Good afternoon, everybody. I call the meeting to order. Pursuant to Standing Order 108(2), the committee begins its study on the subject matter of supplementary estimates (B) 2016-17, votes 1b and 5b under Veterans Affairs.
I'd like to welcome the Honourable , the Minister of Veterans Affairs, and Walter Natynczyk, deputy minister and retired general.
We'll start with the minister for 10 minutes, and then we will go to the witnesses. We have that all in order.
Welcome, Minister. The floor is yours.
Good afternoon, Chair and members of the committee. I'm pleased to return to the Standing Committee on Veterans Affairs to discuss the 2016-17 supplementary estimates (B) to Parliament on behalf of Veterans Affairs Canada.
Let me preface my remarks before this committee with an observation of the debt Canada owes its men and women in uniform. Veterans Affairs Canada is working hard to provide veterans and their families with the care and supports they need, when and where they need it.
We're also working to engage Canadians in commemorating all who have served. Last year, the gave me a mandate to ensure that our government lives up to its obligation to veterans and their families. The department has done a lot of work over the past year and has delivered on a number of the priorities in my mandate letter. These supplementary estimates reflect those accomplishments and the work that remains to be done.
My first year as has been rewarding, albeit challenging. I've travelled across the country and I've met outstanding people: older veterans and younger veterans, as well as current members of the Canadian Armed Forces, who will one day become veterans. They have shared their stories and their struggles. I have learned so, so much.
I have learned that while 73% of veterans successfully transition from military to civilian life, 27% of them struggle. They need our help. That is why our department is here, and it's where we're at. This is the reality that we face, and there is no silver bullet. We will make incremental changes and find better and better ways to help veterans rebuild their lives. As a country, we must provide that help.
We are transforming the way the Department of Veterans Affairs works, improving the way we deliver services to veterans and their families. That's the purpose of this supplementary allocation. For this year's supplementary estimates for Veterans Affairs Canada, this supplementary allocation will provide $130 million in funding. This 3.6% increase over the current budget increases it from $3.64 billion to $3.77 billion. These funds will help our government fulfill its commitment to Canada's veterans.
What is the additional allocation for? It will be used to move forward on our stated and approved initiatives, to move forward on the goal of ensuring that we live up to our obligations to our men and women in uniform. These include: increasing the value of the disability award from $310,000 to $360,000; enhancing the earnings loss benefit from 75% to 90% of an injured veteran's pre-release salary; enhancing the permanent impairment allowance so that veteran is appropriately compensated for the impact of a service-related impairment on his or her career; reopening the nine Veterans Affairs offices across the country, with an additional one in Surrey, British Columbia, and extending mobile outreach in Canada's north to ensure we are serving our first nations, Métis, and Inuit veterans adequately; and, hiring more staff to improve delivery of much-needed services to veterans, including hiring more case managers. Each case manager's workload will be, on average, 25 cases to one manager.
The commemoration of Canada's men and women in uniform and of their accomplishments is a key part of Veterans Affairs' responsibilities. That's why the supplementary allocations include funds to commemorate major milestones of the First and Second World Wars, in 2017, the same year in which we will celebrate Canada's 150th birthday.
Events will be held in Canada and France to mark the centennial of the Battle of Vimy Ridge next year. Commemorative ceremonies and events will be held at the Canadian National Vimy Memorial in France, at the national war memorial in Ottawa, and in communities across the country on April 9. Major milestone events will also be held to mark the centennial of the Battle of Passchendaele and the 75th anniversary of the Battle of Dieppe.
The estimates also include an increase in the funeral and burial program that is administered by the Last Post Fund, which provides financial assistance for funeral and burial services, including grave markings for eligible veterans. This will make it easier for veterans' families to provide a dignified funeral and burial for their loved ones.
In addition, there's an allocation for the 2017 Invictus Games in Toronto, which will be the host city for this international sporting competition for ill and injured military members and veterans. It leverages the rehabilitative powers of sport to honour the men and women who have come face to face with the reality of sacrificing for their country. Team Canada will proudly represent the host country with a roster made up of as many as 90 active Canadian Armed Forces members and veterans.
Finally, the allocation includes a request resulting from the Treasury Board submission for the transfer of Ste. Anne's Hospital from federal to provincial authority.
Veterans Affairs Canada has accomplished a great deal over the past year, but there is still much more to do, and we are working with the Department of National Defence to reduce the complexity of the transition from Canadian Armed Forces member to veteran. We are also working closely with veterans groups and stakeholders to ensure that we get it right on the other items on the priority list, including the re-establishment of an option for a lifelong pension.
