FSD 41 - Health Care Travel
At a number of locations abroad, the standards of medical care and the extent of treatment facilities or specialist services are inadequate in comparison with those in Canada. Additionally, at several locations, while adequate health care/facilities exist, treatment costs are excessive. This directive is designed to ensure that an employee and/or dependant have access to necessary and suitable health care facilities and services on a cost-effective basis as determined by the deputy head.
Please refer to the Instructions and Guidelines at the end of this Directive for additional information or greater clarification of certain sections.
Note: These definitions only apply to this directive.
Dependant (personne à charge) means each dependant or dependent student, as defined in FSD 2 - Definitions respectively, who resides with the employee at the post, or is in full-time attendance at an educational institution outside of Canada.
Living expenses (frais de subsistance) means:
(a) actual and reasonable local transportation expenses to and from the treatment centre, and
(b) actual and reasonable living expenses in commercial accommodation, or
(c) the cost of board, lodging and laundry in private accommodation, at a maximum of the Private Non-Commercial Accommodation Allowance in accordance with the NJC Travel Directive;
(d) the cost of telephone calls between the location of the person on health care travel and the family members at the employee's post, up to the cost of one ten-minute direct dialed long distance telephone call per week from the location of the person on health care travel to the employee's post for the total period of health care travel. (Note: Refer to Guidelines)
41.1.1 The health care facilities or services referred to in this directive may include dental care, only for those posts listed in Appendix A to FSD 9 - Medical and Dental Examinations, and published on the Department of Foreign Affairs and International Trade's website, and reasonable para-medical care.
41.1.2 Where the deputy head is satisfied that necessary and suitable health care facilities or services are not available locally, or local treatment costs exceed costs of travel, treatment and living expenses at the nearest suitable location, another suitable location, or Canada, the following may be approved:
(a) travel leave for the employee,
(b) payment of actual and reasonable travelling expenses during travelling time for an employee or dependant, and/or a young child who is obliged to accompany a parent on health care travel, and, where the need is certified by a qualified medical practitioner, for an escort, between the location of the employee or a dependant and the nearest suitable place as determined by the deputy head; or where the employee so requests, Canada or another suitable place where the required health care is available on a cost-effective basis, as determined by the deputy head, (Note: Refer to Instructions)
(c) actual and reasonable living expenses during outpatient treatment for the employee or a dependant, and/or a young child who is obliged to accompany a parent on health care travel, and, where the need is certified by a qualified medical practitioner, for an escort, (Note: Refer to Instructions)
(d) actual and reasonable living expenses for an escort, where the need is certified by a qualified medical practitioner and, where the employee or a dependant is receiving inpatient treatment and it is either desirable or more economical to have the escort remain at the treatment centre for the duration of the treatment period, (Note: Refer to Instructions)
(e) travelling expenses may be paid for an escort to make a second trip to and from the treatment centre at the conclusion of the treatment period, where it is not necessary for the escort to remain with the person being treated, (Note: Refer to Instructions)
(f) payment of dependant care expenses incurred by employees who are single parents or whose spouses or common-law partners accompany them on health care travel, where expenses are paid for dependant(s) under 18 years of age who reside permanently with the employee at the post where these are in excess of any existing permanent child care arrangements, such that the employee shall be reimbursed actual and reasonable dependant care expenses up to the provisions of the NJC Travel Directive. Where expenses for dependant care are incurred at a post, the maximum amount may be exceeded on the recommendation of the appropriate foreign service interdepartmental co-ordinating committee. (Note: Refer to Instructions)
(Note: Refer to Instructions)
41.2 Travel Leave
41.2.1 Unless the deputy head otherwise directs, travel leave shall only be granted during normal working hours where it is not feasible for the employee to travel during non-working hours.
