1. Special diet allowance for ontario works and ontario disability support program recipients

allocation de rÉgime alimentaire spÉcial pour les bÉnÉficiaires d’ontario au travail et du programme ontarien de soutien aux personnes handicapÉes

COMMITTEE RECOMMENDATION

That Council approve that the City of Ottawa communicate with the Ontario Minister of Community and Social Services requesting the following:

1. That the Province immediately review and revise the Special Diet Schedule with the objective of allowing approved health professionals to prescribe a special diet requirement for other medical conditions that are not currently listed on the form, including medical conditions that are not yet diagnosed;

2. That the Province review the rates that people on ODSP and OW receive and raise them to a more reasonable level in light of current costs of living and the importance of effective treatment of health issues, and the need to consider a strategy of prevention; and,

3. That this Motion be circulated to the Opposition critics, Ottawa-area M.P.P.s, the Association of Municipalities of Ontario (AMO) and the Association of Francophone Municipalities of Ontario (AFMO).

RECOMMANDATION DU COMITÉ

Que le Conseil approuve que la Ville d’Ottawa communique avec le ministre des Services sociaux et communautaires pour lui demander :

1. Que la province révise immédiatement l’Annexe pour régime spécial dans le but de permettre à des professionnels de la santé approuvés de prescrire un régime spécial pour des troubles médicaux qui ne figurent pas sur le formulaire, y compris des affections qui n’ont pas encore diagnostiquées; et

2. Que la province révise et augmente à un niveau plus acceptable les montants accordés aux personnes inscrites au Programme ontarien de soutien aux personnes handicapées et au Programme Ontario au travail, et ce, en raison du coût actuel de la vie, de l’importance d’assurer un traitement efficace aux problèmes de santé et du besoin de prôner une stratégie de prévention.

3. Que cette motion soit distribuée aux porte-parole de l’opposition, aux députés provinciaux de la région, à l’Association des municipalités de l’Ontario (AMO) et à l’Association française des municipalités de l’Ontario (AFMO).

DOCUMENTATION

1. Councillor Cullen report dated 23 March 2006 (ACS2006-CCS-HRS-0005).

2. Extract of Minutes, 6 April, 2006.

Report to/Rapport au :

Health, Recreation and Social Services Committee

Comité de la santé, des loisirs et des services sociaux

23 March 2006 / le 23 mars 2006

Submitted by/Soumis par: Councillor Alex Cullen / Conseiller Alex Cullen

Contact/Personne-ressource: Councillor Cullen

(613) 580-2477 / Alex.Cullen@ottawa.ca

Ref N°: ACS2006-CCS-HRS-0005

SUBJECT:	SPECIAL DIET ALLOWANCE FOR ONTARIO WORKS AND ONTARIO DISABILITY SUPPORT PROGRAM RECIPIENTS
OBJET :	ALLOCATION DE RÉGIME ALIMENTAIRE SPÉCIAL POUR LES BÉNÉFICIAIRES D’ONTARIO AU TRAVAIL ET DU PROGRAMME ONTARIEN DE SOUTIEN AUX PERSONNES HANDICAPÉES

REPORT RECOMMENDATION

For discussion.

RECOMMANDATION DU RAPPORT

Pour discussion.

BACKGROUND

The attached memo dated 22 February 2006 was circulated to all members of Council on 23 February. Concerns have been raised by service providers and poverty groups regarding the impact this initiative will have on Ontario Works recipients. As a result, I believe we should be briefed on this matter and be able to discuss it.

CONSULTATION

I asked that the Poverty Issues Advisory Committee and the Health and Social Services Advisory Committee be circulated a copy of this memo for their review. Subsequent to their discussions, the following is provided:

Poverty Issues Advisory Committee

On 13 March 2006, several members of PIAC attended a sub-committee meeting with members of the Health and Social Services Advisory Committee to discuss the memo from staff on this issue. The sub-committee prepared a Motion for the consideration of the PIAC, which would be submitted as a joint Motion to the Health, Recreation and Social Services Committee. Subsequently, on 14 March, the PIAC received and approved a Motion (see Document 2), with the request that it be forwarded to the Health and Social Services Advisory Committee for consideration at their meeting on 28 March 2006.