All the funding in supplementary estimates (B) has been previously approved by Treasury Board. Our meeting today is simply to have the funding added to the department's current budget. This will allow the department to move forward on its initiatives, with the overarching goal of ensuring Canada's veterans receive the respect, support, care, and economic opportunities they deserve.
Thank you so much for being here today, and thank you so much for your hard work on this committee. It is greatly appreciated.
Thank you very much, Mr. Chair.
Minister, thank you so much for being here again before our committee, and General, welcome back. It's good to have both of you with us.
I want to say first of all, Minister, that I believe you are doing a good job in putting together the outcomes that we are looking for and that were expressly mandated to you in the mandate letter. I want to thank you for the good work you've done. I think we are on the right track.
I want to ask you specifically about the earnings loss benefit and the fact that this will increase the pre-release salary to 90% from 75%. I know that the money being allocated for that is part of the supplementary estimates here. Could you talk a bit about the earnings loss benefit and why it is so important to fulfill that commitment?
I will now turn to the office reopenings, which are also mentioned in the supplementary estimates. Minister, I want to thank you for going to Sydney, Nova Scotia. I'm from the other end of Nova Scotia, but I know that you were there with the to see the reopening of that office. It was very important to veterans right across the Maritimes to know that the office was reopening. I thank you for being there to do that.
With regard to the offices right across the country, you've said that five of them have now reopened, so there are four more of the nine to go, as well as an additional one that I think was committed to, in Surrey, British Columbia. Could you talk about those openings and when we can expect to see them right across the country?
It was a great day in Sydney with the , where we met the community that was looking forward to the reopening of that Veterans Affairs office. It was a real joy for me to be there personally. As well, you could see the relief in the community and among many of the veterans who were looking forward to that occurring.
I can say that we have opened five of the offices to date. We will have all nine open by May 2017. We continue to hire new employees to fill those spaces and to adequately staff them. When we came into office, shortly after October 19, our analysis was that we needed some more help, given that in Surrey, B.C., we have a large cohort of veterans who are settling in that area. I think the number is upwards of 5,000, so that area needs help and assistance.
We never had outreach in the north that was really effective and proactive, so we put together a mobile team to go out there and do the good work, ensuring that our first nations, Métis, and Inuit veterans, as well as other members who have served up in the north region and who choose to settle there after the fact, get the help they need from our department. This is a large nation, and I think moving towards that northern presence has been a good move. It will allow us to serve the population better and will allow more flexibility in programming and getting people help wherever they live in this great nation.
Thank you, Minister, for being here.
I have a number of questions. I hope we can get to all of them.
The first is in regard to Ste. Anne's Hospital. I'm wondering what is the benefit to veterans of that transfer from the federal department to the province, because I have heard some concerns raised and some complaints from veterans that the service has declined since the transfer. Are you aware of those complaints? If so, have you responded or will you respond to those concerns? That's number one. The second part of the same question is, are the working conditions of the staff who look after folks there the same as prior to the transfer or different?
Ste. Anne's has a long proud history in our nation. It was the first Veteran's Affairs hospital. It came on board after World War I. As you know, when we went to national health care in 1967, we essentially went to provincially run health care systems, and Ste. Anne's was the last of the Veterans Affairs hospitals that we returned to provincial control.
Largely, Veterans Affairs Canada provides health care in over 1,500 facilities across the nation from coast to coast to coast. That's largely what our veterans community has called for; they want to live in the communities where they're living. This model that we have gone to is essentially a more effective and more efficient way. I can also say that because at Ste. Anne's Hospital some veterans were reaching the end of their lives, sadly, we were were not using the hospital as much.
In the midst of running an efficient health care system that allows more of the Quebec people to take part in it, this is a good deal for us at Veterans Affairs Canada and for the Province of Quebec. We have to look at the whole health care system in that manner. I can say that, in the transfer, we know—I was back there on November 11—that many of the veterans are very happy with what is happening there. I can say that we're always on the listen to what is happening on the ground. Yes, we have heard some issues come up, yet we remain committed to the veterans at Ste. Anne's. I know that my deputy minister is in contact on a regular and ongoing basis.
Maybe you would like to take it from here, Deputy.
Thanks very much, ma'am, for the question.
I'll just say that about half of the federal employees accepted offers with the province. Before the transfer, we worked with the Province of Quebec to recruit and to train many additional staff for the hospital. One of the positives of this transfer, as the indicated, is that folks in need in the region now have access to the facility.
