Veterans Affairs Committee on May 29th, 2008

[Steve Muro]

No. In a national cemetery, we provide the burial space, the outer container, and we also assist with honours, and chaplains and ministers.

At the private cemetery, we basically provide a headstone for the eligible veteran. We don't put the spouse's name on it, but we do leave space for the veteran's family to go ahead and add the spouse's name at the time of the spouse's death.

In a national one, we put them on.

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

Okay.

I think this one will likely go to Ms. Graham, and Ms. Fischetti may have a comment too.

Regarding your electronic health records, your digitized health records, you indicated that you've been using those for some 20 years. Later on, I believe, Ms. Fischetti, you indicated that some of the records you have are mainly paper-driven and that some could be a foot thick.

I'm wondering if you could just help me a little bit on these two comments, please.

[Gail Graham]

I think the difference was between the claims file in the veterans benefit administration and the medical records in veterans health administration.

Some 20 years ago we adopted lab, radiology, and pharmacy, for example, so that information has been electronic for a long time. About 10 years ago we adopted clinician order entry and became almost 100% reliant on the electronic record.

The claim file may contain some veterans health administration records. It may contain private sector records. It may contain military records that the veteran assembles and currently puts in a paper format to gather them together for the claims processing part.

I do want to point out that the claim adjudicator has access to the VA health record for treatment that we've delivered. That information is available to them in real time. The example that was used was that if a clinician who identifies a patient that they are concerned about who's suffering from post-traumatic stress disorder or another medical disorder makes contact with VBA, they can actually look immediately to see what the clinician has documented.

So it really has more to do with...and I'll defer to you about your processing.

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

Okay. Thank you very much.

If I understood you correctly, pretty much all of your health services and benefits come from Veterans Affairs--mainly the services--but you talked about an example, I think in Alaska, where it's difficult to reach rural or very remote areas. You also mentioned the number of female military who now are becoming veterans.

You likely won't have time to get into detail on this, but I would like to understand at some point in time--you can maybe forward this to us--the different type of service that is required between male and female. Obviously we're two different individuals, but we're being asked to do a similar task when we get into the military. So as we come back out, how is that dealt with, the difference between a male and a female?

[Gail Graham]

I'll just quickly comment that many of the services that the female veterans need in terms of general primary care, orthopedics, and those types of things are frequently delivered within our medical centres. However, we're seeing, for example, a younger veteran population now who are in need of obstetric services. We really don't provide obstetric services, so we would normally pay for that female veteran to receive those in the private sector, as an example of things.

We have added more and more services relative specifically to the needs of the female veteran, but we have an office of women veterans, and we can certainly give you that breakdown of what additional services there are.

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

Thank you. I haven't gotten the pull yet indicating my time's up, so I guess I have a second here.

One of the issues we have--I suspect it is not much different for you folks in the States--is educating and communicating with our veterans. I think it's more of those we would call our traditional veterans than it is our new veterans who maybe don't want to acknowledge that they have an issue, particularly outside of a physical one. So if it's an operational stress injury, we seem to have trouble getting the communications to them.

How are you dealing with that, educating them that the services are available and that in fact it's good and proper to come forward?

[Gail Graham]

The examples were given of what are called Stand Downs. We may also have health clinics we'll run in the veterans service organizations buildings and places around the country where we have VA clinicians there to talk to these individuals, but I think we have some of the same challenges. I think we're more educated in screening for some of these things--in primary care, for example, not waiting for a referral to mental health. These community-based outpatient clients we have were initially focused on primary care but have added mental health services to all of those community-based clinics.

So I think it's an ongoing effort for us. I think there's some stigma still on their part. It can be a challenge to get over.

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

Thank you so much for your time. I appreciate it.

[The Chair, Conservative, Rob Anders]

Thank you.

We now go over to the Liberal Party of Canada, to Mr. Valley for five minutes, with Monsieur Petit on deck.

[Roger Valley, Liberal, Kenora, ON]

Thank you.

I got what I wanted when I asked the question about gaps, because one of the comments I picked up on is about the low percentage of veterans who are served or who come forward, which my colleague also commented on.

The number is very similar, I believe, here in Canada. We have huge difficulty reaching out to the veterans. We think it's as simple as maybe they could talk to their members of Parliament or their Congressman. We don't know who they are. And with the privacy laws that are in place, this is where we're failing them. We're failing to let them know that those services are out there. We're failing to let them know that parliamentarians like me are there to service them.

I don't know how to get around that, but if we look at all the things we do, if we could reach more people or get them to come forward.... I don't know the situation where you serve, and if politicians are allowed to have names of people coming back. There's something we're not doing right, up here, and based on the percentage of veterans who are being served, it may not be the best situation down there.

As the senior people who are looking after many of these people, we have to find a different way of doing this, so we look to you to help us, because we can't figure it out up here. And it's the same question that was asked before, but it's not about one specific issue, PTSD. How are we going to get the veterans to come to us?

I struggle with that, because we need them to come. We are people persons; that's how we get elected. We can recognize a lot of things, and we'll know where these people are. It's as simple as a letter we could send them once a month, but we're not allowed to know where the veterans are located.

We're charged with many things in government. We know many things the general public doesn't, and yet we cannot know where the people we're trying to serve are.

