http://gatfl.gatech.edu/tflwiki/index.php?title=AT3:_AT_Reuse_%26_Medicaid_Guidance_for_AT_Act_Programs&feed=atom&action=historyAT3: AT Reuse & Medicaid Guidance for AT Act Programs - Revision history2024-03-29T05:21:56ZRevision history for this page on the wikiMediaWiki 1.36.4http://gatfl.gatech.edu/tflwiki/index.php?title=AT3:_AT_Reuse_%26_Medicaid_Guidance_for_AT_Act_Programs&diff=3457&oldid=prevCphillips45: /* How to Get Started */2017-08-07T14:45:23Z<p><span dir="auto"><span class="autocomment">How to Get Started</span></span></p>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Medicaid covers the entire state, so decisions must be made about how to serve different geographic areas. Reuse programs frequently encounter the issue of transportation for device delivery. Programs often create a network using existing agency resources, volunteers from organizations in the network, or contractual arrangements with commercial suppliers.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Medicaid covers the entire state, so decisions must be made about how to serve different geographic areas. Reuse programs frequently encounter the issue of transportation for device delivery. Programs often create a network using existing agency resources, volunteers from organizations in the network, or contractual arrangements with commercial suppliers.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*'''3)ADDRESS LIABILITY CONCERNS AND PROGRAM OPERATIONS</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*'''3) ADDRESS LIABILITY CONCERNS AND PROGRAM OPERATIONS</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Most programs face two areas of liability concern: </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Most programs face two areas of liability concern: </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>#issues of organization structure, governance, insurance and human resources, and </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>#issues of organization structure, governance, insurance and human resources, and </div></td></tr>
</table>Cphillips45http://gatfl.gatech.edu/tflwiki/index.php?title=AT3:_AT_Reuse_%26_Medicaid_Guidance_for_AT_Act_Programs&diff=3456&oldid=prevCphillips45: /* How to Get Started */2017-08-07T14:44:46Z<p><span dir="auto"><span class="autocomment">How to Get Started</span></span></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 14:44, 7 August 2017</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Medicaid covers the entire state, so decisions must be made about how to serve different geographic areas. Reuse programs frequently encounter the issue of transportation for device delivery. Programs often create a network using existing agency resources, volunteers from organizations in the network, or contractual arrangements with commercial suppliers.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Medicaid covers the entire state, so decisions must be made about how to serve different geographic areas. Reuse programs frequently encounter the issue of transportation for device delivery. Programs often create a network using existing agency resources, volunteers from organizations in the network, or contractual arrangements with commercial suppliers.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*'''ADDRESS LIABILITY CONCERNS AND PROGRAM OPERATIONS</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*'''<ins style="font-weight: bold; text-decoration: none;">3)</ins>ADDRESS LIABILITY CONCERNS AND PROGRAM OPERATIONS</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Most programs face two areas of liability concern: </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Most programs face two areas of liability concern: </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>#issues of organization structure, governance, insurance and human resources, and </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>#issues of organization structure, governance, insurance and human resources, and </div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Customer follow-up helps to ensure that the device is appropriate, acceptable and being used.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Customer follow-up helps to ensure that the device is appropriate, acceptable and being used.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Programs need to be prepared to dispose of devices that have no more useful life, either through cannibalization for useful parts or environmentally safe disposal by using certified companies for disposal. Reuse programs are cautioned against altering devices from the original manufacturer specifications (remanufacturing) as a serious potential liability. All repair and refurbishing should be consistent with the original manufacturer’s specifications.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Programs need to be prepared to dispose of devices that have no more useful life, either through cannibalization for useful parts or environmentally safe disposal by using certified companies for disposal. Reuse programs are cautioned against altering devices from the original manufacturer specifications (remanufacturing) as a serious potential liability. All repair and refurbishing should be consistent with the original manufacturer’s specifications.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*'''PREPARE A PROJECT PLAN AND PRELIMINARY BUDGET</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*'''<ins style="font-weight: bold; text-decoration: none;">4) </ins>PREPARE A PROJECT PLAN AND PRELIMINARY BUDGET</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The Pass It On Center includes a preliminary project plan among its resources , but it might prove useful to review the experience of recently implemented programs. Every project is different because the state, the Medicaid program, and the issues vary. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The Pass It On Center includes a preliminary project plan among its resources , but it might prove useful to review the experience of recently implemented programs. Every project is different because the state, the Medicaid program, and the issues vary. </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The Medicaid program will need to develop a budget for the agreed-upon activities. For example, in Kansas this includes supporting the database and tracking expenses for all reutilized equipment and compensating suppliers for repairs for those devices reassigned to Medicaid beneficiaries. It might include expense allocations for the use of professionals for other specific activities, and for the pickup or delivery of equipment. The budget would be based on assumptions about the number of patients to be served. Again, recent experience in other programs might offer useful data. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The Medicaid program will need to develop a budget for the agreed-upon activities. For example, in Kansas this includes supporting the database and tracking expenses for all reutilized equipment and compensating suppliers for repairs for those devices reassigned to Medicaid beneficiaries. It might include expense allocations for the use of professionals for other specific activities, and for the pickup or delivery of equipment. The budget would be based on assumptions about the number of patients to be served. Again, recent experience in other programs might offer useful data. </div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The program will first need to determine how it will operate and the level of funding needed to support the infrastructure. It will take some time to establish a reassignment network – that is a network of organizations that provide intake, eligibility, matching and distribution services. It will also take some time to build a working inventory from donated devices to have the appropriate equipment to reassign. Once the program is established and the public becomes aware of the need and the services, circumstances change rapidly. (For example, Oklahoma experienced a rapid expansion in supporters and voluntary partners shortly after start-up as other agencies and organizations working with people with disabilities recognized the value of the reuse program. At that point, equipment purchased by sources other than Medicaid (insurance, private pay, etc.) is being donated and some Medicaid-purchased equipment is being recovered. When this point is reached, a return of one to two dollars for every dollar spent is probably a safe assumption. The return on investment could be much higher, but this depends on the inventory and distribution model. Each program must analyze the decisions made about the operational model for budgeting assumptions.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The program will first need to determine how it will operate and the level of funding needed to support the infrastructure. It will take some time to establish a reassignment network – that is a network of organizations that provide intake, eligibility, matching and distribution services. It will also take some time to build a working inventory from donated devices to have the appropriate equipment to reassign. Once the program is established and the public becomes aware of the need and the services, circumstances change rapidly. (For example, Oklahoma experienced a rapid expansion in supporters and voluntary partners shortly after start-up as other agencies and organizations working with people with disabilities recognized the value of the reuse program. At that point, equipment purchased by sources other than Medicaid (insurance, private pay, etc.) is being donated and some Medicaid-purchased equipment is being recovered. When this point is reached, a return of one to two dollars for every dollar spent is probably a safe assumption. The return on investment could be much higher, but this depends on the inventory and distribution model. Each program must analyze the decisions made about the operational model for budgeting assumptions.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*'''DETERMINE HOW PROGRAM WILL BE FUNDED</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*'''<ins style="font-weight: bold; text-decoration: none;">5) </ins>DETERMINE HOW PROGRAM WILL BE FUNDED</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>There are many models for reuse partnerships, and they should be examined to determine which, if any, are appropriate for the circumstances in a given state. Medicaid can analyze which items or categories of devices represent the greatest potential for successful reuse. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>There are many models for reuse partnerships, and they should be examined to determine which, if any, are appropriate for the circumstances in a given state. Medicaid can analyze which items or categories of devices represent the greatest potential for successful reuse. </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>In some states, the reuse program uses Medicaid funds to refurbish equipment for Medicaid beneficiaries. The refurbishing may be done by a separate reuse facility or by commercial suppliers that partner with Medicaid. In other states, DME refurbishing suppliers offer repair services for Medicaid and the public, and submit the request for reimbursement for Medicaid beneficiaries directly to Medicaid. Medicaid may pay the cost of inventory management for all used devices recovered in exchange for priority claim on devices. Medicaid could identify a specific category (or categories) of devices that it deems more practical or beneficial for reuse.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>In some states, the reuse program uses Medicaid funds to refurbish equipment for Medicaid beneficiaries. The refurbishing may be done by a separate reuse facility or by commercial suppliers that partner with Medicaid. In other states, DME refurbishing suppliers offer repair services for Medicaid and the public, and submit the request for reimbursement for Medicaid beneficiaries directly to Medicaid. Medicaid may pay the cost of inventory management for all used devices recovered in exchange for priority claim on devices. Medicaid could identify a specific category (or categories) of devices that it deems more practical or beneficial for reuse.