Veterans Affairs Committee on March 12th, 2020

[The Chair, Liberal, Bryan May]

Good morning, everyone.

Pursuant to Standing Order 108(2) and the motion adopted by the committee on Tuesday, February 25, 2020, the committee is continuing its study of the backlog of disability benefit claims at the Department of Veterans Affairs.

We're very pleased this morning to have two different panels. On our first panel, from Union of Veterans' Affairs Employees, we have Virginia Vaillancourt, national president, and Mr. Mike Martin, communications.

Welcome to you both.

From the Royal Canadian Legion, we have Raymond McInnis, director, veterans services, Dominion Command, and Steven Clark, national executive director.

Thank you to all of you for being here.

Very quickly, I don't know if you've all been to a committee meeting before, but you'll each be given an opportunity to make opening remarks, and then we'll have questions.

My role is as referee to try to keep us on time.

I believe we're going to start with the Union of Veterans' Affairs Employees.

Ms. Vaillancourt, are you speaking today? The next 10 minutes is all yours.

[Virginia Vaillancourt, National President, Union of Veterans' Affairs Employees]

Thank you for the opportunity to appear before the committee today. We're here this morning as representatives of the Union of Veterans' Affairs Employees, which is a component of the Public Service Alliance of Canada.

UVAE represents over 2,800 employees with Veterans Affairs Canada, including most of the front-life staff who deal with veterans and their families every day. We are here today to talk to you particularly about the work and challenges of case managers within Veterans Affairs Canada pertaining to their caseloads and the backlog of disability claims.

Veterans Affairs programs and services, like the needs of our veterans, are vast, complex and always evolving. Our case managers are one group of front-line staff who are subject matter experts in VAC services and benefits. They must understand applicable legislation and the various regulations, policies and acts that are used to determine eligibility for those services and benefits. They must know how to deal with mental health issues, crisis intervention, frustrated and sometimes angry clients and suicide prevention, and they must understand and use motivational interviewing techniques.

As you have heard from departmental officials and others, one of the major problems is that the backlogs and wait times for services continue to grow, and veterans are waiting longer for services. This is causing financial, physical, mental and emotional pain and hardships for veterans and their families. It is also having a direct impact on those on the front lines who are attempting to serve them. We wish we could tell you that this is a new development, but the backlog and increased caseloads for case managers at Veterans Affairs have been growing for years.

In 2015-16, the Minister of Veterans Affairs made a commitment to reduce case manager ratios to 25:1 in order to allow more time and focus on the needs of veterans and their families. This was also supported in a 2016 brief to the House of Commons by the veterans ombudsman.

Despite this promise and several attempts by the federal government since that time, VAC has failed to meet that target. By any metric, they have failed miserably, as you will see from the information we are about to provide.

This committee has already heard about the impact this has had on veterans and their families. This includes increased wait times and reduced services, fewer home visits, and fewer frequent physical and mental health interventions unique to the veteran population. This morning we will also tell you about the impact this is having on the front-line staff who work with veterans and their families every day.

When we learned that your committee was studying this issue, we started to gather information from case managers from across the country. In the last two weeks, we interviewed case managers from the regions about their caseloads, their working conditions and the impact this was having on their work and the veterans they serve.

My colleague Mike, who completed the interviews, is going to take over now and provide you with what he learned from those interviews.

[Mike Martin, Communications, Union of Veterans' Affairs Employees]

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.

[Virginia Vaillancourt]

We realize that we've only given you a snapshot of what we've heard and what is happening across the country when it comes to how veterans' services are being provided, but we hope you will appreciate that from the perspective of the front-line workers, the case managers, this is a system in crisis, and it has been in crisis for far too long.

When we were talking to them, we also asked them to give their recommendations to help fix this problem. Here are their recommendations for change.

First and foremost, they want the caseloads to be lowered as quickly as possible to a manageable level. Twenty-five may not be possible in the short term, but that should be a goal over time, but there should not be another five years of waiting. They've already been waiting for five years since the initial promise to reduce caseloads to 25:1. There must be immediate change for the benefit of our veterans and the employees.

They also demanded that Veterans Affairs Canada immediately hire more front-line staff to clean up the backlog and start treating veterans in a timely manner with the respect they deserve. This too is a situation that has dragged on far too long, and we hope this committee will press the government and the department for swift action in this regard.

They also want better support systems for employees, more training and support for employees, and higher level training and support for managers and supervisors to help them do their jobs more effectively.

Finally, they would like the federal government to review their job descriptions and classification levels to ensure that they fully capture the important work they are engaged in.

Thank you for inviting us to meet with you to raise the issues, concerns and recommendations of our case managers. They have given us their voice to bring you these messages. Their hope and ours is that positive change can come for the benefit of veterans, their families and those who have the honour to serve them. Our veterans deserve better.

[The Chair, Liberal, Bryan May]

Thank you very much.

Now from the Royal Canadian Legion, I believe, Raymond, the next 10 minutes is all yours.

