At Home Program Medical Benefits

Abstract

The At Home Program (AHP) Medical Benefits by the Ministry of Children and Family Development (MCFD) provides medical equipment to children and youth with support needs in British Columbia. However, there has been no formal evaluation of its effectiveness or the definitions of "basic" and "medically necessary" since its inception over 30 years ago. The number of children benefiting from AHP Medical Benefits has tripled in the past three decades. However, criticisms highlight inadequacies and outdated definitions, leading to inequities in accessing benefits. Studies show that children with medical complexity or neurodevelopmental disorders require more support, and caregivers often face burnout navigating the system. Three focus groups were conducted with healthcare providers and AHP Medical Benefits staff, revealing discrepancies in interpreting "basic" and "medically necessary" equipment. The adjudication process was critiqued for its length and lack of clarity, impacting access to benefits. In discussions, participants highlighted semantic hurdles, bureaucratic inefficiencies, and the need for clearer communication. Recommendations from focus group participants include clearer definitions, increased funding, and hiring healthcare professionals as AHP Medical Benefits staff. Frustration exists due to a lack of education and alignment between healthcare providers and AHP Medical Benefits staff. This research aimed to bridge this gap and improve policy alignment to better serve children and youth with complex needs. In conclusion, addressing the identified challenges and implementing the recommendations can lead to a more effective and equitable At Home Program Medical Benefits, ensuring better support for children, youth, and their families across British Columbia.