March 11, 2014
ATTN: Ministry of Social Development and Social Innovation
RE: Disability White Paper Submission from Together Against Poverty Society (TAPS)
Thank you for initiating and conducting this important discussion on increasing accessibility for persons with disabilities in British Columbia. TAPS has been working with some of the most vulnerable, low-income persons with disabilities in British Columbia for 25 years. As such, you will find our submission is a thorough assessment of the types of legislative and policy changes that would primarily benefit and increase accessibility for the vulnerable individuals we serve. For each issue we described the challenge and offered a potential recommendation. It is important to note that these issues are not listed in order of importance. Please feel free to contact us at any time for further clarification.
Index
· CPP-D/PWD – Disabilities benefits, a two-tiered system
· Definition of Spouse
· Community Volunteer Supplement
· PWD application
· PPMB
· Dental services for people with disabilities
· Hardship/Lifetime Ban
· Monthly Nutritional Supplement
· Asset Exemption
· Reconsideration Supplement
· Family Maintenance Enforcement Payment Clawback
· Shelter Support Minimum
CPP-D/PWD – Disabilities benefits, a two-tiered system
Challenge:
British Columbia has a two-tiered system for persons with disabilities. A person living with disabilities, who applied for and was found eligible to receive a Canada Pension Plan-Disability (CPP-D) amount over the provincial persons with disabilities (PWD) amount before applying for PWD is not eligible for Medical Services Only (MSO). This can cause extreme hardship as it leaves that person without extended health coverage, a vital necessity for persons with disabilities.
CPP-D amounts are based on the amount of contributions one has made to the system through their work in paid employment. The longer you worked, the more you contributed, the bigger the monthly amount you will receive. The current system penalizes those people who worked the longest.
Recommendation:
Medical Services Only (MSO) should be available to both provincial PWD recipients and federal CPP-D recipients.
Definition of Spouse
Challenge:
If a recipient of ministry assistance decides to cohabitate with an individual for 3 months consecutively or 9 of the previous 12 months, and their relationship to the individual with which they reside, demonstrates both social, familial and financial dependence or interdependence consistent with a marriage-like relationship, then ministry staff may determine them to be in a marriage-like relationship, negatively impacting the individual(s) level of status or support.
The effects of this determination can result in several outcomes. Once the ministry determines that two individuals are living in a marriage-like relationship, the income and assets of both individuals must be assessed when determining the level of support that the ministry will provide. If the combined income of the two individuals is beneath the ministry support rate and asset exemptions, then the two will continue to receive ministry support at a reduced amount then they would be eligible for if treated as separate individuals. For example, two individuals receiving basic income assistance would receive $877.22 per month if found to be spouses instead of $610.00 each or $1220.00 for the household. Alternatively, the ministry may determine that the income or assets received by one individual are above the allowable level resulting in the discontinuance of assistance to the individual who was receiving assistance. This essentially forces dependency onto the individual that they would otherwise not choose and can lead to significant exploitation within the home.
Contrasting the ministry definition of spouse with definitions found in other provincial legislation is telling. For example; the Family Act, s. 1, Wills Variation Act, s. 1, Estate Administration Act, s. 1, Family Compensation Act, s. 1, Cremation, Internment and Funeral Services Act, s. 1, Workers Compensation Act, s. 1, Pension Benefits Standards Act, s. 1, Property Transfer Act, s. 1, Home Owner Grant Act, s. 1, Notaries Act, s. 58 and the Forest Act, s. 53(1), all require a 2 year cohabitation period to determine spousal status.
When it comes to those reliant on income support, the time period for determining spousal dependency is in sharp contrast to other areas of law. The three-month requirement in MSDSI’s legislation is highly anomalous and leaves the impression that the inconsistency is designed to target people living in poverty of disadvantageous treatment.
