Changes to the Ontario Drug Benefit – Effective August 1, 2016
The Ontario government is introducing changes to the Ontario Drug Benefit (ODB) Program that will make access to drugs cheaper for more than 170,000 seniors (65 years old and beyond) based on new eligibility thresholds.
Starting August 1, 2016, the government will change the income thresholds required to qualify for the low-income seniors benefit, called the Seniors Co-Payment Program, as follows:
Senior Co-Payment Program
SINGLE SENIOR SENIOR COUPLES
New income-threshold effective August 1, 2016 Less than or equal to $19,300 Less than or equal to $32,300
Current income threshold Less than or equal to $16,018 Less than or equal to $24,175
Seniors enrolled in the Seniors Co-Payment Program pay no annual deductible and only pay a $2 co-payment fee per prescription and save approximately $130 a year in out-of-pocket drug costs.
How to Apply for the Seniors Co-Payment Program
Complete a Co-payment Application for Seniors form and send it to the Ministry of Health and Long-Term Care.
It takes time to process an application, so we encourage eligible seniors to send in their form before July 1, 2016, i.e. one month before the program’s yearly start date of August 1, 2016.
Applications can be found: • At most Ontario pharmacies and all MPP Offices; • On the Ministry of Health & Long-Term Care website: http://www.health.gov.on.ca/en/public/programs/drugs/programs/odb/opdp_after65.aspx OR • By calling the Seniors Co-Payment Program at 1-888-405-0405; or 416-503-4586 in Toronto
Forms have also been sent to retirement homes and elderly persons’ centres.
The Ontario Seniors’ Secretariat (OSS) is pleased to announce the June 1st introduction of the Seniors Active Living Centres Act which is proposed legislation to modernize the Elderly Persons Centres (EPC) program.
EPC Review Led to Modernized Legislation
The new legislation, if passed, builds on what we learned in the 2015 program review and is the next step in strengthening Ontario’s EPCs.
We listened, and analyzed information from each of the review’s three key components:
a scan of Canadian and international models of seniors’ centres;
a survey of existing EPCs; and
province wide stakeholder consultations.
Then we considered the review’s recommendations, both medium and longer-term that are summarized in the chart below. While achieving all of the recommendations is not immediately possible, as some are of a longer-term nature and will need investment, the best way to implement most is through modernizing the EPC legislation.
Program Review Recommendations
Reduce administrative burden e.g. clarified audit requirements and current monthly payment requirements.
Enhance capacity building, e.g. strengthen the Regional Advisors’ role through additional training and support materials to facilitate EPC networking and learning.
Build the profile of EPCs, e.g. new program name and clarified, consistent mandate.
Define OSS oversight role and greater clarity regarding OSS relationships with key partners, e.g. other ministries and agencies serving older adults.
Enable potential new program partnerships e.g. learning institutions (such as universities and colleges) and First Nations Communities.
Research, evaluation, and knowledge dissemination, e.g. support evaluative research to align best practices and outcomes.
Potential expanded access e.g. enhancing capacity of existing EPCs and enabling new EPCs in the future.
It was your feedback that helped us better understand the existing network, key features of the program and areas for improvement. This, together with a legislative review of the current EPC Actand regulation, determined the best governing framework for EPCs.
We would like to tell you about how we are working to help meet the needs of Ontario’s seniors now and in the future though the proposed Seniors Active Living Centres Act.
The new name reflects a new approach to active and healthy aging, with modern provisions that build on the strengths of the EPC program and maintains flexibility, accountability and program clarity that aligns with government direction.
In addition to the renaming, the proposed legislation would if passed:
Clarify the mandate - states purpose of the program is to promote active and healthy living, social engagement, and learning for persons who are primarily seniors by providing them with activities and services;
Preserve the strengths of the current legislation by maintaining key provisions such as the program requirement of a minimum 20% municipal contribution;
Add flexibility to ensure that the government has the choice to explore program partnerships between EPCs and organizations, in addition to municipalities, in the future; and
Move the majority of EPC administrative program rules from legislation and regulation to program guidelines.
A modernized Act and program will not change the current program funding model. It will contribute to better support for seniors and provide a foundation for future investment in the program.
Although the legislative process began today with introduction of the proposed bill into the Legislature (what is known as First Reading), the pace, sequencing for each step of the process, and final approval is guided by the Legislative Assembly of Ontario. Please note, the Government House Leader and not OSS determines the scheduling of debates and votes. Additionally, the option to send the bill to Committee for further input and review is determined by the Legislature.
The bill must complete the entire legislative process in order to be voted on. Only after the bill receives Royal Assent would the law change and the modern Seniors Active Living Centres Act come into force. If you would like to learn more about how a bill becomes law in Ontario please visit the Legislative Assembly website.
To learn more about the review and its outcomes please visit the OSS website. As well, we have provided you with a link to the government’s news release regarding the introduction of the legislation here, and if you wish to view the full text of the legislation please click here.
If you are staff or are involved in governance at an EPC and have questions - please connect with your Regional Advisor.
If you feel that others in your organization need to be aware of this update please feel free to forward the content of this email to those individuals.
We look forward to sharing information with you as the proposed legislation moves through the legislative process. However, if you are interested in continuous information on the progress of the bill, please visit the Legislative Assembly website.
Abby Katz Starr Assistant Deputy Minister (A), Ontario Seniors’ Secretariat