Persons with Persistent Multiple Barriers

Overview

The Persons with Persistent Multiple Barriers (PPMB) category provides assistance to clients who have long-term barriers to employment that are not expected to be overcome in the short term despite all reasonable steps by the client.  PPMB clients are exempt from employment obligations.  An earnings exemption is available to encourage clients who want to work to try employment, gain experience, participate more fully in the community as they are able, and earn more income. 

Clients may be assessed for PPMB if they have been on assistance for at least 12 of the past 15 months and are unable to achieve financial independence.  Family units where one or both clients are eligible for PPMB may be provided the higher support rate and additional supplements. 

PPMB applies to clients who are eligible under the Employment and Assistance Act.  PPMB is not included in the Employment and Assistance for Persons with Disabilities Act.  Therefore, PPMB cannot be assessed for spouses of clients with the Persons with Disabilities (PWD) designation.

It is recognized that some clients in this category may overcome their barriers over time and improve their employability while others may not.  Some may have medical conditions that worsen over time and require additional supports.  This is why the PPMB category provides clients with time and supports to overcome their barriers and move towards independence, or transition to other client categories, including PWD designation.

Policy

Effective: July 26, 2004

Recipients who qualify for Persons with Persistent Multiple Barriers (PPMB) are those who have received assistance for at least 12 of the past 15 months and meet one of the following criteria:
 

  • has severe multiple barriers to employment (that is, a score of 15 or greater on the Employability Screen) and has taken all reasonable steps to overcome these barriers and has a medical condition (excluding addictions) that has lasted for at least one year and is likely to continue or recur frequently for at least two years, and which is a severe barrier that seriously impedes the person's ability to search for, accept, or continue in employment

OR
 

  • has a medical condition (excluding addictions) that has lasted for at least one year and is likely to continue or recur frequently for at least two years, and, in itself, precludes the person from searching for, accepting, or continuing in employment, regardless of their score on the Employability Screen (may or may not have severe multiple barriers to employment)

A person with PPMB will be reassessed at least every two years.

Effective: March 1, 2006

Note: In cases where both a medical condition and an addiction issue have been identified as barriers to employment, it must be determined whether in the absence of the addiction issue, the medical condition would be considered to seriously impede or preclude employment.

Seriously Impedes

A medical condition is considered to seriously impede the recipient’s ability to search for, accept, or continue in employment when, as a result of the medical condition, the recipient is unable to participate in any type of employment that would enable independence from income assistance.

When determining if the medical condition seriously impedes employment, the following factors should be taken into consideration:
 

  • Number of hours a recipient can work
  • Hourly rate a recipient could earn
  • Skills and experience of the recipient
  • Impact of the medical condition on the recipient’s ability to work full-time or only part-time
  • Impact of the medical condition on the recipient’s ability to work on a regular or sporadic basis

Note: To be eligible for PPMB, recipients whose medical condition seriously impedes, rather than precludes, employment, must also score 15 or more on the Employability Screen (HR2797).

Recipients who have scored 15 or more on the Employability Screen should be assessed for whether their condition seriously impedes, rather than precludes, employment.

Precludes

A medical condition is considered to preclude the recipient from searching for, accepting or continuing in employment when as a result of the medical condition, the recipient is unable to participate in any type of employment for any length of time, except in a supported or sheltered-type work environment.

When determining if the nature of the employment is as minimal or insignificant as to effectively “preclude” the recipient from employment, the following factors should be used when assessing eligibility:
 

  • Is the focus of the work on socialization where the activities are highly supported or supervised (e.g., recycling workshop)
  • Is the recipient limited by the medical condition to very minimal hours on an infrequent basis (e.g., 1-2 hours of babysitting once or twice a month)
  • Is the recipient’s involvement very sporadic or casual (e.g., occasional lawn mowing or housekeeping; or delivering flyers once a month)
  • Is the work more likely to be considered volunteering and compensation, if any, minimal (e.g., covers the costs of volunteering)

Note:  Recipients who are precluded from any type of employment may also require assistance with daily living activities and could qualify for Persons with Disabilities (PWD).  Recipients should be informed of the option of application for designation as a PWD.

[For examples of when a medical condition seriously impedes or precludes employment, see Procedures – Case Examples.]

Effective: April 2, 2012

The following guidelines outline factors to be considered by ministry staff when determining if a person has taken all reasonable steps to overcome their barriers to employment. 

This requirement only applies when a person has barriers that seriously impede the person’s ability to search, accept or continue in employment and does not apply to medical conditions.  These guidelines assist ministry staff to assess PPMB when reviewing the information provided, such as the Employability Screen, the PPMB Checklist, the Employability Profile, the Employment Readiness Information Questionnaire, and the Employment Plan. 

