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37th PARLIAMENT, 3rd SESSION

Subcommittee on Veterans Affairs of the Standing Committee on National Defence and Veterans Affairs

EVIDENCE

CONTENTS

Wednesday, April 21, 2004

1530

The Chair (Mr. Bob Wood (Nipissing, Lib.))

Ms. Verna Bruce (Associate Deputy Minister, Department of Veterans Affairs)

1535

1540

1545

The Chair

Mrs. Elsie Wayne (Saint John, CPC)

1550

Ms. Verna Bruce

Mrs. Elsie Wayne

Ms. Verna Bruce

The Chair

Mrs. Elsie Wayne

The Chair

Mr. Claude Bachand (Saint-Jean, BQ)

1555

Ms. Verna Bruce

Mr. Claude Bachand

Ms. Verna Bruce

Mr. Claude Bachand

Ms. Verna Bruce

1600

Mr. Claude Bachand

Ms. Verna Bruce

Mr. Claude Bachand

Ms. Verna Bruce

The Chair

Mr. Murray Calder (Dufferin—Peel—Wellington—Grey, Lib.)

The Chair

Mr. Brian Ferguson (Assistant Deputy Minister, Veterans Services, Department of Veterans Affairs)

Mr. Murray Calder

Mr. Brian Ferguson

Mrs. Colleen Soltermann (Policy Analyst, Program Policy Directorate, Department of Veterans Affairs)

Mr. Murray Calder

Mr. Brian Ferguson

1605

Mr. Murray Calder

Mr. Brian Ferguson

Mr. Murray Calder

Mr. Brian Ferguson

Mr. Murray Calder

Mr. Brian Ferguson

The Chair

Hon. Bill Blaikie (Winnipeg—Transcona, NDP)

Ms. Verna Bruce

Hon. Bill Blaikie

1610

Mr. Brian Ferguson

Hon. Bill Blaikie

Ms. Verna Bruce

Mr. Brian Ferguson

Hon. Bill Blaikie

Mr. Brian Ferguson

Hon. Bill Blaikie

Mr. Brian Ferguson

Hon. Bill Blaikie

Mr. Brian Ferguson

Ms. Verna Bruce

1615

Hon. Bill Blaikie

Ms. Verna Bruce

Hon. Bill Blaikie

Mr. Brian Ferguson

Mrs. Colleen Soltermann

The Chair

Mr. Rick Casson (Lethbridge, CPC)

Ms. Verna Bruce

Mr. Rick Casson

Ms. Verna Bruce

Mr. Rick Casson

Ms. Verna Bruce

Mr. Brian Ferguson

Mr. Rick Casson

Mr. Brian Ferguson

Mr. Rick Casson

Mr. Brian Ferguson

Ms. Verna Bruce

Mr. Rick Casson

Ms. Verna Bruce

Mr. Rick Casson

1620

Ms. Verna Bruce

Mr. Rick Casson

Ms. Verna Bruce

Mr. Rick Casson

Mr. Brian Ferguson

Mr. Rick Casson

Mr. Brian Ferguson

Mr. Rick Casson

Mr. Brian Ferguson

Mr. Rick Casson

Ms. Verna Bruce

Mr. Rick Casson

The Chair

Mr. Rick Casson

The Chair

Mr. Carmen Provenzano (Sault Ste. Marie, Lib.)

The Chair

Mr. Carmen Provenzano

Ms. Verna Bruce

Mr. Carmen Provenzano

Mr. Brian Ferguson

1625

Mr. Carmen Provenzano

Ms. Verna Bruce

Mr. Brian Ferguson

Mr. Carmen Provenzano

The Chair

Mr. Claude Bachand

1630

Ms. Verna Bruce

Mr. Claude Bachand

Mr. Brian Ferguson

Ms. Verna Bruce

The Chair

Mr. John O'Reilly (Haliburton—Victoria—Brock, Lib.)

Mr. John O'Reilly

1635

Ms. Verna Bruce

Mr. John O'Reilly

Ms. Verna Bruce

Mr. John O'Reilly

Mr. Brian Ferguson

Ms. Verna Bruce

Mr. John O'Reilly

The Chair

Mr. John O'Reilly

Ms. Verna Bruce

Mr. John O'Reilly

Mr. Brian Ferguson

Mrs. Colleen Soltermann

1640

Mr. Brian Ferguson

Mr. John O'Reilly

Mr. Brian Ferguson

Mr. John O'Reilly

The Chair

Mrs. Elsie Wayne

Ms. Verna Bruce

Mrs. Elsie Wayne

Ms. Verna Bruce

Mrs. Elsie Wayne

The Chair

Mrs. Elsie Wayne

The Chair

Mr. Rick Casson

The Chair

Mr. Rick Casson

Ms. Verna Bruce

Mr. Rick Casson

Ms. Verna Bruce

Mr. Rick Casson

Ms. Verna Bruce

1645

Mr. Brian Ferguson

Mr. John O'Reilly

The Chair

Mr. Murray Calder

The Chair

Mr. Murray Calder

Mrs. Colleen Soltermann

Mr. Murray Calder

Mrs. Colleen Soltermann

Mr. Murray Calder

Mr. Carmen Provenzano

The Chair

Ms. Verna Bruce

The Chair

Mrs. Colleen Soltermann

The Chair

Ms. Verna Bruce

Mr. Brian Ferguson

The Chair

Mr. Claude Bachand

1650

Ms. Verna Bruce

Mr. Claude Bachand

Mrs. Colleen Soltermann

Mr. Claude Bachand

Mrs. Colleen Soltermann

Mr. Claude Bachand

Mr. Brian Ferguson

Mr. Claude Bachand

Mr. Brian Ferguson

Mr. Claude Bachand

Mr. Brian Ferguson

Mr. Claude Bachand

Mr. Brian Ferguson

1655

The Chair

Mr. John O'Reilly

Mrs. Colleen Soltermann

Mr. John O'Reilly

Mrs. Colleen Soltermann

Mr. Brian Ferguson

Mr. John O'Reilly

Mr. Brian Ferguson

Mr. John O'Reilly

The Chair

Mrs. Elsie Wayne

Mrs. Colleen Soltermann

Mrs. Elsie Wayne

Mrs. Colleen Soltermann

Mrs. Elsie Wayne

The Chair

Mr. John O'Reilly

Mr. Brian Ferguson

Mr. John O'Reilly

1700

Mr. Brian Ferguson

Mr. John O'Reilly

The Chair

Ms. Verna Bruce

The Chair

Ms. Verna Bruce

The Chair

CANADA

Subcommittee on Veterans Affairs of the Standing Committee on National Defence and Veterans Affairs

NUMBER 002

3rd SESSION

37th PARLIAMENT

EVIDENCE

Wednesday, April 21, 2004

[Recorded by Electronic Apparatus]

¹ (1530)

[English]

The Chair (Mr. Bob Wood (Nipissing, Lib.)): We would like to call this portion of the Standing Committee on Veterans Affairs to order and welcome our witnesses, obviously no strangers to this committee; they've been here a number of times. We have Ms. Verna Bruce. Verna is the associate deputy minister. With Verna today is Brian Ferguson, an assistant deputy minister, and Colleen Soltermann, the policy analyst with the program policy directorate.

Welcome to the committee.

Ms. Bruce, if you have an opening statement, it's all yours.

Ms. Verna Bruce (Associate Deputy Minister, Department of Veterans Affairs): Thank you. I do. I'll probably take about 10 or 15 minutes just to run through this. We do have copies for you in both English and French. That should work to your advantage, because some of the information, although we've tried to be general, does tend to get a bit technical. It will be helpful to have a copy.

I'm really pleased to be here today to pass along greetings from our minister and deputy minister and to share with you information about the veterans independence program, which we all know as VIP. I plan to provide you with an overview of the VIP program in general and also give you an update on our progress with the extension of VIP to survivors and qualified primary caregivers of veterans.

I was going to introduce Brian and Colleen, but the chair has ably done that, so I will move on.

I know that you share the interest of Minister McCallum and that of every Veterans Affairs Canada employee in supporting veterans in maintaining their independence and quality of life. I'm particularly proud of how the VIP program has enabled tens of thousands of veterans to maintain their dignity and independence.

In 2003, last year, a total of 71,700 clients received one or more VIP services through the program, and in that year our VIP program expenditures totalled $186 million.

Since 1981 we've provided services that help veterans remain healthy and independent in their own homes and communities. Through the VIP the department has addressed the fact that the diminished capacity of the elderly to care for their surroundings and maintain their dignity in the community is at least as influential a factor in institutional admission as diminished physical capacity.

