Hon. Frances Lankin and Dr. Munir Sheikh
Commission for the Review of Social of Social Assistance in Ontario
2 Bloor Street West
4th Floor, Suite 400
Toronto, ON M4W 3E2
March 19, 2012
Dear Ms. Lankin and Dr. Sheikh,
The Registered Nurses’ Association of Ontario (RNAO) appreciates the opportunity to provide a response to the Commission for the Review of Social Assistance’s second discussion paper, Approaches for Reform. At this time, RNAO would like to urge the Commission to consider a few simple yet critical recommendations.
The current context includes global economic unrest, upcoming federal and provincial budgets, and the recent release of the report of the Commission on the Reform of Ontario’s Public Services or the Drummond Report. This presents a danger in that a preoccupation with addressing deficits through the imposition of austerity measures might tempt some decision-makers to seize on this review process as an opportunity to cut costs. Instead, Ontario’s registered nurses urge movement towards a genuinely transformed social assistance system that is person-centred and is part of a larger social safety net that enables all Ontarians to live in health and dignity. Getting this right is literally a matter of life and death. To take a recent example from the Project for an Ontario Women’s Health Evidence-Based Report (or the POWER study), if all Ontarians had the same health as Ontarians with higher income, each year there would be an estimated 3,373 fewer deaths among Ontarians living in metropolitan areas.
Although RNAO will not comment on specific technical proposals, we would like to reiterate the urgent necessity of addressing the dangerously low social assistance rates that preclude access to nutritious food and healthy shelter. It is unconscionable that every year public health units across the province document the cost-of-living shortfall between what is needed to obtain adequate food and accommodation compared with social assistance rates, particularly individuals on Ontario Works (OW). As you noted in the discussion document, according to Ottawa Public Health, a single person in that city can expect to pay an average monthly rent of $715 for a bachelor apartment and $254 for nutritious food. Including tax credits with OW, Ottawa Public Health estimates that individual would be short $334 per month. Social assistance rates must be evidence-based so that they reflect the actual cost of living and be indexed for inflation. As a result of any recommendations from the Commission, there must not be any cuts to the income of anyone currently receiving ODSP or OW.
RNAO urges you to continue to listen carefully to people with lived experience   of struggling with the conflicting and punitive rules and regulations of the social assistance system and their advocates   to ensure that the system is actually transformed for the better. It is essential that unanticipated consequences of changes to the current system should be carefully explored to assess impact on the health, well-being, and potential for decreasing or increasing health inequities through Health Equity Impact Assessments. Testing out the actual impact of proposed changes on the real lives of people already facing multiple challenges through meaningful consultation will be critical.
Ontario’s nurses stand with our clients and our communities through these challenging times. As you can see from our attached position paper, Ontario’s most vulnerable need income security for health and human dignity. We must all help to generate the political will to make this a reality.
Doris Grinspun, RN, MSN, PhD, LLD(hon), O.ONT.
Chief Executive Officer, RNAO
David McNeil, RN, BScN, MHA, CHE
To view full text and references for RNAO's Response to the Commission for the Review of Social Assistance's second discussion paper, Approaches for Reform.
RNAO Position Statement Ontario's Most Vulnerable Need Income Security for Health
 Bierman, A., Johns, A., Hyndman, B. et al (2012). Social Determinants of Health and Populations at Risk in Bierman, A. (ed). Project for an Ontario Women’s Health Evidence-Based Report, Volume 2. Toronto: Author, 105.
 Commission for the Review of Social Assistance in Ontario, for the Review of Social Assistance in Ontario (2012). Discussion Paper 2: Approaches for Reform. Toronto: Author, 20.
 ODSP Action Coalition (2010). Telling Our Stories: Disability Should Not Equal Poverty. Toronto: Author.
 ODSP Action Coalition (2011). Dignity, Adequacy, Inclusion: Rethinking the Ontario Disability Support Program. Toronto: Author.
 Campaign 2000 and the Income Security Advocacy Centre (2011). Key Messages from the “Bringing in Women’s Voices” Project. Toronto: Author.
 Stapleton, J. (2010). “Zero Dollar Linda:” A Meditation on Malcolm Gladwell’s “Million Dollar Murray,” the Linda Chamberlain Rule, and the Auditor General of Ontario. Toronto: Metcalf Foundation.
 Income Security Advocacy Centre (2011). Submission to the Commission for the Review of Social Assistance in Ontario. Toronto: Author.
 Income Security Advocacy Centre (2011). Envisioning a New Approach: A Response to the Commissioners for the Review of Social Assistance. Toronto: Author.
 Gardner, B., Barnes, S. and the Social Assistance Review Health Working Group. (2011). Towards a Social Assistance System that Enables Health and Health Equity: Submission to the Commission for the Review of Social Assistance in Ontario. Toronto: Author.