“All reasonable steps to overcome their barriers” refers to a person’s participation in interventions that address barriers that are preventing the person from working.

The factors recognize that each person’s barriers to employment are unique so the reasonable steps to overcome those barriers will vary from person to person.  If the factors suggest that the person has taken all steps that the ministry considers reasonable for the person to overcome their barriers, and all other eligibility requirements are met, the client is eligible for PPMB.

Note:  the factors to be considered are not all-inclusive as it is important to preserve the discretion of the ministry decision maker and allow for flexibility to assess uncommon or unexpected circumstances.

When assessing the information provided to determine if a person has taken all reasonable steps to overcome their barriers, consider the following:

1.  The steps taken by the person

A step is an action taken by the person with the goal to overcome a barrier to employment.  The steps taken may include a wide range of interventions from formal employment programs to personal actions to better enable the individual to address their barriers.  The person or the ministry through a referral may initiate the steps.  When reviewing the steps taken, consider the following factors:
 

  • If the steps taken are related to barriers identified on the Employability Screen
  • Whether the person has attempted or completed an intervention program
  • The availability of intervention programs in the community where the person is residing
  • Whether education interventions meet eligibility requirements for income assistance.  For example, unfunded programs of study require ministry pre-approval and must be identified in the person’s Employment Plan
  • The types of steps taken, including but not limited to:
    • Employment programs ( e.g. Employment Program of British Columbia (EPBC), Service Canada, Ministry of Jobs, Tourism and Innovation, non-profit organizations, etc.)
    • Literacy training
    • Adult basic education
    • Community Assistance Program (replaced by EPBC)
    • Bridging Program (replaced by EPBC)
    • Supervised Independent Work Search
    • Volunteering
    • Training courses such as WHMIS, Foodsafe, Serving-it-Right, Flagging

2. The steps taken are reasonable

The steps the person takes to overcome employment barriers must be determined as reasonable by the ministry.  Reasonable means that the steps are fair and sound in the context of the person’s abilities and the interventions that are available.  When reviewing whether the steps taken are reasonable, consider the following factors:
 

  • If the person has exhausted all available interventions to overcome their barriers
  • If relevant interventions identified in the person’s Employment Plan or Voluntary Participation Plan or EPBC Action Plan (if applicable) were followed through
  • Whether the person demonstrates active participation to the best of their abilities, in the activities intended to move them towards independence
  • Whether the steps taken are intended to overcome their barriers
  • Whether the person is able to participate in an intervention to overcome a barrier given their medical condition
  • If the steps are within the person’s capabilities according to the particular barrier

Example where a person may have taken all reasonable steps to overcome their barriers:
 

  • A person with an anxiety disorder has attempted all interventions to overcome their barriers identified on the employability screen.  However, despite their best efforts, they have not been able to take public transit or be in large groups of people due to their anxiety to complete the interventions.  Although they have not completed the interventions, since they have attempted them to the best of their ability, the person has taken all reasonable steps.

Examples where a person may not have taken all reasonable steps to overcome their barriers:
 

  • A person with the potential to overcome their barriers has chosen not to attempt any interventions.  Their Employment Plan includes interventions that have not been followed through on and the person is refusing a referral to a program or service with no apparent reason.
  • A person has attempted some interventions but has not exhausted all that are available.  The person is attending school part time to address education barriers, but they have not followed through on a referral to an employment program to address employment barriers.

Effective: October 1, 2012

Family units where one adult is eligible for PPMB may be eligible for:
 

  • higher support rate [see Rate Table: Income Assistance Rates]
  • medical coverage that includes general health supplements [see Related Links – Health Supplement Summary]
  • dental supplements [see Related Links – Dental and Orthodontic Services]
  • earnings exemption [see Related Links – Income Treatment and Exemptions – Policy – Earned Income]

Procedures

Effective: October 1, 2012

For procedural guidelines to assist the PPMB adjudication process – see Additional Resources – PPMB Adjudication – Procedural Guidelines.

Persons with Persistent Multiple Barriers (PPMB) should be considered when there is some evidence that a recipient may meet the PPMB criteria or when a recipient requests an assessment for PPMB.  The following six steps are essential in assessing whether a recipient meets the criteria for PPMB and must be completed in order:

1.  Time on Assistance

A person has been a recipient for at least 12 of the immediately preceding 15 calendar months of one or more of the following:
 

  • income assistance or hardship assistance under the Employment and Assistance Act
  • disability assistance or hardship assistance under the Employment and Assistance for Persons with Disabilities Act

2.  Employability Screen (HR2797)

The Employability Screen (HR2797) [see Forms and Letters] assists in determining the existence of multiple barriers to employment.  [For more information, see Related Links – Employability Screen.]

