Proceedings of the Subcommittee on Veterans Affairs
Issue 6 - Evidence - October 20, 2010
OTTAWA, Wednesday, October 20, 2010
The Subcommittee on Veterans Affairs of the Standing Senate Committee on National Security and Defence met this day at 12:08 p.m. to study the services and benefits provided to members of the Canadian Forces; to veterans; to members and former members of the Royal Canadian Mounted Police and their families (topic: implementation of the New Veterans Charter).
Senator Roméo Antonius Dallaire (Chair) in the chair.
[Translation]
The Chair: Good afternoon everyone. Today, we will continue discussing the news releases the government issued recently and especially the component concerning the continuity of care specifically intended for certain veterans.
If you recall, last week, we talked about amended policies and legislation that will be introduced at some point in time in the Senate. Today, we will focus more on the continuity of specific care.
We are welcoming two witnesses today: Ms. Charlotte Stewart, Director General, Service Delivery Management; and Ms. Charlotte Bastien, Regional Director General, Quebec, Service Delivery and Commemoration. I would like to point out that Ms. Bastien is also responsible for Ontario.
I would like to note that since the restructuring undertaken in 2010, if my understanding is correct, the Atlantic region has been under the supervision of another office in Halifax. Ms. Bastien is in charge of Quebec and Ontario, with six subdivisions. Another director, based in Winnipeg, is responsible for all of Western Canada, from Manitoba to the Pacific coast.
Those three entities oversee the delivery of services to veterans.
Ms. Bastien is responsible for delivering services to a very large number of veterans in Quebec and Ontario, and her attendance will be very useful for the committee members.
[English]
Ms. Stewart, we have been given a few PowerPoint slides, which makes me feel comfortable. I will open the floor to you and Ms. Bastien for your opening remarks with the use of those slides, and then we will go into questions.
Colleagues, remember the precedent that members get first crack at the questions. Today Senator Rompkey is formally representing Senator Pépin, who is out of the country, as a member.
Senator Meighen: I am substituting for Senator Wallin.
The Chair: Thank you. Please proceed, Ms. Stewart.
Charlotte Stewart, Director General, Service Delivery Management, Veterans Affairs Canada: I work in Charlottetown with Veterans Affairs Canada. Joining me is Ms. Bastien, currently the regional director general responsible for the regions of Quebec and Ontario.
As a branch, Service Delivery and Commemoration has over 2,000 employees who work predominantly across Canada. We are, in effect, the front-line people that our veterans and still-serving members will meet when they first come to Veterans Affairs for information or for programs and services. We are the front-line staff.
[Translation]
I would like to thank the committee members for the opportunity to talk about how we are modernizing service delivery. I would like to emphasize that this is just one of the components of the major transformation the department is undergoing.
The transformation also involves work done by others in the areas of program, policy, research, technology and memorabilia management.
My colleague and I will begin by providing you with a national overview of current initiatives. For that phase of the discussion, I will ask that you consult the deck distributed to you.
[English]
I know you are particularly interested in what happens on the ground, what happens to the veterans when they need our benefits or services, and what happens when they return if they are injured or in need. Ms. Bastien and I would be pleased to answer in detail those questions.
With respect to our clients, most of you know we are in the midst of a major demographic shift. Our traditional war veterans are declining, and our new veterans — our modern-era veterans, as we call them — are almost at an equal number right now. In fact, next year will be the first time the modern-day veteran clients will outnumber our war service veterans. By 2015, which in terms of our planning and our activity is not far away, the modern-day veterans will outnumber our war service veterans by a factor of almost three to one.
What does that mean to us? We have a very divergent client mix. When we speak about our war service veterans, our oldest is over 100 years old and the average age is 87. In many cases, they and their families are facing end-of-life care issues and supported care, and that is where we need to be for them. Our case management for our traditional war veterans is focused on that aspect of their life.
They are a different client in how they like to work and deal with Veterans Affairs. In large part, they prefer the telephone and written communication, and they have long and established relationships in many cases with people in Veterans Affairs who have served them over the years.
Our modern-day veterans are a different story. Our youngest is just 19. The average age of release is in the mid-30s. These are people who often have families, who are returning. They need support for their families and for themselves to transition. If they are becoming clients of Veterans Affairs, they will usually be looking to us to help them and their families to make that transition from a military life to a civilian life.
To date we have identified about 4,800 clients with service in Afghanistan. About 2,700 of those clients have a disability benefit that is directly related to their service in Afghanistan. Of those, we have about 200 whom we would classify as seriously injured. Those are the people who need our care the most. Serious injuries can incorporate a range of issues: people with amputations or other severe physical injuries, brain trauma, mental health issues and so on.
When we speak about complexity, we are not speaking about one particular injury or another. It can be a mixture of injuries that brings about a strong level of impairment and a real difficulty for these people to move on from the military life to a civilian life. They are the ones we are working with very closely.
