Download Report

Employment Support and Income Assistance
Policy Manual Revisions
Record of Revisions
Revision #
Revision Date
Chapter
Section
239
October 1,
2014
5- Basic Needs
5.1.11 – Policy: Conducting
an Annual Review
New version:
5.1.11 Policy:
Conducting the Annual Review
In order to determine ongoing eligibility for Employment Support and Income
Assistance, a comprehensive review of a recipient’s and/or spouse’s eligibility
must be conducted once a year for all cases.
This comprehensive review will include the caseworker meeting with the recipient
and spouse of the recipient, if applicable, to complete, but not limited to, the
following documentation and information:
1.
a completed ‘Consent to Release and Obtain Information Authorization’
form signed by both the recipient and spouse of the recipient;
2.
a completed ‘Client Personal and Financial Statement’ form signed by both
the recipient and the spouse of the recipient;
3.
verification of income/assets that have not been reported on monthly
‘Income Statements’ form;
4.
copies of documentation regarding assets;
5.
copies of bills and/or statements of expenses since the last review;
6.
update living situation;
7.
the completion of other forms applicable to the recipient and/or spouse of
the recipient situation, for example, CPP ‘Consent to Deduction and
Payment - 1613’ form, EI ‘Assignment of Benefits’ form;
8.
where appropriate:
a. complete the employability screening questions on the ‘Employment
Services Review’ form for both a recipient and a spouse;
or
b.
complete the ‘Report of Present Health Condition’ form for both a
recipient and spouse. Medical information, if required, can include
medical documents, assessments, and information provided by a
qualified medical practitioner.
Medical documentation is not required to confirm a disability in
situations where an applicant/recipient and/or spouse are in receipt
of and/or eligible for:
i.
Canada Pension Plan (CPP) Disability Benefits
ii.
Long-Term Disability Benefit from an employer,
iii.
Disability Tax Credit
iv.
Worker’s Compensation Disability Benefits, and
v.
Working Income Tax Benefit (WITB) Disability
Supplement;
9. review the reporting cycle and payment history to determine if the case
meets the periodic payment criteria. The reporting cycle may be changed
from monthly to periodic where:
a.
recipients not reporting wages, and/or
b.
eligible for ESIA for more than six (6) months, and
c.
no budget changes in three (3) months.
Previous Version:
5.1.11 Policy:
Conducting the Annual Review
In order to determine ongoing eligibility for Income Assistance, a comprehensive
review of a recipient’s and/or spouse’s eligibility must be conducted once a year
for all cases.
This comprehensive review will include the caseworker meeting with the recipient
and spouse of the recipient, if applicable, to complete, but not limited to, the
following documentation and information:
1.
a completed ‘Consent to Release and Obtain Information Authorization’
form signed by both the recipient and spouse of the recipient;
2.
a completed ‘Client Personal and Financial Statement’ form signed by both
the recipient and the spouse of the recipient;
3.
verification of income/assets that have not been reported on monthly
‘Income Statements’ form;
4.
copies of documentation regarding assets;
5.
copies of bills and/or statements of expenses since the last review;
6.
update living situation and complete a home visit;
7.
the completion of other forms applicable to the recipient and/or spouse of
the recipient situation, for example, CPP ‘Consent to Deduction and
Payment - 1613’ form, EI ‘Assignment of Benefits’ form;
8.
where appropriate:
a. reassess the recipient and spouse employability participation
profile by completing the Employment Services Screening
Tool. Complete Employability Participation (EP) codes based
on screening tool.
Where applicable, complete an ‘Understanding of Participation in
Employability Activity’ form and make a referral for:
i. Job Search or
ii. Nova Scotia Employability Assessment (NSEA)
iii. Referral to Department of Labour and Advanced Education
(LAE) – An External Service Provider in your local area
responsible for the delivery of the Labour Market Development
Agreement (LMDA) services for Employment Insurance (EI)
recipients;
or
b. complete the ‘Report of Present Health Condition’ form for
both a recipient and spouse. Medical information, if required,
can include medical documents, assessments, and
information provided by a qualified medical practitioner.
Medical documentation is not required to confirm a disability in
situations where an applicant/recipient and/or spouse are in receipt
of and/or eligible for:
i.Canada Pension Plan (CPP) Disability Benefit;
ii.Long-Term Disability Benefit from an employer,
iii.Disability Tax Credit
vi.Worker’s Compensation Disability Benefits, and
v.Working Income Tax Benefit (WITB) Disability Supplement;
9.
review the reporting cycle and payment history to determine if the case
meets the periodic payment criteria. The reporting cycle may be changed
from monthly to periodic where:
a.
recipients not reporting wages, and/or
b. eligible for ESIA for more than six (6) months, and
c. no budget changes in three (3) months.
Revision #
Revision Date
Chapter
Section
238
October 1,
2014
5- Basic Needs
5.1.2 – Role of Intake
New Version
5.1.2 Policy:
Role of Intake
The role of intake is to make a preliminary assessment of an applicant’s eligibility
and to inform them of their rights and responsibilities. The intake process must
collect relevant information to support an applicants’ request for Employment
Support and Income Assistance and to assess the nature of the request. The
intake process may, when necessary, provide emergency assistance.
There are five (5) major steps involved in the intake process. These steps
include:
1.
Initial Contact: determination of the specific nature of the request and
direct appropriately. This may include a referral to other agencies and
services;
2.
Record and Register;
3.
Potential Eligibility Determination: includes a review job search efforts
in the thirty (30) days prior to making the application for Employment
Support and Income Assistance for both the applicant and/or spouse;
4.
Final Eligibility Determination; and
5.
Cheque Production/Pharmacare Eligibility/Dental Eligibility and
Assignment of Case Manager.
Previous Version
5.1.2 Policy:
Role of Intake
The role of intake is to make a preliminary assessment of an applicant’s eligibility
and to inform them of their rights and responsibilities. The intake process must
collect relevant information to support an applicants’ request for Income
Assistance and to assess the nature of the request. The intake process may,
when necessary, provide emergency Income Assistance.
There are five (5) major steps involved in the intake process. These steps
include:
1. Initial Contact: determination of the specific nature of the request
and direct appropriately. This may include a referral to other
agencies and services;
2. Record and Register;
3. Potential Eligibility Determination and Home Visit: review job
search efforts in the thirty (30) days prior to making the
application for Income Assistance for both the applicant and/or
spouse;
4. Final Eligibility Determination; and
5. Cheque Production/Pharmacare Eligibility/Dental Eligibility
and Assignment of Case Manager.
Revision #
Revision Date
Chapter
Section
237
May 26, 2014
6- Special Needs
6.3.1 – Policy: Special
Needs Schedule
New Version:
6.3.1 – Policy: Special Needs Schedule
Specific criteria regarding each special need item/service are contained within
Policy 6.2 - (Special Needs).
Items of Special Need
Ambulance (Policy 6.2.1)
Approval Criteria
• for emergency use only. Not
approved for non-emergency
transportation
• the approved rate set by the
Department of Health and Wellness
for emergency transportation
Car Seats and Booster Seats
(Policy 6.2.2) (in accordance with
Provincial legislation)
• new car/booster seats that are the
most economical and are Canadian
Standards Association (CSA)
approved
Child Care (Policy 6.2.3)
• up to $400 per month per family
Dental (Policy 6.2.4)
• Policy 6.3.4 – (Dental Fee Guide)
Previous Version:
6.3.1 – Policy: Special Needs Schedule
Specific criteria regarding each special need item/service are contained within
Policy 6.2 - (Special Needs).
Items of Special Need
Ambulance (Policy 6.2.1)
Approval Criteria
• for emergency use only. Not
approved for non-emergency
transportation
• the approved rate set by the
Department of Health and Wellness
for emergency transportation
Car Seats and Booster Seats
(Policy 6.2.2) (in accordance with
Provincial legislation)
• new car/booster seats that are the
most economical and are Canadian
Standards Association (CSA)
approved
Child Care (Policy 6.2.3)
• up to $400 per month per family
Dental Costs (Policy 6.2.4)
• up to $300 per item as per
contracted services
Revision #
Revision Date
Chapter
Section
236
May 26, 2014
6- Special Needs
6.2.4 – Policy: Dental
New Version:
6.3.4 – Policy: Dental Fee Guide
An applicant/recipient, spouse or dependent child may be eligible to receive emergency
dental coverage as per the approved contracted service (the approved dental rates are
included in Policy 6.3.4 - (Dental Fee Guide).
Coverage may be provided in accordance with the approved contracted service under
the following circumstances:
1. for the relief of pain,
2. for control of prolonged bleeding,
3. for treatment of swollen tissue,
4. for provision or repair of broken dentures, and/or
5. for dental problems identified as barriers to employment by Employment Support
staff.
An applicant/recipient, or the spouse or dependent child who has dental coverage under
another dental plan, public or private, may be eligible for coverage by the ESIA
program. Private dental plan coverage must be billed first. The ESIA program will
cover any remaining unpaid balance as long as the total payment does not exceed
100% of the 2014 Nova Scotia Dental Association fee guide and the portion of the
payment from the ESIA program does not exceed the fee listed in this policy manual
(which represents 80% of the 2014 Nova Scotia Dental Association fee guide).
When an applicant/recipient, or the spouse or dependent child requires dental work to
be completed over a period of time and the client is deemed ineligible for a portion of
that time, the work shall be completed within thirty (30) days from the date of ineligibility.
Recipients of Extended Pharmacare benefits may be assessed for dental coverage. In
these cases, the average monthly drug cost is not included in the budget calculation
when assessing eligibility for dental coverage.
Recipients of Transitional Pharmacare benefits who request emergency dental
assistance, will be assessed in accordance with Policy 6.3.4 - (Dental Fee Guide).
Previous Version:
6.3.4 – Policy: Dental Fee Guide
An applicant/recipient, spouse or dependent child may be eligible to receive emergency
dental coverage as per the approved contracted service (the approved dental rates are
included in Policy 6.3.4 - (Dental Fee Guide).
Coverage may be provided in accordance with the approved contracted service under
the following circumstances:
1. for the relief of pain,
2. for control of prolonged bleeding,
3. for treatment of swollen tissue,
4. for provision or repair of broken dentures, and/or
5. for dental problems identified as barriers to employment by Employment Support
staff.
An applicant/recipient, or the spouse or dependent child who has access to dental
coverage under another dental plan, public or private, will be required to use that plan
and they will not be eligible for dental coverage from the Employment Support and
Income Assistance program. The Nova Scotia Health Card number for clients and/or
their dependents will be used as the mechanism to access dental coverage.
When an applicant/recipient, or the spouse or dependent child requires dental work to
be completed over a period of time and the client is deemed ineligible for a portion of
that time, the work shall be completed within thirty (30) days from the date of ineligibility.
Recipients of Extended Pharmacare benefits may be assessed for dental coverage. In
these cases, the average monthly drug cost is not included in the budget calculation
when assessing eligibility for dental coverage.
Recipients of Transitional Pharmacare benefits who request emergency dental
assistance, will be assessed in accordance with Policy 6.3.4 - (Dental Fee Guide).
Revision #
Revision Date
Chapter
Section
235
May 26, 2014
6- Special Needs
6.3.4 – Policy: Dental Fee
Guide
New Version:
6.3.4 – Policy: Dental Fee Guide
RATES SCHEDULE
Procedure
Code
Diagnostic
01205
02111
02112
02131
Scaling
11111
Description
General
Specialist
Practitioner
Fee
Fee
Emergency Oral Examination
Radiographs - Single Film
Radiographs - Two Films
Occlusal Radiograph - Single Film
$37.60
$12.00
$16.00
$22.40
$48.80
$28.00
$29.60
$29.60
Scaling - one unit
$31.20
$68.80
11112
11113
11114
11117
Procedure
Code
Scaling - two units
Scaling - three units
Scaling - four units
Scaling - half unit
Description
$62.40
$93.60
$124.80
$16.00
$137.60
$206.40
$275.20
$34.40
General
Specialist
Practitioner
Fee
Fee
Caries/Trauma/Pain Control
Caries/Trauma/Pain Control
20111
 first tooth
20119
 each additional tooth (same quadrant)
$71.20
$71.20
$76.00
$76.00
Smoothing of Fractured Surfaces
 first tooth
 each additional tooth (same quadrant)
$29.60
$29.60
$33.60
$33.60
$75.20
$98.40
$120.80
$143.20
$169.60
$74.40
$97.60
$119.20
$145.60
$170.40
$87.20
$109.60
$132.00
$155.20
$ 196.80
$87.20
$116.80
$135.20
$169.60
$223.20
$75.20
$98.40
$120.80
$143.20
$169.60
$74.40
$97.60
$119.20
$145.60
$170.40
20131
20139
Amalgam Restorations (Non-Bonded Technique)
Permanent Anterior and Premolars
21211
 one surface
21212
 two surfaces
21213
 three surfaces
21214
 four surfaces
21215
 five surfaces or maximum surfaces per
tooth
21221
21222
21223
21224
21225
Permanent Molars
 one surface
 two surfaces
 three surfaces
 four surfaces
 five surfaces or maximum surfaces per
tooth
Amalgam Restorations (Bonded Technique)
Paid at rate of non-bonded amalgam restorations
Permanent Anterior and Premolars
 one surface
21231
 two surfaces
21232
 three surfaces
21233
 four surfaces
21234
 five surfaces or maximum surfaces per
21235
tooth
21241
21242
21243
21244
21245
Permanent Molars
 one surface
 two surfaces
 three surfaces
 four surfaces
 five surfaces
Retentive Pins
21401

21402

21403

21404

21405

Procedure
Code
one pin
two pins
three pins
four pins
five pins
Description
Tooth Coloured Restorations
Permanent Anteriors
23111
 one surface
23112
 two surfaces
23113
 three surfaces
23114
 four surfaces
23115
 five surfaces or maximum surfaces per
tooth
23311
23312
23313
23314
23315
Permanent Premolars
 one surface
 two surfaces
 three surfaces
 four surfaces
 five surfaces or maximum surfaces per
tooth
Tooth-Coloured Restorations Permanent Molars
Permanent Molars
23321
 one surface
23322
 two surfaces
23323
 three surfaces
23324
 four surfaces
23325
 five surfaces
25754
Anterior Teeth only-with composite core +
pins, where applicable
$87.20
$109.60
$132.00
$155.20
$196.80
$87.20
$116.80
$135.20
$158.40
$223.20
$17.60
$27.20
$37.60
$47.20
$56.80
$30.40
$52.80
$64.80
$84.80
$97.60
General
Specialist
Practitioner
Fee
Fee
$88.80
$112.00
$136.00
$160.00
$210.40
$94.40
$115.20
$168.80
$221.60
$287.20
$104.80
$133.60
$161.60
$190.40
$250.40
$108.00
$145.60
$200.80
$228.00
$280.80
$87.20
$109.60
$132.00
$155.20
$196.80
$87.20
$116.80
$135.20
$169.60
$223.20
$192.00
+ materials
Procedure
Code
Description
Endodontics
32221
Pulpotomy - permanent anterior and
premolars (excluding final restoration)
33111
Root Canals, Permanent Anteriors- one canal
Procedure
Code
Description
Prosthodontics - Removable
Complete Dentures, Standard
51101
 Maxillary
51102
 Mandibular
Dentures, Surgical, Standard (Immediate)
51301
 Maxillary
51302
 Mandibular
General
Specialist
Practitioner
Fee
Fee
$80.00
$141.60
$322.40
$473.60
General
Specialist
Practitioner
Fee
Fee
$592.80 + LAB
$715.20 + LAB
$711.20 + LAB
$776.80 + LAB
Dentures, Partial, Acrylic Base (Immediate)
52111
52112


Maxillary
Mandibular
$424.00 + LAB
$424.00 + LAB
Dentures, Partial, Acrylic, with Metal Wrought/Cast Clasps and/or Rests
Partial Dentures (Acrylic)
52301
 Maxillary
$424.00 + LAB
52302
 Mandibular
$424.00 + LAB
Dentures, Repairs (Three Months After Insertion)
Repairs, Complete Denture No Impression
Required
55101
 Maxillary
$44.80 + LAB
55102
 Mandibular
$44.80 + LAB
55201
55202
Repairs, Complete Denture Impression
Required
 Maxillary
 Mandibular
Repairs, Partial Denture No Impression
Required
$80.80 + LAB
$80.80 + LAB
Procedure
Code
55301
55302
55401
55402
Description


Maxillary
Mandibular
Repairs, Partial Denture Impression
Required
 Maxillary
 Mandibular
General
Specialist
Practitioner
Fee
Fee
$44.80 + LAB
$44.80 + LAB
$111.20 + LAB
$111.20 + LAB
Dentures Relines and Rebases
Only one reline or rebase will be covered per arch per two0year period. Relines and
rebases are not covered within 6 months of the date of insertion of a new denture.
Reline, Complete Denture
56211
 Maxillary
$194.40
56212
 Mandibular
$194.40
56221
56222
Reline, Partial Denture
 Maxillary
 Mandibular
56231
56232
Reline, Complete Denture (Processed)
 Maxillary
 Mandibular
$260.80 + LAB
$268.00 + LAB
56241
56242
Reline, Partial Denture (Processed)
 Maxillary
 Mandibular
$236.00 + LAB
$260.80 + LAB
56311
56312
Rebase, Complete Denture
 Maxillary
 Mandibular
$258.40 + LAB
$300.00 + LAB
56321
56322
Rebase, Partial Denture
 Maxillary
 Mandibular
$236.80 + LAB
$249.60 + LAB
Dentures, Therapeutic Tissue Conditioning
Complete Denture
56511
 Maxillary
56512
 Mandibular
Partial Denture
56521
 Maxillary
56522
 Mandibular
$164.80
$170.40
$100.00
$100.00
$100.00
$100.00
Procedure
Code
Description
General
Specialist
Practitioner
Fee
Fee
Oral Surgery
Surgical Consultation
01601
(Payable only with a referral from a Medical
$82.40
Doctor or a General Dentist)
Panoramic Radiograph
Payable only if rendered by an Oral Surgeon. Limited to one film per five-year period.
Not payable for orthodontic reasons.
02601
Single Film
$62.40
Surgical Removal of Erupted teeth:
71101
 single tooth, uncomplicated
$90.40
$88.80
71109
 each additional in same quadrant, same
$60.80
$58.40
appointment
71201
 complicated, requiring surgical flap
$178.40
$208.00
71209
 each additional in same quadrant, same
$119.20
$208.00
appointment
Removal, Impacted Teeth
Payable only as part of a prior-approved treatment plan.
72111
 single tooth
72119
 each additional tooth, same quadrant
Removal, Residual Roots, Erupted
72311
 first tooth
72319
 each additional tooth, same quadrant
$178.40
$119.20
$208.00
$208.00
$70.40
$47.20
$85.60
$85.60
Removal, Residual Roots, Soft Tissue Coverage
72321
 first tooth
72329
 each additional tooth, same quadrant
$128.00
$85.60
$164.80
$164.80
Removal, Residual Roots, Bone Tissue Coverage
72331
 first tooth
72339
 each additional tooth, same quadrant
$261.60
$174.40
$253.60
$227.20
$158.40
$176.80
Gingivoplasty
73211
Per Sextant
$67.20
$180.00
Sedation (Requires pre-approval)
92431
One Unit of Time
92432
Two Units of Time
$60.80
$84.48
$60.80
$84.48
Alveoloplasty
73121
Per Sextant
(Requires pre-approval)
ESIA Denturist Rates Schedule
Applicants may be eligible for assistance to cover the cost of dentures when recommended by a
physician or a dentist. Dentures shall be obtained by the most economical means. If dentures are
provided by a denturist, then the denturist must be licensed in the Province of Nova Scotia to do so.
Procedure
Code
Diagnostic
10010
10020
10030
Description
General Oral Examination
Limited Exam New Patient (Emergency or Specific)
Limited Exam Previous Patient (Recall, Emergency, and
Specific)
Dentures
31310
Complete Standard Maxillary Denture
31320
Complete Standard Mandibular Denture
31330
Complete Standard Maxillary and Mandibular Denture
Dentures, Reline, Processed, Complete Denture
32110
Maxillary
32120
Mandibular
32130
Maxillary and Mandibular Combined
Relines, Chairside Softlining
Payable only as part of a prior-approved treatment plan.
32318
Complete Maxillary
32328
Complete Mandibular
32338
Complete Maxillary and Mandibular
Denture, Rebase, Processed
33117
Maxillary
33127
Mandibular
Denture Repairs
36110
Complete Maxillary Repair - No Impression
36120
Complete Mandibular Repair - No Impression
36210
Complete Maxillary Repair
36220
Complete Mandibular Repair - with impression
- with Impression
ARM fees need to be billed separately using the procedure
codes below. Not as a LAB.
Additional Repair Material (ARM)
71310
Repair Model/Lab Produced – No Impression
71311
Opposing Model – With Impression
Fee
$86.40
$56.00
$56.00
$692.00
$796.00
$1,488.80
$224.80
$224.80
$473.60
$222.40
$236.00
$459.20
$269.60
$293.60
$74.40 +
ARM
$74.40 +
ARM
$108.0040
+ ARM
$108.0040
+ ARM
$13.60
$51.20
Procedure
Description
Code
71313
Additional Tooth – Per Tooth
71314
Multiple Fractures – Per Denture
71315
Additional Flange – Per Denture
Tissue Conditioning, Complete Denture
Fee
$23.20
$27.20
$31.20
Tissue conditioning is limited to two (2) services per arch in conjunction with new dentures, relines or
rebases. If dentures have been done, tissue reconditioning can only be provided to the standard
dentures.
37110
37120
Maxillary
Mandibular
Procedure
Description
Code
Diagnostic
Partial Dentures Acrylic Base - With Clasp
41610
Partial Maxillary
41620
Partial Mandibular
41630
Partial Maxillary and Mandibular
Partial Dentures Acrylic Base - Without Clasps
41612
Partial Maxillary
41622
Partial Mandibular
41632
Partial Maxillary and Mandibular
Relines, Processed
42116
Partial Maxillary
42126
Partial Mandibular
RELINES - Payable Only As Part Of A Prior-Approved Treatment Plan
Payable only as part of a prior-approved treatment plan.
42318
Partial Maxillary
42328
Partial Mandibular
42338
Partial Maxillary and Mandibular
Rebase, Processed
43116
Partial Maxillary
43126
Partial Mandibular
Repairs
46110
Partial Maxillary - No Impression
46120
Partial Mandibular - No Impression
46210
Partial Maxillary - with Impression
46220
Partial Mandibular - with Impression
Tissue Conditioning, Partial Denture
$56.80
$56.80
Fee
$692.00
$796.00
$1,488.80
$608.00
$708.80
$1,316.00
$235.20
$251.20
$230.40
$248.80
$479.20
$284.00
$307.20
$74.40
$74.40
$108.00
$108.00
Tissue conditioning is limited to two (2) services per arch in conjunction with new dentures, relines or
rebases. If dentures have been done, tissue reconditioning can only be provided to the standard
dentures.
47110
Partial Maxillary
$56.80
Procedure
Description
Code
47120
Partial Mandibular
LAB
Copy of lab invoice required for this service.
98888
Repairs and Additions
Fee
$56.80
$20.00 to
$29.60
Previous Version:
6.3.4 – Policy: Dental Fee Guide
RATES SCHEDULE
Procedure
Code
Diagnostic
1205
1601
2111
2112
2131
2601
Preventative
11111
11112
11113
11114
11117
Procedure
Code
Description
General
Specialist
Practitioner
Fee
Fee
Emergency Oral Examination
Surgical Consultation
Radiographs - Single Film
$31.20
Radiographs - Two Films
Occlusal Radiograph - Single Film
Panoramic Radiograph - Single Film
$12.80
$16.80
$24.80
$24.80
$54.40
$27.20
$54.40
$81.60
$108.80
$13.60
$59.20
$118.40
$177.60
$236.80
$29.60
Scaling B one unit
Scaling - two units
Scaling - three units
Scaling - four units
Scaling - half unit
Description
Amalgam Restorations (Non-Bonded Technique)
Caries/Trauma/Pain Control
20111
 first tooth
20119
 each additional tooth (same quadrant)
$9.60
$42.40
$71.20
$23.20
General
Specialist
Practitioner
Fee
Fee
$60.00
$60.00
$66.40
$66.40
20131
20139
Smoothing of Fractured Surfaces
 first tooth
 each additional tooth (same quadrant)
$24.00
$24.00
$28.00
$28.00
21211
21212
21213
21214
21215
Permanent Anterior and Premolars
 one surface
 two surfaces
 three surfaces
 four surfaces
 five surfaces or maximum surfaces per
tooth
$63.20
$80.00
$100.00
$114.40
$139.20
$49.60
$85.60
$93.60
$ 126.40
$155.20
21221
21222
21223
21224
21225
Permanent Molars
 one surface
 two surfaces
 three surfaces
 four surfaces
 five surfaces or maximum surfaces per
tooth
$69.60
$84.80
$112.00
$139.20
$ 172.00
$63.20
$100.80
$118.40
$146.40
$190.40
$63.20
$80.00
$100.00
$ 114.40
$139.20
$49.60
$85.60
$ 93.60
$ 126.40
$155.20
$69.60
$84.80
$112.00
$139.20
$172.00
$63.20
$ 100.80
$118.40
$146.40
$190.40
$14.40
$23.20
$26.40
$31.20
$37.60
$25.60
$ 45.60
$ 56.00
$ 73.60
$ 85.60
Amalgam Restorations (Bonded Technique)
Permanent Anterior and Premolars
 one surface
21231
 two surfaces
21232
 three surfaces
21233
 four surfaces
21234
 five surfaces or maximum surfaces per
21235
tooth
21241
21242
21243
21244
21245
Permanent Molars
 one surface
 two surfaces
 three surfaces
 four surfaces
 five surfaces
Retentive Pins
21401

21402

21403

21404

21405

one pin
two pins
three pins
four pins
five pins
Procedure
Code
Description
Tooth Coloured Restorations
Permanent Anteriors
23111
 one surface
23112
 two surfaces
23113
 three surfaces
23114
 four surfaces
23115
 five surfaces or maximum surfaces per
tooth
23311
23312
23313
23314
23315
Permanent Premolars
 one surface
 two surfaces
 three surfaces
 four surfaces
 five surfaces or maximum surfaces per
tooth
23321
23322
23323
23324
23325
Permanent Molars
 one surface
 two surfaces
 three surfaces
 four surfaces
 five surfaces
25754
Anterior Teeth only-with composite core +
pins, where applicable
Endodontics
32221
Pulpotomy - permanent anterior and
premolars (excluding final restoration)
33111
Procedure
Code
Root Canals, Permanent Anteriors- one canal
Description
Prosthodontics - Removable
Complete Dentures, Standard
51101
 Maxillary
51102
 Mandibular
General
Specialist
Practitioner
Fee
Fee
79.20
92.80
114.40
152.00
190.40
82.40
99.20
147.20
192.80
249.60
93.60
120.00
159.20
194.40
222.40
82.40
126.40
151.20
198.40
244.00
69.60
84.80
112.00
139.20
172.00
63.20
100.80
118.40
146.40
190.40
$166.40
+ materials
69.60
123.20
278.40
411.20
General
Specialist
Practitioner
Fee
Fee
565.60 + LAB
616.00 + LAB
Procedure
Code
Description
General
Specialist
Practitioner
Fee
Fee
51301
51302
Dentures, Surgical, Standard (Immediate)
 Maxillary
 Mandibular
567.00 + LAB
617.60 + LAB
52111
52112
Partial Dentures (Acrylic Base)
 Maxillary
 Mandibular
330.40 + LAB
330.40 + LAB
52301
52302
Partial Dentures (Acrylic)
 Maxillary
 Mandibular
330.40 + LAB
330.40 + LAB
Dentures, Repairs (Three Months After Insertion)
Repairs, Complete Denture No Impression
Required
55101
 Maxillary
55102
 Mandibular
32.80 + LAB
32.80 + LAB
55201
55202
Repairs, Complete Denture Impression
Required
 Maxillary
 Mandibular
59.20 + LAB
59.20 + LAB
55301
55302
Repairs, Partial Denture No Impression
Required
 Maxillary
 Mandibular
32.80 + LAB
32.80 + LAB
55401
55402
Repairs, Partial Denture Impression
Required
 Maxillary
 Mandibular
89.60 + LAB
89.60 + LAB
56211
56212
Reline, Complete Denture
 Maxillary
 Mandibular
151.20
151.20
56221
56222
Reline, Partial Denture
 Maxillary
 Mandibular
128.80
132.80
Reline, Complete Denture (Processed)
Procedure
Code
56231
56232
Description


Maxillary
Mandibular
General
Specialist
Practitioner
Fee
Fee
199.20 + LAB
207.20 + LAB
56241
56242
Reline, Partial Denture (Processed)
 Maxillary
 Mandibular
182.40 + LAB
201.60 + LAB
56311
56312
Rebase, Complete Denture
 Maxillary
 Mandibular
199.20 + LAB
231.20 + LAB
56321
56322
Rebase, Partial Denture
 Maxillary
 Mandibular
182.40 + LAB
193.60 + LAB
Dentures, Therapeutic Tissue Conditioning
Complete Denture
56511
 Maxillary
56512
 Mandibular
Partial Denture
56521
 Maxillary
56522
 Mandibular
Procedure
Code
Description
79.20
79.20
79.20
79.20
General
Specialist
Practitioner
Fee
Fee
Oral Surgery
71101
71109
71201
71209
72111
72119
72311
72319
Surgical Removal of Erupted teeth:
 single tooth, uncomplicated
 each additional in same quadrant, same
appointment
 complicated, requiring surgical flap
 each additional in same quadrant, same
appointment
Removal, Impacted Teeth (Requires preapproval)
 single tooth
 each additional tooth, same quadrant
Removal, Residual Roots, Erupted
 first tooth
 each additional tooth, same quadrant
78.40
52.00
72.80
34.40
155.20
103.20
180.00
180.00
155.20
103.20
180.00
180.00
59.20
40.00
74.40
74.40
Procedure
Code
Description
General
Specialist
Practitioner
Fee
Fee
72321
72329
Removal, Residual Roots, Soft Tissue
Coverage
 first tooth
 each additional tooth, same quadrant
109.60
72.80
140.80
140.80
72331
72339
Removal, Residual Roots, Bone Tissue
Coverage
 first tooth
 each additional tooth, same quadrant
223.20
148.80
197.60
197.60
136.80
153.60
56.00
156.80
Alveoloplasty
73121
Per Sextant
(Requires pre-approval)
Gingivoplasty
73211
Per Sextant
Sedation
92431
92432
(Requires pre-approval)
One Unit of Time
Two Units of Time
52.80
105.60
ESIA Denturist Rates Schedule
Applicants may be eligible for assistance to cover the cost of dentures when recommended by a
physician or a dentist. Dentures shall be obtained by the most economical means. If dentures are
provided by a denturist, then the denturist must be licensed in the Province of Nova Scotia to do so.
Procedure
Code
Diagnostic
30010
30020
30030
Dentures
31310
31320
31330
Description
New Patient Exam Complete Maxillary
New Patient Exam Complete Mandibular
New Patient Exam
Complete Standard Maxillary Denture
Complete Standard Mandibular Denture
Complete Standard Maxillary and Mandibular Denture
Fee
48.00
46.40
78.40
603.20
693.60
1,223.20
Procedure
Description
Code
Dentures, Reline, Direct, Completed Denture
32210
Maxillary
32220
Mandibular
32230
Maxillary and Mandibular Combined
Dentures, Reline, Processed, Complete Denture
32110
Maxillary
32120
Mandibular
32130
Maxillary and Mandibular Combined
Relines (Payable Only As Part Of A Prior-Approval)
32318
Complete Maxillary
32328
Complete Mandibular
32338
Complete Maxillary and Mandibular
32410
Complete Maxillary
32420
Complete Mandibular
32430
Complete Maxillary and Mandibular
Denture, Rebase, Processed
33117
Maxillary
33127
Mandibular
Denture Repairs
36110
Complete Maxillary Repair - No Impression
36120
Complete Mandibular Repair - No Impression
36210
Complete Maxillary Repair
- with Impression
36220
Complete Mandibular Repair - with impression
Tissue Conditioning, Complete Denture
Fee
173.60
188.00
361.60
200.00
220.00
420.00
198.40
208.80
407.20
200.00
220.00
420.00
240.00
260.00
46.40
46.40
68.80
68.80
Tissue conditioning is limited to two (2) services per arch in conjunction with new dentures, relines or
rebases. If dentures have been done, tissue reconditioning can only be provided to the standard
dentures.
37110
37120
Maxillary
Mandibular
Procedure
Description
Code
Diagnostic
40010
New Patient Exam - Partial Maxillary
40020
New Patient Exam - Partial Mandibular
40030
New Patient Exam - Partial Maxillary and Mandibular
Partial Dentures Acrylic Base - With Clasp
41610
Partial Maxillary
41620
Partial Mandibular
41630
Partial Maxillary and Mandibular
52.00
52.00
Fee
52.00
52.00
88.00
603.20
693.60
1,223.20
Procedure
Description
Code
Partial Dentures Acrylic Base - Without Clasps
41612
Partial Maxillary
41622
Partial Mandibular
41632
Partial Maxillary and Mandibular
Relines, Processed
42116
Partial Maxillary
42126
Partial Mandibular
RELINES - Payable Only As Part Of A Prior-Approved Treatment Plan
42318
Partial Maxillary
42328
Partial Mandibular
42338
Partial Maxillary and Mandibular
42316
Partial Maxillary
42326
Partial Mandibular
42336
Partial Maxillary and Mandibular
Rebase, Processed
43116
Partial Maxillary
43126
Partial Mandibular
Repairs
46110
Partial Maxillary - No Impression
46120
Partial Mandibular - No Impression
46210
Partial Maxillary - with Impression
46220
Partial Mandibular - with Impression
Tissue Conditioning, Partial Denture
Fee
528.80
617.60
1,074.40
208.00
222.40
204.80
220.00
424.80
152.00
170.40
322.40
251.20
272.80
46.40
46.40
68.80
68.80
Tissue conditioning is limited to two (2) services per arch in conjunction with new dentures, relines or
rebases. If dentures have been done, tissue reconditioning can only be provided to the standard
dentures.
47110
47120
98888
Partial Maxillary
Partial Mandibular
Repairs and Additions
52.00
52.00
20.00 to
29.60
Revision #
Revision Date
Chapter
Section
233
October 1,
2013
6- Basic Needs
6.2.18 Policy: Essential
Medical Treatments
New Version:
6.2.18 Policy: Essential Medical Treatments
An applicant/recipient, spouse and/or dependent child may be eligible for assistance with
essential medical treatments under section 24A of the Regulations. This provision does not
permit requests for private healthcare services that are insured under a Provincial insured
health services program or otherwise funded by Government, or prescription drugs.
The items and services that may be considered are medical treatments prescribed for
medical purposes that are not covered by MSI or otherwise funded by Government. Such
treatments include, but are not limited to, massage therapy, acupuncture, chiropractic and
periodontal.
To be considered, the evidence must establish that there is a properly diagnosed disease,
injury, disability or other serious health issue, and there is convincing evidence that the
prescribed treatment is appropriate and effective in terms of medical efficacy and health
outcomes, and can be provided at reasonable cost.
In determining eligibility all of the following criteria must be met:
1. the item or service has been prescribed by a health practitioner who is licensed to
practice in Nova Scotia as a physician, dentist, or nurse practitioner;
2. the item or service is provided by a medical professional licensed or registered to
practice in Nova Scotia;
3. the ‘Request for Essential Medical Treatment’ form has been completed by the
health practitioner providing details of all of the following:
a. the existence of a diagnosed disease, injury, disability or serious health issue;
b. all other alternative items and services available through the provincial
insured health services (MSI), private insurances, privately / publicly funded
organizations and / or otherwise provided by Government have been
attempted or considered and the reason(s) they were not successful in
addressing the medical condition;
c. the cost of the recommended treatment and the alternatives considered (if
known); and
d. there is medical evidence of the appropriateness, necessity and effectiveness
of the requested item or service; and
4. the item or service is the most economical option to address the need.
Prior to determination of eligibility, a caseworker may request a second medical opinion
from a person qualified to determine if the request meets the criteria to be considered an
essential medical treatment.
Previous Version:
6.2.18 Policy: Essential Medical Treatments
No previous version
Revision #
Revision Date
Chapter
Section
232
August 23,
2013
6- Basic Needs
6.2.12 Policy: Furniture
Current Version:
6.2.12 Policy: Furniture
Where no other alternative is available an applicant/recipient may be eligible for the
following basic household and furniture items in accordance with the approved rate.
Item
Bed
Crib
Mattress (including box spring)
Refrigerator
Stove
Table/Chairs
Washers
Approved Rate
up to maximum of $100
new cribs that are the most
economical and are Canadian
Standards Approved (CSA) approved
up to maximum of $100
up to a maximum of $200
up to a maximum of $150
up to a maximum of $125
up to a maximum of $200
1. plus tax when applicable.
2. when all other options for delivery have been exhausted, the most economical delivery
fee may be included.
Previous Version:
6.2.12 Policy: Furniture
Where no other alternative is available an applicant/recipient may be eligible for the
following basic household and furniture items in accordance with the approved rate.
Item
Bed
Approved Rate
up to maximum of $100
Crib
Mattress (including box spring)
Refrigerator
Stove
Table/Chairs
Washers
new cribs that are the most
economical and are Canadian
Standards Approved (CSA) approved
up to maximum of $100
up to a maximum of $200
up to a maximum of $150
up to a maximum of $125
up to a maximum of $200
1. plus tax when applicable.
2. when all other options for delivery have been exhausted, the Supervisor may approve
most economical delivery fees.
Revision #
Revision Date
Chapter
Section
231
July 1, 2013
5- Basic Needs
5.5.1 Policy: Personal
Allowances and Maximum
Shelter Allowance
Current Version:
5.5.1 Policy: Personal Allowances and Maximum Shelter Allowance
Personal Allowance
Shelter Situation
renting, own home,
boarding
in hospital 30 days or
more
in a residential
rehabilitation program
Adult
Dependent Child
Dependent Child
(Up to age 18)
(Age 18 to 20 inclusive)
$255
$133*
$255
$105
Not applicable
$105
$81
Not applicable
$81
Previous Version:
5.5.1 Policy: Personal Allowances and Maximum Shelter Allowance
Personal Allowance
Shelter Situation
renting, own home,
Adult
Dependent Child
Dependent Child
(Up to age 18)
(Age 18 to 20 inclusive)
$238
$133*
$238
boarding
in hospital 30 days or
more
in a residential
rehabilitation program
$105
Not applicable
$105
$81
Not applicable
$81
Revision #
Revision Date
Chapter
Section
230
May 8, 2013
8 – Overpayments,
Underpayments,
and Recovery
All
There was an entire Chapter 8 rewrite.
Revision #
Revision Date
Chapter
Section
229
May 5, 2013
4- Definitions
4- Definitions
Current Version:
4- Definitions
“unearned income” includes, but is not limited to, the following:
a. income maintenance payments (such as, but not limited to, Canada Pension
Plan, Employment Insurance),
b.
Long-Term Disability benefits,
c.
Workers’ compensation,
d.
regular and/or periodic insurance payments,
e.
income from mortgages,
f.
any maintenance payments,
g.
superannuation, and
i.
income from investments such as stocks and bonds
Previous Version:
4- Definitions
56.
“unearned income” includes, but is not limited to, the following:
a.
income maintenance payments such as CPP and EI,
b.
LTD benefits,
c.
Workers’ compensation,
d.
insurance payments,
e.
damage awards,
f.
income from mortgages,
g.
any maintenance payments,
h.
superannuation,
i.
income from investments such as stocks and bonds
Revision
#
Revision Date
Chapter
Section
228
May 1, 2013
6-Special Needs
6.2.23 Policy: Personal
Development
Current Version:
6.2.23 Policy: Personal Development
A recipient and/or spouse of a recipient may be eligible for Income Assistance to
cover personal development activities such as, but not limited to, assertiveness
training, self-esteem programs, anger management, career development when
they are part of an approved employment plan developed to facilitate their
movement towards independence and self-sufficiency.
Approval may be provided when it has been confirmed that funding is not
available through MSI, private insurances and/or privately/publicly funded
organizations. Up to a maximum of $300 per activity/program to a maximum
total of $600 in a twelve (12) month period may be provided.
Personal development activities ordered or required by other agencies,
departments or court system are not approved items/services of special need.
Previous Version:
6.2.23 Policy: Personal Development
A recipient and/or spouse of a recipient may be eligible for Income Assistance to
cover personal development activities such as, but not limited to, assertiveness
training, self-esteem programs, anger management, career development,
individual counseling when they are part of an approved case plan developed to
facilitate their movement towards independence and self-sufficiency.
Approval may be provided when it has been confirmed that funding is not
available through MSI, private insurances and/or privately/publicly funded
organizations. Up to a maximum of $300 per activity/program to a maximum
total of $600 in a twelve (12) month period may be provided.
Personal development activities ordered or required by other agencies,
departments or court system are not approved items/services of special need.
Revision
#
Revision Date
Chapter
Section
227
May 1, 2013
6-Special Needs
6.2.13 Policy: Guide Dog
Allowance
Current Version:
6.2.13 Policy: Guide Dog Allowance
A recipient, spouse of a recipient, and/or dependent child may be eligible for an
allowance of $90 per month for a guide dog allowance and up to $300 a year for
routine veterinary costs, when all other available resources have been
exhausted, if the dog is:
1. received through the support of a certified guide dog
organization/school with documentation outlining provision of supports;
and
2. used by a recipient, spouse of a recipient or dependent child.
The monthly guide dog allowance is for food and routine care costs such as, but
not limited to, grooming, teeth cleaning, toenail clipping, leashes, and incidentals.
Routine veterinary costs include checkups, vaccinations, and flea and heartworm
treatments.
Expenses for non-routine care for a guide dog are not funded by Income
Assistance. Non-routine expenses include, but are not limited to, surgical
procedures, treatment for fractures, and infections, special diets, euthanasia, and
travel, room and board to acquire a dog.
Retired guide dogs and/or pets maintained by a recipient, spouse of a recipient or
dependent child are not eligible for the guide dog allowance or any other special
needs funding.
Previous Version:
6.2.13 Policy: Guide Dog Allowance
A recipient, spouse of a recipient, and/or dependent child may be eligible for an
allowance of $90 per month for a guide dog allowance and up to $300 a year for
routine veterinary costs, when all other available resources have been
exhausted, if the dog is:
1. received through the support of a certified guide dog
organization/school with documentation outlining provision of supports;
and
2. used by a recipient, spouse of a recipient or dependent child.
The monthly guide dog allowance is for food and routine care costs such as, but
not limited to, grooming, teeth cleaning, toenail clipping, leashes, and incidentals.
Routine veterinary costs include checkups, vaccinations, and flea and heartworm
treatments.
Expenses for non-routine care for a guide dog are not funded by Income
Assistance. Non-routine expenses include, but are not limited to, surgical
procedures, treatment for fractures, and infections, special diets, euthanasia, and
travel, room and board to acquire a dog.
Retired guide dogs maintained by a recipient, spouse of a recipient or dependent
child are not eligible for the guide dog allowance.
Revision
#
Revision Date
Chapter
Section
226
February 19,
2013
5-Basic Needs
5.17.10 Policy: Ages 19 to 21
Residing with Parents and
Attending an Educational
Program
Current Version:
5.17.10 Policy: Ages 19 to 21 Residing with Parents and Attending an Educational
Program
Applicant:
An applicant who is age 19 to 21, residing with their parent(s)/guardian(s) and attending
an educational program may not be eligible to receive Income Assistance as the Nova
Scotia Maintenance and Custody Act may include a young person under the age of 21
who is still pursuing their education as a dependent.
Dependent of IA Recipient:
A dependent child (age 19 to 21) attending an approved educational program, which is
not designated for student loan purposes, may be included in a recipient’s budget up to
21 years of age.
The parent(s)/guardian(s) of an applicant under the age of 21 must be eligible if Income
Assistance is to be provided.
Previous Version:
5.17.10 Policy: Ages 19 to 21 Residing with Parents and Attending an Educational
Program
An applicant who is under the age of 21, residing with their parent(s)/guardian(s) and
attending an educational program may not be eligible to receive Income Assistance as
the Nova Scotia Maintenance and Custody Act may include a young person under the
age of 21 who is still pursuing their education as a dependent.
An individual under the age of 21 who is a single parent, residing with his/her
parent(s)/guardian(s) and attending an educational program is not eligible for Income
Assistance in their own right or on behalf of his/her dependent child.
The parent(s)/guardian(s) of an applicant under the age of 21 must be eligible if Income
Assistance is to be provided.
Revision
#
Revision Date
Chapter
Section
225
April 25, 2013
5-Basic Needs
5.10.1 Policy: Youth Aged 16
to 18 (Inclusive) Eligibility
Criteria
Current Version:
5.10.1 Policy: Youth Aged 16 to 18 (Inclusive) Eligibility Criteria
Applicants for Income Assistance (IA) aged 16 to 18 (inclusive) are the legal
responsibility of their parents/guardian and therefore are not eligible for Income
Assistance, in their own right.
In the circumstances outlined below, IA may be granted if the youth is:
1. exposed to an alleged unsafe home environment or an unresolvable
youth/parent conflict and is unable to return and/or remain in the
parental/guardian home;
2. residing in circumstances where it has been established that parents/
guardians are unwilling and/or unable to provide an appropriate home
environment for the applicant; and
3. not attending a student loan eligible educational program.
While in receipt of IA, youth must be:
1.
willing to participate in an employment plan;
2.
willing to be enrolled and attend an approved educational program not
designated for student loan purposes and/or an approved learning
activity/program;
3.
willing to access counseling or mediation services as required;
4.
willing to access medical services, which are required to preserve their
physical and mental health; and
5.
willing to live in a setting, which provides a degree of supervision,
accountability and guidance in accordance with their age and needs.
Independent living may be considered in circumstances where the youth
demonstrates the life skills and maturity necessary to live independently.
Where appropriate, the Minister will pursue support for the child from the parents/
guardian.
Previous Version:
5.10.1 Policy: Youth Aged 16 to 18 (Inclusive) Eligibility Criteria
Applicants for Income Assistance (IA) aged 16 to 18 (inclusive) are the legal
responsibility of their parents/guardian and therefore are not eligible for Income
Assistance, in their own right.
In the circumstances outlined below, IA may be granted if the youth is:
1.
exposed to an alleged unsafe home environment or an unresolvable
youth/ parent conflict and is unable to return and/or remain in the
parental/guardian home;
2.
residing in circumstances where it has been established that parents/
guardians are unwilling and/or unable to provide an appropriate home
environment for the applicant;
3.
enrolled and attending an approved educational program not designated
for student loan purposes and/or an approved learning activity/program;
4.
willing to access counseling or mediation services as required;
5.
willing to access medical services, which are required to preserve their
physical and mental health; and/or
6.
willing to live in a setting, which provides a degree of supervision,
accountability and guidance in accordance with their age and needs.
Independent living may be considered in circumstances where the youth
demonstrates the life skills and maturity necessary to live independently.
Where appropriate, the Minister will pursue support for the child from the
parents/guardian.
Revision
#
Revision Date
Chapter
Section
224
April 22, 2013
5-Basic Needs
5.2.7 Policy: Assignment of
Maintenance Payments to the
Department
Current Version:
5.2.7 Policy: Assignment of Maintenance Payments to the Department
Providing false or misleading information, for the purpose of receiving Income
Assistance, is an offense under the Employment Support & Income Assistance Act.
When it appears an applicant/recipient and/or spouse has intentionally provided false or
misleading information in order to receive Income Assistance, a thorough review will be
undertaken and income assistance may be reduced or terminated, an overpayment may
be assigned, and criminal charges may be pursued.
Previous Version:
5.2.7 Policy: Assignment of Maintenance Payments to the Department
Recipients may assign their maintenance payments over to the Department. The
Maintenance Enforcement Program (MEP) will forward all payments received on
assigned cases directly to the Department and maintenance will not be included in a
recipient’s budget as chargeable income.
Recipients may be involved with the Assignment of Maintenance program when a
caseworker, a recipient and/or MEP determine that maintenance payments are
irregular. Irregular payments are defined as:
1. payments that are sporadic;
2. payments received late (fifteen (15) or more days) for three (3) consecutive
months; and/or
3. payments that cause difficulties for a recipient (e.g. Percentage Orders,
Provisional Orders, default in Orders that are greater than a recipient’s budget
deficit).
To be eligible to enter into the Assignment of Maintenance option, a recipient must have
been in receipt of Income Assistance for three (3) consecutive months and the order
must be enrolled with MEP.
Ad-hoc cheques will not be issued for maintenance for an assignment case.
When a recipient with irregular maintenance payments does not enter into the
Assignment of Maintenance option with the Department after receiving three (3)
consecutive months of ad-hoc payments, the amount of the maintenance order or
separation agreement will continue to be included in the budget as monthly chargeable
income. In this situation, a recipient will no longer be eligible to have this income
replaced by the Department.
When a recipient who had previously assigned their maintenance payments over to the
Department is no longer in receipt of Income Assistance, the maintenance payments
will continue to be forwarded to the Department from MEP until the balance of
maintenance payments, previously issued to the recipient, have been reimbursed to the
Department. In such situations, the Department will forward any current maintenance
payments, as per a maintenance order or separation agreement, to the former recipient
and apply any additional amounts against the balance owed to the Department.
Revision
#
Revision Date
Chapter
Section
223
April 22, 2013
5-Basic Needs
5.1.9 (a) Policy: Failure to
Report Change in
Circumstances - Fraud
Current Version:
5.1.9 (a) Policy: Failure to Report Change in Circumstances - Fraud
Providing false or misleading information, for the purpose of receiving Income
Assistance, is an offense under the Employment Support & Income Assistance Act.
When it appears an applicant/recipient and/or spouse has intentionally provided false or
misleading information in order to receive Income Assistance, a thorough review will be
undertaken and income assistance may be reduced or terminated, an overpayment may
be assigned, and criminal charges may be pursued.
Previous Version:
5.1.9 (a) Policy: Failure to Report Change in Circumstances - Fraud
Where an applicant/recipient or spouse of an applicant/recipient fails to report a change
in circumstances, Income Assistance may be withheld or discontinued and may result in
an overpayment Policy 8.1.1 - (Overpayments).
When it appears an applicant/recipient or spouse of an applicant/recipient intentionally
gave false/misleading information in order to receive Income Assistance, then a
thorough review of the case will be undertaken and a referral to the police may occur.
It is an offense under the Criminal Code for anyone, by deceit, falsehood, or any other
fraudulent means, to defraud the public of money, property, other valuables and/or
securities.
Revision
#
Revision Date
Chapter
Section
222
April 22, 2013
5-Basic Needs
5.1.4 (b) Policy: Maintenance
Income
Current Version:
5.1.4 (b) Policy: Maintenance Income
As a condition of eligibility, an applicant/recipient and/or spouse are expected to pursue
every feasible source of income including maintenance (i.e. child or spousal support).
It is the applicant’s/recipient’s and/or spouse’s responsibility to pursue maintenance
through the Family Maintenance Income Support program or through the Court when:
1. there is no maintenance Order (an Order is a formal written arrangement that is
registered with the Court and enforceable by the Maintenance Enforcement
Program);
2. the maintenance Order is inadequate based on the ability of the non-custodial
parent to pay and the Federal Child Support Guidelines;
3. an additional child is born;
4. a non-custodial parent is unknown; and/or
5. a non-custodial parent is not able to be located.
Previous Version:
5.1.4 (b) Policy: Maintenance Income
As a condition of eligibility an applicant/recipient and/or the spouse are expected to
pursue every possible source of income including maintenance income payments.
A caseworker will:
1. ensure an applicant/recipient and/or the spouse make every reasonable effort to
secure maintenance;
2. make a referral to the Family Maintenance Income Support (FMIS) program
when:
a. an applicant/recipient and the spouse does not have a maintenance order
(an order is considered to be a formal written arrangement registered with
the court and enforceable by the Maintenance Enforcement program);
b. the maintenance order is inadequate based on the ability of the noncustodial parent to pay;
c. additional child(ren) is born;
d. default in maintenance;
e. non-custodial parent is unknown; and/or
f. non-custodial parent is not able to be located.
3. ensure that referrals to the Maintenance Support program include:
a. ‘FMIS Referral’ form;
b. ‘FMIS Information Respecting Support’ form ; and
c. Any previous Orders/Agreements.
Upon receiving a referral, the Maintenance Support caseworker will work with the
recipient and/or the spouse of the recipient and the non-custodial parent to set up a
Maintenance Agreement in accordance with the Child Support Guidelines.
Revision
#
Revision Date
Chapter
Section
221
April 19, 2013
5-Basic Needs
5.1.11 Policy: Conducting the
Annual Review
Current Version:
5.1.11 Policy: Conducting the Annual Review
In order to determine ongoing eligibility for Income Assistance, a comprehensive review of a
recipient’s and/or spouse of the recipient’s eligibility must be conducted once a year for all
cases.
This comprehensive review will include the caseworker meeting with the recipient and
spouse of the recipient, if applicable, to complete, but not limited to, the following
documentation and information:
1. a completed ‘Consent to Release and Obtain Information Authorization’ form signed by
both the recipient and spouse of the recipient;
2. a completed ‘Client Personal and Financial Statement’ form signed by both the recipient
and the spouse of the recipient;
3. verification of income/assets that have not been reported on monthly ‘Income
Statements’ form;
4. copies of documentation regarding assets;
5. copies of bills and/or statements of expenses since the last review;
6. update living situation and complete a home visit;
7. the completion of other forms applicable to the recipient and/or spouse of the recipient
situation, for example, CPP ‘Consent to Deduction and Payment - 1613’ form, EI
‘Assignment of Benefits’ form;
8. where appropriate:
a. reassess the recipient and spouse employability participation profile by completing
the Employment Services Screening Tool. Complete Employability Participation (EP)
codes based on screening tool;
Where applicable, complete an ‘Understanding of Participation in Employability
Activity’ form and make a referral for:
i. Job Search or
ii. Nova Scotia Employability Assessment (NSEA)
iii. Referral to Department of Labour and Advanced Education (LAE) – An
External Service Provider in your local area responsible for the delivery of the
Labour Market Development Agreement (LMDA) services for Employment
Insurance (EI) recipients;
or
b. complete the ‘Report of Present Health Condition’ form for both a recipient and
spouse. Medical information, if required, can include medical documents,
assessments, and information provided by a qualified medical practitioner.
Medical documentation is not required to confirm a disability in situations where
an applicant/recipient and/or spouse are in receipt of and/or eligible for:

Canada Pension Plan(CPP)Disability Benefits,

Long Term Disability Benefits from an employer,

Disability Tax Credit,

Workers Compensation Disability Benefits, and

Working Income Tax Benefit (WITB) Disability Supplement.
9. review the reporting cycle and payment history to determine if the case meets the
periodic payment criteria. The reporting cycle may be changed from monthly to periodic
where:
1. recipients not reporting wages, and/or
2. eligible for ESIA for more than six (6) months, and
3. no budget changes in three (3) months.
Previous Version:
5.1.11 Policy: Conducting the Annual Review
In order to determine ongoing eligibility for Income Assistance, a comprehensive review of a
recipient’s and/or spouse of the recipient’s eligibility must be conducted once a year for all
cases.
This comprehensive review will include the caseworker meeting with the recipient and
spouse of the recipient, if applicable, to complete, but not limited to, the following
documentation and information:
1. a completed ‘Consent to Release and Obtain Information Authorization’ form
signed by both the recipient and spouse of the recipient;
3. a completed ‘Client Personal and Financial Statement’ form signed by both the recipient
and the spouse of the recipient;
3. verification of income/assets that have not been reported on monthly ‘Income
Statements’ form;
4. copies of documentation regarding assets;
5. copies of bills and/or statements of expenses since the last review;
6. update living situation and complete a home visit;
7. the completion of other forms applicable to the recipient and/or spouse of the recipient
situation, for example, CPP ‘Consent to Deduction and Payment - 1613’ form, EI
‘Assignment of Benefits’ form;
8. where appropriate:
a. reassess the recipient and spouse employability participation profile by completing
the Employment Services Screening Tool. Complete Employability Participation (EP)
codes based on screening tool.
Where applicable, complete an ‘Understanding of Participation in Employability
Activity’ form and make a referral for:
i. Job Search or
ii. Nova Scotia Employability Assessment (NSEA)
iii. Referral to Department of Labour and Advanced Education (LAE) – An
External Service Provider in your local area responsible for the delivery of the
Labour Market Development Agreement (LMDA) services for Employment
Insurance (EI) recipients;
or
b. complete the ‘Report of Present Health Condition’ form for both a recipient and
spouse;
9. review the reporting cycle and payment history to determine if the case meets the
periodic payment criteria. The reporting cycle may be changed from monthly to periodic
where:
1. recipients not reporting wages, and/or
2. eligible for ESIA for more than six (6) months, and
3. no budget changes in three (3) months.
Revision
#
Revision Date
Chapter
Section
220
April 19, 2013
5-Basic Needs
5.1.7 Policy: Request for
Medical Information Related
to Employability
Current Version:
5.1.7 Policy: Request for Medical Information Related to Employability
Where there is potential for employment or involvement in employment services,
an applicant/recipient and/or spouse may be required to participate in a case plan
tailored to their capabilities and intended to maximize their opportunities for selfreliance.
In situations where an applicant/recipient and/or spouse indicate their
disability/illness limits the ability to participate in employment, relevant medical
information may be required.
Supporting documentation will be requested when it is unclear how the disability
or illness affects the ability to participate in employment. It is the responsibility of
the applicant/recipient and/or spouse to obtain further clarification, when
requested.
Income Assistance may be provided for a reasonable period of time until a
medical report is obtained.
Medical documentation is not required to confirm a disability in situations where
an applicant/recipient and/or spouse are in receipt of and/or eligible for:
 Canada Pension Plan(CPP)Disability Benefits,
 Long Term Disability Benefits from an employer,
 Disability Tax Credit,
 Workers Compensation Disability Benefits, and
 Working Income Tax Benefit (WITB) Disability Supplement.
Previous Version:
5.1.7 Policy: Request for Medical Information Related to Employability
In situations where an applicant/recipient and/or spouse indicate their
disability/illness is a barrier to employment, relevant medical and social information
may be required. If a medical report is unclear, it is the responsibility of an
applicant/recipient or spouse to obtain further clarification, if requested.
Income Assistance may be provided for a reasonable period of time until a medical
report is obtained.
Where there is potential for employment or involvement in employment services, an
applicant/recipient and/or spouse may be required to participate in a case plan
tailored to their capabilities and intended to maximize their opportunities for selfreliance.
Revision
#
Revision Date
Chapter
Section
219
April 19, 2013
5-Basic Needs
5.1.3 Policy: Required
Documentation
Current Version:
5.1.3 Policy: Required Documentation
In order to determine initial and ongoing eligibility or to verify information, an
applicant/recipient and spouse must provide the following at the time of application or any
other time while in receipt of Income Assistance.
The following information will be maintained on file:
1. a completed and signed ‘ESIA Program Application’ form signed by both the
applicant/recipient and spouse;
2. verification or copies of social insurance numbers for the applicant/recipient and/or the
spouse and, if applicable, dependent children;
3. copies of the Nova Scotia Health Card of the applicant/recipient and/or the spouse and, if
applicable, dependent children; if a Nova Scotia Health card is not available then a copy
of the birth certificate is acceptable pending receipt of Nova Scotia Health Card;
4. a completed and signed ‘Consent to Release and Obtain Information Authorization’ form
by both the applicant/recipient and the spouse;
5. copies of applicant/recipient’s and spouse’s personal and financial information necessary
to determine initial or ongoing eligibility and/or to verify information relating to eligibility;
6. a completed ‘Client Personal and Financial Statement’ form signed by both the
applicant/recipient and the spouse;
7. required documentation as determined by the applicant/recipient’s and spouse’s
circumstances/situation (for immigrants and non-Canadians this includes documentation
from Citizenship and Immigration Canada), if applicable;
8. a completed and signed ‘Understanding of Participation in Employability Activity’ form by
both the applicant/recipient and spouse, if applicable;
9. verification or a copy from the Canada Revenue Agency of the most recent Income Tax
Notice of Assessment (NOA) for both the applicant/recipient and the spouse of the
applicant/recipient;
10. supporting documentation for both the applicant/recipient and spouse, as
per Policy 5.1.7 - (Request for Medical Information Related to Employability), only
when applicable. Medical information, if required, can include medical documents,
assessments, and information provided by a qualified medical practitioner;
Medical documentation is not required to confirm a disability in situations
where an applicant/recipient and/or spouse are in receipt of and/or eligible for:
 Canada Pension Plan(CPP)Disability Benefits,
 Long Term Disability Benefits from an employer,
 Disability Tax Credit,
 Workers Compensation Disability Benefits, and
 Working Income Tax Benefit (WITB) Disability Supplement
11. a completed and signed ‘Student Family Member Consent’ form by the
applicant/recipient and the student family member of the applicant/recipient; and
12. a completed and signed ‘Confirmation of Relationship of Interdependence’ form signed
by the applicant/recipient and the partner of the applicant/ recipient. If the signature of
the partner is not available, the signature of the applicant/recipient is acceptable when
the required information is provided;
Refusal to Provide Required Information/Documentation
Where an applicant/recipient and spouse refuses to provide information or to provide the
required documentation, as set out above or required for assessment of eligibility, Income
Assistance will be refused and/or discontinued.
Previous Version:
5.1.3 Policy: Required Documentation
In order to determine initial and ongoing eligibility or to verify information, an
applicant/recipient and spouse must provide the following at the time of application or any
other time while in receipt of Income Assistance.
The following information will be maintained on file:
1. a completed and signed ‘ESIA Program Application’ form signed by both the
applicant/recipient and spouse of the applicant/recipient;
2. verification or copies of social insurance numbers for the applicant/recipient and/or the
spouse of the applicant/recipient and, if applicable, dependent children;
3. copies of the Nova Scotia Health Card of the applicant/recipient and/or the spouse of the
applicant/recipient and, if applicable, dependent children; if a Nova Scotia Health card is not
available then a copy of birth certificate is acceptable pending receipt of Nova Scotia Health
Card;
4. a completed and signed ‘Consent to Release and Obtain Information Authorization’ form
by both the applicant/recipient and the spouse of the applicant/recipient;
5. copies of applicant/recipient’s and spouse of the applicant/recipient’s personal and
financial information necessary to determine initial or ongoing eligibility and/or to verify
information relating to eligibility;
6. a completed ‘Client Personal and Financial Statement’ form and signed by both the
applicant/recipient and the spouse of the applicant/recipient;
7. required documentation as determined by the applicant/recipient’s and spouse of the
applicant/recipient’s circumstances/situation (for immigrants and non-Canadians this
includes documentation from Citizenship and Immigration Canada), if applicable;
8. a completed and signed ‘Understanding of Participation in Employability Activity’ form by
both the applicant/recipient and spouse of the applicant/ recipient, if applicable;
9. verification or a copy from the Canada Revenue Agency of the most recent Income Tax
Notice of Assessment (NOA) for both the applicant/recipient and the spouse of the
applicant/recipient;
10. updated medical information on both of the applicant/recipient and spouse of the
applicant/recipient as per Policy 5.1.7 - (Request for Medical Information Related to
Employability), if applicable;
11. a completed and signed ‘Student Family Member Consent’ form by the
applicant/recipient and the student family member of the applicant/recipient; and
12. a completed and signed ‘Confirmation of Relationship of Interdependence’ form signed
by the applicant/recipient and the partner of the applicant/ recipient. If the signature of the
partner is not available, the signature of the applicant/recipient is acceptable when the
required information is provided;
Refusal to Provide Required Information/Documentation
Where an applicant/recipient and spouse refuses to provide information or to provide the
required documentation, as set out above or required for assessment of eligibility, Income
Assistance will be refused and/or discontinued.
Revision
#
Revision Date
Chapter
Section
218
November 19,
2012
6-Special Needs
6.2.30 Policy: Special
Clothing
Current Version:
6.2.30 Policy: Special Clothing
An applicant/recipient or dependent of an applicant/recipient may be eligible for a
special clothing allotment under the following circumstances:
1. special clothing necessary because of a medical condition (i.e. mastectomy) and/or
disability;
2. emergency situations (i.e. house fire); and
3. it has been confirmed that funding is not available through the provincial insured
health services (MSI), private insurances and/or privately/publically funded
organizations.
The Special Clothing Policy does not include footwear for orthotics; refer to Policy
6.2.21 – (Orthotics).
Previous Version:
6.2.30 Policy: Special Clothing
An applicant/recipient or dependent of an applicant/recipient may be eligible for a
special clothing allotment for items such as, but not limited to, mastectomy clothing,
shoes for orthotics under the following circumstances:
1. special clothing necessary because of a disability;
2. emergency situations; and
3. it has been confirmed that funding is not available through the provincial insured
health services (MSI), private insurances and/or privately/publically funded
organizations
Revision
#
Revision Date
Chapter
Section
217
November 19,
2012
6-Special Needs
6.2.24 Policy: Prescription
Drug Coverage
Current Version:
6.2.24 Policy: Prescription Drug Coverage
Coverage of prescription drug costs may be provided to an applicant, spouse and
dependent child when there is no eligibility for Income Assistance (Policy 6.1.6 (Individuals not in Receipt of Income Assistance). Only medications/supply approved in
the Nova Scotia Formulary will be considered.
An applicant must register with the Nova Scotia Family Pharmacare program. When
the Nova Scotia Family Pharmacare monthly out of pocket expenses (actual
prescription costs the applicant is required to pay) are included in the budget calculation
and a deficit results, an applicant may be eligible for the amount of the entitlement
(Policy 5.2.1 – (Initial Budget Calculations)).
In urgent circumstances, pending Nova Scotia Family Pharmacare registration and with
supervisory approval (Policy 6.1.5 – (Supervisory Determination of Higher Amount for a
Special Need Item/Service)), the amount of a one month supply of each prescription
medication can be included in the applicant’s budget.
An applicant/recipient, spouse or dependent child who has a private health care plan
from a public (does not include Nova Scotia Family Pharmacare or Low Income
Pharmacare for Children) or a private entity may be required to use that plan and may
not be eligible for Pharmacare benefits. There may be eligibility for a reimbursement of
the copayment amounts that exceed $5.00 per prescription provided the medication/
supply is a benefit under the Nova Scotia Formulary. Receipts verifying the copayments
from the pharmacy or private health plan organization are required.
For recipients, refer to Policy 9.1.1 – (Pharmacare) for information on Pharmacare
benefits.
Previous Version:
6.2.24 Policy: Prescription Drug Coverage
Coverage of prescription drug costs may be provided to an applicant, spouse and
dependent child when there is no eligibility for Income Assistance (Policy 6.1.6.(Individuals not in Receipt of Income Assistance). Only medications approved in the
Nova Scotia Formulary will be considered.
An applicant must register with the Nova Scotia Family Pharmacare program. When the
Nova Scotia Family Pharmacare monthly out of pocket expenses (co-pay and/or
deductible) are included in the budget calculation and a deficit results, an applicant may
be eligible for the amount of the entitlement (Policy 5.2.1 – (Initial Budget Calculations)).
In urgent circumstances, pending Nova Scotia Family Pharmacare registration and with
supervisory approval (Policy 6.1.5 – (Supervisory Determination of Higher Amount for a
Special Need Item/Service)), a one month supply of each prescription medication can
be included in the applicant’s budget.
An applicant/recipient, spouse or dependent child who has a private health care plan
from a public (does not include Nova Scotia Family Pharmacare or Low Income
Pharmacare for Children) or a private entity may be required to use that plan and may
not be eligible for Pharmacare benefits. There may be eligibility for a reimbursement of
the co-payment amounts that exceed $5.00 per prescription provided the medication/
supply is a benefit under the Nova Scotia Formulary. Receipts verifying the copayments from the pharmacy or private health plan organization are required.
For recipients, refer to Policy 9.1.1 – (Pharmacare) for information on Pharmacare
benefits.
Revision
#
Revision Date
Chapter
216
November 19,
2012
6-Special Needs
Section
6.2.21 Policy: Orthotics
Current Version:
6.2.21 Policy: Orthotics
An applicant/recipient, spouse, and/or dependent child may be eligible for assistance
with the purchase of orthotics and/or orthotic modifications when:
1. the need for the requested item has been verified through documentation provided by
a qualified medical doctor or medical practitioner;
2. the requested item is not covered by the provincial insured health services (MSI),
private insurances and/or privately/publicly funded organizations; and
3. it is confirmed it is the most economical option.
Prior to determination of eligibility, a caseworker may refer to a second medical
professional/practitioner, to determine when:
1. the item/service is required;
2. considered effective; and/or
3. an equally effective, more economical option or treatment is available.
When orthotics or orthotic modifications are prescribed by a medical doctor or medical
practitioner, assistance may be provided, subject to the following maximum rates:
1. Custom Orthotic Supports: Must be custom molded foot supports (inserts) or
customized footwear for orthotic support intentionally designed to accommodate a
medical condition, up to $300 once every two (2) years;
2. Orthopaedic Footwear and/or Modifications: Off-the-shelf orthopaedic footwear
and/or shoe modifications. The combined total is up to $130 for a twelve (12)
month period.
Previous Version:
6.2.21 Policy: Orthotics
An applicant/recipient, spouse of an applicant/recipient, and/or dependent child may be
eligible for assistance with the purchase of orthotics and/or orthotic modifications when:
1. the need for the requested item has been verified through documentation provided by
a qualified medical doctor or medical practitioner;
2. the requested item is not covered by the provincial insured health services (MSI),
private insurances and/or privately/publicly funded organizations; and
3. it is confirmed it is the most economical option.
Prior to determination of eligibility, a caseworker may refer to a second medical
professional/practitioner, to determine if:
1. the item/service is required;
2. considered effective; and/or
3. if an equally effective, more economical option or treatment, is available.
When orthotics or orthotic modifications are prescribed by a medical doctor or medical
practitioner, assistance may be provided, subject to the following maximum rates:
1. up to $300 once every two (2) years for custom orthotic supports; and
2. up to $100 once every two (2) years for orthotic modifications to regular shoes.
Revision
#
Revision Date
Chapter
Section
215
November 19,
2012
6-Special Needs
6.2.16 Policy: Medical
Equipment
Current Version:
6.2.16 Policy: Medical Equipment
An applicant/recipient, spouse, and/or dependent child may be eligible for assistance
with the monthly rental/purchase of medical equipment, such as, but not limited to,
prosthetic appliances (i.e. mobility aids, braces, CPAP machines, hearing aids) and
personal alert emergency response systems (i.e. Lifeline, Project Lifesaver) that are not
covered through any other resource when:
1. the need for the requested item has been verified through documentation provided by
a qualified medical doctor or medical practitioner;
2. the requested item is not covered by the provincial insured health services (MSI),
private insurances and/or privately/publicly funded organizations;
3. it is confirmed it is the most economical option (including monthly rental/purchase)
(Policy 6.1.2 – Process for Special Needs Requests); and
4. prior to determination of eligibility, a caseworker may refer to a second medical
professional/practitioner to determine:
a. if the item/service is required;
b. if considered effective; and/or
c. if an equally effective, more economical device, or piece of equipment is available.
The Medical Equipment Policy does not include dental equipment/prosthesis (for dental
refer to Policy 6.3.4 - (Dental Schedule)).
Previous Version:
6.2.16 Policy: Medical Equipment
An applicant/recipient, spouse, and/or dependent child may be eligible for assistance
with the purchase/rent of medical equipment, such as, but not limited to, prosthetics,
CPAP machines, wheelchairs, crutches that are not covered by through Pharmacare
benefits when:
1. the need for the requested item has been verified through documentation provided by
a qualified medical doctor or medical practitioner;
2. the requested item is not covered by the provincial insured health services (MSI),
private insurances and/or privately/publicly funded organizations;
3. it is confirmed it is the most economical option (including monthly rental/purchase);
and
4. supervisory approval has been obtained.
Prior to determination of eligibility, a caseworker may refer to a second medical
professional/practitioner to determine if:
1. the item/service is required;
2. considered effective; and/or
3. if an equally effective, more economical device, piece of equipment or treatment, is
available.
The Medical Equipment Policy does not include dental equipment/prosthesis (for dental
refer to Policy 6.3.4 - (Dental Schedule)).
The actual amount of any assistance provided is dependent on whether a budget deficit
exists when the cost of the item of special need is included on the Income Assistance
application.
Revision
#
Revision Date
Chapter
Section
214
November 19
2012
5-Basic Needs
5.17.14 Policy: Child Support
Maintenance
Current Version:
5.17.14 Policy: Child Support Maintenance
An applicant/recipient is not eligible to receive Income Assistance when they have not
fulfilled the requirement to pursue maintenance for themselves, a dependent child
and/or another family member.
A recipient who does not have an adequate maintenance arrangement must be referred
to Family Maintenance Income Support, under Policy 5.1.4 (b) - (Maintenance Income).
It may be appropriate to suspend the requirement to pursue maintenance under the
conditions outlined in Policy 5.1.4 (c) – (Suspension of Requirement to Pursue
Maintenance).
Previous Version:
5.17.14 Policy: Child Support Maintenance
An applicant/recipient is not eligible to receive Income Assistance when they have not
fulfilled the requirement to pursue maintenance for themselves, a dependent child
and/or another family member.
A recipient who does not have an adequate maintenance arrangement must be referred
to Family Maintenance Income Support, under Policy 5.1.4 (b) - (Maintenance Income).
It may be appropriate to suspend the requirement to pursue maintenance under the
conditions outlined in Policy 5.1.4 (c) – (Suspension of Requirement to Pursue
Maintenance).
Revision
#
Revision Date
Chapter
Section
213
November 19,
2012
5-Basic Needs
5.2.6 Policy: Non-Receipt of
Maintenance Income
Current Version:
5.2.6 Policy: Non-Receipt of Maintenance Income
Eligibility Criteria for Receiving Income Assistance for Unpaid Maintenance
Payments (“Ad Hoc Maintenance”)
A recipient may be eligible to receive ad hoc maintenance payments, up to a maximum
of their Income Assistance (IA) entitlement, when the following criteria are met:
1.
a recipient does not receive their maintenance payment from the Maintenance
Enforcement Program (MEP) or from the payor directly;
2.
the Order has been charged against the budget;
3.
a recipient has a Maintenance Order that is registered with MEP and provides
the MEP case ID, verification of enrolment i.e. ‘Active’ MEP case status and verification
of non receipt by submitting a current “Maintenance Enforcement Program of Nova
Scotia Record of Payments” report to the caseworker; or agrees to immediate
registration (see MEP Registration); and
Note: For privacy reasons, staff will not request, use or record MEP PIN numbers (even
if offered by the recipient).
4.
a recipient completes a ‘Request for Maintenance Arrears’ form, indicating they
agree to repay the funds to DCS, if they later receive them from MEP or from the payor
directly.
MEP Registration
DCS will not issue an ad hoc maintenance payment for more than one (1) service
period, until MEP registration is completed and any arrears owing to the Department
have been declared.
When a recipient cannot register their Order with MEP before the next service period,
additional ad hoc maintenance payments may be issued with supervisory approval
(maximum of one (1) month’s Order amount per service period).
Private Agreements
A recipient who has a private maintenance agreement that cannot be registered with
MEP must be referred to Family Maintenance Income Support, under Policy 5.1.4 (b) (Maintenance Income), to pursue a formal maintenance arrangement.
Assignment of Maintenance (AOM) Requirement
Ad hoc maintenance payments may be issued for a maximum of three (3) consecutive
months. After three (3) consecutive months, a recipient may choose to enter into an
AOM under Policy 5.2.7 - (Assignment of Maintenance Payments to the Department). If
they do not choose to participate in an AOM, the maintenance amount will be included
in their IA budget as chargeable income and no additional ad hoc maintenance
payments will be issued.
It is not a requirement for a recipient to receive three (3) consecutive ad hoc
maintenance payments before qualifying for AOM. However, they must be in receipt of
income assistance for three (3) consecutive months and have irregular maintenance
payments; exceptions may be made when an applicant’s order is greater than their
potential IA entitlement and would prevent them from qualifying for assistance. For full
AOM eligibility criteria, see Policy 5.2.7 - (Assignment of Maintenance Payments to the
Department).
Overpayments
When a recipient receives maintenance from MEP or from the payor directly for a
service period for which an ad hoc maintenance payment was issued, and does not
return the funds to DCS, an overpayment will have been incurred and will be considered
repayable by the recipient.
IA Reapplication with Established Assignment of Maintenance
A former recipient, who reapplies and becomes eligible for income assistance and has
an AOM that has not been terminated with MEP, will have that assignment immediately
re-activated.
Previous Version:
5.2.6 Policy: Non-Receipt of Maintenance Income
Recipients may be eligible to receive an ad-hoc maintenance payment provided the
following criteria are met:
1. a recipient does not receive their maintenance payment;
2. the Order/Agreement has been charged against the budget;
3. a recipient has a Maintenance Agreement/Order and agree to register it with the
Maintenance Enforcement Program (MEP); and
4. a recipient completes a ‘Request for Maintenance Arrears’ form with a
caseworker, indicating they agree to repay the ad-hoc payment (if a recipient
receives the related maintenance at a later date).
A recipient must agree provide a caseworker with:
1. verification of enrolment; and
2. MEP number and Personal Identification Number (PIN) for the purpose of
verifying MEP information (or an alternative means (e.g. recipient gets MEP to
send original printouts).
MEP registration must be completed prior to issuing maintenance ad-hoc payments for
more than one (1) service period. However, if there are extenuating circumstances that
preclude a recipient from doing so before the next service period (e.g. private
agreement that cannot be registered), additional ad-hoc payments may be issued, with
supervisory approval (maximum of one (1) month’s Order amount per service period).
In situations where a recipient has a private maintenance agreement that cannot be
registered with MEP, the recipient must be referred to the Family Maintenance Income
Support program Policy 5.1.4(b) - (Maintenance Income) to pursue a formal
maintenance arrangement.
Maintenance ad-hoc payments may be issued for a maximum of three (3) consecutive
months. After three (3) consecutive months, a recipient may enter into an Assignment of
Maintenance Policy 5.2.7 - (Assignment of Maintenance Payments to the
Minister/Department). If a recipient chooses not to enter into an Assignment of
Maintenance, the maintenance amount will be included as chargeable income and no
additional maintenance ad-hoc payments will be issued.
If a recipient receives maintenance for a service period for which an ad-hoc payment
was issued, and does not return these funds to DCS, an overpayment will be setup for
the associated funds. An overpayment should only be established when a recipient has
received the funds from both the Department and the payor.
Revision
#
Revision Date
Chapter
Section
212
November 19
2012
5-Basic Needs
5.1.5 Policy: Employability
Screening Questions at
Intake
Current Version:
5.1.5 Policy: Employability Screening Questions at Intake
An applicant/recipient and spouse who meets the general eligibility criteria for Income
Assistance must complete the Employment Services Screening Tool. Completion of the
Employment Screening Tool does not apply to youth aged 16-18. Please refer to Policy
5.10.1 – (Youth Aged 16-18 inclusive) Eligibility Criteria.
The outcome of the Employment Services Screening Tool will be used to determine the
potential requirement for an applicant/recipient and spouse to participate in
employability activities and sign the ‘Understanding of Participation in Employability
Activity’ form.
Refusal to participate in the completion of the Employment Services Screening Tool at
Intake
Where an applicant/recipient or spouse refuses to complete the Employment Services
Screening Tool, Income Assistance will be refused and/or discontinued.
Previous Version:
5.1.5 Policy: Employability Participation Questions at Intake
An applicant/recipient and spouse of an applicant/recipient who meets the general
eligibility criteria for Income Assistance must complete the employability participation
questions located on the ‘ESIA Program Application’ form.
The outcome of the employability participation questions located on the ‘ESIA Program
Application’ form will be used to determine the potential requirement for an
applicant/recipient and spouse of an applicant/recipient to demonstrate his/her job
search efforts in the thirty (30) days prior to making application, to participate in a Nova
Scotia Employability Assessment and to sign the ‘Understanding of Participation in
Employability Activity’ form.
Refusal to participate in the completion of the Employability Participation Questions at
Intake
Where an applicant/recipient or spouse of an applicant/recipient refuses to complete the
employability participation questions, Income Assistance will be refused and/or
discontinued.
Revision
#
Revision Date
Chapter
Section
211
November 19
2012
5-Basic Needs
5.1.4 (c) Policy: Suspension
of Requirement to Pursue
Maintenance
Current Version:
5.1.4 (c) Policy: Suspension of Requirement to Pursue Maintenance
When potential abuse by the absent spouse or non-custodial parent (NCP) poses a
serious threat to the applicant/recipient and/or another family member, it may be
appropriate to temporarily suspend the requirement to pursue maintenance.
A permanent suspension may be established when the absent spouse and/or parent is
deceased or has a disability or illness that will permanently prevent them from paying
maintenance. It may also be appropriate for the applicant/recipient and/or dependent
children to apply for survivor’s benefits under Policy 5.14 (a) - (Canada Pension Plan
Benefits).
Previous Version:
5.1.4 (c) Policy: Waiver of Requirement to Pursue Maintenance
When potential abuse by the absent spouse or parent poses a serious threat to the
recipient, and/or other family members, the requirement to pursue maintenance may be
waived.
Revision
#
Revision Date
Chapter
Section
210
November 19
2012
5-Basic Needs
5.1.4 Policy: Required to
Pursue all other Feasible
Sources of Income
Current Version:
5.1.4 Policy: Required to Pursue all other Feasible Sources of Income
An applicant/recipient and/or spouse is required to pursue all other feasible sources of
income including, but not limited to: wages, Employment Insurance, Canada Pension
Plan, Old Age Security, the Canada Child Tax Benefit, the Guaranteed Income
Supplement, private insurance claims, and maintenance payments. Where an
applicant/recipient and/or spouse refuse to pursue all other feasible sources of income,
Income Assistance will be refused and/or discontinued.
Previous Version:
5.1.4 Policy: Required to Pursue all other Feasible Sources of Income
A caseworker will ensure that an applicant/recipient and spouse of an
applicant/recipient have been requested to pursue all other sources of income during
the intake process and/or while in receipt of Income Assistance.
Other sources of income may be, but are not limited to the following: Employment
Insurance Benefits, Canada Pension Plan Benefits, Old Age Security Pension, Canada
Child Tax Benefit, Guaranteed Income Supplement Benefits, benefits from private
insurances, Maintenance Income Support and other sources of income as determined
appropriate.
Revision
#
Revision Date
Chapter
Section
209
July 1 2012
Appendix 2
Appendix 2 - Policy : The
Nova Scotia Child Benefit
Current Version:
Appendix 2 - Policy : The Nova Scotia Child Benefit
Benefit Structure:
Effective July 1, 2001 the Nova Scotia Child Benefit was fully integrated with the
National Child Benefit Supplement to establish a standard benefit.
The benefits are:
The Nova Scotia Child Benefit Maximum Annual Benefits
# of Children
1st child
2nd child
July 2011
$542.90
$786.90
July 2012
$624.96
$825.00
3rd and each additional child
$878.40
$900.00
The National Child Benefit Supplement Maximum Annual Benefits
# of Children
July 2011
July 2012
st
$2,118
$2,177.04
nd
$1,873
$1,782
$1,926.00
$1,832.04
1 child
2 child
3rd and each additional child
The Nova Scotia Child Benefit is combined with the National Child Benefit Supplement
to establish a standard benefit for each child as illustrated below:
Combined Benefits – July 1, 2012 - June 30, 2013
National
Nova Scotia
Children
Child Benefit
Child Benefit
Supplement
1st child
$624.96
$2,177.04
Combined
Benefits
2nd child
$2,751.00
$825.00
$1,926.00
$2,802.00
3rd and each
additional child
$900.00
$1,832.04
$2,732.04
The following chart illustrates the Nova Scotia Child Benefit combined with the Canada
Child Tax Benefit:
Nova Scotia Child Benefit and the Canada Child Tax Benefit
Families Receiving Maximum Benefits of the Nova Scotia Child Benefit
Monthly Benefits - July 1, 2012
Family Size
Nova Scotia and
National Child
Benefit Combined
Canada Child Tax
Benefit Base
Amount *
Total Monthly
Federal Cheque
1 Child
$233.50
$117.08
$350.58
2 Children
$462.75
$234.16
$696.91
3 Children
$690.42
$359.41
$1,049.83
4 Children
$918.09
$484.66
$1,402.75
5 Children
$1,145.76
$609.91
$1,755.67
Previous Version:
Appendix 2 - Policy : The Nova Scotia Child Benefit
Benefit Structure:
Effective July 1, 2001 the Nova Scotia Child Benefit was fully integrated with the
National Child Benefit Supplement to establish a standard benefit.
The benefits are:
The Nova Scotia Child Benefit Maximum Annual Benefits
# of Children
1st child
2nd child
July 2010
$445
$645
July 2011
$542.90
$786.90
3rd and each additional child
$720
$878.40
The National Child Benefit Supplement Maximum Annual Benefits
# of Children
July 2010
July 2011
1st child
$2,088
$2,118
2nd child
3rd and each additional child
$1,848
$1,758
$1,873
$1,782
The Nova Scotia Child Benefit is combined with the National Child Benefit Supplement
to establish a standard benefit for each child as illustrated below:
Combined Benefits – July 1, 2011 - June 30, 2012
National
Nova Scotia
Children
Child Benefit
Child Benefit
Supplement
st
1 child
$543
$2,118
Combined
Benefits
2nd child
$787
$1,873
$2,660
3rd and each
additional child
$878
$1,782
$2,660
$2,661
The following chart illustrates the Nova Scotia Child Benefit combined with the Canada
Child Tax Benefit:
Nova Scotia Child Benefit and the Canada Child Tax Benefit
Families Receiving Maximum Benefits of the Nova Scotia Child Benefit
Monthly Benefits - July 1, 2011
Family Size
Nova Scotia and
National Child
Benefit Combined
Canada Child Tax
Benefit Base
Amount *
Total Monthly
Federal Cheque
1 Child
$221.74
$113.92
$335.66
2 Children
$443.40
$227.83
$671.23
3 Children
$665.10
$349.67
$1,014.77
4 Children
$886.80
$471.51
$1,358.31
5 Children
$1,108.50
$593.93
$1,702.43
Revision
#
Revision Date
Chapter
Section
208
July 1 2012
5 – Basic Needs
5.5.1 Policy : Personal
Allowances and Maximum
Shelter Allowance
Current Version:
5.1.4 Policy: Schedule: Personal Allowances and Maximum Shelter Allowance
Personal Allowance
Shelter Situation
Adult
Dependent Child
(Up to age 18)
Dependent Child
(Age 18 to 20
inclusive)
renting, own
home, boarding
$238
$133*
$238
in hospital 30
days or more
$105
Not applicable
$105
in a residential
rehabilitation
program
$81
Not applicable
$81
Previous Version:
5.5.1 Policy: Schedule: Personal Allowances and Maximum Shelter Allowance
Personal Allowance
Shelter Situation
Adult
Dependent Child
(Up to age 18)
Dependent Child
(Age 18 to 20
inclusive)
renting, own
home, boarding
$229
$133*
$229
in hospital 30
days or more
$105
Not applicable
$105
in a residential
rehabilitation
program
$81
Not applicable
$81
Revision
#
207
Revision Date
July 1, 2012
Chapter
The Nova Scotia
Child Benefit
Section
Schedule
Current Version:
The Nova Scotia Child Benefit Schedule
Benefit Structure:
Effective July 1, 2001 the Nova Scotia Child Benefit was fully integrated with the
National Child Benefit Supplement to establish a standard benefit.
The benefits are:
The Nova Scotia Child Benefit Maximum Annual Benefits
# of Children
1st child
2nd child
3rd and each additional child
July 2011
$542.90
$786.90
July 2012
$624.96
$825.00
$878.40
$900.00
The National Child Benefit Supplement Maximum Annual Benefits
# of Children
July 2011
July 2012
1st child
$2,118
$2,177.04
2nd child
3rd and each additional child
$1,873
$1,782
$1,926.00
$1,832.04
The Nova Scotia Child Benefit is combined with the National Child Benefit
Supplement to establish a standard benefit for each child as illustrated below:
Combined Benefits – July 1, 2012 - June 30, 2013
Children
Nova Scotia
National
Combined
Child Benefit
1st child
$624.96
Child Benefit
Supplement
$2,177.04
Benefits
2nd child
$825.00
$1,926.00
$2,751.00
$900.00
$1,832.04
$2,732.04
$2,802.00
rd
3 and each
additional child
The following chart illustrates the Nova Scotia Child Benefit combined with the
Canada Child Tax Benefit:
Nova Scotia Child Benefit and the Canada Child Tax Benefit
Families Receiving Maximum Benefits of the Nova Scotia Child Benefit
Monthly Benefits - July 1, 2012
Nova Scotia and
National Child
Benefit Combined
Canada Child Tax
Benefit Base
Amount *
Total Monthly
Federal Cheque
1 Child
$233.50
$117.08
$350.58
2 Children
$462.75
$234.16
$696.91
3 Children
$690.42
$359.41
$1,049.83
4 Children
$918.09
$484.66
$1,402.75
5 Children
$1,145.76
$609.91
$1,755.67
Family Size
Previous Version:
The Nova Scotia Child Benefit Schedule
Benefit Structure:
Effective July 1, 2001 the Nova Scotia Child Benefit was fully integrated with the
National Child Benefit Supplement to establish a standard benefit.
The benefits are:
The Nova Scotia Child Benefit Maximum Annual Benefits
# of Children
1st child
2nd child
3rd and each additional child
July 2010
$445
$645
July 2011
$542.90
$786.90
$720
$878.40
The National Child Benefit Supplement Maximum Annual Benefits
# of Children
July 2010
July 2011
st
$2,088
$2,118
nd
$1,848
$1,758
$1,873
$1,782
1 child
2 child
3rd and each additional child
The Nova Scotia Child Benefit is combined with the National Child Benefit
Supplement to establish a standard benefit for each child as illustrated below:
Combined Benefits – July 1, 2011 - June 30, 2012
National
Nova Scotia
Combined
Children
Child Benefit
Child Benefit
Benefits
Supplement
1st child
$543
$2,118
$2,661
2nd child
$787
$1,873
$2,660
$878
$1,782
$2,660
rd
3 and each
additional child
The following chart illustrates the Nova Scotia Child Benefit combined with the
Canada Child Tax Benefit:
Nova Scotia Child Benefit and the Canada Child Tax Benefit
Families Receiving Maximum Benefits of the Nova Scotia Child Benefit
Monthly Benefits - July 1, 2011
Nova Scotia and
National Child
Benefit Combined
Canada Child Tax
Benefit Base
Amount *
Total Monthly
Federal Cheque
1 Child
$221.74
$113.92
$335.66
2 Children
$443.40
$227.83
$671.23
3 Children
$665.10
$349.67
$1,014.77
4 Children
$886.80
$471.51
$1,358.31
5 Children
$1,108.50
$593.93
$1,702.43
Family Size
Revision
#
206
Revision Date
July 1, 2012
Chapter
5- Basic Needs
Section
5.5.1 Policy – Rates of Income
Assistance Schedule
Current Version:
5.5.1 Policy: Schedule: Personal Allowances and Maximum Shelter Allowance
Personal Allowance
Shelter Situation
Adult
Dependent Child
Dependent Child
(Up to age 18)
(Age 18 to 20
inclusive)
renting, own
home, boarding
$238
$133*
$238
in hospital 30
days or more
$105
Not applicable
$105
in a residential
rehabilitation
program
$81
Not applicable
$81
Previous Version:
5.5.1 Policy: Schedule: Personal Allowances and Maximum Shelter Allowance
Shelter Situation
Adult
Personal Allowance
Dependent Child
Dependent Child
(Up to age 18)
(Age 18 to 20
inclusive)
renting, own
home, boarding
$229
$133*
$229
in hospital 30
days or more
$105
Not applicable
$105
in a residential
rehabilitation
program
$81
Not applicable
$81
Revision
#
205
Revision Date
May 1, 2012
Chapter
9-Phamacare
Section
9.1.1 Policy – Pharmacare
Current Version:
9.1.1 Policy:
Pharmacare
Pharmacare benefits may be granted to eligible recipients and/or spouse and dependents in
receipt of Income Assistance. Any recipient and/ or spouse and dependents having access
to another drug plan, from a public (does not include Nova Scotia Family Pharmacare or
Low Income Pharmacare for Children) or a private entity, may be required to use that plan
and may not be eligible for Pharmacare benefits. There may be eligibility for a
reimbursement of the co-payment amounts that exceed $5.00 per prescription provided
the medication/supply is a benefit under the Nova Scotia Formulary. Policy 6.2.24 –
(Prescription Drug Coverage).
Only those medications/supplies and the approved amount included in the Nova Scotia
Formulary can be considered. Requests for assistance with prescription drug coverage that
is not included in the Nova Scotia Formulary will not be approved as a special needs item.
Policy 9.1.3 – (Exception Drug Status). Receipts verifying the co-payments from the
pharmacy or private health plan are required.
Recipients and/or spouse and their dependents are required to pay a flat co-pay fee of
$5.00 per prescription, unless recipients and/or spouse of recipient and their dependents
is/are eligible for co-pay exemption as per Policy 9.1.4 – (Co-Pay Exemptions).
Recipients and/or spouse and their dependents requiring Pharmacare coverage must
provide their Nova Scotia Health Card Number (HCN).
Where Pharmacare benefits have been provided to a recipient is discontinued because the
total chargeable income of a recipient exceeds the total allowable expenses, a recipient
may be eligible for Extended or Transitional Pharmacare if they meet the specific criteria for
Policy 9.1.5 - (Extended Pharmacare) or Policy 9.1.6 – (Transitional Pharmacare).
Previous Version:
9.1.1 Policy:
Pharmacare
Pharmacare benefits may be granted to eligible recipients and/or spouse of recipient and
their dependents in receipt of Income Assistance. Any recipient and/ or spouse of a
recipient and their dependents having access to another drug plan, from a public or private
entity, will be required to use that plan and will not be eligible for Pharmacare benefits.
Pharmacare benefits are provided in accordance with the contracted service, only.
Requests for assistance with prescription drug coverage that is not included in the approved
formulary will not be approved as a special needs item. Only those medications/supplies
and the approved amount included in the Nova Scotia Formulary can be considered. All
Income Assistance recipients and/or spouse of recipient and their dependents are required
to pay a flat co-pay fee of $5 per prescription, unless recipients and/or spouse of recipient
and their dependents is/are eligible for co-pay exemption.
All recipients and/or spouse of recipient and their dependents requiring Pharmacare
coverage must provide their Nova Scotia Health Card Number (HCN).
Where Pharmacare benefits have been provided to a recipient is discontinued because the
total chargeable income of a recipient exceeds the total allowable expenses, a recipient
may be eligible for Extended Pharmacare if they meet the specific criteria. Policy 9.1.5 (Extended Pharmacare)
Revision
#
204
Revision Date
May 1, 2012
Chapter
7-Employability
Section
7.1.3 Policy – Referral for
Employment Services
Current Version:
Deleted
Previous Version:
7.1.3 Policy:
Referral for Employment Services
A recipient and/or spouse of a recipient who is determined potentially appropriate for
participation in employability activity will be referred to the appropriate internal or
external employment service. This referral will be based on the results of an initial
assessment resulting from the employability participation questions for a Nova Scotia
Employability Assessment (NSEA) facilitated by a person certified by the Department of
Community Services to use the NSEA.
Revision
#
203
Revision Date
May 1, 2012
Chapter
7-Employability
Section
7.1.3 Policy – Nova Scotia
Employability Assessment
(NSEA)
Current Version:
7.1.3 Policy:
Nova Scotia Employability Assessment (NSEA)
A recipient and/or a spouse of a recipient who has been determined potentially
appropriate for participation in employability activity based on the Employment
Services Screening Tool will be referred for completion of the Nova Scotia
Employability Assessment (NSEA).
The NSEA will be facilitated by a person certified by the Department of
Community Services. Participation in the NSEA and a resulting employability
action plan is a requirement to support ongoing eligibility for Income Assistance.
Previous Version:
7.1.1 Policy:
Nova Scotia Employability Assessment (NSEA)
A recipient and/or a spouse of a recipient who has been determined potentially
appropriate for participation in employability activity based on the questions on
the ‘ESIA Program Application’ form will be referred for completion of the Nova
Scotia Employability Assessment (NSEA).
The NSEA will be facilitated by a person certified by the Department of
Community Services. Participation in the NSEA and a resulting action plan is a
requirement to support ongoing eligibility for Income Assistance.
Revision
#
202
Revision Date
May 1, 2012
Chapter
7-Employability
Section
7.1.2 Policy – Referral for Job
Search Activities
Current Version:
7.1.2 Policy:
Referral for Job Search Activities
A recipient and/or a spouse who has been determined to be employable at intake based
on the questions on the Employment Services Screening Tool will be referred for job
search activities.
The services will be provided by the Department of Community Services or a service
provider approved by DCS. Participation in employment related activities is a
requirement to support ongoing eligibility for Income Assistance.
Previous Version:
7.1.2 Policy:
Referral Guidelines for Nova Scotia Employability
Assessment (NSEA) and Employability Participation Code (EP)
A recipient and/or spouse of a recipient must be asked the employability
participation questions located on the ‘ESIA Program Application’ form to assist
in the assigning of an EP code, as illustrated in the chart below, and referred for
the completion of a NSEA. Policy 5.1.5 - (Employability Participation Questions
at Intake).
Appropriate Referral for a NSEA
1. Individual is mentally and physical stable. (EP 01 - Waiting for
Assessment)
2. Individual demonstrates no significant emotional, social or other life
circumstances that could interfere with participation in employability
activities. (EP 01 - Waiting for Assessment)
3. Individual works part-time and is in receipt of Income Assistance and has
the potential to increase his/her self-sufficiency. (EP 01 - Waiting for
Assessment)
4. Individual is capable of benefitting from services offered by Employment
Support Services. (EP 01 - Waiting for Assessment)
Appropriate Referral for a NSEA
5. Individual has a disability and is in receipt of Income Assistance and
potentially eligible for services under the Labour Market Agreement for
Persons with Disabilities program. (EP 01 - Waiting for Assessment)
6. Individuals who are coded EP 04 (not required) who choose to participate
in employability activity and receiving employability supports to participate.
This provision does not apply to individuals participating in adult service
centres.
Inappropriate Referral for a NSEA
1. Individual is pending verified full-time employment which is scheduled to
start within thirty (30) days. (EP 03 - Temporarily Excused)
2. Individual is pending Employment Insurance benefits or another source of
income which will make him/her ineligible for Income Assistance. (EP 03 Temporarily Excused)
3. Individual has been determined to be appropriate for participation in a
NSEA, but is relocating out of the Province within the next thirty (30) days.
(EP 03 - Temporarily Excused)
4. Individual is working full-time, receiving Income Assistance to supplement
earnings and is unable to attend an appointment to have a NSEA
completed at the present time. (EP 03 - Temporarily Excused)
5. Individual has a court appearance within the next three (3) months and
may be temporarily excused depending on the specific circumstances. (EP
03 - Temporarily Excused)
6. Individual has an active substance abuse addiction or has been in recovery
for less than three (3) months. (EP 03 - Temporarily Excused)
7. Individual presents physical and/or mental and/or life circumstances that
indicate any level of participation in employability related activity is not
feasible, at the present time. (EP 03 - Temporarily Excused)
8. Individual is the sole care giver to a critically ill legal or common-law
spouse or disabled child requiring care. (EP 03 - Temporarily Excused)
9. Individual is exempted from participation in employability related activity for
a period of twelve (12) calendar months from the date of the birth of a
child/adoption of a new child unless the Recipient or spouse has chosen to
participate in employability activity. (EP 03 - Temporarily Excused)
10. Individual demonstrates that the ability to seek or maintain either
Inappropriate Referral for a NSEA
employment or other employability enhancing activity is not feasible due to
significant barriers in the areas of physical/mental health, personal, social
or family issues, and it has been determined that there will not be a
requirement now, nor is there likely to be a requirement in the future to
participate in employment related activities. (EP 04 - Not Required)
11. Individual works part-time and receiving Income Assistance to supplement
earnings and it has been determined that there will not be a requirement
now, nor is there likely to be a requirement in the future to participate in
employment related activities. (EP 04 - Not Required)
Revision
#
201
Revision Date
May 1, 2012
Chapter
7-Employability
Section
7.1.5 Policy – Employment
Services Provided
Current Version:
7.1.1 Policy:
Employment Services Provided
A recipient and/or the spouse of a recipient, upon the completion of the
Employment Services Screening Tool and/or the Nova Scotia Employability
Assessment (NSEA), where applicable, will be provided access to the most
appropriate and cost-effective services that are available and necessary to
implement the Employment Action Plan.
A caseworker will ensure that required services can be delivered by the
Department or by community-based partners in a timely manner that is
responsive to a recipient’s needs and consistent with labour market trends before
approving the employment action plan. These services may include but are not
limited to:
1. personal development services which facilitate progressions to selfsufficiency;
2. support for a recipient in the form of referrals to appropriate agencies
which provide services that address a recipient’s needs and goals;
3. job preparation and employment entry supports such as job development,
resume preparation, workshops, employment referrals, placements, etc.;
4. skills development supports such as skill specific training and placements;
5. career development supports consistent with a career/life development
model that promotes lifelong learning and encourages recipient ownership
of the process;
6. office and technology supports such as Internet access, telephone
service, photocopy and mail service; and/or
7. literacy/academic upgrading programs up to and including grade 12 that
meet standards recognized by the Nova Scotia Department of Education.
Previous Version:
7.1.5 Policy:
Employment Services Provided
A recipient and/or the spouse of a recipient, upon completion of a Nova Scotia
Employability Assessment (NSEA), will be provided access to the most
appropriate and cost-effective services that are available and necessary to
implement the Employment Action Plan.
A caseworker will ensure that required services can be delivered by the
Department or by community-based partners in a timely manner that is
responsive to a recipient’s needs and consistent with labour market trends before
approving the employment action plan. These services may include but are not
limited to:
1.
personal development services which facilitate progressions to self
sufficiency;
2.
support for a recipient in the form of referrals to appropriate agencies
which provide services that address a recipient’s needs and goals;
3.
job preparation and employment entry supports such as job development,
resume preparation, workshops, employment referrals, placements, etc.;
4.
skills development supports such as skill specific training and placements;
5.
career development supports consistent with a career/life development
model that promotes lifelong learning and encourages recipient ownership
of the process;
6.
office and technology supports such as Internet access, telephone
service, photocopy and mail service; and/or
7.
literacy/academic upgrading programs up to and including grade 12 that
meet standards recognized by the Nova Scotia Department of Education.
Revision
#
200
Revision Date
May 1, 2012
Chapter
6-Special Needs
Section
6.3.1 Policy– Special Needs
Schedule
Current Version:
6.3.1 Policy:
Special Needs Schedule
Specific criteria regarding each special need item/service are contained within
Policy 6.2 - (Special Needs).
Items of Special Need
Approval Criteria
Guide Dog Allowance
(Policy 6.2.13)
• $90 per month maximum
• The guide dog allowance is for food
and routine care costs such as, but not
limited to, grooming, teeth cleaning,
toenail clipping, leashes, and
incidentals.
• Routine veterinary costs include
checkups, vaccinations, and flea and
heartworm treatments.
Employability Related Special Needs
(Policy 6.2.6)
payment of fees that are directly related
to a return to employment (examples
include but are not limited to, driver’s
licences, criminal record check, driver’s
abstract, child abuse registry check,
medicals, criminal record/pardon
applications, fines)
• up to maximum of $300 per twelve
(12) month period
• up to maximum of total of $200 in a
twelve (12) month period (criminal
records pardon applications may
exceed this amount).
Previous Version
6.3.1 Policy:
Special Needs Schedule
Specific criteria regarding each special need item/service are contained within
Policy 6.2 - (Special Needs).
Items of Special Need
Guide Dog Allowance(Policy 6.2.13)
Employability Related Special
Needs (Policy 6.2.6)
payment of fees that are directly
related to a return to employment
(examples include but are not limited
to, driver’s licences, criminal record
check, driver’s abstract, child abuse
registry check, medicals, criminal
record/pardon applications, fines)
Revision
#
199
Revision Date
May 1, 2012
Chapter
6-Special Needs
Approval Criteria
• $60 per month maximum
• up to maximum of total of $200 in a
twelve (12) month period
Section
6.2.25 Policy– Property Tax
Arrears
Current Version:
6.2.25 Policy:
Property Tax Arrears
Recipients who have been in receipt of Income Assistance for twelve (12) consecutive
months or longer may be eligible for a one (1) time only payment of property tax arrears
based on the following criteria:
1. the recipient must provide documentation that the property will be sold due to
outstanding taxes;
2. only the amount required to avoid a tax sale can be considered;
3. assistance can only be provided if the property is solely in the name of the
recipient;
4. arrears will only be considered for the period of time a recipient was in receipt of
assistance;
5. the overpayment provisions of Policy 6.1.3 - (Overpayments Related to Special
Needs) may apply. In such cases, the overpayment amount will be recovered by a
monthly deduction from a recipient’s entitlement.
Applicants may be eligible for property tax arrears. The assistance may be provided
based on the minimum amount required to avoid a property tax sale on a one (1) time
only basis and subject to supervisory approval.
Previous Version
6.2.25 Policy:
Property Tax Arrears
Recipients who have been in receipt of Income Assistance for twelve (12) consecutive
months or longer may be eligible for a one (1) time only payment of property tax
arrears based on the following criteria:
1.
the recipient must provide documentation that the property will be sold due
to outstanding taxes;
2.
only the amount required to avoid a tax sale can be considered;
3.
assistance can only be provided if the property is solely in the name of the
recipient;
4.
arrears will only be considered for the period of time an applicant was in
receipt of assistance;
5.
the overpayment provisions of Policy 6.1.3 - (Overpayments Related to
Special Needs) may apply. In such cases, the overpayment amount will
be recovered by a monthly deduction from a recipient’s entitlement.
Revision
#
198
Revision Date
May 1, 2012
Chapter
6-Special Needs
Section
6.2.24 Policy – Prescription
Drug Coverage
Current Version:
6.2.24 Policy:
Prescription Drug Coverage
Coverage of prescription drug costs may be provided to an applicant, spouse and
dependent child when there is no eligibility for Income Assistance (Policy 6.1.6 –
(Individuals not in Receipt of Income Assistance)). Only medications approved in the
Nova Scotia Formulary will be considered.
An applicant must register with the Nova Scotia Family Pharmacare program. When
the Nova Scotia Family Pharmacare monthly out of pocket expenses (co-pay and/or
deductible) are included in the budget calculation and a deficit results, an applicant may
be eligible for the amount of the entitlement (Policy 5.2.1 – (Initial Budget
Calculations)).
In urgent circumstances, pending Nova Scotia Family Pharmacare registration and with
supervisory approval (Policy 6.1.5 – (Supervisory Determination of Higher Amount for a
Special Need Item/Service)), a one month supply of each prescription medication can
be included in the applicant’s budget.
An applicant/recipient, spouse or dependent child who has a private health care plan
from a public (does not include Nova Scotia Family Pharmacare or Low Income
Pharmacare for Children) or a private entity may be required to use that plan and may
not be eligible for Pharmacare benefits. There may be eligibility for a reimbursement of
the co-payment amounts that exceed $5.00 per prescription provided the medication/
supply is a benefit under the Nova Scotia Formulary. Receipts verifying the copayments from the pharmacy or private health plan organization are required.
For recipients, refer to Policy 9.1.1 – (Pharmacare) for information on Pharmacare
benefits.
Previous Version:
6.2.24 Policy:
Prescription Drug Coverage
Prescription drug coverage in the form of Pharmacare benefits is provided to eligible
recipients and/or spouses of recipients and their dependents in receipt of Income
Assistance. Any recipient and/or spouse of a recipient and their dependents having
access to another drug plan, from a public or private entity will be required to use that
plan and will not be eligible for Pharmacare benefits.
Pharmacare benefits are provided in accordance with contracted service formulary,
only. Assistance for prescription drug coverage is not funded outside of the Nova Scotia
Formulary. All Income Assistance recipients and/or spouses of recipients and their
dependents are required to pay a flat co-pay fee of $5.00 per prescription, unless
recipients and/or spouses of recipients and their dependents is/are eligible for co-pay
exemption.
Those drugs that are not approved as benefits under the Nova Scotia Formulary, or
drugs not approved for exception status drug coverage must not be covered under
special needs under any circumstances.
A recipient, spouse of a recipient or their dependent child who has a private health care
plan may be eligible for reimbursement of the co-payment amounts that exceed $5.00
per prescription provided the medication/supply is a benefit under the Nova Scotia
Formulary. Receipts verifying the co-payments from the pharmacy or private health plan
organization are required.
Ineligibility for Regular/Extended Pharmacare - Special Needs Requests
If a budget deficit does not exist when the basic needs (personal and shelter
allowances) and allowable special needs are included in the calculation of a budget
deficit, an applicant/recipient will not be eligible for extended Pharmacare or regular
Pharmacare benefits. An applicant/recipient will be advised they must register for the
Nova Scotia Family Pharmacare program. When the out of pocket expenses (co-pay
and/or deductible) are also included in this calculation and a budget deficit results, an
applicant may be eligible for assistance with special needs in accordance with the
amount of the deficit. Only a one-month supply of each prescription medication can be
included in the budget calculation. Policy 6.1.6.- (Individuals not in Receipt of Income
Assistance)
Only those drugs costs for medications approved as benefits under the Nova Scotia
Formulary can be included in the calculation of the budget deficit.
Revision
#
197
Revision Date
May 1, 2012
Chapter
6-Special Needs
Section
6.2.13 Policy– Guide Dog
Allowance
Current Version:
6.2.13 Policy:
Guide Dog Allowance
A recipient, spouse of a recipient, and/or dependent child may be eligible for an
allowance of $90 per month for a guide dog allowance and up to $300 a year for routine
veterinary costs, when all other available resources have been exhausted, if the dog is:
1. received through the support of a certified guide dog organization/school with
documentation outlining provision of supports; and
2. used by a recipient, spouse of a recipient or dependent child.
The monthly guide dog allowance is for food and routine care costs such as, but not
limited to, grooming, teeth cleaning, toenail clipping, leashes, and incidentals. Routine
veterinary costs include checkups, vaccinations, and flea and heartworm treatments.
Expenses for non-routine care for a guide dog are not funded by Income Assistance.
Non-routine expenses include, but are not limited to, surgical procedures, treatment for
fractures, and infections, special diets, euthanasia, and travel, room and board to
acquire a dog.
Retired guide dogs maintained by a recipient, spouse of a recipient or dependent child
are not eligible for the guide dog allowance.
Previous Version:
6.2.13 Policy:
Guide Dog Allowance
A recipient, spouse of a recipient, and/or dependent child may be eligible for an
allowance of $60 per month for food and the routine care of a guide dog when all
other available resources have been exhausted, if the dog is:
1.
received through the support of a recognized guide dog
organization/school; and
2.
used by a recipient, spouse of a recipient, spouse of a recipient or
dependent child.
Routine care includes, but is not limited to, check-ups, rabies shots, teeth
cleaning, toenail clipping, and flea and heartworm medications.
Extraordinary expenses associated with the dog are not funded by Income
Assistance. A caseworker will refer a recipient to the appropriate resources to
exhaust all possible funding sources available for the support of guide dogs.
Extraordinary expenses include, but are not limited to, surgical procedures,
treatment for fractures, and infections, special diets, euthanasia, and travel, room
and board to acquire a dog.
Retired guide dogs maintained by a recipient, spouse of a recipient or dependent
child are not eligible for the guide dog allowance.
Revision #
196
Revision Date
May 1, 2012
Chapter
6-Special Needs
Section
6.2.6 Policy– Employability
Related Special Needs
Current Version:
6.2.6 Policy:
Employability Related Special Needs
A recipient and/or spouse of a recipient may be eligible for Income Assistance to
cover employability related expenses, that are directly related to and necessary
to facilitate employment or participation in an employment plan when they are:
1. employed on a full-time or part-time basis;
2. participating in employment services; or
3. implementing an approved employability plan.
Actual costs may be provided for the following related expenses up to the
allowable maximums:
1.
Approved Personal Development Supports (up to a maximum $300 per
activity to a maximum total of $600 for a twelve (12) month period)—such
as, but not limited to; assertiveness training, self-esteem programs, anger
management, career development, individual counseling not available
through MSI;
2.
Association/Professional/Licensing Dues (up to a maximum total of
$500 per twelve (12) month period - where not already covered through
mandatory employment related costs, such as union dues, professional
membership fees, professional license application and renewal;
3.
Books, Supplies, and Deposits, including seat confirmation deposits (up
to a maximum total of $700 per twelve (12) month period) examples
include books and supplies required to participate in an approved
educational program which is non-student assistance eligible, such as, but
not limited to, academic upgrading, high school, short term course;
4.
Equipment and Supports related to a disability required to return to
employment, where not available through other programs, such as, but not
limited to, job coaching, tutoring, ergonomic supports, obus formes,
special chairs, technical aids (up to a maximum total of $1,000 per twelve
(12) month period);
5.
Other Employment Related Costs (up to a maximum total of $500 per
twelve (12) month period) for other costs associated with participation in
employability related activities that are not covered in this list or by other
policies and/or programs;
6.
Payment of Fees (up to a maximum total of $200 per twelve (12) month
period) for fees that are directly related to a return to employment, such as
but not limited to drivers licenses, criminal record check, drivers abstract,
child abuse registry check, medicals and fines. (Criminal record pardon
applications may exceed this amount);
7.
Personal Hygiene and Grooming Supplies (up to a maximum total of
$50 every four (4) months);
8.
Professional Assessments (up to a maximum $1,000 per twelve (12)
month period)—professional assessments that may be required develop
an appropriate employability plan and that cannot be provided directly by
the Department of Community Services;
9.
Safety Equipment and Gear (up to a maximum total of $300 per twelve
(12) month period) for items such as hard hat, work boots, ear protectors,
eye protectors, safety harnesses, safety gloves, masks, helmets face
shields required for employment purposes;
10. Specific Short Term Skills Training (up to a maximum total of $500 per
course) such as, but not limited to, computer literacy, GED, upgrading,
professional refresher programs, continuing education programs;
11. Tools (up to a maximum total of $500 per twenty-four (24)month period)
for such items as mechanics tools, carpentry tools, electronic tools,
ladders, tool belts required for employment purposes;
12. Training Related Clothing (up to a maximum of total of $200 per twelve
(12) month period) such as, but not limited to, uniforms or specialized
clothing required for the program;
13. Work Related Clothing (up to a maximum total of $200 per twelve (12)
month period) such as, but not limited to uniforms, rain gear, coveralls,
office appropriate attire;
14. Work Related Courses (up to a maximum total of $200 per course) such
as First Aid, WHMIS, CPR, traffic control, non-violent crisis intervention.
Previous Version:
6.2.6 Policy:
Employability Related Special Needs
A recipient and/or spouse of a recipient may be eligible for Income Assistance to
cover employability related expenses, that are directly related to and necessary
to facilitate employment or participation in an employment plan when they are:
1.
employed on a full-time or part-time basis;
2.
participating in employment services; or
3.
implementing an approved employability plan.
Actual costs may be provided for the following related expenses up to the
allowable maximums:
1.
Approved Personal Development Supports (up to a maximum $300 per
activity to a maximum total of $600 for a twelve (12) month period)—such
as, but not limited to; assertiveness training, self-esteem programs, anger
management, career development, individual counseling not available
through MSI;
2.
Association/Professional/Licensing Dues (up to a maximum total of
$500 per twelve (12) month period - where not already covered through
mandatory employment related costs, such as union dues, professional
membership fees, professional license application and renewal;
3.
Books, Supplies, and Deposits, including seat confirmation deposits (up
to a maximum total of $700 per twelve (12) month period) examples
include books and supplies required to participate in an approved
educational program which is non-student assistance eligible, such as, but
not limited to, academic upgrading, high school, short term course;
4.
Equipment and Supports related to a disability required to return to
employment, where not available through other programs, such as, but not
limited to, job coaching, tutoring, ergonomic supports, obus formes,
special chairs, technical aids (up to a maximum total of $1,000 per twelve
(12) month period);
5.
Other Employment Related Costs (up to a maximum total of $500 per
twelve (12) month period) for other costs associated with participation in
employability related activities that are not covered in this list or by other
policies and/or programs;
6.
Payment of Fees (up to a maximum total of $200 per twelve (12) month
period) for fees that are directly related to a return to employment, such as
but not limited to drivers licenses, criminal record check, drivers abstract,
child abuse registry check, medicals, criminal record pardon applications,
fines;
7.
Personal Hygiene and Grooming Supplies (up to a maximum total of
$50 every four (4) months);
8.
Professional Assessments (up to a maximum $1,000 per twelve (12)
month period)—professional assessments that may be required develop
an appropriate employability plan and that cannot be provided directly by
the Department of Community Services;
9.
Safety Equipment and Gear (up to a maximum total of $300 per twelve
(12) month period) for items such as hard hat, work boots, ear protectors,
eye protectors, safety harnesses, safety gloves, masks, helmets face
shields required for employment purposes;
10. Specific Short Term Skills Training (up to a maximum total of $500 per
course) such as, but not limited to, computer literacy, GED, upgrading,
professional refresher programs, continuing education programs;
11. Tools (up to a maximum total of $500 per twenty-four (24)month period)
for such items as mechanics tools, carpentry tools, electronic tools,
ladders, tool belts required for employment purposes;
12. Training Related Clothing (up to a maximum of total of $200 per twelve
(12) month period) such as, but not limited to, uniforms or specialized
clothing required for the program;
13. Work Related Clothing (up to a maximum total of $200 per twelve (12)
month period) such as, but not limited to uniforms, rain gear, coveralls,
office appropriate attire;
14. Work Related Courses (up to a maximum total of $200 per course) such
as First Aid, WHMIS, CPR, traffic control, non-violent crisis intervention.
Revision
#
195
Revision Date
May 1, 2012
Chapter
5-Basic Needs
Section
5.17.5 Policy– Failure to
Participate in the Nova Scotia
Employability Assessment
(NSEA) or an Employability
Plan
Current Version:
5.17.5 Policy:
Refusal to Participate in the Nova Scotia Employability
Assessment (NSEA) or an Employability Plan
A recipient and/or a recipient’s spouse who is required to participate in a Nova
Scotia Employability Assessment (NSEA) and/or the development of an
employability plan and refuses to participate, will be required to contact a
caseworker with a reason or explanation why they did not participate.
A recipient and/or a recipient’s spouse is required to provide a reasonable
explanation for their refusal to participate and if unable to do so, will be ineligible
for Income Assistance for a period of six (6) weeks, beginning with the next
period.
A caseworker will:
1.
review the Employment Services Screening Tool questions and/or the
NSEA and employment plan to determine if there are barriers to
employment that would provide reasons for non-participation; and/or
2.
notify the recipient and/or spouse by letter of any instance of refusal to
participate and set out in writing the conditions that must be met for the
recipient and/or spouse to meet the requirements for participation.
In the case where the recipient and/or the spouse demonstrate a second
instance of refusal to participate with employment services/employment activity,
the caseworker will:
1.
place the Income Assistance case in withheld status, and send a letter to
recipient indicating that the recipient must contact the caseworker to
provide an explanation for the second (2nd) instance;
2.
consult with caseworkers involved in the case to make a decision
regarding a third opportunity for participation with the employment action
plan;
3.
determine whether or not to issue the Income Assistance payment based
on the explanation from the recipient and/or spouse and a review of the
employability participation questions and/or the NSEA and employment
plan to determine if there are barriers to employment that would provide
reasons for non-participation; and/or
4.
issue the Income Assistance payment or if a decision is made to not issue
the Income Assistance payment then send a letter to the recipient and/or
the spouse advising that Income Assistance will be discontinued for a
period of six (6) weeks beginning from the next service period and advise
of the right to appeal this decision.
If the recipient and/or spouse demonstrates a third (3rd) instance of refusal to
participate with employment services/employment activity without a valid reason,
the caseworker will:
1.
place the Income Assistance case ineligible status;
2.
enter an ICM case note to record actions and reasons for refusal to
participate; and
3.
send a letter to the recipient and/or the spouse advising that Income
Assistance will be discontinued for a period of six (6) weeks beginning
from the next service period and advise of the right to appeal this decision.
Previous Version:
5.17.5 Policy:
Failure to Participate in the Nova Scotia Employability
Assessment (NSEA) or an Employability Plan
A recipient and/or a recipient’s spouse who is required to participate in a Nova
Scotia Employability Assessment (NSEA) and/or an employability plan and fails
to participate, will be required to contact a caseworker with a reason or
explanation why they did not participate.
A recipient and/or a recipient’s spouse is required to provide a reasonable
explanation for their failure to participate and if unable to do so, will be ineligible
for Income Assistance for a period of six (6) weeks, beginning with the next
period.
A caseworker will:
1.
review the employability participation questions and/or the NSEA and
employment plan to determine if there are barriers to employment that
would provide reasons for non-participation; and/or
2.
notify the recipient and/or spouse of the recipient by letter of any instance
of failure to participate and set out in writing the conditions that must be
met for the recipient and/or spouse of the recipient to meet the
requirements for participation.
In the case where the recipient and/or the spouse of the recipient demonstrate a
second instance of failure to participate with employment services/employment
activity, the caseworker will:
1.
place the Income Assistance case in withheld status, and send a letter to
recipient indicating that the recipient must contact the caseworker to
provide an explanation for the second (2nd) instance;
2.
consult with caseworkers involved in the case to make a decision
regarding a third opportunity for participation with the employment action
plan;
3.
determine whether or not to issue the Income Assistance payment based
on the explanation from the recipient and/or spouse of the recipient and a
review of the employability participation questions and/or the NSEA and
employment plan to determine if there are barriers to employment that
would provide reasons for non-participation; and/or
4.
issue the Income Assistance payment or if a decision is made to not issue
the Income Assistance payment then send a letter to the recipient and/or
the spouse of the recipient advising that Income Assistance will be
discontinued for a period of six (6) weeks beginning from the next service
period and advise of the right to appeal this decision.
If the recipient and/or spouse of the recipient demonstrates a third (3rd) instance
of failure to participate with employment services/employment activity without a
valid reason, the caseworker will:
1.
place the Income Assistance case ineligible status;
2.
record actions and reasons in the electronic case notes; and
3.
send a letter to the recipient and/or the spouse of the recipient advising
that Income Assistance will be discontinued for a period of six (6) weeks
beginning from the next service period and advise of the right to appeal
this decision.
Revision
#
194
Revision Date
May 1, 2012
Chapter
5-Basic Needs
Section
5.17.4 Policy– Refusal of
Participation in Employability
Activity
Current Version:
5.17.4 Policy:
Refusal of Participation in Employability Activity
An applicant/recipient and spouse are not eligible to receive or continue to
receive Income Assistance when an applicant/recipient and/or spouse refuse to:
1.
participate in the employability screening at intake;
2.
participate in an employability assessment, when required;
3.
participate in the development and undertaking of an employment plan;
4.
participate in an approved upgrading, training or job readiness program to
which an applicant/recipient and/or spouse has been accepted; and or
5.
provide medical verification/ documentation required to determine whether
an employment plan is appropriate for the applicant/recipient and/or
spouse;
In cases where the applicant/recipient and/or spouse have legitimate
barriers, their refusal to participate is considered reasonable.
An applicant/recipient and/or spouse is/are required to provide a
reasonable explanation for their refusal to participate and if unable to do
so, will be ineligible for Income Assistance for a period of six (6) weeks,
beginning with the next service period.
Previous Version:
5.17.4 Policy:
Refusal of Participation in Employability Activity
An applicant/recipient and spouse of an applicant/recipient are not eligible to
receive or continue to receive Income Assistance when an applicant/recipient
and/or spouse of an applicant/recipient refuse to:
1.
participate in a medical examination required to determine whether an
employment plan is appropriate for the applicant/recipient and/or the
spouse of an applicant/recipient;
2.
participate in an employability assessment;
3.
partake in the development and undertaking of an employment plan;
and/or
4.
participate in an approved upgrading, training or job readiness program to
which an applicant/recipient and/or spouse of an applicant/recipient has
been accepted. In cases where the applicant/recipient and/or spouse of
an applicant/recipient have legitimate barriers, their refusal to participate is
not considered unreasonable.
Revision
#
193
Revision Date
May 1, 2012
Chapter
5-Basic Needs
Section
5.1.13 Policy – Conducting
the Annual Review
Current Version:
5.1.13 Policy:
Conducting the Annual Review
In order to determine ongoing eligibility for Income Assistance, a comprehensive
review of a recipient’s and/or spouse of the recipient’s eligibility must be
conducted once a year for all cases.
This comprehensive review will include the caseworker meeting with the recipient
and spouse of the recipient, if applicable, to complete, but not limited to, the
following documentation and information:
1. a completed ‘Consent to Release and Obtain Information Authorization’
form signed by both the recipient and spouse of the recipient;
2. a completed ‘Client Personal and Financial Statement’ form signed by both
the recipient and the spouse of the recipient;
3. verification of income/assets that have not been reported on monthly
‘Income Statements’ form;
4. copies of documentation regarding assets;
5. copies of bills and/or statements of expenses since the last review;
6. update living situation and complete a home visit;
7. the completion of other forms applicable to the recipient and/or spouse of
the recipient situation, for example, CPP ‘Consent to Deduction and
Payment - 1613’ form, EI ‘Assignment of Benefits’ form;
8. where appropriate reassess the recipient and spouse employability
participation profile by completing the Employment Services Screening
Tool. Complete Employability Participation (EP) codes based on
screening tool.
Where applicable, complete an ‘Understanding of Participation in
Employability Activity’ form and make a referral for:
a. Job Search
b. Nova Scotia Employability Assessment (NSEA)
c. Referral to Department of Labour and Advanced Education (LAE) –
An External Service Provider in your local area responsible for the
delivery of the Labour Market Development Agreement (LMDA)
services for Employment Insurance (EI) recipients;
or
9. complete the ‘Report of Present Health Condition’ form on both an
recipient and spouse, where appropriate;
10.review the Reporting Cycle and Payment History to determine if the case
meets the periodic payment criteria. The Reporting Cycle may be
changed from monthly to periodic where there are no budget changes
after three (3) consecutive months of eligibility and no reporting of wages.
Previous Version:
5.1.13 Policy:
Conducting the Annual Review
In order to determine ongoing eligibility for Income Assistance, a comprehensive
review of a recipient’s and/or spouse of the recipient’s eligibility must be
conducted once a year for all cases.
This comprehensive review will include the caseworker meeting with the recipient
and spouse of the recipient, if applicable, to complete, but not limited to, the
following documentation and information:
1.
a completed ‘Consent to Release and Obtain Information Authorization’
form signed by both the recipient and spouse of the recipient;
2.
a completed ‘Client Personal and Financial Statement’ form signed by
both the recipient and the spouse of the recipient;
3.
verification of income/assets that have not been reported on monthly
‘Income Statements’ form;
4.
copies of documentation regarding assets;
5.
copies of bills and/or statements of expenses since the last review;
6.
update living situation and complete a home visit;
7.
the completion of other forms applicable to the recipient and/or spouse of
the recipient situation, for example, CPP ‘Consent to Deduction and
Payment - 1613’ form, EI ‘Assignment of Benefits’ form;
8.
where appropriate, a recipient and spouse of the recipient are asked the
employability participation questions on the ‘ESIA Program Application’
form. If applicable, complete an ‘Understanding of Participation in
Employability Activity’ form and make a referral for a Nova Scotia
Employability Assessment (NSEA); and
9.
a completed ‘Report of Present Health Condition’ form on both an
applicant/recipient and spouse of an applicant/recipient, where
appropriate.
Revision
#
192
Revision Date
May 1, 2012
Chapter
5-Basic Needs
Section
5.1.7 Policy – Satisfying Job
Search Requirements at
Intake
Current Version:
Deleted
Previous Version:
5.1.7 Policy:
Satisfying Job Search Requirements at Intake
If by asking the employability participation questions on the ‘ESIA Program
Application’ form, it is determined that the applicant/recipient and the spouse of
the applicant/recipient are required to participate in a Nova Scotia Employability
Assessment (NSEA) then he/she must demonstrate his/her job search efforts in
the thirty (30) days prior to making application. An applicant/recipient and
spouse of an applicant/recipient must provide evidence of these job search
efforts and sign the ‘Understanding of Participation in Employability Activity’ form.
Failure to Satisfy Job Search Requirements at Intake
Where an applicant/recipient or spouse of an applicant/recipient refuses to satisfy
the Job Search Requirements as part of the Initial Eligibility, Income Assistance
will be refused and/or discontinued.
Revision
#
191
Revision Date
May 1, 2012
Chapter
5-Basic Needs
Section
5.1.6 Policy – Understanding
of Participation in
Employability Activity Form
Current Version:
5.1.6 Policy:
Understanding of Participation in Employability Activity Form
An applicant/recipient and spouse who meets the general eligibility criteria for
Income Assistance and has completed the Employment Services Screening Tool
which determined that they must participate in employability activities, must sign
the ‘Understanding of Participation in Employability Activity’ form to be eligible for
initial/ongoing Income Assistance.
Refusal to Complete and Sign the ‘Understanding of Participation in
Employability Activity’ Form
Where an applicant/recipient or spouse refuses to complete and sign the
‘Understanding of Participation in Employability Activity’ form, Income Assistance
will be refused and/or discontinued.
Previous Version:
5.1.6 Policy:
Understanding of Participation in Employability Activity Form
An applicant/recipient and spouse of an applicant/recipient who meets the
general eligibility criteria for Income Assistance and has completed the
employability participation questions located on the ‘ESIA Program Application’
form which determined that he/she must participate in a Nova Scotia
Employability Assessment, must sign the ‘Understanding of Participation in
Employability Activity’ form to be eligible for initial/ongoing Income Assistance.
Refusal to Complete and Sign the ‘Understanding of Participation in
Employability Activity’ Form
Where an applicant/recipient or spouse of an applicant/recipient refuses to
complete and sign the ‘Understanding of Participation in Employability Activity’
form, Income Assistance will be refused and/or discontinued.
Revision
#
190
Revision Date
May 1, 2012
Chapter
5-Basic Needs
Section
5.1.5 Policy– Employability
Participation Questions at
Intake
Current Version:
5.1.5 Policy – Employability Screening Questions at Intake
An applicant/recipient and spouse who meets the general eligibility criteria for
Income Assistance must complete the Employment Services Screening Tool.
The outcome of the Employment Services Screening Tool will be used to
determine the potential requirement for an applicant/recipient and spouse to
participate in employability activities and sign the ‘Understanding of Participation
in Employability Activity’ form.
Refusal to participate in the completion of the Employment Services
Screening Tool at Intake
Where an applicant/recipient or spouse refuses to complete the Employment
Services Screening Tool, Income Assistance will be refused and/or discontinued.
Previous Version:
5.1.5 Policy:
Employability Participation Questions at Intake
An applicant/recipient and spouse of an applicant/recipient who meets the
general eligibility criteria for Income Assistance must complete the employability
participation questions located on the ‘ESIA Program Application’ form.
The outcome of the employability participation questions located on the ‘ESIA
Program Application’ form will be used to determine the potential requirement for
an applicant/recipient and spouse of an applicant/recipient to demonstrate his/her
job search efforts in the thirty (30) days prior to making application, to participate
in a Nova Scotia Employability Assessment and to sign the ‘Understanding of
Participation in Employability Activity’ form.
Refusal to participate in the completion of the Employability Participation
Questions at Intake
Where an applicant/recipient or spouse of an applicant/recipient refuses to
complete the employability participation questions, Income Assistance will be
refused and/or discontinued.
Revision
#
189
Revision Date
May 1, 2012
Chapter
5-Basic Needs
Section
5.1.2 Policy– Initial and
Ongoing Eligibility
Current Version:
5.1.2 Policy– Initial and Ongoing Eligibility
An applicant/recipient and/or spouse is required to pursue all other feasible sources of
income including, but not limited to: wages, Employment Insurance, Canada Pension
Plan, Old Age Security, the Canada Child Tax Benefit, the Guaranteed Income
Supplement, private insurance claims, and maintenance payments. Where an
applicant/recipient and/or spouse refuse to pursue all other feasible sources of income,
Income Assistance will be refused and/or discontinued.
Previous Version:
5.1.2 Policy– Initial and Ongoing Eligibility
A caseworker will ensure that an applicant/recipient and spouse of an
applicant/recipient have been requested to pursue all other sources of income during
the intake process and/or while in receipt of Income Assistance.
Other sources of income may be, but are not limited to the following: Employment
Insurance Benefits, Canada Pension Plan Benefits, Old Age Security Pension, Canada
Child Tax Benefit, Guaranteed Income Supplement Benefits, benefits from private
insurances, Maintenance Income Support and other sources of income as determined
appropriate.
Revision
#
188
Revision Date
May 1, 2012
Chapter
5-Basic Needs
Section
5.1.2 Policy– Role of Intake
Current Version:
5.1.2 Policy – Role of Intake
The role of intake is to make a preliminary assessment of an applicant’s eligibility and to
inform them of their rights and responsibilities. The intake process must collect relevant
information to support an applicants’ request for Income Assistance and to assess the
nature of the request. The intake process may, when necessary, provide emergency
Income Assistance.
There are five (5) major steps involved in the intake process. These steps include:
1. Initial Contact - determination of the specific nature of the request and direct
appropriately. This may include a referral to other agencies and services;
2. Record and Register;
3. Potential Eligibility Determination and Home Visit - review job search efforts in
the thirty (30) days prior to making the application for Income Assistance for both the
applicant and/or the spouse of applicant;
4. Final Eligibility Determination; and
5. Cheque Production/Pharmacare Eligibility/Dental Eligibility and Assignment of
Case Manager.
The role of intake is to make a preliminary assessment of an applicant’s eligibility and to
inform them of his/her rights and responsibilities. The intake process must collect relevant
information to support an applicants’ request for Income Assistance and to assess the
nature of the request. The intake process may, when necessary, provide emergency
Income Assistance.
There are five (5) major steps involved in the intake process. These steps include:
1. Initial Contact: determination of the specific nature of the request and direct
appropriately. This may include a referral to other agencies and services.
2. Record and Register;
3. Potential Eligibility Determination and Home Visit: this includes, but is not limited to,
job search efforts in the thirty (30) days prior to making the application for Income
Assistance for both the applicant and/or the spouse of applicant. Where appropriate, the
applicant and/or the spouse of the applicant may be asked to complete a supported job
search Policy 5.1.9 - (Request for Medical Information Related to Employment). They may
also be provided assistance in conducting a supported job search, where appropriate.
4. Final Eligibility Determination; and
5. Cheque Production/Pharmacare Eligibility/Dental Eligibility and Assignment of
Case Manager.
Previous Version:
5.1.2 Policy – Role of Intake
The role of intake is to make a preliminary assessment of an applicant’s eligibility and to
inform them of his/her rights and responsibilities. The intake process must collect relevant
information to support an applicants’ request for Income Assistance and to assess the
nature of the request. The intake process may, when necessary, provide emergency
Income Assistance.
There are five (5) major steps involved in the intake process. These steps include:
1. Initial Contact: determination of the specific nature of the request and direct
appropriately. This may include a referral to other agencies and services.
2. Record and Register;
3. Potential Eligibility Determination and Home Visit: this includes, but is not limited to,
job search efforts in the thirty (30) days prior to making the application for Income
Assistance for both the applicant and/or the spouse of applicant. Where appropriate, the
applicant and/or the spouse of the applicant may be asked to complete a supported job
search Policy 5.1.9 - (Request for Medical Information Related to Employment). They may
also be provided assistance in conducting a supported job search, where appropriate.
4. Final Eligibility Determination; and
5. Cheque Production/Pharmacare Eligibility/Dental Eligibility and Assignment of
Case Manager.
Revision
#
187
Revision Date
May 1, 2012
Chapter
4 – Definitions
Section
4.1 Policy– Definitions
Current Version:
4.1.1 Policy:
Definitions
“periodic” reporting/payment type are for cases that meet the following criteria:
a. no change in basic monthly payment for three (3) months prior to implementation,
b. recipient does not have income that fluctuates month to month, and
c. no change in basic monthly payments are anticipated in the foreseeable future;
Previous Version:
4.1.1 Policy:
Definitions
“periodic” reporting/payment type are for cases that meet the following criteria:
a. recipients not reporting wages and/or
b. eligible for ESIA for more than six (6) months and
c. no budget changes in three (3) months.
Revision
#
186
Revision Date
May 1, 2012
Chapter
5 – Basic Needs
Section
5.11.4 – Applicants
Determined at Intake to be a
Resettled Refugee
Current Version:
5.11.4 Policy:
Applicants Determined at Intake to be a Resettled Refugee
Immigrants in this class may be granted permanent resident status for
humanitarian reasons of international obligation by the Government of Canada.
They must either be a privately sponsored or sponsored by government
(Government Assisted Refugee).
Government Assisted Refugees (GARs) are provided with financial assistance
through the Refugee Assistance Program, administered by Citizenship and
Immigration Canada. They are also provided with settlement and integration
assistance by the Immigrant Settlement and Integration Services (ISIS).
Private Assisted Refugees (PARs) are provided settlement and integration
assistance by an approved sponsoring group. GARs or PARs who no longer
qualify for federal government or private sponsorship assistance may qualify for
Income Assistance.
Previous Version:
5.11.4 Policy:
Applicants Determined at Intake to be a Resettled Refugee
Immigrants in this class may be granted permanent resident status for
humanitarian reasons of international obligation by the Government of Canada.
They must either be a privately sponsored or sponsored by government
(Government Assisted Refugee).
Government Assisted Refugees (GARs) are provided with financial assistance
through the Refugee Assistance Program, administered through Immigrant
Settlement and Integration Services (ISIS). Private Assisted Refugees (PARs)
are provided sponsorship and integration assistance by an approved sponsoring
group. Immigrants who no longer qualify for the above program may qualify for
Income Assistance.
Revision
#
Revision Date
185
September 26,
2011
Chapter
Section
6 – Special Needs
3 – Special Needs
Current Version:
Funeral Costs (Policy 6.2.11):
• professional services and
merchandise i.e., cremation,
cremation urn or casket
• up to $2,700
• up to $1,100
• cash disbursements i.e., opening
and closing of grave, grave lot,
clothing
• $0.60 per kilometer
• mileage
Previous Version:
Funeral Costs (Policy 6.2.11):
• opening and closing of grave, grave
lot, clothing
• up to $1,100
• professional services and
cremation urn or casket
• up to $2,700
• mileage
• $0.60 per kilometer
Revision
#
Revision Date
184
September 26,
2011
Chapter
6 – Special Needs
Section
2 – Special Needs
Current Version:
Allowable Expenses
Maximum Approved Amounts
Professional Services and
Merchandise – i.e. cremation,
cremation urn or casket.
up to a maximum total of $2,700 +
taxes
Cash Disbursements for the
following:
up to a maximum total of $1,100 +
taxes
1. Cemetery Charges (open, close,
clean up grave, burial permits,
etc.);
2. Grave Liner (wooden);
3. Cemetery equipment & set up;
4. Radio notices;
5. Newspaper notices;
6. Clothing for the deceased;
7. Honorariums (Clergy, Music,);
and
8. Grave Lot
Mileage over 25 kilometers
Any exceptions requested in addition
to the approved funeral cost such as,
but not limited to, oversized casket,
special-embalming preparations, outof-province transfer.
may be paid on a per kilometer
basis at a rate of 60 cents per
kilometer
approval of the Supervisor required
Previous Version:
Funeral Rates Schedule
Allowable Expenses
Maximum Approved Amounts
Professional Services and
Merchandise – i.e. cremation, urn
or casket.
up to a maximum total of $2,700 +
taxes
Cash Disbursements for the
following:
up to a maximum total of $1,100 +
taxes
9. Cemetery Charges (open, close,
clean up grave, burial permits,
etc.);
10. Grave Liner (wooden);
11. Cemetery equipment & set up;
12. Radio notices;
13. Newspaper notices;
14. Clothing for the deceased;
15. Honorariums (Clergy, Music,);
and
16. Grave Lot
Mileage over 25 kilometers
Any exceptions requested in addition
to the approved funeral cost such as,
but not limited to, oversized casket,
special-embalming preparations, outof-province transfer.
may be paid on a per kilometer
basis at a rate of 60 cents per
kilometer
approval of the Supervisor required
Revision
#
Revision Date
183
September 12,
2011
Chapter
6 – Special Needs
Section
1 – Special Needs
Current Version:
6.1.2 Policy: Process for Special Needs Requests
An applicant/recipient and/or spouse of an applicant/recipient will provide the following
information, where applicable, when requesting a special needs item/service:
1. the reason for the request;
2. a description of the special need;
3. any professional documentation supporting the special need (examples include, but
not limited to, medical physician, dietician, dentists, social worker, psychiatrist, police);
4. the monthly total cost of the special need item/service;
5. information regarding the resources/alternatives that have been investigated with
respect to obtaining the special need item/service from other sources;
6. requested estimates; and
7. invoice or receipt for the special need item/service.
Prior approval is required for special needs items/services. Only in emergency
situations, can a special need item/service be approved after the purchase and/or
utilization of a service. If the special need item/service has already been acquired, and
is an approved item/service under ESIA Policy, an invoice or receipt for the special
need is required.
In determining eligibility in cases where the special need items/service being requested
is related to the health or medical needs of the individual, the caseworker may obtain
further information as required and/or consult with a person qualified to provide advice
regarding appropriateness, necessity and effectiveness of the requested special needs
item/service. This may include, but not limited to, a request for a second opinion from a
person who specializes in the area related to the special need item/service.
Previous Version:
6.1.2 Policy: Process for Special Needs Requests
An applicant/recipient and/or spouse of an applicant/recipient will provide the following
information, where applicable, when requesting a special needs item/service:
1. the reason for the request;
2. a description of the special need;
3. any professional documentation supporting the special need (examples include, but not
limited to, medical physician, dietician, dentists, social worker, psychiatrist, police);
4. the monthly and/or total cost of the special need item/service;
5. information regarding the resources/alternatives that have been investigated with respect
to obtaining the special need item/service from other sources;
6. requested estimates; and
7. invoice or receipt for the special need item/service.
Prior approval is required for special needs items/services. Only in emergency situations,
can a special need item/service be approved after the purchase and/or utilization of a
service.
In determining eligibility in cases where the special need items/service being requested is
related to the health or medical needs of the individual, the caseworker may obtain further
information as required and/or consult with a person qualified to provide advice regarding
appropriateness, necessity and effectiveness of the requested special needs item/service.
This may include, but not limited to, a request for a second opinion from a person who
specializes in the area related to the special need item/service.
Revision
#
Revision Date
182
September 12,
2011
Chapter
6 – Special Needs
Section
1 – Special Needs
Current Version:
6.1.1 Policy: Provision of Special Needs
An applicant/recipient and/or spouse of an applicant/recipient may request assistance for an
item/service of special need in accordance with the special needs schedule of approved
items/services Policy 6.3.1- (Special Needs Schedule).
An applicant/recipient and/or spouse of an applicant/recipient must demonstrate that they
have exhausted all possibilities for full or partial coverage of the cost of the special need
item/service from all available resources, private/publicly funded or community
organizations.
Items/services required for medical purposes for which an alternative exists under the
provincial insured health services program (MSI), or otherwise funded by government, will
not be approved as an item of special need. MSI is a program of the Department of Health
and Wellness.
Pharmacare benefits are provided in accordance with the contracted service, only. Request
for assistance with prescription drug coverage that is not included in the approved Nova
Scotia Formulary will not be approved as a special needs item. Only those medications/
supplies in the Nova Scotia Formulary can be considered. Policy 9.1- (Pharmacare).
The provision of special need items/services may not be approved regardless of
recommendations regarding their medical necessity. Assistance will not be provided for the
following:
1. physician services that are not recognized as insured health services by MSI or
otherwise funded by government; and/or
2. services provided by other health care workers, which are not insured under MSI
such as, but not limited to, chiropractors, physiotherapists, podiatrists, massage
therapists, naturopathic or homeopathic practitioners will not be approved as an
item/service of special need.
3. prescription medications, drugs and substances that are not listed as benefits
under the pharmacare programs in the Nova Scotia Formulary;
4. medical treatments and substances that are not covered as an insured service
under MSI; including equipment, supplies, materials or services used in
producing or administering the treatments or substances;
5. shelter costs and personal allowances.
Special Needs Benefits Granted before August 8, 2011
A recipient, spouse or dependent receiving special need items or services prior to
August 8, 2011 will continue to be eligible if the following conditions apply:
1. there has been no break in eligibility for the item or service since the last time
assistance was determined for the special need; and
2. the reasons why the special need is required have not changed.
Previous Version:
6.1.1 Policy: Provision of Special Needs
An applicant/recipient and/or spouse of an applicant/recipient may request assistance for an
item/service of special need in accordance with the special needs schedule of approved
items/services Policy 6.3.1- (Special Needs Schedule).
An applicant/recipient and/or spouse of an applicant/recipient must demonstrate that they
have exhausted all possibilities for full or partial coverage of the cost of the special need
item/service from all available resources, private/publicly funded or community
organizations.
Items/services required for medical purposes for which an alternative exists under the
provincial insured health services program (MSI) will not be approved as an item of special
need. MSI is a program of the Department of Health and Wellness.
Pharmacare benefits are provided in accordance with the contracted service, only. Request
for assistance with prescription drug coverage that is not included in the approved Nova
Scotia Formulary will not be approved as a special needs item. Only those medications/
supplies in the Nova Scotia Formulary can be considered. Policy 9.1- (Pharmacare).
The provision of special need items/services may not be approved regardless of
recommendations regarding their medical necessity. Assistance will not be provided for the
following:
1. physician services that are not recognized as insured health services by the
provincial insured health services program, Medical Services Insurance (MSI);
and/or
2. services provided by other health care workers, which are not insured under MSI
such as, but not limited to, chiropractors, physiotherapists, podiatrists, massage
therapists, naturopathic or homeopathic practitioners will not be approved as an
item/service of special need.
Revision
#
Revision Date
181
September 12,
2011
Chapter
5 – Basic Needs
Section
17 – Ineligibility
Current Version:
5.17.2 Policy: Supervisor Can Modify Calculation of Budget Deficit
A supervisor may approve Income Assistance in situations where a budget deficit does not
exist provided all other available resources have been exhausted. The decision to modify
the calculation of a budget deficit will be reviewed monthly or at such intervals as is
considered appropriate in the circumstances. Under the following circumstances, a
supervisor may determine it is necessary to modify the calculation of the budget deficit:
1. to protect the health and safety of an applicant/recipient, spouse or dependent child;
and/or
2. to preserve the dwelling of the applicant/recipient;
Previous Version:
5.17.2 Policy: Supervisor Can Modify Calculation of Budget Deficit
A supervisor may approve Income Assistance in situations where a budget deficit does not
exist provided all other available resources have been exhausted. The decision to modify
the calculation of a budget deficit will be reviewed monthly or at such intervals as is
considered appropriate in the circumstances. Under the following circumstances, a
supervisor may determine it is necessary to modify the calculation of the budget deficit:
1. to alleviate the pain and suffering of an applicant/recipient, spouse or dependent
child;
2. to protect the health and safety of an applicant/recipient, spouse or dependent child;
and/or
3. to preserve the dwelling of the applicant/recipient;
Revision
#
Revision Date
Chapter
180
September 12,
2011
4 - Definitions
Section
Current Version:
“Nova Scotia Formulary” means the publication of the Department of Health and
Wellness that details which drugs and supplies are benefits under the Nova Scotia
Seniors' Pharmacare Program, Family Pharmacare Program, Diabetes Assistance
Program, Community Services Pharmacare Programs and Drug Assistance for Cancer
Patients.
Previous Version:
None
Revision
#
Revision Date
Chapter
179
September 12,
2011
4 - Definitions
Section
Current Version:
“MSI” means the Medical Services Insurance Program administered under the Health
Services and Insurance Act;
Previous Version:
None
Revision
#
Revision Date
Chapter
178
September 12,
2011
4 - Definitions
Section
Current Version:
“special needs” means a need for any of the following items or services,
(I)
dental care approved in accordance with the ESIA Dental Fee Guide
approved by the Director;
(II)
optical care;
(III)
pharmacare coverage;
(IV) special diet;
(V)
transportation;
(VI) child care;
(VII) implementation of an employment plan;
(VIII) funeral arrangements;
or an item or service prescribed in policy by the Director.
The following items and services are not included:
a. an item or service that is insured under a Provincial insured health services
program or otherwise funded by government;
b. an item or service for medical purposes for which an alternative exists under
MSI;
c. prescription medications, drugs and substances that are not listed as benefits
under the pharmacare programs in the Nova Scotia Formulary;
d. medical treatments and substances that are not covered as an insured service
under MSI; including equipment, supplies, materials or services used in
producing or administering the treatments or substances;
e. shelter costs and personal allowances.
Previous Version:
“special need” means a need for:
a. an item or service with respect to:
i. dental care,
ii. optical care,
iii. funeral arrangements,
iv. special diet,
v. transportation, child care,
vi. implementation of an employment plan, or
b. another item or service that is in the opinion of a caseworker essential for an
applicant, recipient, spouse or dependent child,
c. but does not include an item or service that is insured under Provincial insured health
services programs or otherwise funded by government;