Currently, we have in the order of 260 veterans in the hospital, but the capacity of the hospital is well above 400. Opening those beds to Canadians across the board is key. The other aspect is that is so positive is that we actually have spouses of veterans who for the first time can be in the same facility as the member who served.
Thank you, Minister and General, for being with us today in explaining some of these numbers and giving us more detail.
As you know, we've been focused on service delivery over the last several months. but one of the numbers here that I would like to talk about today has to do with commemoration. As a committee, we all understand that it's a very important item in the budget. I see here that there has been a significant increase. I'd like to comment. I feel that we've seen a surge of response from Canadians over the last few years when it comes to commemoration. Specifically, in this last year, we've recognized Beaumont-Hamel. Also, recently we've had a fair bit of support for my colleague Colin Fraser's private member's bill on Remembrance Day as a federal legal holiday.
As we go into the next year, we are looking at commemorating Vimy Ridge, Passchendaele, and Dieppe. I see an amount here. I'm wondering if you could expand for us on what events that amount is going towards and what's happening here in Canada.
I too would like to applaud Colin on his private member's bill on Remembrance Day as a national holiday. I think it's a good move that sets the stage for leadership in the ways we should be commemorating and thinking about the men and women who have served in the Canadian Armed Forces, the 2.3 million of them have served in that role since the beginning of Confederation.
It's a given that this is a big deal for commemoration, and it's important for us not only as Canadians and not only in remembering, but also in ensuring that we have good people who are willing to come into to the military. If we don't honour and respect their service and the sacrifice of these people and their families, then we don't do their memory the honour it deserves, and we don't show respect for those in the Canadian Armed Forces. We don't encourage good people to go into this honourable career that we in this room cherish so much and that in fact Canadians do.
It's a given that this year is very important, and I think our supplementary estimates show that. We have the 100th anniversary of the Battle of Vimy Ridge, which many historians, and in fact our , often say was the birth of the Canadian nation, where we really accomplished a great deal. Also, we have the 100th anniversary of the Battle of Passchendaele and the 75th anniversary of the Battle of Dieppe.
I had the privilege this summer of going to France to recognize that it's 100 years since the start of the Battle of the Somme and the Battle of Beaumont-Hamel, which is so important to Newfoundlanders and to this nation, and to understand the significance of what transpired all those years ago. Going back there is to understand the role Canada still wants to play in the world: how we want to lead and how we want to be part of building a better, more secure, more peaceful and human-rights-based world. Honouring the sacrifices that those men and many Canadians have made over the years is truly important to the work we do.
This year is a big year for that. I know that the and others will be going to France for the celebrations in Vimy, and I know the whole nation is looking forward to it. It's an important thing that we do here as parliamentarians. It's an important thing that Canadians do. Our department is going to ensure that we do it right.
We have a transition committee that we maintain with the province. On that, we have two key leaders out of Veterans Affairs, plus a veteran from the region, retired Lieutenant-General Michel Maisonneuve, who is also on the foundation of Ste. Anne's Hospital, and they are meeting with the province and with the hospital staff on a regular basis, and following up where there are challenges.
The key challenge, as has been alluded to before is staff, because half of the staff have changed. The key was that the federal staff had a culture and had an understanding of the veterans. When you see half of the hospital staff change over, and then we have the introduction of additional civilians and additional staff coming in, we have a period of cultural transition and training transition. It is difficult, especially dealing with a population who has served the way they have but are older in age. That has been the key challenge.
We're working very closely, as the minister indicated, and I maintain contact with the province on a very regular basis, as do the senior leadership of the department. We have visits, as the minister has indicated, and I visit as well with the hospital in talking to not only the residents' committee but also to the families of those veterans and to other key veterans in the hospital.
When we got the budget passed at the end of June, we had to work with our , Judy Foote. To her credit, once that budget money was secure and we gave her the specifications of what we would need and what type of veteran population was in the area, she went about and did her good work and came up with appropriate offices in terms of serving the veterans and their family populations.
Of course, these offices that can do a multitude of things, from intake to basic form-filling, to health and wellness guidance, and to putting veterans in contact with appropriate resources at various levels of different governments. They're really welcomed by our veterans community. We've actually moved with great speed, if you think about the budget passing here just last June, in already getting five of the offices open. I think it's a tremendous credit to and her team and how they've gone about doing things.
