Monthly Nutritional Supplement

Overview

A monthly nutritional supplement is provided to recipients eligible for the Person with Disabilities designation who are in receipt of disability assistance and who have a severe medical condition causing a chronic, progressive deterioration of health with symptoms of wasting. This supplement is intended to prevent imminent danger to the person’s life by providing essential, specified items to supplement regular nutritional needs.

Policy

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Effective: September 1, 2015

A monthly nutritional supplement (MNS) may be provided to recipients with Persons with Disabilities designation who are in receipt of disability assistance (except for persons living in a special care facility, unless the person is in an alcohol and drug treatment centre) and who have a severe medical condition causing a chronic, progressive deterioration of health with symptoms of wasting. This supplement is intended to prevent imminent danger to the person’s life by providing essential, specified items to supplement regular nutritional needs.

An MNS may consist of one or both of the following:

additional nutritional items (to supplement a regular diet)
vitamins and minerals

The maximum amounts provided under MNS are shown in Rate Table: Health Supplements and Programs.

Eligibility

Effective: July 1, 2019

A monthly nutritional supplement (MNS) is only available to a recipient eligible for the Persons with Disabilities designation who is receiving disability assistance and if the ministry is satisfied that the following conditions are met based on written confirmation by the recipient’s medical practitioner, nurse practitioner or registered dietitian:

the person has a severe medical condition causing a chronic, progressive deterioration of health
as a result of this deterioration of health, the person displays two or more of the following symptoms:
- malnutrition
- underweight status
- significant weight loss
- significant muscle mass loss
- significant neurological degeneration
- significant deterioration of a vital organ
- moderate to severe immune suppression
to alleviate these symptoms, the person requires one or both of the following items:
- additional nutritional items that are part of a caloric supplementation to a regular dietary intake
- vitamins and minerals
failure to obtain these items will result in imminent danger to the person’s life

An MNS may only be provided if the person’s family unit does not have any resources available to pay for the items.

Recipients who are in receipt of the nutritional items portion of the MNS are not eligible for any other nutrition-related supplement. Recipients who are only in receipt of the vitamins and minerals portion of the MNS retain eligibility for a diet supplement or supplement for short‑term nutritional products. [See Related Links – Diet Supplements, Nutritional Supplements or Tube Feed Supplement.]

Recipients of a nutrition-related supplement through an appeal award under section 2 (3) of Schedule C are not eligible for an MNS. If the amount of their nutrition-related award is less than $205 per month, they may apply for the MNS. If approved, the MNS would replace the previously awarded supplement.

Reviewing the Monthly Nutritional Supplement

Effective: July 1, 2019

As nutritional needs and medical conditions can change, it is necessary for the ministry to complete regular reviews to confirm a recipient’s continued eligibility for the monthly nutritional supplement (MNS).

The eligibility review will begin with a review of existing medical information already on the system. During this first stage of the MNS review, the ministry will consider various factors including, but not limited to, the nature of the medical condition, likelihood of improvement/recovery and the duration of need indicated by the medical practitioner, nurse practitioner, or registered dietitian.

In cases where the medical documentation on file confirms ongoing eligibility requirements have been met, there will be no change to the client’s file and they will continue to receive MNS.

In cases where there is insufficient information to confirm ongoing eligibility, recipients will be notified that a new MNS application form must be submitted. Upon receipt of the new MNS application, the ministry will make an eligibility decision and advise the client of the outcome.

Applicants with Indigenous Services Canada MNS Moving Off Reserve

Effective: October 19, 2016

An Indigenous Services Canada (ISC) Monthly Nutritional Supplement (MNS) recipient who moves off reserve and subsequently applies for assistance with the ministry may not be required to complete a MNS application (HR2847) form. With the applicant’s signed consent, the ministry can obtain a copy of the applicant’s ISC MNS application (SA431) and any related information. This documentation will be used to determine if they meet the criteria for MNS through the ministry.

If the ministry is unable to make a decision based on the information in the ISC MNS application form, the applicant will be required to submit a completed ministry MNS application form.

Recipients with MNS Moving On Reserve

Effective: October 19, 2016

To receive the Monthly Nutritional Supplement (MNS) on reserve, an applicant must be determined eligible through Indigenous Services Canada (ISC).

Recipients who have been determined eligible for MNS from the ministry before they move on reserve may not be required to complete an ISC MNS application (SA431) form. With the client’s signed consent, the ministry will forward a copy of their MNS (HR2883) application form and any related information directly to ISC. This information will be used to determine if they meet the criteria for MNS through ISC.

Procedures

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Processing Applications for the Monthly Nutritional Supplement

Effective: July 1, 2019

To process an application for the monthly nutritional supplement (MNS), follow these steps:

Ministry Staff	1.	Confirm the following: the recipient has the Person with Disabilities designation by reviewing the Case Summary – Contact Details screen for a persons with disabilities status of “E” the recipient is receiving disability assistance the recipient is not receiving a nutrition-related supplement under section 2 (3) of Schedule C or is receiving such a supplement where it is less than $205 per month Note: If the recipient is ineligible for MNS as per criteria in step 1, advise the recipient of the decision and inform them of their right to request reconsideration.
	2.	Open a Service Request (SR) and generate the Application for Monthly Nutritional Supplement (HR2847) [see Forms and Letters], then provide it to the recipient.
Recipient	3.	Review and sign Part B - Application Acknowledgement and Consent. Have a medical practitioner, nurse practitioner or registered dietitian complete and sign Part C of the HR2847 and return the form to the Employment and Assistance Office (EAO). If completed by a medical practitioner they can bill Medical Services Plan directly for fees for completing the form.
Ministry Staff	4.	Receive original form along with any accompanying documents from the recipient and review for complete information and signatures. Scan and attach documents to the SR. As Health Assistance (HA) does not require the original documents, retain the original documents and forward the SR to HA.
HA	5.	Determine if the recipient is eligible for the MNS. Advise the recipient and EAO of the decision. If approved, update the corresponding MNS field(s) in the SD More Info Tab screen to indicate which component or components of MNS have been approved, assign a review date and update the benefit lines in both the Monthly/Ongoing and One Time Allowance Benefit Plans.