Many Canadian Forces, CF, veterans wait several years before coming to Veterans Affairs for support. Sometimes that is because their situation does not arise until later, and sometimes it is because they did not know or did not have the information. However, we do know that we need to reach those people and make them understand what Veterans Affairs Canada can provide for them.
It also means we have to get ready. With Canada's engagement in Afghanistan changing over the next year, we can expect to have more clients coming to us, or more returning soldiers who will be looking for our services. Therefore, we are getting ready.
We know they want one-stop access; they do not want to have an issue where they are getting information from the Department of National Defence, DND, that is not supported by information from Veterans Affairs. They want information that is clear, concise and readily available. They want fast access to benefits and services, and that is what our transformation is about. Our modernization agenda is about ensuring there is the least amount of time between the need of that client and when they receive their service. That is what we will do.
In terms of our transformation agenda, I know you heard from Keith Hillier, Assistant Deputy Minister for Service Delivery and Commemoration. He was here as a witness about a year ago, and he spoke about the modernization agenda. We began that long ago, and even before that. It is moving along. We have real goals, and we are making some progress.
What is it all about? It is building a service delivery network that is modern, proactive and client-based. It will push us to the stage where we do not have a lag time between when we know there is a need and when we can deliver that need.
We know that our new veterans expect service 24/7, maybe on a website or a phone call, but they are used to the modern world of technology. Whatever we do, it must be able to conform to that. It will not be the old way.
At the same time, we want to reinforce that we are still here for the traditional war veteran. That cannot and will not change. Our commitment to them will remain high.
At the same time, we need to get ready. It is a modern world. The new veteran is used to going into a bank or going online, and they can communicate. They do not need to worry about having someone at a storefront or necessarily in a face-to-face situation. We need to be ready for the part of the group that wants to deal with us that way.
There are others who will need our case management services. We will have to be sitting with them, working strongly in a close relationship with them and their families. We will be sitting in their homes working with them and understanding their needs. We will have to be there for them as well. That is part of our transformation.
We need to get better at doing the things that will make it easier and faster for them. We will radically improve wait times for benefits and services. There were legitimate concerns about how long it takes to get our benefits and services. We know that, and we have begun to take those steps. It is having an impact on shortening some of our wait times, but we need to do more.
We will be there for the client who needs case management. We will be speaking a great deal about case management today because it is a key aspect of what Veterans Affairs is about. We have made many significant steps in that area, and our minister has spoken and made a recent announcement as well that shows our continued commitment to meet the needs. Case management is a big part of that. Our veterans and clients will get the help when and where they need it.
At this point, I will ask Ms. Bastien to continue.
[Translation]
Charlotte Bastien, Regional Director General, Quebec and Ontario, Service Delivery and Commemoration, Veterans Affairs Canada: Mr. Chair, the idea behind our service delivery transformation strategy is to modernize our integrated personal support centres in order to reassign resources, total workforce and staff to wherever they are needed. We are working closely with the Department of National Defence on building a network of integrated personal support centres.
Currently, the network consists of 19 sites at military bases across Canada. Over 100 Veterans Affairs Canada employees are currently working in those centres to provide one-stop support to those who need it.
This approach has been very successful. Each month, over 1,500 people make use of those centres. Some of them simply need information, while others need support. In all the centres, releasing members can take part in a transition interview. The interview provides some of them with the opportunity to make initial contact with Veterans Affairs Canada and to find out what we can do for them, should they need our services.
Those interviews are mandatory for members being released for medical reasons, but other members find them relevant as well. Last year, about 4,000 soldiers and reservists participated in transition interviews. We also encourage families to attend the interviews.
We want to improve wait times for benefits and services. Currently, some 197,000 clients are receiving disability pensions or disability awards. This program is far from being our largest program. Each year, we pay out directly to our clients and their families a non-taxable amount of about $2 billion.
This year, we began a major program overhaul. Our goal is to process clients' applications in less than 16 weeks by April 2011. That timeframe is 30 per cent shorter than the current processing time.
To achieve these results, we hired additional staff in the pension application processing sector and we have started simplifying the administrative processes involved. In addition, we have been testing a digital imaging system — a proven and reliable technology — that will enable us to access documents more quickly.
Thanks to the faster processing times, we are already seeing a 35 per cent drop in the volume of calls to our toll-free number from clients inquiring about the status of their application. In addition, we have also created a special unit responsible for speeding up the support process for seriously injured or ill individuals. The average processing time of a disability pension application is 60 per cent shorter than our service standard. If we have access to all the documents we need, we can make a decision in only a few days.
In order to facilitate communications between the department and the clients, we are currently implementing a number of initiatives. People who are injured, ill, suffering from chronic pain or having trouble adjusting to life outside the military have very little patience for bureaucratic red tape.
These people want clear and simple explanations of the reasons behind a decision and of the options available to them. Above all, they want to be able to talk to someone who will listen to their concerns, provide them with assistance and answer their questions. This reality has brought us to revise the wording of our disability decision letters in order to make them easier to understand.
