May 28, 1998

 To:Community and Neighbourhood Services Committee

 From:Commissioner, Community and Neighbourhood Services

 Subject:Ontario Disability Support Program/Social Benefits Tribunal

 Purpose:

 The purpose of this report is to provide an overview of the new Ontario Disability Support Program regulations, which took effect June 1, 1998. This report highlights the key changes contained in the new regulations, and provides an initial overview and impression of the cumulative impacts for Toronto. The recently released regulations governing the new Appeal system proposed for Ontario Works and the Ontario Disability Support Program are also assessed.

 Financial Implications:

 The net financial impact of the new regulations will require further analysis and are therefore not known at this time.

 Recommendations:

 It is recommended that:

 (1)this report be forwarded to the Minister of Community and Social Services; and

 (2)the appropriate City Officials be authorized and directed to take the necessary action to give effect thereto.

 Background:

 In June, 1997, the Social Assistance Reform Act (S.A.R.A.) was tabled in the legislature by the Minister of Community and Social Services (M.C.S.S.). S.A.R.A. created two new statutes: the Ontario Works Act (O.W.A.), which replaces the General Welfare Assistance Act (G.W.A.), and the Ontario Disability Support Program Act (O.D.S.P.A.), which replaces the Family Benefits Act (F.B.A.), and the Vocational Rehabilitation Services (V.R.S.) Act.

 Through the O.D.S.P.A., the Province set out to create a new program solely for persons with disabilities, moving them outside the conventional Awelfare@ system. The stated intent is to Atake people with disabilities off welfare@ and Ato support them towards the goals of independence and employment@.

 In July 1997, the Community Services Department reported to the former Metro Council on the details of S.A.R.A., (Human Services Committee, Clause 2, Report 10). Based on the information available at the time, the report assessed the impacts of the new legislative framework. At that time, the Department indicated it strongly supported the provincial direction with respect to the creation of the Ontario Disability Support Program, and commended the Province for recognizing the inappropriateness of placing persons with disabilities in the existing social assistance system.

 The O.D.S.P.A. was proclaimed on June 1, 1998. Information about the new program was provided to municipal officials in a mid-May briefing session. However, the regulations were not available in final form until the end of May, with the result that the Department is currently in the process of undertaking an in-depth analysis of the impacts for clients and for program delivery. The information contained herein is drawn primarily from the Provincial briefing materials and summaries, and from an initial review of the regulations.

 This report describes the key features of the new program, and briefly discusses the implications for applicants and clients. The report also assesses the program delivery impacts on the Social Services Division of the changes contained in the new regulations.

 On June 1, the new social assistance appeal system also took effect. At this time, the Social Benefits Tribunal replaces the existing Social Assistance Review Board. Again, the regulations governing the appeals process have only recently been made available. This report describes the main features of the new process, and a provides a preliminary assessment of impacts.

Discussion:

 I.Ontario Disability Support Program Act: Key Features:

 The O.D.S.P.A. replaces the former F.B.A. Passed in 1967, F.B.A. provided benefits on a long term basis to a range of eligible clients including single parents, blind, disabled or permanently unemployable person, foster child(ren) and persons 60 years and over. The special needs of F.B.A. recipients were met by granting Supplementary Aid through the G.W.A. delivery system.

 For some time, the disabled community and others have voiced their concerns about providing benefits to people with disabilities and serious long term health problems through the Awelfare@ system. O.D.S.P. addresses these concerns by establishing a separate program targeted at people with disabilities and people over 65 years of age. Of significant importance is fact that the new program recognizes that many people with disabilities can and do wish to work.

 The new program has two primary functions: to provide income support to disabled people who are in financial need; and to provide employment supports to clients who want to work. The new Income Support program provides financial assistance to those who qualify, introduces new eligibility criteria and new approaches to the treatment of assets, income and special needs, and establishes a centralized process for adjudicating disability. The Employment Supports program replaces the V.R.S. Act, and provides services to support people with disabilities as they move towards employment. The Province will continue to deliver the program. However, the City is required to cost-share provincial staffing costs on a 50/50 per cent basis as part of the downloading of responsibilities to municipalities.

