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Date: March 3, 2016 Case Processing Centre – Ottawa 219 Laurier Ave. West, 7th floor, section B Ottawa, Ontario K1A 1L1 Canada UCI: 89295559

Application: E000158425 Email: FMONTOYA@YORKU.CA

Phillip Joseph Motoya - 415 WENLOCK AVE. RICHMOND HILL, ON , L4C 1N3 Canada Dear Phillip Joseph Motoya: This letter concerns your application for permanent residence in Canada. Based on a review of your file, it appears that you or your family member may not meet the requirements for immigration to Canada. I have determined that your family member Nicolas Montoya is a person whose health condition might reasonably be expected to cause excessive demand on social services in Canada. An excessive demand is a demand for which the anticipated costs exceed the average Canadian per capita health and social services costs, which is currently set at $6,387 per year. Pursuant to subsection 38(1) [and pursuant to section 42 in the case of a family member] of the Immigration and Refugee Protection Act, it therefore appears that you may be inadmissible on health grounds. Your family member, Nicolas Montoya, has the following medical condition or diagnosis: Down’s syndrome (759) with Moderate Intellectual Disability. In particular: This applicant was born on 2002/11/28 in Costa Rica. He made an application in the non-EDE category and his province of destination is ON. He has a diagnosis of Down's syndrome. This diagnosis was confirmed based on all information gathered from the Pediatrician, School, and Educational psychologist reports. Psychological testing shows very limited cognitive and language ability, and very limited adaptive skills. He is a 13 year old functioning at a 3 year old level. School principal notes in letter of Sep 3, 2014 that he is attending public school in a community class. His special education teacher provides at least 80 % support and educational assistants provide support 100% of each day. In consultation with Health Branch of Citizenship and Immigration Canada, I have determined that the following social services will be required: The expected cost for special education support for this child will likely be $20,000 – $25,000 over one year. This amount exceeds the average per capita threshold of $6,387.00 annually and therefore would likely exceed the average Canadian per capita health services and social services costs over a period of five consecutive years. A detailed list of healthcare services required, cost implications as well as sources used to determine these costs are included in Appendix I.


Based upon my review of the results of this applicant's immigration medical examination and all the reports I have received with respect to the applicant's educational needs, I conclude that this applicant is inadmissible under Section 38(1)(c) of the Immigration and Refugee Protection Act which states that "A foreign national is inadmissible on health grounds if their health condition might reasonably be expected to cause excessive demand on health or social services." Citizenship and Immigration Canada Medical Officer Appendix I: Expected Costs of Services Details of Services: Special education support Cost: The average cost of subsidization for special education in Canada ranges between $20,000 – $25,000/year Source: http://www.edu.gov.on.ca/eng/literacynumeracy/inspire/research/Bennett.pdf (p. 2) Date Accessed: Dec 02, 2015 TOTAL COST OF ALL LISTED SERVICES: $20,000 – $25,000/year before I make a final decision, you have the opportunity to submit additional information that addresses any or all of the following: • • •

the medical condition(s) identified; social services required in Canada for the period indicated above; and your individualized plan to ensure that no excessive demand will be imposed on Canadian social services for the entire period indicated above and your signed Declaration of Ability and Intent.

You must provide any additional information by February 14, 2016. If you choose not to respond, I will make my decision based on the information before me, which may result in your application being refused. In order to demonstrate that your family member will not place an excessive demand on social services if permitted to immigrate to Canada, you must establish to the satisfaction of the assessing officer that you have a reasonable and workable plan, along with the financial means and intent to implement this plan, in order to offset the excessive demand that you would otherwise impose on social services, after immigrating to Canada. The sections of the Immigration and Refugee Protection Regulations that define the meanings of “social services” and “excessive demand” are included for your reference. Please ensure that you quote the file number indicated at the top of this letter on any information you submit.

Sincerely, D0877 Encl.


