February 6, 2009
This Communiqué has been replaced by the one dated February 23, 2011.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). It should be noted that employees who are eligible for this benefit are not considered to be on "official government business travel".
This benefit was introduced to provide federal Public Service employees who work in isolated posts with travel assistance to obtain non-elective treatments required without delay when the treatment is not available at the isolated post.
Section 3.1 is intended to cover situations where a non-elective treatment is required without delay. It is not intended to cover elective treatment or to cover situations where the immediacy of treatment after diagnosis is not critical.
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:
- is not elective;
- is not available at their headquarters; and
- is required without delay.
All three (3) criteria outlined in the directive must be met in every instance.
In addition, 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, be it the employee or the employee's dependant(s).
Note: Employees who submit a certificate from a practitioner who has not "actually treated" the patient (at the isolated post) is not eligible for this benefit.
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. What is reasonable is determined on a case-by-case basis. In most cases, this would be immediately, whereas in others, a waiting a few days or even one or two weeks could be considered reasonable. Whether a particular delay is reasonable will also be contingent upon the availability of services at the nearest location where the medical treatment is available.
As a general rule, section 3.1 will apply whenever non-elective medical/dental treatment is required:
- immediately, or
-
immediately upon the availability of access to the necessary medical personnel or facilities.
Section 3.1.4 – "Escorts"
The requirement for "escorts" as originally intended was to ensure that children (who were not of age) who could not provide "consent for treatment" at the nearest location where treatment was available, required an "escort" (normally a parent) to accompany them for this purpose. The intent was further expanded to include situations where "escorts" were required for specific treatments where there existed mobility issues for the patient or when the patient who required such treatment could not get to and return home from the facility without being escorted. The conditions outlined in sections 3.1.4 and 3.1.5 are to be met in all instances.
Exclusions:
The non elective medical/dental travel assistance benefit is not intended for the following situations:
- where the province or territory has a reciprocal agreement with the federal government for the costs of transportation expenses and medical/dental treatment (e.g. Medivac evacuations);
- where an employee would normally be covered by provincial/territorial health care or the RCMP/DND health care regulations (e.g. the services of physicians and other health professionals and care in hospitals);
- where an employee would normally be covered under either the provincial/territorial health care, the Public Service Health Care Plan or the RCMP/DND health care regulations (e.g. orthodontics);
- for ongoing therapy appointments (acupuncture, physiotherapy, chiropractic, chemotherapy, radiation, etc). (Collective Agreements, PSHCP/ provincial/territorial health care/RCMP/DND regulations would apply in these situations);
- for obstetrics and childbirth services. In the unusual situation where there is no medical facility or nursing station at the isolated post where this service is available but the service is offered at another isolated post (which is the nearest location in Canada where the service is offered) section 3.1 may apply. This does not however automatically entitle the employee (or the dependant(s)) to reimbursement of all travelling and transportation expenses incurred if the employee (or the dependant(s)) leave the isolated post one month prior to the delivery;
- for ongoing long term treatments resulting from an accident or illness (the provisions of the Collective Agreements would apply in these situations in combination with provincial/territorial health care);
-
for high risk pregnancies and cancer treatments which cannot be treated at the isolated post (these exceptional circumstances may be covered by the delegation of authority to deputy heads to approve "exceptions" to the provisions of a number of Treasury Board Secretariat (TBS) policies on behalf of individual employees in unusual circumstances. The intent of this authority is not for the administrative approval exception to be used to override other authorities which fall under other jurisdictions (e.g. NJC Directive) or as a means to circumvent otherwise justifiable ceilings and/or limitations that are policy specific. Employees have no discretion. The exceptional circumstances must be fully substantiated by the attending medical practitioner. Departments are invited to seek clarification from the TBS in such instances prior to granting an employee approval.
Other Leave:
Employees are expected to return to the isolated post almost immediately after having received the treatment. It is not the intent of the IPGHD to combine non-elective medical/dental travel assistance with other leave (such as annual or compensatory) for personal reasons.
