Ontario Works - Image of two men reviewing notes

Author Site Reviewresults

7A.4. Travel & Transportation for Medical Purposes

 

Ontario Works Effective Date: July 1, 2009
Topic: Benefits/Mandatory Benefits Replaces: November 1, 2004
Subject: Travel & Transportation for Medical Purposes Policy No. H.7A.4.

 

POLICY 

Authority OW Act: Sec. 8 and 74(4) & OW Directives: Dir. 7.2 

Travel and transportation costs for medical treatment are paid when the costs exceed $15 per benefit unit in a given month. Verification is required from the appropriate health provider confirming the person requires the service. 

Travel costs could include attendance at:

  • medical appointments,
  • rehabilitation (therapy),
  • healing lodge,
  • psychological counseling,
  • drug and alcohol recovery groups (e.g., Alcoholics Anonymous, narcotics Anonymous, etc.) or
  • for other medical or health-related purposes.

A monthly payment equivalent to a transportation pass can be issued if the participant is required to attend on-going appointments for medical or health-related purposes.

Case Managers must obtain medical verification where necessary. The Case Manager should also ascertain if transportation coverage is available from the programs themselves; or from community. In cases where medical travel may be covered by the Northern Health Travel Grant, the Case Manager will ensure the Northern Health Travel Grant is assigned to the Manitoulin-Sudbury DSB before funds are issued.  

As a rule, the cost of transportation for medical appointments will be up to the maximum cost for public transportation. Where more expensive transportation is necessary (such as a taxi for those unable to take public transportation or have no personal means of transportation) medical verification to be provided.

Applicants/participants should make use of residences available at hospitals, or the most economical accommodations available to:

  • Actual cost of room up to $100 per day to a maximum of $700 per medical trip;
  • $20 per person/day for meals to maximum of $280 per medical trip
  • Transportation to be the most economical method (ie.bus or equivalent) where a participant uses their own vehicle or has access to a vehicle for travel, the actual costs will be equivalent to the mileage rate permitted by the Northern Health Travel Grant.

Note:  Meals are available only when the participant is out of town overnight. 

Any other exceptional circumstance maybe considered at the discretion of the Director of Integrated Social Services.
 

PROCEDURE    

  1. Applicant/participant to obtain verification from a physician.
  2. Verification of attendance must be provided prior to reimbursement of transportation costs. 
  3. Prior approval is always required. Where an applicant/participant is unable to request prior approval for medical reasons; they are to submit receipts upon return for reimbursement.  Northern Health Travel Grant Advances and other exceptional cases may be issued “up front” monies.

On occasion Sick Children’s Hospital will contact the Case Manager because the child of an OW participant has arrived and needs accommodation at either Ronald MacDonald House or the Family Residence and meals.
 

OW PARTICIPANTS
  1. Fax is sent to the accommodation provider approving the number of required nights up to seven nights.  
  2. Fax is sent to Sick Children’s Hospital approving the per diem meal allowance that is advanced by the hospital.
  3. Notation is made in the Social Assistance Computer System explaining situation and what steps have been taken.  
  4. Copy of fax is placed on hard file. 
  5. When the invoice is received, a request for a benefit is completed, paying the service provider directly for the approved items under medical transportation. 
     
NORTHERN HEALTH TRAVEL GRANT  

Family Doctors are required to provide the form to clients. Case Managers can issue the form in an emergency situation where a family doctor referral is not required. Please call 675-4010 or 1-800-461-4006 to determine is your client is experiencing an emergency situation.  

  1. Complete Section 2 of the Northern Health Travel Grant. Applicant and Case Manager’s signature required in this section. 
  2. Ensure northern referring doctor has completed & signed Section 3.  Section 3 need not be completed for follow-up appointments.  
  3. Ensure participant has completed & signed Section 1
  4. If patient needs accompaniment (i.e. a child) ensure Section 5 is completed. 
  5. Issue an advance payment for their travel expenses. Make a photocopy of the travel grant. Give the original back to the client. Record activity in the Social Assistance Computer System notes.
  6. Send email to Administrative Assistance with the:
  • Date of appointment
  • Who the appointment is for
  • Date of the cheque
  1. When the client returns after their appointment, ensure the information from the Specialist is completed in Section 4. Take another photocopy of the grant, destroying your previous one. Mail the copy for the client. 
  2. When payment is received it is forwarded to Finance.  Once deposited Finance forwards a copy of the cheque to Head Integrated Program  Assistant for posting.

Note:  Northern Health Travel Grant only available for those persons requiring medical services not available within the Manitoulin or Sudbury Districts.
 

Second and Subsequent Requests 

If an applicant/participant is requesting a travel grant advance for the second time, the Social Assistance Computer System note is to be checked to see if payment has been made on the previous request. NOTE: The reimbursement may take up to 8 weeks to receive funds from Ministry of Health. If there has not been a payment, the applicant/participant is to contact the Ministry of Health to determine why. The Ministry of Health will respond either in writing to the participant or verbally to a Case Manager. The response determines whether there will be another advance granted. For example: if the advance was not granted because it was not an item covered by the Travel Grant and the current request is for the same reason, the advance would be denied. 

Exception: The time duration was too short for the first travel grant to be processed. In that scenario, one additional travel grant could be processed. 

Applicants/participants travelling out of town for medical reasons may be issued: 

  • Actual cost of a room up to $100 per day to a maximum of $700 per medical trip;
  • $20 per person/day for meals to maximum of $280
  • Transportation to be the most economical method (i.e. bus or equivalent). Where a participant uses their own vehicle or has access to a vehicle for travel, the actual costs will be equivalent to the mileage rate permitted by the Northern Health Travel Grant. 

Prior approval for a specified time period is required. Applicant/participant is to submit receipts upon return for reimbursement for actual number of days.  Exceptional cases may be issued “up front” money.

Exception: Children receiving Assistance for Children with Severe Disabilities (formerly Handicapped Children’s Benefits) are not eligible to receive monies for food and accommodations. These extra costs are taken into consideration when the assessment is made for this benefit. If there are extra costs, refer the applicant to the MCSS Case Manager who can reassess the case.