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Health Supplements and Programs
- Health Supplement Summary
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- Decisions, Reconsideration and Appeal
- Family Maintenance Program (FMP)
Payment of Assistance
Intent: May 25, 2015May 25, 2015
Assistance is provided to eligible family units in one of four ways:
- Support and Shelter
- Room and Board
- Special Care Facility User Charges and Comforts Allowance
The intent is to provide assistance of no more than the prescribed rates for the applicable situation after deducting any non-exempt income of the family unit. [For more information, see Related Links – Income and Exemptions.] Assistance is issued for items or costs authorized in the applicable Act or regulation to the level required for meeting basic needs.
Applicants found ineligible for income assistance or disability assistance may be assessed for hardship assistance. [For more information, see Related Links – Eligibility for Hardship Assistance.]
For information on dates pertaining to monthly cheque issue, see Resources for Clients – BC Employment and Assistance Cheque Issue Dates.
Support Allowance: November 25, 2008November 25, 2008
Support allowance in the amount shown in Rate Table – Income Assistance – Support Rate [see Rate Tables] is paid to recipients. The support allowance is prorated based on the number of days remaining in a calendar month, beginning with the date of application.
Note: Clients in emergency shelters or transition houses are eligible for the support allowance.
Family Bonus Top-up
For information about the family bonus top-up, see Related Links – Family Bonus Supplement.
Shelter Allowance: May 25, 2015May 25, 2015
For definitions that are relevant to the discussion of shelter allowance, such as "rent," "landlord," "tenant," "hotel," and "residential premises," see Residential Tenancy Act under Resources for Clients – Residential Tenancy Office.
For the purposes of determining the applicable shelter allowance, a family unit includes a child who is not a dependent child and who resides in the parent's place of residence for not less than 40% of each month, under the terms of a court order or an agreement filed in a court in BC. [For the legal reference, consult the EA Regulation, Schedule A 4(1) or the EAPWD Regulation, Schedule A 4(1).]
Allowable Shelter Costs
When calculating the actual shelter costs of an eligible family unit, only the following items may be included:
- rent for the family unit's place of residence
- if the family unit's place of residence is owned by a person in the family unit, any of the following costs for the place of residence:
- mortgage payments
- a house insurance premium
- property taxes
- with the minister's prior approval, the actual cost of maintenance and repairs [see Policy – Home Maintenance and Repairs]
- any of the following utility costs:
- fuel for cooking or heating
- garbage disposal provided by a company on a regular weekly or bi-weekly basis
- rental of one basic residential single-line telephone
In addition to the shelter costs above, both of the following can be included in calculating shelter costs (to the maximum shelter allowance) for a family unit:
- monthly strata corporation assessment fees for a residence owned and lived in by the client
- a house insurance premium for co-op and strata owners
If utility costs fluctuate, they may be averaged over the following two time periods:
- October 1 to March 31
- April 1 to September 30
Documentation of actual shelter arrangements and costs must be provided by the client and scanned and profiled to the client's case.
Note: Regardless of their actual shelter costs, eligible family units of two or more that include someone receiving Old Age Security/Guaranteed Income Supplement (OAS/GIS) are entitled to a maximum shelter rate for the family size in Rate Tables – Income Assistance or Disability Assistance [see Rate Tables].
This provision applies regardless of whether the family unit is sharing residential accommodation or is receiving room and board.
If two or more eligible family units share the same place of residence, the actual shelter costs of any one of the units is the lesser of the following:
- the calculation of the following steps:
- dividing the actual shelter costs for all of the family units by the number of persons occupying the residence
- multiplying the result by the number of persons in that one family unit
- dividing the actual shelter costs for all of the family units by the number of persons occupying the residence
- the amount declared by the family unit as its shelter cost
Re-mortgaging can be approved prior to the end of the mortgage term by the Supervisor. Clients must be informed that if they are re-mortgaging prior to the end of the mortgage term, any increases in mortgage payments will not result in an increase in the shelter allowance even if they are currently receiving less than the family unit's maximum shelter rate.
Home Maintenance and Repairs
Home maintenance and repair costs referred to in Schedule A, section 5 (2)(f) mean only those essential items of protection, replacement, and repair that are part of the physical structure of the recipient's home. The costs may be prorated to future months, provided eligibility to include these costs continues. Schedule A stipulates that prior approval must be given by the minister (EAWs are the delegated authority) for home maintenance costs.
