Veterans Affairs Committee on June 5th, 2007

[The Chair, Conservative, Rob Anders]

Good morning, ladies and gentlemen. This is yet another glorious meeting of the Standing Committee on Veterans Affairs. We have, as our witness this morning, Pierre Allard, who is the Royal Canadian Legion service bureau director, Gerontological Advisory Council. Of course, this is all under the veterans independence program and health care review.

Sir, you know the rigmarole here, but I'll say it anyhow. You have 20 minutes to use as you see fit. Then we will have questions from committee members. The floor is yours, sir.

[Pierre Allard, Royal Canadian Legion Service Bureau Director, Gerontological Advisory Council]

Thank you very much.

On behalf of Comrade Jack Frost, the Legion’s dominion president, who unfortunately cannot be here today, it is my pleasure to appear again at your committee. We value the work that you do on behalf of veterans and your dedication to the cause.

The subject at hand is the ongoing veterans health services review, or health benefits review, which has also been called the veterans health care review. You have already heard from officials from Veterans Affairs Canada and from members of the Gerontological Advisory Council.

On behalf of Comrade Jack Frost, the Legion’s Dominion President, who unfortunately cannot be here today, it is my pleasure to appear again at your committee.

I would like to congratulate you on the work you are doing on behalf of veterans.

The subject at hand today is the ongoing Veterans Health Services Review, which has also been called the Veterans Health Care Review. You have already heard from officials from Veterans Affairs Canada and from members of the Gerontological Advisory Council.

I am here today as both a member of the GAC--Gerontological Advisory Council--and also as the director of the service bureau of a major veterans organization, the Royal Canadian Legion, which represents both traditional and modern-day veterans. Even though the mandate of the GAC is focused on traditional veterans, we also in the GAC, as we do in the Legion, recognize that a veteran is a veteran is a veteran.

Recognizing that VAC has a long history of modifying programs and services to better respond to the evolving needs of veterans, Keeping the Promise recommends that VAC combine its three existing health and social programs to create veterans integrated services. You should keep in mind that there are actually two Keeping the Promise reports. One was submitted by the GAC--Gerontological Advisory Council--and it deals with health benefits. There was another Keeping the Promise report, actually submitted by the Senate Subcommittee on Veterans Affairs, which was also labelled Keeping the Promise, and it dealt with long-term care issues. Keep that in mind.

Recognizing that VAC has a long history of modifying programs and services to better respond to the evolving needs of Veterans, “Keeping the Promise” recommends that Veterans Affairs Canada combine its three existing health and social programs to create the Veterans Integrated Services.

Veterans integrated services, or VIS, should focus on needs rather than complex eligibility criteria. It should promote early intervention, health promotion, more intensive home support, and a wider range of residential choices, all accessible through a single entry point.

What is the driving force behind VIS? The reality is that current programs and services have strengths but also weaknesses.

Another very important factor in favour of change is the sad reality that traditional veterans are dying at a rate of 2,000 a month. In fact, 12,000 veterans have died since Keeping the Promise was issued in November of 2006; 16,000 died between the time it was identified that the GAC should formulate its recommendation for change and Keeping the Promise was published. Approximately 70 veterans will die today, as we speak.

When we talk about strengths and weaknesses, it should be clear that VAC's health programs have been far-sighted in helping older veterans and their caregivers while adapting to their changing needs. The weaknesses can be found in the complex eligibility criteria, the reactiveness of the programs, and the limited choices of housing options. From a service provider's perspective, our experience through the Legion's service bureau has revealed very practical inconsistencies.

For example, to meet eligibility criteria, why should a veteran apply for a hearing loss pension at age 85—and I would suggest a frail veteran at age 85—to establish eligibility when all this veteran seeks is to stay in his house with the benefits provided through the veterans independence program?

For example, to meet eligibility criteria, why should a Veteran apply for a Hearing Loss pension at age 85 to establish eligibility when all that this aged veteran seeks is to stay in his house with the benefits provided through the Veterans Independence Program, the VIP?

Does it make sense for VAC to provide all 14 programs of choice--and programs of choice are a separate health benefit, which I can address if you ask--because he has achieved a certain level of disability, while he truly does not need all these 14 programs of choice? Does it make sense to provide eligibility for long-term care to a specific class of veterans but only in the facility with the highest costs?

I've included in your package a table that basically gives you a good overview of a complex eligibility criteria for only one of the three health care programs, that is, long- term care. You've heard about these complex eligibility criteria. This table sort of gives it visibility, gives an image of how complex it is. I stress that this is only for long-term care, even though in this table there are some VIP benefits that are associated with long-term care. To navigate this table, there is eligibility type, 18 different categories, and then there is long-term care, whether it be in a contract bed, in a community facility for chronic care, or in a community facility for intermediate care, which then may give you access to VIP. If you look at page 5, there are all the various codes. “E” stands for eligibility, and the numerical code represents a gateway, if you wish, that is deemed to give eligibility for these benefits.

