Veterans Affairs Committee on Feb. 6th, 2018

[Cmdre Sean Cantelon]

A time immemorial success story, and my own personal experience as a junior officer in the early 2000s, is that once people have been medically identified to have breached the universality of service and they're going to get out, we start early with the engagement with the vocational rehabilitation SISIP file to get them examined and in. Therefore, up to a year in advance, they're looking at what kinds of skill sets they need to find gainful employment. That's a success story that is working and has worked and has been adjusted over time.

I would turn to Manulife to give a more modern, concrete example.

[Kathleen McIlwham]

Our goal very much is to approach every person who's going to come to us, so it's not as if they have to decide to apply. Anybody who comes into our LTD program is contacted by a vocational rehab specialist. All of our rehab people are in house, so they have access to the information that the case manager has. There's a lot less going back and forth trying to sort all of that out.

They can be pretty effective almost immediately. About 75% of the plans are assessed, made, and agreed upon with the member on the first meeting. When we look at the plans, we look at a member very much holistically. There's the education and training that they have from their military experience, but they may have hobbies or other types of things that they're interested in—electronic stuff, or whatever. We look at the region they live in, and where they want to live. We try to assess what makes sense for them to re-enter the workforce.

We can get them into the program six months before the actual date of release so that they can really get engaged up front. We believe very strongly that the quicker you get people engaged and looking to their future, the more success they'll have.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Ms. Douglas, did you want to speak to it as well?

[Elizabeth Douglas]

We have several programs that we think are a success, one being our rehab program itself. We've just heard about the stats coming from that program, and for the most part they are successful. We are successful in dealing with our veterans and ensuring, as they move into home, community, and workforce, that they are higher-functioning than they were when they arrived with us.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Speaking of community, what role could associations, community-based organizations, and the private sector play in supporting transition?

[Elizabeth Douglas]

In terms of not only supporting transition but of supporting the veteran overall, we rely greatly on our partnerships with several of the organizations, such as the Royal Canadian Legion. There are a number of veteran's organizations that really help our veterans, work with us, and partner with us.

In addition to that, we do have a new well-being fund that is going to come into place on April 1. With that, there will be funding of approximately $3.5 million yearly to look at research into addressing veterans' needs and to look at innovative new programs. We are expecting that some of our non-profit organizations will be putting forward applications for that program.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Kitchen, you have six minutes.

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

Thank you, Mr. Chair.

Ms. Douglas, you mentioned a number of reports just previously. Could we get copies of those presented to the committee? I think it would be of benefit if we could.

[Elizabeth Douglas]

Do you mean the life after service studies? Yes, absolutely.

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

Thank you very much.

As we look at our soldiers as they're transitioning.... I had mentioned that my father transitioned out quite easily, although he had back problems, etc. I was a family member, I was older, and I had a career of my own. The reality is that it was quite easy. Let's move that to 20 years earlier, if my father had to transition out because of jumping off of tanks all of his life, resulting in a bad back, and look at it from a family perspective.

I recall all the military stuff when I was younger. I was always brought onto bases for my health care. When I went to boarding school, who was covering my health care was a big challenge.

Family members have these transitions as they transition out. How are you dealing with that, and how are we closing that seam so that families are having an easier time during that transition process?

Do you have any suggestions for what we should look at to help family members as they transition?

[Elizabeth Douglas]

Indeed, the health of the family member is an indicator of the well-being of the veteran and his family. We have numerous programs in place. We've spoken about the increased to 32 of military family resource centres. That too will be implemented, as of April 1 this year, and there are a wide span of programs available there—everything from emergency counselling to child care.

During transition, we encourage family members to be with the member, soon to be a veteran, who is going through that transition process. Quite often we cannot enforce that, but we do strongly encourage it.

From a VAC perspective, we also have a 1-800 telephone line for assistance. We have counselling services. We've just put in place a new online caregiver course, so if you're caregiving for a family member, for a veteran, you can go online and take this course and get support. There are numerous processes, programs, benefits, and supports in place.

We also recognize through the rehabilitation program that counselling is available for problems of marital stress or problems with a child. Services are open to others besides the veteran if that is needed.

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

My colleagues and I often hear from veterans who have problems filling out forms. It's form after form after form. We've heard from Ms. McIlwham about an initiative whereby they've been doing it over the phone, and I know veterans would much prefer to have that type of service. Do you have it? If not, why not, and if not, can you put it in place?

[Elizabeth Douglas]

First, when you call our NCCN number, you can get assistance in completing forms. What we're trying to do is move people towards online services and a My VAC Account. To that end, we have offered training to our case managers so they can assist the veterans in using their My VAC Account to do their forms. We're doing the same with Service Canada and we have services offered through them.

On the My VAC Account, we have tutorials on how to complete forms. We can go back and look into doing even more of that, but we do recognize that streamlining our application forms is part of our service delivery and we're in the process of doing that right now. We're looking at how we can eliminate some of these forms. Ultimately, we would like to get to one application.

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

I'll defer to my colleague.

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

Thank you.

I'd like to ask a couple questions on case managers.

I've had many conversations with vets who say their case manager is made of gold. They value them so much and they are a crucial part of this whole process, but when I look at trying to make transitions smoother, I see that case managers are stuck between a rock and a hard place. They're dealing with veterans and they're dealing with the bureaucracy. A lot of times, with all the transitions taking place in programming, case managers are not educated and are not trained and do not have the authority they could have if given the responsibility to make decisions and show what's available to veterans so that there isn't more delay and a long wait for a response.

