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Supplement for Handicapped Children Requiring Exceptional Care

Application for the Supplement for Handicapped Children Requiring Exceptional Care

On 11 June 2019, the Québec government announced the addition of a second tier for the Supplement for Handicapped Children Requiring Exceptional Care.

This financial assistance is paid to parents who care for a child under age 18 who is in one of the following situations:
- He or she has physical impairments or a mental function disability causing severe and multiple disabilities that prevent him or her from carrying out the life habits of a child of his or her age.
  Expected duration of the disabilities: at least 1 year
  OR
- He or she requires complex medical care at home for which parents have received training at a specialized centre in order to learn the specific techniques for using the required equipment. The care must be administered by the parents. They must also be able to respond to any potentially life-threatening change in their child's clinical condition.
  Expected duration of the disabilities or care: at least 1 year
The parents must be receiving for the same child:
- Family Allowance
- the Supplement for Handicapped Children

Your child's eligibility for the Supplement is assessed by Retraite Québec's team of physicians and health professionals, based on specific requirements.

Severity of the limitations

Your child's eligibility is not determined solely upon the diagnosis, but also based on the severity of his or her limitations in carrying out life habits. Different decisions could therefore be rendered for applications filed for children with the same diagnosis.

Absolute limitation

The child is absolutely incapable of carrying out a life habit, or always has extreme difficulty accomplishing a life habit in an autonomous manner for his or her age despite the presence of facilitating environmental factors, such as technical aids. Carrying out every element of the life habit depends entirely on the assistance of another person.

Serious limitation

The child always or nearly always has considerable difficulty carrying out a life habit, for his or her age, despite the presence of facilitating environmental factors, such as technical aids. Without the help of another person, the child cannot fully and adequately accomplish the life habit.

Life habits taken into consideration

The life habits taken into consideration when processing applications are those that a child must accomplish, depending on his or her age, with respect to his or her personal care and social life. The life habits are the following:

Using a baby bottle or a cup
Using utensils
Eating (mastication, swallowing, ingestion)

Getting dressed and undressed
Washing hands and face
Taking a bath or a shower
Maintaining good excretal hygiene (urinating or bowel movements)

Standing up, sitting or lying down
Remaining standing or seated
Walking
Using stairs

Seeing
Hearing
Understanding instructions or spoken information
Expressing needs
Engaging in conversation

Maintaining affective relationships with immediate family
Building and maintain relationships with friends
Respecting social norms
Controlling behaviour in relationships with others

Assuming responsibilities for the child's age
Managing safety (do not put the child's life or that of others in danger, react appropriately to a dangerous situation)
Respecting social norms (personal effects and rights of others)
Controlling behaviour in relationships with others

Carrying out activities related to knowledge acquired at preschool (psychomotor development)
Carrying out activities related to learning (reading, writing, arithmetic)
Participating in school life (at school or afterschool care)
Participating in social life in the context of playing and learning

Main factors taken into consideration when analysing the child's ability in carrying out a life habit

Age of the child
Example :
A child's autonomy normally develops with age. A child becomes less and less dependent on the adult. Therefore, a child aged 2 who has difficulty handling utensils will not have the same limitations as a child aged 12 who has the same difficulties.
The effects of facilitating environmental factors on the ability of the child in carrying out a life habit
Example :
A child age 13 with cerebral palsy who is able to move about autonomously wearing supports will not be seriously limited in his ability to move about because of this technical aid.
The knock-on-effect of the limitations in carrying out a life habit on the child's ability to carry out other life habits
Example :
A child age 5 who has an autism spectrum disorder and who is unable to engage in a conversation because he does not speak will have at least a limitation in carrying out 2 life habits, namely communication and interpersonal relations.
Visual and/or hearing impairment
Example :
A child with significant limitations resulting from a visual and/or hearing impairment could be limited in his or her ability to move about or other life habits, such as his or her ability to communicate.

The Supplement for Handicapped Children Requiring Exception Care is paid to the parents of a child under age 18 who has severe and multiple disabilities that prevent the child from carrying out his or her life habits, or whose medical condition requires specified complex medical care at home. A child could be eligible for the Supplement if his or her condition corresponds to either of those situations.

In addition, depending on the severity of the child's condition and age, a child can be eligible for Tier 1 or Tier 2 of the supplement. The eligibility criteria for Tier 2 are less restrictive than those currently applied to determine eligibility for the Supplement for Handicapped Children Requiring Exceptional Care's Tier 1. However, the criteria are medically based, thus giving the program its exceptional character.

The child has physical impairments or a mental function disability causing severe and multiple disabilities that prevent him or her from carrying out the life habits of a child of his or her age. The disabilities are expected to last for at least one year.

Nutrition
Moving about
Communication

With regard to those three life habits, the child has:

Tier 1

Absolute limitations respecting 3 life habits

Tier 2

An absolute limitation respecting 1 life habit

1 serious or absolute limitation in at least 1 other life habit

With regard to all the life habits taken into consideration, the child has:

Tier 1

Absolute limitations respecting 4 life habits

1 serious or absolute limitation respecting one other life habit

Absolute limitations respecting 3 life habits, including moving about

serious or absolute limitations respecting 2 other life habits

Tier 2

Absolute limitations respecting 2 life habits

1 serious or absolute limitation respecting one other life habit

An absolute limitation respecting moving about

1 serious or absolute limitation respecting one other life habit

The child's medical condition requires specified complex medical careat home for which parents have received training at a specialized centre in order to learn the specific techniques for using the required equipment. The care must be administered by the parents. They must also be able to respond to any potentially life-threatening change in their child's clinical condition. Parents are expected to administer the complex medical care to their child for at least one year.

