Veterans Affairs Committee on June 5th, 2007

[The Chair, Conservative, Rob Anders]

Thank you very much.

We now go on to Mr. Stoffer and the NDP.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you very much, Mr. Chairman, and I want to thank the clerk as well for bringing in the chocolate milk today; that was a very kind thing.

Mr. Allard, thank you very much for your presentation. Thanks to everyone at the Royal Canadian Legion for the continuous work they do, not just in assisting our veterans but also in advising young people on what happened during the various wars and conflicts. You continuously educate our young people on the sacrifices and services of our military, not only in the past but currently as well. Thank you very much for that.

Sir, I always like things to be fairly simplified. I've always thought--and I'd like your response to this--that if a military person served, and now they're out of uniform and they require services, shouldn't the only criterion be whether you served? Then, if you did, what do you need? It's not necessarily what you want, but what you need after a careful assessment.

It gets so complicated. I have 22 veterans in the Dartmouth riding who have all been denied hearing aid assistance because they didn't have a hearing test when they left World War II or Korea. As you know, what happened was they worked on the naval ships and on the battlefields; they came home and, typical of most young people of those ages, they went back to work, went back to their communities, and thought nothing of it.

Now they're getting older. Their hearing is impaired. The audiologist says very clearly that there is a direct link from wartime service to now, but because they didn't have an actual test, DVA has denied them any assistance in that regard.

In VIP programs, if a person didn't get a pension, they're not covered. It's also if they make too much money; one veteran I know, who is 95, was accused of being too healthy and wealthy. All he's asking for is a little assistance around the yard--denied.

I know I'm being simple when I say this, because I've been accused of that before, but shouldn't the only criterion be whether you served--and if you did, what do you or your family need?

[Pierre Allard]

I think this is exactly what Keeping the Promise identifies as the approach to take. What is your need? The reality is that a certain percentage of either the standard population or veterans have high needs. These programs should be applied to the people who have high needs. They should receive the service of a care manager to make sure they get the services and benefits they require. We should couple this approach with a very strong health promotion approach through the serving time of the military member and then after he retires so the needs are minimized.

You raised the issue of hearing loss. I don't want to correct you, but being a service provider I know the criteria that are established for entitlement to a disability pension for hearing loss. The reality is that if you do not have an audiogram from when you were released after World War II or Korea, you have a high chance of success of getting your hearing loss covered through Veterans Affairs Canada if you have a hearing loss problem today. The issue is that some people who served in World War II or Korea continued to serve in the Canadian Forces after those two conflicts and have had hearing loss on release. In other words, they have dual service.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Sir, not to correct you back--I would never have the gall to do that--but if the minister and previous people said that the benefit of the doubt should fall upon the veteran, what are we arguing about? That's what these people have heard--from what they can hear. The national Minister of Veterans Affairs has said that the benefit of the doubt should go to the veteran.

[Pierre Allard]

As I said, my understanding of it from how the program operates is very clear. The Veterans Review and Appeal Board tribunal has basically looked at hearing loss from the perspective that somebody might have been identified as having a hearing loss, but it did not meet certain guidelines. Those guidelines were not necessarily used for eligibility but for assessment. The tribunal has exercised its option to look at these cases and apply the assessment table to eligibility.

This case was taken upon by one person, Mr. Nelson. He went to the federal court and got a favourable judgment by Judge O'Keefe. Then the federal government went to the appeal court and tried to basically deny—shame on them—Judge O'Keefe's decision.

Here is the judgment of the appeal court that was published a couple of days ago. It basically tells the Veterans Review and Appeal Board to apply the law as it stands and recognize that if there is a disability--and it clearly provides a definition of disability because it is in the VRAB Act and the Pension Act--they should follow the guidelines and recognize eligibility for entitlement.

So progress is being made. It is slow. But if you have any cases where you know for sure there was no audiogram on release--and only from World War II or Korea--send them to me and I'll look after them.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

I just use hearing as an example. There's also asbestos, chemical spraying, and all kinds of other things they were exposed to during their wartime service, or even peacetime service, for that matter. Now, 30, 40, or 50 years later they're suffering the results of these things. When they go to DVA for assistance of any kind--medical equipment, pension, or whatever--the battles they have to go through in the legislated format are incredible. Many of them just say to hell with it.

[Pierre Allard]

The reality is that the disability pension process is evidence-based. A minimum of evidence must be put forward by the applicant. If any of your constituents have problems, we have professional service officers who assist veterans through all levels of the disability pension process to two levels of appeal and reconsideration. Send them my way. I'm not saying they will get disability entitlement, but we certainly know how the system works and will help them.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you.