An Employability Screen must be completed, or updated, any time a recipient is considered for PPMB, regardless of whether their medical condition is expected to seriously impede or preclude employment.

3.  All Interventions Tried

The Client Employability Profile (HR2865), in combination with the client's history and previous Employment Plans (HR2863), assist in identifying the severity of the barriers and in determining if the client has taken reasonable steps to overcome their barriers to employment, (excluding medical conditions).  The EAW must complete the following steps:
 

  1. Review recipient’s history of referral and job search activity.
     
  2. Complete the Client Employability Profile (HR2865) with the recipient in the following circumstances:
  • if a recipient obtains a score of 15 or greater on the Employability Screen
  • if a recipient appears to have a medical condition that could preclude the recipient from searching for, accepting or continuing employment, regardless of their score on the Employability Screen

[see Related Links – Client Employability Profile]
 

  1. Determine if an appropriate service or program is available to address specific barriers.  For a complete list of interventions available in the community, see Appendix 1 of the PPMB Checklist that is available in each Employment and Assistance Office.

[For examples of interventions that must be considered when determining PPMB, see Policy – Steps to Overcome Barriers]
 

  1. If appropriate, amend the recipient’s Employment Plan (HR2863) to identify referral and required participation in specific services or programs to overcome the barrier(s) to employment.  [see Related Links – Employment Plan]

4.  Medical Report – Persons with Persistent Multiple Barriers (HR2892)

The Medical Report – Persons with Persistent Multiple Barriers (HR2892) [see Forms and Letters] confirms the diagnosis and duration of the recipient’s medical condition and the nature of any resulting restrictions that need to be considered in determining the impact of the medical condition on the recipient’s ability to participate in employment or employment-related training.  Medical practitioners are compensated for the amount shown in Rate Table: Fees for Medical Practitioners for completing the HR2892.  Fees for medical practitioner completing the HR2892 are paid through the Medical Services Plan.

To confirm a recipient’s medical information, follow these steps:
 

  1. If a recipient is determined to meet all other PPMB criteria, and appears to have a medical condition that may seriously impede or preclude the client's ability to search for, accept or continue employment, provide the client with the Medical Report - Persons with Persistent Multiple Barriers (HR2892) for completion by a medical practitioner.  Use the Information Required – Medical Letter (HR3237) as a covering letter.  [see Forms and Letters].
     
  2. Review the Medical Report - Persons with Persistent Multiple Barriers (HR2892) to determine if the medical practitioner has confirmed both requirements:
  • the recipient has a medical condition (excluding addictions)
  • the condition has lasted for at least one year and in the opinion of a medical practitioner is likely to last for at least another two years; OR the condition is episodic, has occurred frequently in the past year and is likely to occur frequently in the next two years
  1. Gather any additional evidence from the recipient's file that may be relevant in determining the extent to which the recipient’s condition impacts their employability.  The following should be considered:
  • review the recipient’s reported income for the past 12 months (since the medical condition must have existed for at least the past 12 months, a review of income reported may help determine whether a medical condition impedes or precludes employment)
  • for recipients who score above 15, the medical condition must either seriously impede or preclude the recipient’s ability to search for, accept or continue employment
  • for recipients who score below 15, the medical condition must preclude the recipient’s ability to search for, accept or continue employment

[see Policy – Medical Condition: Seriously Impedes or Precludes]

5.  Preparing for PPMB Adjudication

In cases where a recipient appears to meet the PPMB criteria or the recipient has requested PPMB, the EAW must do the following, once the preceding steps 1 – 4 have been completed:

EAW

1.

Complete all sections of the PPMB Checklist (HR2892A) [see Forms and Letters].

 

2.

For recipients who score 15+, complete the PPMB Checklist – Appendix 1, which includes the following information:
 

  • whether or not the recipient has been referred to each of the interventions on the list
  • if not referred, an explanation of why (e.g., program refused recipient based on their medical condition)
  • if referred, whether or not the intervention was successfully completed
  • in cases where an intervention was not successfully completed, an assessment as to why not (i.e., was it for reasons beyond the recipient’s control, such as the recipient was hospitalized or the program cancelled)

Note:  A copy of the PPMB Checklist – Appendix 1 that contains an up-to-date list of all interventions available in the community is available in each Employment and Assistance Office.

 

3.