We're very excited by the progress. In fact, when I went to the announcement this summer, there was a sense of excitement in Brandon. Unfortunately, I wasn't able to be there with you when you actually opened it up, but I'm assuming that it was well received from the community.
Did you note any challenges, General? Is everything going fairly smoothly?
In the main, we have gone about the business of hiring staff on a regular and ongoing basis since last October 19. We've committed to hiring 400. Some areas of the country are easier to staff than others. It is a challenge to find appropriate people in some regions, with the Canadian government having a relatively linear pay scale and with some of the areas of this country having different expectations and different costs associated with housing and the like. But we're finding good people with backgrounds in social work and with the expertise that we need at various levels.
I think it's also important to note that Veterans Affairs is also concentrating on giving veterans an opportunity, where possible, to be hired within our department. We're putting a greater focus on that. I'm very proud of how we lead by example on that to get as many veterans hired.... The former government brought in the in 2014. We haven't yet seen real outcomes on that, but that's why we're trying to drive this as a department and to challenge other departments to really lean in on this to be able to assess where we can give more veterans and people leaving the Canadian Armed Forces a real opportunity to be a part of the public service.
I know that our department is taking this seriously. We had a good meeting on this last week. We've actually brought a person on board to head public service recruitment within our department and then to hopefully expand out, to allow him to leverage his expertise and how he arranges that within our department to look at a whole-of-government approach to finding more success for our men and women who leave the military.
That's also part of the work I'm doing with Minister on the transition piece. We're really lining things up so that when a man or woman leaves the military, they're good to go, and so that when they leave the military, they leave with their pension cheque on day one, and they leave with ideas about what they're going to do around work, where they're going to get education, where they're going to find their family doctor, and where they're going to get their illness and injury treated, should that be necessary. It's really about professionalizing the release when men and women leave our military. We do a great job at getting them into the military, from basic training to training them up for ops, and for extended missions, and the like, and we are putting more focus now on professionalizing their release.
That's what a lot of the work has been devoted to over the last eight months, since the end of the last session. Really, I can really say that the work with Minister , as well as with General Natynczyk and Chief of the Defence Staff Vance, because of their extraordinary experience, both in the military and understanding that challenge, and now, with General Natynczyk's knowledge of Veterans Affairs.... He has been here for....
Is it four years now?
You have a huge mandate here. One item that it appears you have completed is as follows:
Provide injured veterans with 90 percent of their pre-release salary, and index this benefit so that it keeps pace with inflation.
That was a campaign promise as well, and I've watched it move throughout the process to where it's actually in your mandate letter.
What was never included is any information about your changing the level in terms of corporal going to senior private, which has meant minimal increases to those who are on, shall we say, the bottom of the totem pole. Also, there was no mention that it was retroactive, so I appreciate the fact that this has been done; veterans obviously would not say no to that. However, out of the funds that have been provided thus far—and obviously this is a one-time expense—I'm curious to know how much of these funds have gone towards that retroactive payment.
Minister, you've mentioned that whatever the treatment that is needed, VAC is prepared to help our veterans. However, there isn't a recognition of the fact that mefloquine has caused specific issues for veterans, and they are not being treated specifically for them. They're being treated for PTSD, which is a mental health issue, versus a brain stem injury. My concern is that we have all these people available to serve them, yet they are not able to get the specific help they need.
My understanding is that for an individual who has been treated specifically for mefloquine actuallly, the appearance is that it's for PTSD, because otherwise that individual wouldn't get the type of treatment that's needed. Why aren't we focusing on this mefloquine issue and finding out exactly what kind of treatment these veterans need to make sure they get it?
We consulted with medical experts, veterans, beneficiaries, licensed producers, and a whole array of individuals. As well, we did a literature review. I'll remind you that cannabis for medical purposes is not a licensed drug at this time.
Since there is a policy vacuum around this.... Again, I was shocked to come into this. Looking into where the department has gone with this, I was surprised that three former ministers had been briefed on this issue, as was the former government, yet we saw no policy rationale behind this. Given where we were, we worked with these communities, with these stakeholders, to put in place a policy that we believe is fair.
I also remind you that the Royal College of Physicians and Surgeons has stated that three grams a day is within where they find that in the vast majority of cases of people who use this they should be able to find relief. Given what we saw in the department and given that there was no policy rationale, we had to act in the interests of the wellness of veterans and their families.
That ends our time for the first session of this meeting. We're going to suspend.
Again, Minister Hehr and General Natynczyk, thank you for taking some time out of your day to answer questions. I notice that the deputy has made some notes to get some information back to us. If you could get that to the clerk, sir, he will distribute it to the committee.
