Mandatory Benefits
Ontario Works recipients, spouses and any dependents
may be eligible to receive Ontario Works mandatory
benefits.
Discretionary Benefits
Discretionary benefits are provided on a case-by-case
basis at the discretion of the First Nation Ontario Works
Administrator to:
• Ontario Works recipients, including Temporary
Care Assistance
• ODSP recipients
• ACSD recipients
The amount provided for discretionary benefits is
determined by the First Nation Ontario Works
Administrator.
Mandatory Benefits
Discretionary Benefits
Transitional Support Funding
Transitional Support Fund
MCSS provides 100% provincial funding to First Nation
Ontario Works delivery agents to address housingrelated needs on reserve for low-income individuals
and families, including Ontario Works and ODSP
recipients.
Ontario Works Policy Reference:
Ontario Works Directives: Section 7 – Benefits
Transitional Support Fund Interim Program Guidelines
To access these references please visit the Ontario Works
Extranet at
http://www.ontworks.css.gov.on.ca/forums/index.html
(The Ontario Works Extranet is password protected. If you
do not have the password please contact ONWAA)
Mandatory Benefits include: Ontario Works recipients, spouses and any dependents may be eligible to receive the following mandatory benefits: Health Benefits o Prescription drug coverage for items covered by the Ontario Drug Benefit (ODB) Program (ODB cards are issued monthly) o Dental and vision care for dependent children and children in temporary care (basic dental coverage, as outlined in MCSS Schedule of Dental Services and Fees for Mandatory Dental Coverage, and frames and lenses every 3 years) o Diabetic supplies, surgical supplies and dressings (With a physician’s prescription) o Medical transportation costs $15 and over (If service is not available by FNIHB Patient Transportation) o Consumer contribution for assistive devices and eligibility assessment under the Assistive Devices Program (ADP) o Batteries and necessary repairs for mobility devices o Routine eye examinations once every 24 months (ages 20-­‐64) o Extended Health Benefits Guide Dog Benefit o Due to a disability, has a specially trained dog certified for use as a guide, hearing or service dog by an accredited training facility is eligible for an amount of $76 per month to assist with the costs for routine care of the dog. Full Time Employment Benefit o Is provided to a recipient, a spouse included in benefit unit or a dependent adult to help with expenses associated with beginning full time employment. FTEB can be issued up to $500 in a 12-­‐month period of each eligible recipient. Other Employment and Employment Assistance Activities Benefit o Is provided to a recipient, a spouse in the benefit unit, a dependent adult not attending secondary school full time or a training program, or a dependent child who has graduated from secondary school. This benefit is provided to assist with costs associated with beginning or changing employment or an employment assistance activity. The maximum amount that may be provided for each eligible recipient of this benefit is up to $253 in a 12-­‐month period. Advance (up front) Child Care o May be provided to a recipient, a spouse included in the benefit unit, a dependent adult or a dependent child with a dependent child if in the opinion of the Administrator the person is required to pay in advance for child care that is necessary to permit employment or an employment assistance activity. This payment can be issued in any 12-­‐month period up to the maximum amount of actual costs for licensed child care under the Day Nurseries Act or up to $600 for unlicensed (informal) child care costs. Transitional Child Benefit o Is a mandatory benefit provided to assist recipients with dependent children under the age of 18 who are: o Not receiving the Ontario Child Benefit (OCB) and National Child Benefit Supplement (NCBS) o Receiving less than the maximum amounts of the OCB and NCBS o Receiving less than the maximum amount of the OCS and $0 NCBS o Receiving $0 OCB and less than the maximum amount of the NCBS o The amount of the TCB is up to a monthly maximum of $222 per eligible dependent child, and is recoverable in situations where a recipient receives a retroactive payment of the OCB and NCBS for the months in which a TCB is paid. The amount of the TCB may be recovered by a reduction of the recipient’s budgetary requirements. In these cases, the budgetary requirements will be reduced in the month following payment of the retroactive OCB/NCBS. o An overpayment of the TCB can only be created if the recipient is found to have been ineligible for the TCB. An overpayment cannot be created if the recipient is issued an incorrect TCB amount. Discretionary Discretionary benefits are provided on a case-­‐by-­‐case basis at the discretion of the FNOW Administrator to: • Recipients of Ontario Works; including Temporary Care Assistance Benefits • Recipients of Ontario Disability Support Program include: • Recipients of Assistance for Children with Severe Disabilities (ACDS) The FNOW Administrator determines the amount provided for discretionary benefits and approves all requests. Discretionary benefits decisions are non-­‐appealable. Health Related •
