Veterans Affairs Committee on Nov. 20th, 2007

[Roger Valley, Liberal, Kenora, ON]

I'll use some more of your words: “Veterans are demanding more choice in care options. Unfortunately current criteria often limit choice.” Just before that, you stated, “The result is that we are faced with complex eligibility rules.”

With all the changes and revisions and new programs, are we able to actually reduce some of the red tape at some point? The nature of the complex rules discourages people. Are we able to work with some of that and actually remove some of it?

[Darragh Mogan]

I think it's fair to represent the work of the health services review, done in response to the report of the Gerontological Advisory Council, as aiming to reduce to as few as we can the barriers to good health care that come from complex eligibility rules, apart from administrative costs. So I think there's a fair appetite for making real progress on that.

[Roger Valley, Liberal, Kenora, ON]

Thank you, and I'll pass off the questions to my colleagues.

[The Chair, Conservative, Rob Anders]

Thank you, Mr. Valley. You took 7 minutes and 52 seconds, which was pretty good.

Mr. Perron, for the Bloc, for seven minutes.

[Gilles-A. Perron, Bloc, Rivière-des-Mille-Îles, QC]

I hope I'm going to get my 52 seconds also.

Good morning, Mr. Mogan and Mr. Miller.

I have a lot of questions as a result of your presentation. For example, you say you have agreements with 14 major hospitals. Can we have the names of those major hospitals?

My second concern is that you say you have agreements with virtually every province because the provinces don't have the same systems. In Quebec, long-term care comes under a provincial program that covers virtually all of them. Are the costs incurred by our veterans who have access to this care entirely paid by Quebec? I'd like you to give me a snapshot of the Canadian system and provincial systems, and I'd like to know the percentage you pay in each of the provinces to occupy the beds.

A trivial question also comes to my mind. Are there still a lot of veterans overseas? I wonder how many of them have stayed there and have access to services.

Lastly, I'd like you to give me more details on what is my biggest concern. I'm talking about your eligibility rules, which virtually none of the veterans or their friends and family know. I'm also talking about the complexities that these people have to face in registering for the program.

Those are the questions I had to ask you.

[Darragh Mogan]

Thank you for your questions.

I can't name the 14 hospitals at this time; I don't exactly remember them. I can send you the list after the committee meeting.

[Gilles-A. Perron, Bloc, Rivière-des-Mille-Îles, QC]

I will wait for that list.

[Darragh Mogan]

We have agreements with some provinces, but not all. In some cases, agreement is...[Technical difficulty--Editor]. Where we do have agreements with provinces, these focus primarily on the management of these long-term care contracts.

[Gilles-A. Perron, Bloc, Rivière-des-Mille-Îles, QC]

Pardon me for interrupting you, but we have technical problems. It's hard to hear you and your voice is being cut off. I understood absolutely nothing of what you just said.

[Darragh Mogan]

Okay. Is this better?

In regard to agreements with provinces, there are some agreements with provinces but they are only used to normalize the relationship between the provinces and the federal government for the management of these contract beds. For instance, we have them in Ontario and in Manitoba. We don't have many contract beds in the province of Quebec, so there's no federal-provincial agreement there, but there are agreements with the facility. For instance, in Quebec City there are agreements with the facility there on the day-to-day operation of it, the admission criteria, who pays for what, and the relationship between admission of a veteran to one of these facilities and the civilian eligibility. Across the country, the care of veterans is very much a cooperative federal-provincial enterprise and we rarely, if ever, have any difficulties in that area, which is a very good thing.

Where Veterans Affairs is asking a province to provide a service, we pay for the service. Where it's for the care of a pension disability, someone who has a war injury, we pay 100 percent of the cost, no matter what province it occurs in.

Mr. Perron noted that there were problems with eligibility and the rules governing eligibility. He was no doubt right.

Monsieur Perron was commenting on the complex eligibility rules, and from a public service point of view, we couldn't agree with you more. One of the goals of the health services review, which Mr. Ferguson and I spoke of last May, was to attempt to reduce if possible, and we think it is possible, these rules that have been built up over 60 years of adding eligibility each time there was a political interest in doing that, without reconciling all the different criteria that a veteran might have to meet. We feel it's more important to focus our administrative resources on our abilities in caring for veterans rather than managing rules, and I think there would be general agreement at the political level with that goal.

Monsieur Perron, I hope I've addressed some of the questions you raised.

[The Chair, Conservative, Rob Anders]

Mr. Perron, go ahead, please.

[Gilles-A. Perron, Bloc, Rivière-des-Mille-Îles, QC]

It is true that we must address the problem of the complex nature of the laws.

I have a final question to ask you. What is being done with our young veterans, those who come back from war with psychological injuries? For example, at Sainte-Anne-de-Bellevue, after we fought for it, seven beds are now available for them, instead of five beds that there had been for a long time.

