Veterans Affairs Committee on Oct. 18th, 2016

[The Chair, Liberal, Neil Ellis]

I call the meeting to order.

Thank you, everybody, and I apologize to our witnesses. As you're well aware, we were all whipped to stay at the House for an extra 20 minutes.

We will start the meeting. The procedure, in case you haven't been in front of this committee in past Parliaments, is that we'll start with 10 minutes from each group and then go to questions.

Pursuant to Standing Order 108(2) and a motion adopted on February 25, the committee is resuming its study on service delivery.

Our witnesses today are as follows: from the Canadian Association of Veterans in United Nations Peacekeeping, we have Mr. Mac Culloch, national president. Welcome. From the Union of Veterans' Affairs Employees, we have the national president, Mr. Gannon. Thank you for coming. From the Valcartier Family Centre, we have Ms. Michaud, chief executive officer.

Welcome to all.

We can start with 10 minutes for Mr. Gannon from the Union of Veterans' Affairs Employees.

You don't have to use all of your 10 minutes, and if you start encroaching on the 10 minutes, I'll give you the wave. Thank you.

[Carl Gannon, National President, Union of Veterans' Affairs Employees]

Chair, Vice-Chairs, ladies and gentleman of the committee, Parliamentary Secretary, I thank you for your time and indulgence in allowing me to address the committee directly.

My name is Carl Gannon Jr. I am the national president of the Union of Veterans' Affairs Employees, and I represent the vast majority of the thousands of employees at Veterans Affairs Canada, as well as the employees at the Deer Lodge Centre in Winnipeg, Manitoba.

My position and my affiliations within the veterans community have afforded me a unique opportunity to offer a comprehensive perspective regarding shortfalls within the department and their impact on both employees and veterans alike. I have travelled the country several times over, meeting directly with employees and injured veterans and their families to examine all of their plights.

I have visited almost every VAC office across the country, and while all have their own issues, when comparing and contrasting employee issues with the issues crippling our veterans, consistent trends have emerged.

In all fairness, these trends did not begin with the election of our current Liberal government. They began when our already underbudgeted and understaffed department serving Canadian heroes was forced to cut close to 1,000 staff, with many of the 1,000 staff being in the realm of service delivery.

In order to achieve this unachievable task, the department underwent an exercise coined as “transformation”. Transformation was the remaking of VAC after the realization of the drastic staffing reductions. Upwards of 25% to 30% of the front-line positions were cut by the previous government, so transformation forced the centralization of regional functions and tried to mitigate the aggravating factors associated with cutting this many staff while trying to maintain a high level of service quality.

As you can imagine, this was a bit of a fallacy. This could never happen, and the negative consequences started to appear almost immediately. Morale hit an all-time low within the department, as employees desperately tried to escape their working realities. Employees went on extended sick leave, sometimes unpaid, and some just basically up and quit, most of them with absolutely no job prospects on the other side. The tension within our offices was palpable, and bullying and harassment complaints sharply increased.

While my team and I have worked very closely with management and HR at the department to try to curb some of these underlying issues, staffing levels are still not anywhere close to where they need to be across the board, which means that staff are still operating in a hyper-stressed, expectation-driven environment in which many of the expectations being bestowed upon them are unmanageable.

This leads me to my first major bone of contention with the current situation that we have right now, more specifically with our current minister, the Honourable Kent Hehr.

For months I have been hearing about all the staff that have been hired by the department and by our current government. I know this because the minister has told me himself, probably about 100 times. I've seen it on TV. I've read it in the newspaper. It's basically everywhere.

However, there is one major problem with this narrative. Of the 275 staff hired over the last 18 months or so, only 19 of those 275 have come from the 2016 budget. The reality is that 256 have come from the 2015 budget. From the Treasury Board approval to the actual staffing actions themselves, none of this actually had anything to do with the current government we're in right now.

In fact, I could easily be found, before and after the election, speaking to many media outlets regarding the Conservative government's generous gift of hundreds of staff and questioning if the Liberal promise of 400 new staff actually meant 400 new staff, or if it meant that we were going to be piggybacking on the Conservative government's previous staffing actions.

