Proceedings of the Special Senate Committee on Aging
Issue 2 - Evidence, December 4, 2006
OTTAWA, Monday, December 4, 2006
The Special Senate Committee on Aging met this day at 12:35 p.m. to examine and report upon the implications of an aging society in Canada.
Senator Sharon Carstairs (Chairman) in the chair.
[English]
The Chairman: Honourable colleagues, welcome again to a meeting of the Special Senate Committee on Aging, a committee that is examining the implications of an aging society in Canada. As you notice, we have a great number of witnesses before us today. We have essentially called in all those departments of the federal government that have a special interest in dealing with those who are aging in our society, and we want to hear from all of them today.
We will go around the room starting on my left. We have Peter Hicks, Executive Director, Strategic Analysis, Audit and Evaluation, Human Resources and Social Development Canada, HRSDC; Margaret Gillis, Director, Public Health Agency of Canada; Leslie MacLean and Shelagh Woods, Health Canada, First Nations and Inuit Health Branch.
[Translation]
We have Ms. Havelin Anand, Director General, Social Policy and Programs Branch, Indian and Northern Affairs; Mr. Bryson Guptill, Director General, Program and Service Policy Program, Veteran Affairs Canada; Douglas Stewart, Vice-President, Policy and Planning Sector, Canada Mortgage and Housing Corporation.
[English]
We have the secretary of the Treasury Board of Canada Secretariat represented by Dan Danagher, who is the Executive Director, and from Public Service Renewal and Diversity in Public Service Human Resources Management Agency of Canada, Cecilia Muir, who is Director General.
I understand Ms. Muir is not here to speak, but will answer questions.
[Translation]
Peter Hicks, Executive Director, Strategic Analysis, Audit and Evaluation, Human Resources and Social Development Canada: Madam Chair, on behalf of the Minister of Human Resources and Social Development Canada and the Minister responsible for Seniors, I am pleased to give you an overview of the role played by the department in preparing for the effects of a rapidly aging population.
[English]
The mandate of our department, broadly stated, is to develop policies and programs that enable Canadians to use their talents, skills and resources to participate in learning and work in the community and to be supported as they move through life's transitions. As pensions are our largest programs, seniors are for us a priority target group. However, the department's work also embraces many other issues associated with population aging.
I have only a few minutes so I would like to touch on these programs and conclude with observations you may find interesting with respect to the usefulness of the concept of aging as a way of framing policy agendas.
With respect to income security, Canada is in the enviable position of being one of the few countries that has a public pension system that is both sustainable and successful in meeting its objectives. The chief actuary has confirmed that changes made to the Canada Pension Plan, CPP, in 1998 have put the plan in a sound financial footing for at least the next 75 years and that includes the peak of the aging population.
The Old Age Security Program, OAS, has been a driving factor in the dramatic decrease we have seen in poverty amongst Canadian seniors. Between 1980 and 2004, the incidents of poverty fell from 21 per cent to an all-time low of 5.6 per cent: from one of the worst in the OECD to one of the best, close to the best, in that time frame. Together, the CPP and OAS have put $50 billion in the hands of seniors every year. Last week, our minister introduced Bill C-36 into the House of Commons to make further amendments to the CPP and OAS. If passed, those amendments will make it easier for seniors to apply for benefits and ease eligibilities for certain claimants. We have experts present — I am not one of them — who can answer technical details on any of the matters on public pensions now and later on in these hearings.
However, pension work is only one part of our work. We do policy and research work and outreach that extend well beyond public pensions to the entire retirement income system. We also work with private employer pension plans, private savings and many other dimensions of population aging. For example, with respect to family care giving, which will be affected by aging, this government expanded the definition of ``family member'' under the Employment Insurance compassionate care program to make it easier for Canadians to take time off work to take care of terminally ill loved ones.
Community involvement is another example. I am told that you are interested in hearing more about our department's New Horizons for Seniors program. The program provides grants of up to $25,000 for community projects that encourage seniors to share their skills, experience and wisdom in support of their communities and promote ongoing involvement of seniors in communities to avoid the risk of social isolation.
Older workers are another example. This government recently announced $70 million for a national cost-shared program with the provinces and territories called the Targeted Initiative for Older Workers that will help unemployed older workers remain active and productive participants in the labour market while their communities undergo adjustment. We are also taking some feasibility work around longer-term approaches towards older workers.
I want to touch briefly on collaborative work that our department leads with other federal departments and other governments. For example, our minister co-chairs the forum of federal, provincial and territorial ministers with responsibility for seniors, which currently focuses its work on elder abuse, healthy aging and social isolation. Given your order of reference, I will also mention that in collaboration with other departments, many of whom are here today, we will lead the development of a report of Canada's progress under the 2002 Madrid International Plan of Action on Aging.
I want to conclude by raising a number of issues for your consideration about the usefulness of the concept of aging for framing policy agendas. I am borrowing on some of my international experience, as well as research in the Government of Canada, as I make these points.
First, an aging focus helps us identify important pressures and policies. However, we and other countries have found that it adds little to the discussions of policy responses to those pressures.
Second, aging is not the most important change taking place in population characteristics. Why do we highlight it in such a fashion?
Third, unless one is careful, aging might unintentionally lead to ageist thinking, as opposed, for example, to a policy framed under a broader life-course agenda.
Fourth, there can be tension between a policy agenda centring on aging and an agenda centring around seniors. They are not the same thing.
Fifth, in other countries there is an increasing interest in demographic issues surrounding the effects of below- replacement fertility, not only in the age structure but in the size of the population. That has not happened here yet at the national level, although it is an issue at the sub-national level.
Margaret Gillis, Director, Division of Aging and Seniors, Public Health Agency of Canada, Centre for Healthy Human Development: The Public Health Agency of Canada is pleased to present its views to the Special Senate Committee on Aging. Created in 2004, the agency has a broad mandate to protect and promote the health of Canadians and to prevent disease.
Seniors and aging are broad horizontal issues and they are a fundamental part of the federal agenda. The agency works closely with its federal partners, many of whom are around the table here today. The agency work is focused on health promotion, the prevention of chronic diseases such as diabetes and cardiovascular diseases, and injury prevention and emergency preparedness. However, within the health portfolio, we collaborate on seniors' issues with colleagues in Health Canada and at the Institute of Aging at the Canadian Institutes of Health Research. Finally, we work in tandem with the provinces and territories, seniors' organizations, researchers, gerontologists and academics.
By now, you are no doubt well versed in the statistics. Of our total health care expenditures, 44 per cent are attributed to seniors — who are 13 per cent of the population. We will have more Canadians over age 65 than under age 15 in the next 10 years. Studies show that health promotion and disease prevention strategies can help those who are aging well, those with chronic conditions and those who are at risk for serious health problems even late in life. It follows, then, that investments in health promotion and disease prevention should also be a given.
The agency currently focuses its resources on four main areas: active aging, emergency preparedness, mental health and falls prevention. These four areas provide an umbrella under which a broad range of issues that affect seniors can be addressed. Let me give you a few examples of the work that we are undertaking currently.
First, in collaboration with the World Health Organization and other international and domestic partners, the agency is assisting and funding a global initiative to foster the development of age-friendly cities that promote active aging and focus on seniors. The World Health Organization will compile the results of this project into practical age- friendly cities guidelines that can be used worldwide. Thirty-four cities, including four Canadian cities — Portage la Prairie, Manitoba, Saanich, British Columbia, Sherbrooke, Quebec, and Halifax, Nova Scotia — are participating in this initiative.
We know that one-third of Canadian seniors live in rural areas. Building on our age-friendly cities project, we are collaborating with the provinces and territories to develop a parallel initiative that will explore the age-friendly city factors in small, rural and remote Canadian communities. That is being done with our colleagues at HRSDC through their role with the ministers responsible for seniors.
Recent disasters have shown us that seniors are a particularly vulnerable group in health emergencies and disaster situations. We all watched in horror during Hurricane Katrina, which showed reports that seniors had been left in their beds to drown in a care facility. We also know that 63 per cent of deaths from severe acute respiratory syndrome, SARS, in Canada were people over age 65.
The agency is providing leadership among domestic and international partners, such as the World Health Organization, the United States Administration on Aging, and the provinces and territories to determine the best approaches to ensure that older adults are considered in all aspects of planning, responding and recovering from emergencies. This work also takes advantage of the valuable wealth of experience of seniors themselves in terms of preparation, assistance and coping skills.
Recently, the division of aging and seniors at the Public Health Agency of Canada accepted an award from the Queen for our work on this file. Continuing this leadership, the agency will host an international workshop on emergency preparedness and seniors in Winnipeg in February 2007, with 100 world experts and seniors. This workshop is to develop a blueprint for action and to influence changes to emergency preparedness policy and practice to better integrate seniors' contributions and needs.
Seniors' mental health is often overlooked. Problems such as depression are often viewed as an inevitable part of aging. In fact, mental health problems in later life occur in the context of mental illness, disability and poor social support.
A project by the Canadian coalition on seniors' mental health, funded by the Public Health Agency of Canada, resulted in the development of the first-ever national guidelines on seniors' mental health. These guidelines address depression, suicide, delirium and the management of mental health issues in long-term care facilities. They are important in the assessment, diagnosis and treatment of seniors' mental health problems.