Gather all relevant documentation that is needed for an adjudicator to determine eligibility for PPMB, including:
 

  • PPMB Checklist
  • PPMB Checklist – Appendix 1
  • Client Employability Profile
  • Employment Plans
  • Employment Readiness Information Questionnaire (ERIQ)
  • Employability Screen
  • Voluntary Participation Plans
  • Medical Report - Persons with Persistent Multiple Barriers
  • Any other relevant information already on file or provided by the client unsolicited.  Examples include:
    • A letter from a social worker, probation officer, health professional with whom the recipient is involved, which describes circumstances of the client that could impact employability
    • Proof of earnings declared in the last 12 months

 

4.

Scan and profile all documents related to this Service Request (SR). There is no need to batch file any hard copies. Provide a copy of these documents to the client if requested.

 

5.

Forward the SR to the PPMB Adjudicator for adjudication. 

6.  Adjudication

PPMB Adjudicator

1.

Review the information in the SR forwarded from the EAW and determine if, based on the documentation, the recipient meets all eligibility criteria for PPMB as set out in the legislation.  The applicant must meet section 2(2) and either 2(3) or 2(4) of the Employment and Assistance (EA) Regulation.

[see Additional Resources for access to a Medical Dictionary and information on ICD9 and DSM-IV codes used on the Medical Report- PPMB]

[For information on PPMB Reconsideration Adjudication procedures see Related Links – Reconsideration and Appeal – Reconsideration – Procedures]

 

2.

Complete the adjudicator section of the PPMB Checklist that includes the following:
 

  • decision
  • reason for the decision
  • date of decision
  • review date (if applicable)

 

3.

Enter the following information on the SD More Info applet:
 

  • decision date
  • decision code, eligible or ineligible
  • review date

If the recipient is eligible, complete the following steps:
 

  • update the Case Details applet in More Info / More Info IAchange employability status from 03 to 01
  • close the Employment Plan (EP) if required
  • issue any required top-up as appropriate

 

4.

Document all of the reasons for the decision on the SR for Application / PPMB.

PPMB Adjudicator or Regional Clerk

5.

Send the appropriate letter to the recipient advising them of the approval or denial of PPMB using one of the following:
 

  • PPMB Approval (Single Person) (3241)
  • PPMB Approval (Single Parent) (3242)
  • PPMB Approval (Both Applicant and Spouse Approved or Spouse ETW) (3243)
  • PPMB Denial (New PPMB Applicant) (3245)

 [see Forms and Letters]

PPMB Adjudicator or Regional Clerk

6.

 Close the PPMB SR.

Effective: October 1, 2012

Reviews are conducted at least every two years based on the recipient’s individual situation. 

To conduct a review, follow these steps:

1.  Advise Recipient of PPMB Review

Upon receiving notification that a recipient’s review date is three months away, send the First Appointment – PPMB Review Letter (HR3232) [see Forms and Letters] to notify the recipient of the review. 

Note: Adjudication must be completed within the three-month period or the system will remove the  PPMB decision code of eligible and additional rate and supplements will end.  If a recipient fails to attend a review appointment, attempt to phone to reschedule or send the Second Appointment - PPMB Review Letter (HR3235) [see Forms and Letters].

If contact is established with the recipient, advise them:
 

  • the review of their eligibility for the PPMB category must be completed within the time remaining in the three-month period, including the return of a Medical Report
  • when the Medical report is due and that they must submit it to the EAO, and
  • if the information requested is not provided within the time frame indicated, they will be determined to be ineligible for PPMB

Document the verbal notification of consequences on the system.

If unable to contact the client by phone, use office caseload management protocols to follow up.  If the recipient does not contact the office at cheque issue, the standard file closure procedures would apply.  Should the recipient re-apply within 12 months of leaving income assistance as a PPMB, see Policy – Reapplication for Employment and Assistance.

If the recipient contacts the office at cheque issue, rebook the appointment and advise the recipient that they must attend the review appointment to determine continued eligibility for PPMB.

If a recipient does not attend this second appointment, then take the following steps:
 

  • send the PPMB No Contact – Missed Appointment Letter (HR3262)
  • update the SD More Info by changing the PPMB decision code to Ineligible
  • set a review date that is at least three cheque periods in the future
  • ensure that the recipient has an Employment Plan completed before the PPMB review date

Note: It is important to document all steps taken to complete the PPMB review in the system.

2. Conducting a PPMB Review

At the appointment follow these steps:

EAW

1.

Ensure that a current Medical Report – Persons with Persistent Multiple Barriers has been received by the EAO.  If not, request that the recipient have their medical practitioner complete a Medical Report – PPMB.  Advise the recipient that the Medical Report – PPMB must be returned within the time frame indicated, or they will be determined to be ineligible for PPMB.

 

2.

Update the Employability Screen to ensure that the recipient has an up-to-date score.

 

3.

