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Ontario Disability Support Program Act, 1997

ONTARIO REGULATION 562/05

Prescribed Policy Statements

Consolidation Period:  From April 20, 2018 to the e-Laws currency date.

Last amendment: 276/18.

Legislative History: 471/06, 487/06, 1/09, 13/11, 351/11, 9/12, 425/12, 23/13, 223/14, 276/18.

This is the English version of a bilingual regulation.

Medical conditions re: special diets

1. (1) For the purposes of paragraph 4 of subsection 30 (1) and paragraph 4 of subsection 33 (1) of Ontario Regulation 222/98 (General) made under the Act, the following is the policy for interpreting and applying those provisions:

Note: On September 1, 2018, subsection 1 (1) of the Regulation is amended by striking out “and paragraph 4 of subsection 33 (1)” in the portion before paragraph 1. (See: O. Reg. 276/18, s. 1 (1))

Note: On November 1, 2018, subsection 1 (1) of the Regulation is amended by adding “and subparagraph 3 ii of subsection 32 (1)” after “paragraph 4 of subsection 30 (1)” in the portion before paragraph 1. (See: O. Reg. 276/18, s. 1 (2))

1. The only medical conditions requiring special diets are those set out in Column A of Schedule 1, subject to subsections (2) and (3).

2. The amount to be included in a recipient’s budgetary requirements if a member of the recipient’s benefit unit has a medical condition requiring a special diet shall be determined in accordance with section 2.  O. Reg. 471/06, s. 1; O. Reg. 351/11, s. 1.

(2) If a member of a recipient’s benefit unit has gestational diabetes, the Director shall include in the recipient’s budgetary requirements the amount for that condition determined in accordance with section 2 for the remainder of the member’s pregnancy and for a period of up to three months after the end of the pregnancy.  O. Reg. 13/11, s. 1 (1).

(3) If a member of a recipient’s benefit unit has a medical condition referred to in item 30 or 31 of Schedule 1 relating to breastfeeding infants, the Director shall not include the special diet allowance for that condition in the recipient’s budgetary requirements after the first birthday of the infant in question.  O. Reg. 13/11, s. 1 (2); O. Reg. 351/11, s. 1; O. Reg. 276/18, s. 1 (3).

Budgetary requirements re: special diets

2. (1) For the purposes of subparagraph 4 i of subsection 30 (1) and subparagraph 4 i of subsection 33 (1) of Ontario Regulation 222/98 (General) made under the Act, the amount determined in accordance with Schedule 1 that the Director shall include in the recipient’s budgetary requirements shall be, for each medical condition requiring a special diet that a member of the recipient’s benefit unit has,

Note: On September 1, 2018, subsection 2 (1) of the Regulation is amended by striking out “and subparagraph 4 i of subsection 33 (1)” in the portion before clause (a). (See: O. Reg. 276/18, s. 2 (1))

Note: On November 1, 2018, subsection 2 (1) of the Regulation is amended by adding “and sub-subparagraph 3 ii A of subsection 32 (1)” after “subparagraph 4 i of subsection 30 (1)” in the portion before clause (a). (See: O. Reg. 276/18, s. 2 (2))

(a) the amount set out in Column C of Schedule 1, subject to subsections (4) to (9); or

(b) if Column B of Schedule 1 indicates that the medical condition is a condition that may cause weight loss, the amount determined in accordance with subsections (2) and (3).  O. Reg. 13/11, s. 2; O. Reg. 351/11, s. 1; O. Reg. 23/13, s. 1 (1); O. Reg. 223/14, s. 1 (1).

(2) If a member of a recipient’s benefit unit has a medical condition that may cause weight loss, as indicated in Column B of Schedule 1, the amount that shall be included in the recipient’s budgetary requirements shall be, subject to subsection (3),

(a) if the member has lost more than 5 per cent but no more than 10 per cent of his or her usual body weight, the amount set out in Column C of Schedule 1; or

(b) if the member has lost more than 10 per cent of his or her usual body weight, $242.  O. Reg. 13/11, s. 2.

(3) If a member of a recipient’s benefit unit has more than one medical condition that may cause weight loss, as indicated in Column B of Schedule 1, the amount to be included in the recipient’s budgetary requirements shall be determined as if the member only had one such condition.  O. Reg. 13/11, s. 2.