Similarly, Alzheimer's disease and related dementias represent a crucial health issue among seniors, their families and caregivers. We now have evidence that early intervention can delay progress of the disease. This year, the agency funded and hosted a national key stakeholders' workshop on Alzheimer's disease and related dementias. Strategic options identified at the workshop will assist in strengthening federal action to improve prevention and management of Alzheimer's disease and related dementias.
Finally, injuries resulting from falls can have a disastrous impact on the health and autonomy of seniors. Falls account for about 85 per cent of all injuries among seniors and they are the second leading cause of seniors' deaths, after motor vehicle collision injuries, for all the population.
Evidence shows that the causes and impacts of falls can be greatly reduced. In 2005, the agency produced the report on seniors' falls in Canada, which provides comprehensive data on falls, injuries and deaths, as well as evidence on risk factors and best practices for prevention. We also released publications aimed at seniors themselves to help them understand the causes of falls and to outline steps they can take to minimize falls at home.
In the new year, the agency will host a national forum to discuss seniors' falls surveillance data. Falls prevention practitioners, surveillance experts and researchers from across Canada will attend, and the outcomes intend to help design interventions to reduce falls. Because of our success with falls prevention, the World Health Organization is using our approach to conduct a similar project on a global scale.
The agency strives to assist seniors in maintaining and improving their health. We have a wealth of valuable information on many health-related issues that percolate down to researchers, the general public and seniors themselves. Thank you for inviting us to attend today and we wish you well with your work.
[Translation]
Leslie MacLean, Director General, Non-Insured Health Benefits, Health Canada, First Nations and Inuit Health Branch: Madam Chair, I would like to thank you for inviting me to appear before you this afternoon to talk about the important issues of aging and the health of First Nations and Inuit. I will first give you a brief outline of the Non- Insured Health Benefits Program; then, my colleague Shelagh Jane Woods will provide some facts about the Home Care Program.
[English]
I believe that you heard from other witnesses on the demographics of aging, so you are aware that there is a significant difference in the general age of the First Nations and Inuit population compared to that of the general Canadian population. We have brought along a couple of fact sheets that speak to some of the statistics you were looking for in your earlier deliberations such as mortality, disease prevalence and so forth. They are among your materials.
You are aware, of course, that the First Nations and Inuit population is young — almost half are under the age of 20, while under 6 per cent are over age 65. We have brought you a fact sheet on the Non-Insured Health Benefits, NIHB, Program that provides supplementary health benefits to eligible First Nations and Inuit in Canada of all ages, regardless of whether they live on- or off-reserve. It is the largest of all the federal health benefit programs with a budget this year of about $881 million. Key benefits delivered under the NIHB Program include pharmacy, dental services, vision care, mental health counselling and medical transportation to access health care services that are not available on-reserve or in the community where people live. The pharmacy benefit funds prescription drugs, some over- the-counter medications and medical supplies and equipment such as wheel chairs and hearing aids, which account for about 45 per cent of our program expenditures — about $385 million this year. The price of prescription drugs, in particular those for chronic diseases, is a key contributor to the costs of the program.
As you know, among First Nations and Inuit chronic disease is usually associated with older age. Diabetes, rheumatoid arthritis or cardiac conditions are more prevalent than they are in the general population and have an earlier onset. That point is particularly important. Even though almost half the population is currently under 20, there will be a dramatic increase in 30-plus-years' time of Aboriginal seniors.
Again, as you are aware, each additional person over the age of 65 increases program costs sharply. For example, in the area of drug expenditures, where we see that in the last years of life expenditures tend to be higher than at any other time, we spend an average of $2,000 per year on prescription drugs for each client over the age of 65. In comparison, the average for those under age 65 is about $600 per year. As a population ages, continuing to address issues such as value for money and client safety will be critical. For example, we cover acetaminophen, known familiarly as Tylenol, for all clients as a milder therapy to treat osteoarthritis, which is a common ailment in seniors. We have systems in place to warn pharmacists of harmful drug interactions, such as allergies or negative drug interactions. We also delist drugs. When there is a clinical indication that they are harmful to seniors or others we take them off the list of what we pay for.
As the population ages, it is important to ensure that we continue to respond to senior-specific health and safety issues. I will ask my colleague, Ms. Woods, to speak to the home care program.
[Translation]
Shelagh Jane Woods, Director General, Primary Health Care and Public Health Directorate, Health Canada, First Nations and Inuit Health Branch: The First Nations and Inuit Home and Community Care Program was created only seven years ago while provincial home care programs have been in place for over 30 years.
The FNIHCC program is intended for the most vulnerable segments of the First Nations, i.e. seniors, handicapped persons and those suffering from chronic illness.
[English]
Today, 95 per cent of First Nations and Inuit have access to basic home care services. Home nursing and personal care is delivered in a fully managed environment by home care nurses or licensed practical nurses and trained personal care workers, many of whom come from the communities. Last year, the program provided nearly 1 million hours of service to 26,000 clients, 50 per cent of whom were over the age of 65. As expected, the majority of services are for people with chronic disease, although over 11 per cent of services are provided to the frail elderly. We have found that while the care needs of First Nations and Inuit are similar to those of the general population, there is a higher percentage of people with high levels of need. Families and the informal care system are particularly important and enable the elderly and very ill to remain in their homes longer than would be expected. Some people, we have found recently in our research, care for up to five relatives each day. Thus, our system needs to support both the clients and their families.
The First Nations and Inuit Home and Community Care Program experiences similar pressures to those of the provincial and territorial home care programs: increasing complexity of care needs to respond to multiple conditions as the served population ages and, of course, an increasing desire for home-based palliative care. Health Canada works most particularly with Indian and Northern Affairs Canada and with First Nations and Inuit to more fully document continuing care needs and to develop approaches to meet these needs.
Havelin Anand, Director General, Social Policy and Programs Branch, Indian and Northern Affairs Canada: I am honoured and grateful for this opportunity to speak to you on behalf of Indian and Northern Affairs Canada. I will present you with an overview of INAC's Assisted Living Program, formerly known as the Adult Care Program. The ALP is meant to provide social support services to individuals of all ages, including seniors. The objective of the program is to provide non-medical social support services to First Nations people who have functional limitations because of age, health problems or disabilities, to help them maintain their independence, to maximize their level of functioning and to enable them to live in conditions of health and safety.
The ALP consists of three main components. First is in-home supportive care, which provides non-medical personal care such as meal preparation, light housekeeping, minor home maintenance and assistance with various daily living activities. In that way, people can live in their homes and communities as long as possible, maintaining a certain level of independence.
Second, institutional care provides non-medical care in designated facilities on- and off-reserve. People receiving these kinds of care require type-one and type-two levels of care. Clients in the type-one level of care category can walk and are mobile but they have certain decreased mental and physical faculties and require ongoing supervision and assistance with their daily living. Type-two levels have relatively stable chronic diseases or disabilities.
Third, foster care provides supervision and care in a family-like setting as an alternative to institutional care. The scope of services was expanded in 2003 to include services to children with special needs. Therefore, we changed the name of the program from adult care to assisted living to include children in the program. The program is based on the following two principles: INAC social support services on-reserve are provided as a matter of policy, and these services are delivered at standards that are reasonably comparable with programs and services offered by the reference province or territory in which the reserve is located. The program is available to all persons ordinarily resident on-reserve, who have been formally assessed as requiring assisted living services. Those under the age of 65 must also be eligible for income assistance support.
As for institutional care, the facilities must demonstrate that they operate according to the licensing accreditation requirements or guidelines of the relevant province or territory in which the reserve is located.
The annual allocation for this program is approximately $80 million and the services of the assisted living program are delivered in 614 First Nations communities. INAC also funds some 21 personal care homes and elders' lodges, which have approximately 600 beds. These personal care homes and elders' lodges are right across the country.
Approximately 8,978 First Nations individuals receive assisted living social support services. The drivers for this program, as you know, are demographic factors such as aging: First Nations populations are also aging like the rest of the Canadian population. Another important factor for consideration is the high incidence of chronic conditions and disabilities occurring at a much younger age than in the general population.
INAC, as my colleague Shelagh Jane Woods said, works closely with officials in Health Canada. We are co-funding a multi-stakeholder initiative for developing a national policy program and program framework for continuing care of which assisted living is an integral part.
The objective of this work in the policy and program framework is to develop a seamless approach to the delivery of care services currently delivered by Health Canada, INAC and in some instances, the province.
The joint working group includes Health Canada, INAC, the Assembly of First Nations and the Inuit Tapiriit Kanatami. The working group has been established for the purposes of developing a business case for this continuing care policy and program framework, and we hope this work will be completed some time in the year 2007.
Bryson Guptill, Director General, Program and Service Policy Division, Veterans Affairs Canada: Madam Chairman, it is a pleasure to be here today to speak to this committee on the programs that Veterans Affairs offers. I am tempted to say I am excited to talk to the honourable senators, but I guess it is in a different context.
The programs Veterans Affairs offers, as you know, apply largely to war service veterans. Approximately 1 million veterans served during World War II, and about 240,000 war service veterans are still living today. We provide comprehensive benefits to a significant number of these veterans, their survivors in many cases and associated veterans, for example, merchant navy veterans, Korean War veterans, and other groups.
In some ways, the department has been a pathfinder in terms of programs it offers to an aging population, in the sense that the average age of the population that we are dealing with in terms of war service veterans is about 82 years of age. The Korean War veterans average about 72 years of age. Therefore we have considerable experience in dealing with this older population.
