O. Reg. 562/05: PRESCRIBED POLICY STATEMENTS

Ontario Disability Support Program Act, 1997

ONTARIO REGULATION 562/05

PRESCRIBED POLICY STATEMENTS

Historical version for the period January 27, 2011 to March 31, 2011.

Last amendment: O. Reg. 13/11.

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.

(2) If an approved health professional confirms that 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. 471/06, s. 1.

Note: On April 1, 2011, subsection (2) is revoked and the following substituted:

(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).

See: O. Reg. 13/11, ss. 1 (1), 7.

(3) If an approved health professional confirms that a member of a recipient’s benefit unit has the medical condition referred to in item 27 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. 471/06, s. 1.

Note: On April 1, 2011, subsection (3) is revoked and the following substituted:

(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).

See: O. Reg. 13/11, ss. 1 (2), 7.

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, as confirmed by an approved health professional,

(a) the amount set out in Column C of Schedule 1; 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), (3), (4) and (5). O. Reg. 471/06, 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 subsections (3), (4) and (5),

(a) if the approved health professional confirms that the member has not lost any weight or has lost 2 per cent or less of his or her usual body weight, the amount set out in Column C of Schedule 1;

(b) if the approved health professional confirms that the member has lost more than 2 per cent but no more than 5 per cent of his or her usual body weight, $150;

(c) if the approved health professional confirms that the member has lost more than 5 per cent but no more than 10 per cent of his or her usual body weight, $180; or

(d) if the approved health professional confirms that the member has lost more than 10 per cent of his or her usual body weight, $240. O. Reg. 471/06, s. 1.

(3) If the medical condition that may cause weight loss is one of the following conditions, the amount that shall be included in a recipient’s budgetary requirements is the amount determined in accordance with subsection (4):

1. Anorexia nervosa.

2. Cystic fibrosis.

3. Kwashiorkor.

4. Marasmus. O. Reg. 471/06, s. 1.

(4) The amount to be included in a recipient’s budgetary requirements if a member of a recipient’s benefit unit has a medical condition referred to in subsection (3) shall be,

(a) if the approved health professional confirms that the member has not lost any weight or has lost 2 per cent or less of his or her usual body weight, the amount set out in Column C of Schedule 1; and

(b) if the approved health professional confirms that the member has lost more than 2 per cent of his or her usual body weight, $150. O. Reg. 471/06, s. 1.

(5) If an approved health professional confirms that 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. 471/06, s. 1.

(6) If an approved health professional confirms that a member of a recipient’s benefit unit has a medical condition referred to in item 14 of Schedule 1, the Director shall include in the recipient’s budgetary requirements for the first month after the confirmation is received an amount of $75 to compensate for the cost of purchasing a blender, in addition to the monthly amount set out in Column C of Schedule 1. O. Reg. 471/06, s. 1.

Note: On April 1, 2011, section 2 is revoked and the following substituted:

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

(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.

(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. O. Reg. 13/11, s. 2.

(5) If a member of the recipient’s benefit unit has both Stages 1 and 2 and Stages 3 and 4 referred to in Item 4 (Chronic wounds requiring protein) of Schedule 1, the amount to be included in the recipient’s budgetary requirements shall be $191. O. Reg. 13/11, s. 2.

(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.

See: O. Reg. 13/11, ss. 2, 7.

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, as confirmed by an approved health professional, 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. 471/06, s. 1.

Note: On April 1, 2011, subsection (1) is revoked and the following substituted:

More than one medical condition

(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.

See: O. Reg. 13/11, ss. 3, 7.

(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.

Definition

4. In this Regulation,

“approved health professional” means a person who is an approved health professional under subsection 2 (4) of Ontario Regulation 222/98 (General) made under the Act. O. Reg. 471/06, s. 1.

Note: On April 1, 2011, section 4 is revoked. See: O. Reg. 13/11, ss. 4, 7.

Transition: amyotrophic lateral sclerosis

5. (1) If, in determining the amount of income support paid or payable to a recipient for the period between September 1, 2006 and the day section 2 of Ontario Regulation 487/06 comes into force, an amount is or was required to be included in the recipient’s budgetary requirements for a special diet required for a member of the recipient’s benefit unit who has a medical condition known as amyotrophic lateral sclerosis, the Director shall adjust the amount of income support paid or payable in accordance with subsection (2). O. Reg. 487/06, s. 1.

(2) The amount of an adjustment under subsection (1) shall be the difference between the amount to be included in the recipient’s budgetary requirements for the special diet referred to in subsection (1) based on Schedule 1 as it read before the day section 2 of Ontario Regulation 487/06 comes into force and the amount to be included for the special diet based on Schedule 1 as it reads after that day. O. Reg. 487/06, s. 1.

