Veterans Affairs Committee on May 29th, 2012

[The Chair, Conservative, Greg Kerr]

I think we've seen you folks before.

As I said, our time gets more restricted, and if you're going to add to it, sorry about the time squeeze, but that's what we have to do. If the others want to comment, you'll have to jump in really quickly, because we are under a time restraint.

We stopped with Mr. Casey, so we are over to Storseth for four minutes, please.

[Brian Storseth, Conservative, Westlock—St. Paul, AB]

Thank you very much, Mr. Chair.

Thank you very much to the witnesses for once again showing up. It's always good to hear about the transformation initiatives and today to talk a little more about the future direction of some of these initiatives.

One of the questions to start off with, Ms. Stewart, is about the relationship with DND. How is communication about clients shared between the two departments, and what are some of the best practices used now and that we foresee using into the future?

[Charlotte Stewart]

Thank you very much, Mr. Chair, for that question.

With respect to the best practices with DND, I think the starting point for those would be the VAC-DND steering committee, a high level committee that meets regularly and that has established a very strong agenda of partnership between the two departments. I already mentioned two item briefly, one being the continuity of care, which is the harmonization of programs and services; and the other casualty management and transition. Others include research, which is a key cornerstone of our commitment to working together; and a fourth would be the development of programs and services in support of families. So that's a very good practice.

I'll mention one, though, that came about as a result of more recent activity around Afghanistan, and it has to do with casualty protocols. This is very specific to what happens when a member is injured in service. The two departments respond very quickly to this need and work together with two case managers, one from each department, to support the member and the family. That commitment to immediately providing programs and services to that veteran, to committing two case managers to working together with that veteran, has been in place for almost two years and I think it's a key sign of a best practice. What it has led to is a very rapid response in the provision of benefits and services to that ailing member in a very short turnaround time. So it's treated with high priority and acted on very quickly.

Transition is another area. We work together through our integrated personnel support centres to support transition. We've committed together to 24 such centres across the country. We're doing ongoing quality reviews of these. This is where our case managers work together and meet with releasing members, meet with those who are still in the service, and provide good knowledge in support of VAC's benefits and programs for them.

[Brian Storseth, Conservative, Westlock—St. Paul, AB]

Thank you very much.

How much time do I have left, Mr. Chair?

[The Chair, Conservative, Greg Kerr]

You have one and a half-minutes left.

[Brian Storseth, Conservative, Westlock—St. Paul, AB]

I don't mean to be offensive here, but can you explain to me, without the bureaucratese, what it looks like for a serving member from my community who is going through the processes with DND and is going to be dealing with VAC. Can you explain to me in plain language what that looks like to them?

Also, one of the concerns I sometimes hear from members is their sometimes feeling pressured to leave on a medical release. So could you encompass that concern in there and tell me what it looks like from the member's point of view.

[Charlotte Stewart]

Krista.

[Krista Locke]

Sure, I can start and, Charlotte, if you have anything to add or, Bernard, you can continue.

Certainly, medical releasing involves working with a DND case manager and being part of an IPSC, an integrated personnel support unit. Our VAC staff also work in each of the integrated personnel support centres across Canada, so we have a case manager who would connect with the case manager at DND. The releasing member would work closely with both of those case managers, as Charlotte had said, for a very smooth transition, ensuring that all of their needs are met as they are releasing.

As well, we provide a mandatory transition interview. So, again, the member when they are releasing would have a transition interview with one of our client service agents or case managers. Normally it's with a client service agent, who goes through a very detailed interview to ensure we are meeting all of his or her needs as they release.

[The Chair, Conservative, Greg Kerr]

Okay. You got to use up the time this time.

Thank you.

Ms. Mathyssen, go ahead for four minutes, please.

[Irene Mathyssen, NDP, London—Fanshawe, ON]

Thank you very much, Mr. Chair.

Again, thank you for being here. DVA also looks after RCMP veterans, and yet no mention was made of them in the brief here. I'm wondering where they fit. Where does the RCMP come in?

[Charlotte Stewart]

We do indeed, on behalf of the RCMP, provide certain programs and benefits to that community, and they are one of our major client groups, so they are important.

[Irene Mathyssen, NDP, London—Fanshawe, ON]

Thank you.

Ms. Locke, on page 3 of your brief, you say that “workload intensity tools have been developed to help front-line staff balance fair and equitable caseloads”. Were front-line staff members consulted in the development of these tools? What did they contribute, and could you describe that process? Finally, how did you determine what is fair and equitable in terms of caseloads?