When we implemented the VIP, known in the early days as the aging veterans program, we knew that veterans preferred to stay in their own homes and communities for as long as possible. Over the years this preference has remained strong. We also knew that it was going to be challenging to meet the long-term care needs of a large population of aging Second World War and Korean War veterans through the institutional beds that are available for veterans in provincial facilities.

Since that time the popularity of the VIP among our veterans has been documented time and time again. The success of the VIP program is reflected in the fact that it's seen by many, at home and abroad, and including the major veterans organizations, as a model for the implementation of a national home care program for all of Canada's seniors.

So let me tell you a little bit about how the VIP works. In accordance with the veterans health care regulations, the VIP offers self-managed care in cooperation with provincial and regional health authorities when the required services are not available federally or provincially. It is important to note that the VIP is not intended to replace other federal, provincial, or municipal programs, but to be a top-up or a supplement when the veteran, his family, or a spouse residing with him can't provide the services he requires.

The services that clients receive depend upon their particular circumstances and health needs. Appropriate services for the individual might include things like home care services, including the ones you're probably most familiar with--groundskeeping and housekeeping--personal care, nutritional services, and health and support services such as professional nursing care.

The VIP can also provide for ambulatory health care services such health assessments and other services under the supervision of a health professional. Some veterans receive support for transportation to access certain health care services--doctors appointments--or to enable them to participate in social activities.

The VIP can also provide for home adaptations that accommodate activities of daily living such as bathing, and in other cases the veteran may need nursing home care, where the long-term care bed in a community facility is funded through the veterans independence program.

I'll talk about the recent extension of the VIP to survivors later on, but I want to clarify that the two VIP services that are available to a veteran's qualified survivor, or where there is no survivor, another other primary caregiver, are the grounds maintenance and/or housekeeping services. It's just the two that a surviving spouse would be eligible for if the veteran received them at the time of his death.

The VIP is very specific to the needs of the individual, who qualifies on a needs assessment. It's not a cookie-cutter program with the same set of services for everyone, and this is actually the fundamental strength of the program because it enables us to provide assistance where it will make the greatest difference in terms of meeting personalized care needs. However, it also makes it somewhat challenging to provide a simple explanation of who might qualify and what services they should receive, and again this will vary from province to province depending on what's available through provincially funded programs.

¹ (1535)

As Minister McCallum and Deputy Minister Jack Stagg mentioned during their March 11 meeting with the full committee, eligibility for the VIP can occur in a number of ways. I'll try to provide you with a clear explanation without quoting regulations.

[Translation]

As Minister McCallum and Deputy Minister Jack Stagg mentioned during their March 11 meeting with you, eligibility for VIP can occur in a number of ways.

[English]

The first group of people who qualify are those pensioners whose medical assessment determines that they require services to help them cope with their pensioned disability. This could be a modern-day CF veteran or a wartime service veteran. The key here is that their pensioned disability requires them to have a VIP service. We can answer your questions on this afterward. We'd be quite happy to.

There is also a provision under the regulations specific to wartime pensioners who have significant disabilities, and the way we define this is that a seriously disabled wartime veteran is somebody who is pensioned at 78% or higher. A medium-disability pensioner is somebody who is receiving a pension between 48% and 77%. These people may qualify for VIP services based solely on medical need. In other words, for them, and they're just a very specific group, their need might result from medical conditions they have in addition to their pensioned disability that make it difficult for them to remain independent.

A common question about the VIP is whether eligibility is based on income levels, and I know this came up at your March 11 meeting. The short answer here is no. It's a needs-based program. So those who have a medical need for the services because of a pensioned disability can receive the service regardless of their income. There is a provision in the regulations so that low-income war veterans may qualify for services even if they do not have a pensioned disability. The income levels are established under the War Veterans Allowance Act. They are national monthly rates tied to inflation, and since 1930 they've been tied to the OAS rates. As of April 1, the cut-off level is $1,107 per month for a single war veteran and $1,681 per month for a veteran who is married or who has a common-law partner.

As if that's not complicated enough, VIP services are also available for totally disabled, non-pensioned prisoners of war, and finally, veteran clients who are at home awaiting admission to a priority access bed, one of VAC's departmental or contract beds.

These two new eligibility groups were part of the urgent needs legislative changes recently implemented to meet the most urgent needs of Canada's war veterans, and I might add that they reflected the priorities of the major veterans organizations.

In terms of process, when a client becomes eligible for our services, our area counsellors work with the veteran and his or her family to identify an appropriate service provider in the community. This could be through a professional service or it could be by an independent local service provider. We work hard to ensure that veterans, whether they live in urban or rural communities, have access to the services they need and are eligible to receive.

As mentioned earlier, I'd now like to discuss the extension of the VIP grounds maintenance and housekeeping services to qualified veterans. Your committee was instrumental in supporting changes to the veterans health care regulations to recognize the years of support given by survivors and other caregivers that actually enabled many veterans to remain at home in their final years. The changes enable qualified survivors of veterans who have died since September 1, 1990 to access VIP housekeeping and/or grounds maintenance services for life. In cases where there is no survivor, other primary caregivers may qualify. The services that are provided, if they're needed, are those services that were received by the veteran at the time of his or her death. So it's not possible to add on a new service; the veteran has to have been receiving it at the time they died.

Since the new regulations were approved on December 3, 2003 I'm very happy to tell you that we have personally contacted nearly 23,000 survivors or primary caregivers of veterans to provide them with an application kit. We've also advertised in community newspapers across the country. To date we've received 12,000 completed applications and we've reviewed approximately 1,000 of those.

¹ (1540)

More than 900 applicants so far have been approved. Now that the significant task of contacting eligible recipients is complete--that was our first focus and priority--we'll be able to expedite the approvals of the remaining applications. Our target is to have all eligible clients in receipt of these services by December 30, 2004.

In addition to these applications, every month about 200 survivors maintain their eligibility for VIP. Without the recent extension of VIP benefits, these spouses would have ceased receiving their services one year following the death of their veteran spouses. Now, if the veteran's spouse is receiving it, we continue it for life.

There's been much discussion about extending VIP to survivors of veterans who died before 1990. In 1990, VIP housekeeping and/or ground maintenance services were made available to surviving spouses of those veterans who had been receiving the services for the very first time. Prior to 1990, these services were not available for spouses. At that time, they received the benefit for one year after the death of the veteran. On the rationale for that, we recognized that withdrawing those services immediately could place hardship on their surviving caregiver, therefore increasing the benefit for one year would theoretically give people an opportunity to adjust.

As much as we agree that VIP is an excellent program and very useful to those who are eligible, we could not reinstate a program or benefit that did not exist before that date. We continue to counsel survivors regarding other programs that may exist within the municipality or province, to respond to their needs.

As Minister McCallum stated in his last meeting with you, he has asked the department to look into VIP eligibility for groups that do not currently receive it. We're very aware, for instance, that there are some groups of veterans who do not qualify. We're constantly reviewing the many competing priorities to maximize existing veterans' programs.

We were very pleased to implement changes in 2003, initially in June and then later in December, that allow for the continuation of VIP for those survivors of veterans who had qualified for these benefits in the past. It does represent a substantial enhancement to VIP.

Let me conclude by saying that the acceptance and use of VIP by veterans and their survivors is a testament to the value of VIP as a viable alternative to long-term care. The development of the program, since its inception in 1981 demonstrates how effective we've been at working together to ensure that as the needs of Canada's veterans continue to evolve, so must our programs and services.

The Royal Canadian Legion sees the potential of VIP as a model for a truly national home care program for all Canadian seniors. This is a recommendation they have made to the former Prime Minister's task force on seniors, and to other caucuses. I understand that they see a Canada-wide seniors independence program to be modelled after VIP; a program that would recognize the right and responsibility of seniors to remain at home for as long as is reasonable, safe, and practical. The program would offer the joint benefits of supporting personal independence for seniors, while delaying very expensive institutional care.

It's important to note that the cost of providing VIP services and VAC treatment benefits to veterans living at home is approximately one-sixth the cost of institutional admission. But perhaps more importantly, it provides the flexibility and care options that our veterans have told us they want.

[Translation]

In closing, thank you for having me here today. We can feel confident that the VIP program is improving the lives of many deserving Canadians.

[English]

I believe the fact that since December we've been able to reach out to 23,000 survivors of primary caregivers, who can also hope to qualify for the program, is a great accomplishment.

Thank you for your hard work on behalf of Canada's veterans and their caregivers. The work of this committee has been essential to the progress we've been able to make to date.

