National Defence Committee on Dec. 10th, 2013

[The Chair, Conservative, Peter Kent]

Thank you. Your time is up.

Mr. Norlock, please.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Thank you very much, Mr. Chair, and through you to the witnesses, thank you for attending here.

The first question would be to Tim.

In my previous occupation, which was paramilitary, before we transitioned out of the police force—in my case, I retired—we had a retirement preparation course. It was only a day or two; I think it was two days. Is there something similar in the military? In other words, somebody says they're going to leave the military. Is there a specific course that prepares them?

What I found very valuable was that part of that course had several members who had retired saying how it affected their relationship with their family. All of sudden you don't have to put in 40 hours a week, or maybe you want to do something else, etc. There are also financial implications: What am I entitled to? What's my retirement pay? How does that compare? What is your experience?

Is there something in the military currently? Isn't that what you're talking about, preparing people for that transition to civilian life and what the options are?

[Tim Laidler]

There are some programs that I can talk about, but I'm not fully qualified to speak on them completely. I can relate as well that my father served his whole career in the police force and made that transition himself recently.

I'd say in the current service model they have a lot of programs for the most extreme cases with mental health. If you have a full diagnosis of PTSD, there are a lot of programs there for you.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Excuse me, Tim. Mental health is important, but I think if you took a course like this given by peers, they would've discovered what you discovered yourself. I guess what I'm saying is that it should be for everyone. So if you could talk about everyone, and then transitions....

[Eric Jackson]

Yes, and that's what I was just saying. Mental health is a small percentage.

On the other end there are the SCAN seminars. There are a lot of educational programs that can give you the different options out there, and that's something any military person being released can then access.

The gap we've identified is that there's an in-between place. People can come out, they can know cognitively what all the different occupations available to them are, yet there's this psychological transition, this identity transition, that seems to be missing. This is what we're hoping our program can fill. It's something that hasn't really shown up before. We haven't had such a blending of the mental health issues from places like Afghanistan and other overseas missions with the general transitions where people retire from the forces without having experienced stressful or traumatic events.

I think you bring up a great point. It is something we're trying to say. Whatever it is, 10%, 20%, or 30% who have PTSD, it's an important population to pay attention to. Of the people releasing though, 80% could benefit from a program like ours. They don't have a diagnosis, yet they are struggling with who they are going to be once they leave.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Thank you very much.

To our friends from the Canadian Chiropractic Association, I'm always cautious when someone...I mean, I've used the services of chiropractics for many years. They're not cheap. So when you come to us and say you'll save us money, I wonder how you can do that. Is there some peer-reviewed study from another country that has experienced savings? We're talking about hundreds of millions of dollars spent on medical services for our men and women in uniform. How, specifically, can you say you're going to save us money when your services are...? Most of you have.... You're not poor is what I'm saying.

Specifically, how do you see you saving the medical system and the Canadian Armed Forces money?

[Eric Jackson]

That's an excellent question.

It's been studied in a number of different scenarios. One was in Tennessee where they looked at total health care costs because the costs were contained within an HMO. An HMO pays for everything. When you belong to an HMO they are responsible for covering all your costs, similar to the Canadian military. When you're a member of the military, your costs are contained within the military.

When you look at the cost of including complementary or alternative medicine, that is, when the member was taking part in conservative alternative medicine, chiropractic being 80% of that in terms of the dollar value, in an average claim year, instead of $2,700, they were able to reduce it to $2,200. If you were receiving chiropractic care you were costing the HMO less money.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Thank you for that. Could you please provide our researchers with some of those studies so they can make it part of this study?

My preference would be that if we're going to consider your type of medical interventions that it would be a trial, over 18 months or a specific time of around 24 months. After that, they could come back to the Canadian government and say, working with your society and the medical fraternity....

Would you recommend that kind of study so that we don't get ourselves into a permanent fix where it ends up you guys didn't really save us any money, that you just added to the cost?

Is there a trial study that has been done which showed this one way or the other? Is there one that you could give our researchers so they could best advise this committee?

[Eric Jackson]

Thank you.

Let me speak to the fact that there was a congressional bill in the U.S. that was made to include chiropractic. This was a professional decision, not a political one. The decision was made in 1991, and in 1994 they incorporated chiropractic services into the military. By the time they had reviewed that, they determined that it was productive and cost effective and that it reduced their overall burden of health care and burden of injury both to the member and to the veterans. That's been shown.

The other thing I wanted to say was that the Canadian Chiropractic Association has already proposed exactly what you've suggested and agreed to fund such a project. What we're looking for is the political will to incorporate that into the defence department.

