The Ontario
Special Diet Allowance

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Ontario
Special Diet Allowance (SDA)

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In a nutshell:

The Special Diet Allowance (SDA) is a cash allowance that's payable for special nutritional requirements in addition to basic social assistance under Ontario's two social assistance programs. The SDA came under fire for perceived abuses in the annual reports of the Auditor General of Ontario for 2004, 2009 and 2011. In March 2010, the Ontario Government announced it would overhaul the SDA (tighter controls, fewer eligible medical conditions) and move the program to the Ministry of Health and Long-Term Care. By November 2010, though, the government changed its mind and announced that it would keep the program in Community and Social Services until the outcome of the Commission to Review Social Assistance (the Lankin-Sheikh Commission) in June of 2012. In February 2012, the Drummond Commission ("Commission on the Reform of Ontario's Public Services") released its report on the austerity measures that the province of Ontario should implement ASAP to control the provincial deficit.

At that time, the SA review commission will make recommendations regarding the SDA as part of its overall recommendations, and the government will take all recommendations into consideration.

The purpose of this page is to present some background about, and a status update on, the Special Diet Allowance as of the date at the top of this page.

Read the information below and submit your views to the Commission about its Discussion Paper #2 (this link takes you further down on the page you're now reading). Note that all comments and submissions must be received by the Commission before March 16, 2012.

Special Diet Allowance : Background

Social assistance in Ontario 101:

Ontario’s social assistance system is made up of two programs: Ontario Works (OW) for people in temporary financial need, and the Ontario Disability Support Program (ODSP), which is intended to help people with disabilities live as independently as possible and to reduce or eliminate disability-related barriers to employment. Together, Ontario Works and ODSP serve approximately 857,000 Ontarians each month. In 2009–10, total provincial expenditures on social assistance were about $6.6 billion, about six per cent of the provincial budget.

Source:
http://www.socialassistancereview.ca/social-assistance-today

The Special Diet Allowance - what is it?

The Special Diet Allowance (SDA) provides for additional assistance to each recipient of ODSP and OW and their families who require a special diet as a result of an approved medical condition. Before such an allowance can be provided, a health care professional—such as a doctor, nurse or dietitian—must complete an official application. A special-diet payment schedule issued by the Ministry is used to determine the amount of the allowance, depending on the medical condition. The amounts generally vary from $10 to $100 per condition per month. However, the total allowance for any one member of a family may not exceed $250 per month.

More information about the SDA from
the OW and ODSP Policy Directives manuals:

Ontario Works Policy Directives --- The Special Diet Allowance
http://www.mcss.gov.on.ca/en/mcss/programs/social/directives/directives/OWDirectives/6_6_OW_Directives.aspx

Ontario Disability Support Program --- The Special Diet Allowance
http://www.mcss.gov.on.ca/en/mcss/programs/social/directives/directives/ODSPDirectives/income_support/6_4_ODSP_ISDirectives.aspx

Ministry responsible for social assistance:
Community and Social Services
http://www.mcss.gov.on.ca/en/mcss/index.aspx

What's the problem with the SDA?

The 2004 Report of the Ontario Auditor General contained
two chapters on social assistance in Ontario, one for each program:

Chapter 3.03 Ontario Disability Support Program (pdf 187kb)
Chapter 4.01 Ontario Works Program (pdf 70kb)
Both chapters deal with issues such as timeliness of the application process, eligibility issues and other admistrative concerns, although neither chapter addresses the Special Diet Allowance issue.

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The 2009 Report of the Ontario Auditor General raised some
serious concerns about potential abuse of the SDA in both OW and ODSP.

OW:
Province-wide, the total spent on special dietary allowances has increased substantially since the time of our last audit. In the 2002/03 fiscal year, annual special dietary payments totalled $5 million; in the 2008/09 fiscal year, the amount exceeded $67 million, a more than 12-fold increase. A significant part of this increase may be due to a campaign by advocacy groups critical of Ontario Works allowance amounts. At least one such organization has organized clinics where health-care professionals have immediately completed special diet allowance applications that entitled each attendee to the maximum $250 monthly supplement.
Recommendation #4 : "... the Ministry should review the special dietary allowance with a view to limiting its possible abuse.
Source:
Chapter 3.09 : Ontario Works Program (PDF - 352K, 23 pages)
http://www.auditor.on.ca/en/reports_en/en09/311en09.pdf
[OW chapter, page 264 ]

