Nova Scotia

Health fund restrictions hurt poor: advocates

Advocates for people with disabilities say policy changes at Community Services will hurt Nova Scotia's most vulnerable people.

Advocates for people with disabilities say policy changes at Community Services will hurt Nova Scotia's most vulnerable people.

The department has tightened the rules for special needs funding. As a result, it will no longer pay for some drugs and medical services for clients on income assistance.

April Keddy was three years old when she was diagnosed with a rare disorder. She spent much of her childhood in hospital and at 31, she still battles many symptoms and a lot of pain.

Since Keddy started massage therapy, she's reduced the amount of her medication, is in less pain and has greatly improved her quaility of life.

"I am able to do more than I was before. I'm also able to functiion and keep my independance," said Keddy.

Under the changes, Keddy would not be covered for massage therapy. However, because she was previously approved, she will continue to be covered. but anyone else who now applies for massage therapy will not.

Other items taken off the table include psychological counselling and a range of alternative medicines, including marijuana.

Adrienne DeYoung worries that will make her life much more difficult. She has multiple sclerosis and a number of other illnesses. She stopped working two years ago and is now bedridden.

"I guess this is my profession now — managing MS," she told CBC.

DeYoung cried when she heard about the new regulations. She's on income assistance. She worries that Community Services won't pay for some of her new prescriptions, which change frequently.

"I had two medications covered. Then I find out about this," she said. "It kind of scares me."

Under the new rules, Community Services will only pay for medication listed on the province's insured drug plan.

This means dental care, psychological counselling, physiotherapy and massage are excluded, along with medical marijuana, gym memberships and equipment such as hot tubs.

The department will continue to support those already covered as long as they can prove it remains an essential health need.

The changes blindsided DeYoung and the lawyers who represent clients like her.

"We were a little discouraged," said Claire McNeil, a lawyer with Dalhousie Legal Aid. "There was no advance notice or public consultation with health rights or disability rights groups in advance."

McNeil said the program was designed to cover essential needs or to alleviate pain and suffering, and now there's no flexibility.

"It was an open-ended, accommodative provision that allowed people to seek help," she said Tuesday.

The policy changes were made after a client on income assistance forced the department to pay for her equipment to grow medical marijuana.

The Department officials said the old regulations were vague and open to interpretation. They said the criteria had to change so that the rules for receiving funding are clear, consistent and ensure everyone is treated equally.

Right to health services

McNeil disputes any suggestion that limits on special needs funding are necessary to keep the costs of the program in check. There are currently 20 to 25 cases funded through the program out of a total caseload of 33,000, she noted.

"From our point of view you can't put a price tag on human rights," she said.

"Access to essential health services or to services that alleviate pain and suffering — that goes to the core of people's right to adequate health services, the right to life, the right to security of person."

McNeil said the move will likely mean higher costs in the end, through more visits to doctors and emergency rooms.

DeYoung doesn't know what to do next. She worries about other people on income assistance who don't have the money to pay for the health services or drugs they need.

"I have a lot of luck and a lot of fight, but not everybody does," she said.

The province however, said nothing has really changed.

Department of Community Services spokesman Dan Troke said they're just clarifying which special needs are and aren't covered and making the decisions consistant and fair province-wide.

"Anybody who would have received any kind of benefits under special needs in the past, effectively moving forward, they are guaranteed they will continue to receive that," he said. "If it is an item that is not covered under the formulary or under MSI, it never would've been an item that a case worker would've approved when that individual was coming through the door."

Troke said it was not done to save money.

"It definitely was not a cost saving measure," said Troke.