41.3.1 In cases of accouchement, where payment of actual and reasonable travelling expenses has been authorized under subsection 41.1.2 for an employee and/or a dependant who travels to the nearest suitable place; or where the deputy head determines it is cost-effective and the employee so requests, to Canada or another suitable place where accouchement may take place, the deputy head may also approve:
(a) the payment of actual and reasonable living expenses both before and after the time of delivery where:
(i) the visa or other re-entry regulations delay the return to the post; and/or
(ii) the common carrier approved by the deputy head to provide the most suitable and appropriate means of transportation requires that such travel take place prior to the expected date of delivery; and/or
(iii) there is a medical requirement acceptable to Health Canada;
(b) an allowance for travelling expenses and living expenses for a period not to exceed five days, in accordance with subsection 41.1.2, to enable the spouse or common-law partner to be present at the birth of the child. (Note: Refer to Instructions)
41.4 Report to Health Canada
41.4.1 When health care travel is authorized under this directive, a medical report from the attending physician, acceptable to Health Canada, must be sent to:
Medical Officer in Charge
Occupational Health Clinic
Public Service Health Program
Emergency Preparedness and Occupational Health Directorate
Regions and Program Branch
171 Slater Street, 12th Floor, P.L. 3712M
Ottawa, ON K1A 0K9
Instruction for 41.1.2 - Application
The deputy head shall determine the suitability of health care facilities by reference to the advice of a roster doctor, an official of Health Canada or other qualified medical practitioner. An assessment of the suitability of treatment centres should also take into account cultural, social and political factors.
Instruction for 41.1.2(b) - Application
While the standard for air travel is economy class (including APEX, charters and other reduced fares), there may be situations which, in the opinion of the deputy head, justify a higher standard of travel. The lowest available airfare appropriate to a particular circumstance and/or itinerary shall be authorized. Particularly where health care travel can be anticipated and travel arrangements made in advance, discount and reduced fares shall be selected, where these rates are available. Significant savings can be realized if flights are booked as far in advance as possible. In non-urgent situations, it is the responsibility of the employee to make every effort to schedule medical appointments and/or treatment in order to take advantage of advance bookings.
Instruction for 41.1.2(b) and 41.1.2(c) – Application
When approving payment of travelling and living expenses for accompanying dependent children on health care travel, the deputy head shall consider each case on its own merits taking into account such factors as the ages of the children accompanying the parent and the availability and cost of child-care services at the post.
Instruction for 41.1.2(d) and (e) - Application
The need for an escort to remain with the person being treated will vary with the circumstances. For example, if the person being treated is a small child, it may be necessary or desirable for an escorting parent to remain with the child throughout the treatment period. On the other hand, if it is not necessary for the escort to remain with the person being treated, it may be more cost-effective to have the escort make a second trip to the treatment centre at the conclusion of the treatment period, rather than to pay living expenses throughout the treatment period.
Instructions for 41.1.2(f) - Application
1. Receipts for dependant care costs under this section shall include the cost, dates of employment and the sitter's / company's name and telephone number, as well as the sitter's social insurance number (where applicable).
2. The provisions for dependant care under this directive also apply to joint custody situations where the dependant qualifies as a dependant under the provisions of FSD 2 - Definitions. Depending on the terms of the joint custody agreement, dependant care assistance shall not normally be provided where the child's other parent resides in the same location as the child who requires dependant care.
Instructions for 41.3.1(b) - Accouchement
1. Additional leave in connection with travel under paragraph 41.3.1(b) should be claimed under FSD 48 - Other Leave, and not under this directive.
2. Provisions for the issue and verification of travel allowances under paragraph 41.3.1(b) are found in FSD 70 - Reporting Requirements and Verification of Allowances.
Guidelines for Definitions – Living expenses, paragraph (d)
1. Telephone calls are to be supported by receipts or an appropriate statutory declaration that the costs have been incurred. Where direct dialing facilities are not available, the deputy head shall determine the appropriate cost limitation.
2. More than one telephone call may be claimed per week, as long as the total cost for the period of health care travel does not exceed the total cost for one ten-minute call per week for the total period of health care travel.