The Ontario government is replacing the Special Diet Allowance Program with a new nutritional supplement program.
As it designs this new program, the government must ensure that it is not viewed in isolation from other aspects of the social assistance system and the problems that people who rely on it experience on a regular basis.
There is widespread recognition that the levels of financial support provided through Ontario Works and the Ontario Disability Support Program are insufficient to meet even the most basic needs of the people who rely on these programs. This means that people on OW and ODSP cannot adequately afford healthy food, appropriate shelter, clothing, transportation, hygiene supplies, and other basic items.
There is also widespread consensus that the poverty experienced by people on social assistance is directly related to poor health outcomes. Income and food security are two of the primary social determinants of health, and people with low incomes have been shown to have a much higher incidence, prevalence, and severity of chronic illness, acute illness, injuries and death. People relying on social assistance incomes thus have more extensive needs for additional dietary support.
Communities across Ontario agree that the entire social assistance system needs to be re-imagined so that programs can be created that better support the financial, educational, employment training, nutritional, and social needs of the people who rely on them. Ontario has responded by committing to undertake a Social Assistance Review as part of its Poverty Reduction Strategy.
Recognizing that the new program will be created before the Review can take place, we urge the Ontario government to use the following five principles as guideposts for the development of an “Ontario Nutritional Supplement”:
1. CLEAR POLICY OBJECTIVE:
The overriding policy objective of the new program must be to ensure that people who depend on social assistance benefits, who have associated additional dietary costs due to health challenges, receive the additional financial support that they need for dietary purposes.
2. ACCESSIBILITY, ADEQUACY, AND EQUITY:
The design of the new program must be driven by a commitment to:
- Genuine accessibility to the program. This includes ensuring that the program is delivered locally, and that health challenges be verified by a range of health care professionals, including nurse practitioners, physicians, registered dietitians, registered midwives, and traditional Aboriginal midwives.
- Adequate levels of support. This includes using an evidence-based process to determine levels of financial support so that the supports provided will be sufficient to meet the additional financial requirements of people with health challenges. Such a process must reflect the needs of people living in communities with disproportionately more expensive food costs, such as those in remote, rural, and otherwise food insecure areas.
- Regular adjustments to keep up with rising costs. A special market basket measure that reflects the costs of nutritional needs related to various health challenges should be developed as the benchmark for determining increases.
- Equity. This includes ensuring that all people on social assistance who have health challenges are given financial support appropriate to their needs.
3. MEETING THE NEED:
The new program must provide monetary support.
Expansion of the Ontario Drug Benefit, distribution of coupons, or some other non-monetary program intended to only provide access to nutritional beverages and vitamins will not be sufficient to meet the variety and extent of the special dietary needs that people with health conditions require.
The new program must start with an initial budget at least equal to the current budget of the Special Diet Allowance program, which the Premier has indicated is approximately $250 million per year.
4. RESPONSIBILITY FOR CURRENT RECIPIENTS:
Ontario has already committed to ensure that current recipients of the Special Diet Allowance Program will continue to receive this benefit until the new program is put into place. However, recognizing that people’s health and social circumstances can change at anytime, it is essential to ensure that everyone – current recipients or those newly diagnosed – who meets the criteria of the Special Diet Allowance Program should be granted access to that program during this time of transition.
Ontario should also ensure that no one will be worse off as a result of this transition by grand-parenting every person who is now covered by the Special Diet Allowance Program into the new program.
And Ontario must also ensure that no one will lose their entitlement to OW or ODSP as a result of the cancellation of the Special Diet Allowance, because of the way in which OW and ODSP general budgetary requirements are calculated.
5. TAKE THE TIME TO GET IT RIGHT:
Ontario should take the time to get the new program right, recognizing that an insufficient program will result in higher costs to government in other parts of the health care system.
The government’s primary consideration should be to ensure that the new program has a coherent policy objective, as outlined above, and a sound delivery mechanism, and that key stakeholders – including health care experts, community agencies, advocates, municipalities, social services delivery agents, and people with lived experience – are adequately consulted in the design of and prior to the implementation of the new program. The process and its results need to be open and transparent.