Ban no longer in effect

Authority Ministry of Social Development and Poverty Reduction

Josh was receiving his disability assistance benefits through a contracted third party administrator (TPA) because the Ministry of Social Development and Poverty Reduction had banned him from having direct contact with ministry staff. Josh was having difficulty communicating with the ministry due in part to his disability, and was placed on TPA status to assist him with getting the support he required. Josh had been on TPA status for six years, unable to contact the ministry directly for help. When he requested through his third party administrator that the ministry review his TPA status and allow him to have direct contact with the ministry again, his request was denied. Confused by the response from the ministry, Josh turned to the Office of the Ombudsperson for help. We reviewed the ministry’s records relating to Josh’s TPA status, and learned that the TPA agency had recommended to the ministry several months earlier that he be returned to direct service delivery based on his positive behaviour and appropriate interactions with them. When we asked the ministry why the ban on direct service had continued despite this recommendation from the TPA agency, we learned that the ban continued because Josh had previously sought assistance from his MLA and then from the Office of the Ombudsperson.

We raised our concerns with the ministry about this decision, as under the Ombudsperson Act, any member of the public has the right to submit a complaint to us without any risk that such contact would impact on their access to programs or services from that public agency. The ministry acknowledged our concerns and agreed to do a proper review of Josh’s file to determine whether the ban on direct service actually needed to be continued. Through this review, the ministry concluded that Josh could in fact return to direct service delivery with the ministry, and they wrote to him to inform him of their decision. The ministry also met with Josh to discuss a transition plan to help him be successful with direct service delivery. The ministry also indicated they were reviewing all TPA procedures to provide more clarity for staff and clients.

Category Income and Benefits
Type Case Summary
Fiscal Year 2017