Veterans Affairs Committee on March 10th, 2016

[Gen Walter Natynczyk]

I would like to say more on these broad changes in culture and processes regarding psychological injuries.

We have an expeditious process in place to help men or women who are suffering from a psychological injury due to a training accident, be it during a deployment to Somalia, Rwanda, Bosnia, Kosovo or Afghanistan.

[Alupa Clarke, Conservative, Beauport—Limoilou, QC]

Unfortunately, following a pilot project that involved several Canadian cities, we found out that over 2,000 veterans are homeless in Canada.

What was the nature of that pilot project exactly? What do you intend to do about the fact that there are that many homeless veterans in Canada?

[Gen Walter Natynczyk]

There was a conference here this week, two days ago in Ottawa. All of the participants in that pilot project were present. A lot of lessons were learned by all of the participants and all of those lessons were shared. The department's objective is to bridge the gaps, to have a strategy and a development plan and to make recommendations to the government.

There is one challenge that remains to be met regarding the number of veterans who are homeless, and that is to find out where they are and to determine who is providing support to them.

Last year, I went to Victoria. I met representatives of the Royal Canadian Legion. The Legion has a shelter there, Cockrell House. That is a local initiative. The weather on Vancouver Island is relatively mild. That house is for soldiers who are homeless. We are now able to offer them shelter while they begin their transition. It is another element of support that allows us to provide treatment for their addictions and mental health problems. We offer them vocational training and a process for their future.

[The Chair, Liberal, Neil Ellis]

You're done. Thank you.

Mr. Fraser.

[Colin Fraser, Liberal, West Nova, NS]

General, thank you very much for being here with us today.

I also thank Mr. Butler and Mr. Doiron for their presence at this meeting. I thank them as well for their presentations, which were greatly appreciated.

Regarding the benefits for veterans who are permanently ill or injured, I have some concern about the financial difficulties that many of our veterans are facing. Here, I appreciate the question by Mr. Clarke a moment ago about homeless veterans and there may be other systemic reasons why that's happening.

However, I'm wondering if you can help shed some light on the benefits that permanently ill or injured veterans receive and comment on whether or not that is sufficient for them to make ends meet and not struggle financially.

[Gen Walter Natynczyk]

Mr. Chair, I'll say a few words and then ask Bernard to add.

We've got two acts and regulations that provide services.

Until March 31, 2006, if a veteran came forward with an injury or illness, they were covered under the Pension Act. For any injury the department became engaged with after April 1, 2006, the individual is covered by the new Veterans Charter. We have quite a lot of veterans who had coverage under the Pension Act and then with a new injury or illness that may have arisen since April 1, they're also covered under the new Veterans Charter.

It's quite complicated when you lay out all that, and some have called it a quilt or a patchwork, but we're dealing with two specific acts.

I'll turn it over to Bernard now.

[Bernard Butler]

Thank you, Deputy and Mr. Chair.

The benefit suite we have was the subject of a fair amount of study by this committee back in 2014. As the deputy said, since 2006 the program for modern-day veterans who make applications for financial and other supports has been captured under the new Veterans Charter suite of benefits.

For those who are seriously injured or seriously ill as a consequence of their service, there are several key program elements designed to support them. The first one is a compensation award. It's a lump-sum award for serious problems, such as a 100% disability. Currently, that's a $310,000 lump-sum benefit. It is called a non-economic benefit. The policy basis for it is to recognize and compensate veterans for their disability.

On the income-support side, the economic support side, if members have a service-related rehabilitation need, they have access to a suite of rehabilitation programming—vocational, psychosocial, and medical. While they are in those rehabilitation programs, they are eligible for 75% of their pre-release income. It ensures that their pre-release income doesn't fall below a 75% level. In 2014, this committee recommended that this amount be increased. Those of you who have studied the minister's mandate letter will notice that there are references to increasing this award.

Veterans who have requirements from permanent impairment and who meet certain criteria under the legislation are eligible for an additional payment over and above the benefit for loss of earnings. These are paid in three categories, roughly between $600 and $1,600, based on the degree of disability. Those payments are for veterans who cannot successfully re-establish themselves or be rehabilitated. Earning-loss benefits and benefits like the permanent allowance are paid until age 65.

