Thank you, Mr. Chair, and good afternoon to you and all the members of the committee.
Thank you for the opportunity to appear today to discuss the 2018-19 supplementary estimates.
At this midpoint in the fiscal year we are seeking a 1.2% increase in our funding. The majority of this is related to readying ourselves to implement the return of a lifelong pension, which I announced last December.
As you know, starting on April 1, 2019, veterans with service-related illness or injury will have the option of a tax-free monthly pension for life. As had been requested by our veterans and stakeholders, the pension for life includes recognition and compensation for the pain and suffering as a result of a service-related illness or injury.
I want to take a moment here to clear up a key misunderstanding. The new pain and suffering compensation under pension for life is not simply the former disability award split up on a monthly basis. It's not anywhere close, actually. When taken as a monthly benefit, the pain and suffering compensation offers up to a maximum of $1,150 per month for life. A seriously disabled 25-year-old veteran who lives to the age of 75 would stand to receive $690,000 in pain and suffering compensation alone, well above the current disability award of $360,000.
The pension for life program also includes additional compensation for the most seriously injured veterans and an income replacement of 90% of a veteran's pre-release salary for veterans who are in rehabilitation or who are permanently and severely disabled.
Regardless of the duration of their military career, all members of the Canadian Armed Forces will be released one day. Our job is to help them transition smoothly and successfully to life after military service. Our duty is also to commemorate and recognize the service of all military members.
It's important to remember that 93% of all Veterans Affairs' expenditures goes directly to programs and benefits for veterans and their families. This includes health and well-being benefits, transition to civilian life programs and supports for families.
On top of that, over the last three years we have significantly increased the support for veterans. For example, in 2017, the maximum disability award rose from $314,000 to $360,000, indexed to inflation. This alone meant approximately $700 million for more than 67,000 veterans who had already received a disability award.
You may note, actually, that there appears in this year's estimates a slight decrease over last year. This is due directly to the amount we disbursed in topping up veterans with $700 million in disability awards. Even if we hold that one-time payment off to one side, we are still providing more direct benefits to veterans than ever before.
We also increased the earnings loss benefit to 90% of a veteran's indexed salary at time of release, previously set at 75%.
We have also increased supports for families. On April 1 of this year we introduced the caregiver recognition benefit, a benefit that offers $1,000 a month tax free, indexed annually, which is paid directly to the person who cares for an injured veteran.
We also know that the transition from Canadian Armed Forces member to veteran must always include their families, so we have ensured access to the veteran family program at all 32 military family resource centres for veterans who release medically and their families. This helps them establish successfully in their new community while retaining their connection to the military community.
For members with complex needs—for example, those transitioning for medical reasons—a case manager will help coordinate transition planning with the Canadian Armed Forces, side by side with Veterans Affairs Canada. Case managers can also refer veterans and their families to a network of 4,000 mental health professionals. Veterans and family members can receive assistance through our 24-hour toll-free helpline, with access to psychological counselling and other services.
On top of that, for veterans with a service-related illness or injury, there is a range of physical and mental health services available to them. A network of 11 operational stress injury clinics and satellite service sites across the country delivers services where veterans need them.
We can also provide access to mental health services for a veteran's family member if it can be shown that it would help the veteran achieve their rehabilitation goals, but let me be clear—treatment benefits will not be provided by Veterans Affairs if that family member is under the care or custody of a federal institution or correctional facility.
For veterans looking for a career after their military service, we offer qualified career counsellors to advise about labour markets, help prepare resumés and give job search training. In some cases, they can help a veteran find a job.
We also offer veterans access to funding for tuition at colleges and universities or professional training. Those with at least six years of service can be eligible for up to $40,000. Veterans with more than 12 years of service can receive up to $80,000. Since April, when we introduced this education and training benefit, over 1,600 veterans have been approved to get the education and training they want to improve their post-service lives.
I'd also like to take a moment now to discuss the new veterans emergency fund. Established in April of this year, the fund allows Veterans Affairs to provide emergency financial support to veterans, their families and survivors whose well-being is at risk due to an urgent and unexpected situation. The emergency fund is intended to ensure short-term relief while we work to identify long-term needs and provide solutions through our other programs and benefits. To date we have spent over $600,000 to assist veterans and their families in emergency situations.
