Voice Related Devices and Respiratory
Consumables Clinical Criteria
This criteria has been developed in consultation with expert clinicians and is based
on available evidence at the time of development. This document is designed to
specify the criteria to access assistance through EnableNSW for this group of
assistive technology, and provide a basis for consistent and transparent decision
making.
VOICE PROSTHESIS, ELECTROLARYNX AND RESPIRATORY CONSUMABLES FOR
LARYNGECTOMY
Included Equipment - Voice
Allocation
Electrolarynx or
1
Indwelling Voice Prosthesis or
Up to 2/yr
Non-indwelling Voice Prosthesis
Up to 6/yr
Voice Prosthesis Consumables: dilator; gel cap insertion system; gel caps;
Once only
flushing device; cleaning brush
Eligible Prescriber
Speech Pathologist with >1 year experience + 3 previous prescriptions for equipment in this category
Included Equipment (Non Standard) - Voice
Allocation
Tracheostoma/hands free speech valve starter kit
Once only
Eligible Prescriber
Speech Pathologist with >3 years experience + 5 previous prescriptions for equipment in this category with
input from the treating physician
Included Equipment – Respiratory Consumables
Allocation
Heat Moisture Exchangers (HME)
365/yr
OR
OR
Foam stoma covers
365/yr
HME attachment devices:
Tracheostoma button
1/yr
OR
OR
Standard adhesive seals (base plates)
365/yr
OR
OR
Non-standard adhesive seals
180/yr
Laryngectomy tubes (fenestrated or non-fenestrated)
1/yr
Laryngectomy tubes/tracheostoma button securing device:
Neck straps
12/yr
Eligible Prescriber
The primary prescribing team may include: Speech pathologist in consultation with a specialist physician in
Respiratory Medicine, Ear Nose and Throat, Head and Neck, or Intensive Care.
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Exclusions
Plug inserts for voice prostheses; cloth stoma covers; shower covers; silicone adhesive; adhesive
barrier and remover products, lubricant.
Consumers who have a short term need for equipment and consumables (less than 12 months)
Consumers who have not completed an appropriate trial
Allocation over and above the listed supply
Consumables for short term (including post surgery while surgical sites settle), intermittent, episodic
or emergency situations
Equipment to facilitate discharge
Equipment for treatment purposes
Batteries
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Voice Related Devices and Respiratory
Consumables Clinical Criteria
This criteria has been developed in consultation with expert clinicians and is based
on available evidence at the time of development. This document is designed to
specify the criteria to access assistance through EnableNSW for this group of
assistive technology, and provide a basis for consistent and transparent decision
making.
Contracts in place
318 Respiratory Consumables
Ineligible Groups
Consumers who are eligible for services and equipment to be provided under any of the following will not
be eligible to receive equipment through EnableNSW (see EnableNSW Policy).
 ADHC owned and operated supported accommodation facilities
 Respite or temporary care facilities
 Transitional Aged Care Package
 Commonwealth Home Care Packages (levels 1-4)
 Motor Accidents Authority Lifetime Care and Support Authority
 Dust Disease Board
 Department of Veteran’s Affairs Gold Card holder
 Department of Veteran’s Affairs White Card holder if the requested assistive technology is for an
injury/condition developed during/or as a result of time in service
 Third party/Worker’s Compensation/other compensation related to the injury/disease
Equipment Eligibility Criteria

Voice prostheses may be funded when the trache-oesophageal fistula is stable post surgery AND
the voice prosthesis is required for ongoing, long term use by the consumer for primary
communication

Electrolarynx may be funded when the consumer requires an electrolarynx for primary
communication