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ODSP:
"... province-wide, the total spent on special dietary allowances has increased substantially since the time of our last audit in 2004. At that time, the payments totalled $18.1 million; in the 2008/09 fiscal year, the amount exceeded $104 million, more than a five-and-a-half fold increase. We found that many payments for special dietary allowances to purchase particular foods, which must be authorized by an approved health professional, seemed questionable.
Source:
Chapter 3.11 : Ontario Disability Support Program (PDF 436kb)
http://www.auditor.on.ca/en/reports_en/en09/309en09.pdf
[ ODSP chapter, page 232 ]

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Related comment from the
Income Security Advocacy Centre:

Ontario Auditor General’s Report Underlines Need for Social Assistance Reform
http://goo.gl/ogaOH
December 11, 2009
Whether he meant to or not, the auditor general’s December 7th analysis of OW/ODSP let a dysfunctional social assistance system off the hook, instead laying blame with the people who have nowhere else to turn to for basic support. (...) The auditor general states that "[M]any special dietary allowances were paid under questionable circumstances" and that the total amount spent on the SDA for OW cases has increased to $67 million during 2008/09, up from $5 million in 2002-2003. He does not mention that the increase in program costs were in large part a result of Ministry staff promoting what had been an under-utilized program. Furthermore, what does “questionable” mean in this instance? Innuendo rules the day over facts, debasing a program that provides vital support to people for whom nutritional treatment can mean the difference between managing a health condition or sliding into serious deterioration.

Source:
Income Security Advocacy Centre (ISAC)
http://www.incomesecurity.org/

Ontario Works Program (PDF - 224K, 9 pages)
Follow-up on Section 3.09, 2009 Annual Report
http://www.auditor.on.ca/en/reports_en/en11/411en11.pdf
(...) The changes to the administration of the special dietary allowance, which took effect in April 2011, included the following:
• removing from the list of eligible conditions those that the expert committee found to not require a special dietary allowance;
• revising the application form to require recipients to consent to the release of relevant medical information by their physician to support their application;
• requiring Ontario Works recipients to reapply for the special dietary allowance, which has resulted in a drop of about 14,500 cases receiving the allowance, or a funding impact of about $2.6 million per month
• more...

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Ontario Disability Support Program (PDF - 208K, 9 pages)
Follow-up on Section 3.11, 2009 Annual Report
http://www.auditor.on.ca/en/reports_en/en11/409en11.pdf
(...) In March 2010, the government announced plans to eliminate the special dietary allowance and create a new medically based nutritional supplement program for social assistance recipients with severe medical needs that would be administered by the Ministry of Health and Long-Term Care. However, in November 2010, the government announced that the special dietary allowance would continue, but would be revised to comply with an earlier order of the Human Rights Tribunal of Ontario and to address the recommendations of an expert committee.

Related news release:

Ontario Auditor General’s Report Underlines Need for Social Assistance Reform
http://sareview.ca/news/ontario-auditor-general%E2%80%99s-report-underlines-need-for-social-assistance-reform/
December 11, 2011

What does the Drummond Report have to say about the SDA?

The Drummond Report recommendations about Social Programs:
February 2012
Chapter 8
Social Programs:
http://www.fin.gov.on.ca/en/reformcommission/chapters/ch8.html

* Hold growth in social programs spending to 0.5 per cent per year.
* Move aggressively towards a fully integrated benefits system
* The Commission for the Review of Social Assistance in Ontario should examine system design options that deliver a more efficient and higher-quality service to social assistance recipients. This examination should consider combining Ontario Works and the Ontario Disability Support Program, and having the combined program delivered at the local level.
* Advocate for federal reforms in two key areas:
--- Work with other provinces and the federal government to establish a national income-support program for people with disabilities who are unlikely to re-enter the workforce.
--- Implement the final recommendations of the Mowat Centre Employment Insurance Task Force.
* the maximum level of the Ontario Child Benefit is frozen.
[Click the link above for more, including changes to child and youth mental health services, children’s services, health, education, youth justice, developmental services funding, the non-profit sector, etc.]

Source:
Public Services for Ontarians : A Path to Sustainability and Excellence
Commission on the Reform of Ontario's Public Services
February 2012
By Don Drummond

PDF version (5.6MB, 562 pages)
http://www.fin.gov.on.ca/en/reformcommission/chapters/report.pdf

HTML version
http://www.fin.gov.on.ca/en/reformcommission/index.html

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Two related videos from
TVOntario's Steve Paikin on The Agenda:

Laurel Broten: Tackling Youth Poverty (video interview, duration 15:47)
http://ww3.tvo.org/video/164089/laurel-broten-tackling-youth-poverty
Steve Paikin
February 2011
Ontario's Minister of Children and Youth Services Laurel Broten joins The Agenda for a progress report on the government's plan to reduce child poverty. She highlights the Ontario government's work to date on poverty reduction, and she notes in passing that the special diet issue is part of the ongoing review of social assistance in Ontario.