This category of costs does not include replacement of, or repairs to, appliances or decorative items.
TransientsDecember 1, 2003
Support allowance is provided to transients for the cost of food. Shelter allowance for transients is based on the actual cost of housing in a hostel, if one exists in the community.
Room and Board: June 1, 2010June 1, 2010
An eligibile family unit that is living in a room and board situation (other than in a special care facility or with a parent or child of a person in the family unit) is eligible to receive the smaller of the following amounts:
- the sum of the actual cost of room and board plus the amounts shown in Rate Table: Payment of Assistance – Room and Board Situations [see Rate Tables] for each client and dependent child in the family unit
- the amount calculated under Schedule A for the applicable family unit size
Room and Board with Parent or Child
An eligible family unit living in a room and board situation with a parent or child of a person in the family unit is only eligible to receive the support allowance applicable to the family unit (that is, the family unit is not eligible for shelter allowance). [For the support rates, see Rate Tables – Income Assistance, Disability Assistance or Hardship Assistance.]
Special Care Facility User Charges and Comforts Allowance: May 25, 2015May 25, 2015
For an eligible recipient who receives accommodation and care in a special care facility, the ministry pays a user charge to the facility on behalf of the recipient and a $95 comforts allowance to the person. The ministry pays different user charge rates depending on the type of special care facility, as shown in Rate Table – Payment of Assistance [see Rate Tables].
An eligible family unit cannot receive a full support allowance and a comforts allowance in the same month. There are 2 scenarios in which a family unit may receive a partial support allowance and a comforts allowance in the same month:
- a recipient leaves a facility during a month for which they have received a comforts allowance. For an example of how to calculate a partial support allowance for this circumstance, see Case Example #1 in this section.
- a recipient with a spouse and/or dependants temporarily leaves the family unit to receive care in a special care facility, see Related Links – Living Arrangements – Temporarily Reduced Family Unit. For an example of how to calculate a partial support allowance for this circumstance, see Case Example #2 in this section.
In the two scenarios above, the amount of a family unit's partial support allowance plus the comforts allowance should not exceed their maximum support allowance rate.
If a recipient enters a special care facility during a month for which they have received a full support allowance, they are not eligible for a comforts allowance.
To qualify as a special care facility, facilities must be either a residential care or assisted living facility as outlined below [see Resources for Staff for a printable Facilities Overview].
If a recipient is residing in a facility that does not qualify as a special care facility, the ministry cannot pay user charges, but can pay an eligible recipient a support allowance and shelter allowance, or room and board.
Residential care facilities provide a higher level of care than assisted living facilities. There are three types of residential care facilities: community care, mental health, and substance use.
Residential Community Care Facilities
|Facility Setting||Short-Term Residential Care
Convalescent care, respite care, and hospice care
|Hospital Providing Residential Care (1)||Private Hospital||Residential Care||Family Care Homes
(provides same high level of service, but only to 1-2 people)
|Licensing / Registration||Licensed under CCAL Act||Licensed under Hospital Act||Licensed under CCAL Act||License under CCAL Act not required|
|SDSI user charge||$991.20 per month + $95 comforts
$32.50 per day + $95 comforts
|SDSI Regulatory authority||Licensed under the CCAL Act||Extended care beds under Hospital Act||Private Hospitals licensed under Hospital Act||Licensed under the CCAL Act||Specialized adult residential care settings approved by the minister of SDSI for which a license under the CCAL Act is not required|
The Ministry of Health applies user charges to patients who occupy a hospital bed, but who no longer require acute care and have been assessed as requiring long-term residential care services.
Persons receiving acute care in hospital beds under the Hospital Act are not eligible for ministry user charges and comforts.
The ministry may provide the shelter allowance for eligible recipients to allow the recipient to maintain their usual place of residence shelter while in hospital [see Living Arrangements – Temporarily Reduced Family Unit].
