7A.4. Travel & Transportation for Medical Purposes

POLICY 

Authority OW Act: Sec. 8 and 74(4) & OW Directives: Dir. 7.2 

Travel and transportation costs for medical treatment are paid when the costs exceed $15 per benefit unit in a given month. Verification is required from the appropriate health provider confirming the person requires the service.

Travel costs could include attendance at:
• medical appointments,
• rehabilitation (therapy),
• healing lodge,
• psychological counseling, 
• drug and alcohol recovery groups (e.g., Alcoholics Anonymous, narcotics Anonymous, etc.) or 
• for other medical or health-related purposes.

A monthly payment equivalent to a transportation pass can be issued if the participant is required to attend on-going appointments for medical or health-related purposes.

Where no public transportation is available the rate for transportation should be calculated using 0.41cents/km to and from the appointment and must be a minimum of $15.00 to be payable.

The worker must obtain medical verification where necessary. The worker should also ascertain if transportation coverage is available from the programs themselves, or from community. In cases where medical travel may be covered by the Northern Health Travel Grant, the Case Manager will ensure the Northern Health Travel Grant is assigned to the Manitoulin-Sudbury DSB before funds are issued. 

Every time a Case Manager completes an assignment, a copy must be filed in the electronic filing system. Case Managers must input a task in the social assistance computer system for 3 months to follow up if the assignment has been paid. If the assignment has not been paid, Case Managers should follow up with clients to determine why the assignment was not honoured. 

Where assignments are not honoured or reimbursement is not received, an overpayment is established.
If a third party or person acting on behalf of a benefit unit member fails to deduct and remit money to the delivery agent, the benefit unit member remains eligible for assistance. However, if money is received that has been assigned and is not repaid to the delivery agent, an overpayment is established.
When payment is received by the Manitoulin-Sudbury DSB finance department from any external source (i.e. NHTG, WSIB, CPP, EI, OSAP, etc.) A copy of the payment is sent to the Administrative Assistant who then posts it to the client’s file in the social assistance computer system.

As a rule, the cost of transportation for medical appointments will be up to the maximum cost for public transportation. Where more expensive transportation is necessary (such as a taxi for those unable to take public transportation or have no personal means of transportation) medical verification to be provided.

Applicants/participants should make use of residences available at hospitals, or the most economical accommodations available to:

• Actual cost of room up to $100 per day to a maximum of $700 per medical trip- payable only for medical trips over 200 kilometres.

• $20 per person/day for meals to maximum of $280 only for medical trip over 200 kilometres.

• Transportation to be the most economical method (ie.bus or equivalent) where a participant uses their own vehicle or has access to a vehicle for travel, the actual costs will be equivalent to the mileage rate permitted by the Northern Health Travel Grant.

Note: Meals are available only when the participant is out of town overnight.

Any other exceptional circumstance maybe considered at the discretion of the Director of Integrated Social Services. 

PROCEDURE    

1. Applicant/participant to obtain verification from a physician.

2. Verification of attendance must be provided prior to reimbursement of transportation costs.

3. Workers are to issue the funds directly to the client where possible and will ensure that Section 2 of the NHTG is completed for reimbursement

3. Prior approval is always required. Where an applicant/participant is unable to request prior approval for medical reasons; they are to submit receipts upon return for reimbursement.  Northern Health Travel Grant Advances and other exceptional cases may be issued “up front” monies. 

NORTHERN HEALTH TRAVEL GRANT 

Family Doctors are required to provide the form to clients. Case Managers can issue the form in an emergency situation where a family doctor referral is not required. Please call 705-675-4010 or 1-800-461-4006 to determine if your client is experiencing an emergency situation. 

1. Complete Section 2 of the Northern Health Travel Grant. Applicant and Case Manager’s signature required in this section.

2. Ensure northern referring doctor has completed & signed Section 3.  Section 3 need not be completed for follow-up appointments. 

3. Ensure participant has completed & signed Section 1

4. If patient needs accompaniment (i.e. a child) ensure Section 5 is completed.

5. Issue an advance payment for their travel expenses. Scan the original into the electronic filing system. Give the original back to the client. Record activity in the Social Assistance Computer System notes.

6. Send email to Administrative Assistance with the:
    o Date of appointment
    o Who the appointment is for
    o Date of the cheque

7. When the client returns after their appointment, ensure the information from the Specialist is completed in Section 4. Scan the completed NHTG into the electronic filing system and delete the previous copy.  Mail the completed copy to the Ministry of Health on the clients behalf. 

8. When payment is received it is forwarded to Finance.  Once deposited Finance forwards a copy of the cheque to the Administrative Assistant.

Note: Northern Health Travel Grants are only available for individuals travelling 100 km or more 

SECOND AND SUBSEQUENT REQUESTS

If an applicant/participant is requesting a travel grant advance for the second time, the Social Assistance Computer System note is to be checked to see if payment has been made on the previous request. NOTE: The reimbursement may take up to 8 weeks to receive funds from Ministry of Health. If there has not been a payment, the applicant/participant is to contact the Ministry of Health to determine why. The Ministry of Health will respond either in writing to the participant or verbally to a Case Manager. The response determines whether there will be another advance granted. For example: if the advance was not granted because it was not an item covered by the Travel Grant and the current request is for the same reason, the advance would be denied.

Exception: The time duration was too short for the first travel grant to be processed. In that scenario, one additional travel grant could be processed.

Applicants/participants travelling out of town for medical reasons may be issued:

• Actual cost of a room up to $100 per day to a maximum of $700 per medical trip;
• $20 per person/day for meals to maximum of $280
• Transportation to be the most economical method (i.e. bus or equivalent). Where a participant uses their own vehicle or has access to a vehicle for travel, the actual costs will be equivalent to the mileage rate permitted by the Northern Health Travel Grant. 

Prior approval for a specified time period is required. Applicant/participant is to submit receipts upon return for reimbursement for actual number of days.  Exceptional cases may be issued “up front” money.

Exception: Children receiving Assistance for Children with Severe Disabilities (formerly Handicapped Children’s Benefits) are not eligible to receive monies for food and accommodations. These extra costs are taken into consideration when the assessment is made for this benefit. If there are extra costs, refer the applicant to the MCSS Case Manager who can reassess the case.