Proceedings of the Subcommittee on Veterans Affairs
Issue 5 - Evidence
OTTAWA, Wednesday, April 30, 2003
The Subcommittee on Veterans Affairs of the Standing Senate Committee on National Security and Defence met this day at 12:10 p.m. to examine the health care provided to veterans of war and of peacekeeping missions; the implementation of the recommendations made in its previous reports on such matters; the terms of service, post- discharge benefits and health care of members of the regular and reserve forces as well as members of the RCMP and of civilians who have served in close support of uniformed peacekeepers; and all other related matters.
Senator Michael A. Meighen (Chairman) in the Chair.
[English]
The Chairman: Honourable senators, I am pleased to call to the meeting to order. Today we will be considering operational stress injuries and post-traumatic stress disorder. Our witnesses are from the Royal Canadian Legion.
Mr. Allan Parks, Dominion President, Royal Canadian Legion: Honourable senators, the Legion appreciates the opportunity to appear here and testify before the committee.
For your information, the Legion, through a network of professional service officers operating at Dominion Command and at provincial commands, provides representational services for veterans, including the Canadian Forces and RCMP serving members, who are seeking disability pensions from Veterans Affairs Canada. This is a service that the Legion has proudly offered since 1926.
Representation of veterans and serving members has allowed the Legion to maintain a unique overview of the disability pension process as it applies to various disabilities, including operational stress injury and post-traumatic stress disorder. Through the advocacy route, the Legion has been at the forefront of various efforts to educate officials and to promote a better understanding of OSI and PTSD.
The Legion sponsored a PTSD symposium in Charlottetown in 1998 that was attended by various specialists in the field from the U.S., Australia and Canada, with wide representation from all levels of Veterans Affairs Canada, the Bureau of Pensions Advocates, the Veterans Review and Appeal Board and the Canadian Forces.
The nature of military conflict has changed over the years. Even though Canadian Forces personnel can engage in war fighting, they are as likely to find themselves on peacekeeping or peacemaking missions that create unique challenges and can have significant consequences for veterans.
Veterans Affairs Canada has built a system of well-intended programs and benefits over the years, however many gaps and inconsistencies have developed that should be addressed. For example, the Royal Canadian Legion has systematically advocated on behalf of expanding the Veterans Independence Program to include benefits to spouses for life. The Legion recognizes that this is only one step toward a broader, more integrated approach to various programs such as: the Pension Act; the Service Income Security Insurance Plan, SISIP; the Canadian Forces Superannuation Act; the Canada Pension Plan; Employment Insurance legislation, et cetera.
This integrated approach has been summarized in Dominion Convention Resolution no. 1, appended to this presentation for your information. In this context, the Legion applauds your recent report, ``Fixing the Canadian Forces' Method of Dealing with Death or Dismemberment.'' The five recommendations are germane to the Legion testimony. War-fighting produces many hardships and dangers; however, peacekeeping and peacemaking missions also generate significant stressors for participants. Peacekeeping missions can have a positive and a negative effect. For example, peacekeepers are now confronted with a new set of responsibilities, from constabulary presence to monitoring the activities of belligerent parties; to maintaining the safety of non-combatants; to the orderly delivery of humanitarian aid; and to the provision of assistance in the building of infrastructures. One need only look at U.S. military personnel in Iraq, who were combatants one day and a semi-constabulary force the next day, to understand the magnitude of the challenge.
In that new environment, the positive outcomes of operating in a new country, within a new culture, bringing food to starving people and monitoring the peace are associated with low- and high-magnitude stressors, such as being separated from loved ones, not being appreciated by those being liberated and being exposed to traditional war zone stressors. If you add to this mix the tradition of the warrior ethos, which in some way must be subsumed, one should not be surprised that modern soldiers and veterans will be prone to operational stress injury.
What are operational stress injury, OSI, and post-traumatic stress disorder, PTSD? An operational stress injury is, first and foremost, an injury that is triggered by a significant, distressing event or series of events that may have been experienced, confronted directly or witnessed. A significant or severe stressor can be an actual or a threatened death, serious injury, or, in extreme cases, a large-scale massacre. For example, the crash of Swissair 111 off Nova Scotia or the Rwanda massacre would meet the parameters.
The choice of these examples clearly illustrates that OSI and PTSD are not conditions purely related to the military. They can affect individuals employed not only in military operations but also in peacekeeping duties or those providing hazardous response services. Those who suffer from OSI will re-experience their distress on a reoccurring basis, as if they were reliving the event, when confronted with internal or external cues. They suffer intense sociological distress and are deemed to be fragile. This injury can affect an individual's well-being at the personal or medical level, especially if a veteran is unable to obtain appropriate clinical management or peer support.
Symptoms of OSI are debilitating for an individual. These symptoms may include marked diminished interest in participating in significant activities, a feeling of detachment or estrangement, irritability, difficulty with concentrating, hyper-vigilance, et cetera. If left untreated, in extreme cases, OSI can lead to a terminal event that may include pneumonia, respiratory failure, cardiac arrest, circulation failure or cessation of brain function. In comparison with other countries, Australia identifies all of the above conditions as potentially consequential to OSI.
