Isolated Posts and Government Housing Committee

October 21, 2011

Since February 2011, the Committee has reviewed the Communiqué and recognized the need for an amendment.  As such, this Communiqué replaces the one published on February 23, 2011.

The purpose of this Communiqué is to provide clarification on the non-elective medical/dental travel assistance benefit under section 3.1 of the Isolated Posts and Government Housing Directive (IPGHD).   This benefit was introduced to provide travel assistance to federal Public Service employees who work in isolated posts so that they may obtain the non-elective treatments required without delay when the treatment is not available at the isolated post.

Employees who are eligible for this benefit are not considered to be on authorized government travel.

Eligibility

As per section 3.1.2, the attending medical/dental practitioner* at the isolated post must ascertain by means of a certificate that the treatment meets the following three (3) criteria:

  1. is not elective;
  2. is not available at the employee's headquarters; and,
  3. is required without delay.

All three (3) criteria outlined in the directive must be met in every instance. The intent of the IPGHD in respect of the "required without delay" criteria is that the non-elective medical or dental treatment is required within a reasonable period of time as determined by the attending medical/dental practitioner; what is reasonable will be determined on a case-by-case basis. Whether a particular delay is reasonable will also depend on the availability of services at the nearest location where the medical treatment is available.

The attending medical or dental practitioner at the isolated post determines the nearest location in Canada where the treatment is available. Employees have no discretion on location.

*An attending medical/dental practitioner means the qualified practitioner who has treated the patient at the isolated post. Patient includes the employee or the employee's dependant(s).

Escorts

Under certain circumstances, the expenses of an escort may be covered under the Directive.

An escort will be authorized when:

(1) the patient is under the age of majority and requires an escort;

(2) when the patient has a mental or physical disability of a nature such that she/he is not able to travel unassisted (which shall be confirmed by the attending medical/dental practitioner); or

(3) when the patient has dependent(s) who cannot otherwise be cared for at the isolated post, and must therefore accompany the person obtaining treatment.

Other situations may apply, however, the requirements of section 3.1.4 and 3.1.5 must be met in all instances.

Exclusions

The non-elective medical/dental travel assistance benefit is not intended for the following situations:

  1. where an employee's non-elective medical travel would normally be covered by provincial/territorial health care or RCMP/DND health care regulations (e.g., the services of physicians and other health professionals and care in hospitals);
  2. where an employee's non-elective medical travel would normally be covered under provincial/territorial health care, the Public Service Health Care Plan or the RCMP/DND health care regulations (e.g., orthodontics);
  3. travel for ongoing long-term treatments resulting from a workplace accident or illness where a workplace safety insurance plan, collective agreement and/or provincial/territorial health care agreements apply;
  4. travel for elective therapy appointments (such as acupuncture, physiotherapy, chiropractics which may not meet the criteria in section 3.1.2); and/or,
  5. travel for routine obstetrics and childbirth, and high risk pregnancy services in cases where such services do not meet the criteria in section 3.1.2.

You are encouraged to seek clarification from your designated departmental coordinator regarding travel assistance parameters in these cases.  

Other Leave

The actual travel time to the nearest treatment location does not require the employee to submit a leave form. Travel time will be covered without affecting an employee's leave entitlements under employer policies and/or applicable collective agreements. Leave for the period while on treatment is normally covered by employer policies and/or applicable collective agreements.

Any additional leave requested by the employee prior to or following treatment shall be in accordance with the provisions of the applicable collective agreement and/or applicable departmental policies.   Refer to Q7.

Reimbursement of Expenses

The intent of the IPGHD is to ensure that employees living and working in isolated posts are treated in a manner equivalent to employees living and working in locations where geographical access to medical/dental services is not an issue.

For the purposes of travel and transportation, the most economical means of travel and transportation will be determined by the department, consistent with the employee's treatment needs as set out by the treating medical/dental practitioner. If an employee chooses a different mode of travel and/or transportation, the employee will bear any additional costs.

For those situations where the travel assistance benefits apply under Part III of the Directive, economy class fare is the standard.

In addition, commercial accommodation is authorized in accordance with the NJC Travel Directive. Meal expenses, based on receipts, may be reimbursed up to the limit of the applicable meal allowance as established in the NJC Travel Directive. In addition, the daily incidental allowance is also provided to the employee and the escort (where applicable) for each of the travel days.

All expenses incurred once at the location, except for those stated above, are the employee's responsibility. Receipts must be provided for all travel, transportation, meals and accommodation expenses that have been incurred in accordance with the Directive.