Again, on behalf of the committee, I thank you.
We will suspend for five minutes.
I call the meeting back to order.
I'll give everybody a couple of seconds to get back to their chairs. I believe we have a vote bell ringing, so I'm just going to try to—
A voice: Not yet.
The Chair: No, not yet, but we will have a vote bell ringing, so when the bells go off, it's not a fire alarm.
Welcome to our second hour. We have the Department of Veterans Affairs in front of us with Ms. Stuart, Assistant Deputy Minister, Chief Financial Officer and Corporate Services; Mr. Butler, Assistant Deputy Minister, Strategic Policy and Commemoration; and Mr. Doiron, Assistant Deputy Minister, Service Delivery.
Welcome back, everybody. We can start with 10 minutes of presentations, but I spoke to you earlier and I believe you just want to get right into the questions.
First, we want to acknowledge that, as the minister said, one suicide is one too many. We actually take that very seriously, understanding that it does occur. The department has a whole range of mental health services, and I believe I'm here Thursday with Dr. Courchesne to talk about mental health and suicide.
We have a whole range of services for mental health issues available to our veterans, whether in our operational stress injury clinics or some of our apps. We have apps that are available on mental health and first aid. We have 4,000 mental health professionals across the country. Because we don't have an office in every town and we don't have an OSI clinic in every location, we do have contracts with professionals in the field to help veterans. We also have a 1-800 number—and I'm giving you the short version—where there's somebody on the phone seven days a week, 24 hours a day, and they can get counselling very quickly.
However, the important part is for veterans to come forward. We know in Canada that at Veterans Affairs we have 200,000 clients, and approximately 130,000 are veterans. The reality is that we have 10,000 who are case managed, and those we really know and we follow them very closely. But there is a whole segment, between 130,000 and 670,000, who don't come to see us. We don't know who they are. When they come forward, we're there to help them, but they have to come forward for help, even if it's not service related. We always talk about the service relationship. They can use the 1-800 number whether it's service related or not. They can get 20 sessions with a psychiatrist or psychologist very quickly, regardless of whether the injury was service related or not, but it's important for them to come forward.
To your question, your point, of what we are doing for all veterans, we're not tracking all veterans but we are tracking those 10,000 who are case managed, and to a certain extent, the 130,000 veterans we have and 60,000 survivors.
Presently, across the country we are running at 30:1. We're not quite at 25:1. We received the money in July. We are presently staffing the positions.
I forget who asked the question earlier, but the offices are not all staffed up. We opened Saskatoon last week or the week before, so for sure we're not at a full complement yet, but we are staffing that up.
There is an update. In every office where we've added or reopened, there are a certain number of people who are case managed and/or veterans who are managed, not case managed. We're there to provide them services. That's why the offices are not all the same size, because the number of veterans served by the offices are different. The Kelowna catchment basin is not the same size as is Sydney. The size will change the number of employees that you have.
In the case of Sydney, as an example, we were open about a week before the official opening. We actually had three veterans show up at the door for support the same morning we opened our doors. The veterans are coming forward. They do not have to come to an office; that's where we try to be clear. We provide services in all kinds of ways, but for those who prefer the in-person touch they are coming forward.
As to the exact amount of traffic in the offices, I don't have that in front of me but I can probably get that. There is traffic at all of these offices, but we have to remember that case managers will often go to the person's house. For instance, an occupational therapist or a nurse who works in the office will actually go to a person's house. The veteran doesn't need to come to us.
Thank you for the question.
No, you do not need a master's to work at Veterans Affairs. The level of qualification will depend on the position you are going after. If we are hiring a nurse, you need a nursing degree. You need your bachelor's in nursing. If you are going for a case manager, we accept a bachelor's—we do accept a master's, absolutely—but what we are asking for is experience in case management. You have to have taken case management.
We have a whole series of positions—we call them veteran service agents—that do not require education to that level, where we do look at hiring more of our veterans. I have to be careful, because veterans are very well educated. A military nurse, we'd love to have. The VSAs, the veteran service agents, are not case managers, and they don't have the same education.
It all depends on which position we are trying to fill. It varies.
In response to that query.... As you know, this has become an important issue for the government, and certainly for the Department of Veterans Affairs, to the point that the department has actually established a veterans hiring unit in our human resource area. It is being led by a veteran who has now taken on the task of being responsible for reaching out to other government departments and establishing an information base to enable those departments to facilitate the employment of veterans.