It appears as though we have now confirmed this. If this is so, then all that I would ask is for our minister to actually tell us the truth, to tell Canadians the truth.

One of the biggest places that this hits, and I am sure we are all familiar with it, is the 25:1 case management ratio. This is another area where I don't necessarily feel that our minister has, unfortunately, been forthcoming with Canadians and with veterans. We understand that we are definitely attempting to move to a 25:1 ratio. UVAE is in full agreement in moving toward this 25:1 ratio. We think that's the right place to be and that it's where we should be going.

This is evident because this 25:1 number came out long before our current government. I was the one who asked Erin O'Toole publicly for 25:1. We are in full agreement that we should be moving to 25:1, but the reality of the situation is that we're nowhere close in a lot of places to reaching 25:1. In all actuality, there are a lot of places across the country right now that are still running at 45:1. Unfortunately, this ratio has not been contained in some of the rhetoric that I'm hearing, again, from our minister.

We understand that certain things are going to take time. We understand that. I'm not saying that we should be at 25:1 right now. That's not what I'm saying at all. What I am saying is that I think it's very dangerous and very irresponsible for anybody to be prevaricating in a situation where we're not anywhere close to that right now.

Right now, we have extreme staffing issues across the country, especially in certain places. If you look at the whole province of Alberta, for example, we can't attract anybody. Whether it's a case manager or whether it's a veteran service agent, we cannot attract anybody in Alberta, and it's been that way for 18 months. New Brunswick is another place. There are several places across the country where nothing has changed for them. Their realities are still the same, but they are hearing on a constant basis that we're at 25:1.

Where this becomes very dangerous is when we have our Canadian heroes and our veterans also hearing this. They're also expecting certain changes to already be present, because that's what they're hearing, and they don't understand why they are still being treated in the exact same way that they've been treated. They don't understand why they're still not necessarily getting the time with their case managers or their veteran service agents that they feel they should be getting at a 25:1 level. It's unfortunate that this is still the narrative right now.

Again, we're not saying that it should be at 25:1 right now. We're saying that we need to inform Canadians and veterans what the situation is and what type of timelines we're working on to get to that 25:1 ratio.

The last systemic issue within the department that I would like to quickly address is the situation with Blue Cross.

I don't know who around the table is familiar with Blue Cross and familiar with the relationship between Blue Cross and Veterans Affairs. Blue Cross has always played a role at Veterans Affairs. What they used to do was to pay our claims. When a veteran submitted a treatment plan or submitted a request for treatment, that would go to a public servant. A public servant would do what had to be done to ensure that it was approved. Once it was approved, then it was sent off to Blue Cross for payment.

That's not how it is anymore. Blue Cross now pretty much is the deciding factor. They basically approve and pay the exact same claims. When things were in-house, our standard for our appeals unit was basically that about 20% or so of appeals that came in were overturned. When an appeal came in, historically about 20% or so were going to be overturned because somebody made a mistake somewhere in that system.

Where we're at right now with Blue Cross is closer to about 45%. That's saying, basically, that 4.5 times out of 10 a veteran is getting denied something that they should not be denied. That, to me, is an extreme problem.

It is a problem that has to be remedied and rectified ASAP, because some of the treatments and services that are being denied right now could be oxygen, could be transfusions. We're talking about very real situations that literally have a major effect on somebody's life, so I think the time has now come that we must right the ship for veterans across the country and for the staff who serve them.

I would again like to say that while I'm simply a union president and can only shed light on these and other issues, you are the country's highest level of decision-makers. You are in a position to bring real change, and I ask you to look deep within yourselves and ask whether anyone honourably serving our country and fighting our fights should have to come home to fight against their country for benefits they deserve. Their life is pretty much in your hands, so now it's up to you as to what you're going to do.

I thank you again for your indulgence.

[The Chair, Liberal, Neil Ellis]

Thank you.

Next is Ms. Michaud from Valcartier Family Centre.

