|
1. CHANGES TO THE ELIGIBILITY
CRITERIA FOR THE ESSENTIAL HEALTH AND SOCIAL SUPPORTS (EHSS) AND HOME SUPPORT
SERVICES (HSS) PROGRAMS CHANGEMENTS APPORTÉS AUX CRITÈRES D’ADMISSIBILITÉ
AUX SERVICES SOCIAUX ET DE SANTÉ ESSENTIELS (SSSE) ET AUX PROGRAMMES DES
SERVICES D’APPUI À DOMICILE |
Committee RecommendationS
That Council approve the following changes to the
EHSS and HSS Program eligibility requirements as follows:
1) Approve the replacement of the current needs testing with
income-testing using after tax Low Income Cut-Off (LICO), an established and
accepted measure of poverty.
2) Expand the current EHSS and HSS asset policy definitions to
mirror ODSP’s policy definition of exempt assets (Appendix 1).
3) Implement these changes in 2011 subject to approval of the
estimated additional costs as part of the 2011 budget process.
RecommandationS DU Comité
Que le Conseil approuve les changements
suivants aux conditions d’admissibilité du programme de Services d’appui à
domicile et de Services sociaux et de santé essentiels (SSSE) :
1) Approuve le remplacement
de l’évaluation des besoins actuelle par l’évaluation des revenus à l’aide du
seuil de faible revenu (SFR) après impôt, une mesure de la pauvreté bien
établie et acceptée.
2) Élargir les définitions
de la politique des SSSE et des Services d’appui à domicile concernant les
avoirs pour qu’elles tiennent compte de la définition de la politique du
Programme ontarien de soutien aux personnes handicapées (POSPH) sur les avoirs
exemptés (Annexe 1).
3) Mettre en œuvre ces
changements en 2011 sous réserve de l’approbation des coûts supplémentaires
estimés dans le cadre du processus budgétaire de 2011.
Documentation
1. Deputy City Manager's report, City
Operations dated 16 June 2010 (ACS2010-COS-CSS-0009).
2. Extract of Draft Minutes, 29 June
2010.
Report to/Rapport au:
Community and Protective Services
Committee/
Comité des services communautaires et de protection
and Council / et au Conseil
June 16, 2010 / le 16 juin, 2010
Submitted by/Soumis par:
Steve Kanellakos, Deputy City Manager/Directeur municipal adjoint,
City Operations/Opérations municipales
Contact Person/Personne ressource: Aaron Burry, General Manager
Community
and Social Services Department/ directeur générale,
Services
sociaux et communautaires
(613)
580-2424 23666, Aaron.Burry@Ottawa.ca
REPORT RECOMMENDATIONS
That the Community and Protective Services
Committee recommend Council approve the following changes to the EHSS and HSS
Program eligibility requirements as follows:
1) Approve the replacement of the current needs testing with
income-testing using after tax Low Income Cut-Off (LICO), an established and accepted
measure of poverty.
2) Expand the current EHSS and HSS asset policy definitions to mirror
ODSP’s policy definition of exempt assets (Appendix 1).
3) Implement these changes in 2011 subject to approval of the estimated
additional costs as part of the 2011 budget process.
RECOMMANDATIONS DU
RAPPORT
Que le Comité des services communautaires et de
protection recommande au Conseil d’approuver les changements suivants aux
conditions d’admissibilité du programme de Services d’appui à domicile et de Services sociaux et de santé essentiels
(SSSE) :
1)
Approuver
le remplacement de l’évaluation des besoins actuelle par l’évaluation des
revenus à l’aide du seuil de faible revenu (SFR) après impôt, une mesure de la
pauvreté bien établie et acceptée.
2)
Élargir les définitions de la
politique des SSSE et des Services d’appui à domicile concernant les avoirs
pour qu’elles tiennent compte de la définition de la politique du Programme
ontarien de soutien aux personnes handicapées (POSPH) sur les avoirs exemptés
(Annexe 1).
3)
Mettre en œuvre ces changements en
2011 sous réserve de l’approbation des coûts supplémentaires estimés dans le
cadre du processus budgétaire de 2011.