Health and Social Services Advisory Committee

On 28 March 2006, the HSSAC received the Motion approved by the PIAC. After some discussion of the item, the following amended version was approved:

WHEREAS the current ODSP and OW rates are inadequate for those receiving such funding to have a decent quality of life (i.e., affordable housing, nourishing food, adequate clothing, etc.);

AND WHEREAS nourishing food is an essential element of physical and mental health;

AND WHEREAS many people receiving ODSP or OW receive inadequate support to cover special diet requirements to meet their health needs;

AND WHEREAS the Special Diet Allowance permitted those on ODSP or OW to supplement their diet with healthy food;

AND WHEREAS a healthy diet can prevent disease and other maladies not just help those who are coping with such health problems;

AND WHEREAS the province changed the Special Diet Allowance Program in November 2005 such that the clients' specific medical problems now have to be identified by health care professionals, raising concerns about privacy, and the special diets cannot be tailored to clients' specific problems;

AND WHEREAS a number of community health centres are concerned that these changes are creating problems for their clients, including the Somerset West Community Health Centre which sent a letter to the Ontario Minister of Community and Social Services raising their concerns;

BE IT RESOLVED THAT the City of Ottawa communicate with the Ontario Minister of Community and Social Services requesting the following:

1. That the Province immediately review and revise the Special Diet Schedule with the objective of allowing approved health professionals to prescribe a special diet requirement for other medical conditions that are not currently listed on the form, including medical conditions that are not yet diagnosed; and

2. That the Province review the rates that people on ODSP and OW receive and raise them to a more reasonable level in light of current costs of living and the importance of effective treatment of health issues, and the need to consider a strategy of prevention.

COMMUNITY AND PROTECTIVE SERVICES

The Employment and Financial Assistance Branch of Community and Protective Services are generally supportive of the two recommendations reflected in this report.

FINANCIAL IMPLICATIONS

N/A

SUPPORTING DOCUMENTATION

Document 1 – Memo dated 22 February 2006 from the A/Director, Employment & Financial Assistance

Document 2 – Motion from PIAC

DISPOSITION

City Clerk’s office to follow-through on the direction provided by the Committee.

Document 1

M E M O / N O T E D E S E R V I C E

To / Destinataire	Councillor Alex Cullen	File/N° de fichier: File Number
From / Expéditeur	A/Director Employment and Financial Assistance
Subject / Objet	Special Diet Allowance for OW and ODSP Recipients	22 February 2006

Background

In April 2003 the Province (Ministry of Community and Social Services) updated the Special Diet Policy resulting in increased monthly funds available for certain types of diets and an expanded range of dietary items eligible for additional funding through the Special Diet Allowance. For example, the 2003 schedule included the following special diet items: Bottled Water, $30.00; Organic Diet, $190.00; Thickened Products Diet, $25.00; and Vitamin/Minerals and Herbal Supplements, $40.00. As well, the MCSS expanded the list of health professionals who are authorized to verify a client’s special diet needs to include registered nurses (extended class), midwives and dieticians.

The MCSS has always intended that eligibility for the Special Diet Allowance be directly linked to a person’s medical condition, however the Regulation that dealt with the allowance did not specifically state that a health professional had to certify that a person actually had a medical condition in order to recommend the issuance of additional funds to support a special diet need.

In early 2005 social policy advocacy groups, led by the Ontario Coalition Against Poverty (OCAP), began a campaign to help ODSP and OW clients access special diet funds by organizing community clinics where sympathetic health professionals would sign forms verifying that clients needed a special diet. OCAP believes that every person receiving OW or ODSP should be entitled to the full $250 monthly special diet as a way of addressing what it deems to be an inadequate level of social assistance benefits. As a result of this campaign, thousands of additional recipients across Ontario began receiving special diet funds. In some cases, each OW family member received the $250.00 monthly maximum special diet amount in addition to their regular monthly social assistance payment. For example, a couple with two children on OW assistance receives a maximum amount of $1215.00 per month for food and shelter. With the addition of the special diet funds, the entitlement for this family became $2215.00 per month. The MCSS, along with several municipalities, became concerned with the way in which the policy was being interpreted, ie. the allowance was being issued for reasons other than those originally intended by the MCSS and that this had significant financial impacts.

Provincial Response

Effective November 4^th, 2005 the Province, after having worked with the Ontario Medical Association, introduced amendments to the Special Diet Allowance policy under the OW and ODSP Acts. The changes included:

• The requirement for health professionals to confirm that a person has a specific medical condition in order to receive the corresponding allowance.
• The introduction of a Special Diet Application Form (see attached form). These forms are only issued to clients who may qualify for the special diet, and staff may only accept returned original application forms (no faxes or copies).
• A revision of the Special Diet Allowance amounts

Next Steps

As part of the implementation of the changes announced by the Province, all cases in receipt of the Special Diet Allowance on or before Nov 4, 2005 must be reviewed. Clients currently receiving the allowance are required to confirm their eligibility for the Special Diet Allowance by having an approved health professional complete the new application form. Clients have 90 days to return the completed form to their Case Coordinator. It is expected that this review process will occur over a period of 1 year.