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The Special Diet : Mary Kelly (video interview, duration 25 min.)
http://ww3.tvo.org/video/163770/web-exclusive-special-diet
Steve Paikin
January 27, 2011
ODSP recipient Mary Kelly and others like her may be on deathwatch after the upcoming Ontario budget. She makes a compelling case, based on her personal situation, why the Ontario government shouldn't cut the Special Diet under the Ontario Disability Support Program (ODSP) and Ontario Works (OW) in its upcoming provincial budget or its social assistance review.

Source:
TVOntario
http://ww3.tvo.org/home

Commission for the Review of Social Assistance in Ontario

The Commission for the Review of Social Assistance in Ontario is examining the social assistance system.
As part of its review, the commission will look at the Special Diet Allowance.

Here's what the February 2012 Discussion Paper (#2) of the Commission for the Review of Social Assistance in Ontario had to say on the subject of special diets:

"The Special Diet Allowance (SDA) is somewhat different from other special benefits. For some people, the SDA is linked to adequacy and fairness. Some have suggested that the dietary needs of people with certain medical conditions could be managed more easily without a special benefit if a more adequate social assistance rate were provided. Others have asked whether it is fair to provide a supplement to support dietary needs related to medical conditions only for people receiving social assistance and not for all low-income Ontarians. We are also aware that, as a separate social assistance benefit, the SDA is not necessarily aligned with the broader provincial health policy frameworks that address the medical needs of all low-income Ontarians. This raises the question of whether it may be appropriate to eliminate the SDA as a special benefit in social assistance and address the dietary needs of all low-income people, including those receiving social assistance, through the programs and policies delivered through the Ministry of Health and Long-term Care."
Source:
Excerpt from p. 34 of Discussion Paper #2

Discussion Paper 2 : Approaches for Reform (PDF - 1.2MB, 77 pages) February 2012 http://goo.gl/RyvnX Source: Commission for the Review of Social Assistance in Ontario

NOTE: This paper provides opportunities for further discussion, as opposed to final recommendations.
The Commission would like to receive your input by Friday, March 16, 2012.
The Commission’s Final Report is due to the government in June 2012.

NOTE: See page 35 of the above discussion paper for five discussion questions on the issue of the Special Diet if you wish to submit your views to the Commission.

"We'd like to hear from you."
http://www.socialassistancereview.ca/wed-like-to-hear-from-you

Join the discussion by providing your feedback.
You can do this by:

* Making a short comment
http://www.socialassistancereview.ca/make-a-comment-english?language=en_CA&

* Filling out the online Workbook
http://www.socialassistancereview.ca/workbook

* Sending in a submission by regular mail
http://www.socialassistancereview.ca/send-a-submission

The following is an excerpt about the Special Diet Allowance from a summary of the input received earlier by the Commission through written submissions (workbooks, short comments, longer submissions), community conversations, stakeholder meetings and discussions with First Nations:

"Many people commented on the Special Diet Allowance (SDA). Recommended changes included returning the SDA to its previous rules, raising the amount of the benefit, and paying eligible recipients a flat rate to simplify administration. Some argued that the SDA should be delivered through the health system, not social assistance, to all low-income people who require medically prescribed special diets."

Source:
Excerpt from page 27 of:
What We Heard: A Summary
of Discussions on Social Assistance (PDF - 696K, 44 pages)
February 2012
http://goo.gl/uwKUU

150+ Submissions to the
Commission for the Review of Social Assistance in Ontario
(mostly August/September 2011)
http://www.socialassistancereview.ca/written-submissions

From the
Ministry of Community and Social Services:
http://www.ontario.ca/community

Changes to the Special Diet Allowance Program : Bulletin
http://www.mcss.gov.on.ca/en/mcss/programs/social/sda_bulletin_january.aspx
January 31, 2012
Effective January 30, 2012, Ontario will modify the Special Diet Allowance program to include people who have lost significant weight because of the following three medical conditions:
* Muscular Dystrophy
* Huntington Disease
* Parkinson Disease