[Marie-Claude Michaud, Chief Executive Officer, Valcartier Family Centre]

Good afternoon, and thank you very much for having invited me to this meeting. This is a first for me, so please be indulgent if I stray from protocol at times.

My name is Marie-Claude Michaud, and I am the chief executive officer of the Valcartier Family Centre. I have been working with military families for 22 years.

The purpose of my presentation is in keeping with the brief the Military Family Resource Centres submitted to the Minister of National Defence last June. This document asked that military families be integrated into the defence policy, since they are an operational component in the mission of the Canadian armed forces.

The brief, however, also contained the following recommendation.

Do you want me to wait a bit until you put your headphones on?

Fine.

The second recommendation in the brief we tabled concerns veterans and their families. We asked that the resource centres provide service to all veterans and their families.

Why did we make this request? In 2014, a partnership was formed between Veterans Affairs Canada and National Defence to set up a pilot project for military members released for medical reasons and their families. This allowed them to have access to seven resource centres throughout Canada. Consequently, these seven centres now provide services to veterans released for medical reasons, and to their families.

Now, we are in a way the victims of the success of this operation. We knew at the beginning that reserving access to these centres to a particular category of veterans could have certain consequences, which we are currently dealing with.

We have created two categories of veterans in Canada. First, there are those who were released for medical reasons and have access to the services provided by the resource centres. Unfortunately, there there are only seven of these for all of Canada. Then there are the veterans who were released for all other reasons, or who were released before 2014. They do not have access to the centres' services.

Please allow me to speak to you briefly about the experience of the Valcartier resource centre, which is one of the seven pilot project resource centres in Canada. We have provided service there to former military members and veterans for 18 years. We have an agreement with the Government of Quebec regarding our employment assistance service. At the time, the Government of Quebec was looking for an organization that could offer an employment assistance service for reservists and veterans. That is why we developed expertise in helping former military members in their transition to civilian life.

And so we were ready to receive this clientele when we were included in the pilot project developed for veterans released for medical reasons. However, requests for service exploded from the moment we held our press conference. People turned to us for help, not only those who had been released for medical reasons, but also veterans as a whole.

In the course of a single year, 715 people -- 293 of these were veterans -- who were entitled to our services came to our offices in Valcartier. We also had to respond to 127 requests for service from clients who were not eligible. I'm sure you will understand that when people come through the door of our organizations, we cannot investigate to find out whether they were released for medical reasons or not. If people need help, we try to help them. These people are experiencing the loss of their careers and their identity, and their self-esteem suffers as a consequence. Employment is a major factor for these people who are leaving a career in which they invested most of their lives, as you know.

Among the most important services we offer are information and guidance services; we guide people toward resources, provide education and offer a helping hand. We had expected that these three services would be the most in demand, and that is exactly what happened.

Let me say a few words about the clientele our employment assistance service has helped. Sixty-five per cent of them were between 26 and 46 years of age. They are the people the resource centres supported on various missions over the past 25 years. They are young. Over the past two years, we helped rewrite 157 military resumes to make them relevant on the civilian labour market. That is one of the important issues. How do you modify the military resume to help people successfully transition to civilian life?

Over two years, we helped with 150 of these, at the Valcartier Family Centre alone.

Seventy-eight per cent of these people have no diplomas or have a high school diploma. Most of them suffer from physical or psychological injuries. Their mental health is precarious. Many are now considered unfit to work and want to rebuild their lives in some way. They need to be supported individually, in a way that respects their dignity, to get through this.

The Valcartier resource centre has had positive results. This was a good initiative that produced results, but it created two classes of veterans in Canada. We consider this unacceptable, in light of the contribution these people have made to our country.

We also prepared a financial brief outlining how the resource centres could provide service to all veterans and their families. We sent you a copy of that document.

The various mandates that were given to the Minister of Veterans Affairs and Associate Minister of National Defence are related to what the resource centres could offer, such as reducing complexity, restructuring the delivery of services, and strengthening partnerships between Veterans Affairs and DND. What is being done in the resource centres is a concrete example.

Career assistance and vocational assistance are also provided to veterans. That is what we offer in Valcartier, and the results are very positive.