Residential Mental Health Facilities
|Facility Setting||Mental Health Residential Care||Provincial Mental Health Facility (1)
Mental Health and Substance Use Residential Tertiary Care Units
|Mental Health Family Care Homes
(provides same high level of service, but only to 1-2 people)
|Licensing / Registration||Licensed under CCAL Act||Designated under section 3(1) of the Mental Health Act as provincial mental health facilities||License under CCAL Act not required|
|SDSI user charge||$30.90 per day + $95 comforts|
|SDSI Regulatory authority||Licensed under the CCAL Act||Specialized adult residential care settings approved by the minister of SDSI for which a license under the CCAL Act is not required||Specialized adult residential care settings approved by the minister of SDSI for which a license under the CCAL Act is not required|
The following types of mental health and substance use units designated under the Mental Health Act as provincial mental health facilities are not eligible for ministry user charges:
Residential Substance Use Facilities
The Ministry of Health and the community use the term "substance use" rather than "alcohol and drug". For this reason, the term "substance use" has been used in this topic to describe facility types. For the purposes of relating this policy topic to other topics in this manual, "substance use" has the same meaning as "alcohol and drug".
|Facility Setting||Substance Use Treatment Facility|
|Licensing / Registration||Licensed under CCAL Act|
|SDSI user charge||$40.00 per day + $95 comforts|
|SDSI Regulatory authority||Licensed under the CCAL Act|
Assisted living facilities provide a lower level of care than residential care facilities and are registered under the Ministry of Health's CCAL Act. There are three types of assisted living facilities: community care, mental health, and substance use.
Note: Unregistered/unlicensed substance use treatment facilities are often referred to as Supportive Recovery Homes (SRHs). Only registered SRHs are eligible for ministry user charges.
|Community Care||Mental Health||Substance Use
Supportive Recovery Homes
|Licensing / Registration||Registered under CCAL Act|
|SDSI user charge||$631.00 per month + $95 comforts||$30.90 per day + $95 comforts|
|SDSI Regulatory authority||Specialized adult residential care settings approved by the minister for which a license under the CCAL Act is not required|
Clients in CLBC-contracted residential facilities are provided support and shelter and therefore are not eligible for the ministry user charge. [see Clients in CLBC Facilities]
Calculating User Charges
When a recipient is admitted to a special care facility, the approved accommodation and care rate for that facility is paid for the period that includes the day of admission, but excludes the day of discharge or death.
Excess earned income and unearned income received by the client must be deducted from the monthly invoice submitted by the facility to the ministry. For example, the facility must deduct $500 from the invoice if a client receives $500 in monthly CPP benefits. Note: The system calculated CPP tax exemption should not be deducted from the invoice.
The Ministry of Health established a standard methodology for pro-rating the client rate to ensure all health authorities use the same approach (for clients). If a client is admitted to or discharged from residential care services part way through a month, the monthly amount is pro-rated as follows:
|Pro-rated Amount = Client Monthly Rate||x Number of Days in the Facility|
|Number of Days in the Month|
To ensure that providers and clients are not adversely affected, if a client is admitted or transferred they would be charged based on the actual number of days in the month that they are in the facility. Example:
Mrs. Green (whose monthly rate is $991.20) was admitted to a residential care facility licensed under the CCAL Act on May 10. For May, the charge would be for 22 days calculated as $991.20 ÷ 31) x 22 = $703.43
The daily user charge may also be paid while a recipient is absent from the special care facility for either of the following:
- for 14 days for admission to an acute care hospital
- for 14 days for visitation, and seven days extension if approved by the EAW for valid reasons
According to Schedule A of the EA and EAPWD Regulation, the user charge paid to a special care facility is for "accommodation and care", which is distinct from "support and shelter". Therefore, issuing user charges when the client has been issued support and shelter allowances is not considered a duplicate issuance of support and shelter.
Case Example #1
A single person is residing in a substance use treatment facility licensed under the CCAL Act. This client has been in receipt of income assistance for several months and checked into the facility January 15 and will remain in the facility until February 15. The client would like to maintain their place of residence ($400 rent) while in the facility.
January assistance (issued at the end of December): Because the client received their full income assistance for January at cheque issue, they are not eligible for comforts allowance in January. The daily user charge for January 15 – 31 may be issued to the facility, assuming the client resides at the facility for this period of time.
