Ontario Residents: OHIP denying coverage for 3 months to newly adopted kids

[ChristyCanuck]

I'm still trying to track down something official but several ET parents have received the following news from their social workers:

Re:       CHANGE IN ONTARIO HEALTH INSURANCE PLAN

Effective January 27, 2009

NOTE: This change applies to all waiting adoptive applicants for International Adoption.

As you may have learned, there has been a very recent change in OHIP's coverage of children who return from out of country on adoption, regardless of when the adoption occurs. Some international adoptions are not finalized in the country (Korea, Philippines) while others are (eg. Russia, China). In both situations, OHIP is requiring that children must wait for 3 months to qualify.

OHIP's reasoning was expressed as follows: "In order to be exempt from the three month period, an adopted child must hold citizenship or immigration status recognized under Regulation 552 of the Health Insurance Act on the date of the adoption. An adopted child would not be granted Canadian citizenship status until after the date of adoption. Further, "The Health Insurance Act contains no provisions authorizing the use of discretion. All decisions must be based on the existing legislation."

This decision was made without prior consultation with the key adoption ?players". The Ontario Ministry of Children & Youth Services is pursuing discussion with the Ministry of Health & Long Term Care. As well, the private adoption practitioners groups and the International Adoption Licensees are also expressing major concern.

We hope that this matter can be reversed before it affects any of you in future. I invite you to become involved in sharing your concerns by contacting your local MPP. You can refer to the list of members found on Ontario government website: http://www.ontla.on.ca

Apparently, a family who recently adopted from Vietnam was affected and has been denied OHIP coverage for their child for three months.

Has anyone heard anything about this?

I will be contacting my MPP in the morning to see if I can learn more.

[ChristyCanuck]

There is a lot of talk of this on our ET Yahoo group (well, in the 60 minutes since this first came up). I just read that an ET family in the GTA got OHIP coverage yesterday but another of our families knew of a family who returned from China a few weeks ago and was denied coverage for their child for three months.

Is the China Yahoo group discussing this??

[cflower]

Since we went through the New Citizenship route with our child who we've brought home in December, we were able to get OHIP coverage immediately.  I think we got a temporary card the first week after arriving and saw the pediatrician the same week too.

[Rattus]

I don't think Ontario is alone in that. When we brought our son home from Taiwan the call centre person at BC health tried to tell me that Jack would have to wait 3 months for coverage.  After I slowly and carefully explained what c-i-t-i-z-e-n meant, we moved on to my real issue, which was them sending us his card in a reasonble amount of time.

[wonderandwait]

This is being discussed at length on a Vietnam yahoo group.  An official denial letter has been issued to at least one Vietnam family and many more have been denied.  It does not matter which process you used to enter Canada with your child as it seems families using both have been denied. 

The internal memo came out to OHIP offices on January 27th and though that is when denials began many Vietnam families received OHIP cards after that point including one family just this past Thursday.  It depends entirely on whether your office reads and comprehends memos.

One official asked a denied family for the "names" of those who had received their OHIP numbers after the 27th so they could track them down...and revoke their coverage.  Ummmm, no!

Additionally there is talk that  in order for coverage to start after the 3 month mark you applied on day 1 and maintained emergency medical coverage by one of the carriers on OHIP's "list". 

There is a bit of a revolt brewing in the Vietnam group and the media has been invited to participate in party. 

The denial letter, quoting the legislation, was posted on the group.  I could ask the owner if I could share it...

[ChristyCanuck]

wonderandwait -- I just read a letter from Donna and Brad, which is extremely detailed and shares the timeline and events that took place. It was posted, I'm sure with permission, on our ET Yahoo group where there is also much discussion taking place. With one ET family's assistance, we should have the direct email addresses of a number of the bureaucrats involved in this mess and are planing a mass email this weekend so they'll come into it in their in-box on Monday morning. Or better yet, perhaps they have Blackberries and the things will buzz continually on their days off.

Can you ask the family who wrote the letter if it's okay to disseminate it on as many online groups as possible? There are a few ET-related ones that I'm aware of too and it would be great to post it here.

[ChristyCanuck]

I am told that we are encouraged to post this on any adoption boards we're aware of:

Re: New Directive from OHIP Head Office that denies OHIP coverage for 3 months for all internationally adopted children

We are Donna and Brad, a couple who adopted a baby girl, Thao, from Viet Nam. We went to Viet Nam and adopted our daughter on Dec. 29th, 2008. She was granted Canadian citizenship on January 7, 2009. On February 12th, Brad went to the Kitchener OHIP office to apply for Thao's OHIP number. We were shocked when she was refused a number and told that there was now a 3 month waiting period for internationally adopted children. We thought that there had been a mistake.