We also introduced the $3-million veteran well-being fund, because we know there is an incredible amount of community interest in supporting Canada's veterans. I recently announced that there were 21 recipients of this fund, which supports private, public or academic organizations in conducting research and implementing initiatives and projects that support the well-being of veterans and their families. These organizations are tackling complex issues, from veterans' homelessness and transitioning out of the military to mental health and physical rehabilitation.
Over the past year, I've hosted 45 town halls, roundtables and summits. I've met with many veterans, their families and their advocates across the country.
In particular, I met with over 65 organizations during a roundtable on homelessness in Ottawa in June and during the national stakeholder summit in Ottawa in October. Veterans Affairs Canada staff have also held more than 100 outreach activities across Canada.
As a result of this increased engagement, veterans and their families are more aware of the full range of benefits and services that they're eligible for. Over the past two years, we've seen a 32% increase in the number of applications for disability benefits.
We've been listening to veterans. We've heard what they have to say, and we're acting on what we have heard. One of the things that we heard about from veterans was the need to expand the medical expense tax credit to recognize the costs for psychiatric service dogs. Starting this tax year, they can now do that. We also funded a pilot study to evaluate the effectiveness of using service dogs to assist veterans with PTSD.
Veterans also told us they want a tangible connection with the veteran community and a symbol of recognition of their service. We brought back the veteran's service card, now open to more veterans than ever before. We are increasing our capacity to deliver services. We reopened the nine field offices that had been closed. We opened a new one. We increased outreach and hired significantly more staff, including more case managers.
This year, we've invested an additional $42.8 million to eliminate the backlog of applications pending for over 16 weeks. We've just introduced a new wait time tool so that veterans can see the average processing time for programs and services.
Canadians value the contribution and sacrifice of veterans and all those who died in service to our country. That's why remembrance plays an important role in what we do. As Minister of Veterans Affairs, I've participated in significant and moving commemorations. We've marked important milestones, such as the centennial of the First World War and the 65th anniversary of the Korean War armistice. Over the next two years, we'll mark the 75th anniversary of the end of the Second World War.
We are ensuring that every veteran and family member receives the benefits and services they are eligible for, no matter how they come forward for them. No veteran should ever be turned away from the benefits and services they are entitled to through their service. With the right resources in place, we can move forward toward our common goal of providing the care, support and respect that Canada's veterans deserve.
There are a number of things that, combined together, we're really hoping are going to help us crack the problem of homelessness.
I created a full national round table on homelessness with some of the best groups in the country—right across the country—some of them regional, some of the national in scope. It was heartening for me to see them sharing best practices with one another, sharing business cards with one another.
There are some things that are going on in some parts of the country that are proving to be remarkably effective. What we're able to do now with the wellness fund is help to basically ramp them up so that they'll be able to help more people in their region or possibly be able to scope things a little more nationally.
While we are doing many things, the issue of homelessness—and I think anybody involved in the field would agree with this—is something that we have to tackle with groups that are close to the ground. I'm proud of the fact that we do that, whether it's VETS Canada or any number of organizations that exist across the country. The Legion is doing incredible work on this, and again, there are some very small, regionally based ones that are doing great work.
Pension for life, because it's a monthly contact with veterans, I think is going to prove to be a very important tool. Instead of getting a disability award and basically being written off the ledger, we will now have the ability to have monthly contact with the veteran and be able to check in with them more frequently than we can now.
There are other things, like the earnings loss benefit and the psychosocial vocational rehabilitation that comes with that. Many veterans now will be receiving 90% of their previous salary. There is the fact that we can offer career transition services that are more than just $1,000 and “good luck with the job search”. We are proactively able to work with them. We're also able to match them up with private sector hiring.
All of that combined, I think, is going to go a long way to helping solve that problem with homelessness.
What I'm most heartened by, again, is listening to groups from across the country who are now working together.
I can add that one of the key parts of preventing homelessness is actually pre-emptive, and that is overcoming the stigma of mental health injuries. That's why we've taken on a much more presumptive approach to mental health disability claims.
We are working with the Canadian Armed Forces to work upstream while folks are still in uniform. If they are struggling, it's to ensure that they seek help while they are still in the Canadian Armed Forces. We know about their situation as they transition into civil society in Canada, in order to prevent that sense of hopelessness where they lose their sense of purpose and get into a situation.
