Veterans Affairs Committee on March 10th, 2016

[The Chair, Liberal, Neil Ellis]

Good morning. I would like to thank you all for attending today, and welcome everybody in the audience. Today the committee resumes its study on service delivery to veterans by the Department of Veterans Affairs. We'll discuss committee business in camera during the second hour of our meeting.

Today we have as witnesses, General Walter Natynczyk, deputy minister of the Department of Veterans Affairs; Bernard Butler, assistant deputy minister, strategy policy and commemoration; and Michel Doiron, assistant deputy minister, service delivery branch. We will start with the general.

Thank you and good morning.

[Gen Walter Natynczyk, Deputy Minister, Department of Veterans Affairs]

Mr. Chairman, ladies and gentlemen, thanks for the opportunity to provide a few comments as part of the orientation program for your committee's work as you focus on our mission in the care for our veterans and their families.

In addition to my two colleagues beside me, I want to highlight the presence of retired Rear-Admiral Liz Stuart, who appeared before you on Tuesday. Liz retired after over 30 years of service just last month and has joined our team as the assistant deputy minister for human resources, corporate services. She is also our chief financial officer.

I thank the committee for the remarkable work it has accomplished to date.

The report from this committee of June 2014 provided many important recommendations for improving our support for veterans, their mental well-being, and their families.

On behalf of the government, the mandate of Veterans Affairs Canada is to take care of members who became ill or were injured while serving their country, and to support survivors and families.

It's also our duty to keep alive the spirit and to commemorate the service and the sacrifices of our armed forces. It is a noble mission, it's a vital mission, and it's one to which we are fully committed. I understand that you've received a deck presentation that provides an overview of the department. if you wish, we could provide follow-up information on our policies, procedures, and operations. My intent over the next few moments is to expose you to the cultural change that we have embarked on in the department to set the conditions for implementing the government's mandate for veterans.

Allow me to speak to you about the changes we have begun to make to the culture of the department for the purpose of better implementing the government's mandate toward veterans.

There are 700,000 veterans in Canada, aged from under 20 to over 100 years old. Veterans Affairs programs support 135,000 veterans and 60,000 survivors and families, including members of the Royal Canadian Mounted Police.

Between 5,000 and 6,000 members of the military are released annually.

Generally speaking, a quarter of these men and women are being released for medical reasons as they are no longer medically fit for operational duties. Often these sailors, soldiers, airmen and women immediately apply for support from Veterans Affairs for benefits and treatment programs. The remainder are released on a voluntary basis or take retirement at the end of a long career. Many of these people are retiring veterans who apply to Veterans Affairs for support for injuries and illnesses that often surface years after they take off their uniforms.

Approximately 50% of our clients submit a claim for benefits two years or more after having been released from the forces.

Our life-after-service research shows that approximately 65% of men and women who have left the Canadian Armed Forces transition to civilian life with little difficulty. They find a new purpose in a civilian career or in volunteer work. They have some measure of financial security and are able to support their families.

Our research also indicates that a significant number experience varying levels of difficulty in translating their military knowledge, skills, and leadership experience to a new career in civilian life. Many who leave the military early or in mid-career, especially those from the operational classifications such as the combat arms, are vulnerable to experiencing a difficult transition. But each man and woman who served had a unique experience. All of them had different experiences in their training and in their operational deployments, whether on peacekeeping missions, stability operations, or in combat in Afghanistan or during the world wars or the Korean War.

The department's legislation under the Pension Act and the new Veterans Charter, together with related implementation policies, programs, and processes, exists to assist veterans' transition to civilian life and to enable their long-term well-being.

Our programs are successful for many of them.

Injuries and illnesses are assessed, veterans are given treatment and support, and, with that support, they are able to cope with their new circumstances.

Now, we do wish that our support was perfect. We wish that it would meet each and every one of the needs of our wounded, our ill, our injured, and our families, but we are aware that we have had a number of shortcomings in our support programs, and we need to fix them.

