Guide to SELF-DIRECTED Passport Funding -...

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Guide to

SELF-DIRECTED

Passport Funding

Prepared by:

Contact Hamilton, Passport Agency for the communities of: Brant, Haldimand, Norfolk, Hamilton, Niagara

Six Nations of the Grand River Mississaugas of the New Credit First Nation

The Ministry of Community and Social Services has issued Guidelines for Adults with a Developmental Disability

and their Caregivers effective October 1, 2014. This guide must be used in conjunction with these Guidelines.

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What is Passport Funding and What Can I Use it for? Passport is a program that helps adults with a developmental disability be involved in their communities and live as independently as possible by providing funding for community participation services and supports, activities of daily living and person-directed planning. The program also provides funding for caregiver respite services and supports for primary caregivers of an adult with a developmental disability. The Ministry of Community and Social Services (MCSS) has developed Guidelines for the Passport Program (effective October 1 2014). It is very important that you read the Ministry’s Guidelines carefully as they explain what expenses are admissible and inadmissible under the Passport Program as well as other important information about Passport. We have made the Ministry’s Guidelines available to you in your approval package; if you have misplaced it please feel free to call us and we can send you a copy or you can visit this link and get copy directly: www.ontario.ca/bxi7 Our “Guide to Self-Directed Passport Funding” compliments the Ministry’s full Passport Guidelines and highlights key pieces of information as it relates to how we will work together. What is self-directed funding? Self-Directed funding is when an individual or family receives Passport funding directly to purchase admissible services and supports. You must be willing to manage your funding yourself or you can have a third party help you (often called a “broker”); please continue reading this guide for more information about the broker option. With Self-Directed funding, you can choose to purchase your admissible services and supports from anywhere or anyone you prefer, including from Ministry of Community and Social Services funded agencies. Regardless of who you purchase your services and supports from, you will need to make sure that they invoice you so that you can submit them to the Passport office for reimbursement. Do I have to sign a funding agreement? You will be required to sign a formal funding agreement with the Passport office before the funding can be released. How do I get my funding? Passport is a reimbursement-based program. That means that the Passport program will reimburse you for your admissible expenses. You are responsible for submitting invoices and receipts to the Passport office using the required forms and according to the reimbursement schedule (this allows for predictability). The Passport office will review your expenses to make sure that they are admissible. If there are any questions about the expenses, the Passport office will let you know. The Passport office will reimburse you by way of Direct Deposit. For some people, paying for supports up front may cause financial hardship. In such situations, the Passport office is willing to discuss your circumstances and help with making arrangements that work for you. Please call us if you would like to discuss this further.

http://www.ontario.ca/bxi7

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What reimbursement forms do I need to complete? There are three types of reimbursement forms:

- Support Worker expenses - Mileage expenses - Other expenses

Once you have activated your Passport funding, we will provide you with the reimbursement forms (at the beginning and then following each reimbursement claim). If you like, you can also download the expense forms from the Passport office website www.contacthamilton.ca. Reimbursement Form – Support Worker is completed for any support worker hours. If there is more than one support worker then you will need to complete a form for each worker. The first signature and date line is for the support worker and the second signature and date line is for the Primary Contact Person/Passport Funding Recipient. Instructions are provided on the reverse side of this form as shown at the end of this guide. When completing this section, Description of Supports/Activities, please list the actual support and activity provided. We encourage you not to use the terms: Community Outings, Community Participation Supports; and Personal Development & Growth as we are unable to verify if the support/activity is admissible under Passport. An example of how to complete this form is on page 7 and a blank form is shown on page10. Reimbursement Form – Mileage Expenses is completed for any claims for mileage (per kilometre rate or flat rate). This form requires a signature from the driver and the Primary Contact Person/Passport Funding Recipient. An example form is shown on page 8 and a blank form is shown on page 11. Reimbursement Form – Other Expenses is completed for all other admissible claims, receipts and invoices. This form requires the Primary Contact Person’s or Passport Funding Recipient’s signature and date. This form is shown on page 9 and a blank form is shown on page 12.

The Passport Agency reserves the right to seek additional information and/or approve or not approve expenses of these

kinds. If you are unsure about whether an expense is admissible, please contact our Passport Administrator IN ADVANCE

to avoid any disappointment.

How often do I have to submit my Reimbursement claims?

