Medical Equipment - Breathing Devices

Overview

The least expensive, appropriate breathing devices may be provided to specific recipients to assist with a medically essential need. There must be no other resources available to the client to provide the breathing device requested.

The ministry provides breathing devices under the Employment and Assistance Regulation and the Employment and Assistance for Persons with Disabilities Regulation.

Policy

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Types of Breathing Devices

Effective: February 5, 2019

Breathing devices include only the following types of items:

positive airway pressure devices
apnea monitors
suction units
percussors
nebulizers
medical humidifiers
inhaler accessory devices

Eligibility Criteria

Effective: February 5, 2019

Breathing devices are available to clients who are eligible for general health supplements or meet the Life Threatening Health Need criteria. [For information on eligibility for general health supplements, see Related Links - Health Supplement Summary.]

A requested item must meet the following:

General Requirements for All Breathing Devices;

and

Specific Requirements for each Individual Type of Breathing Device.

General Requirements for All Breathing Devices

A client requesting a breathing device must meet general requirements that apply to all breathing devices:

there are no resources available to the family unit to pay the cost of or obtain the breathing device;
the item is the least expensive, appropriate breathing device;
must be prescribed by a medical practitioner or nurse practitioner; and
- if a Positive Airway Pressure Device, the medical need must be confirmed by the assessment of a respiratory therapist; or
- if another item, the medical need must be confirmed by the assessment of a relevant therapist (respiratory, occupational, or physical); and
the request must be pre-approved by the ministry prior to purchase.

Note: the ministry will not accept payment responsibility, except in cases of a life-threatening emergency, for breathing devices purchased without prior approval.

**Specific Requirements for each Individual Type of Breathing Device**
Type of Item	Specific Requirements
Positive Airway Pressure Devices	the ministry is satisfied that the positive airway pressure device or supply or accessory to operate the device is medically essential for the treatment of moderate to severe sleep apnea
Apnea Monitor	the ministry is satisfied that the apnea monitor, accessory, or supply is medically essential to monitor breathing
Suction Unit	the ministry is satisfied that the suction unit, accessory, or supply is medically essential for clearing respiratory airways
Percussor	the ministry is satisfied that the percussor, accessory, or supply is medically essential for clearing respiratory airways
Nebulizer	the ministry is satisfied that the nebulizer, accessory, or supply is medically essential to avoid an imminent and substantial danger to health medically essential to avoid an imminent and substantial danger to health refers an immediate need for a nebulizer where, without the nebulizer, the person is at risk for compromised health. For example: To avoid a significant health risk, a person has been provided with medication by Pharmacare that cannot be delivered without a nebulizer. A person with cystic fibrosis who requires hypertonic saline delivered by a nebulizer to avoid a significant health risk.
Medical Humidifier	the ministry is satisfied that the medical humidifier, accessory, or supply is medically essential to moisturize air in order to allow a tracheostomy patient to breathe
Inhaler Accessory Device (e.g. spacer)	the ministry is satisfied that the inhaler accessory device, accessory, or supply is medically essential to deliver medication

When clients no longer require the breathing device and it cannot be exchanged or traded to meet a current need, they should be encouraged to donate the item to an agency that would benefit from that item.

Non-Eligible Items

Effective: February 5, 2019

The ministry does not provide medical equipment and devices that do not meet the eligibility criteria above. For example:

ventilators

No Other Resources

Effective: February 5, 2019

By regulation, the ministry requires that all other available resources must first be considered before requesting funding. For income assistance and disability assistance clients, other resources include (but are not limited to) accessing breathing devices or funding through:

Other government programs or funding sources (e.g., Fair PharmaCare, Health Authorities, ICBC, WorkSafeBC, Veterans Affairs Canada)
Private insurance.

If there are other resources available, the individual is not eligible for breathing devices from the ministry.

Co-funding may be considered when other resources cannot pay the entire cost. For example, if an insurance company will pay $500 for an item that costs $1000, the ministry may consider funding the remaining $500 if all other eligibility criteria are met.