Clients who meet the new requirement under the amended regulation will receive the allowance according to the amounts specified in the schedule. Clients currently receiving the allowance for a non-medical condition will not be eligible for the allowance however no overpayment will be created where a client does not meet the new criteria or where the allowance amount has been reduced.

When the Province announced the November 2005 policy changes they committed to reviewing the Special Diet schedule in the spring of 2006 and periodically thereafter to ensure that it reflects the medical conditions that require a special diet. As well, between these regular reviews, the Province stated that ad hoc reviews would be done as new medical conditions requiring a special diet are identified and that the schedule would be revised if required, based on these periodic and ad hoc reviews.

Since November, EFA has received some feedback from staff, clients and the community regarding the special diet changes and this feedback has been forwarded to the MCSS. To date the key issues that have been identified are:

· Some medical conditions, e.g. Hepatitis C, are not included in the revised special diet schedule, and

· There is no ability to issue the allowance prior to a diagnosis/confirmation of a medical condition eg when weight loss is apparent but the condition is not yet diagnosed

If you require additional information about the Special Diet Allowance policy, you may contact Micheline McTiernan, Program Manager with the EFA Branch (extension 43009 or Micheline.Mctiernan@ottawa.ca).

Original signed by

Janice Burelle

A/Director, Employment and Financial Assistance

cc: Steve Kanellakos, Deputy City Manager

Micheline McTiernan, Program Manager, Operations & Program Support

Document 2

PIAC MOTION OF 14 MARCH 2006

Whereas the current ODSP and OW rates are inadequate for those receiving such funding to have a decent quality of life (i.e., affordable housing, nourishing food, adequate clothing, etc.);

Whereas nourishing food is an essential element of physical and mental health;

Whereas many people receiving ODSP or OW receive inadequate support to cover nourishing food;

Whereas the Special Diet Allowance permitted those on ODSP or OW to supplement their diet with healthy food;

Whereas a healthy diet can prevent disease and other maladies not just help those who are coping with such health problems;

Whereas the province, without appropriate consultation, changed the Special Diet Allowance Program in November 2005 such that the clients' specific medical problems now have to be identified by health care professionals, raising concerns about privacy, and the special diets cannot be tailored to clients' specific problems;

Whereas a number of community health centres are concerned that these changes are creating problems for their clients, including the Somerset West Community Health Centre which sent a letter to the Ontario Minister of Community and Social Services raising their concerns;

It is recommended that the City of Ottawa communicate with the Ontario Minister of Community and Social Services requesting the following:

That the Province immediately review the criteria around the changes in the Special Diet Allowance program which occurred in November 2005, in order that recipients who previously received the Special Diet Allowance for medical conditions will again be eligible;

And that the Province review the rates that people on ODSP and OW receive and raise them to a more reasonable level in light of current costs of living and the importance of effective treatment of health issues, and the need to consider a strategy of prevention.

Health, Recreation and Social Services committee Report 31B extract of minutes 32 6 April 2006

Comité de la santé, des loisirs et des services sociaux Rapport 31B extrait du PROCÈS-VERBAL 32 le 6 avril 2006

SPECIAL DIET ALLOWANCE FOR ONTARIO WORKS AND ONTARIO DISABILITY SUPPORT PROGRAM RECIPIENTS

ALLOCATION DE RÉGIME ALIMENTAIRE SPÉCIAL POUR LES BÉNÉFICIAIRES D’ONTARIO AU TRAVAIL ET DU PROGRAMME ONTARIEN DE SOUTIEN AUX PERSONNES HANDICAPÉES

ACS2006-CCS-HRS-0005 CITY WIDE / À L'ÉCHELLE DE LA VILLE

Councillor Cullen introduced the item, noting there is a campaign to bring to the attention of the Province, the need to revamp the basic and shelter allowances for recipients of Ontario Works (OW) and Ontario Disability Support Program (ODSP). Following a briefing note from staff and circulation of same to the Poverty Issues and the Health and Social Services Advisory Committees, he explained his intention to put forward the joint recommendations put forward by those two committees.