It would appear that VAC and the CF have made tremendous strides in dealing with OSI and PTSD and in providing support to veterans and their families. For example, the VAC table of disabilities, which has been amended in response to Legion advocacy, provides comprehensive data on subjective and objective parameters to assess the levels of stress and anxiety disorders. If a client is identified as being at risk, special care is provided through timely referral and the adjudication process is fast tracked. Information provided to counsellors to assist in their dealings with clients suffering from OSI and PTSD fully recognizes the requirement for a multidisciplinary approach.
VAC and the CF have established a mental health advisory committee with the objective of standardizing treatment protocols and streamlining services through networks of excellence, which are centred on the St. Anne's Hospital in Montreal and regional clinics in London, Quebec City and Winnipeg. It is planned to reach other geographic areas via tele-mental health. VAC and the CF are making great strides in reaching out to veterans and serving members who suffer from OSI and PTSD, at least at the levels of medical care and research. The network of Military Family Resource Centres also plays a significant role in providing support. However, the support is not well coordinated. For example, the Military Family Resource Centres operate at arm's length from the military. Services provided by other agencies, such as social workers and priests, are not fully integrated. Some of the services that they provide to retired members and their families belong to VAC. Other programs, such as SISIP, may also encroach on VAC programs.
As I alluded to before, VAC and the CF have taken proactive steps to initiate both preventive and post-diagnostic support programs. You were briefed earlier on the operational stress injury social support projects, which include a peer support element and a pre-deployment training module. Both initiatives address the immediate needs of military members, however, the attitude change element is a goal that requires further nurturing.
The DND Ombudsman, in his recent report entitled, ``Off the Rails,'' alluded to the reality that the CF has been slow to adopt a new military ethos that takes into consideration the peacekeeping role. That possibly occurs because the CF is still clinging to an outdated vision of the warrior ethos. To their credit, the CF has made significant progress in providing post-deployment debriefings at stress clinics and immediate medical treatment, when required. As for VAC, it has made tremendous strides in providing better services through a revised disability table, special handling measures, the setting up of PTSD adjudication units and other programs.
Feedback from Legion service officers across the country indicates that VAC is responsive to various claims from traditional war veterans, modern peacekeepers and widows. The remaining difficulties appear to be related to the initial assessment of disability claims. Again, when difficulties are encountered at the first level of adjudication, inequities seem to be resolved at the various review levels.
Health care issues comprise only one element of the broader detriments that are all interrelated. The way ahead requires a clear identification of responsibilities between VAC and the CF, especially in relation to services provided by the Military Family Resource Centres that clearly overlap with traditional services provided by VAC. It requires specific programs to better address the needs of regular force members and reservists. Reservists are often left to their own devices, especially when they return to rural environments. The Legion is uniquely situated to provide support in this area. The provision of affordable housing to veterans and their dependants should also be investigated. Modern day veterans are frequently forced to retire early without sufficient means. In those circumstances, affordable housing is a necessity.
The Legion is currently investigating, through a voluntary sector initiative grant sponsored by VAC, potential policy changes to facilitate the development of affordable housing for seniors and veterans. The Legion currently provides such facilities across Canada at more than 140 sites, with approximately 6,600 units. As the Legion embarks on future housing initiatives, it has identified a need for the provision of seed funding in the planning stages of housing projects. This option requires further investigation because it could meet the needs of newly retired CF members who require assistance.
The way ahead also requires an in-depth overview of what the CF now refers to as ``the personnel tempo.'' It requires more concerted efforts to streamline and integrate services that are currently provided under programs that are not clearly linked, as recommended in the Royal Canadian Legion Resolution, VSS no. 1.
That is attached for the information of honourable senators.
Senator Meighen, as you mentioned earlier, Mr. Allard is the director of our service bureau. He is responsible for all of our service officers at our Dominion Command level and at commands and branches across the country. He is familiar with the issues here. We will try to answer your questions.
The Chairman: Mr. Allard, is there anything you would like to add at this point with respect to the process of providing services?
Mr. Pierre Allard, Director, Service Bureau, Royal Canadian Legion: Not at this point.
The Chairman: I assume that you share the opinions expressed in this brief, as does Mr. Daly?
Mr. Allard: Yes.
The Chairman: The Chair of the Standing Senate Committee on National Security and Defence is here and has a list of questions.
Senator Day: Thank you for being here, gentlemen. I saw a number of you at the special evening that we had a week or so ago with respect to Vimy Ridge Day. I was glad to have a chance to chat with you at that time. It was a special day for us all, in which this committee had a role to play.
You indicated in your report, Mr. Parks, that you have seen our recent report that I will describe as the ``Bruce Henwood report,'' in relation to dismemberment or death. You have had a chance to look that over and have seen our recommendations. Were there any recommendations that you feel were off the mark?