Thank you, Mr. Chair.

¹ (1545)

The Chair: Thank you, Ms. Bruce.

We'll open it up for questions.

Mrs. Wayne, you are first off the mark, for seven minutes.

Mrs. Elsie Wayne (Saint John, CPC): Thank you very much.

I want to welcome you here, Verna, Brian, and Colleen, and thank you very much for the work you do for the veterans.

I get calls every day--Brian, I think you and Verna are very much aware of that--from veterans and their spouses. As you know, they first brought in the program in May 2003. Then we went after it, and they changed it back to 1990. But the problem I'm having with the requests I'm receiving is that the wives of those veterans who died just prior to 1990 are having a difficult time accepting the fact that their husbands were overseas too; their husbands served in the war, yet they're not eligible.

One lady called me from Ontario and said, “Elsie, the lady across the street is eligible because her husband died in September 1990. My husband died just a year before that and was in the same unit as him. Why would she be eligible when I'm not?” She was crying, Verna, she was crying.

That is why I'm wondering why we are not making all of our veterans and the spouses eligible for what has been there for all of those veterans and their spouses since 1990. How do we go about that? I know you're going to hear from us; there's no question about it. That is how we maybe helped a little bit to get this program in place. But it is a major concern.

I have another question as well. Back home, every Sunday after church I'm out at our Ridgewood health centre, as you know. My father-in-law is there. He had his 95th birthday on Sunday. He thought he was 83. He kept saying, “You're telling me I'm 95”? I said, “Yes, Dad, you're 95”. He's in a wheelchair and his mind isn't too sharp, but the nurses all think he's great.

Once again, our veterans are getting older all the time and we need to expand. We need more beds. We have about 100 veterans who are waiting to go into Ridgewood, and we need more beds. That was the case when we travelled across the nation. We found a lot of the hospitals needed more beds. When we looked in Newfoundland, glory be to God, we couldn't believe it. We looked in a room and there were three beds in there; three beds in that tiny room, with one closet. Only one person was supposed to be in that room, not three.

I think they should be number one and we should all make them number one. But what do you think about the spouses, prior to September 1990? What are we going to do for them?

¹ (1550)

Ms. Verna Bruce: I guess I'll start off. We get those calls in our office too, and it is really difficult to try to explain to people how a date can make you eligible or not eligible.

As the minister mentioned when he was here the last time, we were able to get the program back to September 1990--with your help--by talking about the fact that we were trying to reinstate people for something they already had. As you're well aware, reinstating people does give you some flexibility and some ease. Our legislative mandate right now just doesn't allow us to go back before that, which is difficult for those women to understand.

It's also fair to say that the minister has asked us to look at groups of veterans who aren't currently eligible for VIP. There's quite a few of those out there as well. Then we'll have to take a look at the range of possibilities around that.

I can also say that we worked really closely with the Legion and other veterans organizations on this program. We try to work with them on their priorities. When we take a look at who else should be covered by VIP, we will probably want to go back and consult with them as well. But we're certainly well aware of the problem.

Mrs. Elsie Wayne: It costs so much. We have an aunt who is 99, and she's in a nursing home. You would not believe how much it costs per month for her to be in that nursing home, versus veterans being in one of our veterans nursing homes. Those veterans cannot afford it. If they have to go into a nursing home, will the Department of Veterans Affairs pay for that, even if it's $4,800 a month?

Ms. Verna Bruce: That's where you get into some complicated issues about who is eligible for what.

With regard to your second question, on the situation in Newfoundland, Brian can update you on that, because we have been working in Newfoundland to try to improve that situation.

In terms of the number of people on the waiting list, this is a really interesting question. People will tell us that there are 100 people on the waiting list. We find that very often there really aren't 100 people who either want the bed or need it right now. Through one of our pilot projects that we operated here in Ottawa, we found that if people have a choice between getting VIP services at home or going into an institutional bed, most people will stay at home as long as they can. At the Perley Rideau we found that the majority of people who were receiving services at home didn't want to go into a nursing home. So you're in the situation where people are asking for a nursing home bed because they think there's no other option. In fact, for our veterans the option of staying in the community is a very real one, which we will assist with.

The Chair: Thank you. Your seven minutes are up. We'll come back to you.

Mrs. Elsie Wayne: Thank you.

[Translation]

The Chair: You have the floor, Mr. Bachand, for seven minutes.

Mr. Claude Bachand (Saint-Jean, BQ): Thank you very much, Mr. Chairman.

I have read a number of documents, including the notes drafted by our research service, and I have listened to your presentation. The only justification given right now for denying program benefits to widows of veterans who died before September 1, 1990 is that benefits such as housekeeping and grounds maintenance weren't part of the program prior to this date.

You also said that your legislative mandate does not allow you to extend program benefits to widows of veterans who died prior to September 1, 1990. By legislative mandate, I assume you're referring to the regulations, not to the bill as such. Before we bowed to political pressures and amended the regulations, 23,000 survivors were not eligible. I'm curious as to the real reasons, because I have some figures. Program funding is set to increase from last year's level of $187 million to $193 million this year, and to $251 million in 2004-2005. Are these numbers correct? In response to political pressures, we extended program benefit eligibility to 23,000 survivors. How many survivors—surely you have this information—are currently not eligible because of the September 1, 1990 cut-off date? Can you answer that question for me?

¹ (1555)

[English]

Ms. Verna Bruce: There are two groups of widows to think about. The number of people we are aware of who are alive right now is between 1,200 and 2,400. We don't track the number of spouses who aren't part of our caseload, so it's difficult for us to be more precise than that. If we take a look at what we think would be a normal rate of institutionalization for those people, then our estimates are that between 1,000 and 2,000 of those women would not be living in an institution. If they're not living in an institution, then theoretically they could be eligible for VIP groundskeeping and housekeeping if they need it.

[Translation]

Mr. Claude Bachand: Do you have a comparable budget to work with? What additional costs would Veterans Affairs need to incur to meet the needs of these persons?

[English]

Ms. Verna Bruce: The estimate we have right now for the group who would not be institutionalized is that it's probably in the vicinity of $3.6 million. For the total group, if we were wrong on our rates of institutionalization, it would be closer to $4.95 million.

[Translation]

Mr. Claude Bachand: So then, if coverage was extended to everyone, we would be looking at an expenditure of anywhere from $3.6 million to $5 million. Again, I'm wondering if the opposition shouldn't exert some political pressure in order to move the file forward. That's what happened last time. I realize that you're not a politician, but rather a public servant. However, if you were an opposition member, would you be putting pressure on the House of Commons to extend coverage to all survivors? Admittedly, the situation is unfair and cannot really be justified.

Put yourself in our shoes. Consider the case of the woman whose husband died in August 1990 and who is told that she's ineligible because the program wasn't in place back then. Her husband passed away in August, but the program didn't kick in until September 1. According to my figures, between 1,000 and 2,000 spouses in Canada are in a similar situation. In my view, what's missing quite simply is the political will to act. It's not a matter of amending regulations. We've already done that. If we want to treat all survivors fairly, I think we need to extend coverage to everyone.

I'm reassured by what you're telling me. If the costs involved were astronomical, I would have understood the government's reticence, but I think it would be a good thing to extend program benefits to all survivors, and I appeal to my government colleagues on this matter. What's your opinion?

[English]

Ms. Verna Bruce: I won't have the political discussion; I am a public servant.

From our perspective, if we go beyond 1990, there are a whole lot of veterans who don't have access to VIP either.

The mandate for Veterans Affairs Canada is to provide services to veterans. It's our number one reason for being. If you start getting into a world where you're going to provide a benefit to somebody who never received it—and it was not possible, unfortunately, for these spouses, the majority of whom are women, to receive it before 1990—then we have to look at that request in conjunction with a large number of veterans who aren't eligible for VIP right now either.

It becomes a matter, if we have a limited amount of money available, that there needs to be a process in place. The minister has asked us to look at this. How many veterans are there out there who can't qualify for VIP either?

Then it becomes a decision. If you have this group of veterans, and you have 2,000 spouses, and you have only so much money, which group are you going to extend VIP to first? We do have some work to do.

º (1600)

[Translation]

Mr. Claude Bachand: Therefore, you admit that this is a monetary issue and that political will has nothing to do with it. However, we feel that it wouldn't be such a big thing for the minister to extend coverage to all survivors, to add $3.6 million or $4.9 million to the $251 million budgeted for 2004-2005. In my view, this could be done. I think I've made my point.

You also stated that the program was needs-based, not based on income levels. I'm curious as to whether benefits are indexed, and if so, whether they are indexed on an annual basis.