[Darragh Mogan]

I understand, Monsieur Perron, your question very well. From the time of the passage of the new veterans charter in April 2006, our commitment to care for and support younger veterans became more manifest. It is a top priority, between the Department of National Defence and ourselves, to ensure that individuals who are suffering from service-related disabilities, especially coming out of combat zones, but even otherwise, are cared for as a first-rate priority using community facilities and using any of the other capacity that we have developed with National Defence, such as the network of mental health clinics through our OSISS clinics and national defence OTSSC clinics.

You're quite right, having eligibility rules standing in the way of the care of these young people is unacceptable.

[Gilles-A. Perron, Bloc, Rivière-des-Mille-Îles, QC]

Thank you, sir.

[The Chair, Conservative, Rob Anders]

Yes, sorry about that, but Mr. Perron had seven minutes and 46 seconds. So he's seven seconds under.

[Gilles-A. Perron, Bloc, Rivière-des-Mille-Îles, QC]

You owe me.

[The Chair, Conservative, Rob Anders]

Now, normally we would pass on to one of the other members, but they're not here today, so we're going to go to Mrs. Hinton of the Conservative Party for seven minutes.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you, Mr. Chairman.

Welcome, Mr. Mogan and Mr. Miller. It's always a pleasure to talk to you.

I don't have a lot of questions. I'm going to pass to my colleagues, but I do have a couple of comments I'd like to make.

I was extremely happy to see that the contract beds are actually allowing veterans to stay and have their spouses nearby. That's something that's very important to quality of life.

Regarding another thing that Mr. Valley said earlier, and maybe I can help him in this period of goodwill here, I get my message out to my veterans through two mechanisms. One is the ten percenter and one is the householder. I've had a number of veterans who really didn't have any idea they were eligible for some of the things they're eligible for. Perhaps that's one of the reasons why we've added 12,000 brand-new veterans to the role.

Thank you very much for appearing today, and I'm going to pass to Mr. Shipley.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

Thank you.

Thank you, Mr. Mogan and Mr. Miller, for coming today.

I think all of us understand the significance of a VIP program and the extension of that as much as we can to our veterans. I want to follow up, and I suspect we're going to have a number of discussions around similar issues. One thing we talked about was the gerontological report--the GAC report. It's wanting to bring together health benefits, VIP, and residential care issues under one VIS program. I think we agree with that.

One of the comments under the weaknesses talked about the complex eligibility. We've already had some discussions about that. I want to get some comments on how you would set it up so we get away from the regulatory issues and get down to what we all want to see, which is that the service and benefits get to the veterans. It seems that if we are struggling in terms of effectiveness with one program, putting three under one without a sincere change of direction by our department will not make things easier. I wonder whether you have some comments.

[Darragh Mogan]

You've effectively summarized the nub of the problem that the veterans health services review is attempting to address. If complex eligibility rules for one program affect three different program areas and you integrate them into one veterans integrated service like the Gerontological Advisory Council recommends, then one could argue that you have three times the challenges.

Our purpose with the veterans health services review is to attempt to simplify the gates into the programs so we don't have two or three different eligibility gates and sets of rules that someone must adhere to before they can get help from us. In the best of all possible worlds, if a veteran had a need we'd respond to it. That is the goal of the veterans health services review. We hope to be able to make recommendations to the government that achieve that. It's certainly the goal of the Gerontological Advisory Committee's report, Keeping the Promise.

So, Mr. Shipley, your observations seem to be right on the money.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

Just to follow up, you mentioned the attempt to simplify. If that's an attempt to simplify under a new program that is integrated, I'm wondering why that attempt to simplify hasn't been there for the single programs.

[Darragh Mogan]

That's a very good question. The programs do intersect. The long-term care program does intersect with the VIP program. If we simplify the rules in one, it would be quite unfair not to do it for the other, because they are in effect meant to run as a continuum. One of the reasons they can't run as a continuum is that there's this gap in the middle between home and long-term care, and that's assisted living. That's certainly one gap we want to fill.

Others might have different opinions, but I think the department and the Gerontological Advisory Committee felt that this was the right time to fix all the eligibility rules, if we could, and not to fix or have better rules for VIP but then the same complex rules for long-term care.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

You mentioned that the average veteran's age is somewhere around 84 years old. We always have a concern that when something comes up they don't have someone to help them through some of these complex periods in which they're trying to make applications. Do you see where the new ombudsman will come in? Is that a role in which they may be able to help some of the veterans, even under the new regulated service if that attempt to simplify does come in?

[Darragh Mogan]

I would see a really positive advantage to having the ombudsman involved, both pre- and post-change. So I would have to answer, yes, it would be another voice advocating for those veterans who might not feel they're as well supported as they could be--and that's perfectly fine.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

Am I still okay?