Seating and Mobility best practice documents(1–3) and the iNRRTS Code of Ethics(4) identify the need to provide clients with the full range of options that may meet the client needs, yet options that would benefit the client are often not presented if they are not funded by traditional funding programs. Frequently, when innovative equipment is suggested to the therapist, the response is “But there’s no funding for that…..”
Some clinicians may feel that they should only provide funded options, as it is unfair to tempt the client with equipment they cannot afford. This is a paternalistic perspective that disadvantages the client and removes their opportunity to advocate for funding or pursue other opportunities. One way to handle the gap between the client’s options and what the clinician believes they can afford is to engage the client by saying “there are several types of equipment that would be helpful for you. Would you like to hear about all the options, or just the ones where you would likely qualify for some funding?”. That way the client knows that there are many different options, not all of which are funded, and they can decide for themselves whether they want to know about the non-funded options.
Empower the client to find funding
Clients and their families in many cases can be in the best position to advocate for themselves and can be encouraged to keep track of the funding applications. Empowering the client to take responsibility and be involved promotes ownership of the process and a commitment to using and maintaining the prescribed devices.
Where the client and their support network are not able to be advocate for themselves, the responsibility to lead the process falls to the therapist and Registered Rehab Technology Supplier (RRTS®) by presenting options, providing guidance on the completion of funding applications, providing contact information, teaching them how to network and breaking the process down into smaller steps that the client or their support system can implement.
It’s through client advocacy and awareness that some fundingorganizations have become established and grew into the organizations that continue to exist. The March of Dimes is an example of this type of grass roots advocacy. Started by Mothers going door to door to asking for donations to find a cure for polio, the March of Dimes, utilized the organization’s resources to support people with disabilities to allow them to lead more independent lives once the threat of polio diminished.(5) The Shine foundation, as another example, was established by a father as a legacy to his son to enable those in similar situations to live their dreams.(6)
Without having created awareness of the availability of equipment options and new technologies the opportunity for advocacy to establish funding programs could not exist.
Types of Funding Programs
There are many different funding sources beyond the traditional government and non-governmental organization including insurance companies and charities. Part of the responsibility of the clinician and CRT Supplier (RRTS®) is to explore and take note of potential funding opportunities, programs and agencies and provide this information to clients as needed. Crowd source funding, fundraising events and financing programs have become more mainstream options
Regardless of the funding agency, it is important to ensure that both the client and the type of device they require are within the scope of that program. The letter of clinical rationale (or letter of medical necessity) needs to be specific to the client and clearly addresses the eligibility criteria specified by each potential funder.
Although several funding agencies have been listed in the call out box associated with this article, insurance funding, financing and approaching friends and family have been explored in more detail.
Insurance Funding:Some insurance companies may have limiting clauses such as eligibility for a one-time event (i.e. once in a lifetime). In this case, careful planning is required to ensure both the short-term and long-term needs of the client are addressed. Where this clause is not present, clients should never accept the first “no” or denial. Often with persistent advocacy and asking to see the exact details of the policy that confirms the client’s exclusion of funding of the mobility device, prompts a second review of the decision and results in funding approval.
Financing: Financing is often perceived by clinicians as a terrible thing; that clients shouldn’t have to apply for a loan for devices they need. Financing may enable a client to access the device they need now and split their payments into smaller amounts over a longer time. While there may be some fees and interest charged, these vary depending on the agency, and often cost less than paying for a device with a credit card. The client and their caregivers should be given the opportunity to investigate this option and decide for themselves if it is the best solution. Some vendors/suppliers have partnered with financing agencies to bring these programs and services to the client.
Extended Family/Friends: Extended family and friends may want to aid but are not aware of what equipment would be helpful. One option could be to redirect some money spent on birthday presents or other celebrations towards a fund for the needed equipment.
Other Funding Agency Examples:
- Governmental Agencies: NIHB, Saskatchewan Abilities Council, AADL, ADP, BC Ministry of Social Development and Poverty Reduction
- Non-governmental Agencies/Charities: diagnosis specific associations (e.g. MS Society, SCI Ontario etc.), Retail (e.g. https://www.dayforcecares.com/ca/application), Charities, Unions (e.g. steel workers union may provide funding f/or their members/families), March of Dimes, Easter Seals, churches, Lions Club, Mobility Device Manufacturers (e.g. some may donate parts), hospital foundations, Band (Indigenous) funding, Dreamcatcher funding etc.,
- Insurance: different types of insurance may be accessed depending on the client’s situation including health insurance, automobile insurance, employment insurance etc.