BACKGROUND
The Essential Health and Social Supports (EHSS) program was established
in 1998 to fill a gap created when the Province abolished the Special
Assistance (cost shared 50/50) and Supplementary Aid Programs (cost shared
80/20) that assisted low income residents with essential health related items.
The EHSS Program is 100% funded by the City of Ottawa, and approved by
Council. Low-income residents are
assisted with the purchase of items or services such as dental care, vision
care, medical supplies such as prosthetic appliances, diabetic supplies,
hearing aids, and bathroom aids, as well as essential appliances, funerals and
burials. Many EHSS applicants have one-time requirements for the
above-mentioned items or services, while others have longer-term needs that
require ongoing case management by Social Services staff.
The Home Support Services (HSS) Program promotes quality of life for
eligible residents of Ottawa by providing and purchasing home help services including housekeeping,
instruction on preparing nutritious low-cost meals, respite child care and delivering workshops
in the community on topics such as cooking, parenting and living on a low
income. The
program is 80% provincially funded subject to an annual subsidy allocation
limit but open to review with the Province.
On April 12, 2006, Council approved a recommendation to increase the
asset limits for both EHSS and HSS to those allowed under ODSP (an increase
from $3,000 to $5,000 for single people). Although the ODSP asset limits were
adopted, the asset exemption policies were not.
On June 2009, Councillor Cullen put forward a motion to explore
increasing the asset limit for EHSS and HSS from the current $5,000 to $10,000
for non-cash items. Staff were directed
to review this proposal including costing and implementation considerations.
On February 10, 2010 Council approved the Ottawa Poverty Reduction
Strategy. Recommendation 2, which falls
under the strategy to provide a service system that benefits people in need,
relates to the EHSS and HSS Programs as follows:
“Streamline the needs assessment of Essential
Health and Social supports and Home Support Services for people in need”.
This report will address the above recommendations.
DISCUSSION
In order to assess the financial and
administrative impacts of the recommendations, the following reviews were
undertaken:
1.
Inquiry
with other cities about their delivery of similar programs.
2.
Demographic review and comparison of income and
asset levels of current EHSS and HSS program recipients.
3.
Review of new EHSS and HSS applicants in order to
assess the impact of the proposed recommendations.
Similar programs in other cities
A telephone survey of five similar sized municipalities was conducted
in the fall of 2009. Survey findings are summarized as follows:
§ All five
municipalities reported having programs similar to Ottawa’s EHSS, 100%
municipally funded program.
§ Most municipalities use some form of needs or income
test and all allowed discretion when looking at income and assets on a case by case
basis.
§ The majority of
municipalities use the ODSP asset limits in their determination of
eligibility.
§ In terms of items
or services provided, Ottawa provides a broader range of items to clients.
§ Most municipalities
provide the same
type of benefits to low income clients as are provided to social assistance
recipients.
§ Most municipalities
have a ‘mail in’ application process with flexibility of onsite or offsite
appointments
Demographic Review of Low-Income residents in receipt of EHSS or HSS*
(based on June 2009 caseload)
*Approximately 80% of all HSS
clients are in receipt of either Ontario Works or ODSP benefits. They were
excluded from this review as the objective was to compile information related
to low income residents (ie. income other than social assistance) who are
recipients of either EHSS or HSS.
§
Gender: There
were more females (66%) than males (34%).
§
Family
Type: Most recipients were
single (76%), followed by married (13%), single parent (6%), and families (5%).
§
Age: The majority of clients were seniors (65+)
at 73% (see Appendix 2 for further detail on age comparison with overall
City of Ottawa population).
§
Income Levels
- To assess the impact of using LICO for
determining eligibility, average client income by family size, was
compared to LICO amounts. In all
family size categories, the average income of existing cases was under
the LICO amounts (Appendix 3).
§ Asset Levels
o The average asset amounts were equal to
approximately 20% of current allowable asset levels.
o
Average
asset levels did not necessarily parallel family size with the highest level of
assets recorded for families of two at $1,495 and the lowest for families of 5
at $707.
o
Bank
accounts were the most commonly declared assets, followed by life insurance
policies.