Mr. Allard: Certainly not. You are right in line with our views. There is the issue of retroactivity for whatever number of people who were injured prior to the putting in place of the new policy. That remains to be looked at in the fullness of time. Those people deserve retroactive payments correspondent with the Minister of National Defence stressing that aspect of the dismemberment policy.
The new SISIP policy introduced for lieutenant-colonels and below brings up the issue of potentially conflicting policies. That policy is applicable while on duty.
It takes into consideration the point in our presentation that the programs are not well coordinated. They should be rationalized. When you introduce the notion of paying benefits to someone who is on duty through an insurance policy, you are embarking on responsibilities that are attributed to Veterans Affairs under the Veterans Act.
That is one of the issues on the table. All these programs have to be rationalized to create a more concerted approach.
The Chairman: I have received and circulated to all members a letter from the minister indicating that his staff is working on the problem of retroactivity. We are hopeful that, as we are led to believe that we are dealing with approximately 12 cases since 1982, and even though it requires a laborious records search, it can be accomplished. Those who had to leave the Armed Forces by reason of dismemberment would receive some form of retroactive payment.
Neither our report nor the minister's response deals with the situation of death for members of the CF in terms of a lump sum payment. Nor is the question of off-duty injuries addressed. The committee is interested in pursuing those matters.
Senator Kenny: It occurs to me that the Legion could perform a service regarding the outstanding retroactive payments. We are relying upon the department to do a record search. However, you have the capacity, through your magazine, to say, ``Look, if you have friends or know of someone in this situation, draw it to their attention.'' That might be a very effective way to catch people whom the bureaucrats might not.
Mr. Parks: Yes, I agree with you. We will look at that and see if we cannot do a write-up in our service corner and put it out in the bulletin.
Mr. Allard: There are a number of ways in which we can address that. We will take that under advisement and find a way to advertise to people who might have suffered dismemberment while on active duties in the forces. I understand the problem with database searches in SISIP and VAC.
Senator Day: I appreciate the issue with respect to retroactivity. We are working on that.
One of the issues is at page 25 of the book that I gave you, which is a summary of the recommendations. Recommendation no. 3 addresses the case of a member of the Canadian Forces who is seriously injured. That could include someone who has a stress disorder or post-traumatic stress disorder. Perhaps I should use the term ``operational stress injury.'' Is that a generally accepted term now?
Mr. Daly: Yes, it is. It is a term that the Canadian Armed Forces has drawn up to indicate that it is an injury that these people are suffering. It is not an illness or a disorder. It is an injury caused by operations. The Canadian Armed Forces prefers to use that term, and it is applicable.
Senator Day: Are we finding the term used in regulations now? It has not worked its way into any laws yet, but is it in regulations or standing orders?
Mr. Allard: It is cropping up in pension programs of other countries. In Australia, it is becoming a recognized term. We seem to see it more frequently in the Canadian Armed Forces.
Senator Day: Our third recommendation is that an officer be immediately assigned to represent the interests of the injured party. In the fourth recommendation, we talk about a family resource centre providing support to the family.
Are we stepping on your toes in relation to this? What role does the Legion have with respect to providing that support to the injured member and to the family, if any?
Mr. Allard: Our role is strictly one of referral. In other words, if people wish to take advantage of our services to represent them in the process of claiming a disability pension through Veterans Affairs, they may do so. We have carried out that role since 1926. We represent approximately 10 per cent of all the applicants who seek a disability pension. I do not see any problem with your resolution no. 3, which is strictly focused on assigning someone to help a member. The Canadian Forces already does that to a certain degree in other processes. For example, if there is a trial of some kind, the CF will assign an officer to assist; if there is a death, the CF will assign an officer to assist the dependant through the process of funeral arrangements. It would be logical that they would assist in a disability situation to help people understand the benefits.
They do that to a degree, not on an individual basis, but more on a group basis in pre-deployment and post- deployment briefings. I think that there are other things in those venues that could be considered. I do not know how systematically this is done in Canada, if at all, but in Australia, health data is collected on participants who go on peacekeeping missions. That data is available when the participants return to the home country. That provides a small database on what happens to your —
Mr. Duane Daly, Dominion Secretary, Royal Canadian Legion: Senator Day, if I could add a point. The recommendation, as it stands, is to provide assistance to the individual. As Dominion President Parks points out, it is the whole question of culture and ethos — the warrior concept. Soldiers are still loath to admit to a Canadian Forces official that they have a problem. That is the main obstacle in this issue, which is why we changed the name from ``disorder'' to ``injury.'' That way, the soldier will not be afraid to come forward and admit that there is a problem. The Legion has played a vital role in that capacity.
We have offered an avenue to soldiers to come to us when they have been loath to go to someone in uniform to admit that they have a problem. The soldiers are afraid of having their trade specification deteriorate such that they would no longer be members of the combat community. That would initiate a transfer and they would lose their allowances. All of these implications play a role if they are seen as unfit for combat duty.
Therefore, the first step is to get over that obstacle. Once we help them out there, we are able to ensure that at least they get into the system where the disability processing, through Veterans Affairs, is done. We are also able to provide them with guidance on relating to the appropriate contact in the forces. It is fine to tell someone to speak to the surgeon, but the surgeon still wears a uniform and has a certain responsibility to report various disabilities.