 For recipients who score 15+, complete the PPMB Checklist – Appendix 1 to determine if there are new resources that may be appropriate for the recipient.  The following information must be documented in Appendix 1:
 

  • whether or not the recipient has been referred to each intervention on the list
  • if not referred, an explanation of why (e.g., program refused recipient based on their medical condition)
  • if referred, whether or not the intervention was successfully completed
  • in cases where an intervention was not successfully completed, an assessment as to why not (i.e., was it for reasons beyond the recipient’s control, such as the recipient was hospitalized or the program cancelled)

Note:  A copy of the PPMB Checklist – Appendix 1 that contains an up-to-date list of all interventions available in the community is available in each Employment and Assistance Office.

 

4.

Complete all sections of a new PPMB Checklist (HR2892A) [see Forms and Letters].

 

5.

Set a signal for the month the review is due (two weeks before cheque issue) to ensure the Medical Report – PPMB has been returned (if not already received by the EAO).

 

6.

If the Medical Report – PPMB is not returned by the signal date complete the following steps before cut off of the month the review is due:

  • Send the PPMB Denial – No Contact Letter (HR3247) advising recipient that they are being denied PPMB for failure to submit verification.
  • Complete the following in the system:
    • update the SD More Info applet by changing the PPMB decision code to Ineligible
    • set a review date that is at least three cheque periods in the future
    • ensure the recipient has an Employment Plan completed before the PPMB review date

3. Preparing for PPMB Adjudication

EAW

1.

Gather all relevant documentation that is needed for an adjudicator to determine eligibility for PPMB, including:
 

  • PPMB Checklist
  • PPMB Checklist – Appendix 1
  • Client Employability Profile
  • Employment Plans
  • Voluntary Participation Plans
  • Medical Report – Persons with Persistent Multiple Barriers
  • Proof of earnings declared in the last 12 months
  • Any other relevant information already on file or provided by the recipient unsolicited (e.g., a letter from a social worker, probation officer, health professional with whom the recipient is involved, which describes circumstances of the client that could impact employability)

 

2.

Scan and profile all documents related to this adjudication. There is no need to batch file any hard copies. Provide a copy of these documents to the client if requested.

 

3.

Forward the Service Request (SR) to the PPMB Adjudicator for adjudication. 

4. Conducting a PPMB Review

PPMB Adjudicator

1.

.Review the information in the SR forwarded from the EAW and determine if, based on the documentation, the recipient meets all eligibility criteria for PPMB.

[see Additional Resources for access to a Medical Dictionary and information on ICD9 and DSM-IV codes used on the Medical Report- PPMB]

 

2.

.Complete the adjudicator section of the PPMB Checklist that include the following:
 

  • decision
  • reason for the decision
  • decision date
  • review date (if applicable)

 

3.

Enter the following information on the SD More Info applet:
 

  • decision date
  • decision code, eligible or ineligible
  • review date

If the recipient is not eligible based on the available documentation, complete the following steps:

 

4.

Document the reasons for the decision on the SR for Application / PPMB.

PPMB Adjudicator or Regional Clerk

5.

Send the appropriate letter to the recipient advising them of the approval or denial (giving review date of at least three cheque issues in the future) of PPMB using one of the following:
 

  • PPMB Approval (Single Person) (HR3241) PPMB Approval (Single Parent) (HR3242)
  • PPMB Approval (Both Applicant and Spouse Approved or Spouse ETW) (HR3243)

PPMB Denial (Clients Currently Receiving PPMB Rates) (HR3246)   [see Forms and Letters]

 

6.

Close the PPMB SR.

Effective: August 30, 2004

Eligible

In the following examples, the recipients do meet the PPMB criteria:

Assumptions:
Recipients have been in receipt of income assistance for at least 12 out of the last 15 months
Recipients have a medical condition that has existed for at least one year and is likely to last at least two years
 

  • Recipient does one to two hours of transcribing work a week from home and has a score of 15 on the Employability Screen.  A review of the recipient’s history and Appendix 1 verifies that the recipient has made reasonable attempts to find employment using independent job search and employment programs, and has attempted two different types of training programs in the past year.  There are no other interventions that are appropriate for the recipient.  Each time she has been unsuccessful at completing the programs or finding part- or full-time employment as a result of her medical conditions.  The Medical Report – PPMB states:
    • Primary condition: fibromyalgia and osteoarthritis
    • Treatment and Outcome
Treatment Outcome

antidepressants for fibro and anti-inflammatories for osteo,

plus regular exercise and keeping weight in normal range

Fibro was assisted somewhat but condition not stabilized.

OA will progressively worsen

  • Restrictions: extreme fatigue resulting in patient barely managing self care most days

REASON: Score of 15 or more, all steps tried, and medical condition seriously impedes employment.
 

