8.2 — Treatment of budgetary requirements – temporary stays in a hospital or substance abuse recovery home

July 2023

Summary of Policy

For the first three months of a temporary stay in a hospital or substance abuse recovery home (SARH), the budgetary requirements for the member of the benefit unit in the facility shall not be reduced.

After three months, the Director may reduce the budgetary requirements for the member in the facility.

Legislative Authority

Sections 36 (1), (2); 36.1(1),(2) of the Ontario Disability Support Program (ODSP) Regulation

Summary of Directive

A member of an ODSP benefit unit who is in a hospital or SARH on a temporary basis is eligible for income support while he/she is in the facility.

Hospitals may include general, chronic care, convalescent, psychiatric and rehabilitation hospitals.

Income support is determined according to the appropriate budgetary requirements scheme based on the recipient’s principle residence (e.g. basic needs/shelter allowance if the principle residence is owned).

When considering whether it is appropriate to reduce the budgetary requirements for a member after three months in the facility, consideration should be given to the actual cost of maintaining the benefit unit’s community accommodation, as well as other expenses (e.g. monthly payments related to personal debt).

Intent of Policy

To allow recipients and their dependants to maintain their community residence when a member of the benefit unit is temporarily staying in a hospital or SARH.

Application of Policy

First Three Months of a Temporary Stay

Budgetary requirements for the first three months should be determined according to the recipient’s principle residence. For example, if the recipient rents in the community, budgetary requirements for the benefit unit would be basic needs and shelter allowance for the first three months of a stay.

If, during the stay in the hospital, the recipient changes his or her principle residence (e.g., gives up accommodation, changes from renter to boarder or lodger, etc.) the budgetary requirements would reflect the change.

For recipients who do not maintain their community residence while in hospital/SARH, income support is adjusted the month after they cease to maintain their community residence.

Recipients who do not have shelter costs are eligible to receive Basic Needs Allowance.

The first full calendar month that the recipient/dependant is a patient in a hospital or moves into the SARH will count as the first month of a temporary stay. For people who were granted while in a hospital or SARH, the first month of a stay is the month after the month of grant.

Examples

Stays Longer than Three Months

The regulation provides that the Director may reduce the budgetary requirements of the member after three months in a hospital or SARH, but is not required to do so.

The intent of the policy is to assist recipients with maintaining their community residence when a member of the benefit unit is temporarily hospitalized or moves into a SARH. Therefore, when determining whether budgetary requirements of the hospitalized member should be reduced after three months, consideration should be given to the actual costs of maintaining the community accommodation, as well as expenses related to the hospitalized member. In this regard, income support for the hospitalized member should not be reduced below $149 per month, which is the amount equivalent to a Personal Needs Allowance.

Residents in a Substance Abuse Recovery Home

A designated “Substance Abuse Recovery Program” refers to a residential program where counselling and/or treatment for a substance addiction are provided on-site for less than 6 months, and whose core funding is provided by the Ministry of Health and Long-Term Care.

Substance Abuse Recovery Programs, according to the criteria set out above, refer to specific facilities. See Appendix 1 for a list of designated Substance Abuse Recovery Programs.

A recipient shall continue to receive all benefits to which he/she is entitled while in a hospital/recovery home. Recipients should inform the facility of receipt of these benefits to eliminate any duplication.

Hospital/SARH Discharge Procedures

In the month of discharge, recipients are eligible for a full month’s income support based on their accommodation costs and basic needs at the time of discharge.

Recipients who had their budgetary requirements reduced may require assistance with basic needs upon discharge (e.g. food, clothing, etc.). In these circumstances, they may be eligible for a retroactive budget calculation for the previous month(s). Arrears shall be provided on the date of discharge.

Example: Single recipient who is maintaining community residence while in hospital and receiving a shelter allowance of $556; basic needs amount was reduced after three months in hospital to $149. Recipient’s discharge date is January 15, 2024.

Related Directives

6.1 Basic Needs Calculation
8.1 Budgetary Requirements for Recipients Who Reside in Institutions
11.1 Recovery of Overpayments

Bulletins:

008-2001

Appendix 1

Ministry of Health and Long-Term Care Level 1 Substance Abuse Recovery Programs: