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Temporary Changes to the Special Services at Home (SSAH) and Enhanced Respite for Medically Fragile and/or Technology Dependent Children Programs

To support children with special needs and their families while access to the community-based services and supports may be limited or unavailable, and while families remain at home practising physical distancing, eligible expenditures in the programs have been temporarily expanded to support greater flexibility for families. This includes support for those accessing Special Services at Home (SSAH) and Enhanced Respite for Medically Fragile and/or Technology-Dependent Children.

These changes come into effect immediately and will remain in place while communities are under COVID-19 restrictions. Program recipients will be given as much advance notice as possible to prepare for the return of standard protocols, at a future date to be determined by the ministry.

Temporary Expansion of Admissible Expenditures

The following categorized list of expenditures are temporarily admissible until further notice:

1. Sensory Items
   • To support children and youth who rely on sensory items to alleviate anxiety/stress and/or support any clinical or behavioural plans.
     • e.g. multi-sensory related products and technologies.
2. Technology
   • Provide children and youth the means and ability to stay safe, connected, and engaged at home, including in virtual and online learning and skill development activities. These items include:
     • Laptops and tablets;
     • Online educational and e-learning activities and resources;
     • Videogames and videogame systems;
     • Webcams and microphones;
     • Media service subscriptions and platforms (e.g. Netflix, Xbox Live, Disney+) (NOTE: this will not include cancellation fees);
     • E-readers (e.g. Kindle or Kobo); and
     • Remote monitoring devices and medical alert services and devices.
3. Items to support home-based recreation and fitness activities:
   • Supplies to support home-based hobbies and recreational activities that would otherwise be accessed through school and other community-based programs. Some examples include, but are not limited to:
     • Arts and craft supplies;
     • Hobby supplies;
     • Puzzles and games; and
     • Books for leisure/learning.
   • Supplies to support home-based physical activity and fitness. Some examples may include, but are not limited to:
     • Indoor items and equipment (e.g. skipping rope, yoga mat, resistance bands); and
     • fitness/sport equipment and supplies that may be used on the individual’s property (e.g. basketball net, frisbee, badminton set).
4. Personal Protective Equipment and Supplies
   • To enable children and youth, their families and their support workers to be supported more safely at home or as required, in the community, which may be of heightened importance to children/adults who are immunocompromised. This includes items such as:
     • Gloves
     • Masks
     • Gowns
     • Cleaning supplies (e.g. disinfectant wipes, sprays, and hand sanitizer)
     • Goggles and face shields.
5. Essential Service Delivery Fees
   • Where families are unable to leave their homes for groceries or pharmacy needs because of the vulnerability of their family member and/or because of their care requirements, service delivery fees for essential items such as groceries and medication will be an admissible expense. (Note: this does not include the actual cost of the groceries and/or medications, just the service fee for delivery).
   • Delivery fees for takeout food from restaurants are not included.
6. Behavioural Support Plans and Interventions
   • Behavioural supports and interventions intended to assist families to more safely support their child at home. This may include:
     • development of behavioural support plans and recommended interventions (delivered in person or remotely/virtually)
     • Support strategies to reduce challenging behaviours or potential crisis situations.
     • Note: This does not include physiotherapy, occupational therapy or speech therapy.
7. Ability to hire (non-primary caregiver) family members or neighbours/friends to provide respite
   • To allow families who cannot hire respite workers or have concerns about having workers in their homes, to hire trusted family or friends to provide respite.
   • It should be noted that this is already an eligible expense for SSAH.

For SSAH, all other inadmissible expenditures as outlined in the Special Services at Home Guidelines remain in effect.

Temporary Changes to Administrative Requirements for SSAH and Enhanced Respite

To reduce the administrative burden on families, the following temporary administrative changes have been implemented, effective immediately, for SSAH and Enhanced Respite.

These changes support the on-going administration of the program for families and agencies while physical distancing requirements remain in place.

Claim and Invoice Signature Requirements

As physical distancing is currently mandated by all levels of government, and as many individuals/families may not have access to technology to support an e-signature process, the signature requirements for SSAH and Enhanced Respite invoice and claim forms are now waived until further notice. This includes support worker signatures to confirm that a service was provided.

As accurate record keeping will be essential to help ensure program integrity, Regional Offices and agencies are required to maintain accurate records of verbal and email acceptances.

2019/20 Claim Submission Deadline

In order to help families and recipients who are facing challenges to submit their 2019/20 SSAH and Enhanced Respite claims, ministry is waiving the 2019/20 submission deadline to families.

Helping People Access Funding: Pre-flow of Funding

The following changes will allow individuals and families to utilize their direct funding more quickly, while also accommodating the operational challenges being faced by ministry regional offices and transfer payment agencies, as a result of the COVID-19 outbreak.

1. Eligibility for Enhanced Respite

   The ministry is temporarily waiving the requirement for in-person eligibility assessment to be conducted by Local Health Integration Networks (LHINs) to ensure that families who were in approved for 2019/20 funding continue to receive their 2020/21 funding without having to be reassessed.

2. Advance Payments for 2019/20 Claims for SSAH

   To help ease the financial challenges faced by families who have not been able to submit claims or receive reimbursements for admissible expenditures associated with their 2019/20 SSAH funding, active SSAH recipients will receive a payment of up to $1,000 from their remaining 2019/20 authorized amount. For families with less than $1,000 remaining in their 2019/20 authorized amount, they will be provided with that amount in full.

   SSAH recipients are required to continue to submit their claims to be reconciled against the advance payment (up to the maximum of $1,000) of their 2019/20 authorization. Recipients will not be reimbursed for more than their total 2019/20 allocation.

3. Advance Payments of 2020/21 Funding Amounts for SSAH and Enhanced Respite

   SSAH program recipients who submitted claims for the 2019/20 fiscal year and continue to be eligible for funding in 2020/21 will receive a 3-month pro-rated amount of their annual authorized allocation in advance, a payment equal to one quarter of their annual funding amount for the period of April to June 2020.

   SSAH program recipients who have not submitted a claim or have not had their claims processed by the regional offices are required to contact their local ministry regional office to request a pro-rated advance payment.

   For Enhanced Respite, the ministry will automatically pre-flow funding to families who were approved for funding in 2019/20, equal to one quarter of the full annual allocation of up to $3,500 per child.

   This will provide families with immediate financial help to purchase services and supports, including the new temporary eligible expenses, without waiting to be reimbursed for their claim, enabling families to purchase the supports they need while supporting their child/youth with special needs at home.

   Program recipients can continue to submit claims for reimbursement in addition to their advance payment amount, as long as the total value of claims submitted plus their advance payment does not exceed the person’s annual authorized funding amount for the 2020/21 fiscal year.

   All recipients of advance payments are required to retain receipts/invoices to reconcile their actual expenditures against their advance payment. Recipients are encouraged to continue to submit claims to the Regional Offices so their remaining budget amount is up to date.

   For families accessing both SSAH and Enhanced Respite, recipients should track their claims to ensure claims are only submitted once, to avoid duplicate claims.

   Self-admin families:
   Families who self-administer their SSAH funding and who receive their payment through Direct Bank Deposit (DBD) will have their payment deposited into their account as per the usual payment process.

   Agency-admin families:
   For families that have their funding administered by an agency, you may contact your local agency and provide them with the appropriate information that will support an electronic transfer of funds so that this funding can be deposited directly to your account.