Veterans Affairs Committee on Dec. 5th, 2022

[The Chair, Liberal, Emmanuel Dubourg]

I call the meeting to order.

Welcome to meeting number 30 of the Standing Committee on Veterans Affairs.

Pursuant to Standing Order 108(2) and the motion adopted on Monday, November 21, 2022, the committee is resuming its study on the impact of the new rehabilitation contract awarded by the Department of Veterans Affairs on the role of the case manager and quality of service delivery.

Today's meeting is taking place in a hybrid format pursuant to the House order of Thursday, June 23, 2022. Members may attend in person in the room or remotely using the Zoom application.

Interpretation services are available, and those of you using the Zoom application can make your choice at the bottom of your screen.

A reminder that all comments by members and witnesses should be addressed through the chair.

Pursuant to our routine motion concerning login tests, I wish to inform the committee that all witnesses completed the required tests prior to the meeting.

Now I would like to welcome, first of all, the clerk, Naaman Sugrue. He is here with us.

I would like to welcome, as witnesses, the Honourable Lawrence MacAulay, Minister of Veterans Affairs; and, from the Department of Veterans Affairs, Paul Ledwell, deputy minister, and Steven Harris, assistant deputy minister, service delivery branch.

I am pleased to yield the floor to the Minister of Veterans Affairs, the Hon. Lawrence MacAulay.

You have five minutes for your opening statement. Please go ahead, sir.

[Lawrence MacAulay, Liberal, Minister of Veterans Affairs]

Thank you very much, Mr. Chair and members of the committee.

Thank for the invitation to appear today to discuss recent contracting changes to Veterans Affairs Canada's rehabilitation service and supplementary estimates (B), which will be discussed in the second hour.

You have heard a number of views from many people, and I would like to take this time to provide you with some facts.

Up until this year, there have been two separate contracts in place for the delivery of rehabilitation services and vocational assistance. Medavie Blue Cross had previously administered all medical and psychosocial rehabilitation services, and all vocational services have been managed by Canadian Veterans Vocational Rehabilitation Services.

In June 2021, a new national contract for rehabilitation and psychosocial services was awarded to Partners in Canadian Veterans Rehabilitation Services, following an open and transparent process.

I want to clearly point out that this change was made in consultation with veterans, their families, and Veterans Affairs Canada staff to ensure that the services we provide to veterans are improved under the new provider, and that the transition from the old system to the new one is seamless. This new contract provides 14,000 veterans with vital support and access to over 9,000 health care experts and specialists in 600 locations right across the country.

From January to May this year, Veterans Affairs held two rounds of consultations with approximately 60 veterans and their families with experience in the program about how program updates related to the contract might serve them better. Their feedback helped us develop a strategy to best meet their needs.

For example, they want shorter wait times for services and reports, as well as timely service from case managers and service providers. They also asked for more connection time with their caseworkers. This contract addresses these concerns with nationally consistent, standardized and timely rehab assessments and service to help veterans improve their overall well-being.

A third round of consultations is planned for early 2023 for veterans who are part of the first phase of the migration over to the new contract.

Within the department, there were three main working groups that met several times a year. These were made up of various employees from field operations, IT, performance measurement, the national learning unit, and stakeholder engagement, among others. The Union of Veterans' Affairs Employees also identified several employees, most of whom were caseworkers, to participate in various working groups.

The department presented at six town hall sessions for case managers and other service delivery staff, with more planned every six to eight weeks as we continue the migration of veterans to the new contractor. Approximately 800 people attended each of the last two town halls.

Training materials are also provided to ensure that case managers have the information they need when they need it as the systems become available. Training will continue during the transition phase and until full implementation, to ensure staff are fully engaged and comfortable with the new contractor. The thoughts, concerns, and perspectives we have heard have helped shape how services will be delivered to veterans and their families.

When they were consulted, our case managers asked for a more manageable workload and fewer administrative tasks. Under this contract, they will no longer have to help veterans find providers in the community, write rehab plan goals, or chase providers for reports that are supposed to come in every 30 days. With these tasks transferred over to the new service providers, case managers can see a reduction of up to 15 hours a month in administration burden once all clients have been migrated to the new provider. This will allow for more time for veterans and rehab needs, just as our case managers and vets wanted.

Simply put, the contract will not mean any reduction in case managers at Veterans Affairs.

Caseworkers are not health care workers or professional specialists, and this is not work they have ever done at Veterans Affairs. We greatly value the work our case managers do, and that's why we are focused on helping them spend more time with veterans and clients than on doing their administrative tasks.

Thank you, Mr. Chair.

[The Chair, Liberal, Emmanuel Dubourg]

Thank you, Minister.

I would like to welcome one of our colleagues, Mr. Greg Fergus, who is replacing Mr. Wilson Miao.

Welcome, Mr. Fergus.

Now let's go to our first round of questions.