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*'''IDENTIFY DESIRED RETURN ON INVESTMENT</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*'''<ins style="font-weight: bold; text-decoration: none;">6) </ins>IDENTIFY DESIRED RETURN ON INVESTMENT</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Each Medicaid program should consider the categories of devices that result in the greatest expenditures and weigh how reuse might impact those categories. This would include consideration of devices that are more generally short-term use and more likely to be recovered or donated to the reuse program. It could be a consideration for a category that is particularly expensive, such as bariatric devices. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Each Medicaid program should consider the categories of devices that result in the greatest expenditures and weigh how reuse might impact those categories. This would include consideration of devices that are more generally short-term use and more likely to be recovered or donated to the reuse program. It could be a consideration for a category that is particularly expensive, such as bariatric devices. </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>3. Prevention of lost earnings by the user, relatives or other caregivers, and</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>3. Prevention of lost earnings by the user, relatives or other caregivers, and</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>4. Savings from avoided landfill costs related to discarded DME that has a remaining useful life. (See Appendix III.) </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>4. Savings from avoided landfill costs related to discarded DME that has a remaining useful life. (See Appendix III.) </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*'''DONATION AND REASSIGNMENT SAFEGUARDS</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*'''<ins style="font-weight: bold; text-decoration: none;">7) </ins>DONATION AND REASSIGNMENT SAFEGUARDS</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>A first step in safeguarding donations is to ensure that a prospective donor has the right to donate the equipment to the reuse program. Some DME is purchased by organizations that retain ownership and would expect the device to be returned if no longer needed. While reuse programs do not purchase devices (so there is no incentive to donate stolen property), it is still advisable to have policies for ascertaining the right of the donor to give the equipment (IQ-ATR 3.8 - Donated Equipment: Confirmation of Donor’s Ownership).</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>A first step in safeguarding donations is to ensure that a prospective donor has the right to donate the equipment to the reuse program. Some DME is purchased by organizations that retain ownership and would expect the device to be returned if no longer needed. While reuse programs do not purchase devices (so there is no incentive to donate stolen property), it is still advisable to have policies for ascertaining the right of the donor to give the equipment (IQ-ATR 3.8 - Donated Equipment: Confirmation of Donor’s Ownership).</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Reassignment can be safeguarded to ensure that the devices are not being obtained for resale. Appropriate application and intake policies should collect information about the intended user, and that user should be appropriately matched and trained in the device use. This should result in personal interaction with the device recipient. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Reassignment can be safeguarded to ensure that the devices are not being obtained for resale. Appropriate application and intake policies should collect information about the intended user, and that user should be appropriately matched and trained in the device use. This should result in personal interaction with the device recipient. </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*'''DEFINE REIMBURSEMENT MODELS FOR DME SUPPLIERS</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*'''<ins style="font-weight: bold; text-decoration: none;">8) </ins>DEFINE REIMBURSEMENT MODELS FOR DME SUPPLIERS</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>In most Medicaid partnerships, DME devices are not sold. However, if approved by change of law or policies, devices could be refurbished by certified suppliers and purchased by Medicaid for reassignment to beneficiaries. Services, such as device repairs either before or after the device is received, may be reimbursed by Medicaid. In these cases, the program will define qualifications for suppliers. In some cases, the suppliers are commercial DME suppliers with certified technicians. In others, the supplier may be a reuse program with appropriately trained technicians.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>In most Medicaid partnerships, DME devices are not sold. However, if approved by change of law or policies, devices could be refurbished by certified suppliers and purchased by Medicaid for reassignment to beneficiaries. Services, such as device repairs either before or after the device is received, may be reimbursed by Medicaid. In these cases, the program will define qualifications for suppliers. In some cases, the suppliers are commercial DME suppliers with certified technicians. In others, the supplier may be a reuse program with appropriately trained technicians.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*'''EXPLAIN THE ROLE OF REUSE TO BENEFICIARIES</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*'''<ins style="font-weight: bold; text-decoration: none;">9) </ins>EXPLAIN THE ROLE OF REUSE TO BENEFICIARIES</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The program will need a public awareness campaign to explain key facets of the reuse program:</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The program will need a public awareness campaign to explain key facets of the reuse program:</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Why used versus new </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Why used versus new </div></td></tr>
</table>Cphillips45http://gatfl.gatech.edu/tflwiki/index.php?title=AT3:_AT_Reuse_%26_Medicaid_Guidance_for_AT_Act_Programs&diff=3455&oldid=prevCphillips45: /* How to Get Started */2017-08-07T14:43:42Z<p><span dir="auto"><span class="autocomment">How to Get Started</span></span></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 14:43, 7 August 2017</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==='''How to Get Started'''===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==='''How to Get Started'''===</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Before starting a program, it is essential to identify legal barriers to reuse under existing laws or Medicaid program regulations. Change sometimes requires legislative action or regulatory changes within an agency. If changes are needed, it may be possible to secure the commitment for change and proceed with planning while those changes are implemented.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Before starting a program, it is essential to identify legal barriers to reuse under existing laws or Medicaid program regulations. Change sometimes requires legislative action or regulatory changes within an agency. If changes are needed, it may be possible to secure the commitment for change and proceed with planning while those changes are implemented.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*'''CONVENE A WORK GROUP OF KEY STAKEHOLDERS</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*'''<ins style="font-weight: bold; text-decoration: none;">1) </ins>CONVENE A WORK GROUP OF KEY STAKEHOLDERS</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Identify the populations that are served through the Medicaid program. The extent of eligibility varies by state; some coverage is mandated. Having done this, it will be possible to identify agencies, organizations, and individuals who serve those populations and might be affected by a reuse program. Including representatives from all stakeholders increases the opportunities for a successful program launch. This group typically includes representatives from:</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Identify the populations that are served through the Medicaid program. The extent of eligibility varies by state; some coverage is mandated. Having done this, it will be possible to identify agencies, organizations, and individuals who serve those populations and might be affected by a reuse program. Including representatives from all stakeholders increases the opportunities for a successful program launch. This group typically includes representatives from:</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div># Medicaid program</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div># Medicaid program</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>This group could include representatives from other government agencies that purchase DME, with the goal of gaining support for reclaiming equipment that is no longer needed. In Virginia, for example, the Brain Injury Trust Fund and the Veterans Administration also sticker newly-purchased devices for return to the reuse program. It could also include representatives from hospitals that serve large numbers of Medicaid patients, with the goal of assigned needed DME as soon as possible upon or after discharge. This strategy optimizes recovery (or at least best outcomes) and impacts the Medicaid budget by avoiding return visits to doctors, emergency rooms and hospitals.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>This group could include representatives from other government agencies that purchase DME, with the goal of gaining support for reclaiming equipment that is no longer needed. In Virginia, for example, the Brain Injury Trust Fund and the Veterans Administration also sticker newly-purchased devices for return to the reuse program. It could also include representatives from hospitals that serve large numbers of Medicaid patients, with the goal of assigned needed DME as soon as possible upon or after discharge. This strategy optimizes recovery (or at least best outcomes) and impacts the Medicaid budget by avoiding return visits to doctors, emergency rooms and hospitals.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>'''''TIP: An initial step should be acquainting the group with successful models of reuse in Medicaid. The Pass It On Center can provide information and presentations, or the group can invite a representative from an existing Medicaid reuse program.'''''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>'''''TIP: An initial step should be acquainting the group with successful models of reuse in Medicaid. The Pass It On Center can provide information and presentations, or the group can invite a representative from an existing Medicaid reuse program.'''''</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*'''DEFINE SCOPE OF SERVICES</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*'''<ins style="font-weight: bold; text-decoration: none;">2) </ins>DEFINE SCOPE OF SERVICES</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The workgroup will need to define the scope of services to be offered. This includes specification of devices or equipment that will be accepted for refurbishing and reassignment. The program may want to limit reuse to devices or categories that represent the greatest return on investment. Bariatric equipment and sleep apnea devices are expensive and in great demand, for example. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The workgroup will need to define the scope of services to be offered. This includes specification of devices or equipment that will be accepted for refurbishing and reassignment. The program may want to limit reuse to devices or categories that represent the greatest return on investment. Bariatric equipment and sleep apnea devices are expensive and in great demand, for example. </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>There are other considerations. A refurbishing program may elect to limit devices to specific manufacturers. For example, if wheelchairs are accepted only from two or three major manufacturers, technicians will be trained for those and repairs can be made more efficiently. Doing so could also limit the range of spare parts needed. As noted earlier, highly customized devices may be less appropriate for reuse for many reasons.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>There are other considerations. A refurbishing program may elect to limit devices to specific manufacturers. For example, if wheelchairs are accepted only from two or three major manufacturers, technicians will be trained for those and repairs can be made more efficiently. Doing so could also limit the range of spare parts needed. As noted earlier, highly customized devices may be less appropriate for reuse for many reasons.</div></td></tr>