NOTE : This change to the SDA is the result of a ruling from the Human Rights Tribunal of Ontario in the case of Brandon McCarthy, muscular dystrophy sufferer from Ottawa, not a sudden burst of generosity by the Ontario Government.
(Ottawa Citizen article, February 16, 2012 --- http://goo.gl/XkMOQ ]

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Special Diet Allowance Changes
The Special Diet Allowance helps social assistance recipients who have eligible medical conditions receive the special diets they need to help manage their conditions. The Special Diet Allowance will change on April 1, 2011 to make the program more accountable and comply with a Human Rights Tribunal of Ontario decision. The Special Diet Allowance is one of the many social assistance benefits that will be considered in the context of Ontario’s social assistance review.

* How to apply for the revised Special Diet Allowance
* List of eligible medical conditions

* April 2008 Special Diets Expert Review Committee final report (PDF - 3.1MB, 79 pages)

The Special Diet Allowance: Additional resources

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From the
Income Security Advocacy Centre:
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Special Diet Allowance:
Why The Program Is Changing (Word file - 81K, 2 pages)
February 11, 2011

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The Special Diet Allowance:
What You Should Know (Word file - 113K, 4 pages)
February 11, 2011
On November 30, 2010, the Ontario government announced they had decided to keep the Special Diet program instead of cancelling it. But, they said, they were going to make some changes to the program. This backgrounder explains these changes and says what you should know if you currently get a Special Diet allowance. Three big changes are being made starting April 1, 2011...

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Government Has Decided to Eliminate the Special Diet Allowance Program
Posted April 13, 2010
On March 25, as part of its 2010 budget, the provincial government announced that it will cancel the Special Diet Allowance Program and replace it with a new program. The government has said very little at this point about what the new program will be.

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Read ISAC's backgrounder about what the
government has said and how they are justifying the decision.
The decision is a cut to welfare rates. It means that $200 million will come out of the pockets of people on OW and ODSP. For single people with disabilities who get the maximum allowance, this will mean a cut in benefits of up to 20%.The decision is also equality with a vengeance. This is because it makes everyone on assistance equal by giving nothing to everyone.

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Read ISAC's analysis of what this
decision means and how it will affect
the people who rely on it to maintain their health.
The decision to end the Special Diet Allowance program increases insecurity for people on social assistance in Ontario.

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Read ISAC's response to the
2010 Budget and the decision to end Special Diet.
This decision responds in part to a recent Order by the Human Rights Tribunal of Ontario, which found that the way the program was providing benefits to three individuals with medical conditions violated the Human Rights Code.

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* more about the Tribunal's decision and ISAC's role in the legal proceedings
* ISAC backgrounder on what happened to the Special Diet program (PDF - 37K)
* ISAC analysis of what this decision means (PDF - 41K)
* ISAC backgrounder on the Human Rights Tribunal of Ontario's decision on Special Diet

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Ontario Auditor General’s Report Underlines Need for Social Assistance Reform
http://goo.gl/ogaOH
December 11, 2009
Whether he meant to or not, the auditor general’s December 7th analysis of OW/ODSP let a dysfunctional social assistance system off the hook, instead laying blame with the people who have nowhere else to turn to for basic support. (...) The auditor general states that "[M]any special dietary allowances were paid under questionable circumstances" and that the total amount spent on the SDA for OW cases has increased to $67 million during 2008/09, up from $5 million in 2002-2003. He does not mention that the increase in program costs were in large part a result of Ministry staff promoting what had been an under-utilized program. Furthermore, what does “questionable” mean in this instance? Innuendo rules the day over facts, debasing a program that provides vital support to people for whom nutritional treatment can mean the difference between managing a health condition or sliding into serious deterioration.
[ From the ISAC Social Assistance Review website ]

Source:
Income Security Advocacy Centre (ISAC)
ISAC was established in 2001 by Legal Aid Ontario to serve low income Ontarians by conducting test case and Charter litigation relating to provincial and federal income security programs. These programs include Ontario Works, the Ontario Disability Support Program, (un)Employment Insurance, and the Canada Pension Plan. ISAC's legal work takes place in the broader context of law reform, public legal education and community development.

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From the
ODSP Action Coalition:
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The Special Diet Allowance:
What You Should Know (PDF - 184K, 4 pages)
http://www.odspaction.ca/sites/odspaction.ca/files/SpecialDiet_February2011_REV.pdf
February 2011

Source:
ODSP Action Coalition
http://www.odspaction.ca/
The ODSP Action Coalition is made up of community clinic caseworkers, agency staff, and community activists. We undertake campaigns and activities designed to raise awareness of issues affecting persons in receipt of Ontario Disability Support Program ("ODSP") benefits.

