Veterans Affairs Committee on June 5th, 2012

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

Thank you very much. I appreciate the chairman's leniency with me.

[The Chair, Conservative, Greg Kerr]

Do you have a final question?

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

No, that's fine.

[The Chair, Conservative, Greg Kerr]

That makes you the shortest of the lot so far today, Mr. Storseth. I'm most impressed.

Mr. Lobb is next, for five minutes, please.

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

I just want to make sure I am clear here, Ms. Pellerin. Other people have talked about case managers. The first point you made, on page 3, was that you had “improved the timeliness of our decisions through a reduction in the turnaround time for Rehabilitation Program eligibility”, etc. Is this what you are crediting the streamlining of the case managers to, their being empowered to make decisions? Am I clear on that?

[Anne-Marie Pellerin]

That is one of the elements of streamlining decision-making and improving the timeliness of decisions. The other is the authority the case managers have been given, as of about a year ago, to actually make decisions on specific benefits and services that veterans need to support their rehabilitation plan.

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

Those, then, are the two improvements that came through the transformation initiative on that point?

[Anne-Marie Pellerin]

That's correct.

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

Another question I have is for the colonels. On pages 1 and 2, near the bottom, the Intermed is mentioned, the new work tool for case managers. Is Veterans Affairs using this same software program? Is it the same program, or do you use two different software systems?

[Col Jean-Robert Bernier]

That program is to help us in their medical care and assessment. While they're still in the armed forces, we want to retain them. As Colonel Blais was mentioning, by the time we come up with a need to meet for an integrated transition plan, in some cases the medical system may have hung on to someone for up to three years to provide them with every bit of rehabilitation that we possibly can. It's only at the point that we see that there's no possibility of retaining that individual in uniform to continue serving in the armed forces that we then have to throw in the towel and embark on the integrated transition process to transition them to civilian life.

The Intermed, at that point, allows us medically to assess the degree of biological requirements for medical care, but it also includes parameters that permit an assessment of the social, vocational, occupational, and other similar kinds of factors. It's used within the armed forces to guide the integrated transition plan for transition to civilian life and to determine the amount of time and the various efforts that would be required to give the person the best possible transition before being released from the armed forces.

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

Okay.

Ms. Pellerin, I have another question for you about the second of your bulleted points on page 3. You “developed and implemented Workload Intensity Tools” that the case managers can use. When you did this, where did you get the idea from? Is this something that other countries are doing, which you picked up? Where did it come from?

[Anne-Marie Pellerin]

We've introduced one tool that allows us to measure risk of veterans who are being case-managed, and in fact those who are not being case-managed. It allows us to assess the risks to see whether they may in fact be in need of case management services.

The risk tool is one that we modified. It was developed out of Regina by one of the Regina health authorities. They allowed Veterans Affairs to modify a tool they had developed. We have modified it not only for our traditional veterans but also for our younger population, for the needs they have around re-establishment.

It's a tool that has been tested and validated through the work of the Qu'Appelle Health Region in Regina. As I said, they've allowed Veterans Affairs to modify that tool for our use.

The other tool is based on need and complexity. It is one we've developed in-house, within Veterans Affairs, with the support of our departmental research directorate. It's a tested tool and has been implemented nationally. It's showing very good results in terms of uptake by our case managers and of allowing them to understand their caseload and dedicate their time and energies toward those veterans who are most in need of case management services.

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

You've likely talked to peers from other developed countries that have developed militaries and subsequently have developed veterans affairs departments to one level or another. As the director, where do you feel Veterans Affairs Canada sits with respect to case managers and mental health?

And as part of the transformation initiative, where else do you see your goal heading in the next, say, three to five years?

[Anne-Marie Pellerin]

In terms of Veterans Affairs' position and research around the services we provide and the programs we offer to veterans, the research and the collaboration we have with our international partners has been well established. We've looked at the work ongoing in the U.S., Britain, and Australia and we have presented at what's called a seniors international forum at our ministerial and deputy levels. Veterans Affairs Canada was cited a couple of years ago by those international partners as leading-edge in our rehabilitation and Veterans Charter programming and the case management services associated with the delivery of those programs.

We don't, of course, rest on our laurels. We're continuing through transformation to continuously improve, to look at the ongoing development of standards and best practices in the field of case management. This is why, through our transformation agenda, we are investing in tools that help us assess our workload and manage our cases well to ensure that our veterans are receiving the best services we can possibly provide.

[The Chair, Conservative, Greg Kerr]

Thank you very much, Ms. Pellerin.

That will end round one.

Round two is a four-minute round. We'll start with Monsieur Chicoine, please.

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

Thank you, Mr. Chair.

My thanks to our witnesses for their presentations and for making themselves available to answer our questions.

My first question goes to Ms. Pellerin. In the engagement section of your presentation, you mentioned the possibility of ending the case management relationship when the goals are achieved, and of re-engaging the veteran in the case management process.

Who decides when the case management relationship should end?

[Anne-Marie Pellerin]

Thank you for the question.

Case management services are available to veterans whenever they need them and for as long as they need them.

As I described in my opening remarks, the relationship between the case manager and the veteran is about establishing goals, realistic goals, in terms of what the veteran is likely to achieve from a health, a social, and an employment perspective. Once the veteran has achieved those goals, the likelihood is that the intervention of the case manager is no longer required. The goals have been achieved, and the veteran can reintegrate successfully into civilian life.

If at some future point something happens to the veteran or there is a change in the veteran's situation, either from a health perspective or from an employment perspective, there is an opportunity for the veteran to reconnect with Veterans Affairs. If at that point there is a need for case management intervention and re-engagement with that case management process, that opportunity is provided.

The veteran is disengaged, which is the term we use, when he or she has achieved the goals and is ready to be fully independent in society. But as I said, the opportunity to return to the department at some future point, based on a change in circumstance, is there. It's encouraged. We certainly inform our veterans and our veterans' families of that opportunity.

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

As I understand it, a veteran has access to a case manager for as long as he has not achieved the goals. The case manager does not decide whether the veteran has achieved the goals and that the relationship is over. It is done by common consent.

[Anne-Marie Pellerin]

The goals are established mutually between the veteran and the case manager. It's not the case manager dictating the goals. It's working with the veteran to establish realistic goals, given the veteran's health situation and given the skills the person has attained through the military and the likelihood of transferring those skills to a civilian employment situation. Providing retraining may be necessary. The goals are mutually established, and when they have been achieved, it's obviously a mutual agreement on that goal attainment.

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

Thank you.

[The Chair, Conservative, Greg Kerr]

Be very brief.

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

It will not be very brief. It will be too long for Monsieur Bernier to have time to answer. It's okay.

[The Chair, Conservative, Greg Kerr]

What you could do is put your question and get the answer back in writing.

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

Mr. Bernier, I have read in some reports that there is a significant lack of clinical psychologists in the Canadian Forces. Is there a plan to hire more, so that we can reduce the psychological distress that veterans are suffering, especially those coming back from Afghanistan, for whom that distress is catastrophic?

[The Chair, Conservative, Greg Kerr]

Colonel Bernier, what we're going to do is send you the question as asked by Mr. Chicoine and ask for the answer back in writing.

Sorry, but we are being squeezed for time.

We'll go to Mr. Harris, for four minutes. Thank you.