General Relief Policy - Department of Public Social Services

GR 44-231 Special
Need for Therapeutic
Diet
GR 44-231.1 Issuance
of Special Needs for
Therapeutic Diet
When are special needs for a therapeutic diet
issued?
• A therapeutic diet may be allowed only when
recommended by the individual’s physician.
Verification is obtained from a private physician on
the PA 596, Special Diet Allowance Request,
LAC/USC Medical Center provides form H-4015
to authorize a therapeutic diet. The current
authorization from must be on file in the case
record before issuing needs for a therapeutic diet.
• Special need for therapeutic diet CANNOT be
issued on a pending case.
• Special need for therapeutic diet CANNOT be
issued for an individual who receives R&B or B*C
amounts.
• Special need for therapeutic diet CANNOT be
issued for individuals with no cooking facilities or
for any individual who is allowed a meals out
allowance.
• The maximum allowable monthly rates for specific
diets are contained in the following Therapeutic
Diet Chart.
GR 44-231.2
Therapeutic Diet Chart
Therapeutic Diet Chart
Diet Man Woman
Diabetic, Adult
1200 calories
Diabetic, Adult
1500 calories
No
Allowance $.94
No
Allowance $2.47
Diabetic, Adult &
Child 1800 calories $3.43 $5.88
Diabetic Adult
2200 calories $6.30 $8.75