Employees eligible for this benefit are not considered to be on authorized government travel and therefore all business travel benefits such as those provided under the NJC Travel Directive do not automatically apply.  

Sample Form -
Application for Non-Elective Medical/Dental
Treatment Benefit under the IPGH Directive

Questions and Answers:

Q1:   I am a pregnant employee and my pregnancy is not considered high risk. I work in Iqaluit, where appropriate childbirth facilities exist, but I do not wish to deliver my child there. My doctor has provided me with a certificate to leave work one month prior to my delivery to travel away from the isolated post and I have made the necessary arrangements to stay in Ottawa for the time prior to my delivery date. Am I eligible for reimbursement of expenses under Part III of the IPGHD?

A1:    The travel assistance benefit in this instance does not apply. The three (3) criteria outlined in section 3.1.2 have not been met; specifically, the treatment required is available at the isolated post.

Q2:   My spouse and I both work in Old Crow. Because my spouse suffered a heart attack, my spouse was transported to Whitehorse General Hospital via Medivac. May I request reimbursement of my travelling and transportation expenses as I accompanied my spouse to Whitehorse?

A2:    Your return travelling and transportation expenses from Old Crow to Whitehorse may be reimbursable, provided you have a medical certificate signed by the attending medical practitioner. The certificate must state a) the reasons why an escort was essential (e.g., mobility issues); and b) the duration of time an escort was required.

Q3:   I was away on annual leave when my spouse became ill and we sought medical care at a local hospital. The attending medical practitioner determined that surgery was warranted at the earliest opportunity, which was a few days later. Upon release from the hospital, we returned home to the isolated post. Can we request reimbursement of our expenses under Part III of the Directive?

A3:    No, the benefits do not apply to employees who are on leave away from the isolated post (regardless of whether your annual leave was changed to certified sick leave). Similarly to employees not in isolated posts, employees may wish to consider purchasing private insurance for their travels.

Q4:   I have recently accepted a transfer to Yellowknife. My spouse is seven months' pregnant and will remain in Winnipeg with her parents until the delivery of our child.

a) Am I entitled to the non-elective medical assistance benefit to travel to Winnipeg at the time of the delivery?

b) Is she entitled to the non-elective medical assistance?

A4:   

a) No, you are not entitled to the non-elective medical assistance benefit to travel to Winnipeg as you do not require treatment and you are not considered an escort. You may, however, wish to consider using your VTA.

b) No, your spouse is not entitled to the non-elective medical assistance as she is not residing at the post. Had she been at the post, and if the treatment she required was not available there, she would have been entitled to the non-elective medical assistance benefit.

Q5:   I work in Churchill, Manitoba. I have been experiencing severe pain in my jaw which has been diagnosed by the dentist as an impacted wisdom tooth and must be surgically removed. Our dentist has indicated that he could schedule the surgery at the St. Boniface General Hospital in Winnipeg. Is this treatment covered under the non-elective dental travel assistance benefit?

A5:    Yes, provided you have a certificate from your dentist at the isolated post which explains the treatment is non-elective and that it is required without delay. The dentist must also indicate the nearest place (e.g., Winnipeg) in Canada where you can obtain the treatment.

Q6:   I live in Sachs Harbour and I have had pains in my right side for some time. I have been diagnosed with chronic appendicitis and will require surgery before it becomes acute. Do I qualify for this benefit?

A6:    Yes. The attending medical practitioner who has treated you at the isolated post must certify that your condition requires attention without delay and that it is not elective. He/she must also indicate the nearest location in Canada (e.g., Inuvik Regional Hospital) where the treatment is available.

Q7:     I am employed in Rankin Inlet and the nurse at the nursing station has determined that I require a surgical intervention which is not available at the post. The closest place where this can be performed is in Winnipeg. I anticipate a two- or three-week period of convalescence. Are my expenses and leave time covered by the Directive?

A7:      Yes. Your applicable transportation and travel expenses are covered. You are covered for the return travel to Winnipeg (without affectivng your collective agreement or other leave entitlements), the period of time for the surgery (leave would be based on your collective agreement and/or applicable employer policies), and the time required for recovery from the immediate effects of the surgery as determined by the treating physician at the location where treatment occurred (i.e., until you are able to travel) (leave would be based on your collective agreement and/or applicable employer policies). Should you choose to remain longer in the south before returning to the isolated post, you are responsible for any other costs - including accommodation, meals, and travel expenses. Your additional time off would need to be approved in accordance with your Collective Agreement, or your Terms and Conditions of Employment.