The minister, the Honourable Kent Hehr, endorsed the department's strategy to make the changes that were recommended in a multitude of studies and reports, and in feedback from our numerous veterans associations and stakeholders. The entire strategy can be summed up in three words: care, compassion, and respect.

We will care for those who serve: for our veterans, the wounded, the ill, and the injured, and for their families and survivors. We will exercise compassion in our consideration of their needs, ensuring that we apply the benefit of the doubt to support their individual circumstances. Finally, we will respect them. We will recognize their service and commemorate their extraordinary sacrifices.

These are powerful action-oriented words that have changed and operationalized the culture of the department. These words are enabling our employees to do what is right in support of our veterans.

The objective of our strategy is simple. We want to improve the services we provide to veterans and their families.

There are three key objectives in the strategy. First, in everything we do, we will focus on the individual needs of the veteran. Too often, large organizations focus on the policies, programs, and processes, to the detriment of the client's experience.

We are doing everything in our power to put the veteran at the core of all our decisions and policies.

Second, we are making every effort to close the gap between the Canadian Armed Forces and Veterans Affairs to enable a simpler, easier, and successful transition from uniformed service to civilian life.

We work with the Department of National Defence and the Canadian Armed Forces to address any gaps in our departments, and to eliminate cumbersome administrative processes as well as unacceptable delays.

Third, we are striving for excellence in our service. We will search for and apply the best practices, the highest standards, and innovation in all of our policies and practices. This “care, compassion, and respect” strategy acts as a framework and sets the department's culture as we advance on the government's mandate to address the needs of veterans.

You are no doubt aware of the mandate of our government regarding service to veterans. In summary, it contains 15 points to be improved regarding the support we provide to veterans and their families.

Key among them is the financial recognition of pain and suffering related to the wounds, the injuries, and the illnesses attributed to service. Central to this financial recognition is the task to re-establish the lifelong pensions as an option for injured veterans.

It also directs enhancements to our services by reopening offices across the nation and by strengthening our front-line staff. It also tasks the department to enable career transition by addressing the gap between the military and civilian life to provide access to university, college, or technical school and assist veterans to find a job.

Veterans Affairs Canada, together with National Defence and the Canadian Armed Forces, must improve suicide prevention and mental health services.

In particular, we need to continue to address the stigma of mental health and to encourage those veterans who are experiencing a mental health injury or illness to seek professional treatment. One soldier, sailor, airman or -woman suffering from invisible wounds of a mental health injury or committing suicide is one too many. Similarly, we need to support our veterans who find themselves homeless.

These tasks in the mandate are our main effort to support our minister and the government. We'll work closely with the Canadian Armed Forces and consult with stakeholders to deliver on them.

Finally, I wish to reinforce the importance of commemoration, especially as over the next two years we'll remember the achievements, the service, and the sacrifice of the 100th anniversary of World War I and, on July 1 of this year, the Battle of Beaumont-Hamel. Next year will mark the 100th anniversary of the Battle of Vimy Ridge, a singular victory at great cost. We'll also mark the 75th anniversary of the tragedy at Dieppe.

I also want to say that we will be commemorating the achievements of our youngest veterans. Recently we marked the 25^th anniversary of the Persian Gulf War and the liberation of Kuweit.

We will continue to work in partnership with other government departments, the Royal Canadian Legion, other government associations, and stakeholders across the nation, to commemorate our fallen comrades.

A number of memorial projects are ongoing. Our understanding is that we will continue to work with our partners to see these projects to their completion, projects such as a memorial for our troops who served, and for those who made the ultimate sacrifice in Afghanistan.

Mr. Chairman, ladies and gentlemen, I hope my wave-top brief was helpful in providing some context to the briefings you've received. My colleagues and I are available to address your questions.

Thank you.

[The Chair, Liberal, Neil Ellis]

Thank you.

The first round of questions is six minutes, and we'll begin with Mr. Kitchen.

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

Thank you, General, for being here today.