I invite Mr. Blake Richards to go ahead, please, for six minutes or less.

[Blake Richards, Conservative, Banff—Airdrie, AB]

Thank you.

Minister, I want to get to some of the details of the contract in a moment, but first, the last time you were before this committee, you were discussing medical assistance in dying. You indicated to us that there were four veterans who had this issue raised with them by one particular caseworker and that had been referred to the RCMP.

Since that time, I know that I'm certainly now aware of at least eight veterans who have had this occur, and there have been at least three additional case managers or service agents involved in this, so we're at a situation where we have eight veterans and probably as many as four caseworkers.

That includes Bruce, whom I mentioned to you last time, as well as, obviously, one case that was raised in last Thursday's meeting and has been in the media quite extensively since. That's the case of Christine Gauthier, who is in a wheelchair because of injuries she suffered serving this country and has been fighting with Veterans Affairs for five years to try to get a lift put in her house. As she has told us, she has been fought by Veterans Affairs every step of the way. She put it well. She said that Veterans Affairs won't help her live her life, but they have offered to help her die. That is a statement that I think hits everyone who hears it, and it's something that we should all be concerned about.

Now, she wrote to you about that back in July 2021. At that point in time, you were aware of this and did nothing until August 2022, when another veteran's case hit the media. Can you tell us, Minister, why did you do nothing from July 2021 onwards and put other veterans' lives at risk?

[Lawrence MacAulay, Liberal, Cardigan, PE]

Thank you very much.

First of all, for Christine and anybody else out there who has any difficulty with this or has been involved in this issue, we want them to come forward. With Christine, we want to work with her to make sure we help and provide any service that we can in order to help her.

I would tell you that we have reviewed our files, and what I indicated two weeks ago, I believe, here before the committee.... I indicated quite clearly that there were four cases involving one case manager. This is totally unacceptable. Veterans Affairs does not provide MAID services at all.

What I can tell you is that we have found nobody else who has indicated to.... We find no information to indicate—

[Blake Richards, Conservative, Banff—Airdrie, AB]

Minister—

[Lawrence MacAulay, Liberal, Cardigan, PE]

Let me answer the question. You asked the question and—

[Blake Richards, Conservative, Banff—Airdrie, AB]

Well, sure, but let me interrupt, because you're telling me you still believe that there are only four, when we have had Christine Gauthier come forward and we have had Bruce come forward. Also, I'm aware of at least a couple of others. Granted, they haven't come forward, but we know that a couple of them have.

Minister, beyond that, in July 2021.... You say you want them to come forward. Christine Gauthier came to you in July 2021. She did come forward and you did nothing. Do you not see that as a problem?

[Lawrence MacAulay, Liberal, Cardigan, PE]

You've indicated quite clearly in your statement, I believe, that Christine Gauthier was offered this service. I have to be very careful what I indicate about specific files—

[Blake Richards, Conservative, Banff—Airdrie, AB]

Have you done any investigations—

[The Chair, Liberal, Emmanuel Dubourg]

Excuse me.

[Lawrence MacAulay, Liberal, Cardigan, PE]

I believe I would have to ask my deputy to respond. I just want to be careful. I do not want to affect the investigation, but we want to find out exactly what happened, when it happened and who was involved.

I would ask my deputy to respond to that.

[Blake Richards, Conservative, Banff—Airdrie, AB]

Sure, and just before you do that, Minister, I can appreciate that you don't want to do anything that would cause harm to the investigation. However, can you tell us whether you have done anything? You were aware of this case back in July 2021 and clearly didn't pay attention to it, but now that it has come to light in the media and in this committee since last Thursday, have you investigated what happened or done anything to try to investigate what happened in that period of time?

[Lawrence MacAulay, Liberal, Cardigan, PE]

As I indicated previously at the meeting, upon hearing this, I asked my deputy to conduct an investigation. They're doing that. I was briefed a couple of weeks ago, and I asked my deputy to expand the investigation. He has done that. It has been referred to the RCMP. That has been done. What we want to do is make fully sure that anybody who has any difficulty in this way.... However, I think, in all fairness, we have to let the deputy respond to what you indicated at the committee. That's what I have done.

Go ahead.

[Blake Richards, Conservative, Banff—Airdrie, AB]

Just before you do that—

[Lawrence MacAulay, Liberal, Cardigan, PE]

You're not going to let him speak.

[Blake Richards, Conservative, Banff—Airdrie, AB]

Minister, sure I will, but you're the one responsible. This was brought to your attention in July 2021, and you did nothing for over a year. Now you're telling us, “Well, there's an investigation.” That's great. That's wonderful, and we're glad to see that that's happening, but you keep telling us that there are four.

We know that there are more than four, without a doubt. I'm aware that, with regard to the previous case that came in the media, the agent involved is in British Columbia. Christine Gauthier is located in Quebec. I heard her on a podcast this weekend where she indicated that she had two separate caseworkers who both suggested MAID to her. One was male, and one was female, so there is more than one caseworker involved here. There clearly is.

