Veterans Affairs Committee on June 14th, 2017

[Steve Mullins]

Yes, it is a real issue when we have what we would deem downgrades; in our terminology, we would downgrade from a medical perspective. There's been some debate and some conceptual thinking around how best to manage those members who are downgraded. In theory, the attitude that we're leaning towards is keeping them within the team environment. The other side of the story would be to take them away from the team environment and put them into what we would deem a rehabilitation unit in order to increase their rehabilitation aspects and try to get them back into service or operational readiness.

At the present time, we're grappling with the issue, but we believe that the answer lies within having a really good care plan, and so a wrap-around, medically-related, evidence-based time frame whereby command are quite aware of how treatment is progressing, in order to get the operational readiness aspect back as quickly as possible. The majority of our members are very passionate about getting back to their full capacity, so we're obviously dealing with a cohort who are trying their hardest to get back to their physical or mental best.

[Bob Bratina, Liberal, Hamilton East—Stoney Creek, ON]

Yes.

[The Chair, Liberal, Neil Ellis]

Mr. Brassard.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Thank you, Mr. Chair.

Thank you for joining us today.

I want to focus on three areas, if we can. The first one is the case-managed situation. It works out in New Zealand to about 1:200. In Canada, we try for about a 1:30 ratio, from a case management standpoint.

Do you find that in a 1:200 situation your case managers are in fact overwhelmed with the demand of those cases, or are they able to manage appropriately and effectively?

[Bernadine Mackenzie]

I'll just start by saying that the numbers sound high, but it comes down to the needs and to when there is an intensive need for the person to be case-managed. In fact, we have rehabilitation advisers too who support that process. Then, as I said, we have veterans who are being managed within the mental health services and the public health system of New Zealand as well. We will liaise there with the psychiatrist, for instance, who would be the primary caregiver. The majority of our cases are not at that extreme level; we absolutely have a reduced caseload there.

Pat, do you want to talk about the...?

[Pat Povey]

When a veteran comes into our case management service, we clearly look at what their need is and whether they're high risk or not, in terms of mental health, or they might have high surgical needs or mobility needs, so we prioritize those. With every veteran who comes into our case management service, they would have someone assigned within a week, and a phone call will be made and a full needs assessment done over the phone. We have a tool that we use that gives us a full picture of the veteran's need.

A lot of the veterans who are sitting on a caseload have the services in place while they are actively case managed. They might not need a lot of actual intervention, because we've got the things in place. It might be just a matter of a phone call once every six months just to make sure that everything is working. We have master service agreement providers who provide a lot of those services around the home for our veterans to help them maintain their independence. If there are problems, the veteran can contact them straight away and they will work it out. So we might not be the sole provider of something, but might be signposting or putting those services in place, and those providers have to manage the delivery of that service.

[Bernadine Mackenzie]

While that's the current situation, we're also looking to the future because we do believe that we're going to have more intensive case management than what we have now. We're trying to look at modelling what will that look like going forward and what operating costs we will need to cover. That points in the direction of a reduced caseload—

[John Brassard, Conservative, Barrie—Innisfil, ON]

Perhaps related to mental health issues, PTSD, for example.

[Bernadine Mackenzie]

Absolutely.

[John Brassard, Conservative, Barrie—Innisfil, ON]

The second area I want to focus on is the pension issue, because I noticed that pre-1974 those veterans who served then received a monthly income, and post-1974 they received a lump sum income. How have those changes been received?

[Pat Povey]

That's not quite correct. If a veteran pre-1974, under the old act, had a medical condition that was accepted as related to service and a pension were paid, it might be dependent on the level of disability, and that would affect the decision on the dollar amount. With the new act, the first thing that we're looking at is rehabilitation and treatment. So if a veteran comes to us with a medical condition, the first thing we will look at is whether it's related to qualifying operational service and how we should treat that veteran to get them back to fitness.