One individual got funding to go to school and had a unique ask that her manager hadn't seen before. She took it to the higher-ups. At first they said yes, and then, after she'd enrolled in school, they changed their mind and said he didn't qualify for the funding after all. It then becomes the case manager's responsibility to share that information.

Would it not be better to give case managers the training, responsibility, and authority they need to deal with their clients and take care of the responsibilities within VAC??

[Elizabeth Douglas]

In 2015, in response to some earlier outcomes having to do with the rehabilitation program, we put in place an extensive national training program for new case managers. We've now widened the program to include case managers who have been working for some time, as well as others who work in the area offices.

That program lasts 10 months. You're not in training all of the time. First you get basic knowledge about the department, the acts, the delegation of authority, and what you can do. Then we break it down into personalized training and professional training. You go back to the workplace and find out what your challenges are, and then you come back into the training.

There may not be such an extensive case manager program anywhere else. It's really quite complete, quite rich, and quite an investment. We have made huge strides in going forward with our training. We've also created a national training unit that looks strictly at case management and how we can improve it.

[The Chair, Liberal, Neil Ellis]

Thank you.

Go ahead, Mr. Samson.

[Darrell Samson, Liberal, Sackville—Preston—Chezzetcook, NS]

Thank you, and thank you all for your presentations. It's extremely interesting, because it's a file that's very important to our veterans and our military people. I really feel that there's been a lot of improvement over time. There's no question about that, and we praise that.

I'll try to fire some questions. Of course, having the opportunity to speak later drives some questions a little differently, but I'll ask a couple.

Mr. Cantelon, you said that no one should be released prior to all benefits and everything being in place, and I'm 100% behind that. I don't know many professions that are not there. That's very concerning for me, and I believe in it 100%. I know we're saying that we might get there, that we want to get there, and that we will get there.

My question is going to be focused on universality of service. Do you think that would help? If you're not going to be released, then you have two options, guaranteed: either I send you home and I pay you or I find some work in the interim. What is your opinion about changing universality of service or looking at possibilities around universality of service, or not, or to what extent?

[Cmdre Sean Cantelon]

I don't have a personal opinion, just to clarify my response—

[Darrell Samson, Liberal, Sackville—Preston—Chezzetcook, NS]

Of course not, but what about the positives and negatives?

[Cmdre Sean Cantelon]

I know the chief has said publicly that we are, and I don't mean to imply that we're not. We're looking at universality of service. An example that the surgeon general and I have spoken about—I'm not a doctor—is that there have been massive advances in terms of the stability of medication. Many of our policies date from the days when they had to be in a fridge, but we have medication now that's stable in hot environments, which goes to the idea that you wouldn't have access to medical care. With respect to the idea that we would deploy somewhere in danger where we wouldn't have medical care, our goal is to have people in a hospital so that we can deal with them. That's why we have such a high survival rate out of Afghanistan.

The real issue, then, comes down to how we interpret this to provide flexibility. That's exactly where we are. Right now in the Canadian Armed Forces, a person may be what we call “accommodated” in a position for up to three years after they've been deemed to be in breach of the universality of service principle. Part of what we're looking at there is a policy change. Are our universality of service medical principles too rigid? Remember that what we're focused on is the ability to deploy. The chief has spoken about that.

Needless to say, there are many people in NDHQ who are not current on their gas mask or on firing their C7 on the range. You would have to be able to do that, but many positions don't require you to deploy in those environments. The accommodation process is part of it.

At the core part, from a military perspective, you obviously want your Canadian Armed Forces to be able go to bad places, such as a flood or a fire inside the country. There is room for redoing that, and we're in the process of doing it.

[Darrell Samson, Liberal, Sackville—Preston—Chezzetcook, NS]

Thank you. Again, we want to be able to say 100% that we have to put some steps in place. Thank you for that answer.

The second question is for Ms. Douglas. The main focus of this study is to identify what the problems are and then give the solutions. We need to zero in. If we're going to say 100%, we need to zero in. If we're trying to focus on the one, two, or three main issues, we need to identify them. Did the transition task force identify the two or three main ones, and if so, what are the recommendations around those?

[Elizabeth Douglas]

The task force right now is looking at what our priority items are. There's a list of priority items that need to be approved. However, I think that the better answer to that question may be our longitudinal LASS studies. They have identified the fact of that loss of identity during transition. When a member removes his or her uniform is really one of the critical elements around transition. That is also why VAC is looking at the well-being and looking at a holistic model for a veteran. We're looking at the programs and services that fulfill and help to fulfill the functioning of a veteran in those areas.

[Darrell Samson, Liberal, Sackville—Preston—Chezzetcook, NS]

Thank you.

Again, before this study is over I'd like to have exactly the pinpoint—one, two, three.

Let me lead into the third question, which I think is essential. I know there are two departments. There's Veterans Affairs and there's DND. I'm not saying today we should join them, but should we join them when it comes to seamless transition release? I don't mean the bodies, but should we have a joint, seamless transition in which that team is solely responsible for ensuring that no one is released before everything is in place and that everything is in place.

It's not as a criticism, of course, but three times in the discussions so far I've heard, “Not in my responsibility, not in my jurisdiction.” No one could say that if that body were there. I know you're not going to give your opinion, but I'm just asking, what are the positives? Would you see any positives in having a joint team? On the release, no one is released unless everything is in place, and who is to be in charge of that? It's not one or the other, but a joint team.

[Elizabeth Douglas]

Our goal is certainly working towards a seamless transition as much as possible. We too see the benefits of having the CAF employees there, having the case managers from CAF, and working side by side in an integrated fashion with our colleagues from the CAF. Absolutely, from a workplace perspective, we totally agree.