</table>Cphillips45http://gatfl.gatech.edu/tflwiki/index.php?title=AT3:_AT_Reuse_%26_Medicaid_Guidance_for_AT_Act_Programs&diff=3454&oldid=prevCphillips45: /* How to Get Started */2017-08-07T14:43:03Z<p><span dir="auto"><span class="autocomment">How to Get Started</span></span></p>
<a href="http://gatfl.gatech.edu/tflwiki/index.php?title=AT3:_AT_Reuse_%26_Medicaid_Guidance_for_AT_Act_Programs&diff=3454&oldid=3453">Show changes</a>Cphillips45http://gatfl.gatech.edu/tflwiki/index.php?title=AT3:_AT_Reuse_%26_Medicaid_Guidance_for_AT_Act_Programs&diff=3453&oldid=prevCphillips45: /* How to Get Started */2017-08-07T14:39:26Z<p><span dir="auto"><span class="autocomment">How to Get Started</span></span></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 14:39, 7 August 2017</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>**The workgroup will need to define the scope of services to be offered. This includes specification of devices or equipment that will be accepted for refurbishing and reassignment. The program may want to limit reuse to devices or categories that represent the greatest return on investment. Bariatric equipment and sleep apnea devices are expensive and in great demand, for example. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>**The workgroup will need to define the scope of services to be offered. This includes specification of devices or equipment that will be accepted for refurbishing and reassignment. The program may want to limit reuse to devices or categories that represent the greatest return on investment. Bariatric equipment and sleep apnea devices are expensive and in great demand, for example. </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>There are other considerations. A refurbishing program may elect to limit devices to specific manufacturers. For example, if wheelchairs are accepted only from two or three major manufacturers, technicians will be trained for those and repairs can be made more efficiently. Doing so could also limit the range of spare parts needed. As noted earlier, highly customized devices may be less appropriate for reuse for many reasons. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>There are other considerations. A refurbishing program may elect to limit devices to specific manufacturers. For example, if wheelchairs are accepted only from two or three major manufacturers, technicians will be trained for those and repairs can be made more efficiently. Doing so could also limit the range of spare parts needed. As noted earlier, highly customized devices may be less appropriate for reuse for many reasons. </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">*</del>*The group should also address supporting services that will be offered. These could include assessment for appropriate equipment (which requires appropriate professionals), matching to appropriate devices (also sometimes requiring professionals such as occupational or physical therapists), and maintenance and repair of the assigned devices. (Some state laws mandate assessment or fitting of specific devices by healthcare professionals with specific credentials. Again, state law is very important in program design.)</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*The group should also address supporting services that will be offered. These could include assessment for appropriate equipment (which requires appropriate professionals), matching to appropriate devices (also sometimes requiring professionals such as occupational or physical therapists), and maintenance and repair of the assigned devices. (Some state laws mandate assessment or fitting of specific devices by healthcare professionals with specific credentials. Again, state law is very important in program design.)</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Optimizing processes and procedures will contribute to financial outcomes. For example, Friends of Disabled Adults and Children, a nonprofit reuse program in Metro Atlanta, adopted a “value stream” production system to streamline program operations.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Optimizing processes and procedures will contribute to financial outcomes. For example, Friends of Disabled Adults and Children, a nonprofit reuse program in Metro Atlanta, adopted a “value stream” production system to streamline program operations.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>It will be easier to identify participating organizations or individuals and their potential roles in the program after the scope and proposed operating model has been defined. This model should consider:</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>It will be easier to identify participating organizations or individuals and their potential roles in the program after the scope and proposed operating model has been defined. This model should consider:</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>This information can be disseminated through the network of partners and associated organizations and through the use of public media.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>This information can be disseminated through the network of partners and associated organizations and through the use of public media.</div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==='''Resources for Medicaid AT Reuse Programs'''===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==='''Resources for Medicaid AT Reuse Programs'''===</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*A review of existing models can aid the identification of desirable activities and characteristics for the proposed program. The Pass It On Center is a useful resource for implementation resources. The August 2012 webinar on Medicaid is a good starting point for discussions. The slides and audio are available in the webinar archive (accessible from the PIOC website home page. ) *The Knowledge Base (http://www.passitoncenter.org/content/) contains a broad range of information for the operation of a reuse program including a guide to developing a business plan and a three-year financial plan. It also includes an example of a Request for Proposal.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*A review of existing models can aid the identification of desirable activities and characteristics for the proposed program. The Pass It On Center is a useful resource for implementation resources. The August 2012 webinar on Medicaid is a good starting point for discussions. The slides and audio are available in the webinar archive (accessible from the PIOC website home page. ) *The Knowledge Base (http://www.passitoncenter.org/content/) contains a broad range of information for the operation of a reuse program including a guide to developing a business plan and a three-year financial plan. It also includes an example of a Request for Proposal.</div></td></tr>
</table>Cphillips45http://gatfl.gatech.edu/tflwiki/index.php?title=AT3:_AT_Reuse_%26_Medicaid_Guidance_for_AT_Act_Programs&diff=3452&oldid=prevCphillips45: /* How to Get Started */2017-08-07T14:39:03Z<p><span dir="auto"><span class="autocomment">How to Get Started</span></span></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 14:39, 7 August 2017</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''CONVENE A WORK GROUP OF KEY STAKEHOLDERS</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''CONVENE A WORK GROUP OF KEY STAKEHOLDERS</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Identify the populations that are served through the Medicaid program. The extent of eligibility varies by state; some coverage is mandated. Having done this, it will be possible to identify agencies, organizations, and individuals who serve those populations and might be affected by a reuse program. Including representatives from all stakeholders increases the opportunities for a successful program launch. This group typically includes representatives from:</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Identify the populations that are served through the Medicaid program. The extent of eligibility varies by state; some coverage is mandated. Having done this, it will be possible to identify agencies, organizations, and individuals who serve those populations and might be affected by a reuse program. Including representatives from all stakeholders increases the opportunities for a successful program launch. This group typically includes representatives from:</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">§ </del>Medicaid program</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"># </ins>Medicaid program</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">§ </del>Assistive Technology Act Program</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"># </ins>Assistive Technology Act Program</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">§ </del>Independent Living Council</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"># </ins>Independent Living Council</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">§ </del>Agencies on Aging</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"># </ins>Agencies on Aging</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">§ </del>Commercial DME suppliers and/or a representative from the state association of medical equipment suppliers</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"># </ins>Commercial DME suppliers and/or a representative from the state association of medical equipment suppliers</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">§ </del>Nonprofit suppliers of DME or related services in your state (often Goodwill, Easter Seals, United Cerebral Palsy, or faith-based organizations)</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"># </ins>Nonprofit suppliers of DME or related services in your state (often Goodwill, Easter Seals, United Cerebral Palsy, or faith-based organizations)</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">§ </del>Advocacy groups for people with disabilities</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"># </ins>Advocacy groups for people with disabilities</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>This group could include representatives from other government agencies that purchase DME, with the goal of gaining support for reclaiming equipment that is no longer needed. In Virginia, for example, the Brain Injury Trust Fund and the Veterans Administration also sticker newly-purchased devices for return to the reuse program. It could also include representatives from hospitals that serve large numbers of Medicaid patients, with the goal of assigned needed DME as soon as possible upon or after discharge. This strategy optimizes recovery (or at least best outcomes) and impacts the Medicaid budget by avoiding return visits to doctors, emergency rooms and hospitals.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>This group could include representatives from other government agencies that purchase DME, with the goal of gaining support for reclaiming equipment that is no longer needed. In Virginia, for example, the Brain Injury Trust Fund and the Veterans Administration also sticker newly-purchased devices for return to the reuse program. It could also include representatives from hospitals that serve large numbers of Medicaid patients, with the goal of assigned needed DME as soon as possible upon or after discharge. This strategy optimizes recovery (or at least best outcomes) and impacts the Medicaid budget by avoiding return visits to doctors, emergency rooms and hospitals.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>An initial step should be acquainting the group with successful models of reuse in Medicaid. The Pass It On Center can provide information and presentations, or the group can invite a representative from an existing Medicaid reuse program.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">'''''TIP: </ins>An initial step should be acquainting the group with successful models of reuse in Medicaid. The Pass It On Center can provide information and presentations, or the group can invite a representative from an existing Medicaid reuse program.