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From
Citizens With Disabilities - Ontario (CWDO):
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From
Citizens With Disabilities - Ontario (CWDO)

CWDO actively promotes the rights, freedoms and responsibilities of persons with disabilities through community development, social action, and member support and referral. Our primary activity is public education and awareness about the social and physical barriers that prevent the full inclusion of persons with disabilities in Ontario. CWDO is proud to be a full member of the Council of Canadians with Disabilities [ http://www.ccdonline.ca/en/ ].
Source:
Citizens With Disabilities - Ontario (CWDO)

More about CWD

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From
Linda McQuaig:
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Ontario Special Diet Allowance:
Restraint hits poor the hardest : Ontario's
austerity program literally takes food out of the mouths of the hungry.
By Linda McQuaig
May 3, 2010
After inflation, welfare benefits today only have 55 percent of the buying power they had in 1993.
(...) The elimination of the special diet allowance in the recent provincial budget is really just the continuation of the assault on the incomes of the very poorest citizens that began with former premier Mike Harris's 22 percent cut in provincial welfare rates in 1995.
Source:
Linda McQuaig

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From the
Ontario Coalition Against Poverty (OCAP):
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Activist Communique: OCAP defends the Special Diet
By Krystalline Kraus
April 3, 2011
The Ontario Coalition Against Poverty (OCAP) was joined by its allies at a Raise the Rates rally at Nathan Phillips Square on Friday at noon -- on the day that cuts to the Ontario Special Diet program were set to take effect. At issue was the recent cut and re-invention of the Special Diet supplement that was announced in Ontario Premier McGuinty's 2010 budget. [ Source: rabble.ca ]

Driving the Poor Deeper Into Poverty:
The Province and the City of Toronto
Team up to Attack the Special Diet
March 19, 2010
By Liisa Schofield and John Clarke
Since 2005, a large part of OCAP's (Ontario Coalition Against Poverty) work has involved organizing to obtain and defend access to a benefit known as the Special Diet Allowance (SDA). Under this, people living on the Province's sub poverty social assistance system who obtain the appropriate diagnoses from a medical provider, can receive up to an additional $250 a month for food. Access to the Special Diet has had to be fought for tooth and nail. Medical providers interested in helping poor people access this benefit are few and far between. (...) As this is being written, the prospect that the Liberals will use their upcoming Budget to abolish the Special Diet outright is looming very large (see our submission to the pre-budget ‘consultations’ - Feb. 3, 2010).
[ Liisa Schofield and John Clarke are organizers with the Ontario Coalition Against Poverty. ]
Source:
E-Bulletin No. 329
[ The Bullet Socialist Project ]

Source:
Ontario Coalition Against Poverty

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Selected media coverage:
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Liberals urged to ‘put food in the budget’
March 10, 2011
By Laurie Monsebraaten
Back in 1995, the opposition Liberals scorned the Mike Harris government’s so-called “welfare diet,” which purported to show that a single person on social assistance could eat for $90 a month. Today that meagre Tory shopping list — which included pasta but no sauce and bread but no butter — costs $48 more. And yet since the Liberals took office in 2003, a single able-bodied person on welfare gets just $29 more in their monthly cheque for food. “It’s no wonder food bank use in Ontario is soaring,” said social policy expert John Stapleton, who used the 1995 shopping list to buy the welfare diet at a Scarborough discount grocery store in January. It is one more reason anti-poverty activists across the province are calling on Finance Minister Dwight Duncan to put a $100 monthly food supplement for welfare recipients in this spring’s provincial budget.
[ 55 comments ]
Source:
Toronto Star

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Ontario toughens welfare diet rules
By Jonathan Jenkins
February 26, 2011
TORONTO - Extra cash for chronically ill welfare recipients to eat healthy will be harder to get starting April 1 under new rules designed to combat fraud and comply with an Ontario Human Rights Tribunal ruling -- changes that are making some sick people nervous. (...) As of April, recipients of the special diet allowance will all have to reapply for the program, consent to have their relevant medical records checked and have their applications signed by a doctor or registered nurse practitioner, nutritionist or midwife. As well, there are changes to the rates people with different conditions would be paid, with some afflictions getting less money or delisted altogether.
Source:
CNEWS (canoe.ca)