Ms. Verna Bruce: The answer is yes.

Mr. Claude Bachand: Fine. I have no further questions at this time, Mr. Chairman. Thank you very much.

Ms. Verna Bruce: It's automatic.

[English]

The Chair: Thank you, Mr. Bachand.

Mr. Calder, you have the floor.

Mr. Murray Calder (Dufferin—Peel—Wellington—Grey, Lib.): Thank you very much, Mr. Chair.

I want to go on a slightly different track. We know this program came in in 1990. I would imagine you have the numbers of all the people who were registered in the VIP program, or grandfathered—whichever you want to call it. Then the program was changed in 1995.

Colleen, I imagine my questions would be directed toward you. I don't expect answers today, but I would like you to get back with answers for these questions. I have three.

First, how many were registered and/or grandfathered in the VIP program in 1995? I want to set a base number.

The second question would be, if the trigger of the VIP program were raised from $1,007 to $1,807 for singles, and also from $1,681 to $2,381 for couples, what would be the additional cost to the program? The trigger I see right now with the VIP program is a major problem; it's just too low. I'd like to see it raised higher so more can qualify.

The third question is what is the average percentage decrease in the veteran numbers, per year? They are dying off.

Once you get that information back to me, I guess the line of questioning would be very simply this. We know there'll be a base number we start with that's going to diminish, so you know what the maximum cost of the program is going to be to start with, and from there it's going to be a diminishing cost.

I'm wondering whether there wouldn't be a way of developing a strategy with the VIP program such that, once we know the percentage by which the number of veterans is diminishing each year, you could actually raise the trigger. You would have fewer people using the program, and as you raise the trigger, the ones who don't qualify for it right now could in the future, because the numbers are diminishing. I would like your comment on that.

The Chair: Before we start, could we have a copy of Mr. Calder's questions and your answers so everybody can share them? You can send it to the clerk and make sure everybody has it. Thank you.

Brian, you have the floor.

Mr. Brian Ferguson (Assistant Deputy Minister, Veterans Services, Department of Veterans Affairs): First of all, when you pose your question, we'll have to check on that date 1995, because I'm not sure what that date signifies in your mind.

Mr. Murray Calder: There was a grandfathering involved in 1995.

Mr. Brian Ferguson: We'll have a look at it.

Mrs. Colleen Soltermann (Policy Analyst, Program Policy Directorate, Department of Veterans Affairs): The grandfathering that was done in 1995 was with respect to certain qualifying members: the allied veterans in particular, with only ten years post-war residence in.... That's the key grandfathering—

Mr. Murray Calder: Which is another issue I would like to raise.

Mr. Brian Ferguson: Okay, we'll get your answer.

You've raised a really interesting question about the potential diminishing over time of the expenditure, which goes back to the point Verna made earlier, which is that there's a real trade-off between expenditures under this program and long-term care costs. It's an interesting observation, and one I suggest we'll have a hard look at.

º (1605)

Mr. Murray Calder: I would appreciate that, Brian, because quite frankly, if you look at it, we're in a situation here where you could attach x dollars to the program. You don't really have to increase them, because the number of people who will be applying for the program is in fact diminishing.

The other issue is we have veterans who fought in the Second World War as allied vets and then became Canadian citizens and are having a hard time qualifying for the program—if they qualify for the program. I'm wondering whether there isn't a way that could be fixed too. I'd like your comments on it.

Mr. Brian Ferguson: You're referring to the allied veterans. The recent changes that were made, last summer, modified the approach for allied veterans so that any allied veteran who has ten years post-service residency in Canada but who was not grandfathered in 1995 is eligible for care in a community bed if they meet that criterion. Also, they could get into one of our more intense priority-access bed facilities if that community bed is not able to meet their needs, if they're in for a particular reason such as dementia or some respite care. That's the nature of the change that was made.

Mr. Murray Calder: There's one final thing on which I'd like to ask a question and very quickly get your comment. I know we have one federal institution in the country and the rest is basically done with contracts with provincial facilities. I'm wondering what the process is for veterans on the priority list. In other words, what I'm saying is, because you're a veteran, you're bumped to the top of the list. I wonder what the process is for that.

Mr. Brian Ferguson: Are you asking about that process nationally?

Mr. Murray Calder: Yes.

Mr. Brian Ferguson: We have an agreement where there are a certain number of beds established for veterans that we pay for in our institutions across the country. We have a system where we work with the provincial institutions to determine the wait list for veterans for the number of beds that are available to us. There are only two or three areas in the country where the wait lists are a problem. As Verna mentioned, in those areas we instituted a program where, if a veteran went on a wait list for one of those beds, they were able to draw down on elements of the veterans independence program to keep them at home.

As she mentioned earlier, when we went back to tell veterans they could actually avail themselves of a bed because it had opened up, over 90% of them said no thank you, we'd like to continue to stay at home. Actually, that is a better thing for the government because it costs us less for them to stay at home. So we actually have enough beds across the country.

Now, there may be areas where we have to pay particular attention to a shortage, and we then work with the facility or through our area counsellors to try to find a solution, either that type of solution or one where we'll find them a space, potentially, in the community beds. So we have different options at our disposal; we work very hard to analyze each situation and attempt to resolve it.

The Chair: Five minutes--seven minutes; sorry.

Hon. Bill Blaikie (Winnipeg—Transcona, NDP): Thank you. I'm glad you said seven and not five.

I want to thank the witnesses for the explanation of the program. If I understand it correctly, at least from the departmental point of view, for widows of veterans who died before 1990 the distinction is not so much the date but whether or not their husbands were in fact in receipt of that service. Also, I understand that before 1990 no one was in receipt of it.

Ms. Verna Bruce: From 1981 until 1990 the veterans were in fact eligible, but it was only in 1990 we actually got approval to extend VIP to a spouse instead of a veteran. So from 1981 until 1990 the veterans were eligible for VIP, but if they passed away, we cut their spouses off virtually the next month in terms of anything the veteran had been getting around VIP. The major program enhancement that happened in 1990 was that for the first time ever we were allowed to continue to provide a service to the spouse, when the veteran wasn't living, for a period of one year.

Hon. Bill Blaikie: In the case Mrs. Wayne described, the two veterans could have both been in receipt, but one died just before the deadline and the other one died just after the deadline. So there is real discrimination based on the deaths, if you like, between those two widows.

º (1610)

Mr. Brian Ferguson: That situation was actually created in 1990 and was not a result of the recent changes, which brought the date back to....

Hon. Bill Blaikie: One of the things that struck me about your presentation was on page 7, where you said

I ask this question in light of the fact that just a couple of weeks ago, I think, the peacekeepers' association called for legislation to provide veterans of peacekeeping missions with the kind of veterans benefits wartime veterans receive. Yet this sentence here seems to me to suggest there is already some overlap between the benefits modern-day--to use your phrase--CF veterans and wartime veterans receive. How does that work? Are there veterans benefits available now to modern-day CF veterans, and if so, what is it people are calling for that isn't there?

I realize I'm kind of morphing into a different issue here.

Ms. Verna Bruce: The way it works right now for Canadian Forces veterans is that they are eligible for some VIP services but the service has to be related to their pensioned condition, and it's much more restrictive.

Brian, you may want to talk about this.

Mr. Brian Ferguson: With respect, CF members who do not have a pensioned condition with us aren't eligible for the VIP. But generally speaking, other than that, all Canadian Forces members and veterans are eligible for a pension if they are injured in service of Canada, and it doesn't matter whether they're under the old regime or the new.

Hon. Bill Blaikie: So what is it the group is calling for?

Mr. Brian Ferguson: There are a couple of differences to note. One is that there is what we call the compensation principle and the other is the insurance principle. The insurance principle is that you're covered 24 hours a day, seven days a week. That applied to overseas service veterans of World War II and to the Korean force, and it applied in a way such that if they were off duty while they were overseas and they got injured in a car accident or something, they would actually be covered under the pension program; that's the insurance principle. That principle does apply to people who are in special duty areas, for example, overseas in Afghanistan; if they're off duty and get injured, they're covered.

But for people who serve in Canada, they're covered by the compensation principle, just as you and I would be through workers' compensation. The principle is that if they're injured while they are on duty, they qualify for the services of Veterans Affairs, but if they're home barbecuing and something happens, they're not covered.

Hon. Bill Blaikie: Not all peacekeeping missions are special-duty missions, so there could be things that happen--

Mr. Brian Ferguson: It could be like average people who are serving in the Canadian Forces in Canada today, people going to work and coming home at night. When they're home at night, they're not covered by veterans benefits if they're serving in Canada.

