Veterans Affairs Committee on May 1st, 2017

[Guy Parent]

I'm not aware of a particular country.

Again, we have to go back to context. I don't think there's a country in the world that has the same kinds of programs we have as far as vocational rehabilitation, psychosocial rehabilitation, social rehabilitation, and all that are concerned. The transition is different in every country.

Part and parcel of that may be a vocational rehabilitation program for a certain country. It might be less complex, and you might draw from that example. But if you work in the context of the country in the continuum of transition, they're all different. Every one of them is established to meet its own in-country benefits.

[Colin Fraser, Liberal, West Nova, NS]

Are the other countries, though, having a problem similar to what we've seen, with a patchwork over time in different missions? They add layers of complexity, and you end up with this whole system that is very hard to understand and make sense of because it's a patchwork. Do all countries have that same challenge?

[Guy Parent]

I think that's a good question. This was my objective in asking you to look at not the “what” but the “how”. How do they simplify their benefits? How do they actually introduce new benefits into their systems? How do they communicate effectively, where VAC doesn't? How do they eliminate barriers to transition?

I think this is where the important information is. It's not how much it's worth, but how it works for them. Is there any country in particular that has really good success? I know for a fact that right now in the Netherlands, for instance, they don't release anybody from the forces unless all programs are in place, all benefits are in place, and they have a job. That's an example of one country.

Again, you're restricted by time and money in terms of which countries you're going to talk to, but I certainly urge the committee to look at the “how” in all of these places, not necessarily how much, but how they communicate effectively, how they remove barriers, how they provide easy access, and how they simplify things.

[Sharon Squire]

I know that Australia is looking at the interface with the veteran, and trying to simplify it. It's not the benefits they're looking at but how they do it. They're actually looking towards a paperless form and applications, and things such as that. They're automatic. They're in a big push right now, and they have a big task force that is due to respond very soon, so they might be interested to look at the “how”, as Guy said, not the “why”.

[Colin Fraser, Liberal, West Nova, NS]

Okay.

I want to turn now to the military family resource centres, the MFRCs. I know that recently the government announced expanded access to all 32 centres for medically released veterans. I would like to hear your comment on that, how you see that expanded access. Also, is that something that is done in other jurisdictions—providing these types of services to the families as well as the veterans themselves?

[Guy Parent]

Yes, obviously the increased access to family resource centres was a pilot project, first of all, for the veterans. Now it has been announced as being an ongoing benefit that will stay there for veterans and their families. Again, it's something we have recommended before. It's important, especially in the first few years of transition, that you don't completely lose your identity, that you have some places you can go where you are reminded of your identity as a person who served the country, and whose family served with you as well, and that you have access to those benefits.

These family resource centres are useful not just to the veterans but also to the families and the children of veterans who are living with PTSD and a lot of these other challenges.

I know that in the States, for instance, they have the USO, which provides services to both serving military members, and veterans and families. That might be something you want to look at in your study, because that's certainly a successful program in the States. You see USOs at almost all airports. That would be something family-related you could look at.

[Colin Fraser, Liberal, West Nova, NS]

Similarly, there is a caregiver benefit that was recently announced. I think one of my colleagues mentioned it earlier. It is $1,000 per month, tax free, for the person who is taking care of the veteran. I would like to hear your comment on how you see that type of model. Are there similar things in other jurisdictions that you are aware of?

[Guy Parent]

As I said, it is certainly a step in the right direction, a movement forward, to get people or family-member caregivers to access benefits in their own right. It's very important. It has increased the amount of money that used to be in the previous benefit of $7,000 per year for respite allowance. Certainly, a monthly benefit is a good thing.

The Americans, for instance, have a family caregiver program in which they actually engage with the family member who wants to take care of the injured veteran. They train them, certify them, and then employ them at the full salary that would be available to any other caregiver. That's probably the optimum as far as a caregiver program is concerned.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Kitchen, you have five minutes.

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

Thank you, Mr. Chair, and thank you both for coming today.

As you're aware, we're now looking at studying and comparing services for veterans in other jurisdictions. I appreciate your presenting this to us because shiny things sure catch people's attention, and that's good.

If I'm not mistaken, I believe you actually presented this model to us once before, but this is much more eye-catching, and I appreciate that.

Do other countries have similar models?

