Redesigning the ODSP Maze
By Pam Lahey
Network, Fall 2007
The Ontario Disability Support Program (ODSP) was Ontario’s most complained about program in 2006-2007, according to the provincial Ombudsman. How does a system give rise to over one thousand objections in a year? Nancy Vander Plaats, a community legal worker who has worked for 20 years on social assistance issues and chairs the ODSP Action Coalition (of which CMHA, Ontario is a member), says dissatisfaction arises from the system’s maze of rules and regulations.
“The complexity of the ODSP legislation and the rules and policies are hard to understand,” explains Vander Plaats, “and dealing with the ODSP offices is very difficult for some people.” Established in 2002, the coalition has gained the respect of the Ministry of Community and Social Services, which oversees ODSP and has repeatedly invited the coalition to give feedback on the program. Now Vander Plaats wants the ministry to take notice of its call for greater accessibility.
If we improve people’s ability to return to work, everybody wins at the end of the day.”
— Madeleine Meilleur, Minister of Community and Social Services
The ODSP Action Coalition was born of a recognized need to work with the ministry to improve the program. While lobbying for increases to existing income levels has always been one of its purposes, accessibility — or rather, the policy and procedural barriers impeding easy access — has become an increasingly important advocacy issue for the coalition. In fact, the need for accessibility is one of four key messages it is bringing forward in the months leading to the October 2007 provincial election. The coalition has asked for a thorough accessibility audit of the entire ODSP system, including the income and employment supports processes.
“We obviously do mean physical access,” Vander Plaats explains, “but we mean more than that. The ODSP should learn to accommodate people with mental health disabilities, and that means really looking at attitudes of their staff, sensitivity training that staff [should] receive to deal with people who are stressed, [and] it means looking at their policies, figuring out where changes need to be made to recognize the reality of what their clients are dealing with.”
All ODSP cases as of December 2006
(Source: Ministry of Community and Social Services)
1 in 3
Approximate ratio of ODSP recipients who have a mental illness as of December 2006
(Source: Ministry of Community and Social Services)
Number of complaints to the Ontario Ombudsman about the ODSP in 2006-2007
(Source: Ombudsman Ontario)
Rank of ODSP among top 20 provincial programs most complained about
(Source: Ombudsman Ontario)
Minister of Community and Social Services Madeleine Meilleur spoke with CMHA, Ontario about these concerns. The ministry is continuously trying to improve the program, Meilleur says, and is addressing client needs at a September 2007 forum that is part of a larger consultation process with stakeholders. The forum, the minister added, will allow the ministry to “listen to their suggestions to improve services [and identify] how we can assist.”
The two biggest challenges in accessing the ODSP, Vander Plaats says, often go hand in hand: the complexity of the system, which prevents timely access, and the stress of dealing with a system that isn’t well understood by applicants and recipients (or, often, the social service organizations serving them). “Mental health issues are prominent” among ODSP recipients, says Vander Plaats, and “people suffering from those kinds of problems have even more difficulty with ODSP.”
“I have to hold a lot of people’s hands,” says Angela Browne, a self-employed paralegal and herself an ODSP recipient. What applicants need, Browne insists, is individualized attention to guide them through the process. Too many applicants, she adds, just do not understand what is required of them in a process that involves multiple steps and conflicting or ambiguous instructions. And many of Browne’s clients have addictions, mental illness or chronic pain, and may take enough medication to make reading a complicated letter from ODSP that much more difficult. (John Letherby, a ministry spokesperson, says the ministry understands this issue and is committed to making letters to clients easier to understand and friendlier and more sensitive in tone.) Browne wonders how many more people would not complete the ODSP marathon were it not for professionals like her. “These people do not have the temerity to go through all this and keep going,” she says. “They don’t understand the system.”
One solution, Vander Plaats contends, is to hire advocates to help applicants through the process. “The ministry has an obligation, we say, to people with disabilities to help them apply for the support program that is intended to serve people with disabilities.”
This approach was proven effective in a research project conducted by Street Health, a community-based health care organization in Toronto. Recognizing that its homeless clients were eligible for ODSP but were not receiving benefits, Street Health sent a worker into the street to help them through the application process. It discovered that all of the clients who took part in the study were eligible for ODSP benefits, but only 32 percent had ever applied (and all had been denied). Many of the others had attempted to apply before but were unable to complete the process on their own. After being given one-on-one assistance to complete their applications, 93 percent of the applicants were approved for benefits. CMHA, Ottawa Branch and Centre 454, a social service agency in Ottawa, ran a similar pilot program, and the initial results are encouraging.
“It is sometimes the people with the most severe disabilities that can’t get on the program,” says Vander Plaats. And these accessibility issues are intensified in an environment where too few workers are handling increasingly large caseloads. According to Vander Plaats, ODSP staff “clearly can’t give individualized attention [in this] environment.” For example, in Toronto, Vander Plaats states, one caseworker can have as many as 800 clients. Yet, in a 2006 report, the Ontario Association of Food Banks — which says Ontarians with disabilities are among the hardest hit by hunger — proposes a workable caseworker-to-client ratio of 1:200. To reach that goal, the association says, the ministry will need to hire 150 caseworkers at a cost of $9 million.
