Adult admitted to a residential and long-term care centre (CHSLD)
An adult is considered to be living in residential care when they are admitted to a residential setting within the health and social services network, such as a CHSLD or an intermediate resource. In some situations, they may be required to make a financial contribution toward the cost of their accommodation.
This contribution is determined under the Financial Contribution Program for Accommodated Adults, administered by the Régie de l’assurance maladie du Québec (RAMQ). Depending on their financial situation, the accommodated adult may apply for an exemption or a reduction in the amount payable. For example, people receiving income assistance can generally apply for an exemption.
To learn about the applicable conditions and submit an application, complete the designated form and consult the RAMQ guide: (https://www.ramq.gouv.qc.ca/en/media/10436).
Adult admitted to a care and residential facility for persons with decreasing independence (RSHA)
A person admitted to an RSHA in a community is eligible for the rate for persons with a severely limited capacity for employment (SLCE), as described in the following paragraph.
Severe health constraints for the duration of the stay
A person who does not have an SLCE or who is recognized as having a temporarily limited capacity for employment when admitted to a CHSLD or a care and residential facility for persons with decreasing independence will be granted SLCE status for the duration of their stay, without having to provide medical evidence. However, when their stay ends, the person must submit the Medical or Psychosocial Assessment Report form if they wish to have their eligibility for SLCE status assessed.
Operational procedures
Adult admitted to a CHSLD or an intermediate resource (Quebec network)
When an income security client leaves the community to be accommodated in a CHSLD, it is strongly recommended that they submit an application at a Services Québec office in order to receive financial assistance from the province. They may then apply for an exemption from the user contribution, as explained above. This is because maintaining the person’s eligibility for income security in the community creates significant challenges in administering the income security benefit and the exemption from the user contribution.
Adult admitted to an RSHA (in a community)
To inform the advisor or manager in charge of the community’s income security, the RSHA may submit a start-of-stay form. This form is used to confirm various details, including the facility’s address, information about the person admitted, and the start and end dates of the stay.
Processing a new application
To process a new application, the advisor must require the documents needed to establish eligibility for income security. Once eligibility has been confirmed, SLCE status is granted on a prorated basis according to the number of days to be covered in the month. Because the person is eligible for SLCE status, no eligibility test based on liquid assets is required.
Processing an ongoing benefit
Processing of an ongoing benefit for a person admitted to an RSHA is based on the principle of the anteriority of the deficit. Accordingly, the person becomes eligible for SLCE status in the month following their admission.
In all cases, when a person is admitted to an RSHA, it is important to communicate with both the RSHA and the client to explain the following requirement.
Personal expenses: A monthly amount corresponding to the accommodated adult rate must remain available to the person so that they can cover certain personal expenses not covered by the residential facility, such as personal hygiene products, recreational activities, or clothing.
66/72 Allowance
Communities that choose to do so may grant the 66/72 allowance, in addition to SLCE status, to help the client and the residential facility cover costs related to the client’s accommodation and care.