National Defence Committee on June 2nd, 2023

[The Chair, Liberal, John McKay]

I call this meeting to order. I see we have quorum. We are past the time to start already.

I have a couple of things that need to be dealt with immediately.

The first is the request for a travel budget. I would appreciate it if somebody would move it and somebody would second it. Hopefully there is no discussion about it, because we need it.

[Bryan May, Liberal, Cambridge, ON]

Mr. Chair, I so move.

(Motion agreed to)

[The Chair, Liberal, John McKay]

The second item of national crisis is that the coffee is terrible. If anyone wants to slip a note to the chair, the chair would undertake to get sufficient coffee for members to get through the next two hours.

With that, we welcome our witnesses.

From Canadian Forces Morale and Welfare Services, we have Laurie Ogilvie, senior vice-president, military family services. Joining us from the Department of Veterans Affairs, by video conference, is Jane Hicks, acting director general, service delivery and program management. Steven Harris and Mark Roy are here in person.

With that, each of you have five minutes for an opening statement. We'll have one from Canadian Forces Morale and Welfare Services and one from Department of Veterans Affairs.

First, we'll go to Ms. Ogilvie.

[Laurie Ogilvie, Senior Vice President, Military Family Services at Canadian Forces Morale and Welfare Services, Department of National Defence]

Thank you, Mr. Chairman.

Good morning.

My name is Laurie Ogilvie and I am senior vice-president of military family services.

Military family services and personnel support programs are operational divisions of Canadian Forces morale and welfare services.

Canadian Forces Morale and Welfare Services directly supports the Canadian Armed Forces' operational readiness by contributing to and strengthening the mental, social, familial, physical and financial well-being of Canadian Armed Forces members, veterans and their respective families.

Core public funding is received for the delivery of services and programs deemed necessary by the Canadian Armed Forces. As the Canadian Armed Forces’ service delivery partner, we are responsive to them as they remain the functional authority.

I am going to start today discussing the Soldier On program. It leverages the power of sport, recreation and creative activities to support an individual’s recovery, rehabilitation and reintegration. Established in 2007 and expanded in 2019 to align with the Canadian Armed Forces transition group, the Soldier On program supports military personnel and veterans who have sustained a physical and/or mental health illness or injury while serving, whether attributable to service or not.

The Soldier On program has two key lines of operations to achieve its mandate.

The first is communication and outreach, including increasing awareness and facilitating access to programs. The second is the local, regional, national and international camps and events. Activities range from hockey, skiing, golf and yoga to more creative programs such as cooking classes, guitar lessons and woodworking.

You might be familiar with the Invictus Games, which is the highest-profile sporting event for ill and injured personnel. Sports, recreation and creative activities help break down some of the barriers to recovery and, with the support of their peers, a common thread and a shared perseverance is established.

Switching now to family-centred programs and services, most are delivered by us, the Canadian Forces Morale and Welfare Services, or through not-for-profit, provincially incorporated charitable organizations, namely military family resource centres.

Today programming is available in the areas of relocation preparedness, financial resilience, personal and familial health and community involvement. A few examples include emergency family care assistance, mental health counselling in person and virtually, family and intimate partner violence support, including an annual healthy relationships promotional campaign, a 24-7 crisis and referral line, emergency grants and loans, children and youth mental health counselling, educational counselling and non-clinical psychosocial supports, including the family version of road to mental readiness.

We also engage with national stakeholders to extend our capacity to offer services through a spousal employment network and virtual career fairs, telemedicine for relocating families, a pilot program to dispatch personal support workers to a family's home, the military family doctor network, a dedicated crisis text service with Kids Help Phone, and external partners and support through the Seamless Canada initiative.

In 2017, we introduced the veteran family program, which delivers services to medically releasing Canadian Armed Forces members, medically released veterans and their families. A veteran family program coordinator is available in every Canadian community to support the transition into post-service life. In 2022, we extended our telemedicine initiative to the veteran and family cohort.

Also in 2022, military family services formalized its support to transitioning families. Previously, a family liaison officer supported families of the ill and injured before and during the transition, and the veteran family program coordinator supported post-release. A family transition adviser has now been added to the transition centres to support those families of non-medically releasing members.