I want to thank you for your service to your country and for taking on this new role that you've stepped into. It's much appreciated. I know you'll do as excellent a job as you did with our forces for so many years.

I'm going to focus on the service aspect of things, having been a primary health care practitioner in my other life, and having worked for many years with veterans. You mentioned that 50% of services tend to be for people you see two years post their retirement.

Are there any studies that indicate the different levels of service of veterans that might make them more inclined to require post retirement? Is there anything you can enlighten us on at all?

[Gen Walter Natynczyk]

Mr. Chair, I think it would be worthwhile at some point perhaps, having our researchers here, because of the huge body of research we have undertaken.

The study I mentioned in my comments, the life after service study, we do on a cyclical basis every two years. If you have a look, it's one of the most comprehensive views of the successes and challenges of our men and women after they take off the uniform. The research demonstrates the level of injury or difficulty they have, as compared to Canadian society across the board.

The research branch reports to Bernard, and I'm wondering if he wants to add something there.

[Bernard Butler, Assistant Deputy Minister, Strategy Policy and Commemoration, Department of Veterans Affairs]

I would only add, Mr. Chair, that as the deputy has indicated, we are learning more and more through our research efforts, in conjunction with Stats Canada, the Canadian Armed Forces, and with the Department of National Defence, about these very kinds of issues.

Previously we did not know a whole lot about what that transitioning population looked like, and longitudinally what their issues were. We are at a point where we're starting to accumulate the data, starting to get a better picture of it. As that evolves, that will certainly inform the department and the government in terms of where the greatest gaps are and where the needs are for those various groups.

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

Thank you.

On that same note, then, there are potential differences between the cohort of the veterans from WWII, WWI, Korea, and today's veterans.

Is there a proactive approach that you're using to look at the new veterans and what they may be experiencing? Could you expand on that at all?

[Gen Walter Natynczyk]

Yes, sir. Again, Mr. Chair, absolutely.

Indeed, a lot of the research is focusing on those younger men and women who have served in operations over these past few decades. Those veterans from World War II and the Korean War, we consider them to be the traditional veterans. Those veterans who served in the fifties, sixties, seventies, eighties, and this past decade and a half, are a lot of the focus of the studies.

It's interesting when you consider that of the veterans who come to Veterans Affairs, only about 25% of our clientele come to us while they're still in uniform. There are 25% who come within two years after they've handed in their ID card and taken off the uniform. As I mentioned in my notes, it's 50% from year 2 out to year 60.

In some cases, there's a latency. Sometimes there's a latency with regard to a mental health injury that pops up as a result of another event. Sometimes it's a musculoskeletal injury that may not have been documented. With the fact that the person might have been an infantryman or a bosun aboard a ship, or working with aircraft, there's a musculoskeletal injury that can then come s to the surface.

That's what Michel and his team have been working on. How do we look at the entire sailor, soldier, airman's and woman's service, as part of their evidence—for example, an infantryman might have bad knees, bad hips, a bad back, and so on—in order to address their needs more quickly within the department?

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

Thank you. I'm going to get a little bit more specific, then, into the service aspect and health care.

When we're looking at caseworkers or at doctors, whoever the specialists might be, and we're trying to identify who those specialists are—and not to be disrespectful of any of them—are we doing some sort of background check to ensure that we've got the right person for the situation? In other words, as we mentioned, we're dealing with a musculoskeletal injury. Who's the right person to provide the right treatment at the appropriate time based on case studies and generally accepted practices?

Are those standards set out, or is it purely wide open so that anybody could put their name in because they need a paycheque?

[Gen Walter Natynczyk]

Mr. Chair, I guess in this regard, Veterans Affairs does not have a mission to provide primary health care, with the exception of supporting our hospital, Ste. Anne's. Otherwise we rely upon all of the provinces for services, not only for physical injury or illness, but also for mental health injuries and illnesses. We are relying on the provincial systems across the country.