As a function of the last budget, there is a new benefit called the retirement income support benefit. It ensures a minimum of 70% payment or 70% benefits for those veterans who are receiving things like the earnings-loss benefit after age 65.

The long and short of it is that there are a number of support benefits in place for veterans until age 65 and beyond. But in the minister's mandate letter, there was clear direction to look at increasing the amount of the earnings-loss benefit, improving access to the permanent impairment allowance benefit, and increasing the amount of the disability award.

It's fair to say that the department and the government are concerned about these issues. They want to ensure that where there is a need that need will be met.

[Colin Fraser, Liberal, West Nova, NS]

Thank you very much. I appreciate your answer.

I forgot to mention I'll be sharing my time with Mr. Eyolfson.

[The Chair, Liberal, Neil Ellis]

You only have about a minute left, so you'll have to make your question quick.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you all so much for coming. It has been an honour to listen to you.

I'll ask a fairly straightforward question. I'm a physician and so I'm particularly cognizant of issues having to do with mental health. In various medical records, they'll have mental health problems and medical problems as well. When they transition, what is the mechanism for transfer of medical records from the military to Veterans Affairs? Is this an efficient process? Are medical records transferred to a primary care medical or psychiatric provider?

[The Chair, Liberal, Neil Ellis]

You only have a short time to answer that question.

[Gen Walter Natynczyk]

A recommendation by this committee in the past was for the electronic transfer of records. The Canadian armed forces is digitizing its records to ensure that there is a seamless connection to Veterans Affairs.

Over to you, Michel.

[The Chair, Liberal, Neil Ellis]

We won't have time for that answer. Sorry.

Ms. Wagantall, five minutes.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Thank you, General, and thank you to your staff. I'm very honoured to be on this committee. The more I learn and understand the challenges our vets face, the more I appreciate the amazing opportunity we have here to continue to invest in making it a better experience for them.

I enjoyed hearing what's been happening and the recommendations that have been coming forward, and the opportunity we have to build on that.

I have just one thing initially. I had an individual contact me who is a caregiver for a veteran in Saskatchewan, my home province. She made sure to tell me that the Saskatchewan VAC front-line staff are absolutely wonderful. I think it's good to hear those things sometimes. She said the support staff there is just amazing. The ANAVETS program, that contact thing, is so important in our province, along with the My VAC Account. Those in our younger generation are definitely going in that direction to get their services in a lot of ways. They don't feel unappreciated or uncared-for in using that system. I think they see it as quite helpful.

This individual's concern was related to the delivery of services. We talk about wanting these front-line services there for them, but the challenge then is that we now have a medical program that we didn't have with the older vets, that we work through the provinces, and it's about getting those services. The psychiatrist who worked with the individual she worked with flew in from Vancouver and was remarkable. They will not be available to do that anymore, and there's this huge void.

Then I had a call from another individual who works in a recovery centre not far from a base. I believe there are a couple of veterans involved there right now. They have 30 beds, 30 opportunities for care.

I just wonder where the breakdown is on what we can do on this side, into the provinces, to encourage and find those individuals we're asking to help our veterans.

[Gen Walter Natynczyk]

Thanks for the point, madam. All I can do, following this, is to drill down a little bit more into that specific example in Saskatchewan. We do leverage the operational stress injury clinics across the country, and we do have practitioners. Whether they're connected by telemedicine or whether they're able to get on location, it really is a question of how many are there and what our ability is to get the very best professional practitioners to our veterans across the board.

In so many ways we rely on the provinces, but we are actually engaging the provinces to provide a higher level of care for all of these veterans across the country. Just from talking to the Royal Ottawa hospital here in Ottawa, people generally are in the program 18 months to 24 months on average, but then the challenge is that once someone gets through the treatment process, we need to have civilian practitioners who are out there, because it's the civilian practitioners who carry on with the treatment beyond that specialist treatment.

This is complicated, and it's unique to every location across the country. If you wish, we can have a drill-down, as we do on a daily basis, in your region. If there's something we have dropped or missed, we will engage.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

I appreciate that. Thank you.