If a client receives an unfavourable decision, he or she will also be provided with the name of a disability pension officer to call in order to get further explanations. Clients with an active case plan can call our toll-free number and will be transferred directly to their case manager.
Our next initiative will consist in transforming our website into an online tool enabling our clients and their families to file a benefit application and to follow the status of their application online. This initiative is not yet fully implemented, but we are getting closer to meeting our objective.
In terms of strengthening case management capacity, case management, work is nothing new for the department. Since the New Veterans' Charter was adopted, we have been trying to move from the benefits-based model to a needs-based model.
Not all clients need a case plan or a case manager. However, for those that do need those services, early intervention is crucial. We know that clients with greater needs sometimes need much longer to recover and rehabilitate. Our job is to ensure that clients with greater needs receive more support.
Last year, we adopted a comprehensive national case management strategy, and its implementation has already begun. In response to the joint initiative — a Legacy of Care announced recently by Veterans Affairs Canada and the Department of National Defence — we have hired 20 new case managers and assigned them where they were most needed.
Altogether, we have 270 case managers who are part of a national network of client service teams. These teams consist of various health professionals, physicians, nurses, psychologists, occupational therapists and clinical care managers. In addition, we have retooled the workloads to allow case managers more time to focus on clients with more demanding needs.
We have also delegated more decision-making powers to case managers, so that they can make decisions based on the clients' case plans. Clients will now have faster access to the services and benefits to which they are entitled. Also, in order to support our staff better, we have created a new case planning tool. Our staff has received training on how to use those tools and will be given additional training regarding their newly acquired decision-making power.
[English]
Ms. Stewart: At this time of year, we want to mention remembrance. We believe that delivering services and benefits to our clients, to veterans and their families is an important way for the Government of Canada to thank them for their service to our country.
We would like to note that this year, as in others, there will be hundreds of opportunities to take part in these ceremonies across the country through our remembrance programming and through the participation of communities.
We also want to say that we are honoured that the Senate will host a ceremony the morning of November 5 to pay tribute to Canada's past and present military heroes. When we are working service delivery, we believe there is a true link between the work we want to do to improve our services and to continue to offer our services to our clients and remembrance and appreciation for what they have done. We thank you.
When we speak about our modernization, we know that while this process has begun, we have a lot of work to do. As Ms. Bastien said, some key initiatives are already under way, but our work is far from done. We believe we will be making significant progress, and we would be pleased to continue to provide updates to your committee over time on the progress we are making.
That concludes our opening remarks.
The Chair: Very good. Thank you for giving us an overview of what is ongoing. We have been looking at the recent announcements of the legacy of care. I will ask my colleague, the deputy chair, to ask the question in a moment.
I would like to bring one point as a backdrop to our questioning today. It comes from the fact that we were briefed or told that there were further announcements of the New Veterans Charter but that they were being held up by the central government agency's involvement in the process.
Could you give us, as part of your answers to my colleagues, the backdrop of where these fit in with the other things that are coming and why they are being held up at this time?
Senator Manning: I am not sure our guests can answer the chair's question, but we will see what happens.
I want to talk about the numbers that will change in the next five years in relation to your clients. This is an eye-opener. We realized that the number of our modern-day veterans was increasing. I did not realize it is as early as next year, as you say, that they will be overshadowing the numbers of our war service veterans.
You talk about modernizing your points of service. Much of the testimony we have received in the past has to do with the service and the concerns that, in most cases here, modern-day veterans have expressed to us.
Could you elaborate on that? To give you an example, several witnesses testified that they are not necessarily aware of what programs are available to them. More or less it was word of mouth, and when they investigated, it was a long-drawn-out process.
From a communications point of view, have you given some thought to how to improve the knowledge base of our modern-day veterans?
Ms. Stewart: I will begin, and perhaps Ms. Bastien will join in. A key element that will help us address the point you raised is the integrated personnel support centres, IPSCs. There are 19 of those across the country. Those are our VAC-DND partnership base. Those are centres where VAC employees work hand in hand with DND, and they are located on or near bases.
When you think about a new veteran or a potential client who is still serving or a soldier who is returning from Afghanistan, in many cases, if they are still in the military, they will get their information in a way that is close to home and close to where they are still serving. The IPSCs are physical locations where they can get information on VAC programs and services.
If they are still serving and are injured and are likely to be making a transition, then there is an active process with DND now where VAC and DND case managers will work together on behalf of that client. There is information sharing at that point.
Communication is key to everything we do, and we are trying to get the message out earlier and better. Some of it is that we will meet with people before they go on a deployment. At that point in time, frankly, they are not that focused on VAC's programs and services, so we have to find other ways as well. When they return, we also have an opportunity to give them information.
We have information on our website, and of course in inter-district offices, which are located across the country. You can walk in and get information in that way.
Moving towards more electronic-based information flow for the newer veteran will be a key item as well. We need to work more closely with DND in getting out to the veteran, the client, on the bases, and that is part of our plan for this year as well.
