Veterans Affairs Committee on April 14th, 2016

[Joe Martire]

Thank you for that.

In 2012, in the chapter when we looked at the transition, we also looked at the governance process between the two departments to ensure that information about benefits and programs is coordinated, harmonized, and shared.

As mentioned in paragraph 4.69 of that report, we found that there were gaps in the steering committee between some senior officials. They were charged with addressing the issues that you're raising, one of which was information sharing. What we found was that they had these priorities, but they weren't really tracking whether they were being accomplished and whether they had timelines for their completion, so there were gaps.

The good news was that there was a mechanism to coordinate and harmonize, but it wasn't being tracked and there were gaps in that process.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Clarke.

[Alupa Clarke, Conservative, Beauport—Limoilou, QC]

Thank you, Mr. Chair.

Mr. Auditor General, Ms. Campbell and Mr. Martire, welcome to the committee. I am happy to see you here today.

I will preface my first question.

I would like to come back to what my colleague Mr. Eyolfson said earlier. He felt that it was taken for granted that those who were submitting applications were faking, as they had to provide records to support their application if they wanted to receive specific services or benefits from Veterans Affairs Canada.

Mr. Auditor General, military members are under extreme pressure every day. It's an environment where people have to constantly prove themselves to their peers and their superiors. In a way, that's completely normal, as the government asks the Canadian Armed Forces to carry out missions despite sometimes insufficient resources. In addition, senior army officers have to ask their members to meet that requirement.

Here is what I think military members find difficult. The culture of military members having to constantly prove themselves is perpetuated, in a way, when they deal with Veterans Affairs Canada. For example, they have to do research to access their documents in order to prove that they have a service-related injury. I don't know whether this is true, but according to what I have been told, in the United States, the burden of proof lies with the Department of Veterans Affairs, and not the veterans themselves. Mr. Eyolfson also talked about that earlier.

My question is simple. Did you look at the burden of proof system in the United States in your audit? If so, what did you find out? If you did not look at it, what do you think about the burden of proof right now?

[Michael Ferguson]

I want to begin by pointing out that our audit examines the way the department processes applications for services. It focuses only on how the department handles those issues. Our audit did not look into what other countries are doing.

Generally speaking, I think the burden of proof is problematic for military members. It is especially important in mental health, as the audit shows. It is difficult for a member of the armed forces to admit that they are having mental health issues and to ask for help. That is an obstacle in the program in general.

The veteran must begin by deciding that they need help. Then, they have to prepare their application properly and perhaps file an appeal in case of a refusal. That is a cultural aspect of this kind of a program.

[Alupa Clarke, Conservative, Beauport—Limoilou, QC]

Thank you.

Should you soon have an opportunity to carry out a study on Veterans Affairs Canada's services, I strongly recommend that you look into how the burden of proof is handled in the United States. That burden is actually assumed by the U.S. department in charge of veterans, and not by veterans themselves. I would really like to see the results of that study.

In your audit, you made a recommendation on the mental health hotline. That recommendation has been implemented.

Have you considered the option of having a hotline for suicide prevention? That also exists in the United States.

Many veterans have told me that it was good to have the mental health hotline, but in situations of extreme crisis, they would like to be able to call experts who could manage their situation and help them avoid committing suicide.

[Michael Ferguson]

I think that is another consideration for the department. During this audit, we identified the various types of services available, including the hotline. However, it is up to the department to decide whether specific services for veterans should be implemented. That was not something we covered in our audit.

[Alupa Clarke, Conservative, Beauport—Limoilou, QC]

You said that it was easier to have access to the rehabilitation program than to the disability benefits program. Do you think that is a matter of money?

Obviously, disability benefits require considerably more financial resources. Do you think this could explain the difference in eligibility between the two programs?

[Dawn Campbell]

The requirements are not the same for the two programs. The problem with the rehabilitation program is really a temporary one.

There has to be a more permanent disability in order for one to be eligible for the disability program.

[The Chair, Liberal, Neil Ellis]

Mr. Fraser.

[Colin Fraser, Liberal, West Nova, NS]

Thank you for coming to meet with us today and for making your presentation.

I would like to ask about the Veterans Review and Appeal Board. I know that one of the recommendations was that Veterans Affairs work together with the Veterans Review and Appeal Board on a number of items. I'm wondering if you can comment on any delay that you noticed in the Veterans Review and Appeal Board in matters coming before a hearing, and then also whether there was a delay in a decision actually being rendered.

[Dawn Campbell]

I'll respond to your question. We really were taking a look at the process globally, in terms of how long. We stepped back and took at look at, for every veteran who had a successful decision, how long it took and whether or not there was a component of that that was taken up in terms of the review and appeal process at the appeal board. We didn't really look into the nuts and bolts or the subcomponents of that, but more how that added to the timeline overall.

[Colin Fraser, Liberal, West Nova, NS]

Okay, thank you.

With regard to an outreach strategy, did you take a look into how there was maybe different outreach needed in larger centres or more rural areas, where Veterans Affairs was to try to engage veterans who do not have access to services that maybe some folks in larger centres did or where there were service centres?

[Michael Ferguson]

I would go to the overall finding that we had on this item in paragraph 3.50 in the audit on mental health services for veterans, where we said, “Overall, we found that Veterans Affairs Canada’s mental health outreach strategy is not comprehensive enough.” We didn't get down to the rural-urban type of issue or those types of things, but what we felt was that the strategy needed to do some more in terms of areas like outreach to family doctors and families of veterans. There was still more that they could do. The types of things that you are talking about are maybe other things that perhaps they had considered or that they should consider. The department would have to go to that detail, but fundamentally, what we felt was that their strategy wasn't comprehensive enough.

