PURPOSE ALLOWANCES AND BENEFITS Human Resource Manual MEDICAL TRAVEL ASSISTANCE (MTA) 1. The Government provides its employees and their eligible dependants with Medical Travel Assistance (MTA) to the nearest centre where appropriate and necessary insured non-elective medical treatment is available. This includes approved orthodontic treatment for employees in the Nunavut Teachers Association bargaining unit. 2. Patients and authorized escorts receive MTA only if they are required to travel where adequate treatment is available at the nearest community. The Department of Health & Social Services determines the nearest community and authorizes the travel. 3. The employee is required to make every reasonable effort to schedule medical or dental treatment with other forms of leave and travel. APPLICATION 4. These guidelines and procedures do not apply to the following Government employees: casual employees with less than four months of continuous employment; substitute teachers; employees on leave without pay who do not remain in Nunavut; employees on leave without pay for personal reasons; and travelling under a Workers Compensation Board claim Entitled Benefits Eligible employees and qualifying dependants or escorts are entitled to MTA benefits similar to those provided under the duty travel directive; however, there are limitations that vary, depending upon the applicable employee group. 1) For employees who are members of the Nunavut Employees Union, benefits are specified in the Nunavut Employees Union Collective Agreement. August 10, 2006 1
2) For employees, who are classified as Senior Managers, Excluded Employees refer to the Senior Managers & Excluded Employees Handbooks. 3) For employees who are members of the Nunavut Teachers Association, refer to the Nunavut Teachers Association Collective Agreement. 4) In situations where there are exceptional circumstances, the Deputy Minister of Finance (or delegate), in consultation with the Department of Health and Social Services may authorize, on an individual basis, MTA benefits referred to in these guidelines and procedures. DEFINITIONS 5. Accommodation Warrant is the official form, which authorizes payment for accommodation. 6. Duty Travel Rates are defined by the NEU Collective Agreement Article 41 and the NTA Collective Agreement Appendix B4 or the employee handbooks, whichever applies. 7. Escort is someone who accompanies the patient: Medical Escort is a health professional required to provide medical care to the patient while in transit. Non-Medical Escort is a spouse, parent or person of the age of majority (19 years or older) required to assist the patient and is certified by a qualified medical practitioner practising in Nunavut. 8. Medical Treatment is a service that is an insured non-elective benefit under the Nunavut Health Care Plan. 9. Nearest Community is the nearest centre where appropriate and necessary insured health services or dental services can be obtained. 10. Non-Elective Treatment is medical treatment that is an insured service under Nunavut Health Care. August 10, 2006 2
11. Orthodontic Treatment for members of the NTA is orthodontic treatment approved by the dental committee established by the Nunavut Department of Health and Social Services using the criteria established by the Medical Services Branch of Health and Welfare Canada in its schedule of Dental Services for Nunavut. 12. Point of Departure/Nearest Treatment Centre: For all communities in the Baffin Region is Ottawa or the nearest centre where appropriate and necessary insured health or dental services can be obtained, whichever is closer. For all communities in the Kivalliq Region is Winnipeg, Iqaluit, Yellowknife or the nearest centre where appropriate and necessary insured health or dental services can be obtained, whichever is closer. For all communities in the Kitikmeot Region is Edmonton, Yellowknife or the nearest centre where appropriate and necessary insured health or dental services can be obtained, whichever is closer. 13. Practitioner in Nunavut is a licensed medical doctor, dentist or registered nurse. A Referring Practitioner is a Nunavut medical practitioner who recommends medical treatment be obtained outside the employee's community of residence. An Attending Practitioner is a practitioner who provides medical treatment at the place of referral. 14. Travel Warrant is the official form, which authorizes payment for travel by a commercial carrier. PROVISIONS General 15. MTA is available to employees and their dependants only when certified by a qualified medical practitioner practising in Nunavut when required medical treatment is not available in their community of residence. August 10, 2006 3
16. Normally MTA is not provided for referrals by dentists for dental procedures. However, MTA is available for orthodontic treatment if the treatment is approved by the Nunavut Department of Health and Social Services using the criteria established by the Medical Services Branch of Health and Welfare Canada in its Schedule of Dental Services for Nunavut. 17. MTA is provided to employees who are required to attend alcohol or drug rehabilitation programs if the program is not available in the employee's community of residence. Normal procedures for MTA apply in these circumstances. 18. MTA is not provided if a similar benefit is available through another employer or insuring body. 19. Referrals must include a certificate from the referring practitioner stating that the treatment is an insured non-elective benefit under Nunavut Health Care and is not available in the community of residence. 20. MTA is only provided to the nearest treatment centre, up to the point of departure, where appropriate and necessary insured health services are available. Note: For further information about medical services provided at various communities within Nunavut, please consult the Department of Health and Social Services. 21. Travel assistance may be provided with an approved MTA beyond the nearest treatment centre when: the nearest centre has been contacted and cannot accept the referral; the delay in accessing the nearest centre is clinically unacceptable because of the patient's medical condition. 22. A travel authorization and expense claim form must be supported by MTA. 23. Travel assistance is provided for the shortest possible period required for medical treatment. 24. Expenses related to treatment not covered by the Nunavut Health Care or the current applicable Government Health Insurance Plan is not reimbursed. August 10, 2006 4