As you can see, this is a very complex scenario and is difficult to understand, even by expert staff.

One look at the above table will help you to understand the complexity of these eligibility criteria, and the same can be said for the other two elements of the health services, namely, treatment benefits, which shows those 14 programs of choice, and VIP as a stand-alone program. Some of these gateways have been based on low income, others on level of disability, pension or type of service.

Keeping the Promise promotes not only an integrated approach based on need; it also suggests that healthy aging must be promoted at the earliest opportunity. This philosophy of promoting improved health outcomes is part and parcel of the proposed VIS. To implement VIS, VAC will have to put in place a structured client screening process that identifies client needs from first contact, progressing to a more integrated approach centred on a high-needs care manager. The structure would deliver coordinated services while providing more options, such as intensive home support and a greater range of residential choices for veterans.

The Royal Canadian Legion has been promoting such a model of service delivery, even before the GAC published Keeping the Promise. At our 2006 convention in Calgary, we adopted the resolution which reads in part:

Because of the complexity associated with various entry gates, veterans are often wary to even ask for benefits, let alone understand their eligibility requirements; VAC should undertake a comprehensive rationalization of health care benefits.

The Royal Canadian Legion has been promoting such a model of service delivery even before the GAC published “Keeping the Promise”. At our 2006 Convention in Calgary, we adopted a Resolution which reads, in part:

Because of the complexity associated with various entry gates, veterans are often wary to even ask for benefits, let alone understand their eligibility requirements; VAC should undertake a comprehensive rationalization of health care benefits.

The time to act is now. VIS makes sense, not only for traditional veterans but also for modern-day veterans. These integrated benefits must be available to families as well as to veterans, and VIS must include an outreach program to inform veterans and their families and to encourage them to participate.

The time has come to act. Integrated Services make sense not only for traditional Veterans but also for modern day Veterans. These integrated benefits must be available to families as well as Veterans. VIS must include an Outreach program to inform Veterans and their families, and to encourage them to participate.

This completes my presentation, and I would certainly be very happy to answer any questions.

[The Chair, Conservative, Rob Anders]

Thank you very much.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

On a point of order, Mr. Chair.

Mr. Allard, our witness, has mentioned another report that has the same name as one that we have. Was this report from the Senate subcommittee distributed?

[The Chair, Conservative, Rob Anders]

No.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

If there is a subcommittee in the Senate that is looking after Veterans Affairs and producing reports, do we have a process whereby those will be automatically put through to our clerk and tabled?

[The Chair, Conservative, Rob Anders]

No. I don't know whether we could set up a formal process to do that, but we could certainly give a heads-up to people who keep an eye out for such things and maybe ask them to apprise us of some of those things as they come up.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

Yes. It's a concern of mine that although the other place is the other place, it still resides in the same building, and if a witness has access to some information when we're hearing witnesses and we haven't been apprised of it, it's a bit of a concern.

[The Chair, Conservative, Rob Anders]

I'm sure Senator Kenny would be tremendously....

I'm sorry?

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

On the same subject, it seems to me that it would be appropriate for the Chair of the House of Commons Veterans Affairs Committee and the Chair of the Senate Committee to have a meeting to organize an unofficial transfer of documents, so that we can complete our work properly. We are in the same building and while we know nothing about what is happening on the other side, I think they do not know much about what is happening here. This seems ridiculous to me.

I agree with you completely, David. There should be a mechanism for exchanging information. After all, we are not designing the atom bomb.

[The Chair, Conservative, Rob Anders]

It's an interesting comparison.

Mr. Gaudet, did you have anything further to add to the issue? No?

Well, certainly I'll see what I can do about talking to the senator. We had a great trip with him when he came to Vimy, and he's a very knowledgeable fellow on these issues. I would also ask maybe, because we busy ourselves with all sorts of other things we're working on as well.... I will certainly get in touch in with him, but maybe—you folks stumble around these people on a fairly regular basis—if you can just....

The clerks get together and they.... So we'll follow up on that.

Now, unless there's anything else to that point of order, or—

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

I thank you, Mr. Chair.

[The Chair, Conservative, Rob Anders]

—point of information, maybe, or whatever it was....

Are there any other points on that issue? No? Okay.

Now we're going to move into questions for our witness today.

We have Mr. Valley for seven minutes for the Liberals.