So when a man or woman is serving in the Canadian Armed Forces, the Canadian Armed Forces run their own medical system for all primary care all the way through to the most serious cases. Veterans Affairs only has Ste. Anne's Hospital, and we contract to each of the provinces for operational stress injury clinics in partnership with the Canadian Armed Forces. In addition to that, we rely upon the provincial health care systems across the country.

At this point I'll hand off to Michel. Michel, could you expand on that?

[The Chair, Liberal, Neil Ellis]

We're out of time. Thank you.

Ms. Lockhart.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Thank you very much.

I appreciate your being here today. Your overview was very helpful.

I'd like to focus on the transition part. The report by the standing committee in June of last year cited that one of the challenges has been Veterans Affairs case managers picking up clients early in the transition phase as opposed to near the end of the transition phase. The ombudsman went on to say that the transition process should start much earlier than it does now.

I was encouraged by your comments that it's certainly part of your focus, but at this point, is the department engaging prior to the retirement of a serving member, and how far from retirement does that start?

[Gen Walter Natynczyk]

Mr. Chairman, we are trying to engage with Canadian Armed Forces much earlier in the transition process. When a man or woman gets injured while on duty or off duty, we hope that they recover, rehabilitate, and get back to their primary duties and responsibilities and carry on with their careers. Unfortunately, many cannot recover from a serious injury or illness. The Canadian Armed Forces have this policy of universality of service that I'm sure you've heard of. From a career administration standpoint, the armed forces make a decision that an individual must retire at some point with a medical release.

It is our intent to move our engagement with that veteran as far as possible before that decision. Since your study—and your study was very useful, as I mentioned earlier—we have created an enhanced transition service where we are at this point now engaging at least six months before the release date. We are continuing to work with the armed forces to move that date up even earlier. As the former chief of the defence staff, I know we were able to accommodate folks for up to three years after a decision was made on their career disposition, and there is some discretion. This is not hard and fast, but there's a period of time that individuals are being accommodated in the Canadian Armed Forces, and our intention is to try to engage with the Canadian Armed Forces so that we can provide services to those individuals as early as possible.

I'll be very frank with you. One of the challenges is that many of these men and women aren't ready. They're not ready psychologically and, again, I speak about a lot of the soldiers who served for me, they're not ready. They're not ready to leave their cohort, and being with their cohort is absolutely vital to their well-being.

So what we're trying to do is to provide those services to them and work with them and at the same time stand ready, indeed, if they're ready to go. I spoke to one veteran last year. It's taken six years, but he's finally going back to school.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Thank you.

Would it be fair to say that there is a flip side with this transition, too? No two veterans are the same. For example, I have spoken to a veteran who felt that he was held too long in the service and wanted to be transitioned earlier. Could you elaborate on some of those challenges too?

[Gen Walter Natynczyk]

Madam, you have put your finger exactly on the point, the fact that every individual is different. You have to lay out the options to them and provide as much education to them as possible. As I mentioned, some of these veterans are under 20 years old, so decision-making.... Each one of them is different and unique. Some are in mid-life. It's about providing an array of these programs. When you look at these programs, they might look complex, but they are tailored to meet the unique needs of all these men and women at different times in their life.

When someone leaves the armed forces, the armed forces also have a vote as to when these people leave because they have a huge investment in these folks. They have put a huge investment in them in training. It is in their interest, and in the nation's interest, to try to get these men and women healthy again in order to fulfill their operational functions.

However, at a certain point they are not capable, and unfortunately then they have to transition. This is so difficult psychologically because they all, every one of them, walked into the recruiting centre of their own volition. When they are told they have a medical release, that is not their wish. They want to be with their cohort and fulfill their lifelong dream of a career. That is what makes it so complicated and challenging.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Speaking from your expertise, can you tell me about some viable ways that you see to assist serving members and their families in that transition too? We have talked a lot about families and transition.

[Gen Walter Natynczyk]

At some point, I am going to ask my colleague to say something, but not yet.