Do you have any suggestions? Obviously you suffer from the same problem yourselves.

[Keith Pedigo]

One of the things we have found very useful is information that comes off of service members' discharge papers. When one of our members gets out of the military they're given a discharge. We call it a Department of Defense form 214.

VA gets a copy of each service member's discharge papers. More recently we've been getting electronic copies. The VA uses this information to immediately send what we call a “welcome home” package to the veteran. It's a booklet written in very understandable language that goes over the health care, memorial services, and all the benefits available to the veteran. We've found that to be extremely useful.

In addition to that, once again I'll mention our veterans' service organizations, the extensive network we have in this country in virtually every community. They're almost always there to try to recruit new members when our veterans get out of the military.

Finally, for about the last 12 or 13 years we have been partnering with the Department of Defense. In the last six months of a service member's term of service, we go to military bases around the country, in partnership with our Department of Labour, and put on a three-day seminar for veterans. They are fully informed at that point on the VA benefits that are available, as well as the Department of Labour and other benefits that might be available to them as a result of their military service.

Last year 400,000 veterans went through these briefings. We've found that to be a very useful tool in making sure that the level of information gets elevated.

[Roger Valley, Liberal, Kenora, ON]

Would one of the pieces of information you give out be that politicians are there to act on their behalf? In Canada it doesn't work that way. I've been to 11 bases in the last year, and one of the questions I keep bringing up is, “Has anyone ever thought to go to their politician first, last, or in the middle of the process?”

Are your politicians allowed knowledge of where your veterans are located?

[Gail Graham]

There are provisions under which Congressmen or Senators can request addresses of veterans. It goes through a clearing process to protect privacy rights, but there are conditions.

Our privacy laws also allow representatives to represent veterans if they approach politicians. So if I write to you to say, “I'm having difficulty getting my claim for any of these services”, as a politician you are then empowered to act on my behalf. Politicians frequently contact us on behalf of veterans, and we work through their representatives.

[Roger Valley, Liberal, Kenora, ON]

Thank you.

[The Chair, Conservative, Rob Anders]

Thank you.

Mr. Petit, from the Conservative Party of Canada, now has the floor for five minutes.

[Daniel Petit, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

Thank you very much, Mr. Chair.

Good afternoon, ladies and gentlemen. I hope that you can understand me. I have two or three brief questions for you because I would like to have a few more details.

Earlier, someone mentioned education programs, specifically something that you called the "Montgomery GI Bill". Could you give me a few more details about that? I understand that it is an education program intended for veterans, as well as for their dependents and those who survive them.

Here in Canada, we do not have quite the same kind of program. In some cases, we have employment protection, at least, we are going to. Soldiers going overseas have employment protection for two years. That is not in effect yet, but it is coming. There are also support programs for returning soldiers. This, of course, is the medical support that we have been talking about all through the session.

I would like to hear about your experience. What do you mean by education programs? Are the programs specific—because a lot of soldiers have professions or trades? I would like to know what you mean when you say education programs.

[Keith Pedigo]

The typical VA education program permits the service member or veteran, once they've served a certain amount of time in the service, to seek either a college education or technical training. While they are in college they receive a monthly stipend from VA. So we pay a single veteran who served in active duty $1,101 a month while they are enrolled full-time in a course of education. For various other programs, we pay lesser amounts for those who are pursuing degrees.

This program has been in force now since 1944, and 21 million veterans have received these benefits. And 70% of veterans who have left the military since the beginning of the current conflict have utilized this program.

[Daniel Petit, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

Thank you. Now I am looking for an explanation.

Someone mentioned earlier that you operate about 150 hospitals and more than 600 clinics. That is what I understood when you were making your comments just now.

I am from Quebec. One of our largest military bases, CFB Valcartier, is located in my constituency. We have a state system, meaning that the hospital belongs to the government, and doctors and nurses are paid by the government. Everyone is paid by the government in my constituency and throughout the province of Quebec.

When you say that you operate 155 hospitals and 600 clinics, is your system the same? Does that mean that you pay everyone, the doctors and nurses and so on? Is that what you mean when you say that you operate hospitals and clinics?

[Gail Graham]

The hospitals and clinics that are under the veterans health administration are ones that we own, operate, and staff with both VA employees and, possibly, for scarce resources, contract physicians. They are separate from private hospitals in the United States. As I indicated, in some instances, we may pay for services to be obtained from private hospitals, but these clinics, nursing homes, and hospitals are VA-owned and -run entities.

[Daniel Petit, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

Thank you very much.

[The Chair, Conservative, Rob Anders]

Thank you.

We have somebody who is indisposed and won't be able to ask any questions, so we're now moving from the third party over to the Conservative Party of Canada and, once again, Mr. Sweet for five minutes.

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

Thanks.

I just have two questions I'd like to ask. One is very simple: are the disability benefits all tax-free?

[Keith Pedigo]

Yes, they are.

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

Okay, thank you.

Could somebody there tell me about Virtual Iraq? I understand it's being piloted right now for treatment of PTSD. I just want to know how that's going and if it's a tool that's going to be substantially more effective in the treatment of PTSD, etc. Are you familiar with it and are you using it?

[Gail Graham]

It's operated by the Department of Defense, is it not?

We can get more information for you, but it is operated by the Department of Defense.