Then, as the minister said, it's working with communities across the country, and indeed with veteran networks, because folks know where their battle buddies are. Going to Mr. Kitchen's point, it's battle buddies, shipmates, squadron mates, who are keeping tabs on each other and hopefully intervening early enough before someone gets to that point.
I would also want to reinforce the same point with the Royal Canadian Mounted Police, for whom we provide some support. Those networks are so important.
Also, then, with regard to this emergency fund, there is the fact that we can now offer, for the first time, emergency funds to an individual without having to prove their total situation or eligibility. When I talked to the case managers across the country, what they said was, not only is it in the case of an emergency but it's bringing veterans in the door.
Veterans who would not otherwise come in are coming in the door and saying they have a need. Then, as we drill down, we find out that folks are eligible for much, much more.
Thank you, Minister, and thank you, General, for being here.
In the 2018-19 estimates, you asked Parliament to authorize expenditures not exceeding $4,363,061,570, which is $297 million or 6.4% less than you requested in the previous fiscal year.
We know that there's a tremendous backlog of applications for nearly every program administered by Veterans Affairs Canada. You're missing half of your own targets, including applications for the rehabilitation program, which is backlogged; applications for the long-term care program, backlogged; the career transition program, backlogged; earnings loss benefit, backlogged. The war veterans allowance is backlogged, and of course, there is the monster backlog in the processing of applications for disability benefits.
There are 3,000-plus who have been waiting for more than a year—as my friend Mr. Kitchen outlined—to get the help they need, while your own target is to process these applications in just 16 weeks.
Given these backlogs and the lack of basic services for veterans and their families, why did your department request less money from the treasury this year than last? Shouldn't you be asking the treasury for more money overall until these application backlogs are finally cleared?
The study, which is one that we funded, is very limited in its scope. It deals right now with about 18 veterans. It began with 22, I think, but four dropped out.
The unfortunate thing, too, is that we haven't had the time yet to analyze a few other crucial factors—where a caregiver is involved, or where one is not involved. Where a caregiver is involved it can, not skew but could perhaps affect the results of the study.
In other words, we have to be able to zone in particularly on the effect of the service dog, and we're doing that now, but we basically need more data.
You're quite right in saying that anecdotally, too, we know this. It all seems to be pointing in the right direction, so we didn't waste much time. With the medical expense tax credit in the last budget, we told the veterans that they could put some money aside and it would count towards the expenses. Whether it be for actually buying the dog or for feeding the dog, or veterinary bills, which can add up, they can apply that tax credit. We can do that right now for people who are either going to be purchasing a dog or....
But there is also, to be honest with you, a huge supply issue. Anybody who is familiar with these dogs understands that they are incredibly well trained and it takes time to train them and get them up to the standard that we need.
Yes, thanks very much, sir, for the question.
The department has 23 of these funds. Over time, folks have provided these funds for specific reasons, so there are ones, for example, for folks living on Vancouver Island, and for Edmonton and Ste. Anne's Hospital, or restrictions on how the money could be used. Of the 23 funds, there was only one fund that was kind of open-ended, coast to coast and for emergencies, so case managers, veterans services agents and folks from across the country went to this fund. It was drained on a constant basis, and we did not have an authority under our legislation, regulation, to dispense public funds for requests that were in the grey zone.
We would partner with the Canadian Armed Forces morale and welfare services, which I know a lot about from my previous life. They have non-public funds. We would request funding from the Canadian Armed Forces to top up that specific emergency fund, which was less than adequate, and clearly a government has the responsibility to reach out to these veterans and their families when they are in crisis. It was terrific when we got this funding, and we're making our process as expeditious as possible. I find that things get swamped in bureaucracy, so to speak, but the aim is to enable the most junior case manager, a veterans service agent who is presented with an emergency on a Friday afternoon at four o'clock or five o'clock, to say, “We're going to get the money out to you.”
In some of these cases, we're even doing the paperwork after the fact, and I'm okay with that, just to make sure that, if someone comes calling, we can put a roof over their heads, put some groceries on the table or address their no-kidding emergency.
We have found the difficulty is that what is an emergency in one location could be an enduring situation in another location, so every one of these cases is viewed on its own merits, but I'd also say that we have hired some of the best social workers, psychologists and nurses coast to coast who have a huge amount of experience, and we trust them to get on with supporting our veterans and their families.
Can I also say, Mr. Johns, that what we're doing as well is hiring as quickly as we can and getting folks through a training school to standardize training.