Note: When assessing breathing device eligibility for income or disability assistance clients, exempt assets are not considered. When assessing other resources for persons with a life-threatening health need, persons who are medical services only or transitional health services, see Related Links – Life-Threatening Health Need, Medical Services Only, or Transitional Health Services.

Guidelines for Determining Medically Essential for Treatment of Moderate to Severe Sleep Apnea

Effective: February 5, 2019

Sleep apnea occurs when a person regularly stops breathing for 10 seconds or longer during sleep. It can be mild, moderate, or severe, based on the number of times an hour that the person stops breathing (apnea) or that airflow to the lungs is reduced.

The ministry will consider funding positive airway pressure devices when medically essential for treatment of moderate to severe sleep apnea based on information provided by the Respiratory Therapist.

To determine whether sleep apnea is moderate to severe, ministry staff use guidelines determined by Ministry of Health [see Additional Resources – HealthLinkBC – Stages of Sleep Apnea].

Contracted Positive Airway Pressure Service Providers

Effective: February 5, 2019

The ministry has a contract with Positive Airway Pressure Device service providers throughout the province.

Contracted service providers are the supplier of choice when purchasing Positive Airway Pressure Devices, accessories and supplies. However, when an item is not available or a contracted Service Provider is not available in your area, non-contracted service providers may be considered.

The contracted Positive Airway Pressure Device service providers provide the following service as part of their contract:

Fitting and trial of Positive Airway Pressure Devices;
Provide training for set up and use of Positive Airway Pressure Devices;
Repair and service of Positive Airway Pressure Devices;
Administer any warranties.
Free suitable loaner Positive Airway Pressures devices while the Positive Airway Pressure device is being repaired or serviced during the coverage period.

(Note: If the service provider did not supply the original Positive Airway Pressure Device, then the cost of the loaner, while it is being repaired, may be covered by the ministry.)

