Veterans Affairs Committee on Sept. 26th, 2012

[Sean Casey, Liberal, Charlottetown, PE]

The case managers who are presently situated on Prince Edward Island, are they in the district office?

[Charlotte Stewart]

Yes.

[Sean Casey, Liberal, Charlottetown, PE]

When the district office closes, where are they going to be?

[Charlotte Stewart]

This planning is under way right now. We have the benefit of the time to do this properly, and those decisions will be made in due course.

[Sean Casey, Liberal, Charlottetown, PE]

Are you going to move them off Island?

[Charlotte Stewart]

There's no decision yet.

[Sean Casey, Liberal, Charlottetown, PE]

So you can't assure me that there will be any case managers on Prince Edward Island once all of these changes are implemented?

[Charlotte Stewart]

No. What's important—and it's what's important to our veterans—is that when they need a case manager, when they need a case management service, they'll have it available to them, and that's a commitment the department continues to make and will make in the future.

[Sean Casey, Liberal, Charlottetown, PE]

When you say “available to them”, someone's going to get in a car and drive over from the mainland and do a house call...?

[Charlotte Stewart]

We have many examples where case managers provide that service, and it is very effective. The feedback from our veterans indicates that.

[Sean Casey, Liberal, Charlottetown, PE]

A client service officer...do I have the right term? Is there such a thing?

[Charlotte Stewart]

A client service agent.

[Sean Casey, Liberal, Charlottetown, PE]

A client service agent. How many client service agent positions have been cut through the transformation agenda?

[Charlotte Stewart]

Overall, there were 75 that were reduced.

[The Chair, Conservative, Greg Kerr]

Thank you very much, Mr. Casey. We are over the five minutes.

Mr. Harris is just raring to go, so we'll turn to him for five minutes.

[Dick Harris, Conservative, Cariboo—Prince George, BC]

Thank you, Mr. Chair.

Thank you, ladies and gentlemen, for your presentation.

Since I've been on the committee I think this is the second or third time that you've appeared before the committee, and I thank you for that.

One thing that's been abundantly clear when I've heard the testimony and presentations you've given is that between you and your case managers this could never be considered just a job. When you're dealing with veterans who have a lot of varying situations, health situations that have to be dealt with, you're as close as you can get to your client. In order to do that job efficiently, you have to have, first of all, a passion for it, and also a commitment to the well-being of the person you're dealing with. I want to commend you for that, because I don't believe for a minute that any of you can do this, the work you do, and ever consider it just a job, considering you're dealing with human lives. Congratulations for all that you do, and your case workers as well.

I do know that when the changes came about, as far as the budget goes, you all had input into them. The fact that the overall budget was only cut by 1% reflected your commitment to the work you do. Yet you've been able to, first and foremost, put the veterans first and maintain the service, and even improve the services you were delivering through different technologies, training, and ways of doing things. Congratulations again.

I think it's particularly notable because in fact the budget was only cut by 1%. As I recall, in the years I was here during the previous government, I think its overall budget cuts were somewhere in the neighbourhood of 10% to 12%. It was something; you could really see the effect throughout the department. Congratulations. I'm really pleased to talk about the work you do.

You and your case workers...I just wonder what you feel when you know you're doing your best, and you know what you're doing for your cases, and yet you hear some criticism that in no way reflects what you're actually doing. I urge you to continue that good work, and keep the criticism where it belongs, and keep moving forward.

Given the new Veterans Charter, the number of benefits available to our veterans, is a case management approach vital to ensuring veterans have access to programs and services they need? With the new tools you have, do you believe the current system is more or less efficient than the previous system? Could you take a moment to explain? Do you feel your new system is far better, much better than the old system, in the way you've changed things?

[Charlotte Bastien]

First of all, I want to thank you. We do have staff who are very dedicated and highly skilled. For them, what they do for veterans is more than a job, so thank you. I will relay the message.

Again, as we have mentioned before, the tool that has helped people in the field, on the ground, on the front line is the accessibility, and also timeliness in responding, and also providing an answer to an application or a request from a veteran for a benefit or a service. It's the timeliness and access to the service, and for somebody to assist them with whatever that need is, or a request or an application.

[Dick Harris, Conservative, Cariboo—Prince George, BC]

Thank you very much.

How am I doing for time, Mr. Chair?

[The Chair, Conservative, Greg Kerr]

Even with your excellent soliloquy starting out, you still have about 30 seconds.