Beyond the services we provide, we work to ensure that members, veterans and their families have additional support accessing community and provincial systems of care to maintain their resilience in order to manage the transitions inherent to serving in the Canadian Armed Forces.

Thank you for your time, Mr. Chair.

I am pleased to answer the committee’s questions.

[The Chair, Liberal, John McKay]

Thank you very much.

Is it Ms. Hicks, or is it Mr. Harris?

[Steven Harris, Assistant Deputy Minister, Service Delivery Branch, Department of Veterans Affairs]

Chair, it will be me. I'll do the remarks.

Good morning, and thank you, Mr. Chair and committee members, for inviting us to appear on transition.

I'm Steven Harris. I'm the assistant deputy minister for service delivery, and I'm joined today by my colleagues Jane Hicks and Mark Roy.

As you well know, transition is the process of change from military to post-service life. While every member will experience transition, the experience is not the same for every member. A successful transition to civilian life is dependent on many factors, including health, financial security, housing, community integration, identity and employment or other purposeful activity. A large number of members are able to navigate this transition themselves or with minimal targeted assistance from available services and supports.

However, others have unmet needs or risks that may require more intensive or ongoing supports. For veterans with more complex needs, our case managers work directly with veterans to identify their goals, needs, assessments and a plan to achieve independence, health and well-being.

Both Veterans Affairs Canada and the Canadian Armed Forces are committed to supporting a seamless transition and improving outcomes for transitioning members. As a result, we focused our efforts on reducing the complexity of the transition process and enhancing the well-being of Canadian Armed Forces members and RCMP members, veterans and their families.

Since 2015, Veterans Affairs and the Canadian Armed Forces have been offering enhanced transition services to medically releasing members. This means that we engage earlier with medically releasing members and their families to provide coordinated and integrated support. Early intervention is critical to a successful transition process. We've increased service to medically releasing members during their pre-release stage of transition.

Although we've been working together to provide transition services for a considerable time, historically, there was a potential gap for non-medically releasing members. In 2019, in co-operation with the Canadian Armed Forces, we designed a new joint military-to-civilian transition process for non-medically releasing members and their families. As part of this process, transitioning members are supported by both Canadian Armed Forces transition advisers and VAC staff, who jointly provide assistance and planning. Following earlier trials, this new approach is being implemented nationally and will be fully operational as of March 2024.

Furthermore, Veterans Affairs Canada has a full or part-time presence in each of the 32 transition centres located on CAF bases and wings across the country. At each of these centres, Veterans Affairs Canada offers transition planning services, including transition interviews and outreach and training seminars. During a transition interview, Veterans Affairs Canada staff provide releasing members with advice on applying for Veterans Affairs Canada programs and align members with supports based on their needs.

Transition centre staff conduct briefings on each base and have face-to face seminars with CAF members considering transition to provide important information on available Veterans Affairs Canada benefits and services as well as information on services offered by other organizations. Enhanced transition training courses are available online, anytime, anywhere, and are mandatory for all releasing members and which cover a diverse range of topics.

In addition to these joint initiatives, Veterans Affairs Canada has a variety of other benefits and services in place to support releasing members with their transition. For instance, the veteran family program offers medically releasing CAF members and their families continued access to the military family resource centres and a suite of transition programs, courses and group sessions.

Under this program, we have also introduced a pilot program called the veteran family telemedicine service, which connects medically released veterans and their families to a national network of canadian licensed doctors, nurse practitioners, and healthcare providers who are accessible via video, audio or secure text messaging.

Other existing benefits and services include disability benefits to recognize and compensate CAF members and veterans for their service-related injuries.

On April 1, 2022, Veterans Affairs Canada launched a new mental health program where veterans that applied for certain mental health conditions automatically receive treatment benefits while their application is being processed.

Other important components of our work include support for education and employment. The education and training benefit provides funding for veterans to pursue education and training that will support them in a successful transition and position them to be more competitive in the civilian workforce. Career transition services help with career counselling, resumé writing and job search assistance.

Our objective is to ensure a standardized, personalized and professional transition approach that supports and empowers Canadian Armed Forces veterans and RCMP members, other veterans and their families, before, during and after their transition to life after service.

We're happy to take your questions.

[The Chair, Liberal, John McKay]

Thank you, Mr. Harris.

With that, we'll go to the six-minute round.

