Veterans Affairs Committee on April 12th, 2016

[Michel Doiron]

We welcome the comments from the OAG from last November 2014, I believe it was, which made us move on multiple fronts.

When it comes to the disability side—I think the last time I was here we just touched on it—we've accelerated the way we are now adjudicating what I'll call “the injuries” for our men and women in uniform or for our veterans. Essentially, we are not looking at 500 pages of their medical health records—I think somebody else asked a question to the minister earlier. We're now looking at what their trade or their job was in the armed forces and whether their injuries are consistent with injuries related to that, and we've accelerated the method to adjudicate.

I say injury and not illness. Illness is still very complex. If you have a heart condition that was caused by airborne particles in Afghanistan because of the burn pits, then we probably need doctors to assess what this is and if it's possible. However, if it's the fact that your knees are gone and you've jumped out of a plane a thousand times, I don't think we need a doctor to tell us that, as long as there's a diagnostic.

When it comes to mental health we've also accelerated the method for how we adjudicate it. If you have a diagnosed mental health condition and you were in any special duty area, then you're in the club in that sense. It's much faster.

[The Chair, Liberal, Neil Ellis]

Thank you.

Ms. Romanado.

[Sherry Romanado, Liberal, Longueuil—Charles-LeMoyne, QC]

Thank you for being here today.

As I've said in multiple presentations, the decision to join the Canadian Armed Forces is an incredibly proud one for the members serving, to put on that uniform. When a member is involuntarily—I won't say dismissed—from the Canadian Armed Forces due to injury or illness, it is a huge blow. There is no soft landing. We take away their uniform. We take away their identity. We sometimes take away their family, in terms of the colleagues that they serve with.

While I'm happy to see that there's a 3% increase in the budget for Veteran Affairs this year, I'd like to get a sense from you on what support system we are putting in place when there's a decision to release a member of the Canadian Armed Forces because of injury or illness, to ensure that we are not aggravating that injury by making them jump through hoops or retell their story or prove their injury.

These folks have served our country, and we should be bending over backwards to thank them and make it as easy as possible for them to transition out.

[Michel Doiron]

That is the aim of what we're trying to do in eliminating the seam in the transition process. Since September 2015 we have something called the enhanced transition process, which is where Veterans Affairs case managers or staff, depending on the complexity of the case, start working with the veteran immediately to remove as many impediments as possible.

I agree with you, for some people it will never be a soft landing. We can only do what we can do to help them land, and at the end of the day work with them. That's why we've started the enhanced transition services, to start working upstream. This is from a recommendation that came from this committee, I believe in late 2014, and we've implemented that. We may have to tweak that process. It's new, and as you know with any new process, as you go down you find what works and what doesn't work.

We still need diagnostics. Let's be honest. The person is retiring or being forced out or whatever the right term is for a reason. We do need a medical diagnostic to work with and to work with the client. What we're trying to do is simplify the forms and facilitate the process, understanding that a lot people are involved in that process.

For example, were you injured for service, or is your injury not service related—diabetes or something like that? There are all kinds of reasons why you would breach the universality of service. The deputy and I often use the term “navigator”. How can the person navigate this complex set of rules and processes? That is part of what's in the mandate letter, to look at the financial benefits and the process, and to simplify as much as possible. We're really pushing that process forward.

[Sherry Romanado, Liberal, Longueuil—Charles-LeMoyne, QC]

This may sound like a really bizarre question. I think everyone around this table is committed to our Canadian Armed Forces and our members who have served our country. I'd ask you what the average Canadian can be doing to help the Minister of Veterans Affairs, to help the parliamentarians around this table, to support you in your initiatives and also to support our veterans. What can we be doing, the average Canadian, to help our members who have served our country so valiantly?

[Michel Doiron]

That's a very good question and not an easy question to answer at the same time.

I think it comes back to what a member discussed about health care and things like that. I think if there's one area where everybody could help—and maybe it's not the simple side of it—it's to ensure that our veterans, wherever they decide to retire, receive health care in those locations.

There are a lot of initiatives on employment, whether it's at the federal level or companies stepping up to the plate and hiring veterans, and we're doing a lot of work on homelessness. A lot of groups are involved in homelessness and they want to help, so how do we coordinate all that?

On medical care, I'm not talking about specialists and surgeons, I'm talking about your day-to-day medical help because we can work with the veterans but they often need a family doctor to give them access to some very basic care, and in some cases in some parts of this country, that is very difficult. Veterans Affairs do not have practising doctors in the sense that we don't give prescriptions and the doctors we have are references. They are there to make sure we're doing the right thing. I think if there is one area that collectively we could work on, I really think it's on the health side of ensuring that our veterans get a doctor, that they're not put in long queues. I'm going to stop because I could get on the soapbox on that one. But I think that's an area where I think there's work to be done.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Fraser.

[Colin Fraser, Liberal, West Nova, NS]

Thank you for appearing before the committee again. We appreciate it.

I want to ask a question, if you don't mind, regarding the Veterans Review and Appeal Board. Is that a question that you would be comfortable answering?

