One of the more common queries that associations receive concerns the maximum number of a particular item that a member can obtain through the Stoma Appliance Scheme within a given period.
At times this can be a difficult question to answer because of the diverse range of products available through the scheme, the number of products listed on the Stoma Appliance Scheme Schedule (currently around 3,600) and the shared purpose of many of those products. Also relevant is whether the member holds a current and valid Application for Additional Stoma Supplies (PB050) and if the member is eligible for, and has taken advantage of, the two-month ordering cycle allowed under the Stoma Appliance Scheme Operational Guidelines for Stoma Associations.
When determining a maximum allowance, associations must consider the requirements of the guidelines, which state:
6.5.1 Maximum quantity: It is the responsibility of each stoma association to ensure no more than the maximum quantity of any of the stoma related products is provided to members on a monthly or annual basis unless there has been a certificate of authorisation issued for an increase in quantities forwarded to the Department requesting additional supplies. This certificate must be signed by the members’ health practitioner or STN.
6.5.2 Ordering supplies within one sub-group listed on the schedule: When supplies are requested from within one sub-group listed on the schedule, and the products are intended for the same purpose, the supplied amount is restricted to the maximum limit for that type of product.
6.5.3 Ordering supplies from more than one group listed on the schedule: When supplies are requested from two or more different sub-groups listed on the schedule, but for which the products serve the same purpose, the maximum amount supplied from each group must be reduced accordingly (e.g. if the products are supplied equally from two sub-groups then the maximum quantity for each sub-group should be reduced by 50%).
What this means in a practical sense is that the maximum quantity of a scheme-funded product that an association can issue within a requested period may be affected by other products that serve the same purpose that a member requests within that same period. Consequently, it is not unusual for an association to find it necessary to adjust a member’s order to ensure that the product issued does not breach the guidelines. This can result in some very unhappy members at times when they find that they have not received the full order requested!
As a general guide, the following maximum allowances have been set by the Commonwealth Government for commonly used products—monthly unless otherwise indicated:
- One piece stoma cap: 60
- One piece flat closed pouch: 90
- One piece convex closed pouch: 60
- One piece flat drainable pouch with integrated closure: 30
- One piece convex drainable pouch with integrated closure: 30
- One piece flat urostomy pouch: either 40 or 60*
- One piece convex urostomy pouch: 30
- Two piece flat standard baseplate and closed pouch: 30 baseplate + 90 pouch
- Two piece flat extended wear baseplate and closed pouch: 20 baseplate + 90 pouch
- Two piece convex baseplate and closed pouch: 20 baseplate + 90 pouch
- Two piece flat adhesive coupling baseplate and closed pouch: 30 baseplate + 90 pouch
- Two piece convex adhesive coupling baseplate and closed pouch: 20 baseplate + 90 pouch
- Two piece flat standard baseplate and drainable pouch: 30 baseplate + 60 pouch
- Two piece flat extended wear baseplate and drainable pouch: 20 baseplate + 60 pouch
- Two piece convex baseplate and drainable pouch: 20 baseplate + 60 pouch
- Two piece flat adhesive coupling baseplate and drainable pouch: 30 baseplate + 30 pouch
- Two piece convex adhesive coupling baseplate and drain pouch: 20 baseplate + 30 pouch
- Two piece flat standard baseplate and urostomy pouch: 30 baseplate + 60 pouch
- Two piece flat extended wear baseplate and urostomy pouch: 20 baseplate + 60 pouch
- Two piece convex baseplate and urostomy pouch: 20 baseplate + 60 pouch
- Night drainage bags: 5
- Adhesive remover wipes: either 60 per month or 720 per calendar year*
- Adhesive remover spray: 2
- Barrier wipes: either 60 per month or 720 per calendar year*
- Barrier spray: usually 6 per calendar year*
- Seals: 30
- Flange extenders: 60
- Powder: 2
- Pouch deodorant: 1 or 2 bottles*
- Paste: 3
- Lubricating deodorant – bottle: 1
- Lubricating deodorant – sachets: 100 per calendar year
- Pouch belts: 4 per calendar year
- Hernia support belt: 3 per calendar year
*depending on product
A risk of oversupply might arise when—for example—a member is using multiple types of pouching systems (such as closed and drainable pouches or one-piece and two-piece appliances), a range of hernia support garments (e.g. hernia support belts and hernia support briefs/boxers), or different types of barrier and adhesive remover products (such as spray and wipes). In these situations, the association must take care to ensure an oversupply does not occur. It may need to amend an order, often without having the time to consult the member.
For more information about applicable quantities for specific products and for information about other scheme-listed products not listed above, members can consult their Stomal Therapy Nurse or stoma association.