[Roger Valley, Liberal, Kenora, ON]

Thank you, Mr. Chair, and thank you, Mr. Allard. I'll try to scratch through this; I'm losing my voice.

You mentioned the value of the work of this committee. Thank you for that compliment, but it's the value of the work the Legion has been doing in the community and in the ridings for many years that I'd like to talk about first.

I come from northern Ontario, where there's a Legion branch in every small town. They've been looking after people. We know there are some criticisms of any organization, but in the work that's carried on in small towns—and I'll use my home town, Dryden, as an example—the Legion has been a focal point forever. It's not only veterans who go there for assistance. It's generally the largest organization. It's the organization that helps everyone with everything from getting married to simply helping with social issues.

I'm tremendously proud of the Legion and the work they do and the work they've done for decades and decades for veterans. I wanted to put that on the record. I've said it before and I'll continue to say it: the legions are the backbone of the small town.

Too often any government, and I won't mention anyone in particular, will forget the small town in rural Canada, and we can't do that. So thank you for your valued efforts on behalf of the Legion.

I've talked before about how the legions are struggling. I know you're here to talk about the health care review, but I think it'll be a loss to any veteran, whether modern-day or a traditional veteran, if we lose the legions in the small towns or if we lose the legions across Canada.

Do you have any comment on any kind of support from any government on supporting the Legion as they support our veterans. If the Legion is not in Dryden, the veterans who are left there, either modern-day or not, will not have the access they have right now.

[Pierre Allard]

You're correct. It's not necessarily on the agenda, but I will address it. Thank you for your comments.

First of all, we have prided ourselves over the years that we have never received any support from the government. We are apolitical and we would like to maintain that status. We are not looking for government handouts in any way, shape, or form other than when we try at the local level to get a tax exemption from the municipality, or approaches of that nature.

We had our headquarters down on Kent Street for 50 years. We have built our new headquarters in Kanata. If you, as a committee, ever get a chance, we would certainly like to welcome you there to tell you what we do. I don't think there's enough information out in the public about what the Legion is about. You may want to take that into consideration.

Having said that, a number of non-government organizations certainly struggle to survive and maintain their membership. We will continue to survive as an organization. We will continue to maintain our mandate. We will seek new ways of looking at the way we govern ourselves. We will look at our governance model. We are in the process of doing that right now. We have initiated a unity initiative, if you will, to bring some of the other veterans under our umbrella.

We're currently participating in the new Veterans Charter advisory group. To make sure we are linked with the Canadian Forces veteran of today, we have brought in to that group a still serving military member who has seen service in Afghanistan. We want to establish links and routes to the Canadian Forces.

We have established new programs to meet the needs of the Canadian Forces. We are very present at the Canadian Forces show tours where we send elected officials. We sponsor the major show tours and go into Afghanistan. We're now promoting buying a coffee and donut from the Legion for the troops that are deployed in Afghanistan. That's a program we've just initiated.

We are reaching out to the Canadian Forces member, realizing that he may not join us today, but he will more than likely join us in the future if he sees what our organization has brought forward. In that context we also think our advocacy efforts on behalf of Canadian Forces members, veterans, and families will eventually garner us some support.

I'd like to point out, even to the department, that even though they organized the second national symposium on operational stress injury in Montreal, this was really the third national symposium on operational stress because the Legion organized our symposium in 1998. It was in Charlottetown. We brought together some of the same experts who were in Montreal this year, or in Montreal four years ago. They discussed operational stress, and they ensured that eventually operational stress injury would be recognized as an entitled disability by Veterans Affairs Canada.

We are confident that our advocacy work on behalf of Canadian Forces veterans will garner us some support in the future. With those other initiatives we will survive. We will survive as an independent organization, and we will not seek government support other than the local initiatives I indicated.

For the small branches that are struggling we actually have a consultant for housing projects but also to look after real estate. Sometimes local branches are sitting on valuable land, valuable resources. Through the auspices of Veterans Affairs Canada we have a consultant who basically--I won't call it a secondment--through a partnership agreement has been in Charlottetown since 2000 and provides advice to our local branches to be able to survive and use the assets they have and go on into the future. This is where we stand.

We know we're being attacked. We were attacked in The Hill Times yesterday. I brought you a copy of our rebuttal if you want to see it. We're hopeful that this will be published in The Hill Times next week.

[Roger Valley, Liberal, Kenora, ON]

Thank you.

You don't need to rebut it to me, but I know there are individuals who have problems with any organization.

Clearly, I must look as bad as I feel because everybody is trying to help me today.

