New dental policy for Indigenous children

OTTAWA— The federal government is revising policies around its approval of orthodontic work for Indigenous children after spending more than $110,000 to fight a $6,000 bill for a teen’s braces.

In a settlement reached this week, Ottawa will now adopt recognized standards to account for pain and discomfort when deciding whether such dental work is necessary.

“We are very pleased we were able to reach a settlement,” Jane Philpott, minister of Indigenous services, said Wednesday.

“We agreed to settle and to make some revisions to our policy to make sure that there’s expanded access and a fair process for appeals.”

The case involved Josey Willier, a 16-year-old Indigenous girl from Alberta who suffered dental problems that caused her chronic pain. A dentist recommended orthodontic treatment, saying her problems would worsen as she got older. The costs were not covered by the Alberta Health Insurance Plan, but the teen's mother, Stacey Shiner, sought payment under a Health Canada program that provides coverage to First Nations and Inuit people.

Health department bureaucrats determined that her condition was not serious enough to warrant braces, dismissing the initial application for coverage and all subsequent appeal.

Despite the refusals, Shiner went ahead and had the orthodontic work done. When attempts to be reimbursed were rebuffed by the federal government, Shiner took the claim to Federal Court. Her claim for a judicial review was dismissed a year ago. This week’s settlement ends her appeal of the case.

The department will revise the policy for providing orthodontic treatments, using a new index to better account for the pain and discomfort when deciding whether to approve treatments. As well, if a case is denied, the orthodontist will be able to provide additional clinical dental and medical evidence to support an appeal of the decision.

“We have every reason to believe that this will lead to expanded access and that it will be fair for families,” Philpott said.

In the first four months of last year, Ottawa spent $110,336.