Ms. Bastien: To give an example, we have had a VAC office at Valcartier since 2004. As part of the transition process early on with DND we worked out a procedure with a checklist: Go see VAC when you are released. They would come and see us and see what we could offer.
From the get-go we had been invited pre- and post-deployment. That is happening throughout all the bases across the country. We give a brief of what we can offer and what we can provide and what the members are entitled to.
The other approach is we have been working with the reserve units. Through the IPSCs, we are communicating and contacting the reserve units and are available to brief them on what we can do and offer.
Senator Manning: You mentioned in your opening remarks adding more case managers, and you touched on working together with DND to do that. Could you give us an idea of what that increase would be? Is the plan to increase to work side by side with DND, or is it to increase the number of case managers, or are you planning on bringing together some of the services?
Ms. Stewart: The recent announcement by the minister on the legacy of care allowed us to add 20 new case managers to our complement. We now have 270 case managers operating across the country. We placed those 20 in the areas of greatest need: There were four in Atlantic Canada, ten in Quebec, three in Ontario and the balance in the Western region.
The purpose of the legacy of care was to ensure that we had sufficient case managers to meet the needs, particularly of the newer veterans, at this time.
Going forward, we do have a plan to make sure that case managers have a workload they can work with. There is no point in having well-trained case managers who have such a number of clients that they cannot possibly give them sufficient attention.
We have been developing clear protocols around how much would be an appropriate caseload and how to know if a case manager has the right number or mix of cases. Frankly, if someone has a very high number of complex cases, it will be hard for them to meet the needs of those client groups. We have a means now to measure the complexity of the cases. We can assign factors to measure the complexity so that each case manager will have a mix of clients, a mix of complex and less complex clients. That is a way we can ensure that they can manage their workload.
Based on that, and based on the number of clients who are currently getting our rehabilitation program, for instance, which requires case management, we can work out generally speaking how many case managers the department should have and where we need them. Equally important is the fact that we do not want to add new case managers in offices or regions or districts where the number of clients is on the decline.
In addition to the 20 case managers that we received through the announcement, we have been managing our case managers as a group, and we have been making sure that if a vacancy comes up in an office where the number of clients is decreasing, that position may not be filled. We will make sure that the clients there have the case management they need, but we may not fill that position and will make a decision to put that position in Valcartier or Petawawa or Edmonton, for instance, bases where there is a great deal of activity right now.
We do have a very active management of the case management group. If the department finds that it needs more case managers, then a decision will be made about how to meet that need as well.
Ms. Bastien: I would like to add that the reorganization of the workload and the distribution of active caseloads to the case managers was completed for all of Veterans Affairs at the end of August. We began the process a couple of months earlier, at the end of 2009, and completed it for all of Veterans Affairs, with Ontario being the last region at the end of August. That has made a difference for the case managers and, most important, for the clients by allowing more time for the case manager to do the follow-up and have regular communication with the client and the family.
As well, I would like to point out that as we do our human resources plan and forecasts, we have been managing our HR, as Ms. Stewart mentioned. That process has been ongoing for the last year, so that when there is an opportunity through attrition for a vacancy in a certain office, we either fill the position or review the composition of the team and the number of professionals needed in that office. We have been doing that for the last year. In anticipation, we also did a recruitment process to create a pool of qualified individuals. With the recent announcement, we were able to staff right away, not start the staffing process to fill this position, whether in Petawawa, Valcartier, Gagetown or any other site.
The Chair: We are limited in time, but we want complete answers, of course.
Senator Manning: In your presentation, you mentioned the fact of reducing the client's decision by 30 per cent, from what it is now, by April 2011 and introducing a plain-language decision letter. I certainly would suggest that if you get to the point where you do come up with a plain-language decision, you send it out to all other government departments as well. It would straighten out many things across the country.
You talked about being able by April 2011 to provide clients with a decision under disability benefits within 16 weeks, which will be 30 per cent faster than it is now. What process are you pursuing to do that? A drop by 30 per cent is substantial. How do you plan to do that?
Ms. Bastien: First, we will re-engineer the work process. We might be limited by legislation. We cannot get around that. We will look at how we can access documentation or reports faster and put the effort on how we can streamline the process to access the information and to process the application.
Ms. Stewart: We did add extra adjudicators, who were able to eliminate the backlog of existing cases. Currently, we are piloting the use of scanning technology. We want to test that to ensure that it will help to reduce the need to move paper copies around. We have found ways to organize work so that people who have more experience in certain files will work on those files. By segregating the work, they have managed some efficiencies as well. The 30 per cent is significant, but it has been achieved for the newer applications in many cases.
The Chair: The chair permits itself a follow-up. So much of what you have been describing seems to be reacting to the demand and trying either to catch up or to respond to it. The New Veterans Charter took effect in 2005 because we needed it for our new veterans injured since 1989, at the end of the Cold War, in particular the Gulf War; and now we have Afghanistan. Under the New Veterans Charter, were these reforms and modernization requirements not all identified for a new generation of veterans in the hundreds, if not thousands, even before our participation in Afghanistan?