 The O.D.S.P. is substantially changed from the former F.B.A. and V.R.S. programs, and in many instances is significantly improved. Having undertaken a preliminary review of the O.D.S.P. regulations, the Department reiterates its support for the Province=s approach to serving disabled people. The following section highlights the key features of the new program. Appendix A provides an overview of the major changes made under the O.D.S.P. regulations, and the impacts on clients.

Program Purpose and Objectives:

 The O.D.S.P.A. contains a clear statement of purpose for the program which emphasizes the importance of providing both income and employment supports to disabled individuals. A number of equally clear objectives have been articulated for the program, to ensure that it now provides: :

1.clear and understandable new criteria for eligibility based on recognizing restrictions in the activities of daily living in the home, in the community and in the workplace, supported by a new process for assessing whether a person qualifies;

2.greater opportunities for independence by recognizing costs more fully within the program=s policies regarding assets, income, and gifts and loans; and

3.additional emphasis on assisting people towards employment with practical employment supports that range from employment planning assistance and skills development, through technological aids and devices, to interpreters and ongoing job supports.

 The Department supports these objectives, and believes that they are largely accomplished through the regulations governing the program.

 Eligibility for O.D.S.P.:

 A person is eligible for O.D.S.P. who is 18 years or older, has a disability that substantially restricts activities of daily living, and is in financial need. Persons aged 65 years and older, who are not eligible to receive Old Age Security (O.A.S.), are also eligible. For the first time, persons in receipt of Canada Pension Plan Disability benefits are eligible if they meet the financial needs criteria. Previously, under F.B.A., such individuals had to undergo a separate medical exam to qualify.

  A positive feature of O.D.S.P. is that persons aged 60-64 who qualified for F.B.A. before January 1, 1998, will continue to be eligible for O.D.S.P., as will permanently unemployable and disabled recipients eligible before May 1, 1998. The Department strongly supports this provision. Current benefit levels, which compare favourably with levels provided to disabled people in other provinces, are retained for all program beneficiaries.

 Employment Supports:

 Through a new Employment Supports program, the O.D.S.P. provides a range of services to people with disabilities who can and want to work. These services will be provided to any person for whom a disability presents a substantial barrier to employment, whether or not they are receiving income assistance under the O.D.S.P. Prescribed employment supports include employment consultation and planning, employment preparation and training, job placement services, as well as provision for the costs of various tools, equipment or aids necessary to secure and sustain employment. The Province has indicated that the budget for the wider range of supports provided has been increased to about $35 million per annum, versus $18 million under the former V.R.S.

 Unlike F.B.A., persons who reapply for benefits within one year following an unsuccessful employment experience will be rapidly reinstated without retesting, provided they qualify financially for the program. This is a positive step. Overall, the new program increases incentives for, and expands services to, people who want, and are able, to work.

 Definition of Disability:

 The O.D.S.P. establishes a new definition of disability which refers to Asubstantial restrictions in one or more activities of daily living such as personal care, functioning in the community, and the workplace.@ The disability, which may result from mental or physical impairment, has to be major, continuous, or recurrent in nature, and must last for one year or longer. This is a much more focused definition than was used under F.B.A. It consciously avoids labelling people unemployable, a feature of the previous disability test that was considered unproductive by the disabled, and by advocates and organizations working with the disabled community.

 At the same time, people previously considered permanently unemployable who were eligible for Family Benefits, including non-disabled people who had a serious employment barrier (e.g. drug or alcohol problem), will no longer be considered disabled, and will not be eligible for O.D.S.P. These individuals must now apply for social assistance benefits through Ontario Works (Appendix B highlights the implications of this change for singles and families). As the Department has previously indicated, single parents and new applicants aged 60-64, who previously could receive F.B.A., will now only be eligible to receive social assistance through O.W.