Hon. Bill Blaikie: I'll have to look more into what they're actually asking for, because I'm sure it's not just a choice between barbecuing and--

Mr. Brian Ferguson: That's the one difference, though, I wanted to make you aware of, and there are a few others. They're not entitled to priority access to beds as are overseas veterans; they don't have an automatic entitlement to that. There are a small number of differences.

Ms. Verna Bruce: If I could, I'll just take a second, and if I have this wrong, Colleen, correct me.

An example would be if you had a Canadian Forces veteran who'd lost a leg. They've been pensioned for the loss of their leg, and because they don't have two legs, it's difficult for them to do groundskeeping, housekeeping, or whatever. Then they would be eligible for VIP. But if you have somebody who perhaps can't do those things because they've been diagnosed with cancer or they've been diagnosed with some other condition that's not related to a pensioned condition, then they can't access VIP even though they may be disabled. Is that correct?

º (1615)

Hon. Bill Blaikie: Wartime veterans can if they're below a certain income.

Ms. Verna Bruce: Or if they're above a certain level of disability.

Hon. Bill Blaikie: Just on the income thing, I wonder, do you have a breakdown of where there is the most uptake on the VIP? Mrs. Wayne says she gets calls about this all the time. As the NDP veterans affairs critic, I've certainly advocated for this. I've written letters and I've asked questions in the House, but I have to say I've only had a few calls. I was starting to think to myself, why is that? Maybe it's because most of the veterans in my riding are over the income threshold and therefore don't qualify anyway. Is that a reasonable explanation for why I never hear from anybody? Do you have a kind of breakdown of--

Mr. Brian Ferguson: It's need-based, so there might be a large number of veterans who don't receive VIP simply because they don't have the need.

Colleen, you may have some further data on that.

Mrs. Colleen Soltermann: With regard to regional breakdowns, I don't have the information with me, but the program is used widely across the country. As Mr. Ferguson just said, there are criteria that have to be met with respect to accessing VIP; it's for your pensioned condition when you're a pensioner, and in some cases when veterans have low income they can also qualify. There may be veterans who don't have the low income and don't have a pensioned condition that would allow them access, so they may not be contacting you.

The Chair: Thank you very much.

We'll go the second round, where we'll be alternating back and forth, and we'll start off with the Conservatives.

Mr. Casson, you have the floor for five minutes.

Mr. Rick Casson (Lethbridge, CPC): Thank you, Mr. Chairman.

I appreciate your being here, and as I mentioned before, I appreciate the briefing we received from your department some time ago. It was excellent.

The issue I want to raise is the fact that when a veteran who was in receipt of VIP passes away, regardless of what services he was receiving, the surviving spouse is only entitled to groundskeeping and housekeeping. Is that right?

Ms. Verna Bruce: If he was receiving that...[Inaudible—Editor].

Mr. Rick Casson: Okay. But if he was getting medical or whatever, the surviving spouse would be entitled to only those two things.

Ms. Verna Bruce: Yes.

Mr. Rick Casson: Do you have to have an approved firm or organization do the work for you? Does it have to be pre-approved? Can your neighbour come over and do it and give you a bill? How does that flesh out?

Ms. Verna Bruce: We've made some adjustments on that, so I'll let Brian speak to that one.

Mr. Brian Ferguson: Essentially, yes, you can get just about anybody to do it for you, even a relative if they're not living in your house with you. I think that's the rule.

But what we did recently with the introduction of changes to our federal health claims processing system is include in the competitive contracting the provision to...or we changed all the accounting processes so that in fact the processing of these claims is done through Atlantic Blue Cross Care, who's the contractor. They take the burden off the individual to actually submit claims. Once we've pre-approved their claim, they get sort of automatic approval, and the individual they've assigned to do this work is paid by Atlantic Blue Cross Care.

Mr. Rick Casson: So the surviving spouse does not have to pay up front for that service? The bill can go directly to the veteran?

Mr. Brian Ferguson: They just have to get approval from us, and then they don't have to pay up front.

Mr. Rick Casson: That'll be helpful.

What is the maximum amount a spouse is eligible for in a year for these services?

Mr. Brian Ferguson: For groundskeeping and housekeeping, I think it's around $8,000.

Ms. Verna Bruce: We have different amounts of maximum rates that we can provide for various benefits. It depends on what the needs are of the survivor. We have one element, home care, that includes personal care, VIP, housekeeping, and VIP grounds maintenance. The maximum for those three services, which are grouped together, is about $8,000 per year.

Of those elements, there are two that survivors are entitled to, which would be the housekeeping and/or grounds maintenance. There's a yearly maximum of about $900 for the grounds maintenance. The housekeeping itself is more based on a need and on how much the veteran needs in order to remain independent. There are maximums. There are cases where we can exceed those maximums on an exception basis, but those are maximums that we can provide.

Mr. Rick Casson: So a survivor gets $900 for groundskeeping?

Ms. Verna Bruce: Up to, if the need is there, yes.

Mr. Rick Casson: And it's flexible on the other. Is that what you're saying?

º (1620)

Ms. Verna Bruce: It's more flexible on the housekeeping, yes.

Mr. Rick Casson: Okay. But whatever it is, it's based on use?

Ms. Verna Bruce: Yes, it can be based on use and need.

Mr. Rick Casson: There seemed to be some confusion from some survivors that what their spouse was getting before they passed away, they were entitled to. But they are not.

Mr. Brian Ferguson: Because we're now extending this to the spouses, we're doing a fairly efficient assessment, I'd say, of whether or not the spouse has the same need. Our basic operating assumption, when we go into that process, is that they do. So I wouldn't expect you'd see too many who would get a different amount from what the deceased veteran was getting.

Mr. Rick Casson: Based on the services that they're eligible for.

Mr. Brian Ferguson: Yes, with that qualification.

Mr. Rick Casson: That's what they're having some problem with. They don't understand that they're not eligible for everything that was coming through the program before.

Mr. Brian Ferguson: And that's a problem we encounter, getting the communication clear on this. It's very difficult to do that, and we're working on it.

Mr. Rick Casson: I also want to comment on the statement you made here, on page 7:

A common question about VIP is whether eligibility is based on income levels. The short answer is no. It is a needs-based program.

Then you go on to say, well, it is actually based on income levels to some degree on some of the services. So I think that might be a bit confusing to some of the people who are applying for it.

Ms. Verna Bruce: On that one, just to clarify, there is a small group of people who don't have a pension condition and who have low incomes, and that's how we make them eligible. But the number of people who truly come in because they have extremely low incomes is relatively small, and we're pretty generous in how we calculate that.

What we will also say--it's kind of like doing your income tax, in a way--is that if you were eligible for this, if you didn't have OAS/GIS, then we'd kind of take that into account as well. We'd say, well, your income could be $1,500 a month, but if you don't have OAS/GIS, your income would be $900 a month, and we'd consider you to be eligible for the purposes of giving you VIP.

So we really stretch it in terms of trying to accommodate as many people as we can for an income qualification.

Mr. Rick Casson: Is that it, Mr. Chair?

The Chair: Yes.

Mr. Rick Casson: Okay.

The Chair: Mr. Provenzano, you have the floor for five minutes.

Mr. Carmen Provenzano (Sault Ste. Marie, Lib.): I have five minutes?

The Chair: You have five minutes. Can you do it in five?

Mr. Carmen Provenzano: I'm going to have to. I can do it, if you'll indulge me.

I have four questions. We may not get to the four of them. If you'll answer with the fullest answer that you can in the briefest possible way, then we're in business.

There's something here that I haven't been able to rationalize, and I try to listen carefully. On the entitlement for priority access beds, it seems to me there's no income assessment required for a priority access bed for a vet who served in a war theatre. There's no income assessment there at all, right?

Ms. Verna Bruce: That's correct, for most.

Mr. Carmen Provenzano: We seem to be saying that for people who would qualify for priority access beds at x number of dollars a day, if they were applying for VIP, their income is a factor, when it's not a factor for the priority access bed.

If you have a waiting list, you could have this scenario. You have a waiting list. For someone who then applies for VIP, who is income-tested on that basis and is disqualified, he or she would be otherwise entitled to a priority access bed at whatever rate the department is paying on a daily basis. Yet we all agree that from the veteran's standpoint it's better for the vet to stay in the vet's own home. From the department's standpoint, it's a lot cheaper to support people in their own homes than it is for a priority access bed.

Can you explain the rationale that creates the situation, if it in fact is there?