Brad returned home and called the information line to obtain clarification about what exactly the policy was about granting coverage to internationally adopted children. The woman who he spoke with told him that a memo had been sent out from the Minister's office to all OHIP offices on January 27th, 2009 directing them to refuse coverage to children who were not Canadian citizens when they were adopted. Of course, Brad explained that that is impossible, that the process is that a child is adopted and then becomes a Canadian citizen. The woman checked with OHIP's head office and confirmed that the correct procedure is to deny OHIP coverage in our case. Brad asked why it was that the 2 other couples, who we met in Saigon and who had adopted children at the same time as we had, had gone to their OHIP offices in Toronto and Ottawa and had been immediately given OHIP numbers. She told him that their situations must be different from ours since they were granted OHIP numbers. When he assured her that they had adopted their children after us and had obtained their children's Canadian citizenship after Thao had obtained hers, she asked him if he could send her their information. He asked her if their coverage could be revoked if it was determined that their situations were the same as ours. She replied that, yes, their coverage could be revoked. Brad told her that he obviously
wasn't going to provide her with any information that could jeopardize their children's OHIP coverage.

After many phone calls, emails, and meetings with OHIP officials, our local MPP, our social worker, other parents, lawyers, and adoption agency directors, we now know the following: we were not a clerical error. We were not a special case. We were not a mistake. Denial of coverage to internationally adopted children for 3 months is policy. This policy was not publicized so it is taking everyone involved in adoption, from agency directors, to social workers, to parents, by surprise. This policy is so new that it is being inconsistently applied from OHIP office to OHIP office so that on the same day in Ontario, one child might be granted OHIP coverage while somewhere else in the province another child in exactly the same circumstances is denied it. However, one thing is clear: while, as far as we know, our child was the first to be denied coverage, the numbers of children who are being denied is increasing every day throughout the entire province.

The first thing that everyone who has adopted a child, or is going to adopt in the future, needs to know is that the Ministry of Health considers the granting of OHIP coverage to all internationally adopted children in the past to be a mistake. The Ministry has been contacted by many agency directors and social workers who have heard about our case, and, we surmise that as a result of the number of queries about the denial of coverage for our daughter, Sue Graham, a representative from the head office of the Ministry of Health contacted us to obtain more information about our case. What she told us exactly was that the Ministry considers that all adopted children, who did not have citizenship or valid immigration status on the date they were adopted, were given OHIP coverage by mistake. She clearly stated that the refusal to grant our daughter coverage until after a 3 month waiting period was the correct procedure. She told us that our file was being sent to her manager and would most likely be sent to her manager's manager.

On Wednesday, March 4th, we received the official denial of the three month waiting period exemption for our daughter. The core of their argument is that "an adopted child must hold a citizenship or immigration status recognized under Regulation 552 of the Health Insurance Act on the date of adoption". Of course, as you know, this is impossible since you can't get citizenship until after you have actually adopted your child. This is definitely a change in policy and from what we understand is the result of the memo/directive (we haven't been able to get a copy) from Minister Caplan's office on Jan. 27, 2009, although, as we wrote, not all health offices have been enforcing it. As has been mentioned, two other couples who were in Saigon with us and returned after us, one to Ottawa and one to Toronto, got immediate coverage.

So, where do things stand right now? Needless to say, we are incensed for Thao and for all internationally adopted children. We have retained a lawyer and have filed a formal appeal to the Ministry of Health. Our lawyer and other interested lawyers have studied the Health Insurance Act line by line to determine if the provincial government's position has any validity. In their view, there is not a requirement for citizenship on the date of adoption.

We are also in touch with members of the media to make this public. We are sending this email to as many adoption agencies, social workers, and parents, as we can, as we become aware of them.

We are sending this to you to ask you for your help in our fight against what is obviously an unjust and discriminatory policy. If you know of anyone who has been refused health care coverage for their child, please ask them to email us immediately (donna.brad@sympatico.ca). As well, please email, Premier McGuinty, Minister of Health Caplan, your local MPP, and Sue Graham at OHIP (sue.graham@ontario.ca). The person who sent us the letter informing us of Thao's denial of OHIP coverage did not provide an email address. However, her name is Susan Pinnery, A/Director, Registration and Claims Branch.

Finally, we believe that the provincial government thinks that the number of people affected by this policy is small and that we don't carry much weight. Therefore, please forward this on to your friends, relatives, and anyone else who is opposed to this policy.

Cheers,
Brad and Donna

[ChristyCanuck]

The Ethiopian adoption community is taking action on this issue this weekend and we encourage anyone touched by adoption in Ontario to do the same.