As we discuss various concepts here and I brief our stakeholders.... One of our stakeholders is General Dallaire, who reminds me constantly that the families transition with the veterans. As we talk about moving to a new normal, if the veterans can find their new purpose again, be it a career or volunteer work, and if their family is with them, those two components are vital. We know that our partners, spouses, and close friends are essential in giving us counsel, especially when we are having a difficult time. The support we provide to the veteran's family is key.

You'll be aware, based upon the recommendations of this committee, that we have launched pilot projects with the Canadian Armed Forces to provide military family resource centre services in seven locations so that, after people have taken off the uniform because of a medical reason, they have access to the MFRCs and settling in the new location. Especially for those veterans who are most seriously injured, with both physical and mental injuries, family support is essential to their recovery.

[The Chair, Liberal, Neil Ellis]

Sir, thank you.

Ms. Mathyssen, go ahead.

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

Thank you, Mr. Chair.

Thank you for being here. I, too, would like to say how grateful I am for your service.

We have heard recently in the committee about efforts to restaff VAC after considerable layoffs, and I wonder what percentage of the VAC staff are temporary or contract employees. How often would a veteran be given a new caseworker? What kind of effort is made to make sure that there is consistency in terms of that veteran having a caseworker over the long term? If those caseworkers are rotated, for what reasons are veterans given new caseworkers? Finally, how many cases, how many veterans, are assigned? Is there a maximum number of cases that a caseworker would be allowed to take?

[Gen Walter Natynczyk]

Of the 135,000 veterans we are supporting—again, about 60,000 are families—those who need very close support because of their complex, series injuries, who at this time number 9,300 veterans, have case managers. The remaining number are supported by individuals we call veterans service agents. A veterans service agent would handle those veterans with uncomplicated, straightforward, low-touch support needs. It's minimal engagement.

This number and the number of field staff were reduced over the past few years. You'll be aware that about a year ago, the government made an announcement that we would hire additional case managers, veterans service agents, nursing staff, and so on, with a target of getting to about 30 veterans to one case manager.

Jump in if I'm offside here, Michel.

Across the country, Veterans Affairs has been working to engage these specialized folks; we're talking about psychologists, nurses, and those people with experience in case management. In some areas of the country, we have been very successful. At this point, we have hired a total of 180 staff. The number....

Go ahead, Michel.

[Michel Doiron, Assistant Deputy Minister, Service Delivery Branch, Department of Veterans Affairs]

We've hired 180 staff of the 309 that we were approved to hire over a number of years. Of those, we've hired 72 new case managers who have been deployed to the field. You will accept that prior to their being fully up to speed, we have a training program to make sure they're providing the proper services, and they have now started to take on new veterans.

On average, right now across the country, we are meeting no more than 30 to 1. That said, there are parts of the country where we are above that ratio because we were not able to recruit or hire. Everybody we had in the pool, I'll call it, was hired in case management, so we've gone out again to the public to rehire and make sure we bring up those numbers. Our aim is to hire a total of 167 case managers.

[Gen Walter Natynczyk]

If I could add, in some parts of the country, we've had real challenges hiring, just because of the labour market in the area and finding the right people with the right expertise and experience.

I'm aware that we're still in the area of north of a ratio of 45 to 50 veterans per case manager. As the new people come in, we are then moving veterans to these new staff, so that's why you see movement.

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

Are there temporary or contract employees? Is the hiring that you described full-time and permanent?

[Michel Doiron]

Yes. The people we're hiring now are full-time, but we do have some temporary and casual employees, usually to fill an immediate need or where we do not have the resources to put in an indeterminate employee. I do not have those percentages with me, but I can get them to the committee.

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

That would present some problems, certainly if they're temporary and there are gaps in fulfilling needs. Thank you.

I've heard anecdotally from veterans the concern expressed that case workers are encouraged to minimize their contact; in other words, to not always provide the veteran with information about all the programs they may be eligible to receive. I wonder whether you've heard any of that from the veterans you serve. Is that a concern you might have?