Ms. Stewart: Yes, modernization did go back and begin with the New Veterans Charter. Yes, some backlogs occurred around the disability pension and disability award, which are high-demand, paper-driven processes. We need to note as well that a big part of the New Veterans Charter is the rehabilitation program. We refer to it as the holistic program for medical, social, psychological and educational rehabilitation. That is where the new veterans are most likely to find the help they need when they are transitioning.
Our staff were trained on that at the beginning of the New Veterans Charter. Case managers were put in place and were added to. It is working well. There are no backlogs there. If a soldier or veteran is interested in the rehabilitation program and is identified as high need, his eligibility can be determined quickly. Currently, the average wait time to get into that program is about 35 days and is decreasing.
We prepared very well around the rehabilitation program, but there is still some work to do. The disability pension and disability award programs in the past have been more paper-based. Those are the ones where, frankly, we need to modernize around technology and other aspects.
Senator Plett: I congratulate you on the tremendous work that you have done and some of the things that you will continue to do. Indeed, we have had some great announcements, and we eagerly await the rest of the pending announcements. The great work you have done is wonderful, especially with the 30 per cent improvement in benefits.
At the last meeting, prior to our going from questioning to debating, I had a supplementary question, but we ran out of time. I will start with that question, and then I have a few others.
How does VAC define ``catastrophic injury''? Is there a difference between catastrophic injury and permanent impairment?
Ms. Stewart: This is a policy area, in some ways.
Senator Plett: What were the words of my good senator here that you would issue something that would be simple and straightforward?
Ms. Stewart: A catastrophic injury in many cases will render the individual incapable of what we consider a successful transition. The injuries are severe and profound. Permanent impairment allowance for permanent impairment is for those individuals who will not work to the full extent of their work prior to injury, and that impact is permanent in their life. They would not be able to return to what we would consider a sufficient earning ability.
We can follow up and perhaps provide you with a more detailed explanation of that. At the working level that is how we have differentiated between the two.
Senator Plett: I would appreciate it if you could send us some information on it. I would also like to know who determines what is catastrophic and what is not catastrophic. There has to be someone sitting in a chair somewhere making that determination. I would think that the odd veteran would say that what has happened to him is catastrophic, whereas someone else might not think so. I would like some follow-up on that, please.
In your presentation you talked about the average age of a veteran, which amazingly is 87 years. You said that much of what you do for these veterans is end-of-life care. I would like you to explain what you do for end-of-life care and compare it to end-of-life care for a civilian.
Ms. Bastien: Helping them at the end of life could be through the Veterans Independence Program by providing support so they can stay at home as much as possible before they require placement in a long-term care facility. Also, it could be when the unfortunate time comes that they need placement in a long-term care facility. When the time comes that they need placement in a long-term care facility, it could be working with the veterans and their families on what options are available to assist them with that process and also with long-term care, if they are eligible for that. If palliative care is required, we would assist the veterans and their families throughout that phase.
Senator Plett: Would our present medicare not provide for most of that?
I need to fly home this afternoon to see my father, who is currently in need of end-of-life care. I am hoping that he will still be able to speak to me when I get home tonight. He is close to the age of the average veteran. He is getting wonderful care, and he is not a veteran. What does Veterans Affairs provide that he does not get?
Ms. Bastien: It depends upon where he lives. We have contract beds in certain facilities that are reserved for veterans. If eligible veterans seek placement in those facilities through us rather than through the provincial system, we work with them on that. If the required level of care is not provided by the province, Veterans Affairs can provide alternatives.
Senator Plett: This written presentation says that upon implementation, some veterans released from the Canadian Forces due to catastrophic injuries may be provided an additional $1,000 a month.
If you cannot provide the answer to this question now, I would appreciate receiving it later. Exactly how will the award of the additional $1,000 be decided upon? At what point is the decision made that a particular veteran needs $1,000 a month?
The Chair: The chair looks forward to receiving those responses.
We know that veterans need different care than the general population, and that care is provided at Sainte-Anne-de-Bellevue, for example, which you are closing. Do you still have enough places dedicated to serving veterans without them having to go to provincial or civilian institutions?
Ms. Bastien: We have no wait lists anywhere in the country. Some areas are more problematic due to demographics, but in some facilities we now have vacancies.
The Chair: They might be filled by the new generation of veterans at a much younger age. Thank you very much for that.
Senator Meighen: Welcome, witnesses.
I want to return to what Senator Plett was exploring. I think it would be extraordinarily difficult and largely subjective to decide what is catastrophic and what is not. I do not envy your task. What is a catastrophic injury for me might not be for you and might not be for whoever makes the decision. I just hope that if there is difficulty in deciding, the benefit of the doubt will be given to the veteran. I do not know whether that is written in your operating manual.
Ms. Stewart: We will follow up with the information you need. It is based on a determination of the percentage of the level of disability or impairment. Through adjudication, the client will be assessed a certain degree of impairment, which is referenced as a percentage term. Impairment is based on the impact on their ability to resume normal functioning or on their mobility. There are a number of factors. Those numerical determinations are used to determine what is catastrophic. It is not subjective.