We'll have Mr. Kelly for six minutes.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Thanks to all of our witnesses today.

I'd like to talk about the process for transferring family information and health documents when members are moved throughout Canada. This is an issue that's been identified before. I'm not sure who might be best to answer that.

Do you want to go first, Mr. Harris?

[Steven Harris]

There are a couple of different ways this might happen.

When you're talking about members during their service transferring between different postings, it's the responsibility of the Canadian Armed Forces to make sure their health information follows them. When they release from the Canadian Armed Forces, then it becomes work between Veterans Affairs Canada and the Canadian Armed Forces to ensure that Veterans Affairs can access medical records, where appropriate, to be able to establish eligibility criteria or compensation that might be required for veterans.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

How long would it normally take for members who are still in the forces and are changing location to access health care in a new province when they've moved? I'll let you talk about that, and then talk about transition as well.

[Steven Harris]

Sure.

Once again, the Canadian Armed Forces would deliver health care services to members as they transition from one location geographically, provincially or otherwise. That would be its responsibility.

When a veteran leaves the service, how long would it take for them to access benefits and services? There are two streams. We have people who are still serving in the Canadian Armed Forces who apply for Veterans Affairs benefits, things like pain and suffering compensation and others. About 25% of applications we see for pain and suffering compensation come from still-serving members of the Canadian Armed Forces.

That means about 75% of them come after, so there are many who transition out of the military, realize they may have had impacts to their health as a result of their military service and may come back to us at Veterans Affairs a year later, five years later or even 25 years later, to say that they've had impacts from their service. At that time, we would go get their medical records from the military to be able to assess and make the determination of a service relationship to the injury they've suffered. That's easier in a digital age, but we still have a number of records that would still be in paper files, so we have to be able to go get them from wherever they're located within the Canadian Armed Forces or within the National Archives.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Has there been improvement to the communication between National Defence and Veterans Affairs?

We constantly hear of members who have sustained an injury and transitioned out of the forces, and then have to be reassessed for the same injury. We're talking about pretty obvious injuries in some cases. They are things that one ought not to have to re-prove over time.

Has there been improvement in this?

[Steven Harris]

The process is a bit different. The Canadian Armed Forces assesses its active personnel as to their capacity to fulfill the role that they're in. When it's been determined that they would be required to medically release—in other words, they can no longer perform the duties necessary—they would leave.

The assessment for Veterans Affairs programming may be different. We have to assess a service impact related to what it is. We have people who leave the Canadian Armed Forces for medical reasons that are not actually related to their service. They may have sustained an injury or an illness outside of the confines of their service.

That would be a determination that we need to make from a Veterans Affairs point of view, to understand that there's a relationship between their service and the injuries they've sustained.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

I'll turn to Ms. Ogilvie.

You've spoken in the past about the importance of identifying family supports as part of operational readiness. Can you describe that?

Your remarks on the record are from quite a number of years ago. How is that going?

[Laurie Ogilvie]

In 2020, we completely changed the family support program to recognize the challenges that families are currently facing, not what they were facing 25 years ago. What we continually do is update the program to ensure that families are ready to be support or be supported in any of the operational changes.

For example, there's the introduction of telemedicine for relocating families. It was introduced to make sure that families don't have a break in access to medical service when they're relocating to different provinces. A number of years ago, we were successfully able to negotiate with all provinces and territories to waive the 90-day wait period for families to access medical care when they move to a new province.

It's those types of things that we try to do—and there are many more examples—to make sure that families are ready to support military members. During COVID, we found a number of different initiatives that we put in place, especially around spousal employment and access to mental health and child care, to be able to support.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Is there any research being done on this and how it impacts retention in the forces? We know of the crisis of recruitment, the crisis of retention and the crisis of personnel. This has been identified by almost every witness we've heard from within the department.

If a family can't get a family doctor after they move, if a spouse of serving personnel cannot access employment because of credential issues between provinces.... These are all things that would impact the career choice of a member.

Do you have statistics, numbers or research on factors that contribute to people choosing to leave the forces?

[Laurie Ogilvie]

Absolutely.

In my organization, we conduct research annually and do a community needs assessment. We also do research. The director general military research and analysis within the Canadian Armed Forces also conducts a quality of life survey every three years. That administration has just been completed, so we will be getting the statistics to be able to then adjust our programming based on what the data is.