Q8:      I work and live in The Pas, Manitoba (MB), and my spouse who resides with me requires surgery. The attending medical practitioner has provided certification confirming the surgery must be performed without delay, and the nearest location where the treatment is available is Winnipeg, MB. However, my spouse would rather drive to Winnipeg, MB for the procedure. What, if any, benefits would I be eligible for under the IPGHD non-elective medical assistance?

A8:      The department, consistent with the medical certification, will determine the most economical and practical travel plan. As such, your eligible expenses will be assessed against this plan (i.e., travelling and transportation expenses which would have been incurred, supported with receipts). For example, if you are unable to fly for medical reasons, you will be reimbursed at the lower kilometric rate, based on the NJC IPGHD kilometric rates. If, however, you are able to fly, but choose for personal reasons to drive, and flying would have been less expensive, you will be reimbursed for the equivalent cost of the flight. Meals and incidentals will be covered as applicable. Accommodation expenses would also be reimbursable, based on those associated with flying to the nearest location.

Example

Surgery in Winnipeg, MB (day surgery and next day follow up), certified by attending medical practitioner in The Pas, MB.

Return airfare to Winnipeg; departure evening before surgery and return day after surgery

Accommodation – two nights in Winnipeg

Meals and incidentals

A. Air Travel to Winnipeg, MB

- Leave The Pas at 19:20 hours on Tuesday; arrive in Winnipeg at 20:40 hours (receipts)

- Transportation costs

- Hotel for Tuesday and Wednesday in Winnipeg (receipts)

- Incidentals Tuesday (receipts not required)

- Meals on Wednesday (receipts)

- Incidentals Wednesday (receipts not required)

- Meals (breakfast and lunch) on Thursday, up to the maximum applicable meal allowance (receipts)

- Leave Winnipeg Thursday 13:00 hours after follow up appointment, arrive The Pas 14:30 hours

- Incidentals Thursday (receipts not required)

B. Alternate travel to Winnipeg, MB by personal motor vehicle

- Lower kilometric rate for the distance between The Pas and Winnipeg and return (reimbursement not to exceed the approved airfare cost)

- Transportation costs

- Hotel for Tuesday and Wednesday in Winnipeg (receipts)

- Incidentals Tuesday (receipts not required)

- Meals on Wednesday, up to the maximum applicable meal allowance (receipts)

- Incidentals Wednesday (receipts not required)

- Meals (breakfast and lunch) on Thursday, up to the maximum applicable meal allowance (receipts)

- Leave Winnipeg Thursday 13:00 hours after follow up appointment

- Incidentals Thursday (receipts not required)

If an escort is required, additional expenses are also permissible. In this case, this includes three days of incidentals (receipts not required), meals on Wednesday (up to the maximum applicable meal allowance with receipts), and breakfast and lunch (as per meal allowance rates with receipts) for the approved escort.

Q9:     I live in Masset and I've been diagnosed with cancer. I must leave the post for my cancer treatment program (chemotherapy/radiation). Are travelling and transportation expenses covered under the non-elective medical/dental travel assistance for my spouse and I?

A9:      Yes - your travel and transportation expenses will be covered, provided the attending medical practitioner attests the treatment meets the three criteria (i.e., is non-elective, is not available at the post, and is required without delay). If your medical practitioner attests that your spouse is required to accompany you as an escort, your spouse's expenses would also be reimbursed.

Q10:   I could take a taxi, but instead, would like to rent a car to go from the airport to the hospital. The taxi fee would be approximately $60 each way. Is this in accordance with the Directive?

A10:   The rental of a car (limited to daily vehicle rental charges) would be reimbursed up to the amount of the taxi fee (in this case, $120). The reimbursement would be based on previous taxi receipts for a return trip from the airport to the hotel that were submitted by the employee and receipts incurred for the car. The employee is responsible for providing an estimate or previous receipts. No additional expenses (i.e., kilometric rates, insurances, gas) associated with the use of a rental car will be reimbursed.

Q11:   My pregnancy has been deemed by my medical practitioner as high risk. However, there are no treatment services for high risk pregnancies in my community. Am I excluded from coverage under the Directive?

A11:   As long as your situation meets the three criteria of section 3.1.2 (i.e., is non-elective, required without delay, and is not available at the isolated post), you qualify. For more detail on high risk pregnancies and travel, you should contact your designated departmental representative.