 The Department anticipates that the outcome of these changes there will be a sizable decrease in the number of people who will be eligible under O.D.S.P.A. compared with F.B.A. The degree the new definition of disabled and the actual disability test restrict eligibility will depend on the actual operation of the new disability adjudication process. The Department is concerned that the impact of this change will be to increase the number of hard to serve clients receiving O.W. The potential impacts for the Social Services Division will be delineated in section II.

 Disability Adjudication Process:

 The program introduces a new standardized and comprehensive disability test, and clear criteria for retesting, which should result in greater consistency in the assessment process across the province. The newly formed Disability Adjudication Unit will make decisions verifying that a person is disabled. The Unit will include a broader range of expertise than was previously the case under F.B.A., and include Occupational Therapists, Nurse Practitioners and Physiotherapists, as well as Physicians, Psychologists and Optometrists.

 Once a disability determination has been made, clients will only be retested if and when the disability is expected to improve. Persons with no expectation of improvement in their disability, will not be retested. Under F.B.A., all clients were required to undergo regular medical exams on an ongoing basis to qualify for benefits.

 Treatment of Assets and Income:

 The program contains revised financial rules (notably higher asset limits) than the former F.B.A. program, plus a range of other changes which will allow people to access and retain income from specific sources. Clients with disabilities will be able to keep more of their assets to cover the costs associated with a disability. Specific details regarding these changes are contained in Appendix A. Overall, the impact of these changes is to increase the resources available to disabled persons and their families to support a higher quality of life, and to expand their potential to seek employment if they wish to.

 II.Program Delivery Impacts:

 The O.D.S.P. will have a number of impacts on the Social Services Division, and for the social services delivery system in Toronto. As indicated previously, the new regulations have been received only recently. Consequently, this assessment is based on an initial review of the regulations.

 O.D.S.P. Service Delivery Model:

 A key impact for Toronto=s social services delivery system relates to the Province=s decision to use Ontario Works as the entry point for the majority of clients applying for O.D.S.P. While the Province initially indicated O.D.S.P. and Ontario Works would operate independently, the relationship between the programs is in many ways similar to that which existed between G.W.A. and F.B.A. In essence, there has been minimum disentanglement of the municipal and provincial delivery systems.

Thus, any client in immediate financial need will be expected to apply for financial assistance through Ontario Works while a decision is being made regarding eligibility for O.D.S.P. The Province estimates that over 80 percent of all applications to O.D.S.P. will be made through Ontario Works. In most instances, cases can be expected to remain on O.W. for at least four months before a determination of eligibility is made. It is also very likely that O.W. staff will be required to assist clients prepare the information and materials necessary to make a disability claim.

 The Department has two overall concerns. First, the application process for disabled clients needs to be further streamlined. The application process will be discussed in greater detail below. Second, there will clearly be staff resource and operational implications for the Social Services Division related to serving O.D.S.P. applicants..

 O.D.S.P. Application Process:

 As indicated, disabled clients in immediate financial need will apply for O.D.S.P. through the Ontario Works program. The application process has a number of features:

 1.anyone who believes he/she has a disability has the right to apply for O.D.S.P.;

2.financial eligibility for O.W. must be established immediately for all clients who apply for O.D.S.P. through the O.W. program;

3.applicants for O.D.S.P. who are receiving O.W. financial assistance will have participation requirements deferred without medical documentation once in their lifetime;

4.applicants who request immediate financial assistance through O.W. can use the substantially higher O.D.S.P. asset levels once in their lifetime to establish financial eligibility for O.W. pending resolution of their eligibility assessment under O.D.S.P.;

5.in most circumstances, applicants must now request an application for disability determination directly from the O.D.S.P. office which will then be forwarded to them for completion;

6.applicants have 90 days to complete the forms necessary for the determination of disability by the Provincial Disability Assessment Unit, after which an application may be withdrawn; and

7.when it is determined that an applicant has a disability and is eligible for O.D.S.P., financial eligibility must be re-confirmed by the O.D.S.P. office.