[Dick Harris, Conservative, Cariboo—Prince George, BC]

That's wonderful. I could easily continue and applaud your work for the next 30 seconds.

When a veteran or a transitioning Canadian Forces member approaches a case officer, can you walk us through, perhaps, the steps and services that are made available to them at the initial meeting? What do you say to them when they come to you looking for help?

[Charlotte Bastien]

We do a screening. It could be a client service agent or it could be a case manager. It depends on the situation. The basic question is about how the veteran is doing, what his or her situation is. Some of them might know what they're looking for. Some of them might not be aware of what we have to offer, so there would be a series of questions and answers to see what we can offer the individual, and in some cases their family. Also, if the veteran is not sure of what he or she is seeking, then we would do an exam or an assessment of what the situation is, what the issues would be, to see how we can help and what would be required in that particular case. So whether that person needs to be referred for case management or for a disability award, or be referred to any of the number of services—whether it's the veterans independence program or others, it depends on the situation of the individual—there would be an assessment based on questions in an interview.

[Dick Harris, Conservative, Cariboo—Prince George, BC]

Well, thank you for everything you do.

Thank you, Mr. Chair.

[The Chair, Conservative, Greg Kerr]

Thank you.

Now to Ms. Mathyssen for five minutes.

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

Thank you very much, Mr. Chair.

I would like to say very clearly to you that you do indeed do a remarkable job with not enough resources. It's painfully clear that there simply is not enough in terms of the resources that we should have in place to look after the many veterans.

I want to come back to numbers. You said there are 250 case managers and about 40 clients, veterans, per case manager. That is 10,000 veterans who are receiving help and support. Now, in light of the fact that there are 217,000 veterans, is it enough? How can you manage? How can these folks possibly deliver the service that they want to deliver?

On the second part of the question, last spring—and I know absolutely, because I saved the Hansard—we were assured that when the cuts came there would be no cuts to front-line workers, that there would be no cuts in regard to these case managers, yet I've just heard you say that 75 case managers were cut. So we have a significant number of veterans, 10,000 who are in desperate need, and if we look at the stats, 55% are affected with a combination of mental and physical health problems. That's 5,500 veterans—30% with physical conditions, which is 3,000, and 15% with mental health conditions. Those are very demanding needs.

How do you manage it all with the cuts to case managers, with the reality that there are great demands on the system?

[Charlotte Stewart]

You've asked a number of questions. I'll try to address them in order.

First of all, it's true that we have about 218,000 clients, but that includes a very large number of survivors—about 76,000—who typically do not require case management services. Within that, we have about 137,000 veterans, and within that 137,000, 73,000 are Canadian Forces.

What's important to note here is that not everyone is case-managed. Case management is a service. It's a professional practice that the department uses to assist those with the most need, either to transition from a Canadian Forces career to a civilian career or to address profound difficulties they're having at some stage of their life. Case management is a service that we use for those most in need.

On the tools that we've discussed, the main factor we use to identify those in need.... In my opening remarks I about the tools being used to identify those at risk, those with complex issues. Charlotte Bastien just mentioned the interview, where there's a further assessment done, so we develop a profile of the individual very quickly. These are done by professionals, so that when they do this, they come back with a very good picture of what this individual might need.

Not all people—veterans—who leave the military need case management. That's an important point. When we move forward as a department, we look at those that we need to serve. Right now, as I mentioned, the ratio is 40:1. In fact, that is our goal; 40:1 is our target. Right now, we're operating well below that. Our national average is about 30:1, so it means that an average case manager would have about 30 cases. We know that we're comfortably within our capacity. When I say that, there are 250 case managers and they're able to manage their workload appropriately, using the assessment tools we have.

When there is an increase in an area, when it looks like we need to adjust our case management numbers, we do so. While there are parts of the country where the offices are getting smaller, there are other parts of the country where the offices are getting larger to accommodate that need, and that's another very important point.

The client service agents are supporting the case managers. There are two different roles.

When I spoke about the reduction of client service agents, that's true. The department has been.... First of all, the demographics are changing, and the department is going to be smaller, and some of our positions will decline as a result of demographics. Also, for client service agents, as we've streamlined within the department and streamlined our programs, their work has been impacted to some degree. These are internal functions that we have streamlined, and they have, over time, contributed to a need for fewer client service agents. But there are still 180 client service agents active in this department, supporting 250 case managers. As I mentioned, our ratio is very much within our target.

I believe I've covered your questions.