February assistance (issued at the end of January): The client is eligible for shelter allowance and comforts. On cheque issue, $400 would be issued for shelter (in most cases this would be sent directly to the landlord). A comforts allowance, less the additional $25 above the shelter maximum of $375 provided for rent, would be issued to the client. The daily user charge for February 1 – 14 would be issued to the facility, assuming the client resides at the facility for this period of time and February 15 is the date of discharge. On discharge, the client is eligible for pro-rated support for the balance of February.
Case Example #2
A client, whose family unit includes a spouse and two children, has been in receipt of income assistance for several months. The client checked into a substance use treatment facility licensed under the CCAL Act on January 15 and will remain in the facility until February 15. The client would like to maintain their place of residence while in the facility.
January assistance (issued at the end of December): Because the client received their full January income assistance at cheque issue they are not eligible for comforts allowance for January. The daily user charge for January 15 – 31 may be issued to the facility, assuming the client resides at the facility for this period of time.
February assistance (issued at the end of January): The client is eligible for comforts allowance. The client's family would receive their full family unit's shelter rate, plus the full family unit's support rate minus the client's comforts allowance amount. The daily user charge for February 1 – 14 would be issued to the facility, assuming the client resides at the facility during this time and is discharged on February 15. On the client's discharge, the family unit is not eligible for further support allowance for February.
Clients in CLBC Facilities: June 1, 2007June 1, 2007
Clients in CLBC-contracted residential facilities are eligible for disability assistance (support and shelter) as shown in the Rate Table – Payment of Assistance, as well as supplemental assistance (if eligible). As such, clients are responsible for paying their own client contribution (rent) to the service provider. The amount a client must pay as client contribution (rent) is standardized by CLBC and adjusted whenever disability assistance is adjusted. If clients wish to have their rent paid directly to the service provider, the client (or designate) should contact their local office.
The remaining support allowance is intended to cover personal expenses, including clothing. This client group is not eligible for the clothing supplement.
Dependants who Turn 19 While Attending Secondary SchoolDecember 1, 2003
A dependent child of a family unit receiving income assistance or disability assistance, who turns 19 while attending secondary school may remain on the family unit for the purposes of determining the monthly income assistance or disability assistance rate for the family unit. This provision may continue for each calendar month that the person (the former dependent child) is residing with the family unit and attending school, until the end of that school year. The amount of support allowance that may be issued is shown in Rate Tables – General Supplement – Family Bonus Top-up Supplement. [see Rate Tables]
Note: The same provision does not exist in Schedule D (Hardship) of either the EA Regulation or the EAPWD Regulation for recipients of hardship assistance.
65 and Older and Pending Old Age Security/Guaranteed Income Supplement: May 25, 2015May 25, 2015
If a recipient, who turns 65 years of age while in receipt of assistance, or an applicant with the PWD designation who is 65 years of age or older, is eligible for Old Age Security/Guaranteed Income Supplement (OAS/GIS), but is not receiving OAS and GIS, they may still be eligible for assistance. Any assistance issued is to be on a month-to-month basis and is not repayable. Confirmation of OAS and GIS applications are required. The amount of assistance is found in the Rate Tables – Income Assistance and Disability Assistance. Recipients are not to be issued Hardship – Awaiting Other Income due to pending OAS and GIS.
An applicant, who is 65 years of age or older and is eligible for OAS and GIS may still be eligible repayable for hardship assistance if they:
- do not have the PWD designation and,
- are not receiving OAS and GIS
[For more information, see Related Links – Hardship – Awaiting Other Income.]
"In Kind" Assistance: October 22, 2007October 22, 2007
In communities that have no ministry office, or in any community after regular office hours, there may be unique and extremely urgent situations where an individual or family has a compelling need and there are no means to meet this need.
In urgent situations where an immediate need has been identified and where eligibility cannot be determined via a formal application, ministry staff may issue "in kind" goods or services for essential food and shelter. Ministry staff will assess immediate needs based on the criteria established in the immediate needs policy. [see Related Links – Immediate Needs]
Note: Where an immediate need has been identified, the provision of "in kind" assistance is to be used only if at least one of the following also applies:
an application cannot be expedited
contracted resources are not available to meet the need
alternative resources are not available to meet the need
Issuance of "in kind" goods and services must be limited to a one-time issue (limited to a maximum of one issue per month and three issues per calendar year). "In kind" assistance must be issued using a supplier cheque or Purchase Authorization (HR149). [see Policy – Methods of Payment]
The local office is responsible for completing the Quarterly Monitoring – In Kind Expenditures [see Forms and Letters] on a quarterly basis. Expenditures are collected and monitored related to the provision of "in kind" assistance.