We provide, as a department, comprehensive disability programs, primarily in the form of disability pensions. These pensions apply to conditions such as hearing loss, post-traumatic stress disorder and loss of limb, for example, in the case of the disabilities that have taken place not only during the wartime period, but disabilities that may have surfaced in the intervening period and can be linked to wartime service. The department spends about $2 billion a year on these disabilities pensions. The pensions are tax-free and payable monthly. The maximum amount payable is about $2,000 per month.
In addition, we provide war veterans allowance to low-income war service veterans. This program is similar to a provincial welfare program. It is income tested. Perhaps for the purpose of the committee though, the most interesting program that we provide along with the programs that my colleagues have talked to you about are fairly comprehensive health care programs that are available to war service veterans, but also veterans from current deployments such as Afghanistan. Some of you will be aware of some of the more extensive programs that we have put in place recently under what we call the New Veterans Charter.
Our health care programs are divided into three primary areas. There is a very comprehensive home care program that we call the Veterans Independence Program. It provides personal care, housekeeping and grounds maintenance to help veterans and their survivors remain healthy and in their own homes to the extent possible and for as long as possible. I will talk more about that program in a couple minutes.
We also provide extensive treatment benefits to veterans. The most significant program is the prescription drug program, which is comparable in many ways to programs provided elsewhere by my colleagues to their client groups.
We also provide an extensive long-term care program that provides care in community settings or care in what we call contract facilities. These are facilities where Veterans Affairs Canada pays the health care cost.
The total program expenditure in our three health care programs is something in the order of about $900 million a year, so it is close to the amount that my colleague Ms. MacLean spoke to in terms of the programs offered by Health Canada.
At the moment, we are undertaking an extensive and comprehensive health care review that was announced by this government when the government came into power. We have started this review and our minister has made announcements about it. We are working closely in the health care review with a group we call the Gerontological Advisory Council, which is composed of expert gerontologists from all parts of Canada, as well as representatives of veteran's organizations. These folks are helping us examine our health care programs from a perspective of can we do what we do in our health care program more effectively and can we provide benefits to a larger group? I am encouraged by some the early work that we are doing with the Gerontological Advisory Council and the veterans organizations.
One thing the Gerontological Advisory Council has recommended that we do, at a recent press conference at the National Press Gallery, is integrate all our health care programs — I mentioned we have three — into one so that we have a single point of entry and comprehensive client assessments, needs-based assessments that we now carry out. Also, they recommend that we have a needs-based approach rather than one based on entitlement. Our programs now are divided along the lines of what kind of veterans we deal with. The recommendation from the Gerontological Advisory Council has been that we look more comprehensively at the needs of our clients. I believe some interesting and exciting work is taking place in that area.
Veterans Affairs is obviously facing an aging population, and I have talked a little about that. A growing emphasis is on long-term care and there are opportunities for us to use interventions other than interventions in institutions. I mentioned the home care program as a specific case in point. It is significant that the Royal Canadian Legion has called upon us to expand, not only in the area of veterans but for all seniors, a seniors' independence program as a model for providing home care across the country.
In addition, we have provided significant programming through Seniors Canada On-line and Canadian Seniors Partnership network. Some of my colleagues who are not here today would be prepared and pleased to speak to your committee more about the specific things under the Seniors Canada On-line project.
Douglas Stewart, Vice-President, Policy Planning, Canada Mortgage and Housing Corporation: First, I want to thank the members of the Special Senate Committee on Aging for inviting us to appear here today. My presentation will focus on three things: the housing characteristic of seniors; the housing challenges we can expect as the population ages; and some of the CMHC programs that benefit seniors.
In 2001, there were a total of 2.4 million senior-led households in Canada: 93 per cent of these seniors lived in private households and 7 per cent lived in collective dwellings. Of senior-led households, 43 per cent lived alone with the majority being women, and those who lived alone were most likely to be renters. On the other hand, over two thirds of senior-led households own their own home, 85 per cent of these homeowners are mortgage free and 57 per cent of them live in single detached dwellings.
The great majority of seniors in Canada are well housed. This means their housing is adequate in condition, suitable in size to meet their needs and affordable. Affordable means it requires less than 30 per cent of their pre-tax household income.
On the other hand, in 2001, 17 per cent of senior households were in core-housing need and this need is a slight decrease from 18 per cent in 1996. Core-housing need means that 394,000 senior-led households lived in housing that was crowded, in poor condition or they paid more than 30 per cent of their income for housing and could not afford to meet their housing needs in their local housing market. Affordability was the main reason why Canadian senior households fell into core-housing need.
Our research tells us that the most pressing current housing issues facing seniors are housing affordability, the need for more housing options and the coordination of housing with services that support independent living.
We understand that most seniors want to age in their current homes and communities. Aging in their own homes may require modifications to the housing stock to better accommodate their changing needs as they age. In many parts of the country, it means a broader range of housing options at the community level for those who can no longer stay in their current homes. Finally, coordination of needed services is required in conjunction with housing to support seniors living independently in their homes.
Turning to some of the CMHC programs, CMHC mortgage loan insurance and securitization activities facilitate access to mortgage financing for all Canadians, regardless of where they live, at the lowest possible cost. CMHC is committed to providing mortgage loan insurance in every part of the country including small rural and northern communities. Mortgage loan insurance also includes rental, nursing homes and retirement housing. The private sector mortgage insurance providers either do not serve or are less active in these locations and housing types.
The Government of Canada, through CMHC, currently spends about $2 billion annually in support of housing programs for low- to moderate-income Canadians. We estimate that about one third of the 633,000 existing federally funded social housing units are occupied by low-income seniors. CMHC currently works with provinces and territories on the delivery of the $1 billion Affordable Housing Initiative. Most provinces use a portion of that funding for affordable rental housing for seniors, including supported housing.
The Residential Rehabilitation Assistance Program provides assistance to low income seniors to help them undertake repairs to ensure their dwelling meets basic health and safety standards. The program also modifies housing to meet the needs of persons with disabilities and supports the creation of affordable housing for low-income seniors and persons with disabilities, through the development of secondary suites.
CMHC also offers assistance to low-income seniors through the Home Adaptations for Seniors' Independence program, which pays for minor home adaptations to help seniors remain independent in their present homes.
As well, through Budget 2006, the federal government provided $1.4 billion to provinces and territories for affordable housing, northern housing and housing for Aboriginal people living off-reserve.
CMHC is actively involved in research and information transfer activities that address housing challenges for seniors, as well as the possible solutions. This service includes documenting seniors' housing conditions, exploring innovative housing options and providing information to help seniors live safely and independently in their homes and communities.
I brought a number of these publications with me today. I did not rehearse this but on top of the pile was a brochure that we have made available for seniors and the title is Preventing Falls on Stairs. I have also included in your kit a complete list of our publications and we would be happy to make any of those available to the senators if they would find them useful.
At CMHC, we are aware that aging of the Canadian population will be one of the most important challenges facing us over the next 25 years and I am sure that the Senate committee's work on this issue will be of great benefit.
Dan Danagher, Executive Director, Labour Relations and Compensation Operations, Treasury Board of Canada Secretariat: Thank you for the opportunity to speak to you today about the impact of an aging population on Canada's largest employer, the Government of Canada. Today I want to give you an overview of the roles and responsibilities of Treasury Board of Canada Secretariat and the Public Service Human Resources Management Agency of Canada. As well, I want to touch on the trends and areas where we are taking action in relation to aging as it pertains to our public service.
As the committee has many witnesses to hear, I will keep my remarks short. I will be happy to then answer any questions.
The Treasury Board of Canada Secretariat oversees government management performance and expenditure, and financial management. It also supports the Treasury Board, the employer for the core public administration and, in that capacity, manages compensation, pension, benefits and labour relations.
The core public administration is comprised of employees working in all departments listed in Schedules 1 and 4 of the Financial Administration Act, representing approximately 189,000 employees. The core public administration also forms a part of the larger federal public service, which includes employees working for separate employers. The federal public service represents about 250,000 employees in total. Broader yet — and I am sorry for these definitions but they are important — the federal public sector includes the federal public service, the Crown corporations, the Canadian Forces and RCMP personnel, representing about 468,000 employees in total. These distinctions among employee groups are important because, depending on their nature, the policies and authorities of the Treasury Board Secretariat apply, more or less, broadly across the categories of employees.
Because of this secretariat's function as a central agency responsible for the administration of the Public Service Pension Plan, we have compiled statistics of employees covered by the Public Service Superannuation Act, PSSA. These employees include employees of that core public administration I mentioned earlier, separate employers and some of the Crown corporations representing about 270,000 employees, or somewhat larger than the federal public service of which I spoke earlier.
My statement today will be based largely on the statistics and projections related to employees covered by the PSSA.
The Public Service Human Resources Management Agency of Canada is part of the Treasury Board portfolio, together with the Canada School of Public Service. The agency supports the Treasury Board by bringing together most human resource management functions including human resource planning, values and ethics and many others. The agency is also a key player in the renewal of the federal public service.
I understand the committee heard from Statistics Canada on November 27 and that some discussion was related to the impact of an aging population on the labour market, especially as it relates to a workforce made up from an increasing proportion of workers above the age of 55. The Treasury Board portfolio, in support of the Treasury Board as the employer of the core public administration, is keenly interested in the impacts of these anticipated changes. Not the least of these changes is that these demographics tend to result in occupational groups being more heavily populated at the maximum rates of pay in their range; this result is often a function of years of service, making it more expensive to sustain these groups. In the context of a tightening labour market, which we anticipate, the pressures in this regard are only heightened.