25. All expense claims must be submitted within ten days of completing the trip with an approved MTA. 26. Extensions to the initial period of assistance must be supported by a letter from the attending practitioner. The employing department & The Department of Health & Social Services must be notified as soon as possible. 27. Where medical travel costs by the Government can be reimbursed from a health care plan, the employee assigns any reimbursement to the Government. Air Transportation 28. An airline ticket is purchased with a medical travel warrant issued by the Department of Health & Social Services. 29. In exceptional circumstances, where the referral does not permit adequate time to apply for a medical travel warrant, the employee may be reimbursed for travelling expenses. However, a medical travel warrant must be completed upon return to Home Community. In this case, the employee is reimbursed for Goods and Services Tax (GST) with an approved MTA. 30. Transportation assistance is provided to the nearest treatment centre, or point of departure, and back whichever results in the lesser expense with an approved MTA. 31. Transportation costs cannot exceed the return economy airfare and, wherever possible, excursion rates will be used. Emergencies are an exception. 32. An employee is reimbursed at duty travel rates for accommodation and meals enroute when travel to the treatment centre is interrupted by weather or other circumstances completely beyond an employee s control. August 10, 2006 5
Accommodation 33. Hotel accommodation for 25 days or less is paid by the employee represented by the NEU and reimbursement must be requested when the employee submits an expense claim. Where an employee requests reimbursement for accommodation, reimbursement is for room charges (not to exceed the maximums as outlined in the MTA Guidelines) provincial room tax and GST. The employee may request an accommodation warrant in advance of the trip. Note: NTA Employees or their dependants, who receive specialized treatment as outpatients, will be reimbursed for accommodation, meals and local transportation expenses based on a per diem rate in the Duty Travel Section of this Agreement. This applies for periods over seven (7) days, but not to exceed thirty (30) days. Senior Management and Excluded Employees may claim per diem cost for meals in accordance with the per diem expense schedule revised from time to time by the Department of Finance. 34. An employee travelling within Nunavut is reimbursed for actual expenses incurred for accommodation with an approved MTA. 35. An employee may claim fifty ($50.00) for each night outside Nunavut, adjusted as the Federal rate is changed, and seventy-five ($75.00) for each night within Nunavut when staying in private non-commercial accommodation. No receipts are required for private non-commercial accommodation. Note: Members of the NTA bargaining unit may claim $50.00 per night. Meals and Expenses 36. All eligible expenses are reimbursed to a maximum of 40 days based on: (a) (b) the first 25 days at duty travel rates; and $50 for any period beyond twenty-five (25) days, and not to exceed forty (40) August 10, 2006 6
Note: Members of the NTA bargaining unit are reimbursed seven days meal costs, but not to exceed fifteen calendar days in accordance with the rates specified in Appendix B4.05. 37. No long distance phone call charges are reimbursed unless prior approval is obtained. Collect calls are accepted by the employing department from employees advising of extensions. 38. Receipts are required for all taxi fares. 39. Airport shuttle service must be used where available. Escorts 40. Non-medical escorts shall be reimbursed where a qualified medical practitioner practising in Nunavut certifies that it is necessary for the patient to be accompanied. 41. An employee may claim for only one escort. 42. Normally escorts must be over 19 years of age. 43. A spouse, the parent or another person designated by the employee must accompany the patient when someone other than a medical attendant or person designated by Health and Social Services is required. 44. In the case of an employee being the non-medical escort for a member of their immediate family, the employee may be granted special leave. Such leave will not be unreasonably denied. 45. No assistance is provided for compassionate escorts. 46. The referring practitioner or an authorized H&SS personnel completes part one of the Applications for MTA. 47. The employee completes part two of the Application for MTA, attaches a Photocopy of MTA with Leave Form and forwards them to the employing department for approval. The MTA must be guaranteed by an appropriate person. 48. If the application is approved, the employing department completes part three of the Application for MTA and keeps copy one of the Applications for MTA. August 10, 2006 7
49. The department of Health & Social Services issues the medical travel and accommodation warrants for the specified dates and returns copies two, three and four of the Application for MTA to the employee. 50. If the application is not approved, it is returned to the employee specifying the reasons for non-approval. 51. The department of Health & Social Services makes reservations for air travel and accommodation and delivers the warrants to the travel agent/airline and/or hotel. 52. The attending healthcare professional completes part four of the Application for MTA to confirm attendance. 53. If extended treatment is required, a letter from the attending practitioner must be provided to allow reimbursement of additional approved expenses. 54. The attending physician, or the last attending physician/dentist, if more than one, completes part four certifying the patient's ability to travel. 55. After returning from medical travel, the employee forwards copies two and three of the completed Application for MTA claim form and receipts attached to the department of Health & Social Services to verify the claim and mails a cheque for all approved expenses to the employee. AUTHORITIES AND REFERENCES 56. Main Collective Agreement with the NEU Article 20.09, Transportation to a Medical Centre Article 51, Casual Employment 57. Collective Agreement with the NTA Article 14.07, Medical Transportation Assistance 58. Senior Managers' Handbook Medical Travel Assistance August 10, 2006 8
59. Excluded Employees' Handbook Medical Travel Assistance 60. Financial Administration Manual Directive No. 820-4 CONTACTS 61. For further information or clarification, please contact: Director Employee Relations Department of Human Resources Iqaluit, Nunavut 975-6211 or Director Compensation and Benefits Department of Finance Iqaluit, Nunavut 975-5881 or Director Corporate Services Department of Health and Social Services Iqaluit, Nunavut 975-5711 August 10, 2006 9