  • Recipient has completed a university degree and has a good work history that ended as a result of late onset of Schizophrenia.  Employability Screen score of 9.  The Medical Report – PPMB shows the following:
     
    • Primary condition: Schizophrenia
    • Treatment and Outcome 
Treatment Outcome

Several medications have been tried

None have been effective to date

Hospitalized twice in the past year for suicide attempts

 
  • Restrictions: not capable of focussing attention for any length of time, delusions regularly result in aggressive and suicidal behaviour

REASON: Medical condition precludes all types of employment and recipient cannot work for any amount of time.
 

  • Recipient was diagnosed with epilepsy as a child and has no work history.  Employability Screen score of 16.  A review of the recipient’s history and Appendix 1 indicates that there are no interventions that are appropriate for the recipient.  The Medical Report – PPMB shows the following:
     
    • Primary condition: Epilepsy
    • Treatment and Outcome: 
Treatment Outcome

Anti-epileptic medication (tegretol)

Reduces the number of seizures, still has daily seizures

  • Restrictions: unable to drive, extra time required to complete daily living activities

REASON: Score over 15, no interventions appropriate as per Appendix 1 of the PPMB Checklist (HR2892A), and medical condition seriously impedes all types of employment.
 

  • Recipient is a 40-year-old male with a grade 8 education.  Sporadic employment history mostly in labour type jobs.  He states that he is an alcoholic in recovery for 5 years and attends Alcoholics Anonymous meetings regularly.  Recipient scores 12 on the Employability Screen. Medical Report – PPMB states:
     
    • Primary condition: hepatitis C
    • Treatment and Outcome: 
Treatment Outcome

[no information provided]

[no information provided]

  • Restrictions: malaise, reduced exercise/activity tolerance, nausea
  • Attachments to Medical Report – PPMB – lab report
  • Consultation with ministry medical practitioner – Lab report shows liver enzymes are high, this suggests that hepatitis C is in an advanced stage.

REASON: Medical condition has been proven to preclude the recipient from participating in any type of employment for any length of time.

Not Eligible

In the following examples, the recipients do not meet the PPMB criteria:

Assumptions:
Recipients have been in receipt of income assistance for at least 12 out of the last 15 months
Recipients have a medical condition that has existed for at least one year and is likely to last at least two years
 

  • Recipient has been on assistance for most of the past 15 years.  A review of the history shows that during most of his time on assistance this recipient was categorized as “unemployable” or “persons with a level one disability.”  Recipient scores 16 on the Employability Screen.  The recipient has not been to any employment-related interventions.  The Medical Report – PPMB shows the following:
     
    • Primary condition: HIV
    • Treatment and Outcome
Treatment Outcome

antiviral medications

 

  • Restrictions: none

REASON: This recipient has a serious medical condition, but the condition at this time does not seriously impede or preclude their ability to work.  Also, there is no indication that all interventions have been tried.
 

  • Recipient is 55 years old and scores 16 on the Employability Screen.  Employment history shows construction work (though not recently).  The Medical Report – PPMB shows the following:
     
    • Primary condition: chronic back pain
    • Treatment and Outcome
Treatment Outcome

analgesia, regular exercise, weight loss

 

  • Restrictions: limited lifting, bending, walking, cannot do strenuous work

REASON: Medical condition may impede some types of employment but has not been proven to seriously impede any type of employment.  Also, there is no indication that all interventions have been tried.
 

  • Recipient is 38 and has been off and on assistance for over 10 years.  He scores 16 on the Employability Screen.  The recipient has been to multiple addiction recovery programs in the past.  The Medical Report – PPMB shows the following:
     
    • Primary condition: alcohol and drug addiction
    • Restrictions: none

REASON: Alcohol and drug addiction is not included as a medical condition for the purposes of PPMB eligibility criteria.
 

  • Recipient is 27 years old, has a grade 10 education, and very little employment history.  She scores 10 on the Employability Screen.  Medical Report – PPMB states:
     
    • Primary Condition: Depression
    • Secondary Condition: Alcohol addiction
    • Treatment and Outcome: 
Treatment Outcome

Zyban

Patient not taking consistently, alcohol use interferes with treatment

needs alcohol and drug counselling

 
  • Restrictions: none

REASON: Medical condition, in the absence of addiction, has not been proven to preclude the recipient from participating in employment.  Recipient should be referred to alcohol treatment programs available in the community.
 