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. When deciding how a particular situation should be dealt with, managers should consider the identical situation occurring in a non- isolated post and how it would be dealt with in the same circumstances.
Section 3.1.5 – "Reimbursement of Expenses"
The return travelling and transportation expenses refer only to the expenses incurred from the isolated post to the nearest location in Canada where the treatment is available. In addition to those, accommodation and meals (which are not provided free of charge to the persons referred to in this section) are also covered. The "maximum" reimbursable expenses will be based on the meal rates outlined in the NJC Travel Directive.
Receipts must be provided for travelling, transportation, meals and accommodation expenses that have been incurred.
Employees are to be on authorized (e.g. sick) leave from the period they arrive to the location where the treatment is available until such time they are returning to the isolated post. The actual "travel time" does not require leave. All expenses incurred once at the location (e.g. parking fees, taxis, etc) except for those stated above are the employees' responsibility. An incidental allowance is provided to the patient and the escort (where applicable) for each of the travel days.
The most economical means of travel will be determined by the department. If an employee chooses a different mode of travel, they will do so at their expense.
Questions and Answers:
Q: I am a pregnant employee. I work in Iqaluit and do not wish to deliver my child at the local facility. My doctor has provided me with a certificate to leave work one month prior to my delivery to travel away from the isolated post. I have made the necessary arrangements for a hotel stay in Ottawa for the four weeks prior to my delivery date. Am I eligible for reimbursement of expenses under Part III of the IPGHD?
A: The travel assistance benefit in this instance does not apply. The three (3) criteria outlined in section 3.1.2 have not been met.
Q: My spouse and I both work in Old Crow. My spouse has suffered a heart attack. My spouse was transported to Whitehorse General Hospital via Medivac evacuation. The travelling and transportation costs were covered by the Yukon Territorial government. May I request reimbursement of travelling and transportation expenses for me as I accompanied my spouse to Whitehorse?
A: Your return travelling and transportation costs from Old Crow to Whitehorse may be reimbursable provided that you have a medical certificate by the attending medical practitioner who attended to your spouse. The certificate must state the reasons why an escort was essential for your spouse's return home. Not all expenses will necessarily be covered for a lengthy period of time. The "return travelling and transportation costs" are only for the period you are required as an escort (as certified by the attending medical practitioner). You will be responsible for any additional costs.
Q: I was away on annual leave with my spouse when he became ill and we sought medical attention at a hospital. The attending medical practitioner determined that surgery was warranted at the earliest opportunity. Surgery was performed a few days later and 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?
A: 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).
Q: I have recently accepted a transfer to Yellowknife. My spouse is seven months pregnant and will remain in Winnipeg until the delivery of our child. She will stay with her parents in Winnipeg. Am I entitled to the non-elective medical assistance benefit to travel to Winnipeg at the time of the delivery?
A: The travel assistance benefits under Part III of the IPGHD (non-elective medical or compassionate) do not apply in this situation. The conditions have not been met since your spouse is not at the isolated post. Further the birth of a child does not qualify as a non-elective medical treatment.
Q: 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 caused by inadequate jaw space and which must be surgically removed. Our dentist has indicated that he could schedule the surgery at the St.Boniface General Hospital. Is this treatment covered under the non-elective dental travel assistance benefit?
A: Yes, provided you have a certificate from your dentist at the isolated post which explains that the treatment is non-elective and that it is required without delay. The qualified dentist must also indicate the nearest place (e.g. Winnipeg) in Canada where you can obtain the treatment.
Q: 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?
A: 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. The medical practitioner must also indicate the nearest location in Canada (e.g. Inuvik Regional Hospital) where the treatment is available.
For those situations where the travel assistance benefits apply under Part III of the Directive, "economy class fare" is the standard.
Under no circumstances are business class airfares to be authorized.