The ACSD (Assistance for Children with Severe Disabilities) program provides funding to help offset extraordinary costs associated with caring for a child with severe disabilities. It is offered through the Ontario government for low to moderate income families. Funding amounts are based on annual expenses and income, and can help pay for things like transportation to medical appointments, special clothing/equipment, respite care, and prescribed medications/therapies. To qualify, applicants must submit documentation verifying the child's disability, family income, expenses, and identity.

1. ACSD
Assistance For Children With Disabilities
Presented by
www.respiteservices.com

2. What is ACSD?
• Assistance for Children with Severe
Disabilities (ACSD) is a Government Of
Ontario program that gives funding to
parents to help with extraordinary costs
related to your child's severe disability

3. Ministry of Community and Social Services
and the Ministry of
Children & Youth Services
• ACSD is a non-taxable funding program for low and
moderate income families
• The amount of ACSD funding that can be received
is based on your yearly extraordinary expenses and
gross family income
• This funding can help parents afford extra costs
related to your child's severe disability. Examples of
extra costs are: travel to and from doctors and
hospitals, parking at healthcare appointments,
special shoes and clothing, parent relief, wheelchair
repairs, and financial assistance

4. How much can you qualify for?
• Families may be entitled to up to ($450.00
per month.
• Every family is different!

5. What are Extraordinary Costs?
• Transportation to and from doctor and hospital
appointments
• Special shoes and clothing
• Babysitters for younger siblings during medical
appointments
• Relief breaks for parents
• Special learning and developmental equipment
• Social recreation programs

6. The ACSD Also Includes…
• A Drug Card (used to pay for your child’s prescribed
medication)
• A Dental Card (basic coverage for your child is provided)
• Coverage for items related to your child’s vision and
hearing
• The parent contribution for an Assistive Device for your
child under the Assistive Devices Program (provided
through the Ministry of Health and Long-Term Care)
• The cost of assessment for an assistive device and the
cost of batteries and repairs

7. Please input the parent info here

8. Your child's information
Other children’s names and ages

9. “Please see attached”

10. “See attached”

11. Print Parents Name Here
Today’s
Date
Parent Signs HereWitness Signs Here

12. This section just states that it is important for you to fill
in the forms truthfully and to the best of your ability.

13. Parent
and Child
Names
Check here
for new
application
Check here
and add ID
for renewal

14. Type of
Doctor &
Intersection
Appointments
per Year
$0.18 per km and
parking
or TTC fare per trip
Meals at appointment if over lunch hour

15. Use realistic
rate
Total

16. May be due to:
•Sensory issues – zippers, tags
•Excessive wear – ripping clothes,
wearing down knees of pants
• Multiple outfits per day
Examples:
•Linen for bed wetting
•Towels or bibs for drooling
•Altered clothing for medical equipment
Extra loads of laundry due to:
•Soiling
•Multiple clothing changes per day etc

17. May be due to:
•Dragging feet, toe walking
•Sensory issues
•Crawling and wearing out toes
May include:
•Ensure or Vitamins
•G Tube feeds
•Gluten free diet

18. $300
May include:
•Special school or preschool
•Special daycare
May include:
•Educational books and toys
•Music, DVDs, video games
•Bicycle, sensory toys, etc

19. May include:
•Social skills program at Geneva Centre
•After school or Weekend programs
•Variety Village Membership etc
May include:
• A CHAP worker
• Respite programs

20. May include:
•Vitamins
•Allergy medication
•Tylenol
•Stool Softners
May include:
•Hearing aid batteries
•Special head phones
May include:
•Gloves, sterile gauze, tape
•Bandages, tensor wraps
May include maintenance to :
•Wheelchair
•Walker or braces

21. May include:
•Damage to household items including painting walls
•Patching up holes in the wall
•Laundry detergent or softener
•Carpet cleaning
Include overview of family situation

22. Documentation
• Signed application form
• Completed Expense Report
• Medical statement or psychological assessment that
clearly confirms the diagnosis of your child's disability
• Income verification – Notice of Assessment for previous
tax year
• Birth Certificate for child
• Verification of applicant and child’s status in Canada
• Health Card for child and parent
• Void cheque