This discussion about burden of proof is something that's new to me. In our workplaces, if someone gets injured, they write up a report. You have that documented verbatim report, because in the future you may need it. At the moment you may not.

Is that something that DND does with...?

[Gen Walter Natynczyk]

Ma'am, this is a challenge, because a lot of our men and women in uniform are young, they are resilient, and they think they are indestructible. If you have young kids who are in their teens and twenties, they're indestructible.

I've been parachuting with troops, and I know they're hurting. They're taking Motrin like they were Smarties. They're going to jump. There's nothing in their medical file that says they have bad ankles, knees, hips, or backs, but they're going to do it. Sometimes their spouses, their families, are not there to make sure that there's common sense.

In many cases, our challenge is from legislation, that there has to be some level of evidence. This care, compassion, respect campaign—this strategy—from a compassion standpoint, allows us to exercise what is in the act, “the benefit of the doubt”, and to look at the context of that individual's service.

If they were a gunner, they might have a hearing issue, a back issue, a hip issue. If they were a paratrooper, they have other issues. If they were loading the back of a Chinook or a Hercules, again, it's hearing, back.

We're looking at the specialties of the individual and their service. Where did they deploy? If they were on operational deployments—Rwanda, Swissair 111—all of these have a cumulative effect. What we are now saying in the department is that it's all part of evidence. This is a significant change.

The U.S., as brought earlier, has a presumptive model; they have different laws. I'm told by many lawyers—some who are very close by—that we don't have a presumptive model. But we achieve the same effect by considering the context of the service.

[The Chair, Liberal, Neil Ellis]

Ms. Mathyssen, you have three minutes.

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

Thank you, Mr. Chair.

I guess I'd like to do a little drilling down.

In the 2014 report, the Auditor General said that while the department had provided timely access to the rehabilitation programs, there were still some problems in regard to accessing mental health services. We've heard anecdotally from personnel that they're reluctant to seek that kind of help because of the stigma attached to it, and then when they do many months can go by. That is very detrimental in terms of successful treatment of the medical problem.

What measures have the department put in place to actually measure the performance of the mental health strategy? How do you know what you need to do? How will you know when it's working?

[Gen Walter Natynczyk]

Mr. Chair, thank you very much for the question.

Again, we really appreciate the Auditor General's report and recommendations.

Since that report, the department has moved forward on opening new operational stress injury clinics alongside of the Canadian Armed Forces, not not only main clinics like one in Halifax, but also satellite clinics in smaller communities. It's trying to create offices within a reasonable distance of where key critical masses of veterans are so that they can get support, and where they are more isolated, to leverage technology such as telemedicine.

I'll ask Michel to make a few comments.

[Michel Doiron]

We have implemented with our clinics, tracking mechanisms to see how long it's taking to be accepted in the clinic and how long before a clinician is seen, and a bunch of matrix.

This is new. We started it after the OAG report. We now have about nine months of information, and we're pinpointing where we have some of these issues and we're addressing them. Those matrix, we're now tracking.

[Gen Walter Natynczyk]

I will also say that this is a work in progress.

In partnership with the regional health authorities, our ability to engage the right practitioners and in the right numbers is different in every part of the country.

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

In terms of tracking, General, you said that most CF personnel successfully transition to civilian life.

How do you know that? What mechanisms are you using to be able to say that?

[Gen Walter Natynczyk]

That's their saying that. It's their surveys.

Reporting to Bernard Butler here, we have a Fulbright scholar, Dr. David Pedlar, with one of the best research cells, I would say, in the nation, looking at the human dimension of service. That's obviously with our allies, because he is on a Fulbright scholarship as we speak south of the border.

On a two-year basis, we are doing surveys of those who have released, in order to understand the changing dynamic of our veterans, so that is coming from them.

[The Chair, Liberal, Neil Ellis]

Thank you.

This concludes the first part of our meeting.

On behalf of the Standing Committee on Veterans Affairs, I would like to thank you, General, and your staff for appearing today.

Thank you to everybody in the audience for attending.

We will take a short break and then the committee will return in camera.

[Proceedings continue in camera]