<ins style="font-weight: bold; text-decoration: none;">'''''</ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''DEFINE SCOPE OF SERVICES</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''DEFINE SCOPE OF SERVICES</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">A review of existing models can aid the identification of desirable activities and characteristics for the proposed program. The Pass It On Center is a useful resource for implementation resources. The August 2012 webinar on Medicaid is a good starting point for discussions. The slides and audio are available in the webinar archive (accessible from the PIOC website home page. ) The Knowledge Base (http://www.passitoncenter.org/content/) contains a broad range of information for the operation of a reuse program including a guide to developing a business plan and a three-year financial plan. It also includes an example of a Request for Proposal.</del></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">**</ins>The workgroup will need to define the scope of services to be offered. This includes specification of devices or equipment that will be accepted for refurbishing and reassignment. The program may want to limit reuse to devices or categories that represent the greatest return on investment. Bariatric equipment and sleep apnea devices are expensive and in great demand, for example. </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>The workgroup will need to define the scope of services to be offered. This includes specification of devices or equipment that will be accepted for refurbishing and reassignment. The program may want to limit reuse to devices or categories that represent the greatest return on investment. Bariatric equipment and sleep apnea devices are expensive and in great demand, for example. </div></td><td colspan="2"></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>There are other considerations. A refurbishing program may elect to limit devices to specific manufacturers. For example, if wheelchairs are accepted only from two or three major manufacturers, technicians will be trained for those and repairs can be made more efficiently. Doing so could also limit the range of spare parts needed. As noted earlier, highly customized devices may be less appropriate for reuse for many reasons. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>There are other considerations. A refurbishing program may elect to limit devices to specific manufacturers. For example, if wheelchairs are accepted only from two or three major manufacturers, technicians will be trained for those and repairs can be made more efficiently. Doing so could also limit the range of spare parts needed. As noted earlier, highly customized devices may be less appropriate for reuse for many reasons. </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>The group should also address supporting services that will be offered. These could include assessment for appropriate equipment (which requires appropriate professionals), matching to appropriate devices (also sometimes requiring professionals such as occupational or physical therapists), and maintenance and repair of the assigned devices. (Some state laws mandate assessment or fitting of specific devices by healthcare professionals with specific credentials. Again, state law is very important in program design.)</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">**</ins>The group should also address supporting services that will be offered. These could include assessment for appropriate equipment (which requires appropriate professionals), matching to appropriate devices (also sometimes requiring professionals such as occupational or physical therapists), and maintenance and repair of the assigned devices. (Some state laws mandate assessment or fitting of specific devices by healthcare professionals with specific credentials. Again, state law is very important in program design.)</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Optimizing processes and procedures will contribute to financial outcomes. For example, Friends of Disabled Adults and Children, a nonprofit reuse program in Metro Atlanta, adopted a “value stream” production system to streamline program operations.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Optimizing processes and procedures will contribute to financial outcomes. For example, Friends of Disabled Adults and Children, a nonprofit reuse program in Metro Atlanta, adopted a “value stream” production system to streamline program operations.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>It will be easier to identify participating organizations or individuals and their potential roles in the program after the proposed operating model has been defined. This model should consider device acquisition strategies, safeguards from liability, eligibility, priorities for inventory usage, and a distribution strategy.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>It will be easier to identify participating organizations or individuals and their potential roles in the program after the <ins style="font-weight: bold; text-decoration: none;">scope and </ins>proposed operating model has been defined. This model should consider<ins style="font-weight: bold; text-decoration: none;">:</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"># </ins>device acquisition strategies, safeguards from liability, eligibility, priorities for inventory usage, and a distribution strategy.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Medicaid covers the entire state, so decisions must be made about how to serve different geographic areas. Reuse programs frequently encounter the issue of transportation for device delivery. Programs often create a network using existing agency resources, volunteers from organizations in the network, or contractual arrangements with commercial suppliers.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Medicaid covers the entire state, so decisions must be made about how to serve different geographic areas. Reuse programs frequently encounter the issue of transportation for device delivery. Programs often create a network using existing agency resources, volunteers from organizations in the network, or contractual arrangements with commercial suppliers.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''ADDRESS LIABILITY CONCERNS AND PROGRAM OPERATIONS</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''ADDRESS LIABILITY CONCERNS AND PROGRAM OPERATIONS</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Stories from actual users</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Stories from actual users</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>This information can be disseminated through the network of partners and associated organizations and through the use of public media.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>This information can be disseminated through the network of partners and associated organizations and through the use of public media.</div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">==='''Resources for Medicaid AT Reuse Programs'''===</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*A review of existing models can aid the identification of desirable activities and characteristics for the proposed program. The Pass It On Center is a useful resource for implementation resources. The August 2012 webinar on Medicaid is a good starting point for discussions. The slides and audio are available in the webinar archive (accessible from the PIOC website home page. ) *The Knowledge Base (http://www.passitoncenter.org/content/) contains a broad range of information for the operation of a reuse program including a guide to developing a business plan and a three-year financial plan. It also includes an example of a Request for Proposal.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* IQ-ATR Tool</ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==='''Ensuring Quality AT Reuse with Medicaid'''===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==='''Ensuring Quality AT Reuse with Medicaid'''===</div></td></tr>
</table>Cphillips45http://gatfl.gatech.edu/tflwiki/index.php?title=AT3:_AT_Reuse_%26_Medicaid_Guidance_for_AT_Act_Programs&diff=3451&oldid=prevCphillips45: /* Ensuring Quality AT Reuse with Medicaid */2017-08-07T14:31:36Z<p><span dir="auto"><span class="autocomment">Ensuring Quality AT Reuse with Medicaid</span></span></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 14:31, 7 August 2017</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l66">Line 66:</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*One category of devices that poses a challenge for reuse is complex rehabilitation technology (CRT). In this category are wheelchairs that are fitted, programmed, adjusted or adapted for the needs of a specific individual. Identifying another individual who requires identical customization is very different from reassigning standard devices without modification. Reusing these devices without a professional evaluation of the precise needs of another individual is unsafe. If a program chooses to reutilize complex rehabilitation technology, policies and procedures should be in place to use appropriate allied health professionals to assure that the equipment is appropriately matched to the needs of the individual. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*One category of devices that poses a challenge for reuse is complex rehabilitation technology (CRT). In this category are wheelchairs that are fitted, programmed, adjusted or adapted for the needs of a specific individual. Identifying another individual who requires identical customization is very different from reassigning standard devices without modification. Reusing these devices without a professional evaluation of the precise needs of another individual is unsafe. If a program chooses to reutilize complex rehabilitation technology, policies and procedures should be in place to use appropriate allied health professionals to assure that the equipment is appropriately matched to the needs of the individual. </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The Pass It On Center has published Indicators of Quality for Assistive Technology Reutilization (IQ-ATR) that provide a more comprehensive exploration of a range of best practices that, if followed consistently by reuse programs, can provide safeguards to beneficiaries, reuse programs and third-party providers like Medicaid. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The Pass It On Center has published Indicators of Quality for Assistive Technology Reutilization (IQ-ATR) that provide a more comprehensive exploration of a range of best practices that, if followed consistently by reuse programs, can provide safeguards to beneficiaries, reuse programs and third-party providers like Medicaid. </div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">==='''How to Get Started'''===</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Before starting a program, it is essential to identify legal barriers to reuse under existing laws or Medicaid program regulations. Change sometimes requires legislative action or regulatory changes within an agency. If changes are needed, it may be possible to secure the commitment for change and proceed with planning while those changes are implemented.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''CONVENE A WORK GROUP OF KEY STAKEHOLDERS</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Identify the populations that are served through the Medicaid program. The extent of eligibility varies by state; some coverage is mandated. Having done this, it will be possible to identify agencies, organizations, and individuals who serve those populations and might be affected by a reuse program. Including representatives from all stakeholders increases the opportunities for a successful program launch. This group typically includes representatives from:</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">§ Medicaid program</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">§ Assistive Technology Act Program</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">§ Independent Living Council</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">§ Agencies on Aging</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">§ Commercial DME suppliers and/or a representative from the state association of medical equipment suppliers</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">§ Nonprofit suppliers of DME or related services in your state (often Goodwill, Easter Seals, United Cerebral Palsy, or faith-based organizations)</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">§ Advocacy groups for people with disabilities</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">This group could include representatives from other government agencies that purchase DME, with the goal of gaining support for reclaiming equipment that is no longer needed. In Virginia, for example, the Brain Injury Trust Fund and the Veterans Administration also sticker newly-purchased devices for return to the reuse program. It could also include representatives from hospitals that serve large numbers of Medicaid patients, with the goal of assigned needed DME as soon as possible upon or after discharge. This strategy optimizes recovery (or at least best outcomes) and impacts the Medicaid budget by avoiding return visits to doctors, emergency rooms and hospitals.