Resources centres have over 25 years developed expertise in providing better education, counselling and family training services that provide care and support to veterans afflicted with physical or mental health problems related to their years of service. When military families are transferred from one location to another, even if only for operations, they are constantly undergoing life transitions. In those cases they benefit from our expertise in the field. For 25 years, we have been working in constant partnership with civil society. We have developed expertise which could be very useful for this category of people, who are very important for Canada.

Finally, I'd like to direct your attention to the fourth recommendation in the brief submitted to the Minister of National Defence last June. It concerns the creation of an intergovernmental cell to deal with the issues facing military families everywhere in Canada. Most of the issues faced by military families and veterans fall under provincial jurisdiction. When veterans are released, they must access provincial medical services. We think the creation of such an intergovernmental cell would be a good thing.

I recently met with the deputy premier of Quebec and the Minister responsible for Intergovernmental Affairs, Mr. Jean-Marc Fournier. Quebec is considering the creation of a mechanism aimed at easing adverse effects on military families and veterans and at allowing veterans to access provincial services more easily. Ontario is setting up a similar mechanism.

We have to get off the beaten bath and find innovative solutions to meet all of the needs of this community, which is made up of a million people in Canada.

I thank you for the time you have given me.

[The Chair, Liberal, Neil Ellis]

Thank you.

Next we have Mr. Mac Culloch, from the Canadian Association of Veterans in United Nations Peacekeeping.

Mr. Mac Culloch, thank you for coming today.

[Wayne Mac Culloch, National President, Canadian Association of Veterans in United Nations Peacekeeping]

Thank you very much, Mr. Chair.

Good afternoon.

Thank you for providing me with the opportunity to address you on this topic.

The Canadian Association of Veterans in United Nations Peacekeeping is, not surprisingly, composed of veterans with peacekeeping service in both military and police forces, and it has branches across the country.

In terms of service delivery, while we have seen some improvements recently, such as the reopening of Veterans Affairs offices and an emerging attitude to better assist veterans with the plethora of legislation, statutory regulation, departmental policy, and local procedures, the transition to veteran-centric service is far from complete. Indeed, an advisory group on service excellence was struck by the minister in early spring and so far has succeeded only in defining itself, while future work on the delivery remains only a set of fuzzy goals.

Service delivery must be veteran-centric. In simple terms, this means delivering the services that veterans need, in a painless fashion, with speed and flexibility. This delivery must cover the communications continuum from postal mail to social media, as required by veterans and other clients.

One trial in the area of communicating with VAC clients that was judged a success by veterans was to lengthen service hours on a couple of days per week to accommodate veterans and other clients who had daytime jobs. Sadly, the trial ended without instituting any changes to the national status quo.

Another irritant of long standing is the amount of time required for a veteran to receive a decision on an application for benefits. Four months may seem fast to bureaucrats, but it represents an agonizing wait for someone seeking assistance. This time frame should be further reduced. Using modern decision-making tools and readily according the benefit of the doubt to the applicant should be better brought to bear.

The issue of the delivery of long-term care for modern-day veterans remains a hot topic among the members of the association. While Veterans Affairs has successfully engaged a number of provinces on the issue of priority access for modern-day veterans to obtain community beds, there is no national policy to provide the much-needed holistic national safety net for peacekeeping veterans in their golden years.

At the other end of the service delivery spectrum, decisions on everyday issues for veterans do not seem to follow a predictable standard. I'll use one example of an association member who, going back for his monthly prescription, would sometimes end up receiving it free of charge because of a service-related injury, while on other occasions he would have to pay for it. In each case, he could never get a straight answer from Medavie Blue Cross as to why that was.

The above is only one example of continuing frustrations with wait times for a decision, lack of clear explanations in correspondence, lacklustre telephone conversations, and labyrinthine regulations, policy, and directives. Without question, this service delivery must be improved.

The medium-term solution would involve consolidating direction along the principle of “one veteran” and into transparently accessible clear language, but in the short term, a number of pieces of low-hanging fruit should be implemented without delay.

First, in correspondence, include the name and telephone number of the drafter so that clarifications of the text can be quickly accessed.