[Raymond McInnis, Director, Veterans Services, Dominion Command, Royal Canadian Legion]

Honourable Chairman, members of the parliamentary steering committee on veterans affairs, good morning. It is indeed a great pleasure to appear in front of your committee once again.

On behalf of our dominion president, Mr. Tom Irvine, and our members, my name is Ray McInnis—I use Raymond when I'm in trouble with my mother, but that's okay. I am the director of veterans services at the national headquarters of the Legion. I am a retired chief warrant officer. I served 33-plus years in the regular and reserve forces.

With me today is the Legion's national executive director, Mr. Steven Clark, and we thank you for the work you do for our veterans and their families.

We support your study of the backlog of disability benefits claims at Veterans Affairs Canada. In a minute, I'd like to share some evidence-based advice, but first, I want to outline very briefly how we are equipped to give such advice.

As you may know, the Legion has been assisting veterans and their families since 1926, through our legislative mandate in both the Pension Act and the Veterans Well-being Act. We are the only veterans service organization in Canada that can help veterans and their families with representations to VAC and the Veterans Review and Appeal Board. We do it through our trained, professional and government-security-cleared command service officers and their assistants.

To give you a sense of how busy we are, last year our command service officers prepared and represented disability claims on behalf of over 4,000 veterans to VAC and over 300 reviews and appeals to the Veterans Review and Appeal Board. We also counselled almost 1,100 veterans for various reasons.

In addition to legion command service officers, every branch has an active and trained volunteer service officer to respond to the challenges facing our veteran community. With 1,400 branches across Canada, you can see that our branch service officers offer an essential network of support. They do not complete applications to VAC, but they are often our first line of contact.

When we assist a veteran or family member with a first application or departmental review, it is a very thorough process, and we monitor a veteran's file for life, inclusive of reassessments. We don't send VAC applications unless they contain a confirmed diagnosis. I can tell you, it's a lot of work, but we take great pride in what we do.

Here's what's changed significantly. The majority of our complaints now are about the backlog. We are asked daily about the status of applications. This is even after veterans have visited their My VAC Account and used the wait time tool. They still call us.

Why do they call us? They call us because the wait time tool does not account for the thousands of applications Veterans Affairs has to process before it can even get to yours. The tool provides information on averages over the last 90 days, not what you can realistically expect based on both the current backlog and when your own application was submitted. For example, today you'll get a 54-week processing estimate for a single condition. That estimate would only be valid if there were no backlog.

We'd also like the department to be more transparent and modify the wait time tool to reflect reality. Not only do we receive many unnecessary calls; we can't even tell veterans with any degree of accuracy when their claim will be processed and the decision rendered.

We understand that the backlog is huge, and we do applaud the department for trying to streamline the decision process with veteran benefit teams, limiting the transfer of files and providing the authority to the teams to make the decisions, rather than requiring medical advisory consultation on the claims they do. They can also triage claims for disability benefits to expedite applications for veterans at a higher risk. We use it all the time for our “red zone” applications.

We also need to see consistency in the way that conditions related to certain occupations are handled. For example, we are seeing more unfavourable decisions rendered for those from the support trades who have musculoskeletal conditions, and we have discussed the issue with the department. We still don't have an answer on that yet, but it's there.

We are also supportive of the department's combining conditions that historically have been a consequence of the initial condition, as long as there's a confirmed diagnosis for it. It will be crucial to implement such measures as soon as possible.

I can tell you, I have been with the Legion for nine years, and I've never seen so many applications. We have reached out to veterans' organizations, including the Canadian Armed Forces and the RCMP to advertise our services. As a result, we have seen a steady increase in applications and departmental reviews right across the country.

The increase is also due to the change in what is referred to as the “partial entitlement” policy, which the department quietly changed in February 2018. The change benefited veterans who have received partial entitlements in previous years and can now apply to receive full entitlements in some specific cases.

This one change resulted in many more departmental reviews and appeals. As an example, historically, the Legion will complete approximately 80 departmental reviews in a year, but from August 2018 to December 2018, we completed 552. They were all favourable. In 2019, we completed 601 reviews, and most of these were due to the new partial entitlement policy.

In the end, we believe the department needs to further simplify its processes and get rid of some of the layers that may no longer be needed.

Finally, I'd like to share a couple of important points about the Legion's work, which may be good background for you and for your own work with veterans.

The Legion now offers a one-year free membership to all still-serving military members, retired military, RCMP and retired RCMP who have not yet had the opportunity to join the Legion. It is called the veterans welcome program. It is an opportunity to stay connected to the military and policing family, to honour and support those who served and sacrificed, and to strengthen the community.

Through our poppy fund, we raised and distributed close to $17 million in 2018 to support programs such as Leave the Streets Behind—our homeless veterans program—and to meet the essential needs of veterans and their families who have limited financial means. The poppy fund is available at all levels of the Legion and is accessible to veterans in need, including still-serving members and their families.