(3) The Director shall pay the amount of the adjustment as soon as practicable. O. Reg. 487/06, s. 1.

Note: On April 1, 2011, section 5 is revoked. See: O. Reg. 13/11, ss. 5, 7.

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	$75 or such higher amount as may be permitted in accordance with subsection 2 (2)
2.	Anorexia Nervosa	Yes	$75 or such higher amount as may be permitted in accordance with subsection 2 (4)
3.	Cardiovascular Disease		$10
4.	Celiac Disease
	less than 2 years of age		$58
	2-10 years of age		$115
	11-18 years of age		$147
	19 years of age or older		$131
5.	Chronic Constipation		$10
6.	Chronic wounds requiring protein		$10
7.	Congenital Abnormalities of the Metabolic Type — Adults		$10
8.	Congenital Abnormalities of the Metabolic Type — Infants & Children		$10
9.	Congestive Heart Failure		$44
10.	Crohn’s Disease	Yes	$75 or such higher amount as may be permitted in accordance with subsection 2 (2)
11.	Cystic Fibrosis	Yes	$75 or such higher amount as may be permitted in accordance with subsection 2 (4)
12.	Diabetes		$42
13.	Diverticulum/Diverticulitis		$10
14.	Dysphagia/Swallowing or Mastication Difficulties		$25 and, when appropriate, the one-time amount referred to in subsection 2 (6)
15.	Extreme Obesity: Class III BMI > 40		$20
16.	Food Allergy — Eggs		$10
17.	Food Allergy — Milk/Dairy or Lactose Intolerance
	less than 2 years of age		$95
	2-10 years of age		$97
	11-18 years of age		$55
	19 years of age or older		$35
18.	Food Allergy — Soya		$83
19.	Food Allergy — Wheat
	less than 2 years of age		$38
	2-10 years of age		$77
	11-18 years of age		$98
	19 years of age or older		$57
20.	Gestational Diabetes		$44
21.	Gout		$32
22.	HIV/AIDS	Yes	$75 or such higher amount as may be permitted in accordance with subsection 2 (2)
23.	Hyperlipidemia		$10
24.	Hypertension		$10
25.	Hypertension and Congestive Heart Failure and Grade 1 to 2 left ventricular function		$44
26.	Hypercholesterolemia		$22
27.	Inadequate lactation to sustain breast-feeding or breast-feeding is contraindicated
	- where infant is lactose tolerant		$75
	- where infant is lactose intolerant		$83
28.	Kwashiorkor	Yes	$75 or such higher amount as may be permitted in accordance with subsection 2 (4)
29.	Liver Failure/Hepatic Disorders		$10
29.1	Lupus	Yes	$75 or such higher amount as may be permitted in accordance with subsection 2 (2)
30.	Macrocytic Anaemia		$10
31.	Malabsorption		$20
32.	Malignancy	Yes	$75 or such higher amount as may be permitted in accordance with subsection 2 (2)
33.	Marasmus	Yes	$75 or such higher amount as may be permitted in accordance with subsection 2 (4)
34.	Microcytic Anaemia		$30
34.1	Multiple Sclerosis	Yes	$75 or such higher amount as may be permitted in accordance with subsection 2 (2)
35.	Osteoporosis/Osteomalacia/Osteopenia		$10
36.	Ostomies [e.g., jejunostomy, ileostomy]	Yes	$75 or such higher amount as may be permitted in accordance with subsection 2 (2)
37.	Pancreatic Insufficiency	Yes	$75 or such higher amount as may be permitted in accordance with subsection 2 (2)
38.	Post-gastric surgery		$10
39.	Prediabetes: Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG)		$42
40.	Renal Failure — Dialysis		$44
41.	Renal Failure — Pre-Dialysis		$44
42.	Short Bowel Syndrome	Yes	$75 or such higher amount as may be permitted in accordance with subsection 2 (2)
43.	Ulcerative Colitis	Yes	$75 or such higher amount as may be permitted in accordance with subsection 2 (2)

O. Reg. 471/06, s. 2; O. Reg. 487/06, s. 2; O. Reg. 1/09, s. 1.

Note: On April 1, 2011, Schedule 1 is revoked and the following substituted:

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 requiring protein
	Stages 1 and 2		$88, subject to subsection 2 (5)
	Stages 3 and 4		$191, subject to subsection 2 (5)
5.	Cirrohsis 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)
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)
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)
26.	Renal Failure — Pre- Dialysis (GFR <30)		$52
27.	Renal Failure — Peritoneal/Hemodialysis		$88
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.

See: O. Reg. 13/11, ss. 6, 7.