By Kendall Worth:
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| Jen Brady and Kendall Worth |
This article consists of an interview with Jen Brady, Dietitian, and a few thoughts of my own. I met Jen Brady, in person, (we had previously been at some online meetings, together) when we both spoke at a Basic Income Conference in October 2021, at the Halifax Central Public Library. I have previously posted a link to my speech (see youtube link below), but I was very impressed with Jen's speech which I encourage you to watch below, at this conference. When we spoke, she had a lot to say around how being on Income Assistance discourages healthy eating.
Jen Brady and I met through our involvement with the Basic Income Group. I was inspired by her, and decided I wanted to ask her some questions for my New BLOG. Jen’s responses are in orange.
#1 – What Thoughts come to your mind when you look at section 8.3.31 of the Employment Support and Income assistance Policy Manual? That is the Section that deals with extra diet allowances for people with health problems that would benefit from a special allowance.
When I look at that section of the policy I think about how difficult it is for people seeking assistance to get the support they need and deserve. The policy is, like many legal and policy documents, difficult to read because it is written in dense legal language that not many people can read and understand. I also think that understanding this document, and the rights, roles, and responsibilities it outlines, is just one example of the many many barriers that those seeking social assistance face.
What I would like to see is not just tweaks to what is essentially a broken system, but a major rethink to how we share wealth as a society and how we provide support for those whose employment and other life circumstances means that they need support. With respect to the special diet allowance specifically, I think it also needs a fundamental change. Perhaps I should say first what the special diet allowance is for those who do not know. The special diet allowance is an additional sum of money that people receiving social assistance can receive to purchase items that they need to pay for the foods they need to manage a medical condition. The special diet schedule identifies specific medical conditions that would qualify, someone receiving social assistance, for additional financial support. For example, people who have celiac disease can apply to receive more money to pay for the gluten-free foods they need to manage their celiac disease. There is maximum amount that people can receive based on the medical conditions they have. If someone has more than one medical condition, they can receive money to cover the costs of multiple conditions up to a maximum of $150/month.
What this system means is that people receiving income assistance have to disclose sensitive medical information to case workers who get to judge whether people qualify for a small amount of money, to cover what can be pretty expensive foods, to manage their medical condition. To me, that is unfair and undignified.
The application they make to receive additional funding has to include a letter from either a doctor or a dietitian that confirms that they have a medical condition and that they need a special diet to manage it. Like social assistance generally, I don’t think the way that people access the special diet allowance, or the amount they receive is adequate or respectful of their fundamental right to dignity and to food.
#2 – We also talked about how if Section 6.1.82 of the Employment Support and Income Assitance policy manual did not even Exist how that would support Income Assistance Recipients in the path of eating healthier. This part of the Policy talks about Co-Habitation and what happens to Income Assistance (IA) Clients when they decide to co-habitate.
Food and eating is an important of keeping your body healthy! However, food and eating area also important social activities that connect us to our friends, families, communities, and cultural and spiritual backgrounds. For me, aspects of social assistance that interfere with people’ right to access food also interferes with their right to health and their right to be able to practice their spirituality and culture, as well as to live in ways that important needs for all humans—the need for love, acceptance, and connection. These are all important to mental health. So for that reason, food is important in supporting people’s nutrition and physical health, but also other aspects of our health, including mental, social, spiritual, and emotional health.
Another important thing to consider is the way that living with someone can help people to healthier by allowing people to pool resources, which include money to bulk buy or buy larger amounts of food on sale. It also allows people to pool other resources to make the best use of things like the time it takes for grocery shopping, food preparation, and budget management. As well, for those with disabilities, or who just don’t like cooking, it allows people to pool their abilities and skills to create means of social support in their lives that those who aren’t living on social assistance have access to. In other words, people who don’t live on social assistance have a right to live with who they wish, and they benefit from that in many different way. People living on social assistance shouldn’t be prevented from the enjoying the same things that other people enjoy.
#3 – How do you as a professional feel about IA clients being encouraged to live to the life of loneliness and social isolation. This effects their day to day lives, including why they depend on Soup Kitchens in order to get out of their apartments and “Have a life”, to socialize as well as for the free food?
I completely agree with the point that your questions are getting at. To me, the bottom line is that food is as much a social and cultural thing as it is related to our physical health. To me, preventing people from enjoying the social and cultural aspects of food contravenes their fundamental rights to food, to dignity, and happiness.
I [Kendall] just have to add a note. Some other reasons people are lonely:
Many of them either do not not have any living family left, or if they do have any family their families believe in the stigma about them, and wants nothing to do with them.
Friendships with people from before receiving income assistance from the Department of Community Services have ended.
The Standard household rate for those who are single and housed is $950.00 and their budget does not include money for Social Activity in the Community that can help them get out and meet new people.
Not all income assistance clients are able to work, even part time, because of their disabilities.
#4 – What kind of vision of a different system of income assistance do you have, if we could make changes?