(4) If a member of the recipient’s benefit unit has more than one of the following medical conditions, the amount to be included in the recipient’s budgetary requirements shall be determined as if the member only had the one condition that has the highest monthly amount as indicated in Column C of Schedule 1:

1. Diabetes.

2. Gestational Diabetes.

3. Hypercholesterolemia or Hyperlipidemia.

4. Hypertension.

5. Extreme Obesity.

6. Prader-Willi Syndrome.

7. Congenital heart defect — Have had Ross procedure or arterial switch procedure or have coexisting coarctation of aorta. O. Reg. 13/11, s. 2; O. Reg. 425/12, s. 1 (1); O. Reg. 223/14, s. 1 (2).

(4.1) If a member of the recipient’s benefit unit has the medical condition referred to in item 5 (Chronic Hepatitis C (BMI < 25)) of Schedule 1 and one or more of the following medical conditions, the amount to be included in the recipient’s budgetary requirements shall be determined as if the member only had the one condition that has the highest monthly amount as indicated in Column C of Schedule 1:

1. Chronic wounds or burns requiring protein.

2. Renal Failure — Pre-Dialysis (GFR < 30).

3. Renal Failure — Peritoneal/Hemodialysis.

4. Any medical condition listed in Schedule 1 that is identified in Column B of the Schedule as a medical condition that may cause weight loss. O. Reg. 23/13, s. 1 (2); O. Reg. 276/18, s. 2 (3).

(4.2) If a member of the recipient’s benefit unit has the medical condition referred to in item 6 (Chronic Hepatitis C (BMI < 25) with interferon treatment) of Schedule 1 and one or more of the following medical conditions, the amount to be included in the recipient’s budgetary requirements shall be determined as if the member only had the one condition that has the highest monthly amount as indicated in Column C of Schedule 1:

1. Chronic Hepatitis C (BMI < 25).

2. Chronic wounds or burns requiring protein.

3. Renal Failure — Pre-Dialysis (GFR < 30).

4. Renal Failure — Peritoneal/Hemodialysis. O. Reg. 223/14, s. 1 (3); O. Reg. 276/18, s. 2 (4).

(5) If a member of the recipient’s benefit unit has both Stages 1 and 2 and Stages 3 and 4 chronic wounds referred to in items 7 and 8 (Chronic wounds or burns requiring protein) of Schedule 1, the amount to be included in the recipient’s budgetary requirements shall be $191.  O. Reg. 9/12, s. 1; O. Reg. 276/18, s. 2 (5).

(6) If a member of the recipient’s benefit unit has a medical condition referred to in item 16, 17, 18 or 19 (Food Allergy — Milk/Dairy) of Schedule 1 and a medical condition referred to in item 20, 21, 22 or 23 (Food Allergy — Lactose Intolerance) of Schedule 1, the amount to be included in the recipient’s budgetary requirements shall be the amount the member is entitled to receive for item 16, 17, 18 or 19 (Food Allergy — Milk/Dairy). O. Reg. 276/18, s. 2 (6).

(7) If a member of the recipient’s benefit unit has the medical conditions referred to in item 24 (Food Allergy — Wheat) and item 4 (Celiac Disease) of Schedule 1, the amount to be included in the recipient’s budgetary requirements shall be $97.  O. Reg. 13/11, s. 2; O. Reg. 276/18, s. 2 (7).

(8) If a member of the recipient’s benefit unit has the medical conditions in item 41 (Renal Failure (GFR < 30)), causing weight loss, and item 42 (Renal Failure – Pre-Dialysis (GFR < 30)) or 43 (Renal Failure – Peritoneal/Hemodialysis) of Schedule 1, the amount to be included in the recipient’s budgetary requirements shall be the amount the member is entitled to receive for item 41 (Renal Failure (GFR < 30)). O. Reg. 276/18, s. 2 (8).

(9) If a member of the recipient’s benefit unit has the medical condition referred to in item 44 (Rett Syndrome (BMI < 18.5)) of Schedule 1 and one or more of the following medical conditions, the amount to be included in the recipient’s budgetary requirements shall be determined as if the member only had the one condition that has the highest monthly amount as indicated in Column C of Schedule 1:

1. Chronic Hepatitis C (BMI < 25).

2. Chronic wounds or burns requiring protein.

3. Renal Failure — Pre-Dialysis (GFR < 30).

4. Renal Failure — Peritoneal/Hemodialysis.

5. Any medical condition listed in Schedule 1 that is identified in Column B of the Schedule as a medical condition that may cause weight loss. O. Reg. 223/14, s. 1 (3); O. Reg. 276/18, s. 2 (9).

More than one medical condition

3. (1) Despite section 2, if a member of a recipient’s benefit unit has more than one medical condition that requires a special diet, the maximum amount that may be included in the recipient’s budgetary requirements with respect to all the medical conditions that the member has is $250.  O. Reg. 13/11, s. 3; O. Reg. 351/11, s. 1.