Nevertheless, while much work remains to be done, our analysis suggests that many existing policies and practices put the government in a good position to cope with the pressures of an aging population on Canada's labour market and, therefore, on the public service workforce. The recent age pattern of hiring of employees covered by the Public Service Superannuation Act indicates a shift in age profile of new full-time hires that reflects the changing age structure of the Canadian workforce itself. We currently engage new employees in the indeterminate workforce covered by the act across the entire range of age of Canadian workers.
The pattern of hiring at more advanced years that we have seen has reinforced the otherwise natural aging of the public service workforce that followed the rapid growth in the public service that took place from the late 1960s through the late 1970s. In fact, 1978 was the peak year of hiring in the public service. This means that the public service has itself aged both naturally and as a function of its recent hiring patterns.
For example, in 1982, 41 per cent of the public service was under the age of 35 and only 25 per cent were 50 years of age or over. In comparison, by 2005, 16 per cent of the public service was under the age of 35 — a full 25-per-cent drop — and 35 per cent were 50 years of age or over — a full 10-per-cent increase. By the year 2020, projections are that 40 per cent will be over the age of 50.
For various reasons — a more educated workforce that goes to school longer and joins the labour market later in life, or older, experienced workers joining the government later in their career and keen to provide for their retirement — the longer-term trend is leaning toward an increasing proportion of retirements at a later age. In fact, we project that by 2020, the number of public service employees retiring after the age of 65 will almost triple the current proportions.
The issue of phasing into retirement is becoming a more central human resources issue among Canadians employers. This is why we have already established a number of types of leave that enable variable work arrangements that allow for a better work-life balance for employees. These policies serve the purpose of encouraging a phased approach to retirement, and enable good succession planning and knowledge transfer. In addition, it is important to note that there is no generalized mandatory retirement age in the public service governed by the Public Service Superannuation Act.
On the subject of succession planning, despite public perceptions to the contrary, our projections and recent experience do not point to a baby boomer exit rush from the federal public service in the immediate future. In fact, based on current trends, we estimate that retirements will increase from present levels, but will do so in a gradual and orderly manner over the next 14 years. That is to say, a distinction should be made between employees getting older and employees retiring.
The aging of Canada's population will challenge our recruitment and retention abilities, much as it will for other employers across the country. For example, we anticipate an increasing pressure on wages as all employers in Canada compete for a reduced pool of workers. The federal government must therefore continue to develop innovative approaches beyond mere monetary compensation to anticipate and adapt to these pressures, and to attract and retain qualified workers to continue to meet the expectations of Canadians in terms of a quality public service.
In summary, areas of concentration for labour relations and collective bargaining are in themselves a reflection of the demographics of our workforce. The terms and conditions of public service employment, including pay, reflect the issues to recruit and retain the types of employees we need to accomplish the various missions and mandates of our departments and agencies. As such, we must continue to establish these terms and conditions to anticipate and adapt to the constantly evolving pressures and demands that a changing and aging workforce presents.
The Chairman: Thank you very much for those comments and thank you to all of you who were good on timing. I appreciate that. More importantly, I think it was a good thing to bring you all around the table so you could listen to one another.
Senator Mercer: I echo the chair's last comments. It is probably a good idea to have you all here so you can hear what everyone else is doing.
Mr. Hicks, you mentioned the decline of the number of seniors that were below the poverty line; between 1980 and 2004, they went from 21 per cent down to 5.6 per cent. How did you measure that?
I am on the Standing Senate Committee on Agriculture and Forestry, which is studying rural poverty. Our biggest problem is to define what poverty is and where that poverty line is. Can you tell me that?
Also, in that 5.6 per cent of seniors who are below that line, how many people does that actually represent?
Mr. Hicks: I wish you had not asked me a mathematical question. I will get back to you on multiplying that. It is simply the population; I will come back to you with a precise answer. It is 1.5 million, I am being whispered to; someone has a calculator up there. I will still verify that number in question.
How do we measure? First, use any measure and we will wind up with roughly the same picture. The measure I am particularly talking about is the Statistics Canada low income cut-off, LICO, number; but we can use any number of lines and they all show roughly that same basic decline in low income or poverty between those two years. It went from a high figure, indeed, to a low figure.
However, the technical answer is that a Statistics Canada low income cut-off line was used, which means they needed to use an abnormally high percentage of their income to look after the basic supports for food and housing. That is basically the concept.
Senator Mercer: One problem I have discovered in working with Statistics Canada on my other committee duties is that the LICO criteria is not always accurate because those numbers are ones that people report themselves. There is a tendency not to report accurately to government necessarily. If we use tax numbers, some numbers show people with no income. A person having no income and still surviving does not make sense; some money must be coming in somewhere. Therefore, I am cautious when we review that: we should think about how that measurement is made.
Ms. Gillis, I am interested in your comment on age-friendly cities. I am also interested that my home town of Halifax is on your list. My 87-year-old mother would be mad at me if I did not ask the question. What is an age- friendly city? In a city of a lot of hills, such as Halifax, I cannot imagine it being age-friendly.
Ms. Gillis: You will be happy to know the first part of the project, which we are undertaking now, is asking seniors themselves what they consider an age-friendly city, based on a series of nine questions formulated by the World Health Organization. Each city involved is pulling together a team of seniors, hopefully following various income and gender- specific rules, to ask them exactly what age-friendly is. We will have those answers, probably around January, and then we will work on pulling together what we found across the globe.
Senator Mercer: That would be interesting for us to pursue and maybe to look at the questionnaire together so that we can have an idea of what you are asking.
Ms. Gillis: Absolutely; if you want to go to one of the meetings, feel free. We can set that up.
Senator Mercer: We will not finish our study by January, so as you do your statistics, we would love to hear what the seniors say.
Ms. Gillis: Sure.
Senator Mercer: I have one more question for Mr. Stewart. I should preface it by saying at one time I was the executive assistant to the Minister of Housing in Nova Scotia in the 1970s when we were building seniors' complexes across the country. I want to talk about the buildings I helped make the decision to build. I realize it is a joint operation, but does CMHC pay attention to, or provide funding to the provinces and the municipalities for, the infrastructure and maintenance of these important buildings? I refer to Nova Scotia where we have a large number of these complexes. They are extremely important to continuing communities.
I live in a small village outside Halifax now, and there is a small seniors' complex there. Those people would not live in our community if that complex were not there. They would be someplace else. Our community would deteriorate because they would be away from their families.
As a government, do we pay any attention to the infrastructure and maintenance of these facilities?
Mr. Stewart: The answer is yes. At the present time, CMHC pays about $2 billion a year in support of the existing housing stock. Most of that money is transferred to provinces for the administration of existing public and social housing units.
I am not sure what the percentage is for the province of Nova Scotia, but a significant amount of housing in the province continues to be supported by subsidy payments from the federal government.
Senator Mercer: Is $2 billion doing the job? Are we maintaining the buildings in a reasonable form? I visited a number of these buildings during election campaigns and some of them are not in as good repair as others.
Mr. Stewart: When we transferred the responsibility for the administration of the social housing stock to the provinces, we also transferred the federal dollars that go along with it.
In most provinces, we have found that since that time, because interest rates have dropped and mortgage payments have also fallen, provinces have had more than enough money to maintain the stock.
In fact, some provinces have used those savings to increase the stock of affordable housing.
Senator Mercer: Mr. Stewart, this information may be in the package you have given us, but I would be interested to see a graph on CMHC's participation in the construction of social housing over the last 30 years.
We have been in and out of the business, and some people will be anxious for us to get back in the business.
I know something else we need to look at. When the government transfers responsibility down to the next level of government, it is not necessarily picked up by the next level of government with the same level of enthusiasm there may have been at the federal government level.
Mr. Stewart: The major supply program for affordable housing currently is the $1 billion of federal contributions, the Affordable Housing Initiative.
We are about two-thirds of our way through that $1 billion. I believe we have produced about 30,000 additional affordable housing units.
That money has been transferred to provinces. In the case of the Affordable Housing Initiative, it is in support of provincially designed programs.
Senator Cordy: Thank you to each of you. You have given us a lot of information today.
I want to go back to a comment the chair made, that it was wonderful to hear your comments. It was also wonderful for all of you to hear one another.
I wonder how much opportunity there is for various government departments to sit down and find out what is going on within other government departments.
For legislation or polices relating to seniors, or inclusive of seniors, is there a mechanism in place where various government departments get together and discuss how the legislation will affect seniors?
Mr. Hicks: The answer is yes, there is an interdepartmental committee. One of its current main tasks is to look at the Madrid summit and prepare responses for that.
This development is not new. It has gone under various names and headings for many years. Over the years, it would typically meet three to four times a year for a regular information-sharing session. There would be a more intensive session when a particular topic came up.
There is also coordination with respect to the federal departments and the provincial governments. There is also an ongoing federal-provincial-territorial meeting with a regular sharing of information between the two orders of government, including a series of federal departments working together with a series of provincial departments.
As you correctly identify, the responsibility is widely diffused. I am sure we could do better, but we have tried to pay a fair amount of attention to this area over the years.
Senator Cordy: I am wondering about communication within departments. You said a routine is established.
