The Assured Income for the Severely Handicapped (AISH) is the legal name of a social welfare program and service offered only in Alberta, Canada, to nearly 46,000 Albertans. The AISH Act legislation, proclaimed on May 1, 2007, and updated as of November 1, 2010, defines a "severe handicap" as "adult Albertans with a permanent disability that severely impairs their ability to earn a living." The legal definition in the legislation defines "severe handicap" as an impairment of mental or physical functioning or both that, in the AISH director's findings, causes substantial limitation in the person's ability to earn a livelihood. Also, he/she is likely to continue to be affected permanently because no remedial therapy is available that would materially improve the person's ability to earn a regular livelihood. The final decision on a client's file status is made by the AISH director, after receiving any relevant medical or psychological reports from a qualified health professional(s).