Welfare and Health Supplements (21:X)

A. Introduction

Schedule C of the EAR and EAPWDR set out the availability of supplements for health and dental services, including optical and orthodontic services. See also Part 5, Division 5 of the EAR and Part 5, Division 4 of the EAPWDR.

B. General Health Supplements

Section 67 of the EAR and s 62 of the EAPWDR set out the eligibility criteria for general health supplements. Students should review these criteria carefully if advising your client on any issue relating to a health supplement.

C. “Medical Services Only”

Section 66.1 of the EAR and s 61.1 of the EAPWDR provide that persons may be eligible for “medical services only” in certain circumstances when they are not eligible for income assistance, PPMB, or disability assistance.

D. Optical Care

If the person is between 19 and 64 and gets income assistance, hardship assistance, PPMB, or PWD benefits OR has Medical Services Only Status, they can receive an eye exam every 24 months. Further, children may receive one pair of glasses per year and adults may receive one pair of glasses every three years.

Ss 67.1 and 67.2 of the EAR and ss 62.1 and 62.2 of the EAPWDR set out eligibility criteria for certain optical benefits. See also ss 2.1 and 2.2 of Schedule C of the EAR and ss 2.1 and 2.2 of Schedule C of the EAPWDR.

E. Dental Care

Ss 68, 68.1, 69, 70, and 71 of the EAR and ss 63, 63.1, 64, and 65 of the EAPWDR set out eligibility criteria for supplements for dental work, crown and bridgework, dentures, emergency dental and denture work, and limited orthodontic work. See also ss 4, 4.1, 5, 6, and 7 of Schedule C of the EAR and ss 4, 4.1, and 5 of Schedule C of the EAPWDR.

F. “Healthy Kids” supplements

Section 72 of the EAR provides for certain optical and dental supplements for dependent children of welfare recipients. See also Schedule C.

G. Diet and nutrition

Ss 73, 74, 74.01, 74.1, and 75 of the EAR and ss 66, 67, 67.01, 67.1, and 68 of the EAPWDR set out eligibility criteria for supplements for diet supplements, nutritional supplements, supplements for those who require tube feeding, infant health supplements, and natal supplements for pregnant women. See also ss 8, 9, and 10 of Schedule C of the EAR and ss 6-10 of Schedule C of the EAPWDR.

Note: Monthly nutritional supplements are only available for people who receive disability benefits from the Ministry. Further, the person must be being treated for a "chronic, progressive deterioration of health on account of a severe medical condition". It is very hard to meet the requirements for this supplement. See s 67(1.1) of the EAPDWR for more information. Disability Alliance BC has a useful help sheet regarding the monthly nutritional supplement, at http://www.disabilityalliancebc.org/docs/hs4.pdf?LanguageID=EN-US.

H. Medical equipment and devices

Where a person meets eligibility criteria (see s 67 of the EAR and s 62 of the EAPWDR), MSDSI may provide funding for certain medical equipment and devices. The devices and eligibility criteria are listed in s 2(3) of Schedule C of each regulation. The devices may include:

• canes, crutches, and walkers;
• wheelchairs;
• scooters;
• bathing and toileting aids;
• hospital bed;
• pressure relief mattresses;
• floor or ceiling lift devices;
• positive airway pressure devices;
• apnea monitors;
• nebulizers;
• positioning items on a bed, positioning chairs, and standing frames;
• ventilator supplies;
• orthoses;
• and hearing aids.

NOTE: In order to qualify for these supplements, a prescription from a qualified medical practitioner must be supplied and the cost must be pre-approved by MSDSI. There are very detailed eligibility criteria that must be met for each item requested.

See Schedule C of both Regulations for details.

I. Medical and Surgical Supplies

Certain “disposable or reusable” medical supplies may be provided if they are necessary to prevent the recipient from becoming very ill (to avoid what MSDSI calls “an imminent and substantial danger”) and if they are prescribed by a doctor. See s 2(1)(a) of Schedule C of each Regulation.

The supplies are only available if they are needed for one of these following purposes: wound care; ongoing bowel care required due to loss of muscle function; catheterization; incontinence; skin parasite care; or limb circulation care.

The supplies must be the least expensive ones appropriate for the purpose. Exclusions to this list include: nutritional supplements, food, vitamins and minerals, and prescription medications.

J. “Direct and Imminent Life-Threatening Health Need”

Section 76 of the EAR and s 69 of the EAPWDR provide that MSDSI may provide certain health supplements to a person who is otherwise ineligible for the supplements (or indeed, for welfare benefits), if the person can show that the person faces an imminent and life threatening need that cannot be addressed except by the supplement. See the Regulations for details.

K. Alternative and Complementary Therapies

Up to 12 visits per calendar year are payable by the minister for any combination of physiotherapy services, chiropractic services, massage therapy services, non-surgical podiatry services, naturopathy services, and acupuncture services for which a medical practitioner or nurse practitioner has confirmed an acute need. See Schedule C, s 2 of each Regulation, especially s 2(c).

L. Transportation to Medical Appointments

Under Schedule C, s 2(f) of each Regulation, MSDSI may cover the cost for the least expensive mode of transportation to and from the office of a local medical practitioner, nurse practitioner, specialist, general hospital, rehabilitation hospital, provided that:

• the transportation is to enable the person to receive a benefit under the Medicare Protection Act or a general hospital service under the Hospital Insurance Act;
• and there are no resources available to the person's family unit to cover the cost.