Prime Minister Chrétien had a task force on seniors. One recommendation was that there should be a federal minister responsible for seniors.
Would that be conducive to more knowledge-sharing between departments?
Mr. Hicks: Our minister has been designated as such.
In the former government, a special minister was named. Currently, the responsibility resides with our minister.
There has been an interesting experience worldwide on that subject that you might wish to explore. It has not always worked well in some countries. In other countries, it has worked particularly well. It matters a lot what the mandate is.
Senator Cordy: We heard today of wonderful programs available for seniors. Some of you made mention of wonderful documents that you have with information relating to seniors.
How do you communicate to seniors? Not all seniors are computer-savvy or have access to computers. Direct deposit has meant less mail going to seniors than there used to be. Mr. Hicks, you spoke about the isolation of seniors.
One recommendation this task force made under Mr. Chrétien was to revive the New Horizons for Seniors program. You rightly said that recommendation was acted upon, and that would help reduce isolation for seniors.
These are problems. How do you make sure that seniors are available?
We heard stories about seniors in Nova Scotia not taking advantage of financial programs that are available to them. I am sure that problem goes across the nation.
How do you ensure that seniors receive the available information and programs that we have heard about today?
Mr. Hicks: I suppose every department will want to say a quick word on that subject.
I do not want to suggest that it is finished yet, but we will look to friendlier websites with respect to seniors. That is not the whole answer, because a number of seniors are not current with web technology.
If I might be so bold, you may wish to invite our colleagues from Service Canada to address that issue. They have a wealth of experience on reaching different people in the community. They have a rich base of experience that you may want to probe.
We have outreach programs associated with our various programs. Our CPP/OAS has a rich outreach program. We work hard to address the issues. You say that we have been successful in recent years in that kind of outreach with respect to our particular programs. I am looking for confirming nods. If I understand you correctly, you are thinking perhaps less about program-by-program than about the broader set of issues relating to seniors. I do not know whether my colleagues would care to comment.
Ms. Gillis: We do that in a number of ways. All of us around the table admit that is sometimes a challenge, in particular with respect to more isolated seniors. They are the folks that we want to reach. We liaise with a number of seniors organizations, including the Congress of National Seniors Organizations. We are funding them to come together next week. The minister's National Advisory Council on Aging does a fair amount of outreach. We use Service Canada portals, and we have an extensive mail-out list whereby we try to target various seniors' organizations, medical centres and seniors' centres for our documents.
Senator Cordy: Mr. Guptill, I am interested in your comments on members of the Royal Canadian Legion who suggested that the Veterans Independence Program should be the model for seniors' home care. I was the sponsor of the veterans independence bill when it came to the Senate and I assure you, it is always wonderful to sponsor a bill for veterans because everyone is unanimous in supporting it. How far has this gone? It is a wonderful model. At the outset the Veterans Independence Program was not necessarily for the long term but it was so successful in allowing veterans to stay in their homes that it seems like a great model for the senior population as a whole. Has it gone beyond only members of the Royal Canadian Legion speaking about it with you? Are you pursuing such a program with other government departments?
Mr. Guptill: As you know, there has been a great deal of interest expressed by members of the Royal Canadian Legion to extend this program as a broader-based government program. The government recently expanded the Veterans Independence Program in three different tranches to have more survivors eligible for programming under the VIP, which was started in 1981 and was called the Aging Veterans Program. It was expanded over the years to include many veterans. We provide assistance to a total number of 90,000. That number of clients is significant.
Interestingly, the program was initially put in place as a way of dealing with increasing costs, although I am not sure it was advertised that way. After World War II and as the World War II veterans turned 60 and older, a significant number of World War I veterans were in nursing homes, and there was pressure to have many of these World War II veterans in nursing homes. The thinking at the time was that if these veterans were able to age in place, in their own homes, there would not be a need for expanding the stock of nursing homes across the country. That has probably been the greatest success enjoyed by the Veterans Independence Program. The major program provided has been groundskeeping and housekeeping. A great deal of pressure has been placed on the government to expand that program to more survivors. That expansion is under active consideration as we conduct this health care review.
I am excited by some of the work in the health care review. Some recommendations of the Gerontological Advisory Council state that some elements of the program could benefit Canadian society in general. In particular, a needs- based analysis provides outreach for not only home care but also other components of the VIP available to people on the basis of need. Some researchers that work with us on the advisory counsel recommend sophisticated needs assessments that take into consideration what is referred to as the social determinants of health. Therefore, the work involves not only health care status but also income levels, seniors' activities and interaction in their respective communities. These factors are part of the determinants of how well someone functions in society. We are working on these factors. There is not an initiative per se but much interest has been expressed by the Royal Canadian Legion and its resolutions to expand the program to other parts of Canadian society.
Senator Keon: Mr. Guptill, in my life as a doctor and administrator, it was apparent to me that the Veterans Affairs Canada social safety network was better by far than the standard social safety network in Canada. There is no question about that. When veterans became ill, a whole series of actions kicked in to take care of them that were much better than the normal population received. Heaven knows they deserve it. No one ever questioned whether this treatment was fair because it was felt that it was well deserved.
The point raised by Senator Cordy is that we could learn so much from this. To your knowledge, did anyone ever conduct a comparative analysis of what is available for veterans as opposed to what is available for the standard Canadian citizen of the same age? Does any document anywhere show that? I suspect that information is not available.
Mr. Guptill: I am not aware of any specific document that addresses that point. A significant amount of research is going on. We are doing some collaborative work right now with a researcher on the west coast, Marcus Hollander. This research takes a look at some of the programs offered by Veterans Affairs Canada and compares them to programs available to the Canadian population in various cities and community settings. With this information VAC can determine whether some general benefits might be available. For example, one comparison might be assisted housing versus keeping people in their homes longer. Another comparison might be the costs of community health-care settings versus the costs of some of our contract long-term care facilities.
A significant amount of work is happening in this area. I am confident that this study will have results in the spring. I am sure that many researchers, not only in our Gerontological Advisory Council but elsewhere in Canada will be interested in the results of this comprehensive work undertaken internally by our own research group, in collaboration with Marcus Hollander.
Senator Keon: Can you provide the committee with some references that we can pursue?
Mr. Guptill: Absolutely.
Senator Keon: This model is a superb one for us to look at. There are many good things there for us to consider.
Mr. Guptill: We will follow up with the chair of the committee on that issue.
Senator Keon: Coming to First Nations and Inuit health, I raise the following issue with both of you. Life expectancy of First Nations and Inuit people is lower than for the rest of the country. Hopefully, a number of initiatives underway will rapidly correct that. I hope over the next decade we will see a significant improvement in overall health status of both Inuit and First Nations people. My comment is purely anecdotal but should be considered because I suspect that your projections for the care of seniors and these populations is probably off base. You would not be projecting the life expectancy that we should see in these populations. That is my impression. I know of no scientific evidence to back that up. However, I cannot see it not happening, frankly. Have you anything underway to look at this, or have you flexibility in your system that would allow you to look at this?
Ms. Woods: I will get you some statistics. The change in life expectancy is going in a positive direction, and it has been for some time. When you look at certain specific diseases, you can see dramatic improvements over time. The one I am most familiar with is the rate of tuberculosis. While it is always frightening and still appalling that serious outbreaks occur, the rate has declined, first, precipitously, and then, steadily over the last 25 years. We try to take that into account. In a way, we are cautious and preparing for worst-case scenarios. We make adjustments as often as we can. We do not stick stubbornly to what we knew five years ago. We try to adjust our forecasts on an annual basis.
Senator Keon: In addition to the interventions that would be possible in dealing with chronic disease in these populations, and hopefully chronic disease can be dealt with expeditiously because it is much simpler than some of the other problems, chronic disease accounts for only about 25 per cent of the overall health status of these populations. I hope there are major initiatives into the social determinants of health, the other 12, so to speak — housing, water, food and environment. Social determinants will have a much bigger impact than the interventions that would occur for chronic diseases, even though chronic diseases will get more attention.
How do you factor these things into your equations when you try to deal with what I think will be an escalating curve in life expectancy, compared to the Canadian population?
Ms. Woods: Sitting beside me is Ms. Anand from Indian Affairs. We try to collaborate not only with Ms. Anand's part of the department but other parts of the department. For example, we are trying to adopt what we call a healthy housing approach, and that brings in our colleagues at CMHC. We are aware that the really big wins will come to us from looking at the overall conditions or, to put it in a more negative way, we cannot throw money at each specific disease if we do not also look at the general environment. For example, we work closely on issues of drinking water safety, air quality and housing and that sort of thing. We spend more and more time working collaboratively. I think we are now at the point where we speak the same language. We are taking that approach.
Senator Murray: On the same topic, is there a short answer to the question why the incidence of tuberculosis among registered Indians is 34.5 per 100,000 population, and among Inuit, 82.1 per 100,000 population, compared to 5.5 in the Canadian population as a whole?
Ms. Woods: At the risk of being flippant, there is no short answer. It would be useful to have some of the longer- term statistics so you can see that the incidence is going in the right direction.
Senator Murray: Good Lord, if it is going in the right direction, I hate to think what it was 10 years ago.
Ms. Woods: It was shockingly high 25 years ago.
Senator Murray: I think 82.1 per 100,000 compared to 5.5 in Canada is still shockingly high.
