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Assistive Devices in Sight For British Columbians

Editor's Note: Linda Bartram is President of AEBC's Victoria, British Columbia, Chapter. The following article is adapted from â

British Columbia currently has no universal equipment and assistive devices program for people with disabilities. British Columbians who need access to these vital personal supports must try and find their way through a myriad of programs with different eligibility criteria, whether this is through a variety of provincial ministries or through service organizations. If a person with a disability does not fall into a particular population or category of disability served by these programs, then they fall through the cracks. Accordingly, Statistics Canada reports that people with disabilities in British

Columbia have the highest level of unmet need in Canada for equipment and assistive devices (Statistics Canada, A Profile of Disability in Canada, 2001;

2001 Participation and Activity Limitation Survey, Catalogue No. 89-577-XIE, December 2001).

The Provincial Equipment and Assistive Devices Committee

(PEADC) is a coalition of more than 35 community organizations that has been working together since 2004 to try to change this situation. In a Briefing

Note to government entitled Equipment and Assistive Devices for British Columbians with Disabilities, PEADC argued that the provision of equipment and assistive devices needed to be better coordinated and better funded, and urged government to enter into a partnership with the community in order to achieve this goal.

In October 2005, Claude Richmond, Minister of Employment and Income Assistance, recognized the importance and urgency of the need and took the leadership to initiate the Personal Supports Working Group, which brings representatives from PEADC together with representatives from five government ministries (Health, Education, Advanced Education, Children and Family Development, Employment and Income Assistance), and one crown agency (Community Living BC). The goal of the Working Group is to develop a provincial plan for the provision of personal supports with equipment and assistive devices (EAD) as the starting point. Personal supports are an integral part of the government's disability strategy, which is aimed at achieving the third of its great goals--the best system of support in Canada for people with disabilities, seniors, those with special needs and children at risk.

One of the first tasks of the Working Group was to forge a vision and shared values base for personal supports. The vision, values and principles that have been developed reflect the aspirations of people with disabilities and the ideals of both the community and government. PEADC has developed a Participation Model for the delivery of personal supports that borrows some of the most promising practices from other parts of the world, and creates some brand new ones based upon the direction in which our vision, values and principles led us. Here are some of the key features of the proposed Participation Model:

The model is a description of a dynamic process with the person with the disability as the driving force. The desired outcome is participation, to whatever degree the individual desires.

The model describes a process that begins with the individual. Each individual has goals and a plan for achieving those goals. A goal can be as straightforward as wanting to go shopping once a week, or as complicated as travelling the world in order to participate in educational or sporting events.

An individual plan becomes the doorway into assessment. The assessment focuses on what functional supports are needed to achieve the goal. It is guided by the user, in partnership with family and EAD practitioners, and it considers the social and physical environment within which equipment and assistive devices will be used.

Personal Supports Centers are a mainstay of the process. They are places both virtual and real that provide information, peer support, assistance with making plans, training, exhibits and access to EAD practitioners. These centres build on community capacity by co-locating with existing services and community centres, and by coordinating all personal supports service provision under one unifying delivery philosophy and framework.

The model envisions that each of the functional areas has a series of credits attached to it that translate into purchasing power for equipment, assistive devices, delivery, installation or fitting, training, maintenance and repairs. The number of credits that are given to individuals will depend upon their plan and the assessment of their functional needs.

Although the Personal Supports Centers provide many physical and virtual doorways to enable users, wherever they live, to make plans and get assistance with assessing functional needs, they are unified by the same philosophy and policy framework. However, there is only one doorway to funding. Financing the credits will happen outside of the view of the user through coordination of all of the existing funding sources. Users who have no other available payer are funded through a new stream of expenditure that is dedicated for the purpose of equipment and devices. The model envisions an eventual integration of all of these funding sources.

Once credits have been assigned, individuals are free to use their credits in the marketplace with dealers and distributors who are prepared to abide by a set of standards. The marketplace is constrained as little as possible so that users can meet their unique needs and the market itself can be free to innovate. Credits can be banked for an extended period of time. This enables users to manage their credits in order to take advantage of technological change or to save credits. For example, the purchase of recycled equipment may lead to credit savings, which could then be applied to other equipment needs.

Education, training and peer support are as important as the equipment and devices themselves, and every user is guaranteed access to these resources through the Personal Supports Centers.

The process is dynamic with feedback loops that enable people to re-enter the planning process when needed.

For example, follow-up and evaluation with EAD users may indicate modifications to equipment and devices are needed, as well as further training. For some individuals, as they achieve their goals and participate more fully in the community, their goals will change and Individualized Plans will need to be revised, while for others changes in their disability may necessitate changes in the individual plan and the EAD.

The Participation Model for Personal Supports transforms service delivery by anchoring every component of the process to individual goals, and by freeing the users to access the marketplace and make decisions about how best to meet their functional needs. It is focused on choice, including the choice that some users may make to let an EAD professional, like an occupational therapist or a speech pathologist, make their equipment and devices decisions on their behalf.

For more information about PEADC or for a copy of the full report, contact Linda Bartram, PEADC co-chair, at: labartram@shaw.ca

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