- Crowd sourcing: GoFundMe
- Financing: may be available through different vendors/suppliers
- Extended family/Friends
Sources of Funding Information
When sourcing funding, knowledge is power. The greater knowledge about potential sources, the more likely the client will be able to find the funding for the device. Many vendors/suppliers offer lists of funding agencies, providing links to the funding program websites. The website www.accessassistivetech.ca lists funding agencies by Province and type of device. This website also houses several reports examining access to assistive technology from a policy perspective, which may be of interest to clients, and could help to inform advocacy initiatives. In Canada, clients can also call 211, or go to 211.ca, and connect to information and services in their area, 24 hours per day in more than 150 languages.
Artificial Intelligence (AI) is another way to identify possible funding sources available in a specific region. For example, a recent ChatGPT search for “What organizations provide funding for mobility devices in Canada”, provided a list of 16 different funding agencies divided into Government Programs, Non-Governmental Programs, Charitable Foundations and Local and Community-Based Organizations, all complete with links to the organization’s web pages.
Lastly, networking is a fundamental skill that clients and their caregivers develop that will assist them in accessing funding and other services. Networking with their peers at community events or other activities, clinicians, CRT reps/RRTS®, and manufacturers may provide leads on funding sources or approaches. When a funding agency is unable to provide the total funding required, it is important to thank them for their consideration and ask them what other funding agencies they would suggest approaching. Often funding agencies have ideas about what other agencies may be able to help.
Summary and Practice Pearls
As a clinician or Registered Rehab Technology Supplier (RRTS®), it is easy to assume the client can’t afford a piece of equipment, however, this assumption may not be true. Clients have a right to know about the technology and device options that would best meet their needs, whether it is funded by traditional funding sources, and then they can decide how to proceed. It can pose a disadvantage or reduce functional opportunities to limit the client’s options.
Providing a wide range of funded and non-funded equipment means that clinicians and CRT suppliers/RRTS® have a responsibility to expand their education beyond just understanding basic technology and equipment options to investigating innovative technology and devices that may offer additional medical and/or functional benefits to further independence and quality of life.
Lastly the focus should be on empowering the client and their caregivers to advocate for funding and lead the process of sourcing funding. Empowerment occurs through education about funding, the available funding sources, networking and how to source unique funding opportunities.
Working together as a full CRT team, there may indeed be funding for that!
Linda may be reached at Linda.Norton@motioncares.ca
Linda Norton, B.Sc.OT, MSc.CH, PhD, OT Reg(ONT) is an Occupational Therapist who is passionate about the provision of appropriate seating and mobility equipment and the prevention of chronic wounds. Her diverse experience in various settings including hospital, community, and industry; and in various roles including clinician, educator, manager, and researcher, gives Linda a unique perspective. Wound prevention and management are also Linda’s passions. She has completed the International Interprofessional Wound Care Course (IIWCC), a Master’s in Community Health focusing on pressure injury prevention, and a PhD in Occupational Science focusing on chronic wounds.
Kathy may be reached at kfisher@nrrts.org.
Kathy Fisher has a background in Occupational Therapy and has worked as an Assistive Technology Provider and Clinical Educator over the past 35 years. Fisher has been involved in the provision of high technology rehabilitation equipment with clients in a variety of diagnostic categories including pediatrics and bariatrics. Fisher is the education manager for NRRTS and resides in Ontario, Canada.
References:
1. Armstrong W, Borg J, Krizack M, Lindsley A, Mines K, Pearlman J, et al. Guidelines on the provision of manual wheelchairs in less resourced settings [Internet]. Vol. 1, World Health Organization. 2008. Available from: http://www.who.int/disabilities/publications/technology/wheelchairguidelines/en/index.html
2. Rehabilitation Engineering & Assistive Technology Society of North America {RESNA). RESNA Wheelchair Service Provision Guide [Internet]. Arlington, VA; 2011. Available from: http://www.rstce.pitt.edu/RSTCE_Resources/RSTCE_Res_Doc/RESNA_PP_WSProvisionGuide2011.pdf
3. World Health Organization. Wheelchair provision guidelines. 2023 [cited 2023 Aug 4];1–108. Available from: https://www.who.int/publications/i/item/9789240074521
4. National Registry of Rehabilitation Technology Providers. NRRTS Code of Ethics [Internet]. 2019 Jul [cited 2025 Jan 8]. Available from: https://nrrts.org/wp-content/uploads/2019/08/NRRTS-Code-of-Ethics.pdf
5. March of Dimes Canada. Our History [Internet]. 2024 [cited 2025 Jan 13]. Available from: https://www.marchofdimes.ca/en-ca/aboutus/whoweare/Pages/MODC-History.aspx
6. Shine Foundation. Our History & Mission [Internet]. 2025 [cited 2025 Jan 13]. Available from: https://www.shinefoundation.ca/our-history-mission
