Disorganized Disadvantaged
Disconnected
Accessible Income
Support
What is Income Support?
Ontario Works
• Basic financial and employment supports for
people seeking long-term employment
• Goal is to assist participants to prepare for,
obtain and sustain employment and to make
the transition to long term self-reliance.
• Three components of Ontario Works:
Employment Supports, Placement, and
Community Participation
Income Support Continued
ODSP
• Financial assistance and benefits to
individuals and families living with disability
that is expected to last 1 year or more
• Individuals are required to complete an
application to qualify for these services
• Benefits paid to participants exceed allowance
provided by Ontario Works program
Income Support Continued
Canada Pensions Plan Disability
• Disability benefit is available to people who
have made enough contributions and those
disability prevents them from working at any
job on a regular basis
• The disability must be long lasting or likely to
result in death
• People who qualify for disability benefits from
other programs may not qualify for CPP-D
Application Process
• Applicants for ODSP must also complete
the “Disability Determination Package”
after they are found financially eligible
• Key information needs to be completed
by a medical professional and then
reviewed
• The applicant is then granted ODSP or
denied based on the material
Application Process
• Applicants deemed ineligible on their
application have a right to an internal review
of the decision
• Then a hearing can be made before the Social
Benefits Tribunal
• Canada Pension has a similar process but
applications are available to the public and no
financial assessment is necessary to apply
• A person who qualifies for CPP-D is
automatically medically eligible for ODSP
Origins of the Project
Thomas
• Connected with Brain Injury Association in
2003
• Despite a major brain injury had been living
on Ontario Works Income Support for several
years
• Had no family doctor
• Had been unable to apply for Ontario
Disability Support Program
Origins Continued....
• Thomas was connected with outreach
services
• The process of locating a doctor,
completing the application, appealing
the decision, and attending tribunal took
24 months.
• During that period the client experienced
several major health issues, a housing
crisis, and a bankruptcy
Origins Continued....
• Thomas was granted ODSP at hearing
• At the conclusion of this process staff
were surprised at the degree that this
work changed the individuals life
• Staff then began to work on the premise
a formalized service in this area could be
effective in the same way with a large
number of Durham Region residents
Origins Continued...
• Collaborative committee met in February 2009
• A pilot project was developed
• Proposal submitted to the Ontario Trillium
Foundation and funding was granted in July of
2009
• The Brain Injury Association of Durham Region
agreed to act as the lead partner in the venture
• Staff were hired and a Launch Event was held in
Uxbridge Ontario
Who is Involved
The Transitional Support
Coordinator Initiative is a
group consisting of:
• Community
Employment Resource
Centre-Beaverton
• Cornerstone
Community Association
• Durham Community
Legal Clinic
• Durham Mental Health
Services
• Durham Region Social
Services: Income
Support Division
• Brain Injury Association
of Durham Region
• Literacy Network of
Durham Region
Service Model
• Project serves individuals with serious mental
health issues, cognitive impairments and other
complex issues
• Serves those that require extensive support and
those unconnected to support services
• Support required, is not offered by OW or ODSP
• Staff member works to complete the application
and to improve and stabilize the individual’s life
• Aims to minimize barriers accessing services and
have as few requirements for service as possible
Service Model Cont...
To obtain our service the individual must:
• contact the service directly (no third party
referrals are taken)
• feel they require support applying for
ODSP/CPP
• identify themselves as an individual with a
disability that impacts their life significantly
Support Provided
• Securing identification
• Obtaining medical
services
• Accessing supports
• Completing income
support applications
• Navigating the process
of ODSP or CPP-D
• Applying for additional
income by completing
income tax returns and
tax credits
• Arranging services and
accompanying individuals
to appointments
• Support maintaining
income
• Keeping notes and
reminders to ensure
follow through
• Reminder phone calls and
support maintaining a
schedule
Income Support Application
Staff ensures that people:
• can fill out their portion of the application
• are supported when locating medical
documents to establish medical history
• are supported in collecting their documents
to confirm income eligibility
• are supported in additional work to ensure
they can pursue other goals including
employment and education
Individuals Involved
• 82% of individuals are in receipt of regular
Ontario Works benefits
• 42% have required support in maintaining their
income support, as they struggle to complete the
basic requirements
• Often individuals were introduced to our program
while struggling to complete their intake for
Ontario Works
• At the time of intake 78% of individuals were
unconnected to any community support services
• 20% had no income at the time of intake.
