Guidance for LEAs regarding Durable Medical Equipment (DME)

Sep 16, 2026

Guidance for local educational agencies (LEAs) explains how durable medical equipment (DME) should be assessed, justified, and documented when related service providers are asked to write letters of medical necessity (LMN). It outlines required evaluation steps, including reviewing assessment data and equipment options, visiting all use locations, and coordinating selection with the family and vendor. The guidance also addresses scope of practice, licensure, staffing, insurance, liability, and recommends local policy and procedures for ownership, maintenance, training, loans, and coverage.

LanguageEnglish

CategoryLetters

FormatPDF

Pages2

Reading Time1 min

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Guidance for LEAs regarding Durable Medical Equipment (DME)

Letters of Medical Necessity (LMN)

Assessing DME and Coordination Requirements

Local Policy: Roles, Ownership, Maintenance, and Use

LEA Procedures and Documentation

Technical Assistance Contacts

Funding Notes and Equipment Transfer Rules

North Carolina Department of Public Instruction Exceptional Children Division Supporting Teaching and Related Services Guidance for LEAs regarding Durable Medical Equipment (DME) Related service providers are asked by parents and community-based case managers to write letters of medical necessity (LMN) for equipment and devices. These letters are required to justify the purchase of equipment used at school, at home or both (such as mobility and positioning devices, ramps, adaptive equipment for hygiene and daily living , augmentative communication devices, and assistive technology) When justifying DME, related service providers must assess the student, investigate equipment options, visit and assess all locations where the equipment will be used , and coordinate a meeting with the family and vendor to discuss and select specific equipment. There are issues with scope of practice, licensure, staffing, insurance and liability to consider when related service providers employed by a local educational agency (LEA) are asked to assess need and provide these letters. These letters draw upon assessment information from the student and environment(s), the medical expertise and professional license of the therapist to determine if and what equipment/device should be purchased. It is important that each LEA review what is required to assess and provide these letters. To avoid misunderstanding it is critical to: ➢ communicate the roles and responsibilities of each person ➢ confirm ownership of the equipment ➢ establish responsibilities for maintenance of the equipment To clarify responsibilities for each party, NCDPI ECD encourages the following: • Collaboration between the Exceptional Children Program Director, related service providers and school board attorney to develop a local policy delineating roles and responsibilities of LEA staff regarding letters of medical necessity • The local policy should outline the position of the LEA as to responsibilities for both personal, school equipment/devices and equipment/devices that are used at home, school and in the community, related to: o Allowable instances for writing letters of medical necessity o Allowable home visits to assess, deliver, and monitor DME o Equipment ownership, maintenance and use (DME used at school only, DME for home, community & school uses, DME used at home only, etc.) o Practitioner’s ability to visit homes to assess for DME and monitor or follow up o Scope of LEA responsibility for DME training, monitoring, and repair o Loaning equipment owned by the LEA to the student for use at home over weekends, holidays or summer break (in order to ensure FAPE is provided) o Appropriate insurance coverage • LEAs may want to develop procedures and/or documentation to: o outline the respective responsibilities of the school and the family for maintenance and repair of DME when purchased: ▪ by the school ▪ by the family with assistance from a related service provider ▪ via a 3rd party, hospital or specialty clinic o establish perimeters for loans over weekends/summer o clearly define ‘working condition’ o document training for DME use, precautions and safety, as well as any monitoring or follow-up that is required DPI Consultants are available to provide technical assistance: • Laurie Ray, Physical Therapy Consultant, [laurie_ray@med.unc.edu](laurie_ray@med.unc.edu) • Bridgette LeCompte, Occupational Therapy Consultant, [bridgette.lecompte@nc.dpi.gov](bridgette.lecompte@nc.dpi.gov)[ ](bridgette.lecompte@nc.dpi.gov)• Perry Flynn, Speech-language Pathology Consultant, [pfflynn@uncg.edu](pfflynn@uncg.edu) NOTE: Durable Medical Equipment purchased with Special State Reserve funds (PRC 63) or Risk Pool Funds (PRC 114): Special State Reserve and Risk Pool funds are student-specific and must be used as specified in the funding application. DME purchased with Special State Reserve or Risk Pool funds follow the student for whom t

FAQs

What is the purpose of a letter of medical necessity (LMN) for DME?

An LMN justifies the purchase of DME used at school, at home, or both. It relies on student and environment assessment information and the practitioner’s medical expertise and license.

What steps must related service providers take to support DME justification?

Providers should assess the student, investigate equipment options, visit and assess all locations where the equipment will be used, and coordinate a meeting with the family and vendor to select the specific equipment.

What key responsibilities should a local LEA policy clarify regarding DME?

The policy should define roles for writing LMNs, allowable home visits, equipment ownership, maintenance and use across home/school/community, practitioner visit ability, training/monitoring/repair scope, and loaning equipment to support FAPE.

How do Special State Reserve and Risk Pool funds affect DME ownership and transfers?

These funds are student-specific and must follow the funding application requirements. When a student transfers, the equipment goes to the new LEA; if the student leaves North Carolina, the equipment remains with the original LEA.

Sep 16, 2026

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