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">An initial step should be acquainting the group with successful models of reuse in Medicaid. The Pass It On Center can provide information and presentations, or the group can invite a representative from an existing Medicaid reuse program.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''DEFINE SCOPE OF SERVICES</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">A review of existing models can aid the identification of desirable activities and characteristics for the proposed program. The Pass It On Center is a useful resource for implementation resources. The August 2012 webinar on Medicaid is a good starting point for discussions. The slides and audio are available in the webinar archive (accessible from the PIOC website home page. ) The Knowledge Base (http://www.passitoncenter.org/content/) contains a broad range of information for the operation of a reuse program including a guide to developing a business plan and a three-year financial plan. It also includes an example of a Request for Proposal.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The workgroup will need to define the scope of services to be offered. This includes specification of devices or equipment that will be accepted for refurbishing and reassignment. The program may want to limit reuse to devices or categories that represent the greatest return on investment. Bariatric equipment and sleep apnea devices are expensive and in great demand, for example. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">There are other considerations. A refurbishing program may elect to limit devices to specific manufacturers. For example, if wheelchairs are accepted only from two or three major manufacturers, technicians will be trained for those and repairs can be made more efficiently. Doing so could also limit the range of spare parts needed. As noted earlier, highly customized devices may be less appropriate for reuse for many reasons. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The group should also address supporting services that will be offered. These could include assessment for appropriate equipment (which requires appropriate professionals), matching to appropriate devices (also sometimes requiring professionals such as occupational or physical therapists), and maintenance and repair of the assigned devices. (Some state laws mandate assessment or fitting of specific devices by healthcare professionals with specific credentials. Again, state law is very important in program design.)</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Optimizing processes and procedures will contribute to financial outcomes. For example, Friends of Disabled Adults and Children, a nonprofit reuse program in Metro Atlanta, adopted a “value stream” production system to streamline program operations.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">It will be easier to identify participating organizations or individuals and their potential roles in the program after the proposed operating model has been defined. This model should consider device acquisition strategies, safeguards from liability, eligibility, priorities for inventory usage, and a distribution strategy.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Medicaid covers the entire state, so decisions must be made about how to serve different geographic areas. Reuse programs frequently encounter the issue of transportation for device delivery. Programs often create a network using existing agency resources, volunteers from organizations in the network, or contractual arrangements with commercial suppliers.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''ADDRESS LIABILITY CONCERNS AND PROGRAM OPERATIONS</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">All programs face two areas of liability concern: issues of organization structure, governance, insurance and human resources, and issues related to reuse program operations. Compliance with all prevailing laws and regulations is critical. This includes compliance with provisions of the Food, Drug and Cosmetic Act (FDA) that apply to some devices, especially the ability to identify the recipient of a specific device to respond to alerts and recalls. Programs also need to require prescriptions for those devices that would require prescriptions for acquisitions from commercial suppliers. Liability arising from program operations can be mitigated by implementing policies, procedures and training that are consistent with the Indicators of Quality for AT Reuse (see http://www.passitoncenter.org ). </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Programs should have a protocol in place to ensure that the donor owns the equipment or has the right to donate it. This avoids having items donated that remain the property of some other agency or entity or that were stolen. Other forms of liability are mitigated by having standards for age and condition of donated devices, having the devices repaired and refurbished by qualified technicians, using appropriate replacement parts, and sanitizing the devices properly for the safety of workers and recipients. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Liability follows ownership. In most reuse programs, the reuse program assumes ownership of the donated device, whether purchased by Medicaid or another party. The device is sanitized, repaired and refurbished as needed, then reassigned to a new user who accepts ownership and signs a release from liability. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Intake procedures must include a determination of eligibility based on regulatory or agreed-upon guidelines. HIPAA compliance is essential. Medicaid must determine if it will reserve the right to place priority holds on inventory items, and if so, for how long. The reuse program must determine how long it will hold items in inventory. This could vary by category of device and by available storage space.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Where needed or required by law, appropriate professionals (e.g., physical therapist, occupational therapist or respiratory therapist) should match devices to beneficiary needs. The correct fit or adjustment is a critical factor in acceptance and use of AT.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Liability can take the form of injury or property damage. In over 10 years of operation, the Kansas reuse program has experienced only four incidents that could have resulted in liability issues. A back injury by a staff member, an overturned power chair and a hospital bed collapse were addressed with staff training and clarification of practices. In the fourth incident, gouged vinyl flooring in the customer’s home was replaced.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Customer follow-up helps to ensure that the device is appropriate, acceptable and being used.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Programs need to be prepared to dispose of devices that have no more useful life, either through cannibalization for useful parts or environmentally safe disposal by using certified companies for disposal. Reuse programs are cautioned against altering devices from the original manufacturer specifications (remanufacturing) as a serious potential liability. All repair and refurbishing should be consistent with the original manufacturer’s specifications.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''PREPARE A PROJECT PLAN AND PRELIMINARY BUDGET</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The Pass It On Center includes a preliminary project plan among its resources , but it might prove useful to review the experience of recently implemented programs. Every project is different because the state, the Medicaid program, and the issues vary. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The Medicaid program will need to develop a budget for the agreed-upon activities. For example, in Kansas this includes supporting the database and tracking expenses for all reutilized equipment and compensating suppliers for repairs for those devices reassigned to Medicaid beneficiaries. It might include expense allocations for the use of professionals for other specific activities, and for the pickup or delivery of equipment. The budget would be based on assumptions about the number of patients to be served. Again, recent experience in other programs might offer useful data. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">In most states, the Medicaid program would need to prepare a request for proposal (RFP) to contract services with other suppliers for the reutilization services. The Oklahoma RFP is available in the Pass It On Center Knowledge Base. Responses to the RFP would be reviewed to identify the reuse partner.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Funding the program is a key concern, and budgeting should be realistic. It may not be practical to expect a return during Year One, but significant benefits should be realized after the program is in place. The acceptance of the program will depend on how well it is explained to prospective beneficiaries.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">For start-up budgeting, Dr. Sara Sack, Director of the Kansas Equipment Exchange recommends that Year One and perhaps Year Two assume that the program will be “cost neutral,” that is, that significant savings may not be realized for the first two years. In commercial terms, this would be planning for break-even operations before profitability. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The program will first need to determine how it will operate and the level of funding needed to support the infrastructure. It will take some time to establish a reassignment network – that is a network of organizations that provide intake, eligibility, matching and distribution services. It will also take some time to build a working inventory from donated devices to have the appropriate equipment to reassign. Once the program is established and the public becomes aware of the need and the services, circumstances change rapidly. (For example, Oklahoma experienced a rapid expansion in supporters and voluntary partners shortly after start-up as other agencies and organizations working with people with disabilities recognized the value of the reuse program. At that point, equipment purchased by sources other than Medicaid (insurance, private pay, etc.) is being donated and some Medicaid-purchased equipment is being recovered. When this point is reached, a return of one to two dollars for every dollar spent is probably a safe assumption. The return on investment could be much higher, but this depends on the inventory and distribution model. Each program must analyze the decisions made about the operational model for budgeting assumptions.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''DETERMINE HOW PROGRAM WILL BE FUNDED</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">There are many models for reuse partnerships, and they should be examined to determine which, if any, are appropriate for the circumstances in a given state. Medicaid can analyze which items or categories of devices represent the greatest potential for successful reuse. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The Medicaid durable medical equipment budget should not be used to start a reuse partnership. The program start-up costs should be budgeted separately. Otherwise, neither funding for new devices nor appropriate used devices might be available for beneficiaries. It is important to build a viable reuse program with an inventory of devices appropriate to the population before assuming the availability of lightly-used devices in the budgeting process.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">In some states, the reuse program uses Medicaid funds to refurbish equipment for Medicaid beneficiaries. The refurbishing may be done by a separate reuse facility or by commercial suppliers that partner with Medicaid. In other states, DME refurbishing suppliers offer repair services for Medicaid and the public, and submit the request for reimbursement for Medicaid beneficiaries directly to Medicaid. Medicaid may pay the cost of inventory management for all used devices recovered in exchange for priority claim on devices. Medicaid could identify a specific category (or categories) of devices that it deems more practical or beneficial for reuse.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''IDENTIFY DESIRED RETURN ON INVESTMENT</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Each Medicaid program should consider the categories of devices that result in the greatest expenditures and weigh how reuse might impact those categories. This would include consideration of devices that are more generally short-term use and more likely to be recovered or donated to the reuse program. It could be a consideration for a category that is particularly expensive, such as bariatric devices. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">In addition to the value of equipment (and money saved), there are other factors that can be included in the calculation of return on investment:</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">1. Avoided falls and the resulting consequences (physician visit, emergency room visit, nursing home stay, or hospital stay),</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">2. Increased independence in employment, education, recreation and everyday activities,</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">3. Prevention of lost earnings by the user, relatives or other caregivers, and</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">4. Savings from avoided landfill costs related to discarded DME that has a remaining useful life. (See Appendix III.) </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''DONATION AND REASSIGNMENT SAFEGUARDS</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">A first step in safeguarding donations is to ensure that a prospective donor has the right to donate the equipment to the reuse program. Some DME is purchased by organizations that retain ownership and would expect the device to be returned if no longer needed. While reuse programs do not purchase devices (so there is no incentive to donate stolen property), it is still advisable to have policies for ascertaining the right of the donor to give the equipment (IQ-ATR 3.8 - Donated Equipment: Confirmation of Donor’s Ownership).</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Reassignment can be safeguarded to ensure that the devices are not being obtained for resale. Appropriate application and intake policies should collect information about the intended user, and that user should be appropriately matched and trained in the device use. This should result in personal interaction with the device recipient. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''DEFINE REIMBURSEMENT MODELS FOR DME SUPPLIERS</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">In most Medicaid partnerships, DME devices are not sold. However, if approved by change of law or policies, devices could be refurbished by certified suppliers and purchased by Medicaid for reassignment to beneficiaries. Services, such as device repairs either before or after the device is received, may be reimbursed by Medicaid. In these cases, the program will define qualifications for suppliers. In some cases, the suppliers are commercial DME suppliers with certified technicians. In others, the supplier may be a reuse program with appropriately trained technicians.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''EXPLAIN THE ROLE OF REUSE TO BENEFICIARIES</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The program will need a public awareness campaign to explain key facets of the reuse program:</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* Why used versus new </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* What makes this safe and effective</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* Who owns the equipment, implications for consumers</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* How the beneficiary gets equipment repaired</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">* Stories from actual users</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">This information can be disseminated through the network of partners and associated organizations and through the use of public media.</ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==='''Ensuring Quality AT Reuse with Medicaid'''===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==='''Ensuring Quality AT Reuse with Medicaid'''===</div></td></tr>
</table>Cphillips45http://gatfl.gatech.edu/tflwiki/index.php?title=AT3:_AT_Reuse_%26_Medicaid_Guidance_for_AT_Act_Programs&diff=3450&oldid=prevCphillips45: /* Ensuring Quality AT Reuse with Medicaid */2017-08-07T14:27:53Z<p><span dir="auto"><span class="autocomment">Ensuring Quality AT Reuse with Medicaid</span></span></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 14:27, 7 August 2017</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''SANITIZATION'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''SANITIZATION'''</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>When devices are acquired by an assistive technology reutilization center, one of the first priorities is to make those devices safe for use by other individuals. Steps should be taken immediately to minimize the potential transmission of disease. The best way to protect all individuals who will come into contact with reutilized equipment is to institute sanitization practices that make the objects safe to handle and to use. The recommended practices are based on manufacturer recommendations, guidelines from the CDC and the practical experiences of reuse programs in implementing these recommendations. '''(IQ-ATR 3.10 - Sanitization of Donated Equipment)'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>When devices are acquired by an assistive technology reutilization center, one of the first priorities is to make those devices safe for use by other individuals. Steps should be taken immediately to minimize the potential transmission of disease. The best way to protect all individuals who will come into contact with reutilized equipment is to institute sanitization practices that make the objects safe to handle and to use. The recommended practices are based on manufacturer recommendations, guidelines from the CDC and the practical experiences of reuse programs in implementing these recommendations. '''(IQ-ATR 3.10 - Sanitization of Donated Equipment)'''</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''REFURBISHING, REPAIRING AND STORING DONATED DEVICES'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''REFURBISHING, REPAIRING AND STORING DONATED DEVICES'''</div></td></tr>
</table>Cphillips45http://gatfl.gatech.edu/tflwiki/index.php?title=AT3:_AT_Reuse_%26_Medicaid_Guidance_for_AT_Act_Programs&diff=3449&oldid=prevCphillips45: /* Ensuring Quality AT Reuse with Medicaid */2017-08-07T14:27:00Z<p><span dir="auto"><span class="autocomment">Ensuring Quality AT Reuse with Medicaid</span></span></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 14:27, 7 August 2017</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l72">Line 72:</td>
<td colspan="2" class="diff-lineno">Line 72:</td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''PARTNERSHIPS: AGREEMENTS, ROLES, RESPONSIBILITIES'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''PARTNERSHIPS: AGREEMENTS, ROLES, RESPONSIBILITIES'''</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The contract between Medicaid and the AT reuse program will specify roles and responsibilities. These will be clearly defined. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The contract between Medicaid and the AT reuse program will specify roles and responsibilities. These will be clearly defined. </div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''CONSUMER CHOICE'''</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The customer and direct support provider(s) are informed of all appropriate device options and are allowed to participate in the choice of device '''(IQ-ATR 4.3 - Customer Choice)'''. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''EQUIPMENT TRACKING'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''EQUIPMENT TRACKING'''</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The program should have written policies and procedures and an accurate and efficient method to track the inventory of available devices that includes:</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The program should have written policies and procedures and an accurate and efficient method to track the inventory of available devices that includes:</div></td></tr>
<tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l82">Line 82:</td>
<td colspan="2" class="diff-lineno">Line 85:</td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The inventory system should be capable of capturing detailed specifications for equipment (e.g., manufacturer, model number, serial number, seat height, seat depth, weight limit for a manual wheelchair). This data facilitates the identification of appropriate equipment for specific needs.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The inventory system should be capable of capturing detailed specifications for equipment (e.g., manufacturer, model number, serial number, seat height, seat depth, weight limit for a manual wheelchair). This data facilitates the identification of appropriate equipment for specific needs.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The program may formulate policies related to priority holds or wait-listing for the Medicaid program or other participants.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>The program may formulate policies related to priority holds or wait-listing for the Medicaid program or other participants.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Appropriate disposal of devices that have no more useful life can present a challenge to the reuse center, especially if those devices are electronic and/or digital. The components of many electronic devices are potential hazards to the environment if not disposed properly. When a device has no more useful life, or if some portions remain after it is cannibalized for spare parts, disposal of the device or parts must be done in a manner consistent with environmental regulations. Reuse programs should identify certified recycling resources. (IQ-ATR 3.17 - End-of-life Recycling)</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Appropriate disposal of devices that have no more useful life can present a challenge to the reuse center, especially if those devices are electronic and/or digital. The components of many electronic devices are potential hazards to the environment if not disposed properly. When a device has no more useful life, or if some portions remain after it is cannibalized for spare parts, disposal of the device or parts must be done in a manner consistent with environmental regulations. Reuse programs should identify certified recycling resources. <ins style="font-weight: bold; text-decoration: none;">'''</ins>(IQ-ATR 3.17 - End-of-life Recycling)<ins style="font-weight: bold; text-decoration: none;">'''.</ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''SANITIZATION'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''SANITIZATION'''</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>When devices are acquired by an assistive technology reutilization center, one of the first priorities is to make those devices safe for use by other individuals. Steps should be taken immediately to minimize the potential transmission of disease. The best way to protect all individuals who will come into contact with reutilized equipment is to institute sanitization practices that make the objects safe to handle and to use. The recommended practices are based on manufacturer recommendations, guidelines from the CDC and the practical experiences of reuse programs in implementing these recommendations. '''(IQ-ATR 3.10 - Sanitization of Donated Equipment)'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>When devices are acquired by an assistive technology reutilization center, one of the first priorities is to make those devices safe for use by other individuals. Steps should be taken immediately to minimize the potential transmission of disease. The best way to protect all individuals who will come into contact with reutilized equipment is to institute sanitization practices that make the objects safe to handle and to use. The recommended practices are based on manufacturer recommendations, guidelines from the CDC and the practical experiences of reuse programs in implementing these recommendations. '''(IQ-ATR 3.10 - Sanitization of Donated Equipment)'''</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>REFURBISHING, REPAIRING AND STORING DONATED DEVICES</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''</ins>REFURBISHING, REPAIRING AND STORING DONATED DEVICES<ins style="font-weight: bold; text-decoration: none;">'''</ins></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>The program has written, device-specific procedures that are applied consistently for evaluating the repair and refurbishing needs of donated equipment (IQ-ATR 3.9 - Evaluation of Used Devices). Once identified, the refurbishment/repair of equipment must be performed in a manner that is consistent with manufacturer instructions and original specifications (IQ-ATR 3.11 - Refurbishing Donated Equipment). </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>The program has written, device-specific procedures that are applied consistently for evaluating the repair and refurbishing needs of donated equipment (IQ-ATR 3.9 - Evaluation of Used Devices). Once identified, the refurbishment/repair of equipment must be performed in a manner that is consistent with manufacturer instructions and original specifications <ins style="font-weight: bold; text-decoration: none;">'''</ins>(IQ-ATR 3.11 - Refurbishing Donated Equipment)<ins style="font-weight: bold; text-decoration: none;">'''</ins>. </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Programs offer a limited warranty on refurbished devices, often a 30-day warranty with a commitment to repair or replace the device if necessary (IQ-ATR 3.14 - Limited Warranty for Refurbished Devices).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Programs offer a limited warranty on refurbished devices, often a 30-day warranty with a commitment to repair or replace the device if necessary <ins style="font-weight: bold; text-decoration: none;">'''</ins>(IQ-ATR 3.14 - Limited Warranty for Refurbished Devices)<ins style="font-weight: bold; text-decoration: none;">'''</ins>.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Appropriate storage facilities are essential to separate sanitized from unsanitized equipment; to organize storage of different types of devices; and to provide proper heating, cooling and ventilation as needed (IQ-ATR 3.15 - Storage of Donated Equipment).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Appropriate storage facilities are essential to separate sanitized from unsanitized equipment; to organize storage of different types of devices; and to provide proper heating, cooling and ventilation as needed <ins style="font-weight: bold; text-decoration: none;">'''</ins>(IQ-ATR 3.15 - Storage of Donated Equipment)<ins style="font-weight: bold; text-decoration: none;">'''</ins>.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>TRANSPORTATION</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''</ins>TRANSPORTATION<ins style="font-weight: bold; text-decoration: none;">'''</ins></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Procedures and training are essential for picking up donated equipment or delivering refurbished devices (IQ-ATR 3.16 - Transportation of Donated Equipment).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Procedures and training are essential for picking up donated equipment or delivering refurbished devices <ins style="font-weight: bold; text-decoration: none;">'''</ins>(IQ-ATR 3.16 - Transportation of Donated Equipment)<ins style="font-weight: bold; text-decoration: none;">'''</ins>.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>USER SERVICES</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''</ins>USER SERVICES<ins style="font-weight: bold; text-decoration: none;">'''</ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>User Services address the intake of the consumer at point of application for services, and interactions and services from the time the consumer is assigned a piece of equipment.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>User Services address the intake of the consumer at point of application for services, and interactions and services from the time the consumer is assigned a piece of equipment.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>PATIENT INFORMATION PRIVACY COMPLIANCE (HIPAA)</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''</ins>PATIENT INFORMATION PRIVACY COMPLIANCE (HIPAA)<ins style="font-weight: bold; text-decoration: none;">'''</ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>As noted above, program staff should be trained in the privacy provisions of HIPAA. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>As noted above, program staff should be trained in the privacy provisions of HIPAA. </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>INTAKE AND ELIGIBILITY PROCESS</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''</ins>INTAKE AND ELIGIBILITY PROCESS<ins style="font-weight: bold; text-decoration: none;">'''</ins></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Customer or patient intake may result from referral by a physician, hospital or other professional resource, or it may be the result of self-referral. Each program specifies eligibility requirements. The application for services should gather sufficient detail to determine eligibility (IQ-ATR 4.1 - Customer Intake).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Customer or patient intake may result from referral by a physician, hospital or other professional resource, or it may be the result of self-referral. Each program specifies eligibility requirements. The application for services should gather sufficient detail to determine eligibility <ins style="font-weight: bold; text-decoration: none;">'''</ins>(IQ-ATR 4.1 - Customer Intake)<ins style="font-weight: bold; text-decoration: none;">'''</ins>.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>PRESCRIPTION REQUIREMENTS AND MATCHING DEVICES TO CUSTOMER</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''</ins>PRESCRIPTION REQUIREMENTS AND MATCHING DEVICES TO CUSTOMER<ins style="font-weight: bold; text-decoration: none;">'''</ins></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>As noted earlier, the reuse program should adhere to all prescription requirements. Appropriate device reuse for some categories requires appropriate matching of devices to customers based on medical prescriptions and the services of professionals (e.g., occupational therapists or other AT professionals) (IQ-ATR 4.2 - Matching Device to Customer).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>As noted earlier, the reuse program should adhere to all prescription requirements. Appropriate device reuse for some categories requires appropriate matching of devices to customers based on medical prescriptions and the services of professionals (e.g., occupational therapists or other AT professionals) <ins style="font-weight: bold; text-decoration: none;">'''</ins>(IQ-ATR 4.2 - Matching Device to Customer)<ins style="font-weight: bold; text-decoration: none;">'''</ins>.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">The customer and direct support provider(s) are informed of all appropriate device options and are allowed to participate in the choice of device (IQ-ATR 4.3 - Customer Choice). </del></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''CONSUMER TRAINING AND TECHNICAL ASSISTANCE'''</ins></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>The customer and his direct support provider(s) are given basic training on features, operation, maintenance, safety and troubleshooting for the device at the time the device is reassigned (IQ-ATR 4.4 - Customer Training on Device). The customer is given a trial period with the device (IQ-ATR 4.5 - Customer Trial on Device).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>The customer and his direct support provider(s) are given basic training on features, operation, maintenance, safety and troubleshooting for the device at the time the device is reassigned (IQ-ATR 4.4 - Customer Training on Device). The customer is given a trial period with the device <ins style="font-weight: bold; text-decoration: none;">'''</ins>(IQ-ATR 4.5 - Customer Trial on Device)<ins style="font-weight: bold; text-decoration: none;">'''</ins>.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>If the customer is unable to pick up the equipment, it may be delivered by trained staff. Some programs have limited transportation alternatives (IQ-ATR 4.7 - Equipment Delivery to Customer, IQ-ATR 4.8 - Trained Delivery Staff).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>If the customer is unable to pick up the equipment, it may be delivered by trained staff. Some programs have limited transportation alternatives <ins style="font-weight: bold; text-decoration: none;">'''</ins>(IQ-ATR 4.7 - Equipment Delivery to Customer, IQ-ATR 4.8 - Trained Delivery Staff)<ins style="font-weight: bold; text-decoration: none;">'''</ins>.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>If a new user experiences difficulty, he or she should be able to call for and receive technical assistance (IQ-ATR 4.6 - Technical Assistance).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>If a new user experiences difficulty, he or she should be able to call for and receive technical assistance <ins style="font-weight: bold; text-decoration: none;">'''</ins>(IQ-ATR 4.6 - Technical Assistance)<ins style="font-weight: bold; text-decoration: none;">'''</ins>.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Programs should establish a follow-up protocol to ensure that the needed devices are being used and that the customer has not encountered difficulty (IQ-ATR 4.9 - Customer Follow-up).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Programs should establish a follow-up protocol to ensure that the needed devices are being used and that the customer has not encountered difficulty <ins style="font-weight: bold; text-decoration: none;">'''</ins>(IQ-ATR 4.9 - Customer Follow-up)<ins style="font-weight: bold; text-decoration: none;">'''</ins>.</div></td></tr>
