Non-Insured Health Benefits (NIHB)

Phone: (204) 252-2553
Fax: (204) 252-2151
Toll Free: 1-888-834-9768

The Long Plain Non-Insured Health Benefits programs are funded through a yearly Contribution Agreement with First Nations and Inuit Health Branch (FNIHB). Although the programs are delivered at the community level, the guidelines are developed by FNIHB and it is our responsibility to deliver these programs within their guidelines. Failure to follow the guidelines can result in the program being "taken back" and delivered by FNIHB.

Programs delivered by Long Plain NIHB are:

• Mental Health Services — within Manitoba
• Medical Transportation Services — within Manitoba
• Vision Services — within Manitoba
• Dental Services — across Canada

Programs delivered by FNIHB include:

• Mental Health Services — outside of Manitoba, but within Canada
• Medical Transportation Services — outside of Manitoba, but within Canada
• Vision Services — outside of Manitoba, but within Canada

Programs delivered by FNIHB requiring prior approval through FNIHB include:

• Out-of-province medical transportation for clients who require medical treatment not available in Manitoba
• Medical Supplies and Equipment
• Pharmaceuticals (prescriptions)

Medical Transportation

Medical Transportation consists of the following: transportation, ambulance, meals, accommodations, NNADAP transportation, and traditional healing.

Medical Transportation has 4 medical vehicles (three vans and one 4X4 Jeep), three full-time drivers. One driver shuttles transportation to specialist appointments outside the catchment area. Two drivers transport patients from Long Plain to Portage la Prairie, which has the nearest medical facility. Two drivers are utilized on a casual basis to provide after-hour emergency transportation not requiring an ambulance; these two drivers are also utilized as relief drivers to fill in while the full-time drivers are on vacation or sick leave.

The following is a 3-year comparison of medical transportation services provided:

To Portage la Prairie:

Winnipeg and other destinations:

Ambulance Services

Road ambulance services were provided to tribal members across Manitoba on 352 occasions, which Long Plain NIHB is responsible for payment. The transportation clerk reviews all ambulance claims and forwards the claim to the appropriate agency for payment.

NNADAP Transportation

NIHB assisted with transportation for NNADAP clients to attend treatment centers on 14 occasions.

Traditional Healing

45 requests for tribal members to see healers outside the community and 6 requests for tribal members to see healers in the community were approved. Tribal Members are encouraged to seek traditional healing within the community or to bring traditional healer to the community providing it is economical.

Vision Program

Provision of Benefits — all vision care benefits must be pre-authorized by the Long Plain NIHB Unit and are provided on an individual approval system. In cases where pre-authorization has not been obtained, some costs may be reimbursed to the client depending on the eligibility criteria.

Appeals — an appeal process is available for the Tribal Members not agreeing with their eligibility status, with limited funding there are no exceptions and very few appeals. If an appeal should be brought forward an appeal committee or Chief and Council review them.

Major Accomplishments — although the Long Plain First Nation Band Membership has increased we have been unsuccessful in negotiating for increased funding for this program, resulting in a deficit in this program for the 2005-06 fiscal year. Long Plain NIHB is now requesting all band employees to follow FNIHB guidelines and access reimbursement from their group insurance policy as NIHB remains payer of last resort.

Dental Program

The Long Plain NIHB Dental Program is administered on a National level for all Long Plain Tribal Members across Canada. Claims are received on a daily basis and are confirmed for private, third party plans, city or provincial social assistance coverage prior to payment by our office. Currently we are the only community who delivers this program at the community level, all other communities dental programs are delivered through FNIHB.

Dr. Douglas Brothwell, Head of Dentistry from the University of Manitoba was contracted to review pre-approvals and/or predetermination for approval or denial. During this period changes have been made and FNIHB now provides this service.

Changes made within the Dental Program by FNIHB in the areas of provider fees and removal of the threshold for approved treatment and a population increase have resulted in a deficit in this area and a delay in payment to providers in 2005-2006. This resulted in some providers refusing to provide services. Negotiations during 2005-06 have resulted in an increase in our dental funding for 2006-07.

Mental Health

Mental Health services are available to on-reserve band members through the Community Mental Health Worker at Long Plain NIHB office. On-reserve band members who prefer another Mental Health Worker or off-reserve band members may access these services through a FNIHB approved provider and are responsible for transportation, meals and parking.

Changes in the services provided through the Mental Health Program during 2005-06 include hiring of a Community Mental Health Worker 3 days per week, and clinical supervision duties contracted with Michael Hart. Mental Health Program services include anger management, domestic violence and victimization sessions. Residential School issues, crisis intervention, depression, anxiety, mental illness, family and relationship issues are also addressed. Services are also provided at the school on a weekly basis offering information, resources and support to both students and staff as needed.

To ensure all FNIHB requirements are met prior to payment of invoice, all invoices by off-reserve fee for service providers are reviewed for assurance of prior-approval for treatment, treatment plans and number of approved treatments/sessions.

Current Mental Health Case load is 40 clients with linkages created with DOCFS, Family Resource Centre, Aggasiz Youth Centre, Portage Women's Shelter, AFM Portage, Portage School Division, Portage Clinic and LPFN Probation Services.

NIHB Staff as of March 31, 2006

Margaret Meeches — Medical Transportation Coordinator
Wanda Meeches — Receptionist/Vision Clerk
Donna Beauchamp — Dental Clerk
Jennifer Chmelyk — R.P.N. Community Mental Health Worker
Joe Longclaws — Medical Driver
Sheldon Peters — Medical Driver
Marshall Prince — Medical Driver
Lawrence Robinson — After-hour Medical Driver
Shanlee Peters — Janitor