[Guy Parent]

I'm not sure if they have the same chart. This was introduced to our office to help our front-line officers navigate through the process. There is also an electronic tool called the benefits navigator that is actually available on the Veterans Affairs Canada website right now. You can navigate by identifying the type of veteran you are and it will identify the benefits that are accessible to you. It was designed for that purpose. I'm not sure if any other country has gone that far as to.... But, again, this is more to show the complexity, not to understand....

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

True. For a lot of people seeing something pictorially, oftentimes it is a lot easier for them to understand and to grasp what's going on. Obviously we see from this that there are lots of boxes and lots of circles and they're piled on top of each other. As you mentioned there is a lot of overlap. With that overlap is an overlap in cost and bureaucracy. I'm just wondering. From your point of view, where do you see that some of these boxes might be able to be condensed into one box versus 10 boxes?

Be as brief as you can because it will probably be a lot longer than the five minutes I have

[Guy Parent]

That's a good question. I already mentioned one, the vocational rehabilitation program. It's very confusing. You talk about the monetary cost, but what about the frustration cost? People get process fatigue and then just say, “That's it. I'm not going to bother. It's not worth it.”

The biggest one right now is vocational rehabilitation because there are two programs. One is under the insurance company, SISIP. Unfortunately they are the first payers so people have to go there first. Their program is limited to two years and it's limited in scope as well. It is much less generous than the Veterans Affairs Canada vocational program. We have people now who want to take a university course—education, for instance, of four years—but cannot take it through the first stage of SISIP because it's only two years, so they sit there for two years taking courses in tattooing or whatever it is until they are ready to go to the next program at VAC, which allows for four or five years and $80,000.

These are simple things that would remove right now a full stream from the complexity of this diagram. That's a good example of what can be done.

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

I'm interested in your presentation. You talked about outcomes, and one of the outcomes you talked about was whether we are paying for all out-of-pocket expenses due to this. That intrigues me because I realize that becomes a bit more micromanaging. I guess as we investigate that with other countries because that's the context here, can you tell us where we sit when we're dealing with our veterans? For example, in Saskatchewan, that's one thing I hear a lot from my veterans in rural Canada. They say they have to put this money out of their pocket in order to go to Regina or to Saskatoon. They are prepared to do it, they are more than happy to do it, but they just want to know that once they've done it they can get the money back.

What sort of model can we provide to cut down on the delays that they experience?

[Guy Parent]

I'm glad you brought up that point because this is an issue of unfairness that exists right now with the new Veterans Charter. In the past under the old pension plan or the pension disability, what used to happen then was that when you applied for benefits, and it took maybe nine weeks to get your benefits in place, any expenses you incurred during that time would be paid. In fact, it would be paid 90 days before your application. For instance, hearing aids or that sort of thing would be paid for even though you only got your decision three months down the road.

Now under the new Veterans Charter the expenses are only reimbursed to the time of decision not to the time of application. Now with the waiting times being 22 weeks instead of 12, people do need the treatment. Certainly what we're seeing now is that people are maybe not getting the treatment they should be getting because they can't afford it and they know they won't be reimbursed. That's a big area of unfairness.

The other thing is the simplified way of reimbursing people. I think that's a way that the department has gone right now. For instance, under VIP, expenses, the cost of house cleaning or groundskeeping are now grants instead of putting in your receipt every time, so that simplifies matters. It's things like that they need to introduce for other expenses associated with medical. There is more and more travelling to get their care because we know a lot of older veterans in cities like Vancouver and Toronto are selling their houses and moving to a rural community. Now they don't have access to immediate care because they have to travel and they have expenses. Therefore, that's why it's encouraging, and we need to encourage Veterans Affairs Canada to make it simple to reimburse people.

[The Chair, Liberal, Neil Ellis]

Thank you.

Ms. Ramsey, you have three minutes.

[Tracey Ramsey, NDP, Essex, ON]

To go back to this chart, I couldn't begin to explain this as a parliamentarian, and I couldn't begin to explain this to another country. In going to other countries and asking them to explain their systems, I think we need to take a step back and fix what's right here. You said that clearly. This is too complex for families and veterans, and at some point they get that process fatigue where they say they can't do this anymore.

