Ontario Works Program Update

1. Ontario Works Program Update ONWAA Spring Assembly May 15, 2012

2. Overview • Ministry priorities • First Nations Strategic Implementation Plan • Upcoming changes • 2012 Budget • Program updates • Drug cards and Ontario Drug Benefit Program • Employment Assistance referrals - ODSP

3. First Nations Strategic Implementation Plan • The ministry recently completed a strategic plan for First Nations delivery of Ontario Works • Focus on full delivery of Ontario Works (income and employment assistance) • Positions, prioritizes and plans key activities to support full delivery • Recognizes that First Nations require supports and resources to effectively administer Ontario Works • The plan contains five streams of work designed to effectively support First Nations Ontario Works delivery agents: • Supporting delivery • Strengthening relationships • Building capacity • Enhancing coordination • Improving program management

4. First Nations Strategic Implementation Plan • Key activities: • Revising the Ontario Works funding framework (April 2011) • Implementing new provincial technology • Working with partners to secure access to 3rd party information • Promoting group delivery • Reducing barriers to accessing ODSP • Improving coordination between OW and the Aboriginal Skills Employment and Training Strategy (ASETS) • Partnering with ONWAA on several training initiatives, including: • FN Social Services Administrator Certificate program • Supportive Approaches for Innovative Learning (SAIL)

5. Supportive Approaches through Innovative Learning (SAIL) • SAIL is a professional development program that provides tools and resources for achieving organizational excellence in human services • develops workplace competencies and skills that strengthen relationships • looks at communication and problem solving skills and how best to engage staff and clients for positive outcomes • Recognizes challenges that affect people in all communities, (e.g., mental health, substance abuse, domestic violence) • Delivered in Municipalities since 2008. First Nations communities began to deliver in early 2012 • Module 1 has now been delivered in over 25 First Nations communities. Modules 2-4 available this fall • Groups of First Nations have come together to develop a SAIL Community Plan to customize how SAIL is to be delivered and what cultural aspects are to be included

6. 2012 Budget • Focuses on maintaining gains in education, health care and social programs while reducing spending and balancing budgets as the province continues to recovery from the economic downturn • Some implications for the delivery and cost sharing of social assistance • Raising social assistance rates by one per cent • Funded 100 per cent by the ministry for the 2012 calendar year • Cost-sharing begins January 2013 • Exploring opportunities to integrate OW and ODSP employment services with Employment Ontario • Reducing administrative overlap and service gaps

7. 2012 Budget • Two significant changes to the provision of social assistance benefits: • Capping provincial cost-share for discretionary benefits at an average of $10/case (includes health and non-health related) • Replaces existing cap of $8.75/case used to determine cost-share for non-health related discretionary benefits • Currently no limit on cost-sharing of health-related benefits expenditures. • No change to range of needs that discretionary benefits can cover, with exception of home repairs • Effective July 1, 2012 • Province will continue to upload the cost of Ontario Works discretionary benefits; assuming 100% of costs by 2018 • Removing of Community Start-Up and Maintenance Benefit (CSUMB) and home repairs benefits from OW and ODSP • Includes transferring some CSUMB funding to Ministry of Municipal Affairs and Housing (Long-term Affordable Housing Strategy) • MCSS to retain homelessness-related funding for First Nations • Ministry will engage First Nations on how best to provide services on reserve • Effective January 1, 2013

8. Ontario Drug Benefit (ODB) Program • The ODB program is run by the Ministry of Health and Long-Term care and covers most of the cost of prescription drug products, some nutrition products and some diabetic testing agents • Must be prescribed by an Ontario doctor or other authorized prescriber and purchased from an accredited pharmacy or licensed doctor • Under Ontario Works: • Each member of a benefit unit is eligible for drug coverage for each month they are eligible for social assistance • Ontario Works drug coverage is limited to items on the ODB formulary • Coverage does not include the $2 per prescription co-payment amount • The ODB covers methadone for addiction treatment purposes • However, challenges remain in how policy is operationalized. The ministry understands that First Nations Ontario Works Administrators have questions regarding drug cards and the ODB program: • How drug cards are processed • The process when prescription drugs are not covered • Whether Ontario Works can pay for upfront amounts for dental and vision services • How federal and provincial drug programs work and interact with each other • The ministry will work with ONWAA to provide answers to these questions and develop resources for Administrators

9. Interaction Between Federal and Provincial Drug Programs • Health Canada’s First Nations and Inuit Health Branch (FNIHB) provides drug, dental and supplementary health services and benefits to First Nations and Inuit people on the basis of medical need • FNIHB’s Non-Insured Benefits Program: • provides a range of medically necessary goods and services to First Nations • supplements benefits provided by provincial/territorial programs (such as the ODB) • Based on the federal mandate, Ontario Works clients in First Nations communities should be accessing FNIHB health benefits before accessing Ontario Works health-related benefits • FNIHB benefits cover methadone (cost and medical transportation) for up to four months, after which ODB covers • If federal benefits are not available or have been exhausted, Administrators can then provide benefits under Ontario Works if the client meets eligibility criteria • In exceptional circumstances, the provincial Exceptional Access Program (EAP) facilitates client access to drugs not funded by the ODB (doctor applies on behalf of client) • When methadone is used for pain management purposes, it may be available through the EAP • MCSS will work with ONWAA to develop tools and training material to assist Administrators in helping clients get the medical and dental products and services they need

10. ODSP Employment Assistance Referrals • ODSP caseworkers may refer clients to First Nation Ontario Works offices for employment assistance services • Requirements would mirror those of an Ontario Works client: • Participation Agreement • meet every 3 months • Review necessary supports • The Ontario Works Administrator would maintain contact the ODSP worker (for additional supports, to provide a progress report, etc.) • However, questions/uncertainties remain related to: • roles with respect to case management/non-compliance • how budgets and funding are affected • The Access to ODSP for First Nations Strategy has provided an opportunity to identify gaps in business processes, such as the interaction between ODSP and Ontario Works programs • The strategy will look at developing a process related to these referrals between ODSP and First Nation Ontario Works offices