Ms. Woods: It is terrible, and it is one area where we are trying to collaborate more, as are the two territories where most of the Inuit reside. The medical officers of health spend a lot of time talking together. We are trying to work in a more coordinated way. It comes back to some of the things that Senator Keon mentioned. Much of it is housing quality. Overcrowding is the absolutely ideal condition for spreading tuberculosis. While we have a good program of contact-tracing, directly observed therapy and that sort of thing, we never get ahead of the curve in the communities where housing shortages are critical. If 10 people or more are living in a small house and someone has tuberculosis, everybody will be exposed. We are mindful of that. No one is complacent, and nobody is saying, ``Look at what a great job we have done,'' because the job is nowhere near finished.
Senator Murray: Mr. Guptill, the Veterans Independence Program is not income-tested, is it?
Mr. Guptill: No, it is not.
Senator Murray: You said that some 90,000 veterans and survivors benefit from it. What do they need to do to be eligible for it?
Mr. Guptill: For a veteran to be eligible, like many of the programs that Veterans Affairs Canada offers, essentially the program has two entry points. For war service veterans, the entry points have been whether these individuals have suffered a disability at some time.
Senator Murray: In service?
Mr. Guptill: In service, although our definition of when the service disability took place for 82-year-old veterans has an ability to reach back and say, ``Your disability today is linked to your service in World War II.'' There is a service connection first of all. If the service connection prevents a veteran from carrying out any activities of independent living, activities of daily living, then the veteran is eligible for the Veterans' Independence program. The second gateway is low income. If the veteran is low income, the veteran is also eligible for the VIP program.
Senator Murray: Is the overseas service a requisite?
Mr. Guptill: Not necessarily overseas service. If they served in Canada, Canada service veterans are also eligible if they have suffered a disability as a result of service.
Senator Murray: In war time?
Mr. Guptill: That is right.
Senator Murray: Somewhere in the documentation you left with us are references to the traditional definition of ``veterans.'' You talked there about war-time service. What about people who served in the Canadian armed forces in peacekeeping missions and that sort of thing? Are they considered veterans?
Mr. Guptill: They are considered veterans as well under our umbrella definition of a veteran although, as I mentioned, our eligibility criteria are complex. Not all Canadian Forces veterans would have the same eligibility as war service veterans for some of our benefits, and VIP is one of those areas. Although Canadian Forces veterans have access to health care, they might not have access to exactly the same health care benefits as war service veterans. We are trying to deal with this issue in terms of our review of our health care program. Access is somewhat complex, and some would say overly complex, so one thing that the government has asked us to do is address this complexity issue. As I mentioned, the Gerontological Advisory Council has suggested that we simplify the eligibility significantly.
Senator Murray: Are all former members of the Canadian armed forces considered veterans under the umbrella definition?
Mr. Guptill: Yes, if they have met their basic training requirements so, yes, all members are now considered to be veterans once they leave the service.
Senator Murray: They are not all eligible for the same programs.
Mr. Guptill: That is right. We are in the process of reviewing that eligibility because a more comprehensive approach is needed. As I mentioned, the recommendation is that the approach be based on need, as opposed to this complex entitlement based largely on service.
Senator Murray: Does Veterans Affairs Canada make a distinction between someone who served on the Golan Heights as a peacekeeper, for example, and people who now serve in Afghanistan, those in action being fired upon and firing?
Mr. Guptill: We do not make a distinction in that way. For example, Afghanistan and Bosnia are considered special duty areas. A special duty area — or special duty operations, as we call it in our legislation — is comparable to war service. People who have served in these types of deployments, of which there have been a rapidly increasing number since 1990, are all treated essentially the same way, as war service veterans.
Senator Murray: Is the clientele of the department of Veterans Affairs Canada shrinking as Second World War veterans die off, or is it growing?
Mr. Guptill: It has been growing, surprisingly. We have some difficulty communicating this growth, but it is growing because of two factors. One is that not all war service veterans are our clients. They do not become a client of Veterans Affairs Canada unless they have a war service disability or low income.
About 250,000 war service veterans are still in the Canadian population, but not all those veterans are currently clients of Veterans Affairs Canada. They come to us as they develop disabilities. As a result, as they become older, more and more of them are Veterans Affairs clients.
Senator Murray: Do you have a register of all these people — does the Department of National Defence or someone?
Mr. Guptill: Yes, we keep full service records on them all.
Senator Murray: Veterans Affairs Canada does?
Mr. Guptill: Yes, DND and Veterans Affairs does. If they are clients of ours, we have the records; if they are not clients yet, DND has the records.
Senator Murray: I see; but you do not have the records if they are not clients.
Mr. Guptill: Right.
Senator Murray: Mr. Hicks, the New Horizons for Seniors program has been around a long time, has not it?
There is a cap of $25,000 per project to community groups. Are those community groups always groups of senior citizens or can a Kiwanis Club that is doing something for senior citizens apply?
Mr. Hicks: My understanding is they are seniors, is that correct?
John M. Connolly, Acting Director General, Partnerships Division, Community Development and Partnerships Directorate, Human Resources and Social Development Canada: In most cases, the projects are senior-led. You are right, to follow up: The program started initially in 1972 and it was phased out in 1997. It came back in 2004, and the ceiling is $25,000 per project. One criterion is that the projects are led by seniors. At times, there may be a coalition of groups in a community.
Senator Murray: I have not seen it lately, but they used to put out a press release every month or two, indicating all the projects and all the communities across the country that were funded through this New Horizons for Seniors. What is the total budget?
Mr. Connolly: The budget has increased since it came back in 2004. It was, to be precise, for the grants portion of it —
Senator Murray: Ballpark.
Mr. Connolly: In 2004-05, it was $5 million; in 2005-06, the grants portion was $11.7 million; in 2006-07, it was $15.6 million; and next year, it will be $19.5 million. Then it will continue at the same level thereafter; that is the grants portion.
Senator Murray: Typically, how does a community organization apply? To whom do they apply?
Mr. Connolly: We put up a call on an annual basis, and priorities are set in each province or territory. The application goes up, as it did this year, for example —
Senator Murray: What priorities?
Mr. Connolly: There are review committees in each province and territory.
Senator Murray: Are they set up by the government, by your department?
Mr. Connolly: We established them, but they are made up of individuals from the communities. For example, they may be seniors, people with a government or a variety of individuals. They establish the priorities. For example, in a particular province or territory, a priority might be intergenerational or it might be Aboriginal. The committee would say they are looking for projects of a specific nature. That does not exclude other projects, but the committee establishes priorities.
The call goes up. It is a two-month call, as it was this year, from mid-May to mid-July. Then people apply; either they can download the application from the Internet or they can get it from Service Canada's offices. They fill in the application forms and submit them. Then, an assessment process takes place.
Senator Murray: An assessment process takes place where the regional or provincial committee reviews the application, and then what? Does the committee make a recommendation to someone in Ottawa?
Mr. Connolly: Yes, the application comes in and the committee reviews it to see if it meets the basic eligibility criteria. For example, the project could be over $25,000, or they could be looking for too much capital costs. If the project meets the basic criteria, then the review committees review those projects and make recommendations.
Senator Murray: I do not know how to ask this, but do you simply rubber stamp the recommendations that are made by the regional committees?
Mr. Connolly: The review committees make the recommendations and then, based on the recommendations, an approval takes place here in Ottawa, yes. However, there is not a rubber stamp per se.
Senator Murray: Between 1997 and 2004, was the program greatly missed? Why did they reinstate it? Why did they cancel it and then reinstate it, or do you know?
Mr. Connolly: I would have to base the answer on recollection in 1997. I think it may have had something to do with program review at the time. In 2004, the principal interest was a growing attention on seniors. The New Horizons for Seniors program focuses on contribution and participation, using seniors' skills and knowledge. There was particular interest in it. That is why when I read out the budget figures from 2005, the budget increased the amount available because of the interest in the program.
Senator Murray: I remember the criteria that were put forward at the time of program review, one of which was, is this program a worthwhile government program? Then, is this program one that the federal government should carry out, as distinct from provincial government? I presume, in 1997, it probably failed on the latter count — the program was not something that the federal government ought to be in but rather one for provincial governments.
I have always been sceptical about the program, because I really wondered why the federal government would do this and what gap it was filling in the activities of provincial governments and various voluntary organizations. That question is probably a policy or political one that you would rather not get into. Please do, if you would like to.
The Chairman: I think we should let him off the hook, Senator Murray. Before I turn to Senator Chaput, we have not heard from two witnesses and I would like to hear from them.
First, with respect to CMHC, are any initiatives going forward with respect to building standards that might address the issue of an aging society — for example, broader doors and door openings in new stock housing to address the needs of walkers, wheelchairs and that type of thing?
Mr. Stewart: Certainly, senator: The National Building Code has accessibility standards, so to the extent that the National Building Code is adopted by provincial agencies as their building code, or is adapted to meet their needs, a certain level of accessibility will apply. Also, CMHC has developed a concept over the years that we call Flex Housing. The idea is that the design and construction of the house will allow that house to grow with its occupants. As the family grows, the number of rooms in the house can expand with the family; as the kids leave, those rooms can contract. Also, if they are careful about how they design hallways and doorways and the positioning of bathrooms, as the family ages they can accommodate varying degrees of disability.
We have publicized this concept and we are currently in the process of trying to make it more broadly known to the building industry. Our estimates suggest that the costs of allowing this degree of flexibility at the outset are far lower than modifying a house that did not incorporate those design features at the outset.
