MANDATORY SPECIAL NECESSITIES (MSN)
MSN is available to any person who receives an ODSP cheque, which includes the words “shelter and basic inc sp” (renters) or “basic inc sp and special allowance” (boarders). MSN is included on the ODSP cheque as “Incont Supl” (incontinence supplies) and/or “Medical Tran” (transportation).
ODSP assumed responsibility for MSN on June 1, 1998, which specifically included coverage for:
Diabetic supplies; Ostomy, surgical supplies and dressings, as well as incontinence supplies; and
Transportaion for medical needs and appointments. (Any therapy or treatment covered by the Regulated Health Professions Act.)
For the initial 15 month period, Ontario Works provided this assistance due to technological difficulties within ODSP. As of September 1999, ODSP began providing all aspects of the MSN process.
In some areas, letters were sent out from Regional Directors advising of the MSN process and practical application. In other areas, Introduction Meetings were held. It appears that the MSN process is rolling out smoothly in some areas, slowly in others and in some cases, there has been no mention of this initiative. At the February 11, 2000 OASIS Board of Directors Meeting, a poll of member agencies about the introduction of MSN across the province, was requested. This poll would provide a sense of the scope of the provincial impact. OASIS accordingly conducted a poll of its’ 67 member agencies from February 21 – March 3, 2000.
This poll was summarized and sent out to all OASIS Member Agencies on March 8, 2000. At the May 3rd OASIS Board Meeting, it was further requested that:
a) a letter be sent to Ellen Waxman, Director of the ODSP Branch, identifying the positive impact of MSN and anticipation of the introduction of MSN province-wide;
b) an overview of ODSP rights and responsibilities;
c) an overview of what the MSN feature of ODSP includes; and
d) an outline of the steps to follow in pursuing MSN on behalf of people in receipt of support through the member agencies.
As the Halimand-Norfolk area has been involved in ODSP – MSN since the fall of 1999, the Norfolk ACL was asked to outline its’ process and sample forms.
NACL supports people in homes and pays for all costs related to staffing (salary, benefits and training). All other home related costs (rent, utilities, groceries, repairs, etc. ) are borne by the people living in the home.
One Region’s Experience:
In Halimand-Norfolk, the process is working quite well. In November 1999, meetings were held with the agencies, the MSN process discussed and the practical application was clearly defined. At NACL, incontinence supplies, especially diapers and underliners, were previously paid for by the individual requiring such supplies. Some people were spending up to $1600 per year on diapers. The agency had always purchased vinyl gloves and absorbed this cost. As a result of the introduction of MSN, the people receiving support who require incontinence supplies are now being reimbursed by ODSP on a monthly basis. This has made a significant difference for the impacted individuals in relation to their available personal spending money. The agency is now also saving money in relation to the cost of the vinyl gloves. The agency continues to bulk order gloves, providing each individual with a monthly supply. The agency is reimbursed by the person for the cost of the gloves. The Guide to Diabetic, Ostomy, Surgical and Incontinence Supplies details the involved steps and includes sample forms.
The transportation for medical purposes component appears to be extremely beneficial in rural areas where public transit is essentially non-existent. As a result, a fee schedule and catalogue of transportation rates were developed. Flat monthly rates were introduced to address medical transportation within the region. Out of Region medical travel is addressed through an established fee schedule. This sparsely populated, large geographic region, presents unique challenges as it is without public transit and the majority of specialists are unfortunately, located out of the region. Something as basic as a visit to a psychologist or clinic is often regarded as a day trip. The Guide to Transportation Costs Recovery, outlines the involved process and includes sample forms.
Given that the agency pays for vinyl gloves and the transportation services provided, an invoicing system was developed. This system was set out to monitor timely payments from ODSP to the people supported (especially in relation to Out of Region transportation) serve as a billing system for the agency in relation to reimbursement from the people supported and provide an audit trail.
All In Region and Out of Region medical practitioners were entered in the system as well as a coding system established for the purpose of the visit. The information provided by the Direct Care staff on the ODSP Medical Transportation Log is transferred on to a Key Sheet by the Manager. This Key Sheet is used for entering information into the invoicing system. The long range goal is to also use the individualized outcome invoice as the sole reporting format for ODSP each month. We have yet to achieve this long range goal, however, all other MSN components are operational and running smoothly.
Summarized by Rhonda Clarke-Bruyn