Mr. Brian Ferguson: I think the origin of the priority access bed should be considered. At the end of the Second World War, when this idea was created for a priority access bed, they recognized that a lot of overseas veterans would not need the kinds of services that the Department of Veterans Affairs was offering, particularly those who were healthy and didn't have any injury. Parliament conferred on them one right, which was to enter a priority access bed when they chose to, and needed to, at the end of their days.

That was one of the reasons why priority access beds were given to those individuals. Also, any veteran pensioner who needs to go into a priority access bed, per pension conditions, was also covered. The constitution of who got to have a priority access bed was driven from that. The VIP was recognized as a means of keeping people out of those beds. They are eligible.

What we've now done is actually fix the problem, to some extent, when we said that we can now, as a result of the urgently needed changes that we made last spring, bring into play VIP elements for those types of individuals if they don't want to, or aren't able to, get into a priority bed. We have addressed it in some respects, but it is a fundamental question.

º (1625)

Mr. Carmen Provenzano: It is, and from where I sit it seems that if the policy--and I know you don't set that--were to pay up to whatever amount, Veterans Affairs would pay for a priority access bed to a veteran who wants to stay in his or her own home and would have that kind of assistance up to that amount. That makes sense, but to have these limits on what can be paid--they are not commensurate with the class of priority access bed--and to have it triggered on a needs assessment seems to be superficial, from where I sit.

A statement was made, which I'll just read:

...the department has addressed the fact that the diminished capacity of the elderly to care for their surroundings and maintain their dignity in the community is at least as influential a factor in institutional admission as diminished physical capacity.

My question relates to this. I know that diminished physical capacity is a factor. I've been having some difficulty in finding out whether with diminished emotional capacity, which impacts on physical capacity, dissociative conditions, dementia, stress, you name it--any variety of emotional conditions could impact on a veteran's physical capacity or incapacity--we take that into account.

Let me tell you that I have a real situation. Last week was my first time to consider this. It involves an individual by the name of James Lacey, 83 years old, who cared for his wife. He was healthier than his wife. They're both 83 years old. Mr. Lacey's wife got into a brand-new facility in Sault Ste. Marie, a home for the aged, and he wanted to follow her there but he was deemed to be in too good health. He's been married to his wife for 64 years. Emotionally he is a wreck, and that is impacting him, but the assessment has come down that Mr. Lacey is in too good health to get a priority access bed. Can't we deal with that situation?

Ms. Verna Bruce: We'll look at it and get back to you.

Mr. Brian Ferguson: We'll look at that case, yes. I'm not saying we can resolve it here, but we definitely will have a look at it, Mr. Provenzano.

Mr. Carmen Provenzano: I don't think it's a big gap to bridge to see that situations that create an emotional condition will impact on the physical condition, especially at that age.

The Chair: Thank you, Mr. Provenzano. Your five minutes is up.

Monsieur Bachand, vous êtes le prochain, pour cinq minutes.

[Translation]

Mr. Claude Bachand: Thank you very much.

I'd like to get back to the persons who are discriminated against, and those who are not, because I believe the philosophy behind your program is commendable. You stress that this program also allows people to live independently and to maintain a certain standard of living as well as their dignity. Conversely, those who are denied access to the program, such as the widows of veterans who died before September 1, 1990, run the risk of having to move into an institution sooner because they cannot afford the upkeep on their home.

You stating in your opening presentation that housekeeping and groundskeeping costs represent one sixth of the cost of institutional care.

I also think we need to agree on another point. If a veteran moves out of his home into a nursing home, you cover related costs. However, after the veteran dies, if his survivor decides to move into an institution, you do not assume responsibility for the costs.

Is my understanding of the situation correct?

º (1630)

[English]

Ms. Verna Bruce: That's right. Correct.

[Translation]

Mr. Claude Bachand: I see.

I'm wondering then if it might not be a good idea to consult with the provinces. As I understand it, when a widow is no longer able to remain in her home and moves to a facility, the provincial government ultimately assumes responsibility for her care. I'm wondering if the Quebec government, or another provincial government for that matter, might not be receptive to the idea of working with you, financially speaking, to help widows remain in their homes. Everyone knows how health care services across Canada are stretched to the limit right now. If we can find ways to keep people out of institutions for as long as possible, I'm fairly confident that provincial governments would welcome such suggestions, bearing in mind the fact, of course, that health care, as we've repeatedly stated, is a provincial area of responsibility.

I think you should run this idea by the Quebec minister, stressing the esteem you have for women and your concern for their quality of life and dignity. You can outline your program proposal and at the same time seek his government's participation in order to keep costs down.

You agreed to help the country's veterans because you realized that it's less costly to keep them in their own homes than it is to place them in an institution. However, if you could show the provinces that the same holds true for their survivors, maybe then Quebec or another provincial government would be willing to invest in this program. It could be operated jointly, to avoid a sudden rush of survivors moving to provincially operated institutions.

Have you thought of this before, or did I just come up with a brilliant idea?

[English]

Mr. Brian Ferguson: If I might respond, actually, we're quite aware that this is an area that has attracted a lot of attention--the idea of cutting off when the spouse goes into the long-term care situation. We're looking to see if there are any options for us to address that issue. What you put on the table, I think, is one we should have a look at. I don't know that a lot of provincial governments would be willing to do it, but why not have a look at it and see? It's a really interesting idea, and I think we should take a look at that idea.

Ms. Verna Bruce: There are a couple of things. For us, we do have to remember that our mandate is to provide services to veterans, so that's our number one priority. But we do, obviously, provide now some services to spouses. It is difficult when you get into home care at the provincial level, because that is provincial jurisdiction, so there are some absolutely fascinating challenges around that. Just reading in terms of some of the things that are in the media right now, in terms of the federal role in health care, who knows, but it's an interesting idea. My previous life was in provincial health, and while it would be an interesting thing to look at, it would be difficult to put together.

The Chair: Mr. O'Reilly, you have the floor for five minutes.

Mr. John O'Reilly (Haliburton—Victoria—Brock, Lib.): Thank you very much.

I moved not because Carmen smells bad, by the way, but apparently this light fixture is going to fall on my head.

Mr. John O'Reilly: I have a number of questions. The first one deals with the fact that there's no ombudsman for the Department of Veterans Affairs. Therefore, do you deal entirely with an appeals process? If someone makes a claim and is not eligible, how do they appeal? That's the first question.

º (1635)

Ms. Verna Bruce: There is a very clearly defined process available through the Veterans Review and Appeal Board. If people apply to us for a benefit and are turned down, there are actually three more steps they can follow. One is that they can ask for a ministerial review, which we do. The second is that they can ask for a review at the Veterans Review and Appeal Board, and they can also go through the appeal process.

But I would also say that the veterans organizations have really taken on the role of being ombudsman or ombudspeople for many of the veterans. In fact, in the work we're doing with the Royal Canadian Legion, where they have people in all the facilities where veterans are housed, they're actually taking on an incredibly valuable role in terms of looking at quality of services to veterans and bringing to our attention anything that doesn't seem to fit.

So actually I would make the case that veterans have thousands of ombudspeople out there, including yourselves.

Mr. John O'Reilly: Oh yes, I know that.

I took on the role of being the assistant to the Minister of Veterans Affairs, and since that time I've been swamped with paperwork. The latest one doesn't swamp, but it is from the Royal Canadian Legion in Milton, and they want to know about the 25 recommendations in this report with Mr. Wood's name on it. Mr. Pratt was the chair of the committee at the time, and Mr. Wood was the chair of the subcommittee. This was filed in June 2003, I believe, and one of the recommendations was that Veterans Affairs Canada submit an annual report on the progress with the problems and that the report be tabled in Parliament. So I want to know, have you prepared that report yet? If you haven't, why not? If you are preparing it, how are you meeting the 25 recommendations that were in it?

Ms. Verna Bruce: I think we've already done that.

Mr. John O'Reilly: Have you? Okay.

Mr. Brian Ferguson: We'll have to double-check. I'm pretty certain it has been tabled.

Ms. Verna Bruce: Yes, we'll check. I think we actually tabled that a while ago, but we'll verify for sure and get back to the chair.

Mr. John O'Reilly: I just got this about two hours before I came in here, so I didn't have a chance to check on it.

The chair hasn't seen it. I had to remind him what the recommendations were, let alone that the report be there.

The Chair: There you go. That's why I'm retiring.

Mr. John O'Reilly: The other thing is that I wasn't sure, on Mr. Calder's question on the rising cost of patient care, are you doing an analysis on that?