We work in close partnership with VAC and other funders to ensure our veterans and widows have a complete solution, so that they do not have to go without.

I will end on this thought. There is no quick fix to this major backlog. We do not see any end in sight. In fact, we believe that when the new transition groups are fully operational, more release personnel will be applying for benefits. There is a danger of the backlog becoming longer. We want to help the department avoid this disastrous scenario with some of the ideas presented earlier. We stand ready to help further.

Chairman, we thank you for the opportunity to make this presentation. We'd be happy to take any questions.

[The Chair, Liberal, Bryan May]

Thank you very much, Mr. McInnis.

We are going to start with questions. First up, we have MP Wagantall.

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

Thank you very much, Chair.

I really appreciate your all being here today. Clearly, you have a good handle on the dynamics and the challenges that our veterans are facing.

I'd like to ask our union representatives who are here today a question. In testimony to this committee on March 10, the deputy minister of Veterans Affairs committed to providing this committee with the department's plan to clear the backlog. He promised to provide that in 30 days.

My question is this: Has the deputy minister or the minister consulted with the union directly to develop their plan to clear the backlog? If they have, when did those consultations take place?

[Virginia Vaillancourt]

I had a meeting with the Minister of Veterans Affairs on February 24 before I flew to Charlottetown for some additional meetings. I raised concerns about the wait times, the backlogs and the case management numbers. Unfortunately, I left there not really feeling positive that he's really going to do stuff. It was disappointing, in my opinion, that one of the comments that was made was that he doesn't really control the department, yet if we look at the mandate letter from Trudeau, we know that he does have a responsibility to oversee. I'm going to continue to push.

I met with previous ministers of Veterans Affairs as well and raised the same concerns. It's not like it hasn't been brought up many times before. Unfortunately, we haven't heard from the department in regard to any changes or options for plans to get rid of the backlog.

We meet with senior management twice a year as our union group. We haven't had any discussions there, although we've raised all of our concerns on the caseloads, the morale and the backlogs. We're still waiting.

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

You presented the concerns. You're saying you don't have any discussion.

[Virginia Vaillancourt]

We do talk. When our union reps—there are five regional vice-presidents across the country, my national executive vice-president and I—meet with senior management, we're bringing all of the concerns directly to them. We have discussions about our concerns and what we feel could potentially change those, but we're not seeing the changes.

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

Okay. There is dialogue.

[Virginia Vaillancourt]

There's some dialogue, but not to the degree that I feel is required to effect the change that's needed.

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

Mr. Martin, did you want to say anything?

[Mike Martin]

I would just like to note that we're providing information and asking questions, but we're not getting answers or a plan. If I heard your question correctly, I don't think there's any consultation on the plan to fix the backlog.

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

Correct, so your hope would be as well.... I believe it was made clear that the plan would be available to the public, so I'm assuming it would be available to you as well. We'll wait and see what has transpired 30 days from now.

You mentioned some efficiencies that your union would support to help clear the backlog. I'd just like you to review those again. How did you come to the decision as to what the priority would be?

[Virginia Vaillancourt]

The big portion of that is ensuring that we're talking directly to the staff who are doing the work on a daily basis. In my opinion, they're the ones who can effectively tell the department what needs to be changed and how it is.

As I mentioned, we need those case management numbers lowered. I did read the testimony of the department from February 27, and I had to laugh at the number of case managers who were hired compared with what our stats show. We need those case management numbers lowered down to 25 minimum. We also need more staff in the department to be able to help with the backlog of cases both in adjudication and pay and benefits, and with the case management numbers.

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

Can you tell me realistically, when a case manager comes on, when you look at how complicated and how convoluted the services are, and they're constantly changing, what is a realistic time frame for that individual to get the basic training they would need, and what kinds of tools are available to them? From what you say, the case managers who are already serving are already overwhelmed. Is there an opportunity to interact with each other so they can get the support they need for the questions they have? Where would you go for answers to those questions?

[Virginia Vaillancourt]

I would personally say that it's a minimum of six months when case managers are hired, because there's a lot of legislation, policies and procedures they have to learn. There are a lot of programs they have to learn the ins and outs of. The department just put in, I think it was last year or the year before, a national training program. A lot of those are done via WebEx, so case managers will sit in front of their computers and learn via WebEx training.

In the department, they have standard training evaluation officers, so if case managers have questions, they can reach out to them.

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

Thank you.

Mr. McInnis, the service managers...?

[Raymond McInnis]

Service officers.

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

How long do your service officers stay in those roles? Is it pretty consistent? Do they have a significant amount of experience behind them?

[The Chair, Liberal, Bryan May]

Give a brief answer, please.

[Raymond McInnis]

At Dominion Command, one of the prerequisites I look for is previous military service. None of us is a lawyer; we're all dedicated, compassionate and passionate about what we do. I look to make sure that they have.... I have a different range of combat arms and paramedical, so it's good service. The turnaround time is rather small in Dominion Command, but across the country there's a big turnover.

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

Thank you.