Note: Do not assign an end date to any MNS allowance codes.

Note: MNS cannot be issued on a Purchase Authorization on the Health Goods and Services Benefit Plan.

Applicants with Indigenous Services Canada MNS Moving Off Reserve

Effective: October 19, 2016

Applicants who receive the Monthly Nutritional Supplement (MNS) through Indigenous Services Canada (ISC) who leave a reserve and subsequently apply for disability assistance with the ministry may not be required to complete a new MNS Application as their MNS information on file with ISC and the British Columbia Aboriginal Network on Disability Society (BCANDS), can be made available for adjudication by Health Assistance (HA).

To initiate the release of the client’s ISC MNS information, the Employment and Assistance Worker (EAW) will complete the following steps:

Have the applicant complete and sign the Consent to Release Information (HR3125) [see Forms and Letters].
Send completed consent form to BCANDS at the fax number or address noted on the consent form. When faxing, EAWs must adhere to guidelines concerning transmittal of confidential information.
Scan and profile a copy of the consent form.
Note that the signed consent form has been completed and sent to BCANDS.

Upon receipt of the completed consent form, BCANDS will forward a copy of the client’s ISC MNS application and any related information directly to HA within 12 business days.

HA will complete a review of the ISC MNS information to determine if it is sufficient to proceed with adjudication.

If HA is unable to make a decision based on the information received, the applicant will be required to submit a completed MNS Application (HR2847) form.

Recipients with MNS Moving On Reserve

Effective: October 19, 2016

Recipients who are moving on reserve and have received the Monthly Nutritional Supplement (MNS) from the ministry may request that their MNS information be released to Indigenous Services Canada (ISC) and the British Columbia Aboriginal Network on Disability Society (BCANDS), for the purposes of a file review to confirm their eligibility for the ISC MNS.

Prior to the release of the ministry’s MNS information, the client must complete and sign a consent form, (SA-320) which is available through their Band Social Development Worker (BSDW). The consent form must be sent by the BSDW directly to Health Assistance (HA), as HA is responsible for releasing the requested information.

To initiate the release of the client’s ministry MNS information, the BSDW will complete the following steps:

Have the recipient complete and sign the Consent to Release of Information (SA-320).
Send completed consent form to HA at the fax number or address noted on the consent form. When faxing, BSDWs must adhere to guidelines concerning transmittal of confidential information.
Scan and profile a copy of the consent form and record date sent to HA.

Upon receipt of the completed consent form, HA will forward a copy of the recipient’s MNS (HR2847) Application form and any related information directly to BCANDS for a file review within 12 business days.

Reviewing Eligibility for the Monthly Nutritional Supplement

Effective: July 1, 2019

To conduct a review, the following steps will be completed:

Health Assistance (HA)	1.	Review medical documentation on the recipient’s file to determine if the medical condition(s) and need for the approved supplement(s) may have changed. Factors to consider include, but are not limited to: the nature of the medical condition; the likelihood of improvement/recovery; and the duration of need indicated by the medical practitioner, nurse practitioner or registered dietitian.
	2.	If there is sufficient evidence on file to determine that the recipient continues to meet the eligibility criteria to receive the approved supplement(s), assign a new review date and add a review completion note. Note: When continued eligibility for MNS is confirmed, no action is required by regional field staff.
	3.	In cases where it is determined that updated medical information is required to confirm ongoing eligibility, create a review Service Request (SR). Generate and send a review letter with a new MNS application form (HR2847) to the recipient requesting that the form be completed as required and returned to their Employment and Assistance Office (EAO) within 45 days.
Recipient	4.	Review and sign Part B - Application Acknowledgement and Consent. Have a medical practitioner, nurse practitioner or registered dietitian complete and sign Part C of the HR2847. If completed by a medical practitioner they can bill Medical Services Plan directly for fees for completing the form.
Ministry Staff	5.	Receive original form along with any accompanying documents from the recipient and review for complete information and signatures. Scan into the SR for HA. As HA does not require the originals, retain the original documents.
HA	6.	Adjudicate the new application to determine if the recipient continues to meet the eligibility criteria for the MNS. If approved: update the corresponding MNS field(s) in the SD More Info Tab, as required; assign a new review date; and advise the recipient and the EAO of the decision. If not approved: advise the client of the decision that MNS will be discontinued and include information on their right to request a reconsideration; and advise the EAO of the decision. The reduction will take effect on the next assistance cheque following the denial.
	7.	HA will discontinue the MNS allowance codes in the Monthly Ongoing Benefit Plan.
	8.	Once the benefit lines have been removed, update the corresponding MNS field(s) on the SD More Info tab.
	9.	If the new application is not received within the requested timeframe, eligibility for the previously approved supplements will not continue beyond the review date. Notify the client in writing of the discontinuance of their MNS and HA will remove the MNS allowance codes.