Senator Meighen: Is the loss of four limbs automatically a 10, or would that have to be discussed at an adjudication? What if one became a quadriplegic?
Ms. Stewart: There would be no discussion around that for adjudication.
Senator Meighen: Consider if one lost three limbs, or one arm and one leg, or two arms, or two legs. What is the basis for making a decision? Does it depend upon what my skills are? I suppose that if I lost both legs but have use of both arms I could work at a call centre. However, if my previous occupation was a high school basketball coach, it would be rather difficult to do that job.
I really do not know how you do it.
Ms. Stewart: You are looking for more information further to the announcements that were made recently around catastrophic, and we will be forthcoming with that. In service delivery management we are going back and looking at clients who would be eligible to receive those new benefits.
Senator Meighen: Are you speaking of people who did not receive it in the past but now, with the new policy, might be eligible for it?
Ms. Stewart: One of the new announcements was that there would be a minimum of $40,000 provided to someone through earnings loss. We are going back and looking at the individuals who are currently receiving earnings loss and ensuring that the level for those applicants will be adjusted when these changes have gone through the legislative and regulatory process and come into force.
We are getting ready for that. In service delivery we will contact the clients and let them know about this. There are means we can take to get ready for that, which is important to the service.
Senator Meighen: Would that be retroactive?
Ms. Stewart: No. That would be effective upon the coming into force of the change.
Senator Meighen: The $1,000 additional sum for catastrophic injury is a monthly payment, is it?
Ms. Stewart: Yes, it is.
Senator Meighen: Will that affect SISIP benefits? Will that affect the Earnings Loss Benefit in any way? It is taxable, I presume.
Ms. Stewart: It is taxable. It is part of income, yes.
Senator Meighen: Do you know whether it will have any effect on the Earnings Loss Benefit or the SISIP benefit?
Ms. Stewart: We should provide you with information that would answer that question directly.
The Chair: We have heard from previous witnesses that veterans with injuries that are less than catastrophic are receiving the maximum. Some who have lost a leg and an arm, for example, are receiving the maximum, while some who have worse injuries than that have received no real compensation. That must be investigated. In addition, some with injuries that are considered to be less than catastrophic and completely off the scale will now, with the new legislation, be picked up.
We have had the New Veterans Charter for over four years and are now picking up on a lot of stuff for which there will not be retroactive benefits. Many casualties have not been benefiting during that time. I know that you are learning on the job, but we are hearing that we have been a little slow with the uptake.
I look forward to the modernization of the living document to actually mature. We will talk more about that when we get to the report point.
Senator Rompkey: I have three questions. The first is with regard to the one-stop shopping. I understand the interface with DND, but is there a need for interface with Service Canada as well? The whole point of Service Canada was a one-stop shopping centre. You once had to go to the Canada Pension Plan, Employment Insurance and wherever separately, and now people can go to that one stop. There might not be a lot that Service Canada could provide to veterans — I just do not know. CPP is one thing that crossed my mind. My first question is whether you have an interface with Service Canada, and is there a need?
The second question is with regard to the review board. There used to be a veterans pension review board. There is no longer a veterans pension review board. I assume the only review now is within the department. Is that right? If it is right, could the other be reinstituted? Is there a need for a reinstituted veterans pension review board? We review everything else. This chamber is a review chamber.
Third, what is the average caseload? You mentioned that you are trying to change caseloads. You said you have more people to manage cases, but you did not indicate how many veterans one manager has. I would like an answer to that.
Ms. Stewart: Service Canada, which has over 600 points of service across the country, has high potential to us as a partner. You are absolutely right: Service Canada was set up to provide service to Canadians. We have had some early discussions with them. In fact, they could be used to extend our reach. We would not be use Service Canada and therefore shut down some of our operations. It would be more a question of whether there is a way to partner with an organization like Service Canada to extend our reach, particularly into areas that are difficult to serve and more remote. It is an important point, and it is being factoring into our discussions.
Ms. Bastien: Regarding the caseload, on average a case manager can have between 25 and 60 active cases, but it depends on the intensity, and it is not a static caseload. You have clients moving in and out depending on the length of time they will require support and case management. Some people say an average caseload is between 30 and 40 cases, but depending on the complexity, we are talking about between 25 and 60 cases per case manager.
Senator Rompkey: What about the third question?
Ms. Stewart: The Veterans Review and Appeal Board is in place now in the department, and it still exists for veterans who wish to appeal their decisions.
Senator Rompkey: It is not a non-departmental entity, is it?
Ms. Stewart: It is not; it is indeed independent.
Senator Rompkey: Is it independent?
Ms. Stewart: Yes.
Ms. Bastien: The Bureau of Pensions Advocates is also available to veterans or clients.
Senator Rompkey: How is the board appointed?
Ms. Bastien: I will have to get you the information; I do not have the details.
