Veterans Affairs Committee on May 11th, 2009

[The Chair, Conservative, David Sweet]

There's a fine executive summary at the front, as I remember.

[An hon. member]

Good. That always comes in handy.

[The Chair, Conservative, David Sweet]

We still don't have Mr. Stoffer here, so now it's back to the Conservative Party and Mr. Shory for five minutes.

[Devinder Shory, Conservative, Calgary Northeast, AB]

Thank you, Mr. Chair.

It's an interesting committee and this is a very interesting program. This is my first time on this committee, and this seems like a great program for our veterans.

You spoke about outreach programs in the program itself. Is that correct?

[Carlos Lourenso]

When I spoke about outreach, I think what I said pertained to the outreach that we're undertaking in connection with the extension of the VIP for survivors. We're exploring and implementing some outreach avenues to make sure we have done due diligence in finding survivors who may be eligible for the program but who have not yet applied.

[Devinder Shory, Conservative, Calgary Northeast, AB]

You are saying that basically the program allows you some budget or allows some initiatives to be taken to find the survivors and to provide the benefits.

[Carlos Lourenso]

We would do that as part of our normal operations. We do outreach quite consistently across the spectrum. It's something that we've done in communities, with community partners, from a case management perspective and from the perspective of trying to link with other provincial providers as well. It's certainly a big part of our work every day.

[Devinder Shory, Conservative, Calgary Northeast, AB]

For that initiative, do you have any budgetary limits, any budget allocations?

[Carlos Lourenso]

No, and we're certainly not close to the projected expenditures for that program.

[Devinder Shory, Conservative, Calgary Northeast, AB]

What is your experience with the effectiveness of this outreach approach? Is it successful to an extent?

[Carlos Lourenso]

Do you mean the one connected to the survivors?

[Devinder Shory, Conservative, Calgary Northeast, AB]

Correct.

[Carlos Lourenso]

I can't comment on that. It's fairly new, and I don't know if there are any results on it. We could find out and get back to you, if that's of interest to you.

[Devinder Shory, Conservative, Calgary Northeast, AB]

Okay.

The question of whether the veterans are receptive to the whole program itself came to my mind. Do they appreciate the program? Are they satisfied with the program, or do they have a lot of complaints?

[Carlos Lourenso]

Do you mean the VIP program?

[Devinder Shory, Conservative, Calgary Northeast, AB]

That's correct.

[Carlos Lourenso]

When I was a social worker travelling around northern Ontario delivering the VIP program about 20 years ago, I was the envy of every colleague who came out of my school because I was essentially delivering something incredible.

Veterans are ecstatic about the DVA guy or gal showing up, sitting down with them, running through the various benefits that they're eligible to receive, mutually formulating an agreement with them on what they can do and what we can do, and putting those services in place. The satisfaction rating of that program has been one of the highest among all the programs that we know. It's been an incredibly successful program.

[Devinder Shory, Conservative, Calgary Northeast, AB]

It's normal with age for anybody to become a little rough and tough and perhaps to not even follow the requirements one needs to follow. How important is the health of the veteran in keeping the veteran at home or in the community? In some circumstances, for example, veterans get stuck on the idea that they want to stay home, even though their health doesn't allow it.

How do you deal with those circumstances?

[Carlos Lourenso]

Each of those situations is always very individual, but we have very good people in the field as social workers, nurses, and other health professionals. Our approach has always been to work very closely with clients to identify both their strengths and the areas where they need help.

Certainly it has always been our orientation to allow folks to choose as much as possible where and how they would like to live. We certainly lean on the side of allowing a veteran to have as much autonomy as possible. At a certain point, if there are concerns around their own safety and security, we would sit down with them and their families and try to work out a solution that's amenable to them.

There are a variety of solutions now. Sometimes I think people don't realize that you don't need to move from your house into a traditional nursing home. There are all sorts of options in between that we might be able to help with. I think when we do that, the situation calms itself down accordingly.

[Devinder Shory, Conservative, Calgary Northeast, AB]

Can I have a minute?

[The Chair, Conservative, David Sweet]

Mr. Stoffer has returned now.

Does Mr. André, the member from the Bloc, have one more question?

[Guy André, Bloc, Berthier—Maskinongé, QC]

Thank you for your explanations.

Currently, there is a great deal of pressure on the health-care system and on service delivery, there is much talk about efficiency and effectiveness in delivering services to the population. Money is hard to come by, and certain governments tend to want to privatize services.

The annual cost of the department's long-term care program is $340 million. What is the cost of administering these services?

Have you done an analysis of the way you deliver these services, to determine whether you are being as efficient, effective and economic as possible, not in terms of customer service but rather in administrative and management terms?

I am wondering whether the program would be more efficient if the budget was transferred to the provinces and to Quebec, for example, to departments that are already set up to deliver these services.

[Carlos Lourenso]

Thank you.

First of all, I don't know offhand what the answer is for the administrative costs associated with the program, but we can get that information for you, if you wish.

As for how services are provided, let me explain a little bit how the system works, and that may help you to understand.

When somebody needs long-term care in their province, in their particular health authority, they normally or in almost all cases apply—even the veterans—through the local placement agency. In Quebec, it's the CLSC. So they go there, and they're assessed to be at a certain level of need, and then they're in or they're out. If they're in, they're admitted, or they're put on a waiting list for a particular facility they have chosen.

In most cases and provinces, people are able to choose one, two, or three priorities, and they go into one of those. When they're in that facility, for the vast majority of veterans, they're in a community facility in a community bed. Veterans Affairs' role is to assist them with their cost of care; we have no other role. The facility is owned and operated by its respective jurisdiction. Our role is to ensure that the amount of funds the veteran must contribute is consistent across the country.

With respect to the type of care and the efficiency of that care, once again, we don't assess the efficiency of a system that is essentially provided for, in paying the bulk of that system.

[Guy André, Bloc, Berthier—Maskinongé, QC]

That's what the provincial health departments do. They administer funds and distribute services in the various establishments.

[Carlos Lourenso]

But in some situations, we do have a role in evaluating the services provided. I talked about the quality assurance measures we take and how we watch and monitor what goes on in provinces and facilities where veterans live. Perhaps more importantly, in some of the contract bed facilities that we have—Maison Paul-Triquet and CHUL in Quebec—we sometimes do have specialized programming and other types of programming in those facilities, and we undertake regular analysis of those types of programs to ensure they meet the outcomes that we've set forth. Even in a facility like Ste. Anne's, all sorts of specialization occurs there. It is very well regulated and evaluated to ensure that we're achieving the types of results we want to achieve.

So we can do that very comprehensively in the contract bed facilities and the community facilities outside our jurisdiction. We monitor the care there, but we don't comment on their efficiency of operations.