[The Chair, Liberal, John McKay]

Thank you, Mr. Kelly.

If these documents are in a format that could be tabled with the committee, it would be helpful. I'm sure Mr. Kelly and other members would be interested.

We'll go to Ms. O'Connell for six minutes, please.

[Jennifer O'Connell, Liberal, Pickering—Uxbridge, ON]

Thank you, Mr. Chair.

Thank you, everyone, for being here today.

I wanted to start with you, Ms. Ogilvie.

In terms of accessing health care, we have heard from previous witnesses during this study—I think it was quite eye-opening—about the challenges in the sense that CAF members don't access provincial health care systems and don't carry a health card. I can imagine significant challenges with that at any given time.

In the last round of questioning, you spoke to some of the changes or things you've done to work with provinces and territories to help with this. Are there other gaps or issues that we're still facing to allow for serving members and their families to be able to access health care, or to deal with some of the provincial and territorial access issues?

[Laurie Ogilvie]

I will say that the biggest issue is actually access to physicians. The family doctor network that we established a number of years ago has very active participation by military families.

What we introduced during COVID—telemedicine, because people couldn't access the family doctor network—is intended to be in person. The problem with that is that, if there are an insufficient number of physicians in a particular province or community, there is going to be a gap in access to medical care. Telemedicine was also introduced to be able to at least offset that so that families aren't impacted if they need a referral to a specialist, or if a child is moving between provinces and needs an assessment to go into the school system.

We're trying as best we can, but the biggest issue is access to medical doctors.

[Jennifer O'Connell, Liberal, Pickering—Uxbridge, ON]

Thank you. That information is helpful because eventually, at the end of this study, we need to make recommendations. As much as I understand you're working hard on these issues, it's good for us to know where those gaps are or what still remains as a gap. Don't hesitate to send additional information as well.

This question is actually for both, so feel free to jump in, whoever.

I am curious about operational stress injuries because, when dealing with mental health, it's not like an injury when you break your arm on a given date and know exactly when that injury happened and move forward with the appropriate care. When it comes to things like operational stress injuries or other mental health needs, for some serving members or even veterans, they may not know the date on which the incident happened. If they've never suffered with mental health issues before, they may not even recognize within themselves what's happening. Therefore, they may not seek the care or wellness they need.

What, in your respective roles, are you outlining as some of the education-based things to look for, especially for those who have never experienced it before? How do they recognize some of the signs and symptoms and then seek help?

[Steven Harris]

Maybe I'll just start briefly to say that we have a lot of contact with veterans or Canadian Armed Forces members going through the transition process. We use assessment tools to understand what they may be facing in terms of issues or concerns.

Some of those are occupational stress injury issues. There may be other issues as well, so part of the interaction we have, including the early interaction, both on the Canadian Armed Forces side and on the Veterans Affairs side, is to make sure that we can have proper assessments with those individuals and with members of their families. If they are seeing issues as well, we can often bring in members of the families to sit with us as part of a transition interview.

Second, from an occupational stress injury point of view, we have clinics that are set up via Veterans Affairs, working with our provincial health counterparts in every area of the country, and satellites in other areas as well, that help to support occupational stress injuries. There are dedicated clinics that veterans and RCMP member veterans can access as well to be able to seek treatment for occupational stress injuries.

We've also implemented a centre of excellence on PTSD. It's called the Atlas Institute. It's developing both metrics and norms to share with family physicians and others who may see veterans and military families, to be able to recognize some of these cues and signs and help to address them and treat them.

[Jennifer O'Connell, Liberal, Pickering—Uxbridge, ON]

Ms. Ogilvie, would you like to add anything?

[Laurie Ogilvie]

Within the Canadian Armed Forces there is a psycho-educational program called road to mental readiness. Road to mental readiness is very similar to mental health first aid, in that it educates all members on signs, symptoms and help-seeking strategies for mental health. There is a parallel family program as well.

At all of the MFRCs across the country, we also have social workers who provide direct support to families and members, if it's a familial situation.

We also have virtual counselling, and then we also partner very closely with CF MAP, which is the Canadian Armed Forces member assistance program, which also offers psychosocial and counselling support for members.

[The Chair, Liberal, John McKay]

Mr. Desilets, you have six minutes.