Patients in Hospital
This section is an excerpt from the Ontario Works Act, 1997 prescribed by the Province of Ontario.
Ontario Works Regulations
Residence in an institution
7. (1) A person who resides in an institution that provides for the person’s basic needs and shelter is not eligible for assistance.
(2) Subsection (1) does not apply with respect to,
(a) a person who resides in a nursing home or an interval or transition home for abused women;
(b) a patient in a hospital;
(c) a person who receives emergency hostel services; or
(d) a member of the benefit unit who, with the prior approval of the administrator, resides in a facility for the purpose of participating in a residential program for the treatment of substance addiction for a period not exceeding three months.
Reduction of budgetary requirements – Patient in a hospital
47. (1) Subject to subsection (2), if a member of the benefit unit is a patient in a hospital, the administrator may reduce the budgetary requirements for the person who is hospitalized.
(2) Subsection (1) does not apply for the first three months that the member of the benefit unit is a patient in a hospital.
Assistance is intended to cover the actual budgetary requirements of the family during the time the person is hospitalized and assist in retaining the community accommodation during a temporary stay in hospital of a participant or family member. Hospitals include General, Chronic Care, Convalescent, Psychiatric and Rehabilitation facilities.
This coverage extends to all renters, boarders and owners.
First Three Months of Hospitalization
There should be no reduction in Ontario Works (OW) assistance in the month in which a participant enters hospital.
OW applicants and participants who are patients in hospital and are maintaining their community accommodation are provided with full assistance for the first three full calendar months.
Example: A participant enters a hospital on August 11 – he or she would continue to be eligible for the following three months, from September 1 to November 30.
OW applicants and participants who are patients in hospital and are not maintaining their community accommodation are provided with basic needs for the first three full calendar months.
If, during the stay in hospital, the participant changes his or her community accommodation, (e.g., gives up his or her accommodation, changes from renter to boarder etc.), the Shelter Allowance provided to the participant should reflect this change.
After Three Months of Hospitalization
After three months of hospitalization, the caseworker may reduce the budgetary requirements for the person who is a patient in hospital, but is not required to do so. When determining the budgetary requirements of a participant after three months of hospitalization, consideration should be given to the actual costs of maintaining the community accommodation, as well as expenses related to the hospitalized person.
After three months of hospitalization, the caseworker must review the case with a Supervisor, Direct Program (SDP) to determine if full OW assistance should be continued for a further three months. The assessment is needed to determine if the maintenance of the accommodation is feasible and practical in relation to medical prognosis and should consider these factors:
- the anticipated length of hospital stay and the discharge plans;
- the financial commitments in the community (e.g., rent, mortgage, board and lodging); and
- expenses related to the hospitalized member of the family.
OW should not be reduced below $149 per month, equivalent to Personal Needs Allowance.