We have made a great deal of progress since 1996. Just getting the Canadian Forces officials to attend our PTSD symposium in 1998 was a challenge. People attended from all over the world, but convincing senior military officials here was difficult. They were not ready to accept that those kinds of circumstances exist. We have come a long way since then. However, there is still the problem of getting the soldiers to admit that perhaps they need some help.
Senator Day: I understand that there will be a conference at St. Anne's Hospital soon. Is the Legion participating in that? Is this a conference for officials from Veterans Affairs?
Mr. Allard: We have been invited to send a representative and I will attend. In fact, I will leave this afternoon for Montreal. I will be sharing that information with Legion service officers across the country.
There is an additional element to what our Dominion Secretary was saying in the context of the warrior ethos and seeking representation from the Legion service officers. Our traditional veterans from World War I, World War II and the Korean War have been willing to seek our help in the process. We have never had any problems convincing them that we can play a role. Veterans Affairs has always presented us as a traditional partner.
The Canadian Forces, in the context of this warrior ethos, is an inward-looking institution that suffers a great deal of stress because of personnel tempo, reductions in personnel, et cetera. They tend to look to Veterans Affairs first because it is a government department. We have to convince them that the Legion service officers represent a viable option for them.
Senator Day: My final question concerns our fourth recommendation and the Military Family Resource Centres that are cropping up across the country. Are these centres competing with the services that you were offering?
Mr. Allard: I think they are probably inadvertently competing with Veterans Affairs, to a certain degree. That goes back to what I call the transition phase between what the Canadian Forces can provide in services and what Veterans Affairs should provide in services as a part of their mandate to look after veterans. The Military Family Resource Centres are off to the side as an independent agency that is more responsive to CFPSA than to the military. Outside the chain of command, there is the danger that indeed the focus will move to this semi-independent agency and that we will not have the coordination of effort that we need.
Senator Day: How are you working with them to ensure that this does not happen?
Mr. Allard: We are dialoguing with Veterans Affairs as they look at a continuum of services that are focused on the way ahead and how they want to structure themselves to deal with the veterans after release. We have membership on the CF/VAC advocacy council, where we can make our voices heard. There are a number of fora where we sit at the table to express our views.
This is a learning experience for VAC and the CF because for a number of years, perhaps, we were not paying attention to some of these modern-day veterans. We have seen a spirit of trying to be the first off the mark to provide these services. Now we have to look back and try to refocus these efforts to give the responsibilities to those who should bear them.
Senator Day: Are you talking to the managers of these family resource centres or only with Veterans Affairs?
Mr. Allard: Right now, we are in talks with Veterans Affairs.
Senator Kenny: Given that it is so complicated, that no one really has a good handle on it and that there are so many individual approaches, why would the philosophy be to consolidate it and say to one person, ``You should have a handle on it''? Why would you not want to have a variety of choices to accommodate people who react to different organizations in different ways? Why would we not want to have, just as a matter of philosophy, an overlap and a multiplicity so that we could catch more people? It would not be as neat and tidy and there would be potential for the wasting of some resources. However, as a philosophy, why would you not want to have a multiple-choice solution?
Mr. Daly: Senator, having the choice is positive and would be the right approach. I do not think we would want only a single avenue for members to be able to seek support. For example, the Canadian Forces developed their own family resource centres a few years ago to help with all of those issues that arose within the family as members were leaving home. That met a fundamental requirement at the family level.
Since the recognition of the effects of Gulf War Syndrome, PTSD and all these other types of issues, a plethora of different organizations, councils and activities have been established. Mr. Allard alluded to the problem of those organizations trying to ensure that they are all clear on their responsibilities and get on with the work. As far as servicemen are concerned, there is no doubt that those different options must be available at all levels.
The Legion has always been there. The Legion has been a fundamental resource for them. Soldiers are now learning that there are certain approaches within the Canadian Forces. The Canadian Forces has established the CF Personnel Support Agency, where servicemen can now get information, even anonymously.
The three primary organizations are the Legion, Veterans Affairs and the CF support centre. Those are three different options for a soldier to contact to get information. Supporting those three organizations are all the various committees. The committees are working to get their act together to find out who is doing what and who is recommending what to whom.
Senator Kenny: There is no question there are people suffering terrible stress after a range of operations. It is right and proper that the problem is being addressed. Could you try, for the committee, to reflect on where the balance lies when you are trying to motivate people to put themselves in a position where they could be hurt without giving them an out? They could say, ``Well, this is all terribly stressful for me.'' There is no one going into combat who does not find it incredibly stressful; yet the vast majority of people do what they have to do.
How do you assure people of treatment and support afterwards if they suffer from undertaking an operation without giving them the excuse beforehand to not do their duty?
Mr. Parks: Mr. Allard works more directly with individuals. He may be able to answer it better, and I will make a comment afterward.
Mr. Allard: It is a fine line. I may want to revisit your original question, senator.
