February 15th, 2008
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FROM LISTMATE TAMMY STARR
Hi everyone,
I wanted to let you know that this coming Sunday night, Avis Favaro, the medical reporter, will be doing a story on Carly.
A longer version of the story will be available on the website at
www.ctv.ca:
On Monday morning, there will be an article in The Globe and Mail and it will probably be online at
www.globeandmail.com:
The reporter's name is Carly Weeks so if you put her name in the search box, the article should come up.
Thanks,
Tammy
P.S. I don’t know for sure, but I was talking to the ABC News medical reporter about Carly’s story..and perhaps…he will Pick up on it on Monday….but you never know.
Just keep your eye open Monday at 6.30.
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“PAY IT FORWARD”
SPECIAL SERVICES AT HOME - February 15, 2008
Special Services at Home (SSAH) overview
SSAH is a provincial program (Ontario), which serves families that have children with physical disabilities and/or developmental disabilities, and adults with developmental disabilities; who are living at home with their family, or living in the community (in housing that is not transfer payment, or ministry funded, residential type, group home placements).
SSAH ends at age 18 for children who have only been diagnosed with a physical disability, if your child also has a developmental disability , it is important to get that medical documentation to your Special Agreements Officer, so that eligibility past age 18 can be determined. The best type of medical documentation is a psychological assessment. These are expensive, but could possibly be done through the Board of Education, if the parent requests this.
The key to services after age 18, is a diagnosis of a developmental disability, not just a developmental delay. Disability is defined as a condition of sub average intelligence (IQ of 70 or less, or several adaptive living skill sets falling within or below the 1st percentile) occurring in the individual’s formative years (before age 18). If a child has only been diagnosed with a developmental delay and his or her IQ is over 70, there is a strong possibility they will not get SSAH after age 18. Children and Adults who are diagnosed with mental health issues, and/or behavioural and communication disorders, and/or ADHD/ADD, do not qualify for SSAH. Individuals who have a diagnosis of mild to moderate Autism, like “Aspergers” will not likely get SSAH after age 18, unless there is also a diagnosis of a developmental disability, as defined above.
SSAH is a program that adheres to “guidelines”, this means that it is not legislated and cannot be appealed through regular Ontario court/legal mechanisms. SSAH has two levels of appeal; the first is at the regional office level.
1). Another SAO in the same region will meet with the family, or conduct a telephone interview (the family’s choice) and discuss their reasons for the SSAH appeal. The family will need to show why they think the decision was unfair and how it did not follow the SSAH guidelines. The SAO (at the first level of appeal) is not looking at whether the amount of funding is correct, but seeing if the SAO that made the original decision, followed all of the SSAH guidelines, took all the family’s information on the application into account, and that any new changes in circumstances were considered, when the original funding decision was made. If anything was missed in the decision making process, the original SAO may be asked to re-examine their funding decision, and it is up to the family’s original SAO to determine any change in the funding levels based on this new information (some appeals that are won by the family, do not automatically get an increase in their funding level). This can happen for several reasons; the region has a waiting list and therefore does not have any money to give to the family. The SAO inputs the change in circumstances into the ‘provincial decision making tool’ and the funding level does not show an increase (for instance the changes are about the child’s behaviour and in the decision making tool the child is already receiving the maximum score allowed for behavioural problems). Each area of the provincial decision making tool has minimum and maximum scores for each section found on the SSAH application and once a maximum score in one area is reached it cannot be increased past that score.
2). The second level of appeal is at the Assistant Deputy Ministers ( ADM ) level and that appeal is assigned to another SAO in the province of Ontario, who will go through the same process as the 1st level appeal did. The ADM ’s decision is considered final.
SSAH can be used for:
1:1 worker/mediator to work with the disabled person in the home, out in the community, or at recreational programs such as summer camps. Can also be used for overnight special needs summer camp fees for several weeks in the summer. Babysitting for other siblings so that the parent can work 1:1 with the disabled child or adult. House cleaning, grass cutting, and snow removal. (Grass cutting is not lawn care services like fertilizing and laying sod) .Transportation to and from day programs can also be covered. Receipts are required with the SSAH invoices for services and programs that issue receipts. The service cannot be invoiced through SSAH until it is finished.
SSAH cannot be used for:
1:1 supports at school (the Board of Education is responsible for this), 1:1 support at daycare (the daycare can access a special fund if 1:1 support is required), for professional programs like IBI /ABA, massage therapy, speech and language therapy, chiropractor services, naturopathic services, medical reports or assessments, transportation for any other reason than to and from day programs, regular items that are required by any child, like food, clothing, city recreational or program fees, housing, and medication (to name just a few).
If SSAH is approved for less than what was requested, it is because the provincial decision making ‘tool’ score was for a lower funding level than what the family requested. If the family requests less than the decision making tool score, the family will receive what they have requested. It is better to request a bit more than what is needed to ensure you receive the maximum amount for your circumstances. However, greatly exaggerated requests (for example of more than $10,000.00 per year, where nursing services are not required) will most likely not be considered at that level. The SAO can only approve authorizations of up to $10,000.00, higher amounts will be sent to the Regional Director for approval. That does not mean that every family should request $10,000.00, as that is not appropriate. The family should decide how many hours per week of services they need, how much per hour they are going to pay, any other costs like residential summer camp fees, transportation to day programs, or housecleaning costs, and put that total amount in their SSAH request. The items approved for SSAH reimbursement, can differ from region to region, so, please make sure the item is approved before sending in your invoice, (if it is not on the list above). That way you will not be disappointed if your invoice is returned to you and refused payment. Items that are not paid or denied reimbursement through SSAH are not appealable. Each regional office can set priorities for their area and decide what extra items they will and will not cover on SSAH, depending on these priorities.
This information is provided by an anonymous source.
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