Evidence of meeting #26 for Veterans Affairs in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was program.

A recording is available from Parliament.

On the agenda

Members speaking

Before the committee

Hicks  Acting Senior Assistant Deputy Minister, Service Delivery, Department of Veterans Affairs
Lockyer  President, Lifemark Health Group
Bennett  Chief Executive Officer, WCG Services
Deschamps  Vice-President, Veterans Health and PCVRS Contract Manager, Partners in Canadian Veterans Rehabilitation Services
Pham  Director General, Field Operations, Department of Veterans Affairs
Bourgeois  Medical Director, Mental Health, Partners in Canadian Veterans Rehabilitation Services

11:50 a.m.

Acting Senior Assistant Deputy Minister, Service Delivery, Department of Veterans Affairs

Jane Hicks

The rehabilitation program, as I've indicated, is a voluntary program. While veterans are participating in that program, they're eligible for the income replacement benefit. If they leave the program and they have a diminished earnings capacity, they might get income replacement long-term. However, if they're not actively participating in the rehabilitation program, then they may not get the income replacement benefit.

We do have strict measures in place where we don't just kick people out of the program. We measure and assess, and we work with veterans to identify any of the challenges that they experience. Sometimes veterans are not ready for rehabilitation.

11:55 a.m.

Conservative

Arnold Viersen Conservative Peace River—Westlock, AB

Okay. That didn't make it any clearer to me. A number of them have come forward saying that they were in a program and they had to move to a new program. They were told that if they didn't go to the new program, their benefits would be gone.

Can you try one more time for me there?

11:55 a.m.

Acting Senior Assistant Deputy Minister, Service Delivery, Department of Veterans Affairs

Jane Hicks

PCVRS is a rehabilitation program. We changed our model from providers through Medavie Blue Cross to PCVRS. It's all the rehabilitation program. In order to receive the income replacement benefit, veterans have to be participating in the rehabilitation program. If veterans choose not to participate, then they would not—

11:55 a.m.

Conservative

Arnold Viersen Conservative Peace River—Westlock, AB

I'm getting it. You can see how that doesn't feel very voluntary, when you're saying that they must move from the program they're in to this current program, and if they don't move to this program, they lose their benefit. They feel that—

The Chair Liberal Marie-France Lalonde

Thank you very much, Mr. Viersen. I sincerely apologize that I have to interrupt you.

Mr. St‑Pierre, you have the floor for five minutes.

Eric St-Pierre Liberal Honoré-Mercier, QC

Thank you, Madam Chair.

If I may, I will speak and ask questions in French.

I'd like to thank all the witnesses for being with us today. I know that two hours is quite a long time, so I thank them for their patience.

Ms. Hicks, the PCVRS was established to modernize and streamline rehabilitation and vocational services for veterans on a national scale. Could you briefly summarize the problem this initiative was designed to address?

11:55 a.m.

Acting Senior Assistant Deputy Minister, Service Delivery, Department of Veterans Affairs

Jane Hicks

Yes, absolutely.

There were many challenges that we had with the old system, prior to PCVRS. For example, services were not consistent. It was not rehabilitation-focused or specialized. Veterans were in the program for an inordinate period of time.

We also have case managers. There was a lot of administrative burden on our case managers. They had to find the providers, coordinate the appointments, and follow up with progress reports and other things. There was a lot of burden on our case managers with all of this.

There was an evaluation that was done approximately 12 years ago on rehabilitation and case management services, and they recommended that we needed to make changes. As a result, we looked at the model, and we decided to develop a new one that specializes in rehabilitation, where veterans have access to rehabilitation specialists, as opposed to just general providers. This reduces the burden on our case managers. It was intended to be a more intense model, with standardized processes so that when veterans come into the program, they would have the same experience coast to coast.

Eric St-Pierre Liberal Honoré-Mercier, QC

Do you think this model improves consistency at the national level? Do you think it meets the needs of individuals, of veterans? I’d like you to talk a little about the national strategy.

11:55 a.m.

Acting Senior Assistant Deputy Minister, Service Delivery, Department of Veterans Affairs

Jane Hicks

There have been a lot of improvements.

I think it has made a big difference, certainly in terms of standardized tools and standardized processes. We're seeing better outcomes. Certainly, it's not meeting the needs of everybody. Veterans come to us with very complex needs. Many of them have complex physical and mental health needs. It takes time to work through this, and it doesn't work for everybody. That being said, we have a robust issue-reporting process in place, and we respond to the concerns expressed by veterans. Certainly, we work with them to resolve any issues they encounter.

We are seeing more positive results, more positive outcomes, and certainly satisfaction as well.

Eric St-Pierre Liberal Honoré-Mercier, QC

Concretely, does this change things on the ground? Can you speak to the tangible impact on the ground?

I'm also wondering about the timeliness of services. Do you think services are better adapted and delivered more quickly?

Noon

Director General, Field Operations, Department of Veterans Affairs

Nathalie Pham

I'll answer that question.

We obviously hear a lot of things on the ground. I want to point out that people aren't satisfied, and there is dissatisfaction being expressed.