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Dental care for adults: o Emergency dental care which is necessary to relieve pain or for medical or therapeutic reasons o Dental care which supports the person’s employability or participation requirements Vision care for adults (eye glasses, including lenses and frames, repairs or replacements) when necessary as a result of a significant change in prescription or to support the person’s employability or participation requirements Prosthetic appliances (the recommendation of an approved health professional and estimate of the cost of such appliances are required) Funerals and Burials (recommended maximum of $2250 for funeral and burial or cremation costs) Heating payments and payments for low-­‐cost heating energy conservation measures (may be provided to recipients who are home owners or renters when recipient is responsible for utility) Non-­‐Health Related Vocational training and retraining (when costs do not meet the parameters of training under Employment Related Expenses) Travel and Transportation that is not for health-­‐related purposes (when administrators considers reasonable and appropriate, for example domestic violence, court, etc.) • Moving expenses (The Administrator may approve payments to cover the costs of moving household furniture from one place of residence to another) • Any other special service, item or payment authorized by the Director. The following special services, items or payments are currently approved by the Director: o air conditioners for severe asthmatics o chiropractic services o costs of completing medical o
electric breast pumps o northern allowance for communities forms not covered by OHIP, as th
south of the 50 parallel without year required to verify eligibility for o layettes and baby supplies o blood tests required for Applications round road access assistance, benefits or other for Support where the cost cannot o wheelchair and mobility devices (e.g., required purposes be paid by some other means (e.g., lifts) batteries, replacement batteries o replacement or repair of Legal Aid) and necessary repairs essential household furniture o
cost of preparing a will where the o provision, replacement and repairs of and appliances, cost cannot be paid by some other hearing aids including batteries for o replacement or purchase of means (e.g., Legal Aid) the portion not covered by the smoke alarms and batteries for o
initial deposits required by landlords Assistive Devices Program recipients who own their or others for rent, hydro and heating o certification of a learning disorder by homes and are not in receipt of where necessary a qualified medical doctor or the maximum shelter o
payments for continuation of hydro psychologist allowance, or heating service, or to prevent o cost of an alerting system (e.g., light-­‐ o replacement of household eviction, payments for low-­‐cost flasher, bed-­‐shaker or other items and personal effects in energy and water conservation appropriate alerting mechanism) if emergency situations (e.g., fire, measures the recipient or a member of the flood, storms) benefit unit is deaf or hearing o electric beds to avoid bedsores impaired for persons confined to a bed •
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In addition to the approve list, the Director has authorized the provision of special services, items or payments for: • Health-­‐related purposes (excluding the cost of prescription drugs) where the First Nation Ontario Works Administrator has made a determination of need based on verifiable documentation, and failure to provide would result in a detriment to the health of the recipient or a member of the benefit unit. The payments are based on actual costs. • Non–Health Related purposes on a case-­‐by-­‐case basis up to a maximum of $250. If the costs are more than $250 then approval is needed from Director. Transitional There are a range of services and supports this funding may be used for, including assistance with: • Rent deposits Support Fund • Fuel and hydro deposits includes: •
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Prevent the discontinuance and/or assist with the reconnection of utilities or heating in an existing residence Establish a new principal residence Arrears relating to shelter costs Arrears relating to utility costs and/or Other services, items or costs necessary to maintain the safety or well-­‐being of a person in the household, where such supports cannot be provided for through other means. Funding may not be used to build new structures or conduct major renovations on existing structures. Ontario Works delivery agents determine eligibility for support through the TSF, and establish local policies and practices with respect to the eligibility of individuals for the TSF, including low-­‐income applicants. Where do you claim your expenses?