The test of whether or not an individual is financially or socially dependent on their cohabitant, consistent with a marriage like relationship, is often construed by ministry staff in questionable ways. For example, a roommate assisting their co-tenant in and out of a bath tub could serve as evidence of social and familial dependence consistent with a marriage-like relationship. Another not uncommon example is where two roommates share hydro and phone bills, which is then found by ministry staff to be demonstrative of a financial dependence consistent with a marriage-like relationship.
It has been the experience of TAPS advocates that Ministry staff routinely apply the lawful definition of spouse in the strictest of terms failing to allow for discretion, adding to the negative impacts wrought by this discriminatory legislation. The impact can be immediate and dramatic. Clients are forced to depend on past abusive spouses, are cut off assistance when an alleged spouse refuses to be subjected to income testing, are rendered homeless, forced to acknowledge a heterosexual relationship when they identify as homosexual, and lastly make decisions regarding personal relationships based on their need to survive instead of whom they choose to share their lives with. It is against this back drop that TAPS Advocates have assisted a good many individuals to avoid hardship through appeals and direct advocacy.
Recommendation:
Amend the legislation so it matches the BC Family Law Act definition of spouse.
Community Volunteer Supplement:
Challenge:
1.) Rates are too low and volunteering costs money. Together Against Poverty Society (TAPS) has long argued that the community volunteer supplement was an extremely important program that directly benefitted persons with disabilities by providing them with the financial means to participate in a meaningful way in their communities. In a time when the PWD rates have not increased since 2007, yet the cost of living continues to grow, the CVS was a targeted way of providing money to persons with disabilities who were contributing to their communities by participating in volunteer work.
2.) No ability to appeal. The CVS is now guided by the Supply Act, as a result there is no ability to appeal decision related to their CVS. This is detrimental to those CVS recipients who have been wrongfully cut off or otherwise denied their benefit. Persons with disabilities who continue to receive the CVS
3.) Mobility. Currently, a CVS recipient is not permitted to change volunteer positions and continue to receive the CVS. This can result in negative relationships between organizations and volunteers and volunteers who have no flexibility or autonomy with regards to where they volunteer.
Recommendations:
1.) Reinstate the CVS.
2.) Implement a method of appeal for CVS recipients.
3.) Allow CVS recipients to change volunteer positions if they choose.
PWD application:
Challenges:
1.) Length. The PWD application is unnecessarily lengthy due to repetition. For instance, at page 11 there is a question about restrictions to basic mobility, at page 10 there is a question about how far the applicant can walk, and at page 15, there is a question about restriction to the applicant’s mobility. Applicants and doctors often express their frustration due to the cumbersome nature of the application.
2.) Requirement that a person has to apply for Income Assistance first. The fact that one has to apply for income assistance in order to apply for PWD is cumbersome, unnecessary and often results in confusion and disentitlement for applicants. Furthermore, applicants who are not seeking income assistance are currently waiting months to merely begin the PWD application process.
3.) Retroactive payments to date of application. When a person applies for and is approved for PWD, their application reflects their condition at the time they submitted it, i.e. they were disabled on the date of application. PWD benefits should be retroactive to the date of application.
4.) The burden on doctors: Sections two and three of the PWD application are to be completed by a doctor with whom that applicant has developed a rapport. This poses a difficulty for many applicants who seek medical assistance at walk-in clinics due to the shortage of general practitioners. Clinic doctors often lack the necessary rapport with applicants to be able to ethically and accurately describe an applicant’s disability. Doctors who have enough of a rapport to represent an applicant often find the form itself to be too lengthy. In fact, certain physicians have asked non-profit organization, including TAPS, to complete a template application which they may use to provide the relevant information in a timelier manner.
5.) Unclear language: The use of certain prescribed terms and the different interpretations of these terms by doctors and lay people have complicated how information is presented in the PWD application. Specifically, the use of ‘continuous’ and ‘periodic’ are difficult to distinguish with respect to chronic conditions. For example, certain conditions may be relatively stable for periods of time but become exacerbated unexpectedly for unknown periods, making it difficult to determine when periodic becomes continuous in terms or impairment or disability. Furthermore confusion has arisen from attempting to distinguish ‘needs’ and ‘requires’, with respect to assistance. Many applicants do not have access to the services they require to complete daily activities; however, they manage to barely survive with what is available to them. By barely surviving, these people are considered not to require the services that would allow them to live with fewer daily struggles.