If, at the end of the period of treatment, there is a permanent condition that has been identified or it's reached a stable state, a decision is then made, depending on when the injury occurred, and a fortnightly independence allowance is given, or a lump sum payment is made. And there are the dates around that, so between April 1974 and April 2002, an independence allowance would have been given—and that aligns with our ACC, which Bernadine has spoken about—while post April 1, 2002, if the injury is permanent, a lump sum payment is made based on the level of disability.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Okay. Who determines that level of disability?

[Pat Povey]

It's our decision officers, and they base that on specialist reports, so they don't make a determination just themselves; we get specialist medical reports.

[John Brassard, Conservative, Barrie—Innisfil, ON]

How much time do I have, Mr. Chair?

[The Chair, Liberal, Neil Ellis]

A minute.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Okay.

The last area I want to focus on—and I am glad to have been able to get all three questions in—is the area of transition and specifically the employment of veterans or existing members who are transitioning out.

In Canada, for example, I would call their employment rate in the public service abysmal.

What's been your experience in helping or assisting those members of the armed forces transition into other areas of employment, perhaps the public service or private sector? What's the experience been like there and how successful has that been, in your opinion?

[Steve Mullins]

If I could answer, I would suggest that we have a similar issue. The way we differ a little bit is that a lot of our civilian-related employment opportunities in the New Zealand Defence Force are actually being filled by veterans, meaning that veterans are actually coming back into the defence force into our civilian-related work or employment opportunities.

We are also leveraging a number of other opportunities within the recruitment labour hire markets, trying to have corporate partnerships within New Zealand to promote the value-add of ex-military personnel within the private sector or other government agencies.

But it is a work in progress.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Fraser, I believe you're splitting your time. So you're up.

[Colin Fraser, Liberal, West Nova, NS]

I am indeed. Thank you, Mr. Chair.

I'm just sticking with the transition piece. I'd like to hear a bit about when forces' members are being released from the military and becoming veterans. How well integrated are they and how much co-operation is there between the Ministry of Defence and the veterans' affairs department in this transition. What level of co-operation is there and can you explain how that looks in New Zealand?

[Bernadine Mackenzie]

Well, we are a unit of the New Zealand police force. We're part of the family, if you like, although we have some quite specific accountabilities in regard to our veterans. There are good relationships there. As always, there are privacy issues, and we have worked through these with the health directorate within the New Zealand police force. We are always looking to see how we can do that soft handover better, which Clare Bennett talked about, and taking a proactive response to this. For instance, at the moment, when you exit the New Zealand police force you have to opt in, if you qualify, as a veteran within our service. We are now being proactive with new policy to enable that. You are opted in, and then you have to opt out. We are trying to make that easier for the veterans because, obviously, once you've left the defence force and something happens, you see the world a lot differently and it becomes a lot harder to connect back. So this is trying to make it as easy as possible and a smooth transition.

[Colin Fraser, Liberal, West Nova, NS]

Would you say that forces' members are aware of the benefits and services that are available to them upon their release? Is it common knowledge, or is there some kind of information given to folks as they are transitioning?

[Bernadine Mackenzie]

There is information and we pass off some of the transition programs. We're looking to improve in that area and are mobilizing ourselves in bases, for instance, to ensure that the current proven members actually do know what is available. So we're trying to get the information out and communicate it continuously. Part of it comes back to the recognition of being a veteran as well. It seems that if I'm hitting retirement, I might actually quite like to be a veteran. But before that, for veterans in this country there is an issue around recognition.

[Colin Fraser, Liberal, West Nova, NS]

Thanks very much. I'm going to turn it over to my friend now, Ms. Lambropoulos.

[Emmanuella Lambropoulos, Liberal, Saint-Laurent, QC]

Hello again. We've found here in Canada that a lot of the veterans only seek services later on, unless they've been released on injury. A lot of them come back when they realize that they have post-traumatic stress disorder or depression, as you mentioned earlier. I was wondering if you know approximately what percentage of veterans you serve or are currently being monitored or receiving some kind of service from one of your partnerships?

[Bernadine Mackenzie]

No, we don't.