Currently, I am not too sure that the Canadian Forces personnel are using PTSD or OSI as a crutch.
Senator Kenny: I did not say that. I said that there is an issue in there.
Mr. Allard: Yes, there is an issue of whether it is an excuse or could become the reality.
As I understand the statistics, the Canadian Forces rate of release right now is approximately 4,000 people a year. Of those 4,000, 15 per cent are applying for a disability pension. If you have an effective strength of 52,000, and those numbers are in the ballpark because they come from Veterans Affairs, then you have a problem. It is either at the level of personnel or ops tempo, or at the level of the support and care provided.
The Legion's posture on this is that the care provided should be based on trying to cure individuals. In other words, the intent should not be to sustain payments for the rest of one's life, but to assist people to find some type of treatment that will control whatever symptoms they are exhibiting and ensure that they do not suffer additional, core morbidity effects from their problem.
Senator Kenny: Your argument is premised on the number of people leaving. They may be leaving for all sorts of reasons.
Mr. Allard: Yes, that is right.
Senator Kenny: The second premise you were basing your argument on was the number of applicants. There is a difference between applicants and people who have —
Mr. Allard: Seventy per cent of applicants are successful. You can do some of the math there.
Why do we suggest that we need to rationalize these programs? I agree that it is very nice to have choices and options in a perfect world. However, there is a cost to multiple choices and options. If the government is willing to support that cost, so be it. If you do not have the funds to support all these options, then you may not be providing the best services possible.
I look at the specific mandates of the Pension Act and Veterans Affairs. They are to provide care, treatment or re- establishment in civilian life of any person who served on the Canadian Forces. If you look at the multitude of programs that are trying to achieve that aim, I question whether the system is as efficient as it could be. That is my approach.
Senator Kenny: You could also argue that it is not efficient without a multiplicity of programs. There are all sorts of reasons why people who have nothing to do with the military would approach the government for support or assistance.
Mr. Allard: Yes.
Mr. Parks: It is a fine line, as you mentioned. It is also very new to not only government departments, but to us, our service officers and the doctors and people dealing with it.
Mr. Daly and I recently attended the VAC/CF advisory council. Doctors sitting around the table said that the issue was new, but they felt confident that once an individual sat down in front of them they were able to quickly determine whether the problem was real.
General Dallaire noted that he had visited 18 bases. All of those with whom he spoke who were out of the forces for post-traumatic stress disorder said that they wanted to be well and on their feet. It was not the money. They all would rather be well.
Senator Kenny: It is not entirely new. Programs were available after the Second World War. My father was a POW. When he returned to Canada, he went into hospital. They worked with him for a few months. People were aware of the stress suffered, and efforts were made to deal with it in certainly a significant number of cases.
Mr. Allard: After the Second World War, people never looked at it as PTSD, yet several hundred soldiers likely were suffering from it.
Senator Kenny: No one called it that.
Mr. Allard: It is significant that half of the people who participate in the operational support social group are traditional war veterans who have dealt with this problem for many years. Veterans Affairs has never recognized alcoholism as a disability pension parameter. One could have some long discussions about alcoholism as a core morbidity symptom that is more related to genetic disposition.
However, countries such as Australia recognize alcoholism as a disability pension qualifier that could be attributed to military service and associated with PTSD. We are discovering a number of things as we go along.
Senator Atkins: One of the concerns of our more elderly veterans is what kind of programs there are for their widows, especially those wives who are providing health care at home. Can you fill us in on what is happening there?
Mr. Parks: Yes. That is a good point. It is something that the Legion, as you know, has been advocating for years, and it certainly stands out more now than ever. We feel it is an important subject. One of the main things on the veteran's mind when he is at that age is, what will happen to my wife when I am gone? Right now, if he is on the disability pension and getting the VIP, she receives it for one year only after he dies. The dilemma is, what then? It is a lot of stress on the veteran.
Senator Atkins: And on the widow.
Mr. Parks: We put a priority resolution in place, and we have met with the government several times in the last six months. Our priority resolution is VIP for the spouse for life. A lot of times, when you say ``life,'' it scares people away; in reality, if the individuals then win a lottery, for instance, they do not qualify. Also, what is the term of the life of those individuals? When they go into a nursing home, the VIP is withdrawn because they no longer need it. It is not as if we are paying for many years into the future.
It is beneficial, we feel, not only for the veteran and the widow. We have even suggested it is something that all provinces could look at for the whole senior population. It could be done and ultimately save money in the long run.
If the government eventually has to put the widow or whomever in a long-term care facility, it would cost about $3,000 a month; whereas, if they can keep them on the VIP and in their home as long as possible, it is something like $3,000 a year. It is a win-win situation. I will say the department is taking us seriously on it and looking at it. We hope to have some answers shortly.
Senator Atkins: Is it your recommendation to this committee that we should push hard on that issue?
Mr. Parks: By all means.
Senator Atkins: Once a veteran dies, what is the widow's share of the pension? What percentage is it?