Process Timeline
ODSP Application
Internal review
Social Benefits Tribunal
Tribunal Decision
90 Business Days
30 Days
8-12 months
60 Business Days
Barrier: Accessing Medical Services
Key barriers identified by individuals were
• Obtaining a family physician willing to accept them
• Following through with medical appointments and
instructions
• Being able to communicate with medical staff
• Obtaining records
• Lack insight into their condition
• Inability to advocate for their own health
• Lack of health card or identification
• Literacy, memory and comprehension issues
Barrier: Access to Support Services
• At initial contact, 78% of individuals were not
connected to any other local services agencies
• Many lack the diagnosis or insight into their
impairment for specific services
• Service “silos” leave many unsure that help is
available for them
• Individuals struggling with learning
impairments along with various unknown
cognitive impairments often have few options
for support
Barrier: Accessing Service
• Lack of diagnosis to
connect with specific
services
• Unawareness of help
being available
• No support services
available for their
conditions
• Reluctance to disclose
specific impairments
• Inability to navigate
community services and
advocate on their own
behalf
Lucy and Wayne: Case Example 2
• Lucy and Wayne lived 10 years without
income support
• Both experienced brain trauma
• Lucy from a car accident and Wayne from a
stroke
• They were living off a small insurance
settlement they obtained after Lucy’s car
accident
• After that ran out they had no funds for nearly
2 years
Lucy and Wayne: Case Example 2
• Lucy and Wayne had no gas or electricity
• No income and unable to follow through with
ODSP, CPP or Ontario Works
• A notice for termination of water was received
and had not addressed this bill in nearly six
months
• Wayne suffered from extreme anxiety and panic
that resulted in him not opening mail
• They were buying food by selling items
• Each had not had a family doctor in over 5 years
and needed support attending appointments
Lucy and Wayne: Case Example 2
• Both were supported in obtaining and
remaining on Ontario Works
• They obtained a family doctor, neurologist,
and psychiatrist
• Staff accompanied them to psychiatrist, family
doctor, and specialist appointments
• Special Diet Allowances were obtained when
both were diagnosed with wasting due to
losing more than 20% of body weight
Lucy and Wayne: Case Example 2
• Lucy’s ODSP application was submitted and
denied
• An internal review(with staff support letter)
and complaint was filed due to Lucy being
denied without explanation
• The internal review was granted
• Support was obtained through the Durham
Region Energy Bank and Ontario WorksCommunity Start-Up and the utilities were
turned back on
Barrier: Income Support Application
Clients Struggle with
• Understanding the Requirements
• Timeline and Communication
• Appeals and Social Benefits Tribunal
Process
Barrier: Application Process
Key barriers identified
• Inability to follow through and complete
paperwork
• Lack of transparency in process
• Lack of clear language in communications
• Lack of relevant information provided when
denied
• Limited access to health services and files
Barrier: Application Process
• Difficulty comprehending the application and
appeal
• Difficulty obtaining medical information and
documentation
• Lack of insight of the person into their own
impairment
• Stabilizing during wait period
• Attending and participating accurately in
hearing
Cognitive Impairments
• Cognitive impairments represent 68% of
the people of connected
• Includes those with acquired brain
injuries, learning disabilities,
developmental issues, and unknown
impairments
• Often reported long histories of
difficulties including challenges in school
Cognitive Impairments
• Long term struggles with literacy
• Reported serious injuries, educational
challenges, behavioural issues or illnesses
• 53.5% of individuals reported that a medical
professional was not treating or aware of
the barriers
• 24.2% of these individuals had no family
physician
Cognitive Impairments
• 28% of individuals
supported by the
program had no income
source
• 79% of individuals
required OW
• 60% of individuals had
been on Ontario Works
for more than one year
• 32% more than 5 years
• 10% for more than 10
years.
• 82.8% were unsupported
by any community based
services
Clients with Cognitive Conditions
Income Support(Time on Ontario
Works)
90
80
70
60
50
40
30
20
10
0
No Income
OW
1 year
5 years
10 years
Keith: Example 3
• Keith had been living on Social Assistance for
over a decade
• He struggled with an undiagnosed cognitive
impairment along with considerable mental
health and addiction issues
• He had not had a family doctor until recently but
the doctor was located in Port Hope
• He had applied for ODSP 3 times in the past 10
years and was unable to complete the process
Keith: Example 3
• No explanation was provided by Keith on why
he was denied for his applications
• Each time he became discouraged an unable
to follow through the appeal requirement and
felt their was “no point since he was told he
was not disabled”
• Keith was referred to the initiative by Ontario
Works
Keith: Example 3
• Staff accompanied Keith monthly to his family
doctor
• He was referred for testing and previous
medical documents were obtained
• An ODSP application was submitted but Keith
received no response in over 7 months
• He was support in calling and making a
complaint and was granted a week later
• He continues to be supported transitioning to
ODSP
Cognitive Conditions
Cognitive Related
Number
%
Comment
Clients with
Cognitive conditions
177
68%
Includes clients with conditions like Acquired
Brain Injury, developmental disabilities,
learning disabilities , and unknown cognitive
impairments. % indicate percentage of total
caseload that have identified cognitive
difficulties
Clients with no
doctor
39
22%
Number of clients that had no family doctor at
time of first contact with TSC program
Clients supported to
obtain new doctor
39
22%
Clients that found new doctor with support of
Transitional Support Staff
Clients who’s
cognitive condition
was untreated
124
70%
Clients who reported no current/historical
treatment for cognitive conditions at time of
first contact with TSC program
Cognitive Stats Cont......