We did an opening of a post-traumatic stress syndrome branch in London, and I represented the minister. The one complaint there, the one thing that was brought to my attention, is that the cost of caring for patients is dramatically rising--electric scooters, almost everyone needs one, or a wheelchair now, or bathroom lifts, different care, different things. So I think in any report you make to this committee, that should be part of it, because that is a big part.

We keep thinking the program has fewer people in it, but in fact for the people who are left the costs are rising, and the people who are coming, the people who are included in that particular area of veterans affairs, are also former RCMP officers who have served as peacekeepers, and even civilians who are eligible because they served in certain capacities. So I would hope that some handle is put on that so that people don't think you're losing patients or you're losing clients.

Ms. Verna Bruce: I'm actually glad you raised that, because I was hoping to get a chance to respond to Mr. Calder.

You're absolutely right. While the numbers should be going down, they aren't at the present time.

You'll recall that we've been back here looking for supplementary estimates for those very programs because our costs are increasing, and it's just for that very reason. People are coming through the door, they're much older, they have much higher needs for health care, and our costs, unfortunately, right now are rapidly ramping up.

Mr. John O'Reilly: It seems that everybody who was in artillery has lost their hearing, and we saw that with Judge Lamer yesterday. Certain things put people at a disadvantage.

I'm on the 60th anniversary committee of the D-Day invasion, and I'm there with three artillery guys who phoned me after the meeting to find out what happened. I'm thinking, geez, I was in the artillery, and my hearing is all right. I guess I didn't fire enough. Anyway.... So I know your costs are definitely rising on some of those things.

The other thing is, can you confirm or deny that the survivor's pension is 50%, that a widow receives 50% of the pension of the spouse? That's rather low, I thought, when most other plans are at 60%.

Mr. Brian Ferguson: Colleen can provide you with the details.

Mrs. Colleen Soltermann: When a veteran who is receiving a pension dies, the survivor is entitled to survivor's benefits. We have two rates. One rate is for the survivors of those veterans who were receiving a pension that was assessed at a 50% or higher rate; those are the veterans who were most incapacitated in their pension condition. All of their survivors get a fixed rate, or the same amount. My table here tells me that all of those survivors get about $1,500 per month, which is equivalent to about 75% to what the veteran was receiving prior to his death, as a married veteran. Those survivors of veterans who were pensioned below 47% receive 50% of what the veteran was receiving at the time of death.

So there is a category that receives 50% or less, and there's a category that receives the same amount for all levels.

º (1640)

Mr. Brian Ferguson: So the rationale for that is that the more severely disabled, the more the need is to continue a higher level of compensation.

Mr. John O'Reilly: So it's on a needs basis.

Mr. Brian Ferguson: It's an assessment. Yes, it's need-based in the sense that there's an assumption that if the veteran were more severely disabled and had a higher level of disability pension, there would be a need to continue a higher percentage of compensation to the survivor.

Mr. John O'Reilly: Thank you.

Mr. Chair, I noticed that you gave me seven minutes, but you only gave Carmen five.

The Chair: No, I gave him six minutes.

Ms. Wayne, you have the floor for five minutes.

Mrs. Elsie Wayne: Thank you very much.

I have another case, that of Aldon Tracey. Aldon is from Saint John, New Brunswick, and was in the services from 1943 to, I believe, 1946 or 1947. He's disabled and is now in hospital in Saint John, New Brunswick, but his wife got in touch with me and was wondering if there was any way he could get into Ridgewood, a veterans hospital. I've tried to reach the CEO there, but I've been unable to, and I'm going to continue to try.

His doctor has stated unequivocally that the problems he has, including the fact that he can't hear now, have to do with him being in the armed services from 1943, I think it was, till 1947. But the thing is that he wasn't overseas. He didn't choose not to go overseas; the armed forces had him on these training programs, which they still had in Canada. They're saying that because he wasn't overseas.... His wife was crying when she called and said, “Elsie, we've gone through so much, and he needs to be in the Ridgewood”.

So I was wondering, is there a problem because he wasn't overseas, even though his doctor states that the problems with his hearing and the problem with his physical situation have to do with him having been in the armed services?

Ms. Verna Bruce: As we mentioned earlier, if you were a person who served in Canada, you are eligible to a priority access bed, if you need it.

We can't comment on his case, but we'll certainly take a look at it and get back to you.

Mrs. Elsie Wayne: Yes. I've got all the information, and I'll send it to you.

Ms. Verna Bruce: Please.

Mrs. Elsie Wayne: I've got his regimental number, and everything.

Okay, thank you very much.

The Chair: Is there anything else?

Mrs. Elsie Wayne: No, that's fine.

The Chair: Mr. Casson, you have three minutes, if you'd like to take advantage of them.

Mr. Rick Casson: Can we talk about something else besides the VIP?

The Chair: You can talk about anything you want.

I've got some questions that don't involve VIP.

Mr. Rick Casson: I want to talk about the gold-digger clause. If you marry a vet over 60 years old, you're not eligible for his pension when he passes away, and there is also the fact that the pension is only at 50%, instead of 60%. Those are a couple of issues that keep coming from the veterans' widows.

Ms. Verna Bruce: Actually, the instance I think you're referring to is a problem with the Department of National Defence. It's actually their superannuation plan.

When we tracked the particular case that has been in the media the last little bit, it's actually a National Defence issue.

Mr. Rick Casson: Well, it deals with veterans, though.

Ms. Verna Bruce: The benefit he's trying to obtain is actually a benefit from National Defence under their superannuation plan.

Mr. Rick Casson: Are you aware of that gold-digger clause, as it's called, where you're not eligible for the pension of a veteran who you marry when they are over 60 years old?

Ms. Verna Bruce: That doesn't apply to our pension programs.

º (1645)

Mr. Brian Ferguson: We don't have that type of clause anywhere in our eligibility criteria. It has to do with National Defence superannuation.

Mr. John O'Reilly: I have a point of order. With regard to one of the questions I asked, I've since received a response from the clerk.

The Chair: Mr. Calder, you have the floor for five minutes.

Mr. Murray Calder: I don't think I'll need five minutes, Mr. Chair.

The Chair: Maybe you could share it with Mr. Provenzano. He still has questions that he wants answered.

Mr. Murray Calder: No matter what Mr. O'Reilly says, I do not think Carmen smells.

Some hon. members: Oh, oh!

Mr. Murray Calder: Colleen, I want to go back to Mr. O'Reilly's question to you. We were talking about the surviving spouse. She would be paid $1,500--is that correct?

Mrs. Colleen Soltermann: If the veteran's pension is assessed at 50% and above.

Mr. Murray Calder: They wouldn't qualify for VIP because they would be over the $1,107, or am I wrong in saying that?

Mrs. Colleen Soltermann: If the veteran was receiving it, she will continue to receive it. We don't apply a means test to the survivor for continuing to receive a benefit that the veteran had received in his lifetime.

Mr. Murray Calder: We'll now go to Mr. Provenzano.

Mr. Carmen Provenzano: My important questions have been answered. I don't have any other questions.

The Chair: In that case, I have some. I just want to know a couple of things. A lot of rumours have been circulating for quite a while about the future of the Sainte-Anne facility in Montreal. A lot of renovations are going on right now, and that is causing speculation that the facility will eventually be turned over to the Quebec government. Can you shed any light on that?

Ms. Verna Bruce: We're not involved in any negotiations with the Province of Quebec at the present time.

The Chair: That takes care of that really quickly. Thanks.

On page 5 of your opening statement, Ms. Bruce, you say, “Some Veterans receive support fortransportation to access certain health care services or toenable them to participate in social activities.” When we were travelling, we ran into some people who would like to get that. I just wonder why it's only some of them and not a majority.

Mrs. Colleen Soltermann: That's one of the benefits we provide to veterans who have access to the veterans independence program as a result of low income. Because they can't afford to provide those needs, they are entitled to transportation to access that. With regard to a veteran pensioner who needs transportation in order to get treatment, we also provide that transportation, but we don't provide the transportation element of VIP.

The Chair: What is the average waiting period for someone wanting to get into VIP? Is there an average time that it takes to check people out after they apply to VIP?

Ms. Verna Bruce: One of the ways people can access VIP is by applying for a disability pension. We have established service standards. Once we have all the documentation, we aim to make a decision on a person's pension within 18 weeks. If they're already a pensioner, it would be a lot faster. I'm not sure what the standard is on that.

Mr. Brian Ferguson: Perhaps I could get back to you, Mr. Chair, with specifics on that. Certainly in that case it wouldn't be very long at all. An assessment at the home would be done by the area counsellor, and it would be pretty quick. But I can't give you the exact timeframe. It would be days, rather than months.