Many ODSP recipients say that the problem with accessibility does not stop when they start receiving benefits. Recipients may be eligible to receive extra benefits beyond the basic needs and shelter allowances, such as travel allowances, special diet allowances and specific employment-related supports. Browne says many are confused about the extra benefits and don’t apply for them because they don’t know of them or don’t think the benefits are meant for them. But Browne is, by her own measure, “a fighter,” and she fights for all the extra benefits she is entitled to. “I am so tired of not having anything,” she says. “I have to maximize what I can get!” Her special diet allowance was recently cut — without notice or explanation — and now she’s fighting to get it back. Josephine Grey, program coordinator for the resource centre and advocacy group Low Income Families Together, says, “It is exceedingly stressful to fight for things that you need — particularly if you have depression or PTSD — because you fear losing what little you have.”
Accessibility also means removing attitudinal barriers. While Browne says the caseworkers in her region “know their stuff,” she says many workers do not seem to understand the needs of people with disabilities, especially those with a mental illness. Others have reached the same conclusion; a 2007 report by McMaster University researchers recommended sensitivity training for ODSP staff. The ministry has acknowledged that improvements are necessary. Letherby says it recently launched a new training program that aims, among other things, to help ODSP staff “explore and fully understand the complex social, economic and personal challenges and hardships that ODSP clients experience and how to demonstrate sensitivity to the effects of these challenges on clients.” All management and staff will have received the training by March 2009.
To the ministry’s credit, Vander Plaats says, it has made changes over the years to improve the system in a number of areas. Some of these changes include creating plain language brochures (making their communications easier to read and understand), increasing rates and exemption time limits, enhancing extra benefits and approving transportation costs for recipients to attend mental health programs. When asked what change the ministry should focus on next, Browne suggests improving the employment supports system. Indeed, some changes have already begun.
It is exceedingly stressful to fight for the things that you need — particularly if you have depression or PTSD — because you fear losing what little you have.”
— Josephine Grey, program coordinator, Low Income Families Together
In November 2006, the ministry introduced important improvements to the employment supports system: recipients going back to work now receive a monthly $100 work benefit, and keep the money they earn plus 50 percent of their ODSP benefit, more than in the past. Both of these changes increased the incentive for recipients to enter the workforce or increase their work hours. And in September 2007, Letherby says, the program will change the system clients use to report income, “which will make it easier for ODSP recipients with earnings to understand how their ODSP income support is calculated, improve the accuracy of monthly ODSP income support payments and reduce the number of overpayments and arrears.”
One of the most significant policy changes made to the employment supports program is that “people who are able to work are able to keep their health benefits,” notes Meilleur. She told CMHA, Ontario that she was “shocked to hear that only nine percent [of ODSP clients] were accessing employment supports.” Recognizing that “work is good for morale,” Meilleur hopes these changes will provide the assurance recipients need to enter or re-enter the workforce.
“If we improve people’s ability to return to work,” the minister adds, “everybody wins at the end of the day.”
The ministry has taken significant steps to close the gap between policy design and program delivery. In 2006, it paid $5.5 million dollars to over 5,000 recipients who, under a now-revoked rule that limited retroactive payments to four months, were left without support if their application took longer than four months to process. And the delays that led to those repayments should no longer be an issue. “I am proud to say we have eliminated application backlogs as of December 2006, having surpassed our standard” of 90 business days to judge new applications, says Meilleur. “We are also in the process of hiring a deputy chief medical advisor to help with the application process.” Since many ODSP clients apply to the program through Ontario Works, the ministry also made another substantial change, Letherby notes: clients of Ontario Works no longer have their financial eligibility reassessed if they apply to ODSP, which should improve processing times.
Many recommendations to improve ODSP have been made since it was created almost 10 years ago. There is more work to be done. The ODSP Action Coalition and the ministry will continue to collaborate on making the program work for the people it was meant to serve: the most vulnerable in our society.
Pam Lahey is a community mental health analyst at CMHA, Ontario.
What is ODSP?
The Ontario Disability Support Program is Ontario’s income security program for people with disabilities.
It is administered by the Ministry of Community and Social Services and pays monthly income support benefits. The amount differs depending on a family’s size. A single recipient may receive $979, while couples and people with dependents are eligible for more.
ODSP has two parts:
- Income Supports: Financial assistance for people with disabilities
- Employment Supports: Supports for people with disabilities who need to get and keep jobs
Learn more about the program at www.mcss.gov.on.ca.
ODSP Action Coalition Election Messages
1. Social assistance rates need to provide for the real costs of living. Ontario Works (OW) and the Ontario Disability Support Program (ODSP) rates should reflect average market rents (as determined by the Canada Mortgage and Housing Corporation); cover the average cost of a nutritious food basket (as determined by municipal boards of health); and include money for other basic needs such as transportation and utilities. The rates should also be adjusted annually for inflation.
2. The provincial government needs to establish an independent committee that includes low-income people, representatives of disability and anti-poverty groups and other key stakeholders to develop rational and just criteria for determining ODSP and OW rates so that everyone has a decent standard of living.
3. Low-income families need to get the full amount of the new Ontario Child Benefit more quickly, rather than getting only gradual increases over the next five years.
4. In order to meet its obligations under the Accessibility for Ontarians with Disabilities Act (AODA), the provincial government must undertake a thorough accessibility audit of the entire ODSP system. The audit must include a review of income and employment supports and an audit of each individual office. The audit must include extensive and meaningful consultation with ODSP recipients and other stakeholders. The result of the audit will be a comprehensive and binding accommodations plan for ODSP service delivery.
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