The other thing we're doing is actually looking at each individual veteran. When I meet with case managers, I ask them how many of their cases—and often they have a number between 35 and 40—they actually have to engage with, to support on a weekly basis and so on. Generally the number is much lower than that higher number.
One of the things we have to do is to say who out there is at medium risk or high risk and how do we triage them? Sometimes, just through our processes, if somebody's on a vocational rehab program, we automatically give them a case manager when indeed they're doing really well. Some are master's students or Ph.D. students. We've met ordinary seamen who are going to university and we're providing them a case manager.
We are starting a new program. It will be coming out in the next little while. We've been piloting it for a little while. It's called guided support. We're taking veterans service agents who have a number of files and saying we need to have them now support those veterans who are no longer at a high risk because they're graduating—they're actually moving forward—and provide them support to transition them until we know for certain that they're low risk, recognizing that things can turn around and if they do, we'll get them back to case management. It's a much more agile system than we have right now.
At the same time, we are hiring the best social workers we can. We're attracting them from the provinces, attracting them from anywhere and training them up. It's basically a multi-layered approach to addressing this need. We do know that with our case managers, the probability that someone will be re-established, have purpose and move on with their well-being is much higher.
We're spending approximately $1 million a year on that line. I'm rounding the figures, but it is approximately $1 million a year. Last year we had over 1,300 calls and referrals. This year it's around the 1,600 call mark.
Following your comments a couple of weeks ago at another committee meeting, they came back to me. We contacted Health Canada, because this emergency line is run by Health Canada. We relayed our concerns. I'm not debating the information you brought forward, but if that happened, I'm extremely concerned, because a person who's calling that line is supposed to get a certain level of service.
There are times of the day or certain points when the lines are busy, and they are given three different options. It's quite clear up front. You can wait, give us a number for us to call you back, or call 911 if you're in crisis. Those are the three options.
We have followed up with them, and we've asked for a deep dive. What has happened here? Did something actually happen?
I don't know if I will ever be able to get to the bottom of the case that you brought to my attention, to be honest. They get a lot of cases, but we take it extremely seriously. Our chief medical officer, Dr. Courchesne, who has appeared in front of this committee on more than one occasion, is talking with them to ensure that type of event doesn't happen again.
It's not that complex to keep the statistics. We're actually really digging in to what the statistics are.
It is not easy to close a file, because we're talking about a disability award or a disability pension. We're talking disability. We're talking dealing with health professionals. We're talking medical appointments, so on and so forth, depending on the case. They're not all complex, let's be honest.
The reality is that we are working really hard to facilitate that. Since, I don't know whether it was my last appearance or the one before, we've actually really drilled down on the numbers and on where the files are in the process. Last Friday we had approximately 4,000 files waiting for documentation from either a medical professional or the veteran. When you look at the pending, that's all in the pending. But at the end of the day, the reality is that we have a backlog, and at the end of the day, it's taking us too long to adjudicate.
We have implemented a lot of new initiatives, integrated teams. The files aren't bouncing around between units. You had a unit of juniors, nurses, doctors. The file goes here. Then you send it to the next person, where it stays a couple of weeks on the shelf until somebody takes it off. Then that person does it, and says, “Oh, I have to send it to a doctor”. That takes a couple of weeks.
We have this process that we've piloted, and we're going to go full hog on it, because now the team is integrated. I go to you and I give you the file, you look at it right away, and we make a decision. A file that would have taken eight months, with eight conditions.... That's the other thing people don't often mention. They come forward. It's not one condition. If you're coming forward with hearing loss, period, that's pretty straightforward. What they're coming forward with is eight different conditions. A file like that could take eight or nine months. They did it in half a day, with one letter to the veteran.
Now, let's not say we've won the battle yet, because we're far from having won it. There's still a lot of work to be done, but we are really starting to put some of the stuff.... We've now drilled down. We now know where the files are. We knew that before, but I wanted clarity. What I've learned in 29 years of operations is that you can fix problems, but if you're not fixing the right one, you're just creating something else somewhere else. We've really been digging in to that.
We have a very complex system. I think everybody around this table knows that. The biggest issue is that we have huge amounts coming forward. Last month, November, was our biggest month in history—48,000 files went out the door. Unfortunately for me and for the veterans, 5,400 files came in.