</table>Cphillips45http://gatfl.gatech.edu/tflwiki/index.php?title=AT3:_AT_Reuse_%26_Medicaid_Guidance_for_AT_Act_Programs&diff=3448&oldid=prevCphillips45 at 14:20, 7 August 20172017-08-07T14:20:03Z<p></p>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>#. Where</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>#. Where</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>==='''Talking Points'''===</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>==='''Talking Points <ins style="font-weight: bold; text-decoration: none;">with Medicaid</ins>'''===</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*Reuse serves the uninsured and the under-insured. It can provide an interim solution for people with coverage who experience delays, or a secondary device to minimize the burden of transporting bulky devices to school or workplace. Safe, appropriate and effective reuse matches the beneficiary to the needed device, not “a device”. Customer satisfaction surveys of reuse programs confirm that people in need of a device who lack financial means for timely access are “highly satisfied” to have a lightly used, refurbished device. Of 37,740 persons reporting from 56 states and territories, 89.3% reported that they were “highly satisfied” with the reused device. </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*Reuse serves the uninsured and the under-insured. It can provide an interim solution for people with coverage who experience delays, or a secondary device to minimize the burden of transporting bulky devices to school or workplace. Safe, appropriate and effective reuse matches the beneficiary to the needed device, not “a device”. </div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*</ins>Customer satisfaction surveys of reuse programs confirm that people in need of a device who lack financial means for timely access are “highly satisfied” to have a lightly used, refurbished device. Of 37,740 persons reporting from 56 states and territories, 89.3% reported that they were “highly satisfied” with the reused device. </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*Overall, reuse benefits all citizens by reducing the consumption of natural resources (raw materials and fuel) and minimizes environmental impact by keeping usable devices out of landfills.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*Overall, reuse benefits all citizens by reducing the consumption of natural resources (raw materials and fuel) and minimizes environmental impact by keeping usable devices out of landfills.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>The financial benefits of DME reuse are measurable using return-on-investment (ROI) analysis. Traditionally, this has used only the value of donated equipment and the cost of program operations in the computation. In 2011, the Kansas program returned $3.49 for every dollar spent. Some research has explored the inclusion of the value of preventing additional use of healthcare services into the ROI analysis.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*</ins>The financial benefits of DME reuse are measurable using return-on-investment (ROI) analysis. Traditionally, this has used only the value of donated equipment and the cost of program operations in the computation. In 2011, the Kansas program returned $3.49 for every dollar spent. Some research has explored the inclusion of the value of preventing additional use of healthcare services into the ROI analysis<ins style="font-weight: bold; text-decoration: none;">.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">==='''Initial Considerations for Developing a Quality AT Reuse Program with Medicaid'''===</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*Reuse programs need clear and concise policies and procedures for assessing whether a particular item is appropriate for reuse. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*It is important to determine the safety and cost effectiveness of reuse of a particular device. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*Factors for consideration include the age of the device, the type of use, the environment of use and possible impact of the method by which the device has been transported. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*The type of repair or refurbishing required to sanitize the device or to restore it to original manufacturer specifications could render reuse financially impractical.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*One category of devices that poses a challenge for reuse is complex rehabilitation technology (CRT). In this category are wheelchairs that are fitted, programmed, adjusted or adapted for the needs of a specific individual. Identifying another individual who requires identical customization is very different from reassigning standard devices without modification. Reusing these devices without a professional evaluation of the precise needs of another individual is unsafe. If a program chooses to reutilize complex rehabilitation technology, policies and procedures should be in place to use appropriate allied health professionals to assure that the equipment is appropriately matched to the needs of the individual. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The Pass It On Center has published Indicators of Quality for Assistive Technology Reutilization (IQ-ATR) that provide a more comprehensive exploration of a range of best practices that, if followed consistently by reuse programs, can provide safeguards to beneficiaries, reuse programs and third-party providers like Medicaid. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">==='''Ensuring Quality AT Reuse with Medicaid'''===</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The Pass It On Center has published Indicators of Quality for Assistive Technology Reutilization (IQ-ATR) that provide a more comprehensive exploration of a range of best practices that, if followed consistently by reuse programs, can provide safeguards to beneficiaries, reuse programs and third-party providers like Medicaid. The IQ-ATR developed in 2009, revised in 2017, address all areas of Program Operations. They are cited below in appropriate sections to describe the expected practices.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''PARTNERSHIPS: AGREEMENTS, ROLES, RESPONSIBILITIES'''</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The contract between Medicaid and the AT reuse program will specify roles and responsibilities. These will be clearly defined. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''EQUIPMENT TRACKING'''</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The program should have written policies and procedures and an accurate and efficient method to track the inventory of available devices that includes:</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"># Unique identification of every donated device (by paper label or bar code)</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"># The ability to determine the availability of devices by type</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"># The assignment of an inventory valuation to each device (often based on a percentage of the manufacturer’s suggested retail price)</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"># The ability to identify devices subject to recall notices</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"># The ability to identify customers who have received devices subject to recalls, market withdrawals or safety alerts</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">'''(IQ-ATR 3.4 - Device Tracking, IQ-ATR 3.5 - Device Valuation and IQ-ATR 3.6 - Management of Device Recalls, Market Withdrawals and Safety Alerts)'''</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The inventory system should be capable of capturing detailed specifications for equipment (e.g., manufacturer, model number, serial number, seat height, seat depth, weight limit for a manual wheelchair). This data facilitates the identification of appropriate equipment for specific needs.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The program may formulate policies related to priority holds or wait-listing for the Medicaid program or other participants.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Appropriate disposal of devices that have no more useful life can present a challenge to the reuse center, especially if those devices are electronic and/or digital. The components of many electronic devices are potential hazards to the environment if not disposed properly. When a device has no more useful life, or if some portions remain after it is cannibalized for spare parts, disposal of the device or parts must be done in a manner consistent with environmental regulations. Reuse programs should identify certified recycling resources. (IQ-ATR 3.17 - End-of-life Recycling)</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''SANITIZATION'''</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">When devices are acquired by an assistive technology reutilization center, one of the first priorities is to make those devices safe for use by other individuals. Steps should be taken immediately to minimize the potential transmission of disease. The best way to protect all individuals who will come into contact with reutilized equipment is to institute sanitization practices that make the objects safe to handle and to use. The recommended practices are based on manufacturer recommendations, guidelines from the CDC and the practical experiences of reuse programs in implementing these recommendations. '''(IQ-ATR 3.10 - Sanitization of Donated Equipment)'''</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">REFURBISHING, REPAIRING AND STORING DONATED DEVICES</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The program has written, device-specific procedures that are applied consistently for evaluating the repair and refurbishing needs of donated equipment (IQ-ATR 3.9 - Evaluation of Used Devices). Once identified, the refurbishment/repair of equipment must be performed in a manner that is consistent with manufacturer instructions and original specifications (IQ-ATR 3.11 - Refurbishing Donated Equipment). </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Programs offer a limited warranty on refurbished devices, often a 30-day warranty with a commitment to repair or replace the device if necessary (IQ-ATR 3.14 - Limited Warranty for Refurbished Devices).</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Appropriate storage facilities are essential to separate sanitized from unsanitized equipment; to organize storage of different types of devices; and to provide proper heating, cooling and ventilation as needed (IQ-ATR 3.15 - Storage of Donated Equipment).</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">TRANSPORTATION</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Procedures and training are essential for picking up donated equipment or delivering refurbished devices (IQ-ATR 3.16 - Transportation of Donated Equipment).</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">USER SERVICES</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">User Services address the intake of the consumer at point of application for services, and interactions and services from the time the consumer is assigned a piece of equipment.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">PATIENT INFORMATION PRIVACY COMPLIANCE (HIPAA)</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">As noted above, program staff should be trained in the privacy provisions of HIPAA. </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">INTAKE AND ELIGIBILITY PROCESS</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Customer or patient intake may result from referral by a physician, hospital or other professional resource, or it may be the result of self-referral. Each program specifies eligibility requirements. The application for services should gather sufficient detail to determine eligibility (IQ-ATR 4.1 - Customer Intake).</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">PRESCRIPTION REQUIREMENTS AND MATCHING DEVICES TO CUSTOMER</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">As noted earlier, the reuse program should adhere to all prescription requirements. Appropriate device reuse for some categories requires appropriate matching of devices to customers based on medical prescriptions and the services of professionals (e.g., occupational therapists or other AT professionals) (IQ-ATR 4.2 - Matching Device to Customer).</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The customer and direct support provider(s) are informed of all appropriate device options and are allowed to participate in the choice of device (IQ-ATR 4.3 - Customer Choice). </ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The customer and his direct support provider(s) are given basic training on features, operation, maintenance, safety and troubleshooting for the device at the time the device is reassigned (IQ-ATR 4.4 - Customer Training on Device). The customer is given a trial period with the device (IQ-ATR 4.5 - Customer Trial on Device).</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">If the customer is unable to pick up the equipment, it may be delivered by trained staff. Some programs have limited transportation alternatives (IQ-ATR 4.7 - Equipment Delivery to Customer, IQ-ATR 4.8 - Trained Delivery Staff).</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">If a new user experiences difficulty, he or she should be able to call for and receive technical assistance (IQ-ATR 4.6 - Technical Assistance).</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Programs should establish a follow-up protocol to ensure that the needed devices are being used and that the customer has not encountered difficulty (IQ-ATR 4.9 - Customer Follow-up)</ins>.</div></td></tr>
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