Second, ensure that the signatory to the correspondence reviews its content for clarity and the use of plain language.

Third, in telephone conversations, provide escalation to knowledgeable and available supervisory and managerial personnel.

Fourth, ensure that correspondence indicates the availability of both internal review and Veterans Review and Appeal Board appeal options in clear and plain language.

Last, implement longer business hours twice a week at Veterans Affairs offices and call centres across the country.

This is not rocket science. It's really straightforward and simple to do, and it would remove an awful lot of the daily frustrations that veterans wander into.

In closing, I would like to thank you again for the opportunity to speak to you, and for your time and attention.

[The Chair, Liberal, Neil Ellis]

Thank you.

We'll start our questioning.

The first round will begin with Mr. Kitchen.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you, Mr. Chair.

Thank you all for coming today; we greatly appreciate it.

As you're aware, we are doing this study on service delivery. We can look at what's been there, what we can and can't do, and recommendations we can make for improvement.

Mr. Mac Culloch, you mentioned a little about health care and providing services for your veterans. I'm a chiropractor, and I spent many years providing services for veterans. I went into practice and I learned from the school of hard knocks. I would send a bill to Blue Cross and they'd send it back, saying I hadn't filled it out right, and then I'd finally figure out how to fill out the paperwork and get it sent in. Other than the length of time getting payment, there was never any issue as to someone in Blue Cross saying yea or nay to what was requested. That may be because the veterans I was serving didn't have complicated files; I buy that.

A lot of health care practitioners aren't trained in how to deal with veterans. We go through school, we learn diagnosis, we learn how to treat, we learn how to make prognostic assessments, but we're not given the paperwork, in many cases, on how to do the actual administrative work of providing those services. I see that as being of value in providing that service. Can you comment on that and what you see? Would it be of value? Mr. Gannon, as well, after Mr. Mac Culloch, do you see that as being of any value?

[Wayne Mac Culloch]

I see it as having quite a bit of value because, as you rightly point out, it is simply the school of hard knocks, and it is the same for the veteran as it is for the health practitioner. A lot of the forms are easy to understand if you're a bureaucrat, but quite confusing to those who only have to deal with them every now and again. If there were a simple example, a sort of follow-the-numbers example, along with perhaps a self-study package, I think it would be of great value.

[Carl Gannon]

I mirror that as well. It's somewhat of a shame that we lost our old system, because one of the big areas now where health practitioners will more than likely have to be extremely proficient is in understanding Veterans Affairs' archaic legislation.

Unless you understand the legislation and what a person is entitled to and you have a person who can mitigate some of the really tough legislation that doesn't sometimes seem to make sense.... That's why things worked a lot more smoothly before: it was because you had a public servant who could step in and say what you were missing. They were willing to work with the practitioner to try to approve it.

That's not how it works anymore. Now if you don't have what you need, it's just denied; that's it. You're sent off a denial letter and you start again. Right now, what we're seeing is that a lot of providers don't want to deal with Veterans Affairs anymore.

Veterans are on a fixed income when they're paying for these services and hoping to get reimbursed later on, which is tough for them.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Mr. Gannon, do you feel comfortable commenting on providing services and training your caseworkers so they're continually getting further training and they're up to standards as things advance?

[Carl Gannon]

Most definitely. It's another bone of contention for us right now. At one point, we had a very extensive training package. Unfortunately, when we suffered the cuts, we needed every case manager to hit the ground running.

It's a huge concern, because we are looking at bringing in a whole new slew of case managers. The majority are not going to have the experience of a more experienced case manager, obviously; they're new to the game. It's going to take them a bit of time to hit the ground running, and we need to revamp our systems at Veterans Affairs to ensure that we are providing all the necessary tools for them to do that. We're seeing right now that individuals are not able to meet those expectations, and they're leaving; they're quitting because they can't deal with the situation, and it comes down to training.

We are going to continue to push this; it's imperative.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you.

Ms. Michaud, you mentioned two categories of veterans, which are, I'm assuming, those who are released for medical reasons and those who aren't. Are those the two categories you're classifying or are they the two categories in terms of the old and new Veterans Charters?