Contracted Positive Airway Pressure Device service providers are located in the following areas:
Name	Locations	Toll Free / Phone / Email
Vancouver Island / Sunshine Coast
AvantSleep	Campbell River	778-560-2344 campbellriver@avantsleep.com
	Nanaimo	778-560-2344 nanaimo@avantsleep.com
	Langford	778-265-3109 Victoria@avantsleep.com
CanSleep (Westshore)	Victoria	1-888-512REST info@cansleep.ca
Careica Health	Victoria	250-370-9332 victoriasleep@careicahealth.com
Clinical Sleep Solutions	Sechelt Gibson	1-800-732-7985 info@clincialsleep.com
Coastal Sleep	Nanaimo	1-877-241-9066 info@coastalsleep.ca
Independent Respiratory Services	Duncan Nanaimo Port Alberni Qualicum Beach Sooke Sydney Victoria	1-877-965-6204 qa@irscanada.ca
Island CPAP	Campbell River Courtenay Nanaimo Powell River	250-287-5296 250-897-5296 250-390-0787 604-344-1555 info@islandcpap.com
Island Sleep Health Services (Can Sleep Services)	Victoria	250-592-7378 info@cansleep.ca
MedPro	Colwood Duncan Nanaimo Victoria	1-888-310-1444 info@medprorespiratory.com
Pacific Sleep Care	Campbell River Courtenay Duncan Nanaimo	1-866-210-6585 info@pacificsleep.ca
Respiratory Homecare Solutions	Duncan Nanaimo Port Alberni Victoria	1-877-701-0424 vancouverisland@rhscanada.com
Sleep Easy Respiratory Services	Cobble Hill	1-844-887-5337 Sleepeasy101@yahoo.ca
VitalAire (Sleeptech)	Qualicum Beach	1-877-597-5030 contactus@sleeptech.ca
VitalAire	Courtenay Nanaimo Powell River (appt only) Victoria	1-800-637-0202 vahomecare.bc@airliquide.com
Mainland / Southwest
AvantSleep	Burnaby Maple Ridge North Vancouver Vancouver	1-800-209-2841 ext 7 778-379-4779 778-379-4779 778-379-4779 Vancouver@avantsleep.com
Bayside Sleep Solutions	Delta	1-877-483-3607 info@baysidesleepsolutions.com
CanSleep	Burnaby Coquitlam Delta New Westminster Surrey (Guilford) Surrey (Newton)	1-844-SLEEP40 info@cansleep.ca
Careica Health	Burnaby Langley	604-298-5944 burnabysleep@careicahealth.com
Clinical Sleep Solutions	Abbotsford Burnaby Chilliwack Mission North Vancouver Richmond Squamish Surrey/White Rock Vancouver West Vancouver Whistler	1-800-732-7985 info@clincialsleep.com
Coastal Sleep	Abbotsford Coquitlam Langley Richmond Surrey Vancouver White Rock Burnaby	1-877-241-9066 info@coastalsleep.ca
Custom Sleep Care	Mobile	1-844-278-9260 asleep@customsleepcare.ca
Independent Respiratory Services	Abbotsford Chilliwack Delta/Ladner Gibsons/Sechelt Hope Maple Ridge Mission Richmond Surrey/Langley Vancouver	1-877-965-6204 qa@irscanada.ca
Inspire Sleep	Surrey	604-536-4353 contact@inspiresleep.ca
Lower Mainland Sleep Aid Respiratory Inc. “Sleep Aid”	Burnaby Langley Surrey	604-262-0829 info@sleepaidclinics.com
Mainland Sleep Diagnostics	Abbotsford Burnaby Coquitlam Langley Richmond Surrey Vancouver Whistler	604-370-6775 ministry@mainlandsleep.ca
MedPro	Abbotsford Langley Surrey Vancouver	1-888-310-1444 info@medprorespiratory.com
Oxylife	Chilliwack	604-391-0050 oxylifechilliwack@gmail.com
Respiratory Homecare Solutions	Abbotsford Burnaby Coquitlam Langley Maple Ridge North Vancouver Richmond Surrey Vancouver West Vancouver	604-630-1212 lowermainland@rhs.com
Sleepworks Medical	Burnaby (2) Coquitlam North Vancouver Pemberton Richmond Surrey (9) South Surrey Vancouver (4)	604-372-4000 info@sleepwm.com
Vancouver Sleep Solutions	Vancouver Mobile: North Vancouver, West Vancouver, Burnaby	604-558-0055 Info@vancouversleepsolutions.com
VitalAire	Chilliwack Langley Maple Ridge Surrey Vancouver	1-800-637-0202 Vahomecare.bc@airliquide.com
VitalAire (Sleeptech)	Abbotsford Surrey	1-877-597-5030 contactus@sleeptech.ca
DBA West Care Medical Ltd.	Abbotsford Burnaby Chilliwack Coquitlam Port Coquitlam Vancouver	1-888-540-8288 Reception@westcaremedical.com
Thompson Okanagan
AvantSleep	Penticton	236-422-3131 Penticton@avantsleep.com
CanSleep	Penticton	1-844-SLEEP40 info@cansleep.ca
Good Sleep Health	Kelowna Penticton Vernon	250-862-3062 info@goodsleephealth.com 250-541-0078 Penticton@goodsleephealth.com 250-493-1836 Vernon@goodsleephealth.com
Independent Respiratory Services	Kamloops Kelowna Oliver/Osoyoos Penticton Revelstoke Salmon Arm Vernon West Kelowna	1-877-965-6204 qa@irscanada.ca
MedPro	Kamloops Kelowna Penticton	1-888-310-1444 info@medprorespiratory.com
OkanaMed	Vernon Mobile throughout Okanagan	250-306-6759 tracey@okanamed.co
Oxylife	Kamloops	250-828-6726 oxylifebc@gmail.com
Respiratory Homecare Solutions	Kamloops Merrit Kelowna Vernon West Kelowna	1-855-888-0201 rhskamloops@rhs.com 1-888-534-5024 kelowna@rhs.com
VitalAire	Kamloops Kelowna Penticton	1-800-637-0202 vahomecare.bc@airliquide.com
Kootenay
Columbia Respiratory	Trail (Clinic locations in: Nelson, Grand Forks, Nakusp, New Denver)	250-364-0277 Columbia.respiratory@gmail.com
Independent Respiratory Services	Castlegar Cranbrook Creston Fernie Grand Forks Golden Invermere Nakusp Nelson Trail	1-877-965-6204 qa@irscanada.ca
Kootenay Respiratory	Cranbrook (Clinic locations in: Boswell, Crawford Bay, Creston, Elkford, Fernie, Golden, Invermere, Jaffray, Kimberley, Sparwood)	1-778-517-5600 doug@kootenayrespiratory.ca
MedPro	Castlegar Cranbrook	1-888-310-1444 info@medprorespiratory.com
OkanaMed	Fauquier Golden Nakusp	250-306-6759 tracey@okanamed.co
VitalAire	Cranbrook Trail	1-800-637-0202 vahomecare.bc@airliquide.com
Cariboo
Independent Respiratory Services	100 Mile House Quesnel Williams Lake	1-877-965-6204 qa@irscanada.ca
Nechako
AvantSleep	Prince George	236-601-1091 Princegeorge@avantsleep.com
Independent Respiratory Services	Prince George Vanderhoof	1-877-965-6204 qa@irscanada.ca
MedPro	Prince George	1-888-310-1444 info@medprorespiratory.com
Oxylife	Prince George	250-563-1887 oxylifepg@gmail.com
VitalAire	Prince George	1-800-637-0202 vahomecare.bc@airliquide.com
North Coast
Independent Respiratory Services	Kitimat Prince Rupert Smithers Terrace	1-877-965-6204 hcadmin@irscanada.ca
North East
Independent Respiratory Services	Dawson Creek Fort St. John	1-877-965-6204 qa@irscanada.ca
Island CPAP	Dawson Creek	250-784-6608 info@islandcpap.com
MedPro	Fort St. John	1-888-310-1444 info@medprorespiratory.com
VitalAire	Grande Prairie	1-800-637-0202 vahomecare.bc@airliquide.com

