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Expected to Work/Barriers to Full Employment Policy & Procedures

Published Date: July 10, 2018
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09 Non-Continuous Needs

Emergency Prescription(s)/Drugs

INTENT

To provide a process for one-time issuance of emergency prescription(s)/drugs that will address the urgency of the situation in an effective and efficient manner.

POLICY

Applications for prescription drugs can be made using the EMP 3428 Income Support Application or the more specific EMP 3854 Application for Emergency Prescription(s)/Drugs.

Although both the EMP 3428 Income Support Application and the EMP 3854 Application for Emergency Prescription(s)/Drugs are acceptable for processing the emergency prescription request, the EMP 3854 Application for Emergency Prescription(s)/Drugs details the extent of the authorization and verification required to determine eligibility.

Requests for emergency prescription drugs may be sent after-hours to the Income Support Contact Centre by fax (780-422-9681 ), phone (780-644-5135 or toll-free 1-866-644-5135 ). During work hours, requests can be made by phone or walk-in at an Alberta Supports or Alberta Works Centre.

Documents pertaining to the issuance of emergency drugs should be filed in accordance with Records Management Policy and Procedures as outlined in File Transfer Procedures.

PROCESS

  1. When the EMP 3854 Application for Emergency Prescription(s)/Drugs is faxed from the applicant or an agency such as a shelter:
    1. Community and Social Services staff reviews the form to ensure required information is completed and when possible contacts the applicant to ensure there are no other needs such as ongoing Heath Benefits, Income Support, Child Support Services, etc.
    2. If there are other needs, the applicant is referred to an Alberta Supports or Alberta Works Centre. In the meantime, the emergency prescription(s)/drugs may be authorized.
    3. If the applicant is unable to sign the EMP 3854 Application for Emergency Prescription(s)/Drugs, Community and Social Services staff discusses the reason with the referring agency. If the Community and Social Services staff is satisfied the applicant understands the declaration and consent, they document the reason in the comments section of the form.

  2. When an applicant presents emergency prescription(s)/drug needs at an Alberta Supports or Works Centre or by phone:
    1.  Community and Social Services staff interviews the applicant to ensure there are no other needs such as ongoing Health Benefits, Income Support, Child Support Services, etc. 
    2.  If the application is made over the phone and there are other needs, the applicant is referred to an Alberta Supports or Alberta Works Centre. In the meantime, the EMP 3854 Application for Emergency Prescription(s)/Drugs may be authorized.
    3. Depending on the assessed needs, the applicant will complete either the EMP 3854 Application for Emergency Prescription(s)/Drugs, or an EMP 3428 Income Support Application for ongoing benefits.
    4. Community and Social Services staff will either ensure the applicant reads and understands the declaration and consent or the staff person will read the declaration and consent to the applicant and ensure the applicant understands and provides their consent.
  3. If applicable, the applicant completes the spouse/partner section of the application and signs the declaration.  The spouse/partner does not need to sign the declaration due to the urgency of the matter.

  4. Third parties cannot apply on the client’s behalf, but can assist with the client’s application.
    Note
    If the person returns a subsequent time, they should be referred for a more in depth assessment of need. If it is apparent that the applicant has an ongoing need for prescription drugs, they should be assessed for ongoing benefits under theAlberta Adult Health Benefit - Initial Eligibility - High Drug Needs sub-type.

    If the applicant has children and is low-income but does not qualify for ongoing AAHB or Income Support benefits, they are to be provided information about the Alberta Child Health Benefit (ACHB).


PROCEDURES

When it is determined the need is for an emergency prescription(s)/drugs, and the applicant is eligible for drug coverage (i.e., is not a First Nations person with Registered Status or is not an immigrant in a non-eligible group), the worker:

  1. Advises the applicant that if the prescription drug is listed on the Interactive Drug Benefit List it can be provided immediately by a pharmacist.  If the drug is not on the list, then the applicant can request a review by the Health Benefits Exception Committee (HBEC).  In emergency cases the HBEC request should be submitted immediately and marked "urgent".
  2. Advises the applicant that Community and Social Services will contact the pharmacist to authorize dispensing of the prescription, and that this includes providing the individual’s personal information so their identity can be verified by the pharmacist and the pharmacist’s payment claim can be processed.
  3. Verifies or creates a PID and file number in CCD.
  4. Requests the electronic file by using Function 20 Request for File Download or Function 14 Transfer File in the Local Income Support Application (LISA) system.
    Note
    The stage at which the electronic file is created may depend on each worksite.
  5. Certain information, such as the client's address, Employment Insurance (EI) status, and/or education level may not be known when entering the client's information in LISA. This information is not required in the determination of eligibility for emergency prescription(s)/drugs but the fields must be completed in LISA.
    • When the applicant's address information is not known, the worker may enter the Alberta Works Centre's address and postal code and use the living arrangement code 1.
    • When the application's EI status is not known, the worker may enter "no" in the "Eligible for EI" and "Applied for EI" fields.
    • When the applicant's highest level of completed education is not known, the worker may enter "12" in the appropriate field.
  6. Obtains a drug authorization number – EMP 1976 Drug Authorization.
  7. Contacts the pharmacy to authorize the issuance of the prescription/drug and advises them that their authority to authorize the benefit is limited to the eligibility on the Interactive Drug Benefit List, or drugs approved by the HBEC.
  8. Faxes a copy of the EMP 1976 Drug Authorization to the pharmacy.
  9. Ensures the client(s) information is entered in LISA within one working day. This ensures the systems have the appropriate information so that any necessary prescription(s) will not be rejected.
  10. Ensures a copy of the EMP 1976 Drug Authorization and the EMP 3854 Application for Emergency Prescription (s)/Drugs becomes part of the client’s file.
  11. Enters Notes in Mobius.