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FHA File: 1-493-FOI
July 22, 2013
Via Email
Mr. Bob Mackin
Dear Mr. Mackin:
Re: Freedom of Informati on and Protection of Pri vacy Act (FIPPA) Request
Business case or report for $25 wheelchair fee
I am writing in order to provide Fraser Healths full response to the following FIPPA
request, which was received by my office on June 7, 2013:
Specifically, you have requested the following information:
"The business case or any other type of report that recommended or
justified the decision to charge a $25 a month for wheelchair use at
Mountain View Manor or any other site under the jurisdiction of Fraser
Health."
The Fraser Health FOI Office has determined that the following records, copies of which
are attached, are responsive to your request:
x PBMA Form
x BRIEFING NOTE: Wheelchair Maintenance Fee in Residential Care Owned &
Operated Facilities, dated May 6, 2013.
These records are being released to you in their entirety. No information has been
severed.
We trust that your request for information has now been satisfied and that no further
action with regard to your request is required of this office.
Should you find this response unsatisfactory, you may ask the Information and Privacy
Commissioner to review Fraser Health Authoritys decision. You have 30 business days
from receipt of this notice to request a review by writing to the Office of the Information
Fraser Health Authority Suite 400 Central City Tower Tel (604) 587-4437
Corporate Office 13450 - 102
nd
Avenue Fax (604)-587-4666
Legal Services Surrey, BC www.fraserhealth.ca
Mr. Mackin (1-493-FOI)July 22, 2013
Page 2 of 2
and Privacy Commissioner. Detailed information on how to request a review by OIPC is
available on the OIPC website: http://www.oipc.bc.ca.
If you have any questions or require any clarification regarding the processing of your
request, please email our FOI team at FOI@fraserhealth.ca.
Sincerely,
Doug Luther
FOI Coordinator
Legal Services
Fraser Health Authority
Encl. Records (8 pages)
Fraser Health Authority Suite 400 Central City Tower Tel (604) 587-4437
Corporate Office 13450 - 102
nd
Avenue Fax (604)-587-4666
Legal Services Surrey, BC www.fraserhealth.ca
!"#$%&'()
Title: (max 50 characters)
Wheelchair Rental Revenue
Initiative Type:
Select...
7 Step Framework:
Select...
Program:
Residentail Care
70015:DIXON,LOIS > 61540:VP PRG:RESIDENT & ASSISTED LIV > 51540:COOK,HEATHER >
Type:
Disinvestment
Description
Provide a brief description of the proposed initiative
Contact Person:
Cathy Sleiman
Hospital Site: All FH
Community: All FH
What change to service is being proposed?
(Max 500 characters)
Residents in FH Owned and Operated sites will pay a monthly rental charge
for wheelchairs provided from FH stock
What impact will this change have on current
service levels and what service levels are
expected for this target population?
(Max 500 characters)
Currently residents do not pay for the use of FH wheelchairs. Some
residents have personal chairs which they have purchased. Residents will
be assigned an appropriate wheelchair for their sole use and they will be
charged $25 per month. Charge complies with MOH H&CC policies only if
the wheelchair is provided to a single individual. Low income residents may
not be able to afford the rental costs and a waiver process will be required
What is the target population?
(Max 500 characters)
Residents using FH supplied wheelchairs - estimated to be about 60% of
1800 residents
Who are the partners involved in this initiative
and their role? What providers will be impacted
by this change?
(Max 500 characters)
Occupational Therapists assess and assign wheelchairs based on resident
need. Families/residents will consent to pay and Finance will process bills
and collect fees
What key assumptions are being made with this
initiative (e.g., demographics, HHR capacity)?