Required Documentation

Effective: February 5, 2019

Recipients are responsible for providing required documentation. The ministry is not responsible for any fees associated with documentation.

Repairing or Replacing Breathing Devices

Effective: February 5, 2019

The ministry may consider repairing or replacing breathing devices due to the medical equipment being damaged, worn out, or not functioning.

Repairs may be considered if all of the following are met:

It is more economical to repair, rather than replace, the breathing device;
The breathing device has not been damaged by misuse;
If the device was not previously provided by the ministry, all other eligibility requirements must be met (e.g., prescription, assessment).

Note: Repairs are not considered for breathing devices that are under warranty. Upon the end of the warranty, the ministry may consider funding repairs.

Replacement may be considered if all of the following are met:

It is more economical to replace, rather than repair, the breathing device;
The breathing device has not been damaged by misuse;
The time period, if any, set out in the table below has passed.

Note: The replacement time period does not apply when an item is required due to changes in a person’s medical condition.

Breathing Device	Replacement Time Period
Positive Airway Pressure Devices	5 years
Accessories or supplies required to operate a positive airway pressure device	1 year
Apnea monitors, suction units, percussors, nebulizers, medical humidifiers	5 years
Inhaler Accessory Device (e.g. spacer)	1 year
Accessories or supplies required to operate an apnea monitor, suction unit, percussor, nebulizer, or medical humidifier	1 year

Procedures

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Assessing Eligibility

Effective: February 5, 2019

Persons who are income assistance or disability assistance recipients requesting breathing devices must first be determined to be eligible for general health supplements. If eligible, the following procedures must then be completed to assess eligibility for breathing devices.

Persons who are not income assistance or disability assistance recipients but require medical equipment for a direct and imminent life-threatening health need must meet the eligibility criteria for Life-Threatening Health Needs before being assessed eligibility for medical equipment and devices [see Related Link – Life Threatening Health Needs].