The Chairman: Mr. Danagher, you made an interesting statement and I would like you to elaborate.
In your testimony you used the phrase, I think, the public service is getting older — and we cannot necessarily correlate aging with retirement. Can you elaborate on what you were talking about there?
Mr. Danagher: The point we are making is that there is a difference between an aging workforce and retirement. Our workforce is aging. We all are: it is better than the alternative. Many of us have had 10, 15 or 20 years of experience. We lose people at a rate of approximately 6 per cent a year, and I would say the bulk of those losses, 80-some per cent, is through retirement. We are losing people at a low rate so it should not be surprising to many that if we have 85 per cent or 90 per cent of the people we had last year, they are a year older today. The population of the public service is aging and they tend to stay. They also tend not to retire at earliest eligibility. Our statistics illustrate that they tend to retire a few years after first eligibility. We are dealing with a population that is aging and its retirement is not increasing at an outlandish rate. We hear terms such as ``a tsunami of retirements'' and we are not seeing that.
It is a subtle distinction, perhaps, but it is an important one. We are dealing with a population that is aging and not necessarily leaving.
[Translation]
Senator Chaput: My question concerns access to information. You currently provide information by letter, by e-mail or perhaps through what is called Service Canada, which also uses hardcopy and electronic documents. The National Advisory Council on Aging noted in its 2006 report that over 100,000 seniors eligible for Guaranteed Income Supplement had not received the information. This is for the year 2003. I must therefore conclude that the information sometimes does not reach its target.
When you prepare written information, do you ensure that the text is in a simple style that can be easily understood by everyone? Because we all know that seniors often have trouble understanding what they read or they may not understand either English or French if neither of these is their first language. We also know that many seniors do not use the computer. Have you therefore thought of other means to reach these people and, if so, what are they?
[English]
Mr. Hicks: A representative from Service Canada is now joining me and perhaps can give a first stab at the answer to that question.
John Rath-Wilson, Director General, Operations and Processing, Service Canada: The question you raise is a good one. We have taken steps in the last year or two to increase the number of communications with seniors regarding a Guaranteed Income Supplement. We now notify them three times — seniors we can identify — beginning in March with the return of their T-4 slip, that they must apply for the benefit. There are subsequent communications in April and June. Finally, in July, if we cannot identify whether they have applied, we notify them they will be cut off at that point. We have taken steps to increase the number of times we try to communicate with seniors. In terms of the communication themselves, I believe that the letters are written in an easy-to-understand and clear manner.
Senator Chaput: Have you ever thought of, or are you, using the radio or the television? It seems that most seniors, whether alone or not, listen to the radio or television. Are you using those also?
Mr. Rath-Wilson: That question is a good one. I cannot tell you the answer, but I would be happy to get back to you with it.
The Chairman: I recently had a sixty-fourth birthday and, as a result, I received some communication with respect to pensions. I knew that I could not collect old age pension because I am obviously clearly employed and earning well above the cut-off point, but I could not tell from the application or the information whether I needed to apply for it or not. I think I am a relatively intelligent person, but I could not figure that out. I also wanted to inform the government that I did not want to collect CPP until I was 70. Again, I could not figure out from the forms whether I was supposed to apply for it or not apply for it.
I applied for it and a lovely woman responded to me — I suspect partly because I am a senator — and said, you cannot apply for this pension until you are 69. I said, but that was the whole point. I knew I did not want to apply for it until I was 69, so that I could collect it on my seventieth birthday because I cannot delay beyond that, but I could not tell from the application. If I cannot understand them, I suspect I am not alone.
Mr. Rath-Wilson: We are always striving to improve the clarity of our communications. It is under constant review and we will be glad to take that comment back for further review.
Marla Israel, Director, International Policy and Agreements, Seniors and Pensions Policy Secretariat, Human Resources and Social Development Canada: To clarify, seniors are able to apply — I did not want to leave with anything but the right information — for Canada Pension Plan as early as age 60 if they so choose. Mostly people apply for it at 65, and some delay until age 70, so I would love to know more information, in terms of what you received though, because that is important to us. We want to ensure that seniors are aware of all the benefits to which they may be entitled. Some people go to great lengths, as you said, senator, to inform people as best they can. Certainly, outreach efforts, which Mr. Hicks spoke to, will continue. An entire group of people are devoted to reaching out to vulnerable communities such as Aboriginal peoples, people with low income and immigrant communities. Much information is transmitted through community organizations, and it is important that we work closely with them.
Bill C-36 has received first reading. The bill proposes to facilitate the application process for the Guaranteed Income Supplement even further. By proposing that, people apply only once, and the application remains effective for the rest of their lives. People no longer need to deal with the frustration of some seniors who qualify one year but because of income, might drop off qualification and need to reapply should they become eligible again. Bill C-36 proposes that if they become eligible again, they do not need to reapply. That change would greatly facility the entire application process for the Guaranteed Income Supplement.
Senator Cordy: If you do not hear from a senior after three contact efforts, in respect of receiving the Guaranteed Income Supplement, and the last letter states that they will not receive the GIS, have you thought that perhaps writing the letter is not an effective way to communicate to them and you should try another way?
Ms. Israel: I would need to learn more about not hearing from that group of seniors. There are times when seniors know that they are not entitled to the Guaranteed Income Supplement and, therefore, do not respond. I would need to find out more in terms of how we are reaching out to them and what kind of response we might receive. Sometimes we need to analyze why a senior might not respond because it could be for a variety of reasons.
Senator Cordy: I think of things such as language or lack of literacy skills as possible reasons but perhaps that is the teacher in me speaking. I said earlier that writing letters might not always be the most effective way to reach people and to communicate with them.
Ms. Israel: The key is to reach out continuously because these benefits are for life. I am taking note of what you are saying in terms of how seniors access their information. It is often through word of mouth and at times through radio and television, as you noted. It is important that we look at those population centres that have difficulties. That is why I was talking about outreach to the immigrant communities of our country. We need to work closely with the Italian, Greek and Southeast Asian communities, to name but a few, which are well established. We also want to reach out to those that are not as well established, and we are taking note of that need as well.
The Chairman: I have a number of questions for officials from Health Canada and Indian and Northern Affairs Canada.
Two years ago, I made a number of trips to Aboriginal communities in Northern Manitoba. I was particularly interested in the health facilities, nursing stations, hospitals et cetera, located there. I was shocked at the conditions. I went into a basement in Oxford House where all the drugs were stored, and I saw mould all over the walls and the ceiling. It was depressing. The drugs were in sealed boxes and I suspect the mould could not reach the drugs but it was discouraging.
I saw deeply rusted autoclaves. I discussed with people fights over warming blankets, whereby one community received one from Health Canada only to be told two months later that they must return it because they were not eligible. I discussed another situation of a group of lab techs who came to me to say that they spent $50,000 per year to send members of their community to Winnipeg for a specific kind of test for diabetes. They said the test could be done in the community because they had the training and expertise but they lacked a $5,000 machine.
That situation does not make much sense to me. What kind of resolution is happening in your two branches with respect to dealing with such issues of basic lack of supplies and equipment? These supplies and equipment could enable Aboriginal peoples to have the same quality of health care in their communities as those of us not in those communities absolutely take for granted?
Ms. MacLean: I will speak to the issue of access to supplies and equipment in communities. As I pointed out, the Non-Insured Health Benefits Program funds transportation for services that are not available on-reserve or in a community of residents. Your point is a key one. The more we can bring health professionals to the community or to the reserve, or make the necessary supplies and equipment available, the more people can access service for the same amount of money, and better access to care is there for all.
I would be happy to follow up with you off line and get the name of the community. Our regional offices work closely with communities on exactly the idea of bringing travelling nutritionists, dental professionals or others into the community. It is an important way to make more health available to more people for the same amount of money. In respect of the issue around the storage of drugs, I might pass that to Ms. Woods. First, I would say that we have been working on the issue of transportation cost in a partner support with the Assembly of First Nations to try to have best ideas from communities as well so that we can address some of those critical needs and gain better access to care where people live.
Ms. Woods: The First Nations and Inuit Health Branch recognized about two years ago the difficulties in terms of storage, in particular, of controlled substances but of anything that falls under pharmaceuticals, such as prescriptions. In small nursing stations of larger health centres, we have introduced pharmacy standards on-reserve. Relatively speaking, this is a small part of the business because the big part of the prescription drug business is through the Non- Insured Health Benefits Program, which does not follow the same trail. Nonetheless, communities have important supplies of controlled substances in prescription drugs. We are now seeing a gradual reaching of the goals of the pharmacy standards. The goals include such things as ensuring that pharmaceuticals are kept under lock and key with the appropriate controls, in an appropriate clean, safe environment.
We recognize that in a number of communities this goal has not yet been reached. The question is, how fast we can move on this change. The pharmacy standards are in place and now it is a matter of adopting them across the First Nations and Inuit Health Branch in all First Nation communities. I underscore what my colleague said about bringing the health professionals into the communities. Obviously, that approach is much more cost-effective but it requires an appropriate set-up for the health professionals to work in. We try to keep that in mind.
The Chairman: Progress is positive for our Aboriginal people. Mr. Hicks, I was in Madrid to represent the government as the lead minister for the Madrid International Plan of Action on Ageing. Can you tell me where we stand on addressing the 2002 plan?
Mr. Hicks: I will take notice on that. Perhaps Ms. Israel can respond.