Each type of care was selected and classified under one tier or the other based on:

the complexity of the type of care
the consequences of the type of care on the child's daily life
the risk associated with the complications related to the type of care.

Child under age 18

A child receiving one of the following types of care:

Tier 1

Respiratory care:
- tracheostomy with mechanical ventilation
- for children under age 6 OR for children aged 6 or over who have an absolute limitation respecting one life habit or two serious limitations respecting two life habits, not including personal relationships, and be receiving one of the following types of care:
  - tracheostomy without mechanical ventilation
  - daily non-invasive mechanical bi-level positive airway pressure ventilation using BPAP.
Nutritional care:
- parenteral alimentation (intravenous hyperalimentation)
Cardiac care:
- intravenous inotropic therapy
- ventricular assist device (artificial cardiac pump)
Renal (kidney) care:
- peritoneal dialysis

Tier 2

Respiratory care:
- for children over age 6 who do not have limitations in carrying our their life habits:
  - tracheostomy without mechanical ventilation;
- oxygen therapy or mechanical ventilation (CPAP, BPAP, high-flow oxygen therapy systems) on a daily basis, 24 hours per day
Nutritional care:
- gastrojejunal or jejunal feeding tube
Other care:
- daily skin care for severe and generalized dermatologic conditions at high risk of pressure wounds, webbing and contractures.

Complete the Application for the Supplement for Handicapped Children Requiring Exceptional Care. If you have medical or school documents (individual education plan, report card, etc.) on hand, enclosed them with your application. When Retraite Québec analyzes your child's file, we will take the necessary steps with the professionals in the health and education sectors to obtain additional documents, if needed, and we will assume the entailing expenses.

If you wish to apply for the Supplement for Handicapped Children and the Supplement for Handicapped Children Requiring Exceptional Care at the same time, Retraite Québec must determine whether your child is eligible for the Supplement for Handicapped Children before assessing the child's eligibility for the Supplement for Handicapped Children Requiring Exceptional Care.

Payment of the Supplement for Handicapped Children Requiring Exceptional Care

If your child is eligible for the supplement and his or her condition met the eligibility requirements for a retroactive period of up to 11 months before we received your application, you could receive a retroactive payment for the Supplement for Handicapped Children Requiring Exceptional Care for that period.

In addition, depending on the severity of the child's condition and age, he or she could be eligible for Tier 1 or Tier 2 of the supplement. Note that a higher amount is granted under Tier 1.

Tier 1

Monthly payment of $1 102, for an annual amount of $13 224

Tier 2

Monthly payment of $733, for an annual amount of $8796

You could receive a retroactive payment:

for a period of up to 11 months before we received your application if your child is eligible for Tier 1 and if his or her condition met the eligibility requirements during that period;

OR
as of 1 April 2019 if your child is eligible for Tier 2 and if his or her condition met the eligibility requirements from 1 April 2019 to the date on which we receive your application.

The amount of the Supplement for Handicapped Children is added to the amount you receive for the amount of the Supplement for Handicapped Children Requiring Exceptional Care.

Frequently asked questions

Newsletter

CalculAide

Downloadable

Information bulletins

For more information on the eligibility requirements for the Supplement for Handicapped Children Requiring Exceptional Care, consult the following publications from the Ministère des Finances:

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Application for the Supplement for Handicapped Children Requiring Exceptional Care

This financial assistance is paid to parents who care for a child under age 18 who is in one of the following situations:

The parents must be receiving for the same child:

Severity of the limitations

Absolute limitation

Serious limitation

Life habits taken into consideration

Main factors taken into consideration when analysing the child's ability in carrying out a life habit

Child under age 18

Payment of the Supplement for Handicapped Children Requiring Exceptional Care

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Application for the Supplement for Handicapped Children Requiring Exceptional Care

Who is it for?

This financial assistance is paid to parents who care for a child under age 18 who is in one of the following situations:

The parents must be receiving for the same child:

What is assessed?

Severity of the limitations

Absolute limitation

Serious limitation

Life habits taken into consideration

Nutrition Habits related to eating

Personal care Habits related to cleanliness

Moving about Habits related to moving short or long distances both inside and outside

Communication Habits related to the exchange of information with his or her entourage through speech and language

Interpersonal relations Habits related to relationships with his or her entourage

Responsibilities Habits related to assuming responsibilities

Education Habits related to psychomotor, intellectual and social development, as well as learning

Main factors taken into consideration when analysing the child's ability in carrying out a life habit

What are the eligibility requirements?

Child with severe and multiple disabilities

Children aged 2 or over, but under 4

Children aged 4 or over, but under 18

Child requiring complex medical care at home

Child under age 18

How do you apply?

Payment of the Supplement for Handicapped Children Requiring Exceptional Care