) or funding stream (DHB to MoH).
Q. What if I am not sure if the person meets eligibility and Ministry of Health funding criteria?
Response:
If there is any doubt about whether the person meets the current eligibility and Ministry of Health funding access criteria then the EMS Assessor must communicate with an EMS Advisor (at Enable New Zealand or Accessable)before completing the Prioritisation Tool and submitting a Service Request.
Q. Does the Prioritisation Tool apply to those who meet the LTS-CHC criteria?
Response:
Yes. The decision regarding eligibility for LTS-CHC sits with NASCs, not with Accessable or Enable New Zealand. NASCs must determine that the person is eligible for this funding stream before an EMS Assessor can consider equipment or modifications for a person (under 65 years of age) with a chronic health condition.
It is therefore suggested that when EMS Assessors are considering equipment or modifications for people who they feel may be eligible for this funding stream, that they should contact the NASC.
Where an EMS Assessor is consulting with an EMS Advisor (from Accessable or Enable New Zealand) during the assessment process and consideration of support options, this question may be raised. EMS Advisors can offer advice at this stage but the question should be taken up with the appropriate NASC. It's not always straightforward to determine when the LTS-CHC pathway should be considered but NASCs are best placed to work this through and must make the decision about eligibility.
Q. Can the outcome of the Tool be reviewed i.e. funding not available?
Response:
If the person's needs change in the future they can ask to have another assessment.
Q. What is meant by “subject to all other requirements being met” when the outcome of the Tool is ‘funding available’?
Response:
The requirements to be met will depend upon the service being requested but could include any of the following:
- that the person is eligible for Ministry of Health funding and meets any specific access criteria for the proposed service
- that all correct processes have been followed (including whether consultation with an EMS Advisor has been undertaken where this is a mandatory requirement
- that the outcome of income and cash asset testing has confirmed that a Ministry contribution, either in full or part, can be made
- that the EMS Review Panel recommends the proposal proceed (for a high cost service or where the proposal is seeking funding due to genuine and exceptional circumstances)
- the technical requirements of the service have been confirmed (for complex housing modifications or vehicle modifications)
Q. Do we need to change our password every 60 days?
Response:
Yes. This has been followed up with the Ministry of Health,Information Group.
The recommendation from the Ministry Information Group is that the following timeframe and security measures remain:
1. Users should be forced to enter a 'high strength' password.
2. Users should be forced to change their password every 60 days and should not be able to use their last 12 passwords.
In developing the Tool there was engagement with the Ministry Information Group to ensure all standards of collecting information were met. These are what are known as the HISO standards (Health Information Standards Organisation) and this means that all information collected across health are collected in the same way.
Q. Does the cost of the equipment or modification solution have any bearing on the outcome of the Prioritisation Tool i.e. availability of funding?
Response:
No, the cost of the equipment or modification solution has no bearing on the outcome of the Prioritisation Tool and the availability of funding. Availability of funding is based on the person’s need and the ability to benefit from the proposed solution, but that solution should be the most cost-effective option available.
Q. When is the ‘right time’ to ask a person who has been newly diagnosed with a progressive neurological condition, such as MND, to complete the Impact on Life questionnaire?
Response:
The Impact on Life questionnaire is asking the client to give their perception of the impact of their disability on their life right now. If when you first visit the person there is no impact right now and therefore no solution required at this point, then it is not the right time to complete the Impact on Life questionnaire. It would be difficult to show ability to benefit when there is no impact right now.
Q. Will the Prioritisation Tool threshold get moved during the year, i.e. if the spending is too high or too low for that financial year, would this affect the Prioritisation Tool?
Response:
Following the review of Stage One implementation the recommendation was made to review the threshold each quarter.
Q. How can I get additional copies of the Information for People about Ministry of Health Funding for Equipment and Modification Services?
Response:
Firstly check with colleagues in your own service area or if in a DHB, the Professional Advisor (Occupational Therapy), as a large number of pamphlets has been circulated.