[The Chair, Conservative, Rob Anders]

Thank you very much, Mr. Stoffer.

For the Conservatives, Mr. Shipley, seven minutes.

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

Thank you, Mr. Allard, for coming again today. It's always good to see you. From my perspective, I have something like 19 legions in my riding, from very large and growing to, as you say, struggling. I think it has to do with their location and whether or not there are veterans coming back.

I know this is about health care, but I want to go back just a little bit. I'm not so sure that all the comments that have come against you are very fair.

I was involved for many years in municipal council. One thing we continually talked to the legions about, or that they talked to us about, was the involvement in community funding. I found that for some of the legions where I was involved, they wanted relief from the municipality. On the other hand, they were funding baseball teams and soccer teams and those types of community organizations. And I give credit to the legions for wanting to reach to the community, so it's not that. Do you see yourself, though, as...or could you perhaps help me clarify that?

Also, do you see yourself as sort of an extension to a service club? Often the service clubs do the same thing. I think we need a clear direction on that.

[Pierre Allard]

You're joining the Bloc Québécois here in identifying us as a service club.

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

No, I'm not, but some are.

[Pierre Allard]

Okay.

We get funding from two sources. We get funding from our members through dues. We also get funding from the poppy fund. We have strict regulations on how we can use poppy fund moneys. We cannot use them to sustain branches. That's why, thanks to Veterans Affairs Canada, we have a consultant who can assist local branches make use of the real estate they own, which sometimes can be very valuable and can help them survive.

Do we see ourselves as a service club? If we were only a service club, then we would not provide free representation to any veteran, whether they were a member of a legion or not, or to RCMP members, or to their families in this very complex disability pension process.

I just presented one small window on the eligibility criteria for one program. The same exists for all of their programs, whether or not one is getting benefits under the Pension Act or under the new Veterans Charter. It's a very complex environment. Our professional service officers are trained. They have the tools. They have access to the client service delivery network, which is a VAC database.

If we were just a service group, we would not be doing that. We would not be promoting certain support to the Canadian Forces the way we do. We would not have a defence committee that would argue and basically advocate for a strong Canadian Forces in our country. This is not what a service group does.

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

I think what I hear is that it's an extension to reach to the community in terms of who you are, what you do, and--

[Pierre Allard]

Of course. To put it in succinct terms, we care about our communities. We care about our country. We care about veterans. We are unique. We are almost, I would suggest, an institution in this country, and we intend to maintain our nationwide coverage.

We see ourselves even being able to do an outreach to the reservists. We keep identifying that reservists have special needs that are not catered to. They're out there somewhere, in the smaller communities across the country, and Canadian Forces and Veterans Affairs have trouble touching the reservists. Well, we have the footprint to do that. We have already talked to officials at Veterans Affairs Canada and the Canadian Forces to make sure we can play a role in reaching out to the reservists.

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

I think that's an important part also, Mr. Allard.

Let's go on, as this is about health care. The other day we had the opportunity to meet with a number of people who had been affected by PTSD. You're very aware of that. You've sat through a number of our witnesses' appearances.

In terms of your comments, your help, and your direction to us, we hear different things about barriers, the bureaucracy, and those things that are getting in the way of actually making fluid and fluent assistance to our veterans who are suffering. This particular time it's PTSD, but it's not just that. It's very complex, as you've mentioned.

I'm just wondering if you could give us any idea or any suggestion with regard to recommendations on what we could do to help the access through our system.

[Pierre Allard]

It's interesting. I happen to sit on the OSISS advisory council. If I was to give you one recommendation, it would be a very simple one. Veterans Affairs Canada have their OSI clinics; they are operational stress injury clinics. They currently have five, and they've budgeted for an additional five. The Canadian Forces maintain something they call the OTSSCs, operational trauma and stress support centres. In theory the OSI clinics are there to meet the needs of the veterans while the OTSSC clinics meet the needs of the Canadian Forces serving members.

There has to be a better transition between the OTSSCs and the OSI clinics. As a matter of fact, there should be a seamless transition. The OTSSCs should be renamed as OSI clinics. They should all be OSI clinics, and they should offer services to either the Canadian Forces member or the veteran. They should also offer services to their families. Here is a simple recommendation to put some clarity, some simplicity, in this transition, which we think should be seamless.

