BC’s Medical Services Plan is Funding Out of Province Substance Use Treatment for Workers

A woman in British Columbia is speaking out after she says she was forced to travel across the country for treatment in order to receive disability benefits due to an out-of-province arrangement with BC’s medical services plan and Worksafe BC. 

Elizabeth (whose name has been changed to protect her identity) is a nurse in BC who had taken time off due to burnout and PTSD experienced on the job.

In order to receive compensation from her insurance company under a disability claim, Elizabeth says she was required to provide her insurance case manager with her counselling notes, in which she mentioned that she drinks alcohol in her personal time off. 

This sent Elizabeth on a horrifying series of events in which her insurance company’s case manager and a designated medical coordinator referred her to a private addictions doctor called an Independent Medical Examiner (IME doctor), instead of her regular physician.

Elizabeth says the intake assessment and subsequent report made her “feel like a criminal” and mischaracterized her relationship with alcohol. 

“She asked how much alcohol I had in the house, and when I told her, she said, ‘oh that’s a lot.’ She asked if I’ve ever thrown up or gotten sick from consuming alcohol, she asked if I drank with others which I said yes, my sisters and I enjoy wine and she said, ‘oh, you drink with your sisters?’”

“It was a lot of judgment,” Elizabeth said. “She never asked if alcohol interfered with my professional life because it didn’t.” 

“When I read the report I cried, it’s just so misguided and it demonized me and it’s not a true representation of who I am or my choice to have a drink when I want with family or friends.” 

Elizabeth, was then told by her IME doctor that she should attend treatment out-of-province, specifically for healthcare workers.

According to a Freedom of Information Request obtained by PressProgress, WorkSafe BC has increased the amount of funding available to an out-of-province treatment centre called Homewood, a “residential addiction service” based on the 12-step method.

Worksafe BC has been providing more funds to private recovery centres outside of BC year after year, with BC’s medical services plan also funding recovery facilities for workers out of province.

Funding from WorkSafeBC to substance use/drug treatment services

“BC workers, especially nurses, who are required to go to residential addiction treatment as a condition of employment are being told by the IME addiction doctors that they have no choice where they go, and they have to go to either Homewood or Bellwood private 12-step facilities in Ontario because those are the only facilitations that the MSP will cover for them to attend,” Byron Wood of Workers for Ethical Substance Use Policy told PressProgress.

“Along with the MSP misinformation, workers are also told that these facilities are the only facilities in Canada with specialized programs for health care workers, first responders, military, etc. This is also not true.”

According to Wood, many workers, especially health care workers, are being told by their doctors that they can only receive funding under BC’s Medical Services Plan if they attend specific treatment facilities, including Homewood or Bellwood in Ontario. 

“I wasn’t informed of what kind of assessment, I just knew it was a third-party and it was seven hours of grueling intake—urine samples, drug testing, cognitive, psychosocial all that going back to when I first had a taste of alcohol,” Elizabeth told PressProgress. “Then after that, she wrote a 40 plus page report and sent it to my insurance and my GP and diagnosed me with alcohol-use disorder.”

Due to a car accident, Elizabeth deferred her treatment temporarily, before abruptly being told in the beginning of the year that she was required to go to treatment at the facility recommended by her IME doctor to avoid being found “non-compliant,” and no longer be eligible for compensation from her insurer. 

However, in an email addressed to Wood, BC’s Ministry of Health claims that healthcare workers are able to access treatment within the province—something Elizabeth said she was told was not possible. 

“Healthcare workers, as with any eligible BC Medical Services Plan beneficiary, can access publicly funded residential addiction treatment within the province. It is important to note, however, the Ministry cannot provide case-by-case public funding for individuals to attend residential treatment at facilities in BC that are not public or that do not hold service contracts with a BC health authority. Patients looking for publicly funded in-province treatment are encouraged to contact their community mental health and substance use centre for further assistance,” reads the message from the Ministry.

“While the Ministry has long-term historical relationships with Homewood Health Centre and Bellwood Health Services in Ontario, appropriate referring physicians may request funding for other facilities outside of BC that are public or hold public contracts with the appropriate health authority in their province. Please note that the Ministry does not have any preferred provider list for residential treatment centres, and all funding requests for out-of-province treatment are assessed on a case-by-case basis.”

Elizabeth’s experience differs greatly from what she was told by her IME doctor.

“I was coerced to go. I was told I wouldn’t be compensated, (if I didn’t), I felt like I was under duress,” she added.

Elizabeth says her IME doctor told her that she would be staying at Homewood’s residential treatment facility, which the doctor described as “really nice, with a red-seal chef.”

In actuality, Elizabeth ended up at Homewood Health Centre-inpatient program, which was actually a co-ed hospital ward that was nothing like she expected. 

“I was on a co-ed ward despite having a history of sexual assault—I didn’t feel safe there. I told the nurses that I was told I would be receiving private, individualized care,” Elizabeth said. “The nurses told me, ‘No, you’re not going there. That place is for people with a lot of money like celebrities or if you can pay 2000 dollars a night.”

Elizabeth ended up self-discharging after four days and going home, but was then told by her insurance company that she would no longer receive compensation since she was non-compliant, and that her case was going to be closed.

When Elizabeth’s family called her IME doctor about what happened and that she was sent to in-patient treatment instead of the residence, the doctor essentially passed the buck.

“She said, ‘well, I don’t know. That’s the government’s problem, that’s what MSP covered,” Elizabeth added. “I was duped.”

Similar to workers receiving compensation under WCB, any patient receiving treatment for alcohol or substance use is subsequently forced into years of medical monitoring and sobriety tests.

The relationships with MSP and WCB and several of these facilities, many of which are rooted in the 12-step method and have been accused of having conflicts of interest, are extremely problematic, Wood says.

“When people are getting funding from MSP or Worksafe BC they should be able to choose what services they use,” Wood said.

“The service providers on the lists are mostly residential abstinence based 12-step facilities which lack evidence showing they are effective and put people at increased risk of overdose death upon discharging. Mandated treatment is also ineffective and harmful.”

The facilities that the Workers Compensation Board has contracts with include  “residential addiction services” that are based in the 12-step method:

• The Orchard, a 12-step, private for-profit centre,
• The Last Door, a 12-step centre
• Homewood, a 12-step centre
• Edgewood, which operates several private for-profit 12-step centres in BC
• Cedars, a 12-step, private for-profit centrer
• Together We Can, which has a 12-step, and a non-twelve step centre

“The Workers Compensation Act Occupational Health and Safety regulation says you can’t come to work impaired. But there is nothing about being required to undergo treatment or to be abstinent or undergo drug testing as a condition of working,” Wood said.