In particular, when we're talking about veterans of advanced age who can't access a computer, don't know how to navigate a computer, don't know how to navigate the system, they just give up, so they never receive the service.

I'll go back to something you said that's been sticking with me, and that is “a Canadian solution”. What do you think the Canadian solution is to simplifying and streamlining this so that veterans and their families can actually get the services they need here?

[Guy Parent]

Thank you. That's a good point.

The Canadian solution is to reduce the duplicity and the complexity of it, because there are too many departments involved in it right now. When we talk about seamless transition, it's not seamless right now; it's very confusing. That's why the government needs to introduce a governance process so that one department is responsible for the transition from the military career to a civilian new normal, not just a civilian job but a new normal—stability in finance, stability in health care, all expenses reimbursed, that sort of thing.

Again, I think what's important is to go to other countries. They might not have this particular slide, but they must have some kind of footprint or some kind of map of how they provide benefits and what their intent is. Let's not forget that this new Veterans Charter changed the way we deal with veterans and families. At one point in time under the old Pension Act, it was reimbursement on a monthly pension for life. If you got better, you got less money, and if you got worse, you got more money, so it was not an incentive to get better.

This one is based on wellness and on the actual rehabilitation to civilian employment. We've been dealing with tweaking it from 2006 until now. This is the business now. I would say that once you have an outcome, you can simplify those benefits down to three or four, and that's it.

[Sharon Squire]

While it may take some time to get there, I think in the interim, guided support or helping the veteran to navigate the system is key as well.

[Tracey Ramsey, NDP, Essex, ON]

Has the minister indicated that this is something he would like to do, that he would like to see happen? Is he working on the simplification of our own structure here in Canada?

[The Chair, Liberal, Neil Ellis]

I'm sorry. You'll have to make it short.

[Guy Parent]

I can't speak for the minister, but the idea of reducing complexity is certainly foremost in both the department and the minister's office.

[The Chair, Liberal, Neil Ellis]

Thank you.

We're going to break. I would like to thank you both again for appearing today. Thank you for all the work you do on behalf of our men and women who have served.

I'll recess for about four minutes, and we'll come back to our next witnesses.

[The Chair, Liberal, Neil Ellis]

I'd like to call the meeting back to order. We'll continue our second round.

We have in front of us, from the Department of Veterans Affairs, Bernard Butler, assistant deputy minister of strategic policy and commemoration.

Mr. Butler, you've been in front of us before, so I'll let you go with your 10 minutes. You can use it all and then we'll switch to questions.

The floor is yours.

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

Wonderful. Thank you very much, Mr. Chair.

Good afternoon, honourable members. I would first like to commend you on this important work that you are doing on behalf of Canada's veterans. Second, thank you for the invitation to appear before the committee today. As the chair has noted, it's always a pleasure to be here.

By way of opening remarks, I would like simply to comment briefly on a few issues which I hope may be of some benefit to you in your studies.

It's interesting to note that some of my comments are not dissimilar at all to those of the ombudsman, your previous witness.

The first relates to the evolution of the new Veterans Charter since its adoption in 2006. The second is the proposition that nations respond to the needs of their veterans based on a variety of unique and nation-specific socio-economic considerations. I think the message, therefore, is that simple comparisons are never easy. Finally, I'd like to offer some closing thoughts on where we are on VAC's current focus and plans for the future.

In terms of the evolution of benefits, to serve is an extraordinary commitment. It is an agreement, if required, to put oneself at risk of personal injury or death in defence of our country. It is this commitment that serves as the basis for veterans programming in Canada.

Following the First World War, the Government of Canada developed a program of veterans benefits that was considered groundbreaking at the time. The program included hospitals to provide direct medical care, vocational training, and low-interest loans to purchase farmland. In 1919 the Pension Act was introduced, the same Pension Act that in 2006 was basically replaced by the new Veterans Charter. There was also the introduction of income support programming through the War Veterans Allowance Act in 1930.

Subsequent to the Second World War, we had over a million men and women returning from overseas. A range of new and diverse benefits were introduced at that time to meet the needs of those veterans coming back. The suite of benefits at the time was referred to as the Veterans Charter. As that cohort aged, their needs changed, and so too did the programming that was required to meet the needs.