Review of New Applicants to the EHSS/HSS Programs (January-February
2010)
To assist in assessing the
potential impact of changes to the EHSS/HSS eligibility criteria, data was
analyzed for 356 new applicants during January and February 2010. Applicants to EHSS/HSS programs were asked a
series of questions involving basic demographics, as well as income and asset
information. This information was used
to determine eligibility for the programs using both the needs testing (current
method) and the LICO testing (proposed method), as well as determining whether
changes to the asset limits or definitions would have a significant impact.
·
Demographics: The majority of demographic
traits were similar for both the ongoing caseload and the new applicants, with
the exception of age. The applicant
group tended to be younger than the ongoing caseload with fewer seniors (41%
senior applicants compared with 73% seniors comprising the ongoing caseload).
·
Income:
The majority of applicants claimed some type of income such as: pensions
(38%), earnings (30%), OSAP (7%), and Employment Insurance (5%).
·
Assets:
Slightly more than 50% of the applicants declared assets, with 44%
declaring a bank account, 5% with other assets such as life insurance and a
second property and 3% claimed RRSPs. Asset amounts and types were found to be
similar to those claimed by the ongoing caseload.
·
Eligibility - Using LICO and adopting the ODSP asset exemption policies:
o
Based
on the preliminary information provided by new applicants during their
telephone screening, it is estimated that 84% of the new applicants in January
and February 2010 would have qualified for EHSS/HSS benefits under the proposed
changes, compared to 72% using the current needs test method (see Appendix
4). This provides for a net increase of
12% of applicants being eligible under the proposed changes.
o
Adopting
the ODSP asset exemption policies would be beneficial to a small number. Only
two additional applicants during the two month review (or an estimated 12 cases
per year) would have qualified; both were seniors with cash surrender values on
their life insurance policies.
Currently, cash surrender values
are counted as assets, however, under the recommended change, they would
be exempt
o
Of
further benefit to seniors, with respect to the recommendation of adopting the
ODSP asset exemption policies, is that there would be a streamlining of the
EHSS/HSS eligibility requirements allowing seniors to move from ODSP to EHSS,
when they no longer qualify for ODSP at the age of 65, but remain in need of
essential health items.
·
Eligibility – Increasing the asset
limit from $5,000 to $10,000 for non-cash items:
o
Based
upon the January and February 2010 applicant sample, only one additional
applicant (or an estimated six per year) would have been eligible for EHSS or
HSS services.
In addition to an increase in the
number of clients who will qualify if the eligibility changes are implemented,
it is anticipated that there will be a streamlining of the application process
associated with a move from the current needs test to the recommended income
based testing. The current needs based testing requires clients to provide
multiple documents showing proof of expenses such as heat, hydro and rent. These documents and expenses must be verified
by staff. The income based testing
(LICO) would significantly reduce the number of verification documents and
would result in a less intrusive list of questions posed to applicants. Administrative efficiencies may also be
attained resulting from staff having to spend less time on reviewing and filing
documents.
This streamlined application process
would also provide an opportunity to create an on-line eligibility calculator.
This would allow potential applicants to pre-screen themselves prior to
contacting Social Services.
Conclusion
Implementing the recommendations to
move to a LICO income test and adopt the ODSP asset exemption policies will
help an increased number of people and streamline the application and
verification requirements so that vulnerable residents face a less intrusive
process.
It is
recommended that the above changes be implemented effective 2011. The estimated
additional costs will create a budget pressure as follows:
·
EHSS 100% City: $166K gross and net
o
Calculation
is based upon EHSS costs for 2009: the average cost per EHSS item was $307 and
each client required an average of 2.9 items.
o
A
projected increase 186 new applicants (174 due to LICO changes and 12 related
to asset rule changes) would cost approximately $166K.
