Veterans Affairs Committee on May 29th, 2008

[Keith Pedigo]

On the benefit side of the VA, I think our biggest gap is that we have not developed electronic information systems to keep pace with the increasing complexity of the benefits process that our Congress provides to us. Presently our largest program, the disability compensation program, is pretty much paper-driven. Each veteran has a paper C-file that quite literally can be a foot deep, depending on the veteran's situation.

We're desperately and aggressively trying to move forward now to develop electronic records so that we can improve the efficiency with which we handle veterans' claims.

[The Chair, Conservative, Rob Anders]

Thank you very much for that addition.

Now we will move on to Mr. Perron, from the Bloc Québécois.

You have seven minutes.

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

Thank you, Mr. Chair.

Ladies and gentlemen, thank you for your assistance. All the members of the committee around this table know my concerns very well. I am particularly interested in what I call psychological wounds, that is, post-traumatic stress. For Canadians, this is a new affliction, a new kind of wound. But you in America have a little more experience because, if I remember correctly, you began studying the issue and developing your expertise during the Vietnam War.

What kinds of services do you provide to those young people?

[Gail Graham]

We provide a full range of mental health services. The big thing that we do now is a more proactive screening. For example, problems within our electronic health records are presented to the providers, who see a veteran depending on where that veteran served, when they served, or the conditions, and they really walk them through a screening for things like post-traumatic stress disorder, depression, and suicidal ideation. They'll be screened for these things so they can be referred for broader treatment. So we have extensive mental health services.

Most recently, there's been a lot of publicity about the whole issue of suicide. So we have set up a national suicide hotline that's connected to the country's suicide hotline, but it's specifically for veterans. They are referred from this national line, and there are screening techniques for the possibility of suicidal ideation.

This is an area where we thought you might possibly need a whole other session, if you will, with our mental health professionals. As you indicated, there have been a lot of studies done by both the Department of Defense and the VA, and we can certainly accumulate those materials for you.

In the past few years, as Ms. Fischetti alluded to, we have had a large research contingent. Plus we've also developed a war-related illnesses centre, which looks not only at physical ailments due to combat-related exposure but also at mental health issues.

But you're exactly right that we are very cognizant of these and make sure that these services are available both to our newer and existing veterans.

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

When a young person is diagnosed with post-traumatic stress, how long does he have to wait before receiving treatment, a pension, and all the other veterans' benefits?

[Gail Graham]

I'll speak to that.

On the health care side, the practitioner who identified this would make the referral immediately and it would be a clinical judgment as to whether they needed immediate hospitalization or immediate referral to a psychologist or psychiatrist or their mental health professional or whether they could use a future appointment. It would be completely dependent on their need at that time. So they would not necessarily go into a queue if they had an immediate need for treatment.

[Keith Pedigo]

For the benefits, veterans can get disability compensation for PTSD. It requires an application from the veteran, a medical examination, psychological examinations, a gathering of evidence, and then a final determination as to whether the veteran's condition were service connected. If the answer is yes to all those, we can pay disability compensation.

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

Psychologists and psychiatrists all say that it is extremely difficult to determine the extent of the wound for compensation purposes. Do your young people with psychological wounds receive the same compensation as they would for a physical wound, like a bullet in the shoulder or the knee?

[Keith Pedigo]

That's an excellent question and one that we're currently struggling with.

We rely to a great extent on the clinical expertise of the veterans health administration to advise us on many of the claims that we receive from veterans. Yes, it is much easier to award disability compensation based on a bullet wound or an amputation. We are continuing to try to get ahead of the curve on gaining an understanding of PTSD and providing training to our veteran service representatives who process disability claims. But this is an ever-evolving area of focus. Right now we think we're doing a reasonably good job, but we know that we still have a lot to learn.

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

I have one more question. What is the success rate of your treatment of young people with post-traumatic stress?

[Gail Graham]

I think on that we'll have to get back to you--with Dr. Katz or our mental health providers--on the statistics and the reporting they have on that specific question.

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

I would like to talk about post-traumatic stress all day, but unfortunately, my chair is cutting me off.

[Gail Graham]

That actually could be an entire session, in my personal opinion.

[The Chair, Conservative, Rob Anders]

Thank you very much.

Normally we now go to the next order of opposition parties in the House, but the member is not able to be here today. Normally this five minutes would go to them, but I am going to step into the prerogative of the chair to take up those five minutes. Perhaps the clerk can start the clock so that I don't go over my own time.

First off, I was very impressed and humbled to hear about, in your presentation, all the various things. I think Canada has some way to go. I was impressed with the guarantees and loans for homes, life insurance policies, your education components, etc.

One that I wish to follow up particularly with the questioning is this aspect of your national cemeteries and their designation, in a sense. You mentioned the term “shrines”. I visited your Arlington National Cemetery. It's very impressive. It's a moving tribute.

I'm going to be going to your country, hopefully in a few hours, certainly by later today or tomorrow, travelling into Maine and New York State. Can you give me examples of places, ones that are relatively close, so that I can go and look at some of these? You mention marble, granite, bronze, etc. If I have a chance, I'd like to stop by one of those when I'm down there.

At some point, it might be an interesting thing for us to investigate in this country.

[Steve Muro]

Depending on where you'll be in New York, if you're going to be near the city, Calverton National Cemetery on Long Island is our third-busiest cemetery. They buried 6,000 last year. They have both upright marble and flat bronze markers there. Then we have Cypress Hills, which is in Brooklyn. That is one of our original 14 national cemeteries that date back to when President Lincoln started the national cemeteries. Then in Sarasota, New York, we have a national cemetery with upright marble. It's closer to the city.

[The Chair, Conservative, Rob Anders]

Are those all close to New York City proper?

[Steve Muro]

Yes.

[The Chair, Conservative, Rob Anders]

What about in upper state New York or Maine? Are there examples up in that neck of the woods?

[Steve Muro]

Yes. We have Elmira in the Buffalo area. Out on the cape we have Bourne, which is a Massachusetts national cemetery, and it has flat granite markers.

[The Chair, Conservative, Rob Anders]

Thank you. I appreciate that.

[Steve Muro]

You can find them online under www.cem.va.gov; there you can get the addresses to locate those cemeteries.

[The Chair, Conservative, Rob Anders]

My researcher will make sure he gets that address for me.

I think the idea of a memorial certificate is a good one. Can you give me some details on your Presidential Memorial Certificate?

[Steve Muro]

That dates back to President Kennedy. He developed the Presidential Memorial Certificate, and every president has carried it since then. We provide it to any veteran who has had an honourable discharge.

There are two ways they can get it. When they order a headstone we automatically generate it. The other way is through the benefits division. When they get the first notice of death, that automatically generates it electronically. So the family doesn't have to order it. Once they get one there is an order form, so they can order multiples of it and there's no cost to the family. We generate them here out of our central office. We'll get you an actual one and send it to you by FedEx.

[The Chair, Conservative, Rob Anders]

That would be very much appreciated, sir.

I still have a minute and 12 seconds left.

In your presentation you mentioned the educational components for veterans and their survivors or dependants. What were the dollar figures associated with that?

[Keith Pedigo]

The one for dependants pays $881 a month. For active duty it's $1,101. For the select reserve, the National Guard, it's $317 per month. For the National Guard and reserve who are called to active duty, it's a maximum of $880 per month.