Tube Feed Supplement

Overview

The tube feed supplement is intended to provide liquid nutritional product, equipment and supplies to recipients of income assistance or disability assistance who are unable to take food orally or process it through the gastrointestinal system.  The supplement includes nutritional products, as well as related medical equipment or medical supplies (such as pumps, tubes and bags).

These supplements are available under the Employment and Assistance Regulation and Employment and Assistance for Persons with Disabilities Regulation.

Policy

 

Effective: December 2, 2008

A tube feed supplement may be provided to a recipient of income assistance or disability assistance who is unable to take food orally or process it through the gastrointestinal system. The supplement can be provided for acute short-term or chronic long-term conditions. The supplement includes nutritional product, medical supplies, and medical equipment necessary for tube feeding. The tube feed supplement is available when no other funding (government funded programs or other resources) is available to the client.

Effective: September 1, 2015

The following clients are eligible for the tube feed supplement:
 

  • persons receiving income assistance or disability assistance and their dependants not already receiving another nutrition-related supplement
  • children in the Child in Home of a Relative (CIHR) Program
  • dependants of persons residing in a special care facility
  • persons who were in receipt of the tube feed supplement at the time their family unit transitioned to Medical Services Only (MSO) coverage

[see Related Links – Medical Services Only]

  • persons who were in receipt of the tube feed supplement at the time their family unit transitioned to Transitional Health Services [THS] coverage

[see Related Links – Transitional Health Services]

Effective: September 1, 2015

The following clients are not eligible for the tube feed supplement:
 

  • persons in receipt of hardship assistance and their dependent children
  • persons residing in a  special care facility
  • persons who qualify for a health supplement due to having a life-threatening health need [see Related Links – Life-Threatening Health Needs]
  • persons receiving another nutrition-related supplement
  • persons who were not in receipt of the tube feed supplement at the time their family unit transitioned to Medical Services Only (MSO)
  • persons who were not in receipt of the tube feed supplement at the time their family unit transitioned to Transitional Health Services (THS) 

Effective:  September 1, 2015

Clients may be eligible for a tube feed supplement provided that all of the following conditions are met and confirmed in writing by a medical practitioner, nurse practitioner or a registered dietitian:
 

  • that the person’s primary source of nutrition must be obtained through tube feeding;
  • the type of nutritional product required;
  • daily or monthly quantity of nutritional product required;
  • the expected duration of the condition requiring tube feeding; and
  • the necessary tube feed related supplies or equipment.

Clients are responsible for providing the required documentation. The ministry is not responsible for any fees associated with documentation.

Persons in receipt of the tube feed supplement are not eligible  to receive any other nutrition-related supplement.  Clients that are eligible for more than one of these supplements must choose which of these supplements they would like to receive.  [see Related Links – Diet Supplements, Nutritional Supplements, and Monthly Nutritional Supplements]

The nutritional product and supplies portion of the tube feed supplement may be approved for the period of time indicated on the prescription up to a maximum of 2 years. For ongoing nutritional product and supply requests, the ministry’s Health Assistance Branch will assign a review date at the time of approval. Three months prior to this review date, the client will receive a letter requesting confirmation to renew their request for ongoing nutritional product and medical supplies required for tube feeding. Additional medical documentation will only be requested where necessary (for example, a new medical supply item is required or there is a significant change in quantities).

Procedures

Effective:  December 2, 2008

To assess eligibility for the tube feed supplement, follow these steps:

EAO

1.

Ensure that the client has provided a written prescription and diagnosis from a medical practitioner, nurse practitioner or registered dietitian, including all of the following:

  • that the person’s primary source of nutrition is through tube feeding
  • type of nutritional product required
  • daily or monthly quantity of nutritional product required
  • expected duration of the need for tube feeding
  • necessary tube feed related supplies or equipment

EAO

2.

Forward the original documentation to Health Assistance Branch (HAB) for an eligibility decision.

HAB

3.

Ensure that the client has no other source of funding to meet the cost of tube feeding.

HAB

4.

If approving the tube feed nutritional product, medical equipment and medical supplies, notify the contracted supplier to provide directly to the client.

Effective: December 2, 2008

The nutritional product and supplies portion of the tube feed supplement may be approved for the period of time indicated on the prescription up to a maximum of 2 years. To renew an existing approval for ongoing tube feed related supplies and nutritional product, follow these steps:

HAB 1. Three months prior to approval review date, send a medical supply review letter to the client requesting confirmation of need to renew existing tube feed supplement approval.
EAO 2. If the client brings in a signed renewal letter, review documentation for completeness and forward to Health Assistance Branch (HAB).
HAB 3. If the client returns signed letter confirming there is minimal or no change to the approval, notify the contracted supplier to set up a standing order and reset review date.
HAB 4.

If the client is requesting a new item or there is a significant quantity change for an existing approved item and an updated prescription has not been provided, request supporting documentation from the client.

Additional medical documentation will only be requested where necessary (for example, a new medical supply item is required or there is a significant change in quantities).

Effective: December 2, 2008

In exceptional circumstances, if a client has an emergency need for tube feed related nutritional product, supplies or equipment under $500, follow these steps:

EAO 1. Determine if the client is eligible for the tube feed supplement.
EAO 2. Ensure that the client has no other source of funding to meet the cost of tube feeding.
EAO 3. Ensure that the client has provided a written prescription, a diagnosis from a medical practitioner, nurse practitioner or registered dietitian and a price quote for the medical equipment, supplies, and/or nutritional product. 
  4. Provide payment using the Purchase Authorization on the Health Case.
EAO 5. Record details.

Effective: December 2, 2008

To assess eligibility for an emergency need for tube feed related medical equipment, supplies, and/or nutritional product costing between $500 and $1,000, follow these steps:

EAO 1. Determine if the client is eligible for the tube feed supplement.
EAO 2. Discuss the request with the Supervisor.
Supervisor 3. Consult with Health Assistance Branch to review the options prior to giving approval.

Authorities and Responsibilities

Effective: December 2, 2008

Ministry Workers are responsible for:

  • ensuring that documentation provided by the applicant includes all of the necessary information
  • forwarding the original documentation to HAB for an eligibility decision
  • in exceptional circumstances, issuing nutritional product, equipment and/or supplies related to the tube feed supplement

Health Assistance Branch is responsible for:

  • determining eligibility for the tube feed supplement 
  • assessing renewals for the tube feed supplement
  • ensuring that the client has no other source of funding to meet the cost of tube feeding
  • providing the nutritional product, medical supplies and medical equipment required for tube feeding to eligible recipients through a contracted supplier