  • Recipient is a 40-year-old male with a grade 8 education.  Sporadic employment history mostly in labour type jobs.  He states that he is an alcoholic in recovery for 5 years and attends Alcoholics Anonymous meetings regularly.  Recipient scores 12 on the Employability Screen.  Medical Report – PPMB states:
    • Primary condition: hepatitis C
    • Treatment and Outcome: none
    • Restrictions: tired
    • Attachments to Medical Report – PPMB – lab report
    • Consultation with ministry medical practitioner – Lab report shows liver enzymes are within a normal range, this suggests that hepatitis C is not in an advanced stage, therefore employability would not be expected to be impacted at this time.

REASON: Medical condition has not been proven to seriously impede or preclude the recipient from participating in any type of employment.

Effective: June 10, 2014

Recipients in the PPMB category at the time when their file was closed can be reassessed for PPMB on reapplication without meeting the requirement to receive another 12 months of assistance.  However, the 12-month requirement is only waived if recipients reapply within 12 months of leaving income assistance as a person with persistent multiple barriers.

Applicants who were previously in the PPMB category are required to complete the work search [see Related Links – Work Search] and the intake application [see Related Links - BCEA Application – Stage 1 – Prospecting and Stage 2 – Eligibility Interview].  All regular intake procedures, such as completion of the Employability Screen, continue to apply. 

Former PPMBs who reapply within 12 months of leaving assistance as PPMB but after their review date has passed, can still receive the PPMB rate if financially eligible.  However, the review process should be initiated immediately to determine their ongoing eligibility for PPMB.

Note: The only exception to PPMB being reviewed by the PPMB adjudicator upon reapplication is cases where the recipient has been off assistance for 2 months or less for non-employment-related reasons (i.e., family maintenance arrears, hospitalization, etc.).

Authorities and Responsibilities

Effective: July 26, 2004

Persons with Persistent Multiple Barriers (PPMB)
Employment and Assistance Worker
  • gathering documentation required to determine eligibility for PPMB
  • referring client to available interventions that could overcome the client's barriers
  • forwarding all relevant documentation to PPMB Adjudicator
  • updating the system
PPMB Adjudicator
  • assessing all documentation submitted against the eligibility criteria for PPMB
  • determining a recipient’s eligibility for PPMB
  • notifying the recipient of decision (after the adjudication is complete)

Frequently Asked Questions

 

Question   What if the recipient has provided all the documentation necessary for a PPMB review and then exits assistance or is found ineligible for another reason.  Can they still be adjudicated for ongoing PPMB assistance?

Answer  If a decision is determined before the recipient exits, the PPMB Adjudicator will still advise the client of the decision. 

If a decision has not been determined and the file closes, the Adjudicator will make a comment, to review the documentation and adjudicate upon reapplication if the documentation is still recent.  Materials may need to be updated if the documentation is not recent (i.e., Medical Report, Appendix 1 of the Checklist, etc.).  

 

Question   When a recipient is found eligible for PPMB, when does the PPMB rate take effect?

Answer   Recipients approved for PPMB are eligible for the additional rate and supplements starting the month after the decision is made, as per Section 26(3) of the EA Regs.  These can not be provided retroactively.  For example if a recipient is found eligible for PPMB on August 5, the additional rate and supplements would be effective September 1.  Their new rate would be reflected in their cheque for September issued at the end of August.

 

Question   What if a recipient who asked to apply for PPMB does not meet the 12 months of assistance in the last 15 months? Can the EAW deny PPMB?

Answer  PPMB Adjudicators must approve or deny all requests for PPMB.  If an EAW believes that a recipient does not meet the PPMB criteria, they can explain the PPMB criteria to the recipient.  If the recipient still wants to apply for PPMB, then the EAW must gather all relevant information, including a Medical Report – PPMB (HR2892) and forward the PPMB package to the PPMB Adjudicator for a decision.

 

Question   If a client has a medical condition, which may interfere with employment, which medical report should be used?

Answer   A client with a score of under 15 on the Employability Screen whose only barrier appears to be a drug or alcohol, medical health or temporary medical condition should be assessed first for Expected to Work - Medical Condition using the Medical Report - Employability (HR3069).  If the client appears to meet the criteria for a Person with Persistent Multiple Barriers (PPMB) or is requesting to apply for PPMB, the Medical Report - PPMB (HR2892) should be used.  [see Related Link – Persons with Persistent Multiple Barriers]

 

Question   What if a recipient who asked to apply for PPMB, submits a Medical Report that clearly shows that they do not have a medical condition that seriously impedes or precludes employment.  Can the EAW deny PPMB?

Answer   PPMB Adjudicators must approve or deny all requests for PPMB.  If an EAW believes that a recipient does not meet the PPMB criteria, they can explain the PPMB criteria to the recipient.  If the recipient still wants to apply for PPMB, then the EAW must forward the PPMB package to the PPMB Adjudicator for a decision.