We've doubled the production of our employees, and it's still not enough. We're looking at all avenues. The deputy and the minister talked about some. We're adding staff. We're adding new processes, eliminating steps. We still have a ways to go. We can do better, and we have to do better.
Thank you. That's actually an excellent example.
Some of these standards are difficult to reach. If I take the phones—and I thank you for bringing it up because I wasn't thinking of that one—when we brought in the seven new programs in April, the government could not give me enough money, and I can't put enough people.... I guess they could give me enough money—I shouldn't say that—but I can't put enough people on the phones to answer every phone in April and May. It would be improper use of dollars to do that.
Unfortunately, that means for the rest of the year, I'm catching up. It was the same thing last year when we upped the DA. That month, my accessibility on the phones for April was about 10%. Everybody wanted to know how come they had $40,000 in their bank account and where that money came from.
The rest of the year, we're doing pretty good, but we lost a year in the first month and a half.... Even if you give me the money, I can't get enough people in the seats to answer the phones. Then, what do I do with the people after, because the volume is not there? It's a spike. We have to manage these funds very prudently—it is taxpayers' money—and I feel very strongly about that.
I think where we need to go is not additional money. I think we need to invest—and we are, with PFL—in a new way with our systems and maximizing the use of electronic systems. It's not necessarily the number of people—
Thank you for the question.
Additional staff, for sure, have improved the services, whether it is the nine offices or the additional case managers we've hired and put into the offices, or the additional adjudicators. All the additional resources and the additional programming—because it's not just people, we have received a lot of new programming in the last couple of years—have helped veterans in general. That doesn't mean that we don't have veterans struggling. We do. The downside effect is that I have backlogs, which I keep trying to figure out. However, it has helped.
As a case in point, I've been coming to this committee now for five years. It has been the hardest job I've ever had. Every single day, I would have three to four messages, often from people in various locations, receiving complaints from veterans in crisis—I call it crisis. I still get 20 emails a day from various constituency offices. They go through the minister's office, but they all come to me and I read them all. I have a team working on it, but I actually read them because I want to know what's happening out there.
The reality is that 19 of the 20 are because of the timelines. I won't break down that some are legitimate and some are not. You can go through the whole.... However, it is much better.
That said, as the deputy mentioned, there are still 32% who are having a hard time in transition. We have to do better, and that's why we're working closely with the Canadian Armed Forces on better transition. If we can do a good transition, hopefully it's a better landing.
I think the money and the programming have come a long way. We can still do better, but they've come a long way.
You're right, Mr. Martel. Timelines are currently one of our big issues, but they aren't the biggest issue. That's why we've started to review all our procedures. Veterans Affairs Canada is currently requesting information that isn't necessary. By eliminating these requests, we're eliminating steps.
For example, we've made changes concerning the medical records that we ask the Canadian Armed Forces to provide. We used to ask for the entire medical record, which took an average of 88 days. Since we had only 16 weeks to process an application and we lost 88 days waiting for the medical record, there wasn't much time left for the rest of the process. Now, in many cases, we no longer even ask for the medical record. We have access to their system. Since this involves personal information, it isn't a simple matter and it requires us to comply with all sorts of rules. In addition, when we reviewed our procedures, we realized that we didn't need an 800-page medical record and that one page of information was sufficient. There are many steps to consider, and these steps have been around for a long time. We don't eat an elephant in one day. We take one bite at a time. By working more resolutely to review these procedures, we'll succeed.
I gave the example of integrated teams. If I work on a file and send the file somewhere else, it may take two or three weeks for the other person to process the file. It's not really the person's client until the person opens the file. This is part of the process, but it causes delays. When all these delays accumulate, we have a considerable timeline. However, in an integrated unit, I can sit down with a colleague, show the colleague what I've done and ask whether the colleague agrees. We can make a decision that day on the file, which wasn't done before.
There's certainly a challenge in terms of work culture. We've been trying to change the culture for a few years. We provide disability benefits, and we used to take an extremely rigorous approach. However, in recent years, we've been much more open-minded, particularly with regard to mental health issues. Perceptions of mental health have changed not only at Veterans Affairs Canada, but also among the general public. We're asking for fewer documents, which helps us to proceed much more quickly.
We've needed to change our work culture. Our employees had been doing things a certain way for 25 or 30 years. Now we're asking them to use a completely different method. We're also teaching this method to our new employees, including through the training provided to our case managers and adjudicators.