The Chair: Mr. Bachand.

[Translation]

Mr. Claude Bachand: Some seniors who spend the winter down south have asked me to put a question to you. The law or the regulations state that persons must reside in Canada in order to receive program benefits. I understand this provision. However, do persons who leave on vacation for two or three months continue to receive these payments, or do payments cease?

º (1650)

[English]

Ms. Verna Bruce: Their pension wouldn't stop if they--

[Translation]

Mr. Claude Bachand: I'm not talking about pension benefits, but rather about VIP program benefits.

[English]

Mrs. Colleen Soltermann: There are provisions that limit the amount of time a client can be outside the country.

[Translation]

I can answer that question for you. Service to clients can be maintained while that client is on vacation, but only for a set period of time. I believe we're talking about weeks, not months.

Mr. Claude Bachand: If the client has a doctor's certificate attesting to the fact that he must vacation is a warm climate—some people suffer from arthritis or other such ailments—do you make an exception? Do you take medical certificates into account?

Mrs. Colleen Soltermann: The aim of this program is to meet the needs of the client in his or her principal residence. If the client does not live in his principal residence, then he doesn't need to have his driveway ploughed. In cases like this, we discontinue this particular service, along with housekeeping services. While the client is outside the country, he doesn't need housekeeping services. As I said, the aim of the program is to meet the client's need while he is living at home.

Mr. Claude Bachand: Fine. On the subject of fairness in service delivery, some survivors live in urban areas with ready access to cleaning, housekeeping and groundskeeping services. However, such services are not as readily available in more rural areas. What assurances can you give us that the program is fair, that is that everyone, urban and rural residents alike, are treated equitably?

[English]

Mr. Brian Ferguson: Particularly through the new arrangement that we have with Atlantic Blue Cross Care, one of the requirements that was part of the contractual arrangements was for them to create a list of qualified providers in all regions of the country. I forget how many are on the list. I think there are somewhere around 8,000 VIP service providers on the list at this point. We have a means to get that list, and it's been a very useful tool. We're well aware of the need to do that.

Now, obviously there wouldn't be as many people on the list in a rural area as there would be in an urban one, but we would endeavour to make sure that if the veteran needs the service, we'll connect them to a service provider.

[Translation]

Mr. Claude Bachand: That was my next question. I was told the department maintained a list of individuals and businesses. Is that right?

[English]

Mr. Brian Ferguson: Our service provider--in this case Atlantic Blue Cross Care--has created such a list, which they use to authorize service providers in accordance with certain criteria. So they've created the list on our behalf as part of the contractual arrangements, and it is available to veterans.

[Translation]

Mr. Claude Bachand: Can veterans or their survivors hire the company or person of their choice to do the work?

[English]

Mr. Brian Ferguson: They can if they already have somebody, but that person has to then register their name on the list. There are procedures to get them on the list, but they aren't barriers. So if someone already has somebody who gives them service, we'll make sure they get on that list.

[Translation]

Mr. Claude Bachand: How do you ensure that the rates charged are fair? For instance, some clients might be tempted to hire their daughter's company to do the work, and could be charged double the going rate. How do you prevent that from happening?

[English]

Mr. Brian Ferguson: There are set amounts

[Translation]

for the services provided to veterans and their survivors, as you mentioned.

[English]

So we have standard rates that we apply.

º (1655)

The Chair: Thank you.

Mr. O'Reilly.

Mr. John O'Reilly: One contradiction I find in your report, which I want to ask you about, follows along with a veteran spending a few weeks in Florida or Arizona and not being eligible to carry their benefits with them. You say they have to seek private health care insurance. Who is going to provide private health care insurance to an 83-year-old person on oxygen? That's an oxymoron; it can't be done.

In other words, for a veteran to go visit their grandchildren in Florida or Arizona in the winter, they have to find some way to get private health care insurance or they're not insured. I don't understand that, because a sick person doesn't get health care insurance, private or otherwise. If you have it, you continue with it. If you're ineligible, then you don't have it.

How does that work?

Mrs. Colleen Soltermann: If a veteran pensioner is travelling, they are entitled to treatment for their pension condition when they are out of the country. They are only entitled to the treatment outside of the country if they are a pensioner. When they're inside the country, we can sometimes provide the treatment they need for conditions that are presenting. But outside of the country, it's limited to their pension condition.

Mr. John O'Reilly: In here you say if they require oxygen they're not eligible. If they have an oxygen bottle, take it with them, and have to get it refilled, it's not insurable. Is that what you're saying?

Mrs. Colleen Soltermann: We're getting into the details of the program. I don't know if I can specifically answer the question about the oxygen, but as a general principle, when our veterans are outside the country and need treatment for their pension condition we provide it, but not if it's not for a pension condition.

Mr. Brian Ferguson: Just to carry that example forward, if they needed oxygen because of their pension condition, they would be provided that service.

Mr. John O'Reilly: This research by the Library of Parliament isn't accurate then, because it says here:

Thus,someone who requires oxygen, but not for the condition (such as a disability caused by awartime injury) for which a pension was granted, must arrange for private health care insuranceto cover those expenses while outside Canada.

So they specifically mention oxygen.

Mr. Brian Ferguson: We'll definitely clarify that for you.

Mr. John O'Reilly: Good, because it's different from what you are saying.

The Chair: Thank you, Mr. O'Reilly.

Mrs. Wayne.

Mrs. Elsie Wayne: I just have one short question on meals on wheels. If veterans are being looked after at home and they have the VIP program, are meals on wheels delivered to them? If they are delivered to them, will they continue to be delivered to their wives afterwards? Do they have to pay for the food they receive?

Mrs. Colleen Soltermann: The element you're speaking about is called VIP access to nutrition, which is separate from VIP housekeeping and grounds maintenance. Within the housekeeping, we can provide for meal preparation if someone has a housekeeper coming in to prepare the meals. That's part of the housekeeping support we can provide.

The access to nutrition is a different type of benefit. It allows a veteran access to nutrition, not the nutrition itself. Therefore, we can provide for the delivery of meals on wheels.

Mrs. Elsie Wayne: And they don't have to pay for that food?

Mrs. Colleen Soltermann: The food is the responsibility of the veteran. The delivery or the access is what we cover. Sometimes it is one price combined, and we have a limit we can look at.

Mrs. Elsie Wayne: Thank you very much.

The Chair: Mr. O'Reilly.

Mr. John O'Reilly: There was a program developed through Veterans Affairs and the community service program—a local one in my riding—that dealt with the falls program. It taught people how to not fall, how to exercise without hurting themselves, and all that sort of stuff. The funding was cut off for that, and I just wonder if you have any idea why that happened.

It was a pilot project that was extremely successful in my riding. In fact, the people who ran it were right next door to my riding office, and they told me that the funding was cut off and the pilot project cancelled.

Mr. Brian Ferguson: There was a pilot project, and there was an arrangement we had with Health Canada to jointly provide falls prevention support across the country. The program has ended, but we are now looking at how we can achieve the same results through other means. So we're actively looking at what to do with the program at this point.

I'm really pleased to hear you say that it was a very successful program, from your vantage point.

So we're looking at it. We could give you an update on that in a few weeks to let you know how it's coming along.

Mr. John O'Reilly: They produced a video. It was very well done. They were running the program and it was doing very well.

» (1700)

Mr. Brian Ferguson: Falls prevention is really important, as we all know.

Mr. John O'Reilly: Yes, it's very important. I wanted to see if there was some way that program could be continued and not cancelled.I'd appreciate a report on that.

The Chair: Mr. O'Reilly just twigged my memory--which is kind of weird.

When we were travelling around.... Verna, you probably know where I'm coming from. There's a pad that is put on people's hips now, or something like that. How does that work?

Ms. Verna Bruce: It was something Mrs. Wayne showed us that they were doing in one of the facilities in Saint John. It was a pad, you're right, that provided a bit of extra support, particularly for men who were prone to falling. We agreed at that time we would try it on a pilot-project basis. We can check to see what happened to it, but I have no idea where that went.

A voice: Do you need some?

The Chair: Not yet, I don't.

Voices: Oh, oh!

The Chair:Thank you very much for being here, Ms. Soltermann, Ms. Bruce, and Mr. Ferguson. It's always great when you come before the committee. We appreciate your being here and appreciate the fine work you continue to do for Veterans Affairs.

Thank you very much.

Ms. Verna Bruce: We appreciate your support in what we do. So thank you.

The Chair: Great.

We're adjourned.