·
HSS:
$205K gross and $41K net
o
Calculation
is based upon a projected increase of 60 additional applicants per year who
would be eligible using the new criteria, at an average cost of
$3,400/client/year. This is based on the
assumption that these new clients would receive services for a full year. Cost sharing of HSS is subject to an annual
allocation limit, but this limit is open to review with the Province. Assuming
the City is reimbursed by the Province for 80% of this cost, the increase to
the City would be estimated at $41,000.
The
above projections do not take into account additional factors that could impact
the EHSS and HSS programs, including: the ageing Ottawa population and possible
increased need for EHSS and HSS, the impact of the HST on overall costs, as
well as economic or social policy changes at the municipal, provincial or
federal levels.
RURAL
IMPLICATIONS
There
are no rural implications with this report.
CONSULTATION
Summary
information from this report was presented to the Poverty Issues Advisory
Committee (PIAC) on May 11, 2010. PIAC members indicated that they were
supportive of the report recommendations.
COMMENTS BY THE WARD COUNCILLOR(S)
Not applicable as this is a city wide report.
LEGAL/RISK MANAGEMENT IMPLICATIONS:
There are no legal/risk management impediments to implementing the recommendation in this report.
CITY STRATEGIC PLAN
The proposed recommendation
addresses Recommendation 2 as outlined in the Ottawa Poverty Reduction Strategy.
The Poverty Reduction Strategy was approved by Council on
February 10, 2010 and is supported within the Corporate Strategic Plan.
TECHNICAL IMPLICATIONS
The proposed recommendation would require minor changes to the existing business application.
FINANCIAL IMPLICATIONS
The estimated
additional costs will be included as a pressure in the 2011 budget process. The
additional EHSS cost is estimated at $166K gross and net. The additional HSS
cost is estimated at $205K gross and $41K net assuming that the Department can
negotiate an increased subsidy allocation with the Province to accommodate the
additional costs.
DISPOSITION
City Operations staff
will implement any direction received as part of consideration of this report.
SUPPORTING DOCUMENTATIONS
APPENDIX 1 - ODSP exempt
assets that are recommended for EHSS/HSS
·
Cash
surrender value of life insurance policies exempt up to $100,000 per year.
·
Compensation
payment and awards for pain and suffering exempt up to $100,000.
·
One
motor vehicle owned by a member of the family unit is exempt regardless of
value.
·
Second
motor vehicle is exempt provided net value is less than $15,000 and required to
permit dependant of the applicant /recipient to maintain employment outside the
home.
APPENDIX 2 – EHSS Caseload Ages
compared to City of Ottawa population
APPENDIX 3 - EHSS/HSS Client
Income June 2009 compared to LICO rates
|
Client Income in relation to LICO 2008 |
EHSS recipients < 65 yrs |
EHSS recipients ≥ 65 years |
||||
|
Family Size |
LICO Rates |
Avg. Income June 2009 |
Percentage to LICO |
Avg. Income June 2009 |
Percentage to LICO |
|
|
1 |
$1,531 |
$1,037 |
67.73% |
$1,288 |
84.13% |
|
|
2 |
$1,863 |
$1,612 |
86.53% |
$1,808 |
97.05% |
|
|
3 |
$2,320 |
$1,729 |
74.53% |
$1,682 |
72.50% |
|
|
4 |
$2,895 |
$1,819 |
62.83% |
$2,330 |
80.48% |
|
|
5 |
$3,296 |
$1,971 |
59.80% |
$1,297 |
39.35% |
|
|
6 |
$3,656 |
$1,768 |
48.36% |
$1,392 |
38.07% |
|
|
7 or more |
$4,015 |
$2,940 |
73.23% |
- |
- |
|
APPENDIX 4 - Comparison of
EHSS/HSS Applicants using Current Needs Test vs LICO
|
ASU Survey Sample (n=247
as those who chose to withdraw were removed from
the overall sample of 356) |
Applicants
Who Qualified Under Current Eligibility Test |
Applicants
Who Qualified Under Proposed LICO Test |
|
Eligible |
178 (72%) |
207 (84%) |
|
Not Eligible |
69
(28%) |
40
(16%) |
|
Total |
247
(100%) |
247
(100%) |