8.3 — Special items for residents in chronic care
June 2012
Summary of Legislation
Special Items and services are available for recipients who reside in specific hospitals or health facilities that provide insured services to chronic care patients.
Legislative Authority
Sections 32 (1)(f); 44 (1)1.iv. of the Ontario Disability Support Program (ODSP) RegulationSummary of Directive
The cost of special Items and services (i.e. dental services, dentures, and prosthetic devices including eyeglasses, clothing, wheelchairs, and wheelchair accessories) are covered for recipients who reside a place designated under the regulations under the Health Insurance Act as a hospital or a health facility for the provision of insured services to chronically ill patients and that is a hospital for chronically ill patients, a chronic care hospital or a chronic unit attached to a general or convalescent hospital.
Intent of Policy
To provide for the payment of additional costs associated with special items and services for recipients who reside in chronic care institutions.
Application of Policy
The following special items and services may be provided to recipients in chronic care hospitals:
| Dental Services | The normal services provided by a qualified dentist or dental surgeon that are not covered under the Health Insurance Act including any necessary repairs to dentures. |
| Dentures | The provision and replacement of full or partial plates, crowns, etc. |
| Prosthetic devices including eye glasses | The provision, replacement and cost of repairs to any necessary type of prosthesis. |
| Wheelchairs and accessories | The provision of wheelchairs and accessories such as batteries, cushions and repairs. |
| Clothing | Self-explanatory. |
Assistive Devices Program (ADP)
The Ministry of Health and Long-Term Care (MOHLTC) Assistive Devices
Program (ADP) provides consumer centred support and funding to Ontario
residents who have long-term physical disabilities and to provide access to
personalized assistive devices appropriate for the individual’s basic needs.
Devices covered by the program are intended to enable people with physical
disabilities to increase their independence through access to assistive devices
responsive to their individual needs. For a list of the current items covered by ADP, see MOHLTC website at
http://www.health.gov.on.ca/en/public/programs/adp/default.aspx.
Eligibility includes any Ontario resident who has a valid Ontario Health card issued in his/her name and has a physical disability of six months or longer. There are specific eligibility criteria which apply to each device category.
ODSP recipients who reside in a chronic care hospital or a chronic care wing of a hospital should be referred to ADP when they require any items covered by ADP. ODSP covers:
- the consumer contribution for an assistive device funded by ADP up to the amount approved under that program
- the cost of the consumer contribution for annual lease payments for ADP approved high technology communication devices to the amount approved by that program; and
- the cost of an assessment for an assistive device under ADP if there is no other source of funding for the assessment
It is not necessary for a recipient residing in a chronic care hospital to obtain prior approval from ODSP for the purchase of these items supplied through ADP.