One very effective way to get the attention of the Ministry is to contact the bureaucrats personally. I am pasting the sample letter we are using below. Feel free to copy it word for word, or write one that is completely your own. PLEASE SEND YOUR LETTER THIS WEEKEND, IF POSSIBLE. This will help ensure that the issue is brought to the attention of the right people on Monday morning. If you can't get it out this weekend, as soon after as possible would be best. Get as many people as you can to send it as well: friends, family, people you meet on public transit, etc. Please go ahead and post any or all of this post on other adoption websites that you may know of or participate on. Okay, let's make some noise!

Here's the list of people to send your emails to:
David Caplan - the Minister of Health: dcaplan.mpp.co@liberal.ola.org
Abid Malik - the Director of Policy for the Minister: Abid.Malik@ontario.ca
Heather Mack - the Chief of Staff for the Minister: Heather.Mack@ontario.ca
Ron Sapsford - the Deputy Minister: Ron.Sapsford@ontario.ca
Ken Deene - Assistant Deputy Minister, Health System Accountability and Performance Division. ken.deane@ontario.ca
Dawn Ogram - Assistant Deputy Minister, Corporate and Direct Services. Dawn.Ogram@ontario.ca
Plus your MPP (Especially if you have an NDP MPP)

Here's the sample email:
Dear Minister Caplan,

It has come to my attention that recently several families have been denied OHIP coverage for their newly internationally adopted children, having been told by both ServiceOntario staff and Ministry of Health staff that these children are required to have lived in Ontario for three months prior to obtaining coverage.

This is extremely upsetting to me both as a resident of Ontario and as an adoptive parent. This new policy, implemented January 2009, is clearly discriminatory as it does not provide equal treatment to our adopted children as is provided to their born-in-Ontario counterparts. It is even more confusing that the Ontario government would choose to deny medical coverage to infants and children who have just come from institutional care in developing nations and therefore require immediate medical attention to ensure their well-being, now and in the future.

This matter is urgent as every day, more and more children are being denied health care upon their arrival in Ontario. Ministry staff have quoted Regulation 552 of the Health Insurance Act as the reason for the denial of OHIP coverage, however to my knowledge this regulation has not changed and previous to January 27, 2009 internationally adopted children were able to receive health care immediately upon arriving home to Ontario with their adoptive parents.

Our adopted children deserve to receive fair and equal treatment as compared to children who are born in Ontario. I respectfully request that action be taken immediately to remedy this situation and I look forward to hearing your response on this urgent matter.

Respectfully,
Joe Q. Public

[momto4hopefully]

I hope this all gets worked out soon.  One of the requirements of China is that the adopted child be granted health insurance.  This could have an even bigger effect if they can't work this out, as it is is in direct violation of the agreement with China.  I am so sorry for these families.  Please keep us updated.

[panda2004]

This really angers me! What a dirty card to pull on new parents without a word of warning! To me this is another slap in the face for APs. Potential APs have to take the PRIDE course, and to add insult to injury, their child will be denyed health coverage for 3 months! I will most certainly be contacting people about this!

Thank you Christy Canuck for bringing this to my attention

[TingTing]

Christycanuck, thanks for all the legwork.  I used your letter, added a few things to make it more personal, and sent my volley of e-mails yesterday.

[morganaway]

I've emailed CTV local and national news.  I'll let you know if I hear anything back.
Morgan

[michellev]

I have sent out the e mails as well and passed this info on to some other chat groups.  Has anyone found this stated anywhere on the OHIP site?
Thanks.

[panda2004]

I have sent out the e mails as well and passed this info on to some other chat groups.  Has anyone found this stated anywhere on the OHIP site?
Thanks.

I just took a good look at the OHIP site and haven't been able to find anything on this.  

[ChristyCanuck]

Thanks so much guys!!

No, there is nothing on the government sites anywhere. This just happened. I spoke with the first family this happened to this morning. I have now seen a copy of OHIP denial letter for their child from Viet Nam. It's real. It's in print. It's outrageous.

Apparently it sounds like it has also just happened to adopted children from China, Russia, Rwanda and a second Vietnamese child as well. The two sites who are denying coverage to our kids are: the Kitchener and Oakville OHIP offices. If you are trying to get coverage for your child right now, DO NOT go to these offices. The other offices who are covering newly arrived kids are doing it in error and I'm sure they will be denying our kids soon too.

Morganaway -- If you hear anything back from the media, please let me know. I am working with Donna and Brad to do a coordinated push to the media hopefully later this week to inform them of what is happening to our kids so we're definitely interested and working toward sharing the story.

Every letter we send counts right now and I thank you so much for all of your help!