By the late 1990s, it became increasingly apparent that while the government was responding effectively to the older, traditional war veteran cohort, the needs of the younger Canadian Armed Forces veterans were not being effectively met. After much study, consultation, and debate, the new Veterans Charter was introduced in 2005. The intent was to modernize programs and services, primarily by shifting the focus from one of compensation to one of wellness and rehabilitation, with a view to making it easier for veterans to transition out of the military and to adapt to and be successful in civilian life.

In the same way that veterans programming has evolved over the past 100 years, the new Veterans Charter has continued to evolve and adapt to meet the needs and expectations of Canada's veterans. ACVA, in 2014, concluded that the principles of the new Veterans Charter were sound, but there were some deficiencies or gaps that needed to be addressed. A number of studies by the veterans ombudsman essentially arrived at similar conclusions. As a consequence, over the past number of years significant improvements to programming have been made. These have included changes to the earnings loss benefit, to the maximum amounts payable for non-economic compensation, and to improvements for things like the permanent impairment allowance.

As you know, budget 2017 has placed a focus on investing in education and career transition support for veterans, as well as increasing supports to families. The history of veterans programming reflects a continuous adaptation to the needs of veterans and their families. Veterans Affairs will continue to research, consult, and advise government on best practices and approaches to address those needs.

With respect to the issue of making comparisons, I can't really add a whole lot more to the eloquence of the ombudsman. Suffice it to say that it's always useful to make comparisons with other countries. It does help inform best practices. At the end of the day, however, every country has its own unique political and socio-economic context and its own reasons for military and veteran support. It's therefore difficult to make a clean comparison in any case. In my notes I point out a very good example from simply the United States.

In Canada we have universal health care; therefore, we do not need to have military veterans hospitals. That was the result of a study back in the 1960s, the Glassco commission, which recommended at the time that the federal government divest its responsibility for acute medical care to the provinces, and that all of the veterans hospitals at the time be divested to the provinces. The final transfer occurred in 2016, with Ste. Anne's Hospital in Montreal being transferred to the Province of Quebec. In the United States of America of course, where there is not universal health care, there is an imperative for veterans programming to include acute medical care and treatment. Their model is really quite different from ours in that respect.

The challenge is always to ensure a fulsome understanding of the context in which benefits are provided, why non-economic and economic benefits may be paid at different rates or delivered in different ways, and what the objectives for veterans programming for an individual country might be.

Finally, in the context of where we are, the financial, physical, and mental well-being of eligible veterans and their families is our goal and the strategic outcome to which many of the programs and services of Veterans Affairs Canada contribute. Research shows that there is a higher prevalence of a number of chronic health conditions among Canadian Armed Forces veterans, including things such as hearing problems, musculoskeletal conditions, chronic pain, and mental health conditions such as post-traumatic stress disorder. We also know that the majority of releasing members adjust well to civilian life, but approximately 25% report a difficult adjustment. The types of benefits and services available to veterans are broad and include many elements: treatment benefits; home care; long-term care; medical, psychosocial, and vocational rehabilitation; disability compensation; and financial benefits and supports for career transition and employment. I hope I will have an opportunity to come back to the ombudsman's chart.

Budget 2016 saw the disability award for service-related injuries and illnesses increase to $360,000. The earnings loss benefit increased to 90% from 75%. The permanent impairment allowance was expanded, and additional front-line staff have been added to improve the ratio of clients to case managers.

Budget 2017 includes proposals for a new education and training benefit, removal of an existing one-year limitation period for survivors' access to rehabilitation and vocational assistance services, a redesigned career transition service, expanded access to the military family services program, the introduction of a caregiver recognition benefit, the creation of two new funds, the veteran and family well-being fund and a veteran emergency fund, and the establishment of a centre of excellence on post-traumatic stress disorder and related mental health conditions.

There exists a wide array of benefits and services available to our veterans and their families. We are working to overhaul our service delivery model to simplify access to our programs and essentially reduce complexity. We continue to work with our partners, the Department of National Defence and others, to ensure that releasing members and veterans receive access to more simplified and streamlined programs and services that will be easier to navigate, that will help them access services more quickly, and will make their transition to civilian life easier.

In closing, thank you again for the invitation to speak to you today. I very much appreciate the opportunity to speak about the services and benefits that our department provides to veterans and their families in recognition of their extraordinary contributions and sacrifice.

Thank you.