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Updated May 2006 |
Hardship Fund:
Special Needs Items for Persons Not In Receipt of Social Assistance
With the introduction of Ontario Works (OW) legislation effective May 1,
1998, the provision of both mandatory health benefits and discretionary benefits
was limited to persons in receipt of social assistance: Ontario Works and
Ontario Disability Support Program (ODSP).
Types of benefits:
- mandatory health benefits are
surgical supplies and dressings, diabetic supplies and the cost of
prescription drugs
- discretionary benefits include such
special needs items as dental services, prosthetic appliances including eye
glasses, mobility aids (walkers, canes etc.), orthotic devises, hearing aids,
wheelchair repairs, funeral services etc.
Toronto City Council has directed that a reserve fund be established to
assist persons on a "hardship basis". This fund is 100% municipal
expenditure.
Employment and Social Services recognizes that there are residents who have income which
exceeds OW but they cannot afford to purchase the medically based items. They
include persons in receipt of Old Age Security, Canada Pension, the
"working poor" and other persons on a fixed income.
- To
meet the medically based needs of residents where the cost of these items
would cause undue financial hardship
- To recognize this as a short term
emergency provision in most cases but also having flexibility to assist on a
longer basis when needed
- To recognize that excess income
may not always be available income due to the emergency and urgent
nature of the need. In the same manner, excess assets may not be readily
available.
- To allow caseworkers to use their
discretion and judgement when determining eligibility
- For funeral and burial services
for persons who were not in receipt of social assistance (OW or ODSP), we
will continue to take applications and assess eligibility.
For Vision Care
- If eligible, then glasses will be provided through the usual vendor process.
In the following situations, a person who is not in receipt of OW
can receive a drug card
- If the applicant has prescription
drug costs which are equal to or greater than the excess income; and the
applicant has applied to Ontario Disability Support Program(ODSP) and
has not been deemed ineligible for ODSP; or
- If the applicant has prescription
drug costs and he or she became ineligible for financial assistance as a
result of receiving loss of income or loss of support payments under the
1986-1990 Hepatitis C Settlement Agreement.
- Refer to Eligibility for Extended Health Benefits for full details.
In all other situations, we will assess for reimbursement of drug
costs
- Verification of monthly prescription drug costs are required. It is
also necessary to determine if these costs are reimbursable from another
source (e.g. employment).
- Allowable costs (not the
dispensing fees) may be paid direct to the applicant or to the pharmacy.
- Maximum one month reimbursable
costs. Any extensions must be approved by a Supervisor, Direct Program. In
all cases, the client must apply to Trillium Drug Plan (TDP).
- Original prescription
receipts must be returned to the client so they may be submitted
to TDP.
For Dental Services (including Dentures)
- Seniors are to be referred to Public Health which may charge the person for partial lab fees (dentures) - this cost is an acceptable cost under the Hardship Fund.
-
Public Health Dental Clinics
- Children can receive assistance through Children in Need of Treatment (CINOT) at 416-396-7442.
- In all other cases, we will only provide the same services as OW clients receive (emergency dental care and dentures).
Clients are expected to contribute where there are available assets or income
to meet part of the total costs.
While this fund is meant to be an emergency intervention, we recognize in
some cases due to lack of income and the ongoing monthly needs of the client,
there will be a need for longer term supports.