You mentioned some of those numbers that are shocking on the amount of veterans who have passed away and continue to pass away since this program has been announced. I'm going to call it the GAC because I can hardly say Gerontological Advisory Council any longer. They're shocking numbers, and we have to move quickly. That's what we're trying to do here in this committee. We will bring it up and embarrass the government. It's been so many months, and we know it takes time to do it, but we've got to get it done.

I want to go back to one comment you made because it takes it right back to the street level. The people who are listening to this might think, a coffee and a donut, what is that? A coffee and a donut is about involving somebody at the local level, telling somebody you care, and that's what's important to us.

I want to ask you a question. I know it's going to be covered more at length later on....

I guess I'll thank the chairman. Thank you, sir.

[The Chair, Conservative, Rob Anders]

That was effective. I love that little clock.

Now we go to Monsieur Perron with the Bloc, for seven minutes.

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

Mr. Allard, if I may call you Pierre, as you call me Gilles in private. If I get mixed up and call you Pierre during the discussion, rest assured that there is no ill intent on my part.

I have read your presentation this morning carefully. There are a few paragraphs that shock me. That may be because I am sensitive. The first is on page 2. There were other ways this could have been said, without saying that 70 veterans will die today. That seems to me to be using those people's misfortune to strengthen one's own position. I do not like it, and that is not because it comes from you. I would not like it if any organization made that kind of comment.

The other thing, Mr. Allard, that you are surely aware of, is that I am still very uncomfortable with the demands you are making, even if there is good reason for them. I am thinking about seniors who were not in the war, but who made a huge contribution, if not as great a contribution as veterans, to developing this country, and who unfortunately do not have a third, or a tenth, or 20% of what you have. I say this so that it will be on the record: it affects me directly when I walk around my riding and I see seniors wearing the same sweater for 10 or 15 years because they cannot afford to buy a new one, or when I see seniors who have to choose between buying prescription drugs or a baloney sandwich. It upsets me.

Those are the only comments I can make this morning. There is nothing else I can tell you. I would like to know what you think of this.

I am finished speaking, Mr. Chair.

[Pierre Allard]

All I can say to answer you is that the Royal Canadian Legion advocates not only on behalf of veterans, but also on behalf of seniors. For example, we worked with a group of 15 organizations, I think, who advocated pension income splitting, a program that I think would provide many benefits for our seniors.

We also have a housing program at the Legion, an affordable housing program. It is intended not only for veterans, but also, again, for seniors who need affordable housing. Our consultant can certainly provide information about everything that is available under our affordable housing program for seniors across Canada.

We also try to advocate on behalf of people who are very rightly identified as having needs. We think about them so much that in the case of the VIP program, which is a Veterans Affairs Canada program for veterans, we have argued for three or four years in an attempt to ensure that all seniors in Canada will have access to the program.

We have argued for the Seniors Independence Program in Canada. We are also aware of the needs of seniors. That recommendation was adopted, at one point, by one of the political parties during an election campaign, but nothing was done to meet that need. We think not only that a seniors independence program is necessary for seniors' well-being, but also that it can save the taxpayer money, because it is a program that helps seniors stay in their homes.

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

You say some good things, Pierre. I congratulate you and I thank you. That is not what we see at the Canadian Legion in Deux-Montagnes and the Canadian Legion in Sainte-Thérèse. If we go through the list of Canadian Legions, we see that concern for seniors outside the Royal Canadian Legion does not exist.

[Pierre Allard]

When you make a judgment about the Legion, I would invite you to consider not only what goes on in the branches, but also what goes on at the provincial and national levels.

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

It needs to trickle down.

[Pierre Allard]

We go to see veterans living in long-term care facilities all over Canada. We visit not only the large institutions that offer priority access beds for veterans, but also small institutions in the communities.

Checking to see whether the care that veterans are receiving meets their needs provides the same overall picture for the seniors who are in these homes. I simply ask that you judge us not based on what you see in a branch, but rather based on the work we do throughout the country. This is not a speech.

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

I do not know whether you have ever gone to the long-term care home for the aged on rue Chénier in Saint-Eustache. About three to four percent of the seniors who live there are veterans who are receiving benefits from the Quebec system.

You can also visit the second house down from my office, where eight veterans live. That will give you an opportunity to come and meet with me. That house does not cost the Canadian government or the Legion a cent. Those veterans are looked after by Quebec's long-term care system. No money is transferred. I have verified this, my dear friend. Talk to Mr. Paquette, the director of the home, about that.

What is done for veterans is fine, but there are other seniors living in hardship. Seniors are the poorest citizens of Canada, and unfortunately they get even poorer when one spouse in a couple dies.

[Pierre Allard]

I agree with you completely. That is why we need a Seniors' Independence Program for all seniors in the country.