[Krista Locke]

I can certainly start.

This particular tool is for our case managers, our client service agents, and they were very much consulted to determine the types of tools they needed to do their job better. It was about equipping them with the best possible tool out there so they could get a decision for the veteran more quickly and a better decision as well. So they were very much involved in the consultation to develop that.

In fact, the case plan tool was enhanced, actually. It was in place. We had it in place for a number of years, and as with everything, you continuously look at ways to improve it, and it was recently enhanced to be more efficient, more effective, and to be an online tool to allow for better case planning.

The other one I referred to was the workload intensity tool. Again, that is used to determine the intensity of each client, and to ensure that the workload of each case manager is no larger than 40 case-managed clients. So if, for example, there is a very complex client, the case manager might have a smaller workload for a period of time while trying to spend much more time with that particular client who is very complex and who has complex needs, so that they can address it very quickly.

[Irene Mathyssen, NDP, London—Fanshawe, ON]

I'd like to hand my time to Mr. Chicoine.

[Sylvain Chicoine, NDP, Châteauguay—Saint-Constant, QC]

Thank you.

Given that all health services will soon be transferred to the provinces, have you provided for a mechanism to assess health care in all of the provinces to ensure uniformity?

[Charlotte Stewart]

I'll begin to answer the question, and then maybe someone can add to it

Across the country, indeed, the provision of services differs at times. VAC ensures that to the extent possible there is uniform provision of services to the veterans who need it. We would adjust, for instance, rates to ensure that an individual would get what they needed in terms of chiropractic services or other services equally across the country and that they would never be at a disadvantage because there might be a lack of parity or harmonization in the provision.

To the extent possible we will do that. We will also ensure that we work very hard to fill any gaps. One good example of this is in our operational stress injury clinics, which are obviously an area of high need in the Canadian medical landscape for VAC and DND. We set up operational stress injury networks so that we could provide clinical care on a more uniform basis across the country. We work very hard as well to develop and support providers across the country.

This means that we do a lot of education and outreach to service providers in the health care professions across Canada, with a view, of course, to ensuring that they understand the needs of veterans, that they're well positioned to support veterans, and that they do so in a way that's as streamlined and efficient as possible.

So while the Canadian health care landscape does have some variances across jurisdictions, our job is to try to make sure that is not a factor in the ongoing care of veterans.

[The Chair, Conservative, Greg Kerr]

Thank you.

Once again, we are quite a bit over time.

By the way, it's nice to see you here, Mr. Butt. I know you don't want to ask any questions, so I'll move right on.

[Brad Butt, Conservative, Mississauga—Streetsville, ON]

It's a pleasure to be here. I don't want to interrupt your flow.

[The Chair, Conservative, Greg Kerr]

Okay. I'll move right on to Mr. Lobb, for four minutes, please.

[Ben Lobb, Conservative, Huron—Bruce, ON]

Thank you very much.

The first question I have is in regard to the IT that you're implementing within the department, some of which has been already been implemented.

Is the overarching system that's going to deliver the improvements you're looking for, provide the flexibility you're looking for, and achieve some of the goals you've set a system that is used in other countries to deliver services for departments like Veterans Affairs or other departments? Or is this a new-build system? Is it something we're designing or have designed from scratch? If so, who's designing the system?

[Charlotte Stewart]

We employ a number of systems in the department, and I'll speak about a couple of them.

The technology we use to improve our service delivery and enhance our service is not necessarily full systems that we're putting in place. We're taking advantage of the opportunity to use scanning technology, for instance, in partnership with our colleagues at Public Works and Government Services Canada. We use the backbone of our IT system, which has been in place for many years, called the client service delivery network, to transport the scanned data. So we didn't have to build a new system.

We are doing some enhancements, and we're focusing on increasing the capacity or the bandwidth—some basic things like that. This doesn't require a large-scale investment in a new turnkey system; it's to modify what we currently have in place.

[Ben Lobb, Conservative, Huron—Bruce, ON]

With that, then, for the year 2013-14 the brochure says, “We see the benefits of our new technological capabilities”, and it talks about “tools, size, skills”.

What are the new technological capabilities that we'll see in 2013-14?

[Charlotte Stewart]

I'll speak to scanning. What it means is that when we work with scan—

[Ben Lobb, Conservative, Huron—Bruce, ON]

Is this the scanning of medical records?

[Charlotte Stewart]

Yes, it is.

Currently, it's a very paper-based system.