There are too many problems with the handover from one psychiatrist at one type of clinic--the OTSSC--to an OSI clinic, where maybe the medication profile is different depending on which department is approving what.

If you solve that one, I think that would be a good first step.

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

The other question in terms of--

[Pierre Allard]

And I apologize. I probably come across a little strong, but I really feel--

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

Actually I think it comes across as passionate and direct. That's great.

I'm out of time.

[The Chair, Conservative, Rob Anders]

That means you can come back later.

We'll go to Mr. St. Denis, for five minutes with the Liberals.

[Brent St. Denis, Liberal, Algoma—Manitoulin—Kapuskasing, ON]

Thank you, Mr. Chair.

Thank you, Monsieur Allard, for being here again to help us.

I'd like to focus in particular on page 6, where you mention the gateway. It seems to me that there are three essential stages for a veteran's application for a service. There's entry, getting in; there's a processing period; and then there's a conclusion, what the result was. There are three simple stages, although no doubt there are many complexities within each of those.

Again, I want to focus on the entry or the gateway. You suggest that right now the gateway requirements could be based on income, the level of disability, or the type of service needed. To summarize, there are different criteria to go through this gateway.

Could you speak a little about simplifying the entry? Rather than requiring a veteran to jump all these hurdles simply to get his grass cut, whereas another veteran requires a more complex set of responses, could you speak about making that gateway less intimidating, especially for the veteran who is already sick or maybe has literacy or language issues? I'd appreciate that.

[Pierre Allard]

Just a point of correction. Those are not my gateways; those are the current gateways as they exist. Keeping the Promise is saying you need to shrink those gateways to basically identifying needs. There are some people who have high needs. In another committee it was identified that of the large population of Canadian seniors, there are approximately 12% who have high needs.

Currently, looking at our veterans, it's very difficult to look at the numbers, because there are no precise numbers at Veterans Affairs Canada. But in looking at the numbers, it appears that approximately 14% of clients, if you want to call them that, have been identified as having high needs.

So there are a couple of things that need to be done. I think we need to convince, first of all, Statistics Canada that when they do their census, le recensement à tous les cinq ans, that they must somehow try to identify the target population of veterans across this country. We have to have a firmer handle on the numbers. Keeping in mind the statistics I've just given you, when we anticipate that there might be a slightly higher need--higher statistics of people with a higher need--in our veterans than in our normal Canadian population, then you have to find a way to screen them when they come to get services. There has to be a very quick screening process that would take place at what is currently the National Contact Centre Network, which is really a call centre for Veterans Affairs Canada. There is a simple test, and there is a test in Quebec called PRISMA, which basically asks about seven questions. If somebody answers yea or nay or whatever to those seven basic questions, it could be identified that he's one of those high-needs persons. If he's a high-needs person, then he needs a designated care manager to provide the care package that he needs made up of these various programs that are here under these complex eligibility criteria.

Then that care manager becomes a resource person for that high-needs client. This is basically what Keeping the Promise is recommending. Associated with that, when you go through the PRISMA-like screening, it could be that what you want to recommend to the client who's calling in is to engage in a vigorous health promotion package, which will delay his coming into the gateway as a high-needs person. So in simple terms, this is what we're recommending.

This approach, by the way, would look after the frail veteran of today who, with all due respect to Monsieur Perron, is dying at a high rate. This is what is said in Keeping the Promise, and I won't apologize for that. That frail veteran should be hitting this gateway of high needs not based on a stupid entitlement for hearing loss at 85 years old when all he wants is VIP. This high-needs gateway would look after the Joyce Carters of the world who are asking for VIP, which would actually save money for the Canadian taxpayer. That's what we're saying, too vigorously, I'm sorry, but....

[A voice]

No, no. It's right on.

[Brent St. Denis, Liberal, Algoma—Manitoulin—Kapuskasing, ON]

I think to our researcher, as he tries to summarize as we go along some of the ideas that come from our discussions like this...the fact that Stats Canada or some other agency makes sure that we have a reasonably good picture of what that 14% looks like.

Second, with respect to intake or the gateway--and I'll conclude with this--that it be totally reviewed and redesigned so that in the first few minutes of the gentleman or senior veteran's call, he or she is directed immediately to an agent to help or be told, “Okay, sir. That's a small problem. We can get that dealt with right away.”

In other words, divide them sooner rather than letting them go through all kinds of processing and then say, “Oh, by the way, that was a simple problem. We could have settled that weeks ago.”