Mr. Allard: It all depends on the disability pension that the veteran received. If a veteran was receiving a disability pension that was at 48 per cent or less, and possibly some benefits like attendance allowance or VIP, the widow will continue to receive the full benefit for one year after the death of the veteran. Following that, the widow would receive half of the disability pension and would no longer collect the attendance allowance and the VIP.
If the disability pension were higher than 48 per cent, the widow would receive a full widow's pension for life after the one year. That is predicated on the fact that she is single, so it is a little less than what she was receiving when her husband was alive. However, it is still a full widow's pension, keeping in mind that for one year after the death, she would receive the associated benefits and the full payments.
Senator Atkins: Yet a lot of her overhead would not be eliminated necessarily.
Mr. Allard: Not necessarily. Not everybody receives a disability pension higher than 48 per cent. That is the first thing.
Mr. Daly: To amplify, senator, that relates to a widow of a pensioned veteran. One of the problems we are facing is the situation of the widow of a veteran who was not pensioned or suffering from a disability. We are spending an increasing amount of our benevolent funds to assist widows with fundamental things like repairing the roof or helping with rental payments.
We petitioned the Canadian Forces to look again at the Superannuation Act in terms of widows. Right now, a Canadian Forces member is pretty well forced to retire at about 55 years of age. People in the enlisted ranks will retire with anywhere from a 20- to-30-year pension, up to about 60 per cent of salary. Perhaps, if they are lucky and had been in a long time, it will be 70 per cent of salary.
If he should pass on, his widow receives only 50 per cent under the public service/Canadian Forces superannuation program. That is 50 per cent of the 60 per cent. If that person did not have gainful employment after retirement, she will be in real difficulty.
We have asked the Canadian Forces to allow the Legion to participate in superannuation discussions on this issue. They have refused us every time. We are trying to get them to look at enhancing the Canadian Forces superannuation benefit up to at least 66 per cent. The response is that this will set a precedent within the public service. We are saying that the Canadian Forces Superannuation Act is unique and special. It is designed for those who have made that special commitment to the forces.
This role of the widow is of significant concern to the Legion — the widow of the war veteran — but we are very concerned as well about the widow of the Canadian Forces veteran.
Senator Atkins: What constitutes the VIP in the first year?
Mr. Allard: The Veterans Independence Program is in place for health care and home care. Home care can include groundskeeping. It can include snow shovelling and grass cutting, et cetera, which will help a caregiver, when she is widowed, to stay in her home. It would actually cost the government less over the long term.
When we talk about VIP for the spouse for life, we are not talking about health benefits per se. They remain with the veteran and cannot be transferred after death. However, the other benefits associated with housekeeping or groundskeeping —
Senator Atkins: Comfort services.
Mr. Allard: Yes, the comfort services that would allow a caregiver, who is probably burnt out after caring for a number of years for a disabled husband, to remain in the home and save money for the government at all levels.
The Chairman: Would it be correct to say that you are suggesting that the situation of the Canadian Forces is very different from the public service and the coupling of the two has caused us problems that we are now trying to undo — such as in our report with respect to dismemberment and the other situation you have just brought to our attention? Perhaps we can establish that.
Mr. Daly: The answer is yes.
Senator Day: I would like to explore a line of questioning about the support role that the Legion can offer. I have it in mind that the family resource centres springing up across the country are more for the families of serving members and that the Legion could play a similar role with respect to those who have retired from the Armed Forces. I also understand that operational stress injuries can arise long after the person is retired from the forces.
I would like to know the context, the contacts and the retired members of the Armed Forces, or the RCMP for that matter, who are members of one of your branches. What kind of support are you providing and what kind of information are you providing to your branches so that service officials understand and recognize this problem? What kind of support is being given to individuals and to the families?
Mr. Allard: You are raising a number of issues and we probably could go into a long presentation on the Military Family Resource Centres and when they started to appear on the scene. If I recall, the first centre opened in 1985, when the military realized that there were problems associated with the care of families, et cetera.
Our overriding concern is that much of the activity in Military Family Resource Centres and in transition centres manned by Canadian Forces and VAC may not be fully coordinated with other organizations. There may be people stepping on each other's toes in their efforts. If you look at the Web site of one Military Family Resource Centre, you will see information about PTSD and the military family. Military Family Resource Centres have been talking for the past three years about providing services to serving members, their families, their dependants, veterans, retired members, et cetera.
I am worried that if these mandates were expanded without proper focus on the service that you wish to provide, as a VAC responsibility and as mandated in the Pension Act, perhaps these efforts would be duplicated. There is a certain connectivity with what Mr. Daly was talking about in respect of superannuation, SISIP, CPP, et cetera. All these items are related.
To go back to the service provided by the Legion, each branch's volunteer service officer is familiar with the services and programs offered. These officers act as referral agents to the professional service officers at provincial and Dominion commands. In that way, we are able to obtain referrals for pension plans and for benevolent fund demands. We are receiving many requests for benevolent funds from retired members and widows.