The Passport office provides a Passport Reimbursement Payment Schedule that identifies on a monthly basis, when your

claim needs to be received in order to provide the date for direct deposit. Presently the schedule is based on the first letter

of the Passport recipient’s surname. The current schedules are provided on page 13, 14, 15 and 16.

What are my main responsibilities if I Self-Direct my funding? Please refer to your funding agreement for details. As a self-directed funding recipient, you have the following responsibilities:

Make sure that a support plan is created and regularly reviewed.

Determine if you will be an Employer or if you will contract with self-employed persons. Call the Canada Revenue Agency about your responsibilities and requirements. They will give you the information you need.

http://www.contacthamilton.ca/

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- Adhere to Employment Standards, Labour Relations Act, Workers Compensation, Canada Revenue Agency and any other legislation. You are strongly encouraged to find out more information about any obligations you may have by contacting these bodies; they can assist you and provide you with valuable information and advice.

- Be solely responsible for remitting all statutory payments and remittances (if any) including, without limitation, Income Tax, Employment Insurance, Canada Pension Plan, Employer Health Tax, Federal and Provincial Taxes, including applicable taxes.

Negotiate with and pay your service providers. Document what you agreed upon.

Make sure that services are provided in a manner that is safe for both the individual and the service provider.

Instruct service providers as to what services are needed and how and when they will be provided.

Hire, set wage rate, supervise and schedule worker(s).

Evaluate the effectiveness of supports and services by looking at whether the person’s goals have been achieved

Be responsible for the supervision of workers and quality of services.

Make sure you have adequate general liability insurance is in place.

Submit invoices for reimbursement to the Passport office in a timely manner as outlined in the schedule. Can I get help with managing my Self-Directed funding? Yes. This is optional and available to you if you feel you need it. You may use up to 10% of your approved funding to get help managing your funding (this service is referred to as” brokerage”). Brokerage describes a range of administrative supports that you may use to support you in managing your approved funding. You may choose to hire brokers from agencies, other brokerage organizations, or a person of your choice. For instance, your broker may manage payroll functions on your behalf. In this role, the broker would make payments for services and supports while ensuring that required documentation such as signed receipts are received to support expenditures. Other functions of a broker could include:

Identifying a list of qualified support workers available for hire;

Performing reference checks on potential workers (employment and/or criminal);

Assisting with other elements of recruiting and training workers; and,

Resourcing community opportunities such as day programs and adult learning classes. The Ministry of Community and Social Services has published Hiring a Support Worker: A Guide for Ontarians with a Developmental Disability. You may obtain a copy by visiting the Ministry’s website at: http://www.mcss.gov.on.ca/documents/en/mcss/publications/developmental/HiringSupportWorker.pdf. If you do not have access to a computer/internet and would like a copy of this Guide, please call 905-529-5100 or toll-free at 1-866-288-9659 and ask for the Passport office. Can I get help with planning? Yes. A planning guide developed by the Individualized Funding Coalition for Ontario titled “Creating a Good Life in Community: A Guide on Person-Directed Planning” is available. This resource is free of charge. If you are interested in this guide, you can either get it on line at:

http://www.mcss.gov.on.ca/documents/en/mcss/publications/developmental/HiringSupportWorker.pdf

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http://www.mcss.gov.on.ca/documents/en/mcss/publications/developmental/PlanningGuidePlainLanguageMCSS.pdf or by calling the Passport office at 1-866-288-9659. You are encouraged to use the planning guide when developing your goals and objectives. You can also use up to $2,500.00 of your total funding to purchase a person directed plan through an Independent Planner who can help to develop your plan (An Independent Planner is not associated with any agency.) If you are receiving residential or day programming from a Ministry funded agency, they would be responsible to help you develop your plan, included in their services, at no additional cost. Independent Planners:

The Ontario Independent Facilitation Network is a provincial network whose purpose is to inform, educate, encourage, support, link and promote independent facilitation and planning in Ontario. Information and resources to support person-directed planning are available at www.oifn.ca.

An online map and directory that provides background and contact information for Independent facilitators and independent facilitation and training organizations across the province is also available at: www.independentfacilitation.ca/map/.