(2) Subsection (1) does not apply with respect to a member of a benefit unit to whom subsections 30 (3) and (4) or subsections 33 (2) and (3) of Ontario Regulation 222/98 (General) made under the Act apply.  O. Reg. 471/06, s. 1.

Note: On September 1, 2018, subsection 3 (2) of the Regulation is amended by striking out “or subsections 33 (2) and (3)”. (See: O. Reg. 276/18, s. 3)

4. Revoked:  O. Reg. 13/11, s. 4.

5. Revoked:  O. Reg. 13/11, s. 5.

SCHEDULE 1
SPECIAL DIETS

Item

Column A
Medical Conditions that Require a Special Diet

Column B
Whether Medical Condition may Cause Weight Loss

Column C
Monthly Amount for Special Diet Unless Otherwise Specified

1.

Amyotrophic Lateral Sclerosis

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

2.

Anorexia Nervosa

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

3

Congenital heart defect — Have had Ross procedure or arterial switch procedure or have coexisting coarctation of aorta

No

$86, subject to subsection 2 (4)

4.

Celiac Disease

No

$97, subject to subsection 2 (7)

5.

Chronic Hepatitis C (BMI < 25)

No

$88, subject to subsection 2 (4.1)

6.

Chronic Hepatitis C (BMI < 25) with interferon treatment

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2) and subject to subsection 2 (4.2)

7.

Chronic wounds or burns requiring protein — Stages 1 and 2 chronic wounds
Burns 1 - 10% body surface area

No

$88, subject to subsection 2 (5)

8.

Chronic wounds or burns requiring protein — Stages 3 and 4 chronic wounds
Burns > 10% body surface area

No

$191, subject to subsection 2 (5)

9.

Cirrhosis Stages 3 and 4

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

10.

Congestive Heart Failure

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

11.

Crohn’s Disease

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

12.

Cystic Fibrosis

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

13.

Diabetes

No

$81, subject to subsection 2 (4)

14.

Dysphagia, requiring thickened fluids

No

$125

15.

Extreme Obesity: Class III BMI > 40

No

$51, subject to subsection 2 (4)

16.

Food Allergy — Milk/Dairy — 1 to 8 years of age

No

$32

17.

Food Allergy — Milk/Dairy — 9 to 18 years of age

No

$63

18.

Food Allergy — Milk/Dairy — 19 to 50 years of age

No

$32

19.

Food Allergy — Milk/Dairy — 51 years of age or older

No

$47

20.

Food Allergy — Lactose Intolerance — 1 to 8 years of age

No

$30, subject to subsection 2 (6)

21.

Food Allergy — Lactose Intolerance — 9 to 18 years of age

No

$59, subject to subsection 2 (6)

22.

Food Allergy — Lactose Intolerance — 19 to 50 years of age

No

$30, subject to subsection 2 (6)

23.

Food Allergy — Lactose Intolerance — 51 years of age or older

No

$45, subject to subsection 2 (6)

24.

Food Allergy — Wheat

No

$97, subject to subsection 2 (7)

25.

Gestational Diabetes

No

$102, subject to subsection 2 (4)

26.

HIV/AIDS

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

27.

Huntington Disease

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

28.

Hyperlipidemia or Hypercholesterolemia

No

$51, subject to subsection 2 (4)

29.

Hypertension

No

$86, subject to subsection 2 (4)

30.

Inadequate lactation to sustain breast-feeding or breast-feeding is contraindicated — Where infant is lactose tolerant

No

$145

31.

Inadequate lactation to sustain breast-feeding or breast-feeding is contraindicated — Where infant is lactose intolerant

No

$162

32.

Lupus

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

33.

Malignancy

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

34.

Multiple Sclerosis

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

35.

Muscular Dystrophy

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

36.

Osteoporosis

No

$38

37.

Ostomies [e.g., jejunostomy, ileostomy]

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

38.

Pancreatic Insufficiency

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

39.

Parkinson Disease

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

40.

Prader-Willi Syndrome

No

$200, subject to subsection 2 (4)

41.

Renal Failure (GFR < 30)

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

42.

Renal Failure — Pre-Dialysis (GFR <30)

No

$52, subject to subsection 2 (8)

43.

Renal Failure — Peritoneal/Hemodialysis

No

$88, subject to subsection 2 (8)

44.

Rett Syndrome (BMI < 18.5)

No

$88, subject to subsection 2 (9)

45.

Short Bowel Syndrome

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

46.

Ulcerative Colitis

Yes

$191 or such higher amount as may be permitted in accordance with subsection 2 (2)

O. Reg. 276/18, s. 4.

 

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