Ms. Israel: I can speak to it from the broad strokes. I know that the Madrid International Plan of Action on Ageing will be updated. Countries have been asked to review their progress voluntarily. Currently, we are assembling different departments and it is helpful to have you on this committee to know where we stand in terms of the progress made. We are making a decision to go forward, to report on progress and to listen to other countries to learn of measures taken abroad so that we are better informed. I believe that in February or March we will report to the United Nations.
The Chairman: My other question is about the Compassionate Care Benefits Program, which is a particular baby of mine.
I was delighted to see the broader definition of more members of the family, and even close friends, being able to access the compassionate care program.
We clearly identified two other areas as being inadequate, and we know there is not much uptake on the program. Part of the reason is the deficiencies. It is a short program. It is only six weeks of benefit. Has there been any discussion with respect to a broader length of time for that benefit?
The other issue is more difficult. A lot of families, particularly children, but even adults, do not want to accept that a loved one is going to die within the next six months. That difficulty is a stumbling block for some of them to access the benefit. Is any work being done in that area as well?
Mr. Hicks: Senator, I think you are right. To translate what you are saying, there are certain things you can do under an Employment Insurance program, and there are certain things that are difficult to do under an EI program. I suggest you are absolutely correct. To move in those areas I somehow doubt that the EI program would be the one to be used for that purpose.
The general answer to your question with respect to the EI program is, we did a fair degree of study and research when the last set of amendments came through. Basically you see the results of that.
You are now moving to a broader question about caregiving and compassionate care, and the broader set of issues of care for frail, elderly people near the end of life.
The answer to your question is: Yes, we have started research and study in the whole area of caregiving. It is not at the stage of policy yet, but inside the department we are actively pursuing not only the issues you have raised, but a whole series of issues around respite care.
We welcome the committee's wisdom on this subject. For many of those issues, we need to take a different approach, rather than the EI vehicle itself. Our sense is we may have gone as far on the Employment Insurance vehicle as we can. When you look at these broader issues, it might make sense to look at a broader set of instruments.
We are looking at that now. I think it would be appropriate for your committee to provide its wisdom on that subject.
The Chairman: Mr. Guptill, I know one of the services offered by Veterans Affairs Canada is palliative care. There was an interesting experiment in the Province of Prince Edward Island, which I understand did not get beyond the pilot program.
Can you give me any example of additional programs to ensure that your veterans will remain in their homes as long as they possibly can with respect to palliative care?
Mr. Guptill: Yes: As part of this health-care review, we will look at all end-of-life interventions to make sure that we are comprehensive in how we deal with people with end-of-life care needs.
In a previous role, I was the director responsible for many of the palliative care cases that came forward. They often came forward in an emergency situation, on a Friday afternoon, because someone was released from an acute care facility, and Veterans Affairs Canada was asked to step in to try and deal with the situation.
Oftentimes these palliative cases do not have a particular time frame associated with them. The expectation might have been that someone would live only for a short period of time. In some cases, they lived longer. You cannot have an artificial time limit around palliative care in those situations. I am pleased to say we have been flexible in our policy in that sense.
Our intention is to help people in the home environment in any cases where it is possible. That help sometimes is restricted, going back to Senator Murray's point about who is eligible for the Veterans Independence Program.
In the context of this health-care review, we want to look at the necessary interventions at the right place and time, as opposed to looking at criteria based on eligibility that is largely driven by entitlement, as opposed to need.
We are addressing that issue in this comprehensive health-care review.
Senator Keon: Mr. Danagher and Ms. Muir, I would like you to talk about the phenomenon of soft retirements, or so-called ``soft sunset of retirement.''
Reflecting on my previous profession, we used to plan for years and years for our retirement. Indeed, it took years to train some of the people that we used. I cannot imagine how difficult it must be to look at your personnel chart and not know when anyone will retire.
How do you plan for the appropriate transitions of key personnel, and teams of personnel, that you must fit into place to continue?
Mr. Danagher: This topic was under a fair amount of discussion in the early days at the Public Service Human Resources Management Agency of Canada, PSHRMAC. Perhaps Ms. Muir would like to address it and maybe make mention of the succession planning tool kit.
Cecilia Muir, Director General, Public Service Renewal and Diversity, Public Service Human Resources Management Agency of Canada: Yes, it is challenging. I think we are aware that uptake does not equal eligibility for retirement, which is the point you are making. Usually, when people are eligible to retire, they leave in approximately three years of that time frame, sometimes later. Less often, they leave within the year that they are eligible. That is what we are dealing with.
From media coverage, you are probably aware of the initiative called Public Service Renewal, which is the approach that the federal public service is taking right now as to the strategy for managing both the potential retirements and other factors in the workforce.
What it boils down to is the deputy minister community in the federal public service takes a strong interest in fundamental planning of human resources against the business needs of the government.
Right now they are looking at the needs, not only the retirement potential, but other factors such as mobility, and where the government has need of targeted or specific labour shortages, and doing fundamental human resource planning.
We have developed a number of tools around this process. One is a succession planning tool kit. Another one is basic HR planning against business needs.
It does not sound sexy, but what it boils down to is: do we understand what our current and emerging business priorities are? Do we understand what our current talent base is and where this potential is for departures, which includes retirement, and what is our potential for mobility? Do we understand all that? What are the human resource issues that arise? Where are the shortages, gaps and age matters that need to be managed?
We are putting together plans. Every department needs to do this, and there is a lot of support for doing it. It is forward-looking.
It is about public service renewal. It is about a management plan that integrates business needs and human resource needs. It is about looking at what we have now and the potential for departures, then putting that all together.
Senator Keon: What do you do when you project a truly major retirement and this person decides not to go?
Ms. Muir: I should start by saying that the truly major retirements that have been anticipated for several years now do not happen at the rate at which one might have thought. We are seeing, as I mentioned and Mr. Danagher referred to, that potential-to-retire eligibility does not equal precise retirements. A sort of staggered effect is taking place.
That is one factor: we are finding it does not all happen at once. At the same time, succession planning is all about understanding where the greatest gaps are and how you bring in people — how you recruit or develop existing talent specifically for those areas, and put in place strategies to allow for knowledge transfer. It comes back to what I call the non-sexy planning, but that is what it boils down to. We try to figure out where need and talent come together and recruit specifically for where the talent is needed or develop people internally and put in place processes for mentoring so that knowledge is transferred in the workplace.
Again, something fundamental that does not sound sexy, but allows for knowledge transfer as well is the approach to working horizontally, or teamwork, which many government departments use now for working on issues that are primarily multidisciplinary. A key part of the strategy is increasing teamwork, increasing opportunities for people to work together.
Mr. Danagher: There is no obligation for employees to signal when they could retire. In theory, they could do so a week or two before their final day provided they meet the eligibility criteria. That fluidity obviously complicates planning, and that might have been one of the questions you were going to ask.
There is also no mandatory retirement age, as I referred to in my opening remarks. As a consequence, it is difficult, in many circumstances, to anticipate exactly when key personnel will retire. We focus on the ``key'' part, because for some personnel we want to manage that succession, particularly in technical areas — someone with a lot of specialized experience and knowledge. That is why PSHRMAC is looking at these issues assiduously right now.
One thing we are mindful of is the need for managers to be developed in the softer skills of opening dialogue with their staff to try to discern when those retirements might happen. While the planning tool kits and the HR planning frameworks that we have move in the systematic areas, also the training and management orientation obviously needs to be considered.
Ms. Muir: There is a formal performance management program in the government, particularly at the executive level, but it is also a model that is used below the executive level. At a minimum, an annual discussion takes place, but it happens much more often as well so major surprises do not happen. There is a structured approach to discussions among managers and their employees around what are people's career plans and intentions. It is not an unknown.
Senator Mercer: I would like to go back to the beginning of our discussion this afternoon. We talked about how it was good to have everybody at the table so they can hear each other. This special committee of the Senate, as you know, is studying aging and we will take our time and do this right.
As people involved in various government agencies and departments, do you monitor our hearings so that you can anticipate the questions that may come up as we go through this process? If you see that there are information gaps, will you let our clerk know that there is something that your department or agency can help us with to complete our study? We do not want to miss something in the process.
We always seem to have a large audience at this committee, but the people in the audience do not need to wear name tags to tell us who they are. I assume some of them represent your agencies and departments. However, I thought that since you are all here, it would be a good idea to put it on the record. I hope you are paying attention to what we are doing.
Mr. Hicks: There is only one answer to that question. Yes, we are monitoring the committee, and we do have people sitting here who will follow you closely. As you know, your work affects so many aspects of our department. We need to be aware of where you are at, and to help you wherever we can. We are eager to hear what you come up with. There is hardly an area of our department that is not greatly affected by what you are doing. It is important to us.
In an earlier question, I think I gave a wrong answer. I think I said that there were 1.5 million poor people among seniors. I should have said — I now stand corrected — that there are 1.5 million recipients of the GIS; that was the correct answer. There are probably approximately 200,000 seniors below the low income cut-off line. Most people receive the guaranteed income supplement — those 1.5 million seniors — which brings them over the poverty line, of course.
The Chairman: I want to thank you all for spending the time with us and bringing us up to speed on the work of your departments. Before you go, I also want to thank you all for the work you do on behalf of the people of Canada. Our public servants should receive the accolades that they genuinely deserve. We have an excellent public service in Canada and I am proud of all of you, as are my colleagues.
The committee adjourned.