If there are none, or only a small number, available, the manager or team leader of an organisation can order them through the link below:
Go the right side of the screen, Order a hard copy, and select Place an order.
Impact on Life Questionnaire
Q. What if the EMS Assessor does not agree with the person’s responses to the Impact on Life questions?
Response:
If the EMS Assessor's perception of the current impact of the disability on the person’s life differs from the responses of the person it is strongly recommended that, as a matter of professional practice, the EMS Assessor discusses any disagreement with how the person has responded to their Impact on Life questionnaire with the person or their support person. The purpose of the discussion would be to better inform the EMS Assessor’s evaluation NOT influence the person to change the outcome of the questionnaire. The person’s/ support person’s responses may have taken into account information that the EMS Assessor is not aware of and this gives an opportunity for the EMS Assessor to ask questions around this.
The Impact on Life questionnaire is an evaluation of the impact of the disability on the life of the person, relative to the lives of all other disabled people, in areas considered important to them.
It is extremely important to respect the person’s perception of the impact of their disability on their life. This is the person’s voice in the prioritisation process.
The EMS Assessor must explain the Impact on Life questionnaire well before the person or their family completes it.
Q. What happens if the person refuses to fill out the Impact on Life questionnaire?
Response:
If the person refuses to complete the Impact on Life questionnaire then the Prioritisation Tool cannot be completed. Therefore there can be no opportunity for the person to access government funding.
Q. How long is the Impact on Life questionnaire valid for?
Response:
The Impact on Life questionnaire is valid for 18 months unless the needs of the person change. In this case a new Impact on Life questionnaire will need to be completed.
Q. Is there just one screen for inputting the data into the Tool from the Impact on Life questionnaire, whether child or adult?
Response:
There is only one generic screen in the Tool for the Assessor to input the responses from the client, whether child or adult, as the questions are the same for both. They are just presented a little differently in the actual questionnaire given to the child/family that makes it more personalised.
Q. What happens in a situation where parents aren’t together but have shared custody? If their answers differ, what do you input?
Response
It needs to be a joint decision on responses if more than one person is completing on behalf of the child. You can't have 2 separate questionnaires being completed. There may be times when the Assessor has to decide who knows/understands the child the best.
Q. Some people find it hard to understand the Impact on Life questionnaire, even when explained to them. Is there anything better I can do to explain it to them?
Response
It is acknowledged that some people/families might have more difficulty understanding the questions more than others (this is reality) so the Assessor has to do the very best that they can and if they think it is best to engage others to support the person then the Assessor would facilitate this making sure that the support person also hears the explanation of the prioritisation process and the questionnaire. It was the Consumer Consortium who decided on the questions and the language used in the questionnaire and took 3 years to get to this version. There was representation from all disability groups including families of disabled children.
Q. Is the fact that a person is not able to communicate taken into account in the Tool?
Yes. Q1 in the Impact on Life questionnaire is the only question that has an (e) option. This covers those people who are not able to communicate.
Assessor Section
‘Ability to Benefit’ questions
Q. What if the EMS Assessor expects that the proposed solution will not provide benefit in all areas of the person's life (as outlined in the 5 Impact on Life questions)?
Response:
It is expected that not every solution / intervention will create an impact on all of the five areas outlined in the Impact on Life questions, (and that’s okay, the score weighting against each response will reflect that), but a rating of each of the areas is still needed, to enable prioritisation for access to public funding. If the EMS Assessor does not think that the solution in mind will lessen the impact of the disability on the person’s life in any of the five areas of life then the EMS Assessor's answer should be the same as the persons, to reflect no change is expected to be created in that particular area of the person's life.
Think about what happened in the previous P1 P2 system when an EMS Assessor proposed a solution for the person. The solution did not necessarily provide benefit in all areas of the person's life but may have provided benefit in only 1 or 2 areas.