In the briefing, we alluded to the fact that we provide housing for seniors and veterans across the country. As we developed options for our housing programs, we became aware that some of these people suffering from PTSD or OSI were being released early. Therefore, they would not receive a full superannuation benefit, having been released before the 20-year mark. They may receive a disability pension that is about 15 per cent to 20 per cent of their projected pension, but who knows? They may not be able to find employment and may actually have an urgent requirement for affordable housing. It would be of great benefit to people in such a circumstance if something could be done to facilitate the receipt of seed funding by the Legion to assist us in our housing projects. That seems to be a hang-up, notwithstanding the federal and provincial programs that are now in place, which seem to be difficult to tap into if they are not well coordinated. Perhaps we could assist some of the veterans suffering from OSI or PTSD to find affordable housing in a Legion senior housing project. This is an example of the role of the Legion.
Senator Day: What, if any, training do you give to your volunteers at the branch level to recognize the symptoms of and the social implications for someone who may not have been diagnosed with operational stress injury?
Mr. Allard: We train volunteer officers on a regular basis every year. We visit the regions and hold conferences for our volunteer service officers. We bring them together for a weekend training session to review the full gamut of programs. We also focus on the new programs or the new concerns that are on the horizon. During the next range of training sessions, two of the topics on the agenda will be the SISIP and the senate committee's recommendations on PTSD and OSI, based on some of the additional knowledge.
Senator Day: Do you put posters up at the branch level to explain OSI and to help change the ethos that causes reluctance to come forward?
Mr. Allard: We certainly stress that, and in some small rural communities there is some challenge in self-identifying. In those cases, we ensure that the volunteer service officers know that individuals may seek representation from a professional service officer and that they do not have to go through the branch office, should they choose not to self- identify in a small community. It is a challenge, because volunteer service officers come and go — generally, however, once a service officer, always a service officer. Often, our volunteer service officers are in place for 30, 40 years.
Senator Day: You spoke about referrals at the provincial command level to experts in different areas. Do you have experts in post-traumatic stress disorder?
Mr. Allard: No, I guess we could be called overall experts, but all of our professional service officers are well aware of the intricacies of the programs. They are not medical practitioners, but they understand the challenges of dealing with people who suffer from these disabilities.
Senator Day: What would you do if you suspected that someone was having social problems, could not work and was having family problems? You may suspect that this individual is suffering from a late-blooming post-traumatic stress injury.
Mr. Allard: There are numerous options. We would likely try to put the person in contact with provincial service officers. We are familiar with all the health care services that could be provided. We are also familiar with the Health Canada 1-800 line to provide counselling to the member and his family. We would try to cocoon the member and his family. We would try to help him through the disability pension process by submitting an application for the associated benefits and to offer him all the services that he may need.
From that perspective, and keeping in mind what we talked about in our presentation, Veterans Affairs Canada has a proactive program and VAC staff is prepared to respond in a timely fashion. VAC may even bring some of the claimants to the facility at Ste. Anne's to provide health care. We would negotiate with Ste. Anne's to ensure that the claimant would receive the necessary clinical care prior to processing the claim. All our professional services officers are extremely familiar with these processes and we ensure that they are trained and updated.
Senator Day: Are these professional services officers paid by the Legion?
Mr. Allard: They are paid by the Legion.
Senator Day: Does the Legion receive funding from Veterans Affairs or from National Defence to help to provide the service?
Mr. Allard: In 1926, when we first formed the service bureau, the Legion received a grant from VAC of $9,000. However, that grant amount was never amended over the years to recognize the evolution of services, the complexity of the programs or inflation, for that matter. Therefore, in 1995, when the Legion realized that the grant was still at $9,000, it did not make sense to continue receiving it. That was when we advised Veterans Affairs Canada to terminate the grant. That initial $9,000 was meant to pay one-half the cost of operating a service bureau across all levels of the Royal Canadian Legion.
Our service bureau nationwide costs $2 million per year. We considered it an insult to receive $9,000 toward those services.
Senator Day: Would retired service personnel be better served if you did have some funding or do you not want it?
Mr. Parks: The danger is that we would not want to appear to the public, especially our clientele, as another government agency. The money is nice, but it is also nice to be independent. People know they can come to us if they do not want to go the government avenue in a claim. We are trying to battle with that.
Senator Day: I am talking only about identifying those individuals who might be suffering from post-traumatic stress disorder and have lost contact with the Armed Forces. They may still have contact with the Legion through their local branch. They need help and support. It may become evident five or ten years after they have left the Armed Forces. Do you think that providing a better service for those individuals would compromise your independence? Are you satisfied that they are receiving proper care now?
Mr. Parks: We are doing the best job possible. There are many changes happening.
There is always a regional office of the Department of Veterans Affairs in the same location as our branch, where we have the volunteer service officers. We are always able to work with them to get that expert advice that we need. We partner in many different ways.
Mr. Daly: Mr. Chairman, I want to make it clear that our service officers are not medical practitioners. Therefore, we are not involved in the identification of PTSD. Our specialty is the process of assistance. Once people have been identified in some way as needing assistance, we point them in the direction of gaining that assistance. We also do all the administrative work for them. We are facilitators in the process.
