Government of Ontario: Ministry of Health and Long-Term Care

Corporate Services Division

Rate Reduction Application in Long-Term Care
Document List Required for Assessment of Resident Eligibility

Only to be used by Residents Receiving Income Support from the Ontario Disability Support Program (ODSP)

• As a resident of a LTC home, you are required to pay a co-payment for your accommodation. This requirement is set out in the Long-Term Care Homes Act, 2007 (the Act).
• The Rate Reduction Program is intended to provide a reduction in the co-payment amount you are required to pay based on your available income. Only residents residing in basic accommodation may apply for a reduction in the co-payment amount.
• Before you can apply for a rate reduction you need to apply for other income support and benefit programs available through the federal, provincial and municipal government.
• In order to fairly assess your application for a reduction in the co-payment, otherwise known as a “rate reduction”, it is important that you report all income available to you.
• As a resident receiving benefits from the Ontario Disability Support Program (ODSP), you will be required to show your Notice of Decision Letter or ODSP cheque stub.
• This supporting document list will help you determine whether you have the required documentation to apply for a rate reduction.  The documentation required will be used to assess:
  • Your eligibility based on whether you have accessed all available income; and
  • Your rate reduction based on the income available to you.

Instructions

• Please complete this document by checking “Yes” or “No” for the income sources you are receiving and whether you have the supporting documents required.
• Please ensure you submit this form and all your documents to staff in your LTC Home when you bring in your completed and signed Rate Reduction Application Form.
• Note: This list is for guidance only. Based on your unique circumstances you may be required to provide additional documents. The home processing your application may ask you for additional information and documentation in order to complete a Rate Reduction Application.

All residents are required to have a Notice of Assessment (NOA).  This is the document Canada Revenue Agency sends back to you after you have filed your tax return along with your refund cheque or statement of balance owing.

• There is an exception to the requirement for a Notice of Assessment for resident who have been residing in a long-term care home for less than or equal to a year.

Glossary

Income Tax - Notice of Assessment Form
To replace lost copy of Notice of Assessment form, contact the Canada Revenue Agency at 1-800-959-8281.

Option-C Printout
It is the equivalent of the last notice of assessment you would have received in respect of the most recent taxation year and will serve as a basis for your income assessment.

This printout is issued by the Canada Revenue Agency (CRA, formerly CCRA) and you can obtain it free of charge by calling 1-800-959-8281. Your dependent will also have to obtain an “Option-C Printout”.

If you are not able to obtain and produce an “Option-C Printout”, you will need to provide documentation establishing the amount of income you earned over the period of 12 months preceding the date of your application (i.e. bank statements if you have received interest income; statement of interest if you have other sources of income).

T4A (P) – Canada Pension Plan benefits slip
Canada Pension Plan benefits slip is sent to taxpayers who received any of the following from the government:

• Retirement Benefits
• Survivor Benefits
• Child Benefits
• Disability Benefits
• Death Benefits

Old Age Security (OAS)
OAS is a monthly pension benefit available to eligible Canadians over age 65, even if they have never worked.

Guaranteed Income Supplement (GIS)
GIS provides additional monthly income to eligible individuals already receiving OAS.

Canada Pension Plan – Retirement (CPP-R)
CPP-R is a monthly pension benefit available to individuals who have contributed to the Canada Pension Plan. CPP-R is designed to replace about 25% of an individual’s earnings from employment up to a maximum amount.

Ontario Disability Support Program (ODSP)
ODSP provides income to eligible individuals with disabilities who are in financial need.

Income Replacement Benefits
This benefit compensates for lost income if you are unable to perform the essential tasks of the job you did before the accident.

Death Benefit
Death benefit is a one-time payment to, or on behalf of, the estate of a deceased Canada Pension Plan contributor.

Survivor Benefits
Survivor benefits are paid to a deceased contributor’s estate, surviving spouse or common-law partner and dependent children.

Income Sources from Foreign Country
An annual income sources from foreign countries in Canadian dollars for the annual net calculation using Bank of Canada currency exchange rates.

Financial Income Sources Inquiries Guide

The following guide is meant to provide members of the public direction as to the appropriate governmental and non-governmental offices to direct their federal / provincial benefits, entitlements, supplements, settlement or other financial income sources inquiries.

Resident NOA or C-Print - Line 236
Inquiries should be directed to Revenue Canada Agency at: 1 800 959-8281 or TTY (Teletypewriter) 1 800 665-0354

OAS - Service Canada Letter
Inquiries should be directed to Service Canada at: 1 800 O-Canada (1 800 622-6232) or TDD/TTY (Teletypewriter)
1 800 926-9105 or the Service Canada Web site http://www.servicecanada.gc.ca/.

GIS - Service Canada Letter
Inquiries should be directed to Revenue Canada Agency at: 1 800 277-9914 or TTY (Teletypewriter) 1 800 255-4786
Please note: You can also re-apply for GIS by filing your income tax return. The Seniors section of the Canada Revenue Agency's Web site (i.e. http://www.cra-arc.gc.ca/tx/ndvdls/sgmnts/snrs/menu-eng.html) contains information on filing your tax return.

CPP-R - Service Canada Letter or CPP-R cheque stub inquiries should be directed to Service Canada at:
1 800 O-Canada (1 800 622-6232)TDD/TTY (Teletypewriter)  1 800 926-9105,  a Service Canada Centre near you (http://www.servicecanada.gc.ca/cgi-bin/hr-search.cgi) or the Service Canada Web site (http://www.servicecanada.gc.ca)

ODSP - ODSP Notice of decision letter OR ODSP cheque stub
Inquiries should be directed to the Ministry of Community and Social Services at: 1 888 789-4199

Private Insurance Income Sources
Inquiries should be directed to resident’s private insurance companies. The resident will be required to submit his/her insurance policy, or insurance benefit letter to verify the amounts required to be included in the resident’s annual net income.