Q. I believe my client would benefit from a handrail but funding was not available. What do I do now?
Response:
No one would disagree that your client would benefit from the rail but as the outcome is 'funding not available' the person has not reached the 'threshold' meaning that there are other disabled people in the country who have a greater need and ability to benefit than this person. Ministry funding is only one option. You will have discussed Plan B (other options if funding not available) with the client at the time of assessment.
Q. Do I always put a (c) when responding to the last Assessor section question around ‘Ability to Contribute’ if my client is a child 15 years or under?
Yes. For all children 15 years and under the response is always a (c). This is stated in the response
Online Training
Q. Once I have completed the training am I able to go back to it as often as I like to revisit parts of it?
Response:
Yes, you are able to go back and revisit the training as many times as you need to. You will not lose access to it.
Letter to client template - 'funding not available'
Q. Why can’t the letter be on MOH letterhead?
Response:
The Ministry can only put their letterhead on a letter that is signed off by someone who works for the Ministry. This was explained to the Assessors in the Stage One region and understood. Some organisations have chosen to send the letter out on their organisational letterhead when it is required.
The letter template was developed with input from senior Assessors (most of whom were OTs) in the Accessable region for Stage One implementation of the Prioritisation Tool.
The Assessors were keen to have a letter template that they could use if a person asked to receive something in writing as regards the outcome of the Tool being 'funding not available'. Sending out a letter to the person is not a requirement but a resource to have should the person ask for something in writing.
The Tool provides an Outcome Summary that shows 'funding not available' or 'funding available' that can be printed off from the Prioritisation Tool once this is determined at the end of the Prioritisation Tool process. This Outcome Summary does have the Ministry logo on it and can be attached to the letter. This clearly shows that it is a Ministry process.
The Assessor will also have given the person the Client Information pamphlet at the time of the assessment which also shows that the Prioritisation Tool is a Ministry process.
The letter template is an 'optional' resource provided to help Assessors should they wish to use it. An organisation does not have to use it or they may wish to develop their own template.
For the majority of clients a call from the Assessor regarding the outcome for funding may be all that is required as the Assessor will have given a very good explanation of the process and discussed Plan B with them should funding not be available.
In summary the Assessor can choose the following options:
1. If the person requests the 'funding not available' outcome in writing the Assessor can print off and give the person the Outcome Summary from the Prioritisation Tool that has the Ministry logo on it, or
2. Send the Outcome Summary with the MOH logo to the person with their own organisation letter attached, or
3. Send the Outcome Summary with the MOH logo to the person using the letter template attached.
Important Points for Assessors to bear in mind:
1. The Provider is no longer in the position of "declining" requests for equipment or modifications.
2. As with all Prioritisation Tools being used (elective surgery and the EMS Prioritisation Tool) the clinician delivers the outcome. This is part of their role. The key message has to be that the person's needs, when compared to the needs of all other disabled people, were not as high as those of other people - and as there is not sufficient funding available to meet everyone's needs some people will not meet the threshold.
3. It is important for Assessors to be cautious with the language they use - avoid using the word declined. Instead use 'funding is not available' at this point in time. Should the person's needs change in the future they can ask to have another assessment.
4. Important for Assessors to develop a good, clear explanation of the prioritisation process.
5. The Prioritisation Tool is the objective means of measuring whose needs are the greatest and who can benefit the most.
Link to the letter template
Frequently asked technical questions
All technical queries should be referred to the Enigma
Outlined below are a few common questions.
Access to the Tool
Q. What link do I use to get into the Tool?
Response:
The Assessor will first need to have completed the training and update their details in the Enable online system before they can get access to the Tool.
If this is done please click on the appropriate link below:
Where a Connected Health link is available: (DHBs)
Where a Connected Health link is not available: (other organisations)
Your username is your EMS Assessor Code. If you cannot remember your password, please click the 'Forgot your Password' link on the login screen.
Logging in
Q. I have been unable to log in to the Prioritisation Tool for the past week.
I have had no problems with logging in previous to this. Why is this?