[Marie-Claude Michaud]

You are correct. These are veterans who were released for medical reasons as of November 2014. Those who were released for medical reasons before 2014 do not have access to our services. There really are two categories.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you.

[The Chair, Liberal, Neil Ellis]

Mr. Fraser is next.

[Colin Fraser, Liberal, West Nova, NS]

Thank you very much, Mr. Chair.

Thank you all very much for being here today. I really appreciate the different points of view you have brought. Certainly we want to listen to what you're saying and hopefully make thoughtful recommendations to the department.

Mr. Gannon, I would like to start with you. This study we're doing is on service delivery. Obviously I agree with the point that the folks who work on the front line are essential to making sure that proper service delivery is given to the veterans in our country. Getting the case ratio down to 25:1 is important.

I hope I can take from your comments that we're on our way but we're not there yet. Your comment is that we're not moving fast enough, but we're on the right track. Would you agree with that?

[Carl Gannon]

To a point, yes. I would say most definitely; I guess it's just that reality is not necessarily always matching what we're hearing.

[Colin Fraser, Liberal, West Nova, NS]

With regard to reopening the offices—those are coming online very shortly—we're seeing a concerted effort across the country to get these offices open, the nine that were previously closed and the new one in Surrey, British Columbia. Hiring is under way. They're seeking applications from people who will do a good job and focus on service to the veterans and they're continuing towards hiring 400 front-line staff.

You would agree that this is all important work, and that we're moving in the right direction with reopening those offices?

[Carl Gannon]

That's literally exactly what we've been fighting for, from the time before your government...and we're going to continue to keep fighting, so yes, I totally agree with you there.

The part, though, where I think we have to make a very clear distinction is that we do have issues with the recruitment process. We do have an issue with staffing itself. I think we have to be very clear that we do have an issue with staffing. We've already depleted pools. We have issues in certain places. I think that information has to be present, and it has to be available to those we plan to serve and those who are actually doing the serving.

[Colin Fraser, Liberal, West Nova, NS]

I understand. I mean, it takes time to find the capable people we want working on the front line—I think you alluded to that—but you're not suggesting that the work of trying to attract and hire the best people we can is not being done. The application process is open, and applications are being invited.

[Carl Gannon]

What I would say surrounding this is that it's more complex than it sounds. We're not necessarily looking at the exact same position that we were hiring for previously.

Now, one other thing that was done, unfortunately, by our previous government was that the educational standards for a case manager and for a veteran service agent were changed. They were upped, and they were upped rather significantly.

That creates a smaller pool to actually draw from, and obviously if you have a smaller pool at a time when you need a larger number of staff, it's sometimes counterproductive. Right now we have issues with that process. That's just the reality of the situation.

It's not that the work is not being done: it's that we may have to repackage this work and figure out how to actually attract people, because we're not necessarily doing that right now.

[Colin Fraser, Liberal, West Nova, NS]

Thank you very much, Mr. Gannon.

Mr. Mac Culloch, with regard to what you said, we heard previous testimony that it might be a good idea to look at a concierge service, basically one point of reference for a veteran dealing with VAC, a person they can contact directly or have consistent contact with. Would you agree with that approach?

[Wayne Mac Culloch]

Absolutely.

Just to take that one step further, perhaps you can have a “no wrong window” type of policy as well. If an individual calls in, gets somebody, but it's not the right somebody within Veterans Affairs, you shunt the individual to the right person as opposed to saying, “Sorry, you've hit the wrong office.” I know it's been tried in other government departments and it has worked quite well.

[Colin Fraser, Liberal, West Nova, NS]

Okay, and I think that would be the point of the concierge service. We're here to help solve your problem. It's not about saying, “It's not my issue.” It is your issue if you're the concierge. You have to take it on and help find the solution, so I appreciate that.

With regard to the trial that you mentioned, where they tried opening at more flexible hours to ensure veterans had services provided, you'd like to see that come back. Can you explain the trial that happened and what the hours looked like and how it worked?