News emerged this morning that the City has quietly cut the Hardship Fund – a fund that provides essential medical supports to people who do not receive social assistance, but who have very low or precarious incomes. The Fund meets the needs of residents where the cost of medical items would cause undue financial hardship. Supports and services that are covered include vision care, emergency dental care, reimbursement of prescription drug costs, and funeral costs.
The Wellesley Institute’s health equity impact assessment on the 2012 City budget, The Real Cost of City Cuts, found that cutting the Hardship Fund would have very damaging and disproportionate effects on particularly vulnerable groups, and Social Planning Toronto made saving the Hardship Fund the centrepiece of their budget efforts.
The cut came as a surprise because in the final city budget, Council requested that city staff negotiate future funding with the province. The City committed to continue the fund until July 1 and if the province would not provide additional funding, Toronto Employment and Social Services was to continue their funding until the end of the year.
Cutting the Hardship Fund will have unfair and inequitable impacts on Torontonians’ health, especially those in the poorest and most precarious situations, for three key reasons:
- The Hardship Fund provides support to people who do not receive social assistance. This means that people are able to remain in the workforce even if they have significant health care needs. Eliminating the fund will mean that some people will not be able to afford to remain in paid employment or training. This will increase the number of people receiving social assistance, which will in turn increase provincial and municipal costs in other areas.
- The cut will unfairly impact recent immigrants, who are often overrepresented in precarious and low-paid work, which has negative health implications. The Hardship Fund provides important support for recent immigrants while they build Canadian experience on the path to a good job that includes health benefits. Eliminating the fund may lead to a steeper erosion of immigrant health and ongoing job insecurity and poverty.
- Homeless and poorly-housed people will lose one of the few benefits that support their health. Research shows that many people who are homeless or poorly-housed do not receive social assistance even though they are eligible. The Hardship Fund is one of the few programs that can be accessed in an emergency, which is when this population is most likely to receive medical care. Eliminating this program will lead to homeless or poorly-housed people not having access to essential medical supplies and may increase the number of avoidable emergency room visits, which has significant cost and health system implications.
The Hardship Fund recognizes that it is economically and socially better for the city to have its residents in paid employment or training, and eliminating this program will have unfair and inequitable impacts on the most vulnerable Torontonians.
This cut will have significant cost impacts for the city and province as demand for other, more expensive, health care and social supports increases. The timing of this cut is particularly unfortunate as the Province also recently eliminated the Community Start-Up and Maintenance Benefit – a benefit that helps people on social assistance to retain their housing and avoid becoming homeless – in favour of a much-reduced, and currently undefined, municipal program.
The City should immediately reinstate the Hardship Fund until Council is able to clarify the intent of their direction to staff in the 2012 budget. The City should also ensure that any future changes to the Hardship Fund do not unfairly or inequitably affect those most in need. An equitable system should ensure that all people in need are able to access medically-necessary supplies to ensure good health.