I wonder what you've done to investigate it. Can you maybe tell us—whoever's going to answer it—how many total times your investigation has uncovered that MAID has been brought up in either a call with—

[The Chair, Liberal, Emmanuel Dubourg]

Excuse me, Mr. Richards. I'm sorry. The six minutes are way over. Please leave some time for the witnesses to answer questions.

Now I'd like to go to Mr. Sean Casey for six minutes or less.

Please go ahead.

[Sean Casey, Liberal, Charlottetown, PE]

Thank you very much, Mr. Chair.

Minister, several times you attempted to answer Mr. Richards' questions, and he interrupted you. You have the full six minutes to provide whatever additional information you tried unsuccessfully to present to the committee.

Go ahead, Minister.

[Lawrence MacAulay, Liberal, Cardigan, PE]

Thank you very much.

First of all, there's been an indication made that I received information, that somebody wrote to me indicating that MAID had been discussed with them. Overall, that's not the case. I would like my deputy to respond to the specific issue that came to light here the last day we were at the committee, because it's only fair that the facts be brought out.

[Paul Ledwell, Deputy Minister, Department of Veterans Affairs]

Thanks, Mr. Chair.

To respond to the questions that have been raised.... As indicated at the last appearance before the committee, 402,000 unique veterans' files have been reviewed for any specific reference with regard to MAID being raised inappropriately with a veteran—402,000 unique files. Through those files, we've isolated four cases involving one individual. If there's other information that needs to come forth that is not represented in those files, we'd like to see that. The minister has been clear about that, and we've invited veterans to come forward. If they're not comfortable coming forward to the department, they're welcome to come forward to the veterans ombudsman.

With regard to the specifics about Veteran Gauthier, who was here before the committee last Thursday, those files have been reviewed. They were reviewed as part of the 402,000, through that full review. They've subsequently been reviewed based on the issues that the veteran raised on Thursday. There's no indication in the files, in any correspondence, in any notation based on engagement with the veteran, of a reference to MAID. If the veteran has material and indication of that, again, as we've invited other veterans, we would welcome seeing that, reviewing that and making that part of our investigation.

It's critically important, as the minister has underlined and as we have stated repeatedly, that we get to the bottom of this, the full breadth of this, and that we address the issue. Up to this point, four cases have been established involving one single employee.

[Lawrence MacAulay, Liberal, Cardigan, PE]

I would also urge you, Mr. Richards, if you do have information.... What we're trying to do is get to the bottom of this issue. We have the investigation in place. We have some facts from the investigation. We want to make sure that we get to the bottom of this issue, and I would ask anybody at the committee, any veteran, anybody who's listening, to please bring forward any information they have.

We need to know the facts, and that's what we want to see happen, because we want to make sure that veterans feel comfortable to come to Veterans Affairs. It's very important to realize that there are thousands of employees at Veterans Affairs Canada, and they truly care. They're hurt by this. We want to make sure that we get this situation rectified as quickly as possible. That is what we're trying to do, and that is what we will do.

Thank you.

[Sean Casey, Liberal, Charlottetown, PE]

Thank you very much, Minister.

The reason you were invited to come to the committee today was to talk about the contract, so how about we do that?

I'd like to refer you specifically to some of the testimony that we heard from the president of the Union of Veterans' Affairs Employees and invite you to respond. Virginia Vaillancourt, when she testified before committee, said that case managers fear that, through the new rehab contract, veterans will lose their human face-to-face contact with someone who will be an ally, an advocate and quite often a trusted friend to their families during some pretty dark times.

Minister, how would you respond to that fear as expressed by the union president of case managers?

[Lawrence MacAulay, Liberal, Cardigan, PE]

Thank you very much.

Of course, with this new contract, there are 14,000 veterans, approximately—probably a few over that—who depend on this type of contract. They have access to 9,000 experts, health experts and other experts, in 600 locations right across Canada in order to make sure that they're able to address their needs.

Why this new contract was put together—basically putting two contracts together—is that the caseworkers asked us in consultation to try to make sure that they have more time to spend with veterans. With this contract, they have more time to serve veterans. They have about 15 hours a week, approximately two days more, with this situation alone, because they don't have to do the administrative work and they don't have to find the different experts in the field right across the country. The contract has people in place to do that. That's what we want to make sure of.

My job is to make sure that we provide the best services we possibly can for veterans in the best way we can, where they need it and when they need it, and that's what we're doing with this contract.

Thank you.

[Sean Casey, Liberal, Charlottetown, PE]

Thank you, Minister.

Ms. Vaillancourt also said that the bigger question is whether we want the face of service to veterans to be a kind, caring and compassionate case manager or a for-profit corporation that serves its shareholders. How would you respond to that critique, Minister?