 

Question   What steps should be taken if a medical practitioner does not complete all sections of the Medical Report – Persons with Persistent Multiple Barriers (HR2892)?  Is this an issue for the EAW or PPMB Adjudicator?

Answer   If an EAW notices that a medical practitioner has not completed all sections of the Medical Report, they can ask the recipient to take the form back to the medical practitioner, as eligibility for PPMB cannot be determined if all information is not provided.  In cases where the recipient refuses and requests to proceed with applying for PPMB, the EAW should forward the PPMB package to the PPMB Adjudicator for decision.

 

Question   A person has had an open file for 12 out of the past 15 months but has not received assistance for each of the months within this 12 month period.  Does this person meet the PPMB requirement of having received assistance for at least the past 12 out of the last 15 consecutive months?

Answer   The regulations state that the client must be a recipient of income assistance, hardship assistance, or disability assistance for at least 12 out of the past 15 months.  This means that recipients must have received support and shelter for the past 12 out of the last 15 months.  This automatically excludes a person who did not receive assistance for any number of months within the last 15 months.  Having an open file does not constitute ``receiving assistance``.

 

Question   One of the eligibility requirements for PPMB is the need to have received assistance for at least 12 out of the past 15 months.  If a recipient was a dependent spouse for a number of months and then applies on his or her own, would the time as the dependent spouse count towards the 12 months?

Answer   Yes, the requirement is for the person to have received income assistance, disability assistance or hardship assistance for at least 12 of the past 15 consecutive months.  As a dependent spouse, the individual would have been in receipt of assistance.

 

Question   Would a person who has received assistance for the past 12 months in another province be considered to have met the 12 out of the past 15 months criteria?

Answer   No, the recipient must meet the criteria stated within the Employment and Assistance Act, which is to have received assistance for at least 12 of the past 15 months of one of the following:

  • income assistance or hardship assistance under the EA Act
  • disability assistance or hardship assistance under the Employment and Assistance for Persons with Disabilities Act
 

Question   How many barriers to employment does a recipient need to have to be eligible for PPMB?

Answer   

There is no specific number of barriers.  A combination of the following are taken into account:

  • the recipient’s score on the Employability Screen
  • whether the individual has taken all reasonable steps to overcome the barriers
  • the impact of the recipient’s medical condition on employability

Where the only barrier is a medical condition, it may be a sufficient barrier on its own if it precludes employment.

 

Question   Why does the Medical Report – Persons with Persistent Multiple Barriers (HR2892) not have a similar title to the Employment and Assistance for Persons with Disabilities Application (HR0080) that identifies it as an application?

Answer   

The Medical Report – Persons with Persistent Multiple Barriers (HR2892) is not an application.  It is the form used to confirm one of the PPMB criteria.  In fact, there is no application for PPMB.  Determining if someone is eligible for PPMB is based on a process that includes the following:

  • identifying any barriers (Employability Screen)
  • determining the severity of the barriers and how they affect the recipient’s employability (Client Employability Profile)
  • confirming medical information (Medical Report - Persons with Persistent Multiple Barriers)
  • ensuring that the recipient has taken all steps that the minister considers reasonable to overcome their barriers to employment (Appendix 1 of the PPMB Checklist)
 

Question   How do doctors bill the Medical Services Plan (MSP) for completing the Medical Report – Persons with Persistent Multiple Barriers (HR2892)?

Answer   Fees for medical practitioners completing the Medical Report are paid through the MSP.  Physicians bill MSP directly.  The ministry is not responsible for the billing or payment process for the Medical Report.

 

Question   Must both adults in a family unit be eligible for PPMB to receive the PPMB earnings exemption?

Answer   No.  Only one adult member of a family unit must be eligible for PPMB in order for both adults to receive additional assistance and supplements.  The family unit is eligible for the earnings exemption and either or both adults may claim exempt earnings up to the maximum for the family unit.

 

Question   Do recipients with PPMB have access to the Employment Program of British Columbia (EPBC)?

Answer   Recipients who are eligible for PPMB may have access to EPBC services, as well as non-ministry programs and services to address their barriers to employability.

Recipients are only eligible for PPMB after they have taken all steps to overcome their barriers to employment.

 

Question   Some recipients have barriers that will permanently preclude employment.  Why does the ministry review eligibility for PPMB every 2 years?

Answer   PPMB is to be reviewed at least once every two years to ensure the recipient’s situation has not changed and to determine if there are any new resources that may assist the recipient.  The frequency with which each file is reviewed is determined on a case-by-case basis.  If it is determined that the recipient’s barriers continue to preclude employment, the recipient’s PPMB will continue.

Share Button