Mr. Allard: There is an additional element to accepting government funds. Veterans Affairs is a well-organized department, but they do have some processes that we consider bureaucratic.
The department has put in place a new delayed application policy that, in effect, would terminate a ``date protect'' for someone who was applying for a disability pension. A ``date protect'' is the date that the pension would be effective. There are 22 form letters sent to clients at various stages in that delayed application process. That is not how we conduct business.
Senator Atkins: There will be a change at the deputy minister level. Do you know the new deputy? Do you believe that the relationship with the Legion will work in view of the change?
Mr. Parks: I had the opportunity to meet Jack Stagg last week when he gave a short presentation at a meeting. He met with the group afterwards. He is new with us. We have worked closely and had a good working relationship with the current deputy minister, Larry Murray. He has recommended Mr. Stagg highly to us and feels that he will be a very good deputy minister for us.
At that meeting, Mr. Stagg asked to meet with me. That is a good sign. We can meet and start everything off on the right track.
Our biggest concern is that all the things that we have on the burner will continue to progress. We would not want that to change due to a new deputy taking the post.
By the middle of May, I should have had the opportunity to meet with the new deputy minister, as well as the minister. Hopefully, things will be on stream.
Senator Atkins: He has a tough act to follow.
Mr. Parks: He does.
The Chairman: Perhaps you could provide updates on the two perennial challenges that come to my mind. I receive much correspondence from veterans on hearing disabilities and the way in which these are addressed. We can all agree that it is difficult to determine how much of the hearing loss is attributable to the war injury and how much to the inevitable aging process.
Mr. Parks: We have had a problem with the way in which the VRAB, the Veterans Review and Appeals Board, was looking at those cases. We could not seem to progress with the then chairman. That chair has moved on.
There is now an interim chair, Victor Marchand. I hope they keep Mr. Marchand for some time. He is changing many things and undertaking different initiatives. We are very happy with him and things are working out. I do not know how long he will there, but we are happy to have him. Mr. Allard can bring you up to date on that.
Mr. Allard: Veterans Affairs is bending over backwards to approve disability claims for hearing loss in a timely manner for the traditional veterans — World War I, World War II and the Korean War. The process is facilitated because most of these people did not have an audiogram on release. Currently, serving members do take that test. We do not have any problems in getting a hearing loss disability pension claim approved for a traditional veteran. Sometimes that is the route for a veteran to obtain other benefits that will help during a frailer period of life.
All things being equal, that is a worthwhile trend. A less worthwhile trend is the stringent adjudication of hearing loss claims by currently serving members who have had an audiogram. Unfortunately, we have not been able to convince the VRAB that it should introduce a more liberal interpretation than the mathematical approach that is currently used to adjudicate those claims.
The Chairman: Thank you. The committee had the opportunity, as was mentioned earlier, to go to Sainte-Anne-de- Bellevue to see the hospital. We were impressed with the level of care. As you know better than we, it is the only hospital remaining under federal control. The others are under provincial control.
This committee has heard some testimony in the past that there was room for improvement at the provincially controlled facilities. Is there anything you can tell us in that regard?
Mr. Parks: We would certainly agree that there is room for improvement at the provincially controlled ones.
We have embarked on a few initiatives with the Department of Veterans Affairs. We are in the process of signing a contract to survey all the community care facilities across Canada. We want to ensure that the same level and quality of care is given in B.C. as in Newfoundland. There are thousands of ``mom and pop'' community care facilities that the Department of Veteran Affairs is paying to care for our clients, but it does not have sufficient staff to monitor the provision of care.
We have canvassed the country through the Legion Magazine and come up with 80 surveyors who qualify — some retired doctors and nurses and so on. Our program will start, we hope, before the end of May. We are doing a training seminar for these surveyors; we will be sending them out across the country to all the community care facilities and government long-term care facilities as well.
Their reports will be going directly to the Department of Veterans Affairs, as well as reports to us on things we are looking for to make sure that quality care is there. This should give the department something to act on right away. They will know something is wrong in such and such a place.
We might also pick up new clients. Veterans out there in those homes may know nothing about what is available to them. That is what we have embarked on right now; however, there is a lot to be done yet on long-term care.
The Chairman: Thank you, Mr. Parks.
Senator Wiebe: Would you mind sending our committee a copy of that report as well?
Mr. Parks: I do not see why we cannot.
The Chairman: That would be helpful. Also, if you could, at any time, keep us in the loop if you think it would be helpful. You have always been a vital cog in this machine of public policy development governing the welfare of our veterans. We look to the Legion, and other organizations, but specifically to the Legion, for information and indications as to where we might focus our attention.
Honourable senators, that concludes our meeting. Mr. Daly, do you have a comment you would like to make before I adjourn the meeting?
Mr. Daly: Senator Day and I talked the other day about how the Legion is involved in many more things than veterans' services. We would like to invite your subcommittee to Legion House some evening. I will be in contact with your clerk to arrange that so we can give you a full briefing.
The Chairman: We look forward to that.
The committee adjourned.