Senator Rompkey: I would like to know how many are on there, who they are and who appoints them — whatever you can tell us.
The Chair: May I assist in clarifying? I think the pension review board you are speaking about is a higher body that looked at the overarching pension scheme of veterans and not at the specific review of cases. What you are speaking about is the board that reviews cases that have been brought into appeal. I believe you were talking about that higher-plane board that advises the ministry with regard to the veteran pension status; is that not correct?
Senator Rompkey: No, there was a pension review board that dealt with cases, as I understood.
The Chair: That is still there, yes. There have been comments about not enough veterans in the veterans review board — in fact even throughout Veterans Affairs Canada, but that is another question.
Is there any other clarification on that?
As we go to the second round, you have 19 outlets of these joint places and you have said you have 100 people now doing that. You said you were adding 20 people to this. Do you have enough people? Is 19 enough of the outlets? Is 100 people enough in those joint places to do the job of not only providing service but also selling your product to the potential veterans and getting them to come there?
Ms. Bastien: As of today, yes. In six months time that might change. This is where we are looking when we do our planning and our forecasts with Canada's involvement in Afghanistan, right now with Petawawa coming back and Valcartier going there. When these members are released down the road, we will have to forecast whether there will be a need for services. We will plan accordingly. If we need to add or realign resources, that is an ongoing planning process.
The Chair: How fast can you react? Is it within months or a year?
Ms. Bastien: Weeks to months.
Senator Plett: While you are looking for clarification on some of the questions we have already asked, maybe you could also send us clarification on the words ``full potential.'' I would like to know what that means as well. Probably it is part of the rest of it.
I will ask three questions all at once because they are all related. The benefit for attendant care will be offered to those members who require assistance up to a maximum of $100 a day. To whom is this benefit payable? Would it be to the caregiver or to the member? What expenses will be reimbursable? Is a maximum time limit placed on this benefit, or can the caregiver or member apply for this $100 a day 365 days a year? Until what time, age 65 or 75, or until death?
Ms. Stewart: Are you speaking about the attendants care of Veterans Affairs or the new one that was mentioned?
Senator Plett: The new one that was mentioned, the $100 a day that we heard about in our last committee meeting.
The Chair: Perhaps I could assist before you respond. That is a Canadian Forces benefit that has been brought in.
Senator Plett: That is right.
The Chair: I am not sure how close the link is with that.
Ms. Stewart: It is an important benefit and will support the families of those soldiers who are in transition, but it is a program of the Department of National Defence.
Senator Plett: I apologize, then; I should have asked it the last time.
The Chair: We will be coming back to them.
I am trying to link the New Veterans Charter evaluation, that year-long evaluation that you are involved in and the phase 2 report that appeared on your website in August. With your modernization efforts and this report and this evaluation, are there links now already moving in to implement changes before we see a report maybe published in a year or something?
Ms. Stewart: Absolutely.
The Chair: Is there an actual staff process that is interacting between the evaluation and the modernization plan that is still ongoing?
Ms. Stewart: Yes, there is. Once the findings of the evaluation are put forward, the department is meeting, understanding those recommendations and developing an action plan. In fact, we get an early opportunity to hear what the findings are. We consider it an extremely important part of what informs us about any gaps or issues we have. The action plan around the New Veterans Charter has helped us make decisions around how better to communicate about the rehabilitation program, and some of the gaps around that, and also around case management.
The Chair: As an example, one recommendation out of phase 2 is to implement an outreach strategy. Is your modernization absorbing that as an implementation to meet this communications gap that you say is there?
Ms. Stewart: Yes, it is. The department has been working actively on that, and the findings of that evaluation were important to informing us on that.
The Chair: In the legacy of care — and you mentioned this — authority to make more timely decisions on the critical recovery, rehabilitation and transition will be given down.
I am keen to know a few examples of what has been held up there in the stratosphere of authority and what is now being moved down into the trenches so that people can take decisions and implement things. Give us some examples, please.
[Translation]
Ms. Bastien: Regarding the rehabilitation program and the decision-making process, in our Quebec City and Valcartier offices, we increased the level of delegation for case managers last fall. The delegation changes are currently being implemented from coast to coast for all rehabilitation program managers. Exceptional requests are no longer sent to our head office; they are processed by the case manager at the area office.
As for the Veterans Independence Program (VIP), we have revised delegation to client service officers in district offices for cases under $5,000. We are looking into the possibility of increasing the delegation involved. These cases are not processed at the regional office or at the head office. From now on, client service officers can process cases involving amounts up to $5,000 under the independence program. Training is almost complete, and we are finishing the implementation process in order to ensure that the officers are able to exercise this new responsibility.
The Chair: I am sure we will hear more on this subject.
[English]
Senator Rompkey: I have a question about people in remote areas and the benefits they have access to.
When veterans from the Northwest Territories, Yukon, Labrador, Nunavut — there are not many but there are some — retire, do they retire near bases, or do they go back home? If they retire at home, how would they be served? How would they get access to services?