 The Department has a number of concerns related to potential impacts on clients of the new applications process. Formerly, potentially eligible clients were required to apply to F.B.A. as part of the O.W. requirement to pursue all available sources of income. This requirement no longer exists under O.D.S.P. In addition, Social Services Division staff will no longer be able to make direct client referrals to the O.D.S.P. for clients who refuse to seek the medical attention necessary to complete the disability determination process, as was occasionally the case under the F.B.A. program. These changes restrict an O.W. caseworker=s ability to assist disabled clients who may be eligible for O.D.S.P. and whose needs could best be met through the program, but who do not , or cannot, initiate applications, possibly because of their disability.

The Division also recommends that the Province establish specific protocols for applications from vulnerable clients, such as homeless persons, which waive the 90 day application limit, and which does not penalize such clients if an initial application is not completed.

 Hard to Serve Clients on O.W.:

 As noted previously, people who no longer qualify for O.D.S.P. because of changes in the definition of disability, but who still require financial assistance, will apply for benefits under the Ontario Works program. Many of these individuals may not be employable because they have multiple barriers or health problems. Even with additional resources, it is not realistic to assume that these individuals will be able, or should be expected, to participate in mandatory O.W. activities such as Community Participation placements.

 Therefore, the Department reiterates the request made in its July 1997 that the Province ensure participation requirements can be permanently deferred for people who clearly will not be able to take part in these activities.

 Dependent Adults:

 In families where the family head is disabled and in receipt of O.D.S.P., adult family members over the age of 18 who are financially dependent as defined in the O.D.S.P. regulations are subject to O.W. participation requirements. It is the responsibility of the local O.W. site to ensure that dependent adults establish service plans, meet the objectives set out therein, and comply with OW participation requirements.

 At this time, the number of adult dependents in receipt of benefits under the former Family Benefits program who will have mandatory participation requirements is not known. Nor is it possible to estimate how many new applications for O.D.S.P. will be made by families in which a dependent adult resides. However, any increase in O.W. participants resulting from this policy will have implications for the Division, potentially affecting budgets, staffing and physical space requirements. Until further information about the potential number of adult dependents with O.W. requirements is available, the Division is unable to provide any reasonable estimate of possible impacts.

 During the implementation of O.D.S.P. over the remainder of 1998, the Social Services Division will be required to develop a plan with the Toronto Area O.D.S.P. offices to administer this component of the O.D.S.P./O.W. interface. More information and clarity about the number of clients involved is one issue that will need to be investigated with Provincial staff during the implementation of the new program.

 Implementation Issues:

 In certain cases, the detailed information necessary to begin to implement changes, and to administer the new functions required at the O.W. office, have not yet been conveyed to municipal delivery sites. The Department is working with Ministry officials to ensure that the new processes for referring clients with disabilities to the O.D.S.P. program are put in place with minimum disruption to clients wherever possible. In fact, it is imperative that Ministry and Social Services Division staff collaborate effectively over the next year to achieve this objective, not only with the introduction of O.D.S.P. but with the ongoing implementation of O.W.

 The Division also recognizes that it will be necessary to explore effective ways, with the assistance of key community agencies, of helping disabled people apply for O.D.S.P. Given the scope of the new Provincial package that must be completed as part of the new disability determination process, clients will likely require support from appropriate community organizations, including community health clinics and agencies providing services to disabled persons. The Division is concerned that if these community supports are not developed, certain disabled applicants, particularly the most vulnerable clients, will not be able to fulfill the requirements of the new process.

 Finally, the Department continues to be concerned about the speed with which changes are being made, and the lack of lead time to review the implications of new regulations before they take effect. It has become increasingly difficult to adequately inform and train staff, and inform clients and the community, about the wide range of changes occurring. Substantial efforts will be required to prevent deterioration of service and to preserve program integrity during the implementation period, and to ensure to the degree possible that the O.W. and O.D.S.P. regulations, and the new appeals process can be introduced with minimum disruption to service delivery.

 II.New Appeals Processes:

 As of June 1, 1998, the new appeal processes mandated within the O.W.A. and O.D.S.P.A. take effect. The Province has indicated its intention is to streamline the process and make it more efficient. As part of the change, the Social Benefits Tribunal (S.B.T.)becomes operational. All new appeals, with few exceptions, will be forwarded to the S.B.T., while the existing Social Assistance Review Board is phased out. The basic features of the new appeals system are described below.