Ministry Funded Agencies:

Information about Ministry funded agencies from whom you can purchase person-directed planning is available at: http://contacthamilton.com/main/wp-content/uploads/2012/02/TPA-PDP-List-2014-04-15.pdf

Who do I contact if I have complaints about the service I am receiving? Complaints or concerns about your services and supports should be directed to the service provider delivering the service. How often do I have to re-apply for Passport? Once an applicant has been approved for Passport funding and you are in receipt of funds, you are not required to re-apply. If life circumstances/support requirements change regarding medical, behavioural, or caregiver concerns, you may be eligible to apply for additional funding. Please contact your local Developmental Service Ontario office.

Passport Reimbursement Forms The next section will include the following example forms and information:

Support Worker Claim Form with Examples

Mileage Claim Forms with Examples

Other Expenses Claim Form with Examples

Passport Payment Schedule Due Dates (Based on last name)

http://www.mcss.gov.on.ca/documents/en/mcss/publications/developmental/PlanningGuidePlainLanguageMCSS.pdf

http://www.oifn.ca/

http://www.independentfacilitation.ca/map/

http://contacthamilton.com/main/wp-content/uploads/2012/02/TPA-PDP-List-2014-04-15.pdf

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Important Resource Information for the Hamilton-Niagara Region For more information about Passport please call: Toll free at 1-866-288-9659 (Hamilton local 905-529-5100) For information on Employment Standards, call: Ontario Ministry of Labour Employment Standards Branch 1-800-531-5551 www.labour.gov.on.ca For information about financial responsibilities under the Income Tax Act, the Canada Pension Plan Act and Employment Insurance, call: Canada Revenue Agency 1-800-959-5525 www.cra.gc.ca For information on Workplace Safety, call: Workplace Safety and Insurance Board (WSIB) 1-800-387-0750 www.wsib.on.ca

http://www.labour.gov.on.ca/

http://www.cra.gc.ca/

http://www.wsib.on.ca/

140 King Street East, Suite 4, Hamilton, ON L8N 1B2

Tel: (905) 529-5100 Toll Free Tel: 1-866-288-9659 Toll Free Fax: 1-844-777-6664

Administered by Contact Hamilton

Passport Claim Forms can be submitted by Fax at 1-844-777-6664 or Email: [email protected]

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140 King Street East, Suite 4, Hamilton, ON L8N 1B2 Tel: (905) 529-5100 Toll Free Tel: 1-866-288-9659

Toll Free Fax: 1-844-777-6664


Support Worker Claim Form

Please note we require one form to be completed for each Support Worker. In order to process the claim we require that you complete all dates for services worked, and all required signatures must be completed. Claim Processors cannot determine services provided based on the description of Respite or Community Participation Supports only. Please ensure you are also including a brief description of the activity being provided.

Dates Worked:

Hours Worked:

Hourly Rate or Flat Rate:

Total Amount:

Description of Activities: (Please include specific services provided)

April 1

st, 16

4

15.00

60.00

Respite: Support with meals and hygiene

April 10

th,16

6

15.00

90.00

Community: Trip to Hamilton Art Gallery

April 14

th, 16

4

15.00

60.00

Respite: Parental Relief

April 18

th, 16

6

15.00

90.00

Community: Niagara Butterfly Conservatory/Lunch

April 22

nd, 16

4

15.00

60.00

Community: Movies and Dinner

April 28

th, 16

2

15.00

30.00

Respite: Teaching Guitar Lessons in home

April 29

th, 16

2

15.00

30.00

Respite: Parental Relief

TOTALS:

28

15.00

420.00

TOTAL AMOUNT CLAIMED: 420.00

By signing below, I verify that I have provided the services described above, I am over 18 years of age and I am not the primary caregiver. I will ensure that any and all provincial and federal legislation is adhered to including withholding, remitting, and reporting taxes and benefits where applicable.

Support Worker Signature:

Date:

I hereby certify that I have received the above services. I fully understand that it is my responsibility to pay the above-named person. I have not previously submitted this claim.

Primary Contact Signature:

Date:

Passport Recipient’s Name: Monica Henry

Primary Contact’s Name: Layla Henry

Support Worker’s Name: Sonia Patel

mailto:[email protected]





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Mileage Expense Claim Form

Please note we require your claim forms to be submitted together, once per schedules payment period. Please complete this form for every person who provides transportation services and claims mileage/travel.

In order to process your claim you need to provide the requested information below. If sections are not completed we may not be able to process your claim.

Date of Travel:

# KM Travelled

Rate per KM or Flat Rate

Amount of Expense:

Purpose of Travel: (Please include specific destination)

April 10th,16

30km

0.45

13.50

Trip to Hamilton Art Gallery

April 18th, 16

40km

0.45

18.00

Trip to Niagara Butterfly Conservatory

April 22nd, 16

12km

0.45

5.40

Movies and Dinner

TOTALS:

82KM

0.45

36.90

TOTAL AMOUNT CLAIMED: 36.90

I certify that I have provided the travel identified above for the purposes of supporting the Passport Recipient.

I verify that the Passport Recipient received the travel identified above.


Date:


Person Providing Travel: Layla Henry

Person Claiming Mileage:

Date:






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Other Expenses Claim Form

Please note we require your monthly claim forms to be submitted together, once per month. If all sections of the form are not completed and receipts are missing we will not be able to process all/or a portion of your claim. Claims processors cannot determine if purchases are admissible expenses based on your description alone, a corresponding receipt must be attached for each item you list on this claim. We require official receipts that include the service provider’s name, date of purchase, and description of items purchased. Please note we cannot accept debit or credit card slips.

Date of Expense:

Description of Expense: (Please provide the purchased service or type of supplies)

Amount of Expense:

Receipt Attached:

April 10th, 2016

Hamilton Art Gallery: Admission for Support Worker and Sue

30.00

Yes

April 18th, 2016

Niagara Butterfly Conservatory: Admission for Support Worker and Sue

28.00

Yes

April 22nd, 2016

Movie Tickets for Support Worker and Sue

24.00

Yes

April 28th, 2016

Music Sheet Book for Guitar Lessons

15.00

Yes

TOTAL AMOUNT:

97.00

I verify that the expenses listed above were used only to support the Passport Recipient. I have not previously submitted any of the above expenses.


Date:


Passport Primary Contact Name: Layla Henry






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Toll Free Fax: 1-844-777-6664


Support Worker Claim Form

Please note that we require one form to be completed for each Support Worker. In order to process the claim we require that you complete all dates for services worked, and all required signatures must be completed. Claim Processors cannot determine services provided based on the description of Respite or CPS only. Please ensure you are also including a brief description of the activity being provided.

Dates Worked:

Hours Worked:

Hourly Rate or Flat Rate:

Total Amount:

Description of Activities: (Please include specific services provided)

TOTALS:

TOTAL AMOUNT CLAIMED:

By signing below, I verify that I have provided the services described above, I am over 18 years of age and I am not the primary caregiver. I will ensure any and all provincial and federal legislation is adhered to including withholding, remitting, and reporting taxes and benefits where applicable.

Support Worker Signature: Date:

I hereby certify that I have received the above services. I fully understand that it is my responsibility to pay the above-named person. I have not previously submitted this claim.

Primary Contact Signature: Date:

Passport Recipient’s Name:

Primary Contact’s Name:

Support Worker’s Name:






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Toll Free Fax: 1-844-777-6664


Mileage Expense Claim Form

Please note we require your claim forms to be submitted together, once per schedules payment period. Please complete this form for every person who provides transportation services and claims mileage/travel. In order to process your claim you need to provide the requested information below. If sections are not completed we may not be able to process your claim.

Date of Travel:

# KM Travelled

Rate per KM or Flat Rate

Amount of Expense:

Purpose of Travel: (Please include specific destination)

TOTALS:

TOTAL AMOUNT CLAIMED:

I certify that I have provided the travel identified above for the purposes of supporting the Passport Recipient.

I verify that the Passport Recipient received the travel identified above.


Date:


Person Providing Travel:

Person Claiming Mileage Signature:

Date:






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Other Expenses Claim Form

Please note we require your claim forms to be submitted together, once per scheduled payment period. If all sections of the form are not completed and receipts are missing we will not be able to process all or a portion of your claim. Claims processors cannot determine if purchases are admissible expenses based on the description alone, a corresponding receipt must be attached for each item you list on this claim. We require official receipts that include the service provider’s name, date of purchase, and description of items purchased. Please note we cannot accept debit or credit card slips.

Date of Expense:

Description of Expense: (Please provide the purchased service or supply)

Amount of Expense:

Receipt Attached:

TOTAL AMOUNT:

I verify that the expenses listed above were used only to support the Passport Recipient. I have not previously submitted any of the above expenses.

