Shopping alleged on medical flights

OTTAWA -- Staff at a remote First Nations nursing station near the Ontario-Manitoba border arranged expensive emergency medical flights -- on the federal government's dime -- to go grocery shopping in a more populated community, a newly released document alleges.

A special report by Health Canada investigators sets out troubling allegations about the conduct of staff at the Poplar Hill nursing station in northern Ontario, and about a small airline from which the Canada Revenue Agency is still trying to recover a sizable amount of money.

The claims are brought to light as part of a months-long investigation by The Canadian Press into allegations of wrongdoing by service providers of the federal government's health plan for aboriginals.

The Non-Insured Health Benefits program provides health-benefit coverage to eligible First Nations people and Inuit when they are not insured by private or provincial plans. The NIHB program also covers travel costs when aboriginals need medical treatment but cannot receive care in their home communities.

Medical transportation is supposed to be arranged ahead of time at the Poplar Hill nursing station, the Health Canada report says, but nurses can approve urgent medical transport outside of normal working hours without prior notice. They do so through documents called local purchase orders.

But the report alleges staff at the nursing station may have had ulterior motives for arranging some of these supposedly urgent medical flights.

"Interviews with the (Keeper River Airways) air transportation representatives in Red Lake, nurses from the nursing centre and the community health representatives indicated that the majority of these flights might have been arranged to Red Lake to provide for personal benefits," the document says.

"In one interview, (blank) explained one of the main reasons for going to Red Lake: 'Groceries. People go for groceries. It's a big thing.' "

Keeper River Airways owner and pilot Terry Cousineau confirmed to The Canadian Press that some patients returned from medical appointments with groceries.

"Not only did we have to bring them into Red Lake or Pikangikum to see the doctor, dentist or whoever, we had to take them back home, of course," Cousineau said in a telephone interview.

"So when they went back home, they invariably had at least a bag or a couple bags or couple boxes of groceries or whatever. I can't say as I blame them. Like I say, the price of groceries in Poplar Hill is pretty expensive because it has to be flown in."

The closest place to Poplar Hill to get medical treatment is Pikangikum, a 12-minute flight away. Three local airlines flew between Poplar Hill and Pikangikum: Superior Airways, Wasaya Airways and Keeper River Airways.

The auditors found 479 of the 487 local purchase orders for urgent medical transport, representing 98.4 per cent of all the flights, were arranged through Keeper River Airways, which they say was "by far the most expensive" of the three airlines. Cousineau said he was told his airline was actually the cheapest option.

The auditors also found most of the trips from Poplar Hill were to Red Lake, more than twice as far away as Pikangikum and offers almost identical medical services.

The nursing station could not explain to the auditors why it used what auditors say was the most expensive airline or why it sent patients to the more distant Red Lake instead of Pikangikum.

The auditors claim the nursing station cost the Non-Insured Health Benefits program up to $654,064 more than it should by using Keeper River Airways and sending patients to Red Lake.

Other troubling allegations emerging from the investigation:

-- Information on the local purchase orders did not always match plane logs and flight manifests.

-- Signatures were forged on the local purchase orders in 84 cases.

-- Some local purchase orders were signed days after the medical transport, sometimes by nurses who had nothing to do with the cases.

-- One of the nurses routinely abused her position to travel. She would claim expenses for fake trips and travel under the names of patients or with forged documents.

-- The Canadian Press

Republished from the Winnipeg Free Press print edition September 24, 2012 A9