(Max 500 characters)
Processes will be streamlined to reduce administrative costs, a
waiver system will be developed for residents who can not afford
to pay, FH will continue to have sufficient equipment to meet
residents needs. Revenue estimated to 1800 beds x 60% x 8
months (adjusted to cover movement in & out of residential care)
x $25/month. Start-up will be gradual so maximum revenue will
not be obtained until 2014
Cost
Estimate total annual operating savings
FTE
2013/2014
2014/2015
Ongoing
Direct Program Savings
0.00 100,000 216,000 0
Physician Services Savings
0.00 0 0 0
Clinical Costs and Corporate and Support
Savings(Use 30% of the Program Savings)
0.00 0 0 0
One Time start-Up Savings(e.g. lease,
contracts)
Equipment < $5,000 (operating)
0 0 0
Equipment > $5,000 (capital)
0 0 0
Renovations
0 0 0
Other
0 0 0
Total Estimated Savings
0.00
100,000
216,000
0
Total Investment (If some re-
investment is applicable)
0.00 50,000 0 0
NET SAVINGS
0.00
50,000
216,000
0
Impact
Describe the impact on each criterion with supporting evidence and/or rationale where possible
Risks
Implementation Plan
What risks does this initiative pose and how would these be mitigated?
Financial Implementation would involve minimal risks of significant negative financial impact for FHA
Safety Minimal risk that the implementation will have significant negative safety implications for staff/patients
OngoingOperations Minimal risk that implementation would have a significant adverse effect on ongoing operations
Political Moderate risk that implementation will cause significant political concerns
Technology Minimal risk that implementation will lead to significant technological challenges
Equipment Minimal risk that implementation would have a significantly negative impact on equipment
Facilityconditions Minimal risk that implementation will have a significant negative impact on facility conditions
Legal/regulatory requirements (checkmark indicates yes)
GovernmentDirective:doesimplementationgoagainstanygovernmentdirective?
Accreditation:doesimplementationdirectlyimpactaccreditation?
Code:doesimplementationgoesagainstanypartofthecode?
Legislated:doesimplementationgoagainstanylegislatedmandate?
WorksafeBC:couldimplementationaffectratingwithWorksafeBC?
Project Manager:
Project Status:
Start Date:
Target Completion Date:
Actual Completion Date:
Notes:
BRIEFING NOTE: Wheelchair Maintenance Fee in
Residential Care Owned & Operated Facilities
Date: May 6, 2013
Purpose
Decision
X Discussion
Review
x
Information
Issue / Question:
A proposal to introduce Wheelchair Rental Fees at the Owned & Operated Residential Care Sites
was submitted in the PBMA process. Subsequent to that submission, the MOH requested FH to
implement wheelchair maintenance fees to align with a similar proposal made by VCHA. This
request was based on a desire to have similar practices in all Health Authorities and to align
with the practices in CCALA facilities.
Background
Currently, residents in FH Owned and Operated residential care facilities do not pay for the use
of FH wheelchairs. FH provides the wheelchairs, Occupational Therapists may customize them
with FH owned parts and cushions to meet individual resident needs and FH provides
maintenance to keep the wheelchairs safe and functional. Some residents have personal
wheelchairs which they have purchased. FH staff will provide a safety inspection for the
wheelchair and, if maintenance is required it is the residents responsibility. In CCALA facilities,
most residents purchase or rent their wheelchairs. This creates a two-tiered system based on
which type of facility a resident enters which was noted by the Ombudsperson.
Implementing a maintenance charge for a wheelchair assigned to an individual resident is a
permissible chargeable extra which complies with the Ministry of Health Home & Community
Care regulations. Processes to collect the maintenance fee will be aligned with the current
processes to collect expenses from the residents comfort fund and a waiver system will be
developed for residents who cannot afford to pay. FH Occupational Therapists are available to
assess residents seating and mobility needs and help them select an appropriate wheelchair.
Residents will be encouraged to purchase or rent wheelchairs from outside healthcare
equipment vendors and the cost to purchase a wheelchair ranges from $1,000 to $3,500 for a
manual wheelchair and a typical wheelchair rental from an outside vendor is $70-$100 per
month.
It is estimated that about 60% of the 1718 residents in O&O facilities use a FH owned
wheelchair. Currently, FH has sufficient equipment to meet the residents needs but the
wheelchair fleet is aging as there have been limited equipment purchases in the past five years.
Currently, equipment may be replenished from donations from families and Foundations. A
wheelchair rental program would serve as a cost recovery initiative that would finance the cost
of replacement equipment and ensure that equipment is maintained in optimal condition. This
rental program will not apply to other mobility devices such as walkers and canes.