6.) Adding ‘Employability’ as a Daily Living Activity: While it is certainly beneficial to maintain a definition of PWD as inclusive of restrictions to performing ADL’s it can become a major barrier to approval of the designation to those most in need when employability is not part of the test. This is most challenging as medical professionals incorrectly believe that PWD is tested on employment, leading applications to be foiled by physicians/assessors who stress employability throughout the application. We believe that if employability were considered as just one of a number of other daily living activities it would give a more fulsome and accurate picture of the applicant.
Recommendations:
1.) Length: Remove redundancies within the application.
2.) Requirement that a person has to apply for Income Assistance first. A completely separate or expedited assessment of income assistance eligibility for those seeking only PWD could improve the PWD application process tremendously. An expedited process would assist the Ministry as fewer appointments would be required and resources could be directed to those applicants actually seeking income assistance. Reducing the process by months would also be beneficial for the health of those applicants who seek special and immediate medical attention.
3.) Retroactive payments to date of application: Provide retroactive payments back to date of application.
4.) The burden on doctors and unclear language: Reorganizing the PWD application form with a focus on removing repetitive questions could help clarify discrepancies in language and help make the process less cumbersome for doctors. For instance, the form should consistently use either ‘needs’ or ‘requires’. If both terms need to be used, then they should be clearly defined so that doctors can best express themselves to assist the Ministry.
5.) Adding ‘Employability’ as a Daily Living Activity: We recommend the following amendment to The EAPWD Regulation;
Daily living activities
2 (1) For the purposes of the Act and this regulation, "daily living activities",
(a) in relation to a person who has a severe physical impairment or a severe mental impairment, means the following activities:
(i) prepare own meals;
(ii) manage personal finances;
(iii) shop for personal needs;
(iv) use public or personal transportation facilities;
(v) perform housework to maintain the person's place of residence in acceptable sanitary condition;
(vi) move about indoors and outdoors;
(vii) perform personal hygiene and self care;
(viii) manage personal medication, and
(ix) searching for and/or maintaining employment
(b) in relation to a person who has a severe mental impairment, includes the following activities:
(i) make decisions about personal activities, care or finances;
(ii) relate to, communicate or interact with others effectively.
PPMB - Persons’ with Persistent Multiple Barriers to Employment (PPMB)
Challenge: The PPMB category is a category that fails to offer real support for some of the most marginalised ministry clients.
An individual who demonstrates that they are incapable of searching for or maintaining employment can become eligible for PPMB after being in receipt of income assistance for 12 months and demonstrating that they are unemployable. If the individual meets this test they are then able to benefit from an extended employment earnings exemption of $500.00. Proving that the client is completely unemployable nets the client an increased benefit from performing a task that they have demonstrated they are unable to perform.
In addition they receive a modest increase in income support ($610.00 to $657.92).
While it is true that many people do find a modest benefit from this designation it must be said that these clients, in our experience, are often in need of the more substantial support offered by PWD designation. Unfortunately, these clients can be barred from PWD eligibility as they are capable of many ADL’s while incapable of any form of meaningful employment.
In practise, many TAPS clients who are eligible for PPMB are some of the most marginalised clients, often homeless and unsettled with very little connection to social or medical supports. These clients are typically unable to build a long term relationship with medical professionals and can be in self-denial of their level of restriction to independent function. More and different support is required for these clients including a supportive and clear path to PWD.
As of today’s date the ministry has failed to take any documented action on 6 separate adopted recommendations from the Ombudspersons 2009 report.
Recommendations:
To address the challenges with this designation we make the following recommendations;