Regulatory Definitions Related to Excessive Demand Immigration and Refugee Protection Regulations 1(1)

Règlements sur l’immigration et la protection des réfugiés 1(1)

“Excessive demand” means (a) a demand on health services or social services for which the anticipated costs would likely exceed average Canadian per capita health services and social services costs over a period of five consecutive years immediately following the medical examination, unless there is evidence that significant costs are likely to be incurred beyond that period, in which case the period is no more than 10 consecutive years; or

« fardeau excessif » Se dit : a) de toute charge pour les services sociaux ou les services de santé dont le coût prévisible dépasse la moyenne, par habitant au Canada, des dépenses pour les services de santé et pour les services sociaux sur une période de 5 années consécutives suivant la plus récente visite médicale exigée par le présent règlement ou, s’il y a lieu de croire que des dépenses importantes devront probablement être faites après cette période, sur une période d’au plus dix années consécutives;

(b) a demand on health services or social services that would add to existing waiting lists and would increase the rate of mortality and morbidity in Canada as a result of the denial of or delay in the provision of those services to Canadian citizens or permanent residents.

b) de toute charge pour les services sociaux ou les services de santé qui viendrait allonger les listes d’attente actuelles et qui augmenterait le taux de mortalité et de morbidité au Canada vu l’impossibilité d’offrir en temps voulu ces services aux citoyens canadiens ou aux résidents permanents.

“health services” means any health services for which the majority of the funds are contributed by governments, including the services of family physicians, medical specialists, nurses, chiropractors and physiotherapists, laboratory services and the supply of pharmaceutical or hospital care.

« services de santé » Les services de santé dont la majeure partie sont financés par l’État, notamment les services des généralistes, des spécialistes, des infirmiers, des chiropraticiens et des physiothérapeutes, les services de laboratoires, la fourniture de médicaments et la prestation de soins hospitaliers.

“social services” means any social service, such as home care, specialized residence and residential services, special education services, social and vocational rehabilitation services, personal support services and the provision of devices related to those services,

« services sociaux » Les services sociaux—tels que les services à domicile, les services d’hébergement et services en résidence spécialisés, les services d’éducation spécialisés, les services de réadaptation sociale et professionnelle, les services de soutien personnel, ainsi que la fourniture des appareils liés à ces services :

(a) that is intended to assist a person in functioning physically, emotionally, socially, psychologically or vocationally; and

a) qui, d'une part, sont destinés à aider la personne sur les plans physique, émotif, social, psychologique ou professionnel;

(b) for which the majority of the funding, including funding that provides direct or indirect financial support to an assisted person, is contributed by governments, either directly or through publicly-funded agencies.

b) dont, d'autre part, la majeure partie sont financés par l'État directement ou par l’intermédiaire d’organismes qu'il finance, notamment au moyen d'un soutien financier direct ou indirect fourni aux particuliers


Declaration of Ability and Willingness

In relation to my application for permanent residence, I acknowledge being informed that Nicolas Montoya may be inadmissible under section 38(1)(c) of the Immigration and Refugee Protection Act based on the following identified medical condition: Down’s syndrome (759) with Moderate Intellectual Disability. I acknowledge receiving a letter which listed all the social services required in relation to this medical condition. I further understand that this application may be refused, unless I can provide a credible plan to an officer, ensuring that I or my dependant will not impose an excessive demand on Canadian social services. Section 38(1)(c) states: “A foreign national is inadmissible on health grounds if their medical condition … might reasonably be expected to cause excessive demand on health or social services.” I am providing, with this declaration, the details of the plan I intend to use in Canada. I hereby declare that I will assume responsibility for arranging the provision of the required social services in Canada and that I am including a detailed plan of how these social services will be provided, along with appropriate financial documents that represent a true picture of my financial situation over the entire duration of the required services. I hereby declare that I will not hold the federal or provincial/territorial authority responsible for costs associated with the provision of the social services, which I or my family member would require in Canada and which would otherwise create excessive demand on social services in Canada. I am signing this declaration of my own volition, not due to force or the influence of any other person, and I make this declaration conscientiously believing it to be true.

Signature of applicant:_____________________________ City:____________________ Country:_________________ Date:____________________ Sworn before me ____________________________ Commissioner for Oaths (with seal)

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