Ms. Bastien: When they are going through the release process and the transition interview, one of the questions we would ask is where they intend to live.
Senator Rompkey: What is the pattern, though?
Ms. Stewart: We have some anecdotal information. It seems that soon after release they are staying closer to bases for a period of time. History would say — and we will have to confirm this — that they will eventually move from there or could move from there closer to their home base. It is affected by so many factors. If they have family in a certain geographic area, and depending on their situation, they may wish to return. We have been finding in the period of time right after their release that they tend to stay and locate closer to the bases.
Senator Rompkey: I ask this question because quite often people who live in the North have to travel to care facilities, and family has to travel. That becomes expensive. I have known cases of people who going through an end-of-life experience, and the family had to pay $2,000 a passenger per trip to visit that member because there was no care facility nearby. Is provision made for that? If extra costs have to be involved, is there something? Quite often across government, special recognition is given, for example in tax areas, to people who live in remote areas. There is a housing and a travel tax deduction for people who live in certain areas. That is a Treasury Board guideline. Is that same principle applied in your department?
Ms. Bastien: As part of the rehabilitation program, which is under the New Veterans Charter, there are provisions if there is travel and also for the family if they need to travel. As the veteran is going through the rehabilitation program, if he is in a medical program where he needs to be stabilized medically, some costs could be incurred, and there are some provisions under the rehabilitation program for that.
The Chair: Senator Meighen has a question, but I want to follow up on this.
You have a strong link with DND and even some memoranda of understanding, MOUs, but Service Canada with its 600 outlets would be a great place to employ veterans and to get the message outside. Are you looking at the option of creating an MOU with them with regard to services?
Ms. Stewart: With regard to services, we have had the opportunity to talk to them about that. Service Canada will not necessarily have a storefront operation in the most remote parts of Canada, but they provide for regular visits by some of their agents to those areas to provide service. That could be one way of reaching people in a remote situation.
Before we move off that question, I wish to mention that we have provision, for example, for tele-mental health services. That is one way those clients, although physically separated from a case manager or an operational stress injury clinic, could still access services. Of course, our national call centre network is available throughout Canada for those who want to get more information or be in contact with someone who can talk to them more directly.
Senator Meighen: Taking a leaf out of Senator Rompkey's book, this is a three-pronged question, dealing with the Earnings Loss Benefit minimum of $40,000.
Sandra Williamson told us that that was intended to cover normal living expenses while a veteran is going through rehabilitation. What about the severely injured veterans who perhaps need retrofitting for the home? You mentioned that there are barrier-free transitional accommodation support services near selected CF rehabilitation sites, but once everything is done and the veterans return home, is there anything to help them retrofit their houses so that if they are wheelchair-bound they can get around?
Why was it decided to end the Earnings Loss Benefit at age 65? Is that because Canada Pension might kick in then? Could you clarify that?
Will the Veterans Independence Program, VIP, provide any services to veterans who are severely disabled and living in their own homes?
Ms. Bastien: Regarding VIP, we have had modern-day veterans who either have a disability award or are in receipt of a pension, and because of their disability or pension condition, they were entitled to the VIP program. Under that, there could be assistance for groundskeeping or housekeeping. We also have a program that deals with the home modifications if they need it. This is another program where we have increased the delegation to the district offices and the case manager to have a greater authority to provide benefit under that program. It is available right now.
Senator Meighen: Thank you. Why do we end it at age 65? Is that when people often retire?
Ms. Stewart: My understanding is that it ends at age 65 and then the Canadian Forces support that comes on stream. Also at age 65, Veterans Affairs can provide a supplemental benefit that is equal to 2 per cent of the gross earnings loss amount that they have earned since going on until age 65. That 2 per cent offered by Veterans Affairs under the New Veterans Charter is to compensate for the loss of the individual's being able to contribute to another pension program. They are supported beyond age 65, but not by Veterans Affairs.
Senator Meighen: Thank you very much. I am heartened to see that you are putting emphasis on training your managers because I think I speak for everyone here saying that the myriad of programs, worthwhile as they all are, is quite daunting to keep in mind as to what is and is not available. If you are a veteran who is somewhat traumatized by an injury, it must be hard to know what you could reasonably expect to receive and how you should proceed. The managers are critical in helping them wade through that morass of information.
The Chair: We have now expended our time. Thank you, Ms. Stewart and Ms. Bastien for giving us information on the nuts and bolts of things. We look forward to the information we have requested to come in a timely fashion so we can continue our work.
The session with our witnesses is closed. I wish only to inform the members that we have been looking at the questions of the social contract in the New Veterans Charter and whether it is a social contract or an insurance policy.
I will be sending you a study that was done in 1997 within DND on the concept of a social contract between the veteran who gives his or her life and the Canadian people and government. I think it might be informative for future policy work that we will be doing in the study of the New Veterans Charter. You will be getting that free of charge.
Ms. Stewart: We would like to thank you very much as well for this opportunity.
The Chair: That is very kind of you.
(The committee adjourned.)