[Bernard Butler]

I think probably not in a sense that the Veterans Review and Appeal Board, as you know, is independent of the department. Depending on the question, it might be more appropriate to have that directed to the chair of the review board.

[Colin Fraser, Liberal, West Nova, NS]

Yes, maybe I'll frame my question in regard to the main estimates and the funding for the Veterans Review and Appeal Board. It would appear that the funding was higher in 2014-15 and then went down a little bit in 2015-16. It would appear that it's projected to go up a bit in this fiscal year 2016-17. I'm wondering if you could comment on that, the fluctuations in the amount of money allocated for the Veterans Review and Appeal Board and whether there is some reason for the fluctuation that could be addressed as far as delays that we know are happening at that level are concerned.

[Bernard Butler]

Thank you again for the clarity of the question, but I think that I would have to go back to the observations that my colleague had made earlier, that issues around budgetary expenditures and so on are really not within our domain. Certainly with respect to the operations of the Veterans Review and Appeal Board, that would really be a question that would have to be directed to the chairman of the Veterans Review and Appeal Board, to explain or to clarify the circumstance.

[Colin Fraser, Liberal, West Nova, NS]

Okay, I'll move then on that through you. Would that be possible?

[The Chair, Liberal, Neil Ellis]

Can we get a written answer? Okay, we'll get it through you.

[Colin Fraser, Liberal, West Nova, NS]

Thank you very much, Mr. Chair.

I am wondering about the Last Post Fund. Do you feel okay to answer a question on that?

[Bernard Butler]

Sure.

[Colin Fraser, Liberal, West Nova, NS]

I think it is important that we recognize the importance of ensuring that all veterans receive a dignified burial. Obviously we need to support them during their lifetime, but to ensure that they have a dignified burial is something that I think we all support.

I wonder about the uptake on that, the fact that it has received funding, and whether there has been any criticism of that. How can we improve that to ensure that veterans have access to the services through the Last Post Fund?

[Bernard Butler]

As the minister indicated earlier in the morning, the Last Post Fund administers the program of funeral and burial on behalf of the department. With respect to this budget, one of the biggest criticisms had been that the estate exemption, which had been reduced in 1995, was not keeping pace with the growing costs of funeral and burial expenses. This budget has increased the estate exemption from $12,000 to $35,000 in today's dollars and has provided for indexing of it.

For fiscal year 2014-15, some 1,186 veterans' families benefited from the program. It's a significant uptake, and those were folks who were eligible. We believe that with this change in the eligibility criteria, we will continue to see healthy demand for the program and that there will be a lot of veterans' families who will benefit from it.

[Colin Fraser, Liberal, West Nova, NS]

Can you touch on the eligibility criteria and how this could be expanded?

[Bernard Butler]

Under the program there are two gateways for eligibility. One is called “matter of right”. If a veteran dies from a service-related disability, his or her family automatically qualifies for benefits under the funeral and burial program. The other gateway relates to a means-tested eligibility. If a Canadian Forces veteran dies without sufficient means to assure a respectful funeral and burial, their families can access these benefits.

Prior to the budget, under the means-testing mechanism, if the veteran died leaving assets worth more than $12,000, the family didn't qualify. A house was excluded from that calculation and I believe a motor vehicle. Now, because it has been elevated to $35,000, there will be many more veterans' families who will be able to apply for benefits under the program.

[The Chair, Liberal, Neil Ellis]

Mrs. Wagantall.

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

For clarity, we're supposed to be discussing the main estimates, but we can't really talk numbers. Is that correct?

[The Chair, Liberal, Neil Ellis]

Can you answer questions on the numbers?

[Michel Doiron]

We're not here to justify the numbers. The chief financial officer should do that. We can talk about the programs. That's what we were instructed to do.

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

I have one here that I can ask. It's in regard to the case managers and their roles and responsibilities across the country. A couple of us are focused on rural areas and meeting their needs.

What kind of feedback do you get from the case managers and from the individuals that they're serving regarding the best way to provide those services where a person is not in a major centre? How can such a person access that easily?

[Michel Doiron]

I can provide a lot of insight on that. In respect of the case managers, it doesn't matter if you're in a rural or an urban area. The case managers will travel to serve you in your location. In the north, it may be a bit more problematic, but we're taking steps to fix that. They will go to your residence. They will talk with you on the phone. It's the same thing for our nurses.

We have over 4,000 people working to provide specialized services in locations across the country. We've taken a lot of steps to ensure that the services, whether they're psychosocial, medical, or vocational, are available where the veteran lives. Some rural areas are more difficult to get to than others, but the case managers do go and serve.

When we were running 40:1, the time the case manager had to dedicate to the veteran was problematic. Now that we're going to no more than 25:1, the case managers have more time to dedicate to individual cases. This will greatly improve the service. In any event, I want to be clear that our case managers do travel to the location if that's what the veteran wants.

Depending on where they live, some veterans are happy to come into an office because they go downtown that week or something. If not, we send occupational therapists to the home to evaluate the home. Is it safe for the veteran? What do you need? Do you need a ramp? We do go out to visit.