The ministry requires that all other available resources must first be considered before funding any requests. If there are other resources available, the individual is not eligible for breathing devices from the ministry. Co-funding may be considered when other resources cannot pay the entire cost [see Policy – No Other Resources].

Positive Airway Pressure Devices

Effective: February 5, 2019

All requests for positive airway pressure equipment must be assessed by Health Assistance (HA). To assess eligibility for positive airway pressure equipment, follow these steps:

POC	1.	Confirm that the recipient is eligible for general health supplements or are making an application under life-threatening health needs [see Policy].
	2.	Provide client with list of Contracted Positive Airway Pressure Device Service Providers and advise the client what information is required to complete the application. Note: The Breathing Device Request and Justification form (HR3727) is available through Contracted Service Provider The assessment should include a current baseline overnight oximetry (completed within the past six months) or polysomnogram (completed without CPAP or BIPAP) to demonstrate severity of obstructive sleep apnea (OSA). The ministry only funds CPAP or BIPAP for moderate to severe OSA.
	3.	Contracted Service Provider to submit completed HR3727 including client signature (Section 1), medical practitioner or nurse practitioner prescription (Section 2), and assessment of respiratory therapist (Section 3), quote and other required documentation as outlined above, to HA for adjudication.
HA	1.	Assess application and ensure that eligibility criteria are met.
	2.	If approved, a purchase authorization will be sent to the service provider and client. If denied, the client will be sent substantive reasons for the decision and be offered the right to reconsideration. The service provider will be also advised of the denial.
	3.	Make a note of all details. Details include substantive reasons explaining what is requested and why the eligibility criteria are met or not met. If the item is approved, include the cost of the item and the name of the service provider.

Purchase of Other Breathing Devices

Effective: February 5, 2019

Clients requesting breathing devices must first be determined to be eligible for general health supplements or approved under life-threatening health needs. All other resources must first be considered before the ministry funds any payment of breathing devices.

Health Assistance (HA) will assess a client’s eligibility for the purchase of breathing devices, follow these steps:

POC	1.	Confirm that the recipient is eligible for general health supplements or are making an application under life-threatening health needs [see Policy].
	2.	Verify that there are no other resources available [see Policy].
	3.	Provide client with the Breathing Device Request and Justification form (HR3727) and advise the client what information is required to complete the application.
	4.	For all eligible breathing devices except positive airway pressure devices (for positive airway pressure devices – see separate procedures above), advise the client to take the HR3727 to their medical practitioner or nurse practitioner for completion of Section 2 and to their respiratory therapist, occupational therapist or physical therapist for an assessment and quote which is completion of Section 3.
	5.	Forward the Service Request and all documentation to HA for adjudication.
HA	1.	Assess application and refer to policy to ensure eligibility criteria are met.
	2.	If application is approved, an approval letter will be issued to the client and a purchase authorization will be sent to the service provider. If denied, the client will be sent substantive reasons for the decision and be offered the right to reconsideration. The service provider will be also advised of the denial.
	3.	Make a note of all details. Details include substantive reasons explaining what is requested and why the eligibility criteria are met or not met. If the item is approved, include the cost of the item and the name of the service provider.

Note: If a diagnosis and prescription from a medical practitioner, or nurse practitioner and/or the assessment from the respiratory therapist are received before the HR3727 is completed, Section 1 must still be completed by the client and forwarded with the supplemental documentation to HA.

Repairs of Breathing Devices

Effective: February 5, 2019

Note: All requests for repairs for Breathing Devices must be assessed by Health Assistance (HA).

For repairs of breathing devices, follow these steps:

POC		Forward the Service Request and documentation outlining the repairs needed and the estimated cost to HA for review.
HA	1.	Assess the application and ensure that eligibility criteria are met.
	2.	If approved, a letter will be issued to the client and a purchase authorization will be sent to the service provider. If denied, the client will be sent substantive reasons for the decision and be offered the right to reconsideration. The service provider will be also advised of the denial.
	3.	Make a note of all details. Details include substantive reasons explaining what is requested and why the eligibility criteria are met or not met. If the item is approved, include the cost of the item and the name of the service provider.