Thank you.
There are a number of areas we wanted to report on from the interviews with our case managers. First of all, we asked them about their current caseloads. Here's what they told us. We would like to read this into the record.
This is how many individual veterans they are being asked to assist: 55, 55, 50, 66, 64, 56, 45, 53, 55, 40, 56, 46, 47, 50.
We asked if they could manage that workload. Here's what they told us: “Trying to manage this many cases is ludicrous, impossible”. “I'm trying to play catch-up, and I never can catch up”. “I try to make a difference every day, but this job is making me sick”. “I love my job and love helping vets, but I don't have the time to give them the attention they deserve”.
We asked about their working conditions. Here's what they told us: “We're just putting out fires; on to the next call”. “We don't have time to do proper intake, assessments, referrals, follow-up or consultation with providers”. “We used to do home visits every two or three weeks; now it's once a year”. “We're doing triage, focusing on high-risk cases, but even some of them fall through the cracks”. “We're dealing with complex mental health issues that need constant care and intervention, and we just don't have the time”. “Veterans and their families deserve better than this”.
The high caseloads and demanding working conditions have led directly to high staff vacancies and an employee retention problem, particularly at the case manager level within VAC.
In the Atlantic region, upwards of 25% of positions are vacant, and even more in bilingual areas. This is exacerbating an already difficult situation at the workplace. Here are some more quotes: “The pattern is to hire, train, give them their caseloads and then watch them transfer out or quit because of the workload”. “We've been short-staffed in our office for four years”. “The hiring process takes six months. That means we're without a body for at least that long”. “We need some incentives...to get people to stay as case managers. The turnover is killing us”.
Every single case manager we spoke to had suffered from stress and burnout to some degree. That included anxiety, sleeplessness, weight gain and physical, mental and emotional strain from their work. Here's some of what they told us: “We have to find outside ways to manage the stress. Some take leave, but then the workload is even higher when they come back”. “The intensity and pressure is relentless. Everyone in our office is suffering”. “Many vets are suicidal, and that has an impact on us. We take that home with us to our families”. “The support is just not there for staff”.
There were also some disturbing reports of bullying and harassment by managers within VAC toward the front-line staff. While this is not the case in all regions, some offices reported that negative attitudes and harassing comments by some of the managers made their already-stressful jobs even more difficult. Formal complaints did not achieve positive results, so this became another burden that case managers in those areas had to deal with, in addition to their heavy workload.
The backlog of disability claims has added another level of stress to the system for veterans and VAC staff. Case managers reported feeling it every day. Veterans and spouses are very angry and frustrated by the delays. They call and ask for information, and the case managers have nothing new to provide them. For the case managers, it is heartbreaking to see veterans and their families suffer, but they have no ability to help them. Even worse, this is a definite barrier to the case managers developing a positive working relationship with the veterans and their families. The trust is just often not there. Here are some of the quotes: “Vets are frustrated, angry and often screaming at us”. “We understand why they're pissed off. They don't have any money to live on”. “This impacts their treatment plans, and if their pension monies are held up, too, they are suffering. It hurts to watch this every day”. “Why does the website say it will take 16 weeks when it could take up to two years? Vets see that and they ask me what's going on. I have nothing to tell them”. “The veterans feel lied to, and so do we”.
The backlog has also created security concerns at a number of offices, including those located on bases. There is easy access and little protection for front-line staff. There were reports ranging from verbal abuse to threatening phone calls to actual in-person threats. Several case managers, male and female, reported feeling unsafe at work.
They have reported these incidents and local managers have requested action and additional security measures, but they are slow to be acted upon by headquarters. There is a quote: “Vets and their spouses yell at us all the time. 1 get it. They're frustrated and angry. But I have felt afraid for my physical well-being.”
On the GC case system and disengagement process, the changeover from the old CDSN into the new GC case system has caused and continues to cause problems for everyone in the VAC pipeline. From the case manager perspective, this change, as of April 1, 2019, was abrupt and not well planned. They do not feel adequately trained and they continue to have problems making the system work.
One of the impacts of this rapid change was that they received directions to disengage veterans who were on the old system as of April 1, 2019. They were given lists of veterans and asked to justify why those veterans were still on the system and were told to encourage them to transfer out of the programming into new streams like guided support.
This process felt and looked heavy-handed to the case managers who had to advocate for veterans who still needed support and had not gotten themselves to the point where they could be self-sufficient or employable. Yet in many areas there is continuing pressure to cut off veterans, and case managers are told they could be negatively affected if they do not follow this direction.
This is a very difficult time for case managers and the policy of active disengagement is still, to our knowledge, being actively pursued by VAC headquarters.
Another issue that was raised by many case managers when we spoke to them was the apparent change of direction by VAC when it comes to counselling services for spouses, children and families. Several case managers reported they had been directed to tell family members that they were no longer entitled to access counselling or to see a psychologist because of this policy change.
Understandably the clients are not happy about this change and the case managers are worried about the impact on spouses and children. Here are some quotes: “Kids are getting kicked off counselling when they have issues like 'If I'm good, maybe Dad won't kill himself'”. “Medavie Blue Cross has been calling social workers telling them they have to cut family members off”. “Cutting...family members off benefits like counselling is utterly ridiculous and short-sighted”. “I'm told to send these children to the provincial system, when I know there's a handful of programs and a year-long waiting list”.
I'll turn it back to Virginia for some recommendations.