Primary Contact Signature: Date:


Passport Primary Contact Name:





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Toll Free Fax: 1-844-777-6664


Passport Reimbursement Schedule 2016-2017 (April 1st 2016 – March 31st 2017)

Important Information: Please note we require your claim forms to be submitted together, once per

month, on or before the listed due date below. Due to processing times we ask that you submit

regularly throughout the year; on a monthly basis - no more than quarterly. Any invoices received after

the due date will not be processed until your next payment date.

Last Name: A-E

Invoice Due Date Direct Deposit Date Cheque Date

May 5, 2016 May 12, 2016 May 17, 2016

June 9, 2016 June 16, 2016 June 21, 2016

July 7, 2016 July 14, 2016 July 19, 2016

August 4, 2016 August 11, 2016 August 16, 2016

September 8, 2016 September 15, 2016 September 20, 2016

October 6, 2016 October 13, 2016 October 18, 2016

November 3, 2016 November 10, 2016 November 15, 2016

December 8, 2016 December 15, 2016 December 20, 2016

January 5, 2017 January 12, 2017 January 17, 2017

February 9, 2017 February 16, 2017 February 22, 2017

March 9, 2017 March 16, 2017 March 21, 2017

April 6, 2017 April 13, 2017 April 19, 2017

For Your Information:

If you misplace your Passport Reimbursement Schedule 2016/2017 please access another copy

through our website at www.contacthamilton.ca or contact our office.

How Do We Submit Our Claims

Invoices may be faxed to 1.844.777.6664 or emailed to [email protected]

If you wish to mail your invoices please send them to the following address:

Passport Hamilton-Niagara, Contact Hamilton

140 King Street. East Suite 4 Hamilton, ON L8N 1B2

Please note our office is open Monday to Friday from 8:30am-4:30pm. Faxes and emails are received

24 hours a day/7 days a week.




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Toll Free Fax: 1-844-777-6664


Passport Reimbursement Schedule 2016-2017 (April 1st 2016 – March 31st 2017)





Last Name: F-L



through our website at www.contachamilton.ca or contact our office.

How Do We Submit Our Claims?








May 12, 2016 May 19, 2016 May 25, 2016

June 16, 2016 June 23, 2016 June 28, 2016

July 14, 2016 July 21, 2016 July 26, 2016


September 15, 2016 September 22, 2016 September 27, 2016

October 13, 2016 October 20, 2016 October 25, 2016


December 15, 2016 December 22, 2016 December 28, 2016


February 15, 2017 February 23, 2017 February 28, 2017


April 12, 2017 April 20, 2017 April 25, 2017




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Toll Free Fax: 1-844-777-6664


Passport Reimbursement Schedule 2016/2017 (April 1st 2016-March 31st 2017)





Last Name: M-R


May 18, 2016 May 26, 2016 May 31, 2016

June 23, 2016 June 30, 2016 July 5, 2016

July 21, 2016 July 28, 2016 August 3, 2016


September 22, 2016 September 29, 2016 October 4, 2016

October 20, 2016 October 27, 2016 November 1, 2016


December 20, 2016 December 29, 2016 January 4, 2017


February 23, 2017 March 2, 2017 March 7, 2017

March 23, 2017 March 30, 2017 April 4, 2017

April 13, 2017 April 27, 2017 May 2, 2017














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Toll Free Fax: 1-844-777-6664


Passport Reimbursement Schedule 2016/2017 (April 1st 2016-March 31st 2017)

Important Information: Please note we require your claim forms to be submitted together, once

per month, on or before the listed due date below. Due to processing times we ask that you

submit regularly throughout the year; on a monthly basis - no more than quarterly. Any invoices

received after the due date will not be processed until your next payment date.

Last Name: S-Z


May 26, 2016 June 2, 2016 June 7, 2016

June 29, 2016 July 7, 2016 July 12, 2016

July 27, 2016 August 4, 2016 August 9, 2016

August 25, 2016 September 1, 2016 September 7, 2016

September 29, 2016 October 6, 2016 October 12, 2016

October 27, 2016 November 3, 2016 November 8, 2016

November 24, 2016 December 1, 2016 December 6, 2016

December 28, 2016 January 5, 2017 January 10, 2017

January 26, 2017 February 2, 2017 February 7, 2017


March 30, 2017 April 6, 2017 April 11, 2017

April 13, 2017 May 4, 2017 May 9, 2017











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