Evidence of meeting #38 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 lifemark.
A recording is available from Parliament.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
Right. When he was saying, “Oh, no, no, they can have that care parallel”, and I said, “Well, you're providing the same service from two different places”, it was not clarified that it wasn't for the same injury.
Case Manager and Alternate Vice President, Union of Veterans' Affairs Employees
It isn't. That's right.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
If they said, “Well, yes, you have that there, but I have this provider over here that does that, and that's who I want to work with”, they do not have that option if they are assessed and put through Lifemark. Otherwise they lose their IRB and are removed from the program.
Do you hear that as well?
Case Manager and Alternate Vice President, Union of Veterans' Affairs Employees
There are concerns we see where, if clients choose to not pursue treatment through PCVRS, their IRB benefits, income replacement benefits, can be terminated for what we call non-participation. That is an aspect that is very concerning.
Conservative
Cathay Wagantall Conservative Yorkton—Melville, SK
A woman talked about her knee injury. She had help through PCVRS, and then they said they couldn't help her anymore until she had a knee transplant, but she was too young. The care ended. Is that what would happen under the other program? You need to continue that care until you can have a knee transplant, would you not think?
Liberal
The Chair Liberal Marie-France Lalonde
I apologize, but I'm at the five-second extension.
You can answer yes or no, and then I'll move on.
Case Manager and Alternate Vice President, Union of Veterans' Affairs Employees
Yes.
Liberal
The Chair Liberal Marie-France Lalonde
Thank you very much.
Ms. Auguste will be speaking in French as well.
Please go ahead, Ms. Auguste. You have five minutes.
Liberal
Tatiana Auguste Liberal Terrebonne, QC
Thank you, Madam Chair.
Mr. Vila, the PCVRS program is meant to provide veterans with a multidisciplinary approach. A number of witnesses have stressed the importance of good service coordination. We've heard that coordination can be a challenge when a case involves a number of different professionals. In your practice, what is the best way to ensure that physical and mental health professionals work together effectively? How do we really ensure good coordination between the various service providers?
Kinesiologist, As an Individual
I'm fortunate that the clinic and space I work in is down the hall from many of the other practitioners and clinicians I work alongside, physiotherapists, psychologists, clinical counsellors and such, in order to maintain a continuity or an easy transition between the different aspects of rehabilitation. A lot of the time it's simply walking the client down the hall to their next appointment with the following clinician to give a quick debrief of what's happening and what we've talked about.
Obviously, as a kinesiologist, my scope is quite narrow to the physical function side of it, but alongside that, through conversations with a client during a session, they often start to share their life experiences beyond that. That stuff, although it's not something I necessarily can tackle as a clinician, I can pass along to the appropriate clinician if the client allows me to.
As well, we do a lot of charting, and we keep a record of the things that we treat our clients with—for me it's the physical exercises—but also the subjective things, the things the client shares, how they're feeling and things outside the program that are affecting their life. Again, it's perhaps not something that I myself can treat, but within an interdisciplinary setting, our other clinicians perhaps can tackle those at the same time.
Liberal
Tatiana Auguste Liberal Terrebonne, QC
Thank you.
You said you're fortunate that you work down the hall from other service providers, but that isn't the case for all veterans. The committee has heard a lot of concerns about regional access to services and the availability of professionals. It's harder for veterans in rural areas to access services.
In your experience working with veterans, how do those barriers limit their ability to access physical rehabilitation services quickly, and how can we improve that?
Kinesiologist, As an Individual
Thank you for the question. It is a very relevant one, for sure.
For context, the clinic where I work is in Victoria, B.C., fairly close to the naval base, CFB Esquimalt. Many of the veterans we work with come from there or the air force up the island. There are also many veterans who choose to live in rural areas for various reasons. That can definitely be a hindrance to their participation in the program.
I can think of this example: I have worked with a number of clients in the past, and I do currently, who live up the Malahat, a highway on Vancouver Island. They have to drive about an hour or so on the side of a mountain. It's nothing scary, but it is quite a distance to travel to the city we're in. A lot of the time, there are clients who are unable to do that, whether it's due to time constraints, financial restrictions or perhaps even weather.
We offer services virtually to try to reach those veterans. We provide them with virtual kinesiology, virtual mental health support and even virtual physiotherapy. I recognize, though, that sometimes there is a bit of a gap between in-person and virtual visits. We're fortunate to have a technology like this so we can converse and provide these services. Often, though, especially for services such as physiotherapy, which is much more tactile and hands-on, it can be difficult to serve our veterans that way.
Liberal
The Chair Liberal Marie-France Lalonde
Thank you, Ms. Auguste.
We now go to Ms. Gaudreau for two and a half minutes.
Bloc
Marie-Hélène Gaudreau Bloc Laurentides—Labelle, QC
Thank you.
When services are contracted out, the rationale is completely different. It's about cost effectiveness, accountability, and, in many cases, it's about restrictions. It's upsetting and shocking every time I hear that, because a company has an agreement with us, it will leave us high and dry if we don't deal with it. That's unacceptable.
A department provides service to the public. It develops expertise. It's in full control. Departments themselves certainly have accountability requirements.
What can we take away from the Lifemark contract?
National President, Union of Veterans' Affairs Employees
What you are saying about the department is true. Honestly, I am so proud to have worked for the Department of Veterans Affairs for 24 years. Now, yes, I am a national union representative, but I used to be a veterans services officer. People take great pride in working for a department. There's a sense of appreciation. We have a very meaningful mission. Veterans Affairs Canada upholds very strong values. That's something all employees share.
That's why we are sad to see what is happening with the contract, because our veterans are paying the price. When access is an issue, for example, veterans no longer know which door to knock on. So what happens? They stop knocking on doors and stop asking for services. They are fed up with having to fill out all the administrative forms they are asked to complete and with having to repeat their story over and over to every new person they speak with. This constantly retraumatizes them. That's what is happening, and I am convinced we are losing veterans.
However, I remain confident. Veterans Affairs Canada will work collaboratively to find a solution.
National President, Union of Veterans' Affairs Employees
To do this, it will take more than just Veterans Affairs. It will take the government. It will take a prime minister who is willing to provide funding. It will also take the support of the majority of the people on this committee.
We are going to try to find solutions, but it doesn't look promising.
Bloc