For First Nations administering Ontario Works; there are three types of funding envelopes that support the delivery of Ontario Works. Mandatory Benefits Expensed through your Subsidy Claim (Form 5) Mandatory Benefits are included in Basic Financial Assistance and includes the provision of income assistance, benefits and emergency assistance to eligible Ontario Works recipients. 3. Residents with These eligible expenses do not Status Non-­‐
Non Members Members Status come out of your Discretionary Benefits funding allocation if Mandatory benefits for they are recorded correctly on Ontario Works Diabetic Supplies the subsidy claim. Surgical Supplies and Dressing Medical Transportation Dental Coverage for Dependent Children Guide Dog Allowance Full Time Employment Other (specify) Discretionary Benefits Discretionary Benefits funding allocation is based on your caseload. Caseloads included the combined monthly total of Ontario Works and Ontario Disability Support Program (ODSP) recipients. 2. Residents with Non Status 1. Less than 250 cases Status Non-­‐Members • Will be allocated an Members amount of $2500 per Discretionary Benefits Verification of Travel and month ($30,000 expenditures Transportation (Health annually) must be kept on Related) file for future Funerals and Burials 2. 250 or more cases reference. Dental Services • Will be allocated based Prosthetic Appliances on the capped funding including Eye Glasses formula of $10 per case Vocational Training or Retraining per month Other –Health Related Benefits 3. Group Delivery Other – Non Health • Will receive funding Related Benefits based on the combined First Nations must track and monitor expenditures to ensure total of all First nation expenditures are within funding allocations. Once you deplete your caseloads within their Discretionary budget, your budget will remain at $0 until the new organization at a capped fiscal year. rate of $10 per case per Funeral and Burials costs up to $2250 is charged to Discretionary month Benefits. Any costs above the initial $2250 is charged 100% Provincial in section 4 of the Subsidy Claim. Recorded through your Subsidy Claim (Form 5), tracked in your software system using the Discretionary Benefits Tracking tool. Transitional Support Fund Expenses are reported in the MCSS QTR reporting budget packages. Funding for the Transitional Support Fund is 100% Year to Date Report – Service /Budget Schedule Provincial. Region: First Nation : First Nation Transitional Contract Q1. Q2. Q3. Q4. Fiscal 2013/14 Support Fund TSF) allocations Amount will be based on combined expenditures of the following: Expenditure Summary Expenditures Q1 Q2. Q3. Q4. 2013/14 YTD • 2011-­‐2012 Community Social Start Up and Assistance Maintenance Benefit Clients (CSUMB) Expenditures • 2011-­‐2012 Emergency Non Social Fund (EEF) and Assistance Recipients • 2012-­‐2013 Discretionary Non-­‐SA Benefits in excess of the ADMIN $10 per case cap Variance =TOTAL FIRST NATION % Variance The Transitional Support Fund expenses are NOT claimed on the Subsidy Claim Form. Transitional Support Fund expenses are reported quarterly as part of your Ontario Works budget submission package. Verification of expenditures must be kept on file for future reference. First Nations must monitor budget to ensure expenditures do not exceed funding allocations. TRANSITIONAL SUPPORT FUND (TSF) ALLOCATION First Nations may use up to 10% of the TSF allocation to deliver the TSF to non-­‐social assistance recipients. Discretionary Benefits
Ontario Native Welfare Administrators Association 150 Churchill Blvd. P.O. Box 20119 Sault Ste. Marie, Ontario P6A 6W3 Telephone 1-­‐877-­‐291-­‐7942 www.onwaa.com Discretionary Benefits may be granted to persons in receipt of Ontario Works or Ontario Disability Support
Program when they experience a need. Discretionary benefits are provided on a case-by-case basis at
the discretion of the First Nation Ontario Works Administrator
It is the responsibility of the recipient to ensure that all supporting documentation and estimates
of the costs are provided to First Nation Ontario Works. Recipients will be required to seek
alternative funding or resources when required.
