O. Reg. 562/05: PRESCRIBED POLICY STATEMENTS, Ontario Disability Support Program Act, 1997, S.O. 1997, c. 25, Sched. B
Ontario Disability Support Program Act, 1997
ONTARIO REGULATION 562/05
PRESCRIBED POLICY STATEMENTS
Historical version for the period January 24, 2013 to January 24, 2013.
Last amendment: O. Reg. 23/13.
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:
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 the medical condition referred to in Item 19 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.
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,
(a) the amount set out in Column C of Schedule 1, subject to subsections (4), (5), (6) and (7); or
Note: On January 25, 2013, clause (a) is amended by striking out “subsections (4), (5), (6) and (7)” and substituting “subsections (4), (4.1), (5), (6), (7) and (8)”. (See: O. Reg. 23/13, ss. 1 (1), 3)
(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.
(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. O. Reg. 13/11, s. 2; O. Reg. 425/12, s. 1 (1).
Note: On January 25, 2013, section 2 is amended by adding the following subsection: (See: O. Reg. 23/13, ss. 1 (2), 3)
(4.1) If a member of the recipient’s benefit unit has the medical condition referred to in Item 3.1 (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).
(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 Item 4 (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.
(6) If a member of the recipient’s benefit unit has the medical conditions referred to in Item 12 (Food Allergy — Milk/Dairy) and Item 13 (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 12 (Food Allergy — Milk/Dairy). O. Reg. 13/11, s. 2.
(7) If a member of the recipient’s benefit unit has the medical conditions referred to in Item 14 (Food Allergy — Wheat) and Item 3 (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.
(8) If a member of the recipient’s benefit unit has the medical conditions in Item 25.3 (Renal Failure), causing weight loss, and Item 26 (Renal Failure – Pre-Dialysis (GFR < 30)) or 27 (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 25.3 (Renal Failure). O. Reg. 425/12, s. 1 (2).
Note: On January 25, 2013, subsection (8) is amended by striking out “Item 25.3 (Renal Failure)” and substituting “Item 25.3 (Renal Failure (GFR < 30))”. (See: O. Reg. 23/13, ss. 1 (3), 3)
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.
4. Revoked: O. Reg. 13/11, s. 4.
5. Revoked: O. Reg. 13/11, s. 5.
SCHEDULE 1
SPECIAL DIETS
Item |
Column A |
Column B |
Column C |
Medical Conditions that Require a Special Diet |
Medical Conditions that may Cause Weight Loss |
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. |
Celiac Disease |
$97, subject to subsection 2 (7) | |
4. |
Chronic wounds or burns requiring protein |
||
Stages 1 and 2 chronic wounds Burns 1 - 10% body surface area |
$88, subject to subsection 2 (5) | ||
Stages 3 and 4 chronic wounds Burns > 10% body surface area |
$191, subject to subsection 2 (5) | ||
5. |
Cirrhosis Stages 3 and 4 |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
6. |
Congestive Heart Failure |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
7. |
Crohn’s Disease |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
8. |
Cystic Fibrosis |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
9. |
Diabetes |
$81, subject to subsection 2 (4) | |
10. |
Dysphagia, requiring thickened fluids |
$125 | |
11. |
Extreme Obesity: Class III BMI > 40 |
$51, subject to subsection 2 (4) | |
12. |
Food Allergy — Milk/Dairy |
||
1 to 8 years of age |
$32 | ||
9 to 18 years of age |
$63 | ||
19 to 50 years of age |
$32 | ||
51 years of age or older |
$47 | ||
13. |
Food Allergy — Lactose Intolerance |
||
1 to 8 years of age |
$30, subject to subsection 2 (6) | ||
9 to 18 years of age |
$59, subject to subsection 2 (6) | ||
19 to 50 years of age |
$30, subject to subsection 2 (6) | ||
51 years of age or older |
$45, subject to subsection 2 (6) | ||
14. |
Food Allergy — Wheat |
$97, subject to subsection 2 (7) | |
15. |
Gestational Diabetes |
$102, subject to subsection 2 (4) | |
16. |
HIV/AIDS |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
16.1 |
Huntington Disease |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
17. |
Hyperlipidemia or Hypercholesterolemia |
$51, subject to subsection 2 (4) | |
18. |
Hypertension |
$86, subject to subsection 2 (4) | |
19. |
Inadequate lactation to sustain breast-feeding or breast-feeding is contraindicated |
||
Where infant is lactose tolerant |
$145 | ||
Where infant is lactose intolerant |
$162 | ||
20. |
Lupus |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
21. |
Malignancy |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
22. |
Multiple Sclerosis |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
22.1 |
Muscular Dystrophy |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
23. |
Osteoporosis |
$38 | |
24. |
Ostomies [e.g., jejunostomy, ileostomy] |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
25. |
Pancreatic Insufficiency |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
25.1 |
Parkinson Disease |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
25.2 |
Prader-Willi Syndrome |
$200, subject to subsection 2 (4) | |
25.3 |
Renal Failure |
yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
26. |
Renal Failure — Pre-Dialysis (GFR <30) |
$52, subject to subsection 2 (8) | |
27. |
Renal Failure — Peritoneal/Hemodialysis |
$88, subject to subsection 2 (8) | |
28. |
Short Bowel Syndrome |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
29. |
Ulcerative Colitis |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |
O. Reg. 13/11, s. 6; O. Reg. 351/11, s. 2; O. Reg. 9/12, s. 2; O. Reg. 425/12, s. 2.
Note: On January 25, 2013, Schedule 1 is amended by adding the following item: (See: O. Reg. 23/13, ss. 2 (1), 3)
3.1 |
Chronic Hepatitis C (BMI < 25) |
$88, subject to subsection 2 (4.1) |
Note: On January 25, 2013, Item 25.3 is revoked and the following substituted: (See: O. Reg. 23/13, ss. 2 (2), 3)
25.3 |
Renal Failure (GFR < 30) |
Yes |
$191 or such higher amount as may be permitted in accordance with subsection 2 (2) |