Laryngectomy Respiratory Consumables may be funded when a minimum 2 week trial has been
completed AND the consumables are required for long term use (>12 months).
For laryngectomy respiratory consumables the most clinically appropriate, cost effective option
should be considered. Therefore please assess the suitability of a tracheostoma button as a
method of attaching heat moisture exchange cassettes.
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Voice Related Devices and Respiratory
Consumables Clinical Criteria
This criteria has been developed in consultation with expert clinicians and is based
on available evidence at the time of development. This document is designed to
specify the criteria to access assistance through EnableNSW for this group of
assistive technology, and provide a basis for consistent and transparent decision
making.
Key information to consider or include in the Equipment Request Form (ERF)
Consumer Factors
Confirm
 The consumer’s diagnosis and/or functional disability including relevant surgical dates.
 That the device will be required for ongoing, long term (> 12 months) use by the consumer.
 For voice prostheses, that the trache-oesophageal fistula is stable.
Consider
 That for non-indwelling voice prosthesis the consumer has the ability to clean the prosthesis insitu and
can change the prosthesis or has access to a clinical specialist for device change.
 That for indwelling voice prosthesis the consumer has the ability to clean the prosthesis insitu and has
access to a clinical specialist for device change.
 Information from the clinical and functional assessment of relevant skills including: ability to achieve
functional voice, cognitive factors, dexterity, and vision.
 Any relevant medical information that impacts on consumer’s current and ongoing ability to use the
device such as deterioration or improvement in condition, physiological issues, medications, planned
surgery.
Social/ Carer Factors
Consider
 Whether the carer is able to hear and/or understand the consumer’s speech when the device is being
used.
Environmental and Equipment Factors
Consider
 That a plan is in place for ongoing local clinical support.
 That a plan for training has been made for the consumer, and if applicable the carer, regarding the use
of the equipment, maintenance, cleaning and ongoing review.
 That an emergency plan has been made for the consumer, in the event of equipment breakdown
including early failure of the voice prosthesis. Please note that EnableNSW is not able to provide loan
equipment or emergency orders in the event of unexpected equipment failure.
Trial
 Trial of equipment is required.
 Equipment on loan or equipment previously used constitutes a trial.
Provide
 If non-standard equipment is requested describe how the features/specifications of the recommended
equipment will meet the consumer’s needs in the most clinically appropriate and cost effective way.
Consider
 The consumer’s functional use of the equipment such as: ability to operate the equipment, change or
recharge batteries, clean device, and manage emergency situations.
Plan for delivery and evaluation
 Provide delivery details and instructions including the name and contact details of the consumer/carer or
any clinicians who should be notified of delivery.
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Voice Related Devices and Respiratory
Consumables Clinical Criteria
This criteria has been developed in consultation with expert clinicians and is based
on available evidence at the time of development. This document is designed to
specify the criteria to access assistance through EnableNSW for this group of
assistive technology, and provide a basis for consistent and transparent decision
making.
APPENDIX 1. NON STANDARD EQUIPMENT
Equipment
Non standard equipment may be approved under exceptional
circumstances when:
Tracheostoma/
The consumer is motivated to use hands free speech due to self care needs
hands free speech
(please specify relevant self care needs). The consumer should demonstrate
valve starter kit
compliant use of heat moisture exchange devices and attachments, and have the
required dexterity and cognitive ability to manage a hands free speech valve.
Non Standard
The consumer has trialled a standard adhesive seal for 2 months and due to poor
Adhesive Seals
seal or dexterity is unable to safely use the standard adhesive seal
APPENDIX 2. NON STANDARD SUPPLY LEVELS
Equipment
Non standard annual allocation may be approved when:
Indwelling Voice
Prosthesis
There is evidence of ongoing fungal infection with poor response to treatment,
resulting in early failure of the voice prosthesis. Information regarding average
device life of the voice prosthesis and what anti-fungal measures have been
taken must be provided. Use of non indwelling prostheses, or fungal resistant
voice prostheses, should be considered. A maximum supply of 4 indwelling voice
prostheses may be supplied annually.
APPENDIX 3. VOICE PROSTHESIS CONSUMABLES
Equipment
Trache-oesophageal
Dilator
Gel Cap Insertion kit
Gel Caps
Cleaning brushes
and flushing device
Allocation Amount
One will be supplied for consumers who independently change the voice
prosthesis out of the clinical setting.
One will be supplied for consumers who independently change the voice
prosthesis out of the clinical setting
One pack will be supplied for consumers who independently change the voice
prosthesis out of the clinical setting.
One pack of each will be supplied.
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