For example, First Nation and Inuit Health Branch or other resources.
First Nation Ontario Works must:
1. Determine if the item requested is reasonable and necessary in the opinion of the FNOW
Administrator.
2. Ensure sufficient monies of disc benefits funding is available before approving any requests.
3. Confirm that the item requested is not a mandatory health benefit that is provided by Ontario Works
or Ontario Disability Support Program.
4. First Nations must monitor budget to ensure expenditures do not exceed funding allocations.
5. Ensure that you are allocating benefit to the correct line item in the Subsidy Claim Form.
6. FNOW Administrator and/or caseworkers must document details of the request on file or within your
existing computer program. (AD MORRISON, etc.)
Transitional Support Fund Job Aide
OW/ODSP/Low Steps
Income
Ontario Works 1. Ontario Works recipient must complete Application Form for TSF.
Recipients
2. Ontario Works recipient must provide supporting documentation that all available
resources have been exhausted.
3. First Nation Ontario Works Administrators should determine if recipient qualifies for
any Ontario Works supports, Mandatory Benefits or Discretionary Benefits
• If an Ontario Works recipient qualifies for Ontario Works assistance or benefits,
the FNOW Administrators should provide from Ontario Works assistance and
benefits first. For example:
a. Ontario Works shelter directive allows for payments of arrears related to rent,
utilities or heating when shelter costs are below the maximum shelter
amount. For example;
• A sole support parent with two dependents with shelter costs:
Rent
$450.00
Heating costs
$108.00
Total
$558.00
• The difference of Max Shelter $648.00 – and actual costs $558.00 = $90
The remainder of the shelter monies ($90) can be applied towards
arrears related shelter such as rent, utilities, or heating.
b. Ontario Works shelter directive also states: if heating costs exceed the
maximum allowable shelter amount, the shelter amount payable is the
actual heating costs. Actual heating costs must be documented.
• A two person family – Maximum Allowable Shelter: $596
Shelter
$300.00
Heat
$600.00
Shelter costs
$900.00
• The maximum allowable shelter amount is $596. In this example, the
benefit unit would receive $600, which is the amount to cover actual
heating costs. If shelter amount is the actual heating costs, the shelter
amount should be reviewed and adjusted when the cost for heating is
reduced (i.e. spring/summer)
c. If OW recipient does not qualify for any Ontario Works Benefits then FNOW
Administrator may determine eligibility for TSF.
4. First Nation Ontario Works Administrator is satisfied that no other resources are
available to help the applicant/recipient, then FNOW Administrator may approve
a reasonable amount to cover costs of eligible situation.
Ontario
Disability
Support
Program
(ODSP)
Recipients
1. ODSP recipient must complete Application Form for TSF.
Low Income
Recipients
1. Low-income recipient must complete Application Form for TSF.
2. ODSP recipient must provide supporting documentation that no supports are
available from ODSP. For example mandatory ODSP benefits.
3. If First Nation Ontario Works Administrator is satisfied that no available resources or
supports is available to help the ODSP recipient, then FNOW Administrator may
determine a reasonable amount to cover costs of eligible situation.
2. Low-income recipient must submit verifiable income.
3. Low-income recipient must provide supporting documentation that all available
resources have been exhausted.
4. If First Nation Ontario Works Administrator is satisfied that no other resources are
available to help the client, then FNOW Administrator may determine a
reasonable amount to cover costs of eligible situation.