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Expected to Work/Barriers to Full Employment Policy & Procedures

Published Date: December 03, 2020
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08 Supplementary Benefits

Special Diets

AUTHORITY

Income and Employment Supports Act, Schedule, section 10
Income Support, Training and Health Benefits Regulation, Schedule 4, section 21
Ministerial Order 2018-19 Appendix D: Schedule 4 - Supplementary Income Support Rates


INTENT

To describe the special diet benefits that may be provided to eligible household units to assist with the additional special diet costs required for specific medical reasons.

POLICY

Individuals who require a special diet for health reasons are provided an allowance to cover the difference between the regulated food rate and the additional cost of the food required for a special diet.

The rates in the table below have been set by the Minister. Rates for special diets are not subject to appeal to an Income and Employment Supports Appeal Panel as they are set by the Minister.

For more information on nutritional requirements of these diets, see Special Diets Helpful Information.

Special Diets

Monthly Rate Per
Adult or Child

Low Sodium

$21.00

Low Cholesterol or Low Fat
  • Low cholesterol or low fat have similar nutritional requirements.
  • Either low cholesterol or low fat is issued, not both.

$21.00

High Fibre

$21.00

High Calcium

$21.00

High Protein

$21.00

Lactose Free
  • Either lactose free or milk free would be issued, not both.

$21.00

Low or High Potassium

$21.00

Baby’s needs – Pregnancy

  • All women who are pregnant or become pregnant must be issued these special diet funds.
  • A woman pregnant with twins is issued two times the pregnancy special diet rate.

$26.00

Baby’s needs – Breast feeding mother (of baby up to 12 months old)

  • Funds must be issued for breastfeeding and/or infant formula.
  • A breastfeeding mother of twins may be issued two times the breastfeeding special diet.
  • In cases where the baby is being breast fed and on infant formula, both special diets should be considered.

$31.00

Baby’s needs – Infant formula

It is recommended that, whenever possible, infant formula is issued as a Health Benefit. Alternatively, infant formula may be issued as a Special Diet.

  • Funds must be issued for infant formula and/or for breastfeeding (Baby’s needs – Breastfeeding mother).
  • Workers should review the continued need for the infant formula benefit when the child is approximately one year old.

Infant formula as a Health Benefit:

  • Several formulas are included on the Interactive Drug Benefit List and are covered benefits on the Health Benefits Card with a prescription by an authorized prescriber.
  • Requests for any other infant formula may be authorized by HBEC
  • Clients eligible for health benefits may access these infant formulas with the Health Benefits Card.

Infant formula as a Special Diet:

  • When infant formula is funded as a special diet, the worker may issue the difference between the food rate ($85.00) and the cost of the formula, up to $205.00/month.
  • Director Approval is required if the cost is over $205.00/month
  • An estimate of the monthly cost from a health care professional (nurse, dietician, nurse practitioner, etc.) is required.

As First Nations clients are not eligible for Health Benefits Cards, they may receive special diet funding to cover the cost of infant formula.

Up to $205.00

High Calorie (over 2,500 calories)

  • If Boost, Ensure or similar high calorie supplements are prescribed, then do not issue funds for a high calorie diet.

$37.00

HIV/AIDS or Hepatitis C

  • These are different medical conditions, but have the same nutritional requirements.
  • Even if a person has both conditions, only one is issued, not both.

$37.00

Diabetic or Heart Healthy

  • Diabetic and heart healthy are different medical conditions, but have the same nutritional requirements.  Therefore either diabetic or heart healthy is issued, not both.
  • This diet also contains the nutritional elements covered in low cholesterol, low fat, and low sodium diets. Those diet amounts are not to be duplicated either.

$41.00

Milk Free

  • Either milk free or lactose free would be issued, not both.

$52.00

Celiac/Gluten Free

$82.00

Renal Failure/Insufficiency

  • Contains the nutritional elements covered in high calorie, high protein, low sodium, low potassium, low phosphorous, low fat, diabetic and heart healthy. Those diet amounts are not to be duplicated.

$113.00

 

If a client requests a special diet not on the list, the worker may issue $21.00 pending approval by the Executive Director, Income and Employment Branch. If an individual requires more than one special diet the rates for both diets are issued, except in the circumstances noted above.

Note

If the dietary need for the identified medical condition is addressed by a listed special diet benefit the rate is as listed in the above chart, a non-listed special diet would not be considered.

Nutritional Products and Supplements
The special diet allowance is intended for the purchase of food items. Many nutritional products such as Boost or Ensure, vitamins or special non-food products such as Thicken Up, are listed on the Interactive Drug Benefit List and can be provided through the Health Benefits Card (HBC). Products not listed must be authorized by the Health Benefits Exception Committee.

First Nations Clients Accessing Nutritional Supplements
The Government of Canada’s Non-Insured Health Benefits (NIHB) program provides health benefits to eligible First Nations and Inuit individuals. These individuals would typically not be eligible to receive Health Benefits through IS.

The NIHB program does not provide coverage for nutritional supplements.

A benefit may be provided at the actual cost of the nutritional supplement so that these clients may access nutritional supplements, when a First Nation’s client has written confirmation from a health care professional that they:

  • require nutritional supplements,
  • the number of nutritional supplements required per day, and
  • the duration that the supplements will be required.

Substantiation

For Baby’s Needs - Pregnancy

  • Confirmation from a health care professional or a verbal or written statement from the client.


For Baby’s Needs – Breast-Feeding:

  • Verbal or written confirmation from the client that she is breast-feeding and for how long.


For Baby’s Formula – Infant Formula

  • Letter from a physician, dietician, or nurse confirming the need and the duration the special diet will be needed.
  • Estimate of the cost.


All other special diets:

  • A letter from a physician, dietician or registered nurse explaining the medical condition, the type of diet required, and the duration that the special diet will be needed.
  • The worker may request additional documentation if the worker deems it necessary.
  • If documentation exists on file to show a recipient has a specific health condition listed in the table, further substantiation is not needed (e.g. Hepatitis C or HIV).
  • If it is clearly understood from the available documentation that a condition is permanent, confirmation of the duration of the diet is not needed (e.g. Diabetes).
  • Some special diets have additional substantiation requirements. These include:
    • Lactose Free – Test results confirming lactose intolerance are required.
    • Milk Free – Test results confirming casein allergy are required.
    • Celiac or Gluten Free – Test results confirming Gluten intolerance are required.


PROCEDURES

Need Code
1701
Special Diet

When the need for a special diet has been established, the worker:

  • Issues the table rate for one or more diets.
  • Records in Mobius Notes:
    • Type of special diet (e.g. low cholesterol)
    • Related medical condition (e.g. heart condition)
    • Length of time the special diet is likely to be required
  • Establishes the time period for confirmation of continuing need if the medical condition is not permanent. Enters a Task in Mobius if applicable.

 

Workers do not issue funds as a Special Diet for nutritional products or vitamins. When a request is received for Special Diet funds for a nutritional product or vitamins see the Prescription/Non-Prescription Drugs and Nutritional Products policy.

NOTE:

Requests for nutritional supplements made by First Nations clients covered by NIHB follow the standard procedure for special diet benefits.