I support Basic Income for many reasons. Basic Income provides more money, but also provides people with independence and dignity so that they can make decisions about who they live with and how they spend their money. To me, the changes that are needed are way beyond tweaks to the current system. What we need is a total change in how we address poverty in this province and in this country, starting with how we as a society thinks about people living in poverty. We tend to treat people living in poverty as if it is their fault and their responsibility to lift themselves out of that situation. I completely disagree with this view of course! We need to realize that most Canadians are living paycheck to paycheck and one small bump in the road, which may be an illness, a newly acquired disability, or some other unexpected crisis, and very easily plunge them into poverty. Living in poverty or on social assistance is no one’s fault; it is symptom of a deeply broken social safety net.
5# Basic Income would solve all problems Income assistance Clients are having?
Basic income is often described as the swiss army knife of social policy because it can improve many different problems that are connected to poverty, such as mental and physical health problems, addictions, violence, food insecurity, barriers to education and other things. However, Basic Income is not a silver bullet that will completely solve all of these problem. The reason for that is because these problems are not only caused by poverty, even though poverty is one main cause of them. We need a Basic Income in Nova Scotia to lift people out of poverty and to decrease the many problems that go along with poverty. However, we still need other programs and services that people will still need like addictions and trauma counselling.
I will end this article by saying “ I was very honoured to have the opportunity to meet and get to know Jen Brady”. She is on my side for some of the things I advocate for.
1 Policy Manual 8.3.3 Special Diet Rate Schedule A medical doctor, pediatrician; nurse practitioner or registered dietician/nutritionist is required to confirm: 1. medical diagnosis/condition(s) that requires the special diet(s); 2. explanation of specific dietary requirements and how the special diet(s) is/are relative to the diagnosis(s) and any underlying medical condition(s); 3. the estimated duration of the need for special diet(s) if not for a permanent medical condition that is not expected to change. A referral to a registered dietician/nutritionist assists in determining the specific dietary requirements and provides advice and counselling about diet, food and nutrition. However, special diet documentation does not have to be from a dietician or nutritionist if the medical professional (physician, pediatrician, nurse practitioner) provides the required information. Where there is eligibility for more than one (1) special diet, the special diet allowances will be added together up to the maximum of $150 per month per applicant or recipient and dependent child. When a request for a special diet has the same dietary requirements (e.g. Low Fat), the approved amount will be issued once. Special Diet Approved Amounts Cardiovascular Disease Low Salt $27 Celiac Disease/Gluten Allergy/Wheat Allergy $30. Based on specific dietary requirements with supporting medical documentation, can approve a higher amount up to a maximum. 136 Chronic Constipation/ High Fibre Requirements High Fibre $27 Crohn’s Disease/Ulcerative Colitis High Calorie/High Protein $66 Chronic Fatigue/Fibromyalgia High Fibre/Low Fat $54 Cystic Fibrosis $133. Based on specific dietary requirements with supporting medical documentation, can approve a higher amount up to a maximum. Diabetes 1,000 and under kcalories No additional funds 1,001 – 1,200 kcalories No additional funds 1,201 – 1,500 kcalories $5 1,501 – 1,800 kcalories $18 1,801 – 2,000 kcalories $26 2,001 – 2,200 kcalories $34 2,201 – 2,400 kcalories $42 2,401 – 2,600 kcalories $51 2,601 – 2,800 kcalories $60 2,801 – 3,000 kcalories $68 above 3,000 kcalories $8 for each additional 200 kcalories Dialysis $27 plus a supplement of Nepro or Supplena purchased through a hospital. Food Allergy - Milk/Dairy or Lactose Intolerance Less than 2 years of age see Infant Formulas $30. Based on specific dietary requirements with supporting medical documentation, can approve a higher amount up to a maximum. Gastric/Ulcer or Bland Diets No additional funds as treatment is based on eliminating the foods that cause distress. 137 Gastroplasty Surgical treatment plan Actual amount, up to a maximum of $150. Hepatitis C Low Fat $27 Prescribed for medical condition that is not otherwise prescribed in the schedule where there has been extensive weight loss High Calorie/High Protein $66 HIV/AIDS – High Protein/High Calorie 3,000 kcalories 3,250 kcalories 3,500 kcalories $66 $88 $101 Hyperlipidemia/ Dyslipidemia: Low Fat $27 Hypertension: Low Salt/Low Fat/High Fibre $81 Infant Formulas Soy Formula (includes Isomil, Prosobee) Lactose Free Formula Hypo- allergenic Formula $35 $28 $144 Pregestimil (powder) $144 Alimentum (ready to feed) $121 Nutramigen Note: This amount will gradually be reduced as the child begins eating solid foods Oral Nutritional Replacements Failure to Thrive No Solid Food/Tube Feeding Some Solid Food Actual amount, up to a maximum of $150. This amount will be gradually reduced as the recipient begins eating solid food. Note: Must be paid through purchase order. Paraplegic Diet $36.50 138 Reducing Diets For purposes of weight loss No additional funds 8.3.4 Dental Fee Guide RATES SCHEDULE Procedure Code Description General Practitioner Fee Special
2 Policy Manual 6.1.8 Cohabitation Persons who reside together with shared financial resources such as, but not limited to, credit cards, bank accounts and loans, and who represent themselves to others to be each other’s spouse will be considered as a two (2) adult family unit in determining initial eligibility or ongoing eligibility. Cohabitation is determined to exist in these situations even though there may not be a legal marriage or conjugal relationship.
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