Cognitive Related
Number %
Diagnosis obtained
25
24%
Clients with cognitive
impairments that have
completed ODSP/CPP
application
Clients who have
accessed specialist for
their cognitive conditions
Clients granted
ODSP/CPP income
support
77
73%
23
22%
75
42%
Comment
Number of clients that were diagnosed with
a cognitive impairment with support of TSC
program
Clients whose completed ODSP/CPP
application is being supported by TSC
program
Clients whom received support accessing
medical specialists for cognitive related
condition
Clients whom were granted ODSP/CPP
while supported by TSC program
Brian: Example 4
• Brian contacted the program after struggling
for 10 years to obtain employment
• He was dismissed from over 40 jobs in the
past 10 years
• He had no financial support
• He had no family doctor during his adult life
and his medical history was unclear
• He had also lost the support of his
psychiatrist due to being unable to
remember his appointments
Brian: Example 4
• Brian was supported to obtain a family doctor and staff
attends theses appointments with him
• He would also frequently let his prescriptions run out
and need to renew them after they are empty
• Brian was referred for a psycho-educational
assessment by Ontario Works
• The assessment reveal significant, cognitive barriers,
along with a major diagnosis of ADHD
• An ODSP application was submitted and granted in 6
months
• Staff currently meets with Brian weekly to maintain a
schedule and complete the requirements of Ontario
Works
Quantitative Outcomes
• Individual data reported below reflects service
delivery for 36 months at 5 days per week
with one full time employee
• 80% of individuals have completed their ODSP
application package
• 122 have been supported in obtaining ODSP
or CPP-D income support
Detail
Number
%
ODSP/CPP
Applications
Completed
142
54%
Includes only applications completed
with staff support
Appeals Filed
144
54%
Includes number of Individuals who
have been supported in making internal
review/SBT requests(maximum one
individual counted per appeal)
Applications granted
122 or
119
46%
45%
ODSP/CPP files granted at any stageNote that 3 Individuals had both CPP
and ODSP files granted
Individuals with
applications
completed or granted
211
80%
Includes all individuals who have
completed an application
Final decisions lost
SBT
3
Comment
1.1% Individuals at this stage are offered
support to reapply
Added Value
•
•
•
•
•
•
•
•
•
•
71 supported in filing their income taxes
158 income tax returns have been filed
77 supported in obtaining transportation
37 have received Special Diet Allowances
3 have obtained the Trillium Drug Plan
29 were supported in obtaining Ontario Works
93 supported with OW suspensions
43 supported in obtaining a family doctor
43 individuals have received medical assessments
10 individuals have applied for the Disability Tax
Credit
Qualitative Outcomes
Staff provides direct
support in
• Health
• Housing
• Recreation
• Access to food
• Income security
Impact of Direct Support
• Less fear
• Increased stability day
to day living
• Increased Connection
• Increased
Independence
• Better Health
• Increased voice
Disability Adjudication Process
• Applications granted on initial
submission generally took over 6 months
to receive a cheque
• Those needing to appeal took 14 months
to get their response and first ODSP
cheque(current wait period over 18
months)
• In the past many of these clients missed
their hearings after the long wait
TSC Service Challenges/Limitations
• Time for individual
contact
• Resources
• Methods of contact
• Frequent wait lists
when program is full
• Accessing people in
northern locations
Program Costs and Benefits
Operating Costs
• $75,000.00 per year grant
from Ontario Trillium
Foundation
• Operating on one staff full
time staff
• 95% of the budget went to
direct service(staff, travel and
client related expenses)
• Office space and
administration donated in-kind
• Ongoing funding obtained in
partnership with Region of
Durham
Benefits
• Reduction of Ontario Works
Costs
• Reduced dependency on
emergency medical services
• Reduction of use of
emergency Social Services
• Improved overall health
• Improved access to
alternative income
• Decrease levels of
incarceration
Program Cost and Benefits
• The average client supported in obtaining
ODSP was in receipt of Ontario Works for 4.5
years
• A majority in contact with the program had
little success completing an application
• Most would not have completed the process
without support
Cost Per Case
Detail
Number
Cost Per Year
Comment
Total Cost for
OW Client
$ 30,009.44
Cost for Durham 17%
Region
$ 5271.60 per
person
Individuals
Supported to
exit Ontario
Works
$ 548,246.40
Total cost per year in
benefits and
administration
Durham Region is
currently responsible for
17% of the cost for each
client
People supported in
leaving OW caseload
through ODSP (or other
strategies)
95
Program Cost and Benefits
• The first two year investment of $225,000.00
has saved the Region of Durham an estimated
$548,246.40 per year by supporting people in
accessing appropriate income
• This is along with undeterminable savings in
areas of health, legal, correctional and court
services, and housing
Questions?
Thank you for listening