Eugene Williams, Health Promotions Coordinator, Somerset West Community Health Centre provided the following arguments in favour of the City becoming strongly involved in encouraging the province to revisit the changes made for the Special Diet form and to raise the rates in general for OW and ODSP recipients:

§ Special Diet Form - research has determined that people living in poverty are more prone to various chronic diseases and there is a need to look at prevention issues. The new forms require providers to detail diseases with no possibility to suggest a diet that may be required and there is no room for practioners to do any health prevention and promotion work. It is very specific in terms of prescribing specific diseases where a special diet is warranted, so there is no room for clinical judgement, thereby compromising the patient/client relationship in terms of what they can do. They also support looking at the special diet provisions and encouraging the province to make them less restrictive, so all people are encouraged to eat healthy.

§ Assistance Rates for Recipients of OW and ODSP - the rates were dramatically cut in the mid-90’s resulting in a major impact on people living in poverty. They strongly urge the City to talk to the province with a view to raising those rates.

Leslie Gabos spoke about having to make ends meet on an already inadequate ODSP allowance and was particularly concerned about the impact on he and his wife, who is also on ODSP, by the proposal to drastically cut their Special Diet Allowance. Given the escalating rate of inflation, he recognized the dire need to increase the rates immediately and he did not believe people with legitimate disabilities should be made to suffer by reducing their allowances.

Christina Crawford was concerned that the new Special Diet Allowance forms do not include allowances for mental illness or environmental illnesses, although she understood that medications for mental health could be assimilated easier with a good diet. As an ODSP recipient, she related how she received a letter from the local ODSP office guaranteeing her Special Diet Allowance until the end of 2014. She therefore understood that legal clinics and individuals are saying that it is only in Ottawa that this letter was given and could therefore be considered a legally-binding document which can save the Special Diet Allowance. While she recognized that losing as much as $250/month would have a definite impact on her life, she was more concerned about people with mental disabilities who are unable to understand the issue and the subsequent impact this reduction would have on them. She suggested all three levels of government get together to discuss changes to the ODSP and OW allowances.

Vivianne Boivenue spoke on behalf of her sons who suffer from severe Tourette’s Syndrome. One of them receives the Special Diet Allowance to help diminish the ticks he experiences. Having an improved diet has made things a little easier for him and while his disability prevents him from working in a regular job, his improved diet has allowed him to do volunteer work. As a result of the recent letter about reductions in the Special Diet Allowance, he has experienced more violent ticks and as his only support, it is extremely difficult for her to witness.

Councillor Cullen indicated his intention to add the following recommendation to the existing Motion:

3. That this Motion be circulated to the Opposition critics, Ottawa-area M.P.P.s, the Association of Municipalities of Ontario (AMO) and the Association of Francophone Municipalities of Ontario (AFMO).

Moved by A. Cullen

WHEREAS the current ODSP and OW rates are inadequate for those receiving such funding to have a decent quality of life (i.e., affordable housing, nourishing food, adequate clothing, etc.);

AND WHEREAS nourishing food is an essential element of physical and mental health;

AND WHEREAS many people receiving ODSP or OW receive inadequate support to cover special diet requirements to meet their health needs;

AND WHEREAS the Special Diet Allowance permitted those on ODSP or OW to supplement their diet with healthy food;

AND WHEREAS a healthy diet can prevent disease and other maladies not just help those who are coping with such health problems;

AND WHEREAS the province changed the Special Diet Allowance Program in November 2005 such that the clients' specific medical problems now have to be identified by health care professionals, raising concerns about privacy, and the special diets cannot be tailored to clients' specific problems;

AND WHEREAS a number of community health centres are concerned that these changes are creating problems for their clients, including the Somerset West Community Health Centre which sent a letter to the Ontario Minister of Community and Social Services raising their concerns;

BE IT RESOLVED THAT the City of Ottawa communicate with the Ontario Minister of Community and Social Services requesting the following:

1. That the Province immediately review and revise the Special Diet Schedule with the objective of allowing approved health professionals to prescribe a special diet requirement for other medical conditions that are not currently listed on the form, including medical conditions that are not yet diagnosed;

2. That the Province review the rates that people on ODSP and OW receive and raise them to a more reasonable level in light of current costs of living and the importance of effective treatment of health issues, and the need to consider a strategy of prevention; and,

3. That this Motion be circulated to the Opposition critics, Ottawa-area M.P.P.s, the Association of Municipalities of Ontario (AMO) and the Association of Francophone Municipalities of Ontario (AFMO).

CARRIED