[For information regarding purchase authorizations, see Related Links – Immediate Needs]
Methods of Payment: May 25, 2015May 25, 2015
Direct Deposit is the mandatory method of payment to eligible recipients. Ministry staff must present Direct Deposit as the mandatory payment method when new applicants apply for assistance, or for existing recipients, at any other time of contact. Exceptions are permitted under special circumstances. Most types of payment can be deposited in a recipient's or service provider's bank account (monthly or one time payments), once the bank account information has been received and all eligibility criteria has been met. For exceptions, please refer to the Exceptions Code Table in Procedures.
When assistance is issued by cheque, the cheques must be mailed to the recipient's residential address, or in rural areas to a postal box. Ministry staff must never cash a recipient's cheque.
The daily user charge for Residential Care Facilities and Family Care Homes are billed to the ministry using the Statement of Account – Adult Residential Resources (SD150A) billing form.
Purchase Authorizations (HR149) are an alternative to issuing imprest cheques. They are used to authorize payment to a supplier for the provision of goods or services to a client, in particular when the exact cost of those goods or services is not known. They are issued to the supplier who then provides the goods or services to the client and invoices the ministry.
Ministry staff must never cash a recipient's Purchase Authorization.
Effective Date of Eligibility – Original Decision: July 20, 2011July 20, 2011
[See also Resources for Staff – Effective Date of Eligibility – Workflow Chart]
When the original decision approves the client's eligibility, the effective date of eligibility is dependent on the type of assistance applied for.
- Applicants for income assistance are eligible for income assistance from the date of their application.
- Applicants for disability assistance, who were already designated as a person with disabilities and are re-applying for disability assistance (returning to the caseload), are eligible for disability assistance from the date of their application.
- Applicants who qualify as a person who has persistent multiple barriers to employment (PPMB) are eligible to receive income assistance at the PPMB rate on the first day of the month after the date of the original decision.
- Applicants for persons with disabilities designation are eligible to receive disability assistance on the first day of the month after the date of the original decision.
- Applicants for persons with disabilities designation who are found eligible for the PWD designation prior to their 18th birthday will receive benefits effective the date of their birthday.
- Applicants who are youth in government care (under the care of the Ministry of Children and Family Development), who have been found eligible for disability assistance as of their 19th birthday, are eligible to receive the shelter allowance for the full month in which they turn 19, as calculated in Schedule A for any rent owing, and the support allowance prorated from the day they turned 19 to the end of that month.
- Applicants for a supplement are eligible for the supplement as of the date of the original decision.
T5007 Tax Receipt: July 1, 2010July 1, 2010
Canada Revenue Agency (CRA) requires that everyone who receives provincial income assistance, disability assistance or hardship assistance to report this income on their tax return. Financial and Administrative Services Branch (FASB) issues a T5007 tax report to clients who receive more than $500 in assistance to help them prepare their tax returns. The income shown on the T5007 is not taxable, but is used to calculate entitlement to federal tax and provincial tax credits, and Canada Child Tax Benefit (CCTB).
How T5007 Amounts are Calculated
All reportable assistance amounts issued in (as opposed to “for”) the calendar year are included on the T5007. Usually, this will be for the assistance months from February to January (because assistance for a month is issued in (at the end of) the previous month).
The following categories of assistance are NOT included in T5007s:
medical and health supplements
child care subsidy
job training supplements
Ministry T5007 Information Line for Clients
Clients with questions about T5007s can call the Provincial Contact Centre [see Contacts].
Clients can expect to receive their T5007s by the end of the third week in February. T5007s are sent to clients' last known address as of December 31.
Replacement T5007 Tax Receipts
The ministry will provide duplicates of T5007 tax receipts or a system generated printout upon client's request. Clients do not need to attach a copy of their T5007 to their tax returns as long as they report the correct amount on lines 145 and 250 on the T1 General form.
Clients and former clients who would like a copy of their T5007 information can either:
- contact their local office for a printout
- contact Provincial Contact Centre to request a duplicate T5007 [see Contacts]