That said, if we look at the facts, there has been improvement. Ms. Hicks spoke about the administrative tasks that case managers used to have to handle, including coordination and the search for service providers. Now, through Partners in Canadian Veterans Rehabilitation Services, or PCVRS, they work with a single point of contact, and it is the service provider's responsibility to coordinate the multiple providers. As a result, case managers no longer have to do that themselves.

When the program was implemented, one of the things case managers said was that they felt they didn't spend enough time with veterans, and wanted to have more contact and spend more time with them. When we compare the period since the start of the contract with the six‑month period prior to its implementation, we see a 25% increase in direct contacts with veterans.

For us, these are concrete facts that need to be taken into account when assessing the improvements made possible by the program.

Eric St-Pierre Liberal Honoré-Mercier, QC

My colleague from the Bloc Québécois represents a riding in the Laurentians, which is a more remote region than mine, Montreal. Very briefly, could you speak to how care is delivered in more remote regions?

Noon

Director General, Field Operations, Department of Veterans Affairs

Nathalie Pham

As you know, remote regions pose challenges for the health care system and for all related systems. Together with the service provider, we've identified more than 15,000 providers, so there is a commitment to finding providers in veterans' local communities.

Noon

Liberal

The Chair Liberal Marie-France Lalonde

Once again, I'm really sorry to interrupt you.

With that, let's take a break for about five minutes.

Dear witnesses, you'll be with us for two hours. You might want to drink some water and take a moment to experience the more human side of our nature.

I'll suspend the meeting.

The Chair Liberal Marie-France Lalonde

I call the meeting back to order.

We have Mr. Tolmie for five minutes.

12:05 p.m.

Conservative

Fraser Tolmie Conservative Moose Jaw—Lake Centre—Lanigan, SK

Thank you, Madam Chair.

I would like to piggyback on some of the comments that were made earlier. When I'm sitting here in this chair, I cannot tell the difference between VAC, PCVRS and Lifemark. I want to know where the line of accountability is for veterans.

I'd like to thank my colleague across the aisle for going through all the recommendations and getting one-word answers, but I'm going to dig a little bit deeper.

Ms. Hicks, earlier you said that we received a copy of a report. I'd like to know why we haven't seen that report. When was that report delivered? I'm being told the previous minister did not receive that report on time. That was flagged with her, and we haven't received it.

12:05 p.m.

Acting Senior Assistant Deputy Minister, Service Delivery, Department of Veterans Affairs

Jane Hicks

My understanding is that it was tabled with ACVA. It was recommendation number nine, and a report was tabled with the committee.

12:05 p.m.

Conservative

Fraser Tolmie Conservative Moose Jaw—Lake Centre—Lanigan, SK

Your understanding is different from saying that it was tabled and that we received it. I'd like to have an answer.

The Chair Liberal Marie-France Lalonde

I will allow a few extra seconds.

Our clerk is verifying this, Mr. Tolmie, so please continue.

I can suspend if you want to check.

12:05 p.m.

Conservative

Fraser Tolmie Conservative Moose Jaw—Lake Centre—Lanigan, SK

No, I'll continue on. I have other questions.

We have heard from veterans who have gone through sanctuary trauma, now institutional harm. I'm going to argue that hearing the witnesses today.... It is survivor bias. The reports that you're getting are from people who have gone through the system and not from vets who have had challenges because they're being threatened with losing their benefits. They're not getting the quality of service that is due to them.

I'm going to ask a few more questions. Mr. Deschamps, you said that veterans are encouraged to use those providers. Could you define “encouraged”? What I'm hearing from veterans is about being threatened.

12:10 p.m.

Vice-President, Veterans Health and PCVRS Contract Manager, Partners in Canadian Veterans Rehabilitation Services

René Deschamps

What I said is that providers are encouraged to join the PCVRS network. By joining the PCVRS network, they agree to four things, which are to complete the VAC-approved training, to use VAC-approved report templates, to report at a specified frequency—

12:10 p.m.

Conservative

Fraser Tolmie Conservative Moose Jaw—Lake Centre—Lanigan, SK

What other choices do they have?

12:10 p.m.

Vice-President, Veterans Health and PCVRS Contract Manager, Partners in Canadian Veterans Rehabilitation Services

René Deschamps

I'm not sure I understand the question.

12:10 p.m.

Conservative

Fraser Tolmie Conservative Moose Jaw—Lake Centre—Lanigan, SK

Okay. I'll continue on.

We have veterans who are being threatened that if they change providers, they will lose their benefits. There is no continuity of care, as Ms. Hicks brought up, because veterans are being forced to leave care providers with whom they already have relationships and established care programs to go with something through PCVRS or Lifemark. That relationship is broken, so there is no continuity of care.

Ms. Bennett, you brought up compassionate care. That's not compassionate. You're now severing relationships for veterans who are fragile and who have suffered from PTSD. Could you please explain your view of compassionate care?

12:10 p.m.

Chief Executive Officer, WCG Services

Tania Bennett

Madam Chair, thank you for the question.

The member raises a very good point. Compassionate care, from the perspective of PCVRS, is supporting veterans based on their needs and understanding their needs—