 1.All O.W. delivery sites must develop an internal review system which meets specific criteria laid out in legislation and regulation (e.g. specific time frames and procedures for conducting all internal reviews). The purpose of the internal review process is to ensure that all efforts are made at the local level to resolve issues before they are referred to the Provincial appeals system;

 2.All appeals must be processed through the internal review system before they can proceed to be the Social Benefits Tribunal, which replaces the Social Assistance Review Board as the final decision-maker within the social assistance appeals system; and

 3.The mandate and scope of the S.B.T. is more focused compared to S.A.R.B.=s. A number of matters are no longer appealable, as set out in legislation. The Tribunal will also employ a new case management approach to the hearing process.

The Department supports the requirement to develop an internal appeals system, and believes that embedding this requirement in legislation, and providing clear parameters for the review process, will improve the quality and consistency of decision making.

 The Social Services Division has for some time utilized an internal review process, and intends to build on this process to meet the new legislative and regulatory requirements. At this time, the Division is assessing what changes are required to bring internal appeals process into compliance. For the most part, only minor modifications will be necessary. However, given the fact that the new regulations governing the appeals process have only recently become available, significant efforts and staff resources will be required to rapidly make the needed changes, and to inform staff, and clients, about how the process will work.

 Transition to the Social Benefits Tribunal S.B.T.:

 The Province has recently indicated in a Bulletin from the S.B.T. that the transition to the new appeal system will be gradual. According to the M.C.S.S., the two review boards will continue to operate for some time. Effective June 1, 1998, all decision=s regarding an individual=s entitlement for O.W. or O.D.S.P. must be appealed to the Tribunal, and will be dealt with under the new O.W.A. and O.D.S.P.A. However, S.A.R.B. will continue to hear all appeals filed before June 1. In these cases, the appeals will be dealt with according to the former G.W.A. Act and the Family Benefits Act as appropriate. As well, S.A.R.B. will continue to be the board of review for all decisions made regarding the ongoing eligibility of sole support parents and foster parents under F.B.A.

 The Division anticipates that the overlap between the two systems will be administratively complex to manage, demand additional staff resources, and be confusing to both clients and staff. It is possible that a client could have appeals simultaneously before both S.A.R.B. and the Tribunal. It is therefore critical that the Province provide municipalities with the necessary information to clearly understand how the new S.B.T. will operate, and allow sufficient time for this information to be absorbed and communicated to staff and clients.

 Conclusion:

 The Department believes the new O.D.S.P. represents a positive step in assisting eligible disabled people in Ontario. The inclusion of enriched employment supports, and the favourable changes made to the treatment of assets and income will clearly benefit program recipients. A number of important operational and program administration issues must still be worked out before the new program can be effectively implemented. The Social Services Division has had limited time to review and analyse all of the information recently released by the Province related to the new program. Consequently, the Division will continue to assess the impacts of the new regulations and further Provincial directions, and report back to Council as appropriate

 Overall, the Division supports the approach adopted by the Province in developing an new appeals system, including the emphasis on an internal appeals process governed by clear parameters and criteria. It is anticipated that the changes will improve the quality of decision-making. At this point, additional information is required to more precisely determine the program administration impacts of the new appeals system on the Division.

  Contact Name:

Heather MacVicar

392-8953

 General Manager, Social Services Division

 Commissioner, Community and Neighbourhood Services

 Appendix A

 Summary of Ontario Disability Support Program Regulations

Appendix B: Case Examples:

 I.Changes to Definition of Disability: Permanently Unemployable Clients versus Disabled Clients

 1.Single Person:

 2. Family: Two Parents plus Dependent Adult:

¹Previously eligible under F.B.A. Permanently unemployable category eliminated under new definition of disability.

 ²Responsibility for providing service and monitoring participation requirements of dependent adults resides with Municipal O.W. delivery agents. These families will be required to interact with both O.W. and O.D.S.P. programs.