We're willing to put our money where our mouth is and say we'll fund that study for up to three years. We'll do it at five bases, and we'll look at the numbers. If the numbers don't suggest that it's productive and cost effective, and the outcomes aren't there, then we'll pack our tent and go home. But we think there's lots of evidence from, as I said, Goertz and Heymans, that this is a very effective way to treat.

[The Chair, Conservative, Peter Kent]

Thank you very much.

Ms. Murray, we're very close to cut-off, but in the interest of fair allocation of time, you have five minutes.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

Thank you, Mr. Chair.

I'd like to direct my questions to Mr. Laidler.

Thank you for your presentation and thank you also to the chiropractic association for informing us about the opportunities with chiropractic.

Mr. Laidler, I'm going to ask about this potential scaling up of the Veterans Transition Network. You said the objective is 150 persons helped transition per year by 2015. Beyond 2015 is there a number set for the objectives of the network?

[Tim Laidler]

Our objective is 150 veterans per year on an ongoing basis after 2015.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

With a staff of three that sounds like it might be a challenge. What kind of organization would be needed to contribute at that level?

[Tim Laidler]

Right now we are funding our growth capital to hire more staff. We want to have zone coordinators in five zones across the country, including our headquarters staff and those are the administrative support teams. Clinicians are really our bottleneck, the people who are trying to train up to deliver this program. People need to have their Ph.D. in counselling psychology and then they can work with a master's level counsellor as well. It takes a long time to get training done, and on top of it, they have to come through our training process, which can take six months to nine months depending on....

[Joyce Murray, Liberal, Vancouver Quadra, BC]

Okay. So you're not just going out to clinical psychologists and saying, “Here's a blueprint. Do this.” It takes a considerable amount that is specific to the forces member's situation.

How much of this is being funded through Veterans Affairs or DND at this point in terms of the infrastructure, the staffing, and the training of the Veterans Transition Network?

[Tim Laidler]

We talk about costs. The competitive advantage for our organization is that we have all those costs covered by the private sector currently. Because we were a trial and we were experimental, and we were seeing what the data was going to present, the legion got behind it, and we were able to spend all that money from the private sector building our capacity. Currently, the government is paying for their clients to come through our program only at this point.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

Under the current model, to expand you would need money from the non-profit sector, because it's not really the private sector in the way I understand it. These are organizations that have to go out and get donations from Canadians in order to have a budget to provide some funding, so it probably gets more difficult every year to draw support from the public.

Has there been an application to Veterans Affairs or DND to provide some core funding to be able to expand?

[Tim Laidler]

Not currently, but we're always open to that possibility. Our business plan has been successful so that we have this growth capital from the private sector. If something goes off course in a couple of years' time we could re-evaluate that.

We do have an application in front of DND right now to become a service provider to them. That's going to be our first step. Then we can look at the expansion money after. We're looking at $500,000 next year and $500,000 the year after. For True Patriot Love, we already have interest from most of those organizations, so the only gap in our funding right now is a couple of hundred thousand dollars, and I'm confident we can find that.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

How many people has DND or Veterans Affairs funded to take your program at this point?

[Tim Laidler]

To date, Veterans Affairs has funded eight personnel to come through the program. For DND, again, we're still in negotiations with their health services teams on that.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

Are there constraints that we should know about in terms of funding by DND and Veterans Affairs to have their members take the program?

[Tim Laidler]

I'm not sure on any specifics. I think funding is obviously the big issue with DND. They're talking about supporting our program in principle, and I'm sure, with budget cuts as they are, that everyone is starting to ask where the money is going to come from.

I would say a good place for our program is the delivery of services to veteran populations: get them early; get them on track; get them back into careers. It does save a lot of money over the long term. There are a number of studies that can show just how much money this can save. Just to do one quick cost comparison, if somebody doesn't have a successful transition, and they end up getting an addiction or becoming an alcoholic and they have to go back into some sort of rehab, one rehab program can cost up to $60,000 for a 60 to 90 day program. Ours costs $15,000 for that veteran to come through our three-month program. Again, we don't deal with the addictions necessarily, but if people are successfully transitioning there's a high chance they're not going to end up with the addiction problems.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

Can you table some of the research that has been done over the years with the veterans transition program for our committee?

[Tim Laidler]

I'd be happy to.

[The Chair, Conservative, Peter Kent]

We have reached time.

Thank you...[Technical Difficulty—Editor]...Jackson.

This committee will now suspend and will resume in a couple of moments in camera.

[Proceedings continue in camera]