[Colin Fraser, Liberal, West Nova, NS]

Okay. In one of the responses to the recommendation, I think it was recommendation 6, there was a commitment by Veterans Affairs to improve the My VAC Account portal. I'm wondering, was that in effect when you were doing the audit, and if so, did you look at what is included as services in the My VAC Account portal?

[Michael Ferguson]

I believe that was the recommendation we made about providing mental health outreach. The department has said they will use online tools such as a My VAC Account, and they will continue to invest in the online environment to help veterans and their families find information quickly and easily. Through budget 2014 the Government of Canada committed $2.1 million to make further improvements to the My VAC Account.

That was the response we got after this audit. They said they had received more money to put into it. But what's happened since then I don't know because again we haven't gone back to see what they've done. They made a commitment to make those improvements to the My VAC Account and they had committed $2.1 million to do that.

[Colin Fraser, Liberal, West Nova, NS]

I think you mentioned this in your comments. With regard to the complexity of support programs, benefits, and services for those making the transition to civilian life, and the current commitment by the government to reduce the number of veterans to the ratio of 25:1 for each case worker, do you believe that would be helpful in managing the complexity of these support programs, benefits, and services that you identified as an issue?

[Michael Ferguson]

When we are doing audits we always focus on a way of measuring outcomes and performance. That is a change to the inputs, the resources going into a program. The natural expectation is that if more resources are going into a program there will be better outcomes, but those two things don't necessarily always go hand in hand. I think it's important that whenever there is a change like that or a commitment to do something else or invest more in a program, there needs to be a good way of measuring if it is having the intended outcome.

Making sure there's that performance measurement attached to that increase in resources, I think, will let us know whether it's having the effect it's supposed to have.

[Colin Fraser, Liberal, West Nova, NS]

Thank you.

Those are my questions, Mr. Chair.

[The Chair, Liberal, Neil Ellis]

Thank you.

Ms. Wagantall.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Thank you.

Thank you very much for being here today.

When I look at your 2014 report, number 12 in your results, you focused on timely access, timely decisions, and mentioned that you didn't audit whether your decisions were appropriate or the quality of care. I'm looking on this sheet of your sticky notes this morning.

The big question here is whether you think it would be good for us as a committee to recommend an audit in those areas that you didn't audit.

As someone who doesn't have people in my own family involved in the military, when I look at the mandate to improve the seamlessness between DND and veterans, I'm beginning to learn about the culture and the reality. In some ways that very much mirrors professional athletes where you take it for the team and you have to work as a team in spite of the circumstances you're in.

I think a lot of times that's why that ask for help with mental illness takes so long, or to even recognize that they need help.

I've heard over and over again whether or not more should be done preventively or educationally to prepare our soldiers to deal with mental health issues as a possibility in circumstances where they're facing direct combat.

Years ago when I was scuba diving, I faced a very bad situation way down there and survived. I still think about it. That's nothing compared to what our veterans face in combat. We know parachutists will have trouble with their knees. Those who hit a mine or watch their friends die or face a serious injury, can we not assume they need help? Is that help there in advance? Because to me this is one of the things that's the greatest barrier in achieving the ability to transition to civilian life.

[Michael Ferguson]

I think what your question is leading to is that there are, I'll call it, three stages, and what we looked at was two of them. We looked at once somebody has been discharged, they're a veteran, they're in civilian life, and now they're facing mental health issues, how do they get access to that?

The audit we did in 2012 was looking at people who are about to come out of the military, how they make the transition to civilian life, and what types of supports are there to help them make that transition. Part of that might be to identify that they might need some help with some mental health issues.

You're talking about even before those two things. When somebody is a serving member and they are going through incidents that could have an impact on their mental health, how do Canadian Forces and National Defence manage that? I can't speak to that because that wasn't the aspect we looked at.

The way you started the question was whether there's another audit that could be done. Something we could consider looking at is how National Defence and the Canadian Armed Forces look at managing the experiences that Canadian Forces members go through.

We would have to consider that, I guess. I'll let Mr. Martire add to that.

[Joe Martire]

Thank you for that.

Although, as the Auditor General said, we didn't look at that specifically as a separate audit objective, we did look at the services available within the Canadian Forces if someone becomes ill or injured. We spent quite a bit of time explaining that process.

As you pointed out, the context when you're in the military is much different from when you're in civilian life. In the military, the medical system is there. It comes to you. Once you're out, you're making that transition, you're basically a private individual, so it's a help to have those services.

People who are diagnosed as having medical limitations have to go through a process. If they have mental illness, there are trauma units that are available, and there are case workers. They have a whole system. Those services were there. It's what happens when you have those issues and you're identified, how you're supported, and then what happens to you when you transition to civilian life. That's where we found some of the issues back then were problematic, because of the movement from one system to a different type of system.

[The Chair, Liberal, Neil Ellis]

Thank you for that.

Next is Ms. Mathyssen, for three minutes.

[Irene Mathyssen, NDP, London—Fanshawe, ON]

Thank you very much.

I understand that you've gone in, and you've audited the delivery of services. In that process, obviously based on your recommendations, you must have seen where there were problem areas, and hence your recommendations.

I'm thinking particularly of recommendation six where at the bottom you have recommended a pilot project to provide veterans' families with access to military family resource centres and hiring 15 new peer support coordinators.

Obviously there was some kind of deficiency or you wouldn't have made that recommendation. What were you hoping would be achieved in that recommendation in terms of the resource centres and new coordinators? What would they look like? What was the objective of that recommendation?

[Michael Ferguson]

I guess we're all struggling to figure out exactly which recommendation.