We have not established fixed targets yet for our department, but I think it's very clear that our minister and our deputy minister are looking for higher numbers in employment, so you'll begin to see performance reporting on that coming in the following months. It's a very aggressive, very committed plan right now to try to increase the number of veterans in our department and in the public service as a whole.
You are correct. We do not track the cause of the injury. We track what the injury is. For us, it's not what caused it. I want to be very careful. We've been working very closely with “It's Just 700” and we take this extremely seriously. We're talking to them so our adjudicators have a better understanding of sexual trauma. Our doctors are very well aware, and we're working with them to put something on our website.
But the reality is that when it comes to the adjudication process, for us it's “Is it service-related?” We have to ensure the service relationship, but we have to acknowledge that sexual trauma of all sorts happens on the base, happens on exercises. To us that's a service relationship, but for us what's more important is what the injury is and to treat the injury. Often they come to us as mental health injuries. There are two or three different types that we see more often. Like I say, our adjudicators are working with “It's Just 700” to better understand this, but that's what we track, not the cause.
I know you may say it's not quite the same thing, but if you fall off a truck and you hurt your back, or you parachute jump and you hurt your back, for us the issue is that you have a bad back. When it comes to sexual trauma, there has been an event, and we don't care if the person has been charged or not. If it's been documented and the doctor is telling us you have a diagnosis for this, you will receive the treatment and you will receive the disability award or disability pension to which you are entitled. We don't track many of the causes. We track what the injury is, and then what we are doing to help the veteran.
Thanks very much for the question, and I might say, it's a pleasure to be here with this committee.
The earnings loss benefit is an income-support benefit paid to veterans eligible for our rehabilitation program. If you have a rehabilitation need—vocational, psychosocial, or medical—while you're in that program you are eligible to receive income support. Those decisions are made at the front end of the process at the operational level, and they're made relatively quickly. You can stay on earnings loss benefits for the whole length of time you are completing your rehabilitation plan.
For example, you and your case manager will work out whether it's a vocational rehabilitation need, what your goals and plans are, and what you have to do to become re-established. During that period, which could be three years or even more depending on the circumstances, you will get this monthly income-support benefit. If at the end of that exercise you and your case manager determine that you are not going to meet the goals and objectives of the plan, that you are essentially totally and permanently incapacitated, which is the term the legislation uses, you can then go on what we call the extended earnings loss benefit at the same rate, 90%, through to age 65. At age 65, it ends and you are then qualified for our retirement income security benefit, which is a different program but provides benefits after age 65.
With the establishment of the new Veterans Charter back in 2006, the permanent impairment allowance was a program designed to address the career impacts of severe disability on veterans. That was the fundamental policy rationale. In the legislation, the regulations define eligibility. It's for those most seriously disabled. The categories for permanent impairment allowance include veterans who have lost limbs, have become totally blind, have experienced a total loss of hearing, or have other very severe limitations.
In budget 2015, there was an amendment made to the regulations to try to broaden access to the program. There was an additional element added to the regulations covering veterans experiencing significant issues with mobility, whatever the cause, that had the effect of increasing the number of veterans able to access the program.
With budget 2016, however, there is an effort being made to address what is called the grade level distribution. Within the permanent impairment allowance program, there are three categories of eligibility, and it sets the pay scales from about $500 to $1,500. What budget 2016 has basically said is that we need to do a better job of ensuring that veterans are distributed more evenly across those three categories. Our ombudsman and various stakeholders criticized the program for limiting access to the higher financial benefits associated with PIA. It was simply the distribution. On April 1, 2018, you'll see the introduction of a new model trying to ensure improved grade level distribution across the program.
As the deputy mentioned, a percentage of the staff did not accept the transfer, so the province had to do some recruitment. I don't have all the numbers in front of me, and I wouldn't want to give you wrong numbers. They did have some initial challenges in getting some people there, but our veterans were always taken care of and the medical staff was on site.
Some of the issues we have been hearing about are more in the realm of the culture. You know, the staff at Ste. Anne's had been at Ste. Anne's for...well, the director had been there for 35 years, I believe, or 37 years. There was a real culture of serving our veterans and the new people coming in have to learn this. The Province of Quebec is totally committed to ensuring that the veterans receive the care they deserve and they need. We're already seeing some benefits, as the deputy mentioned. Family members, and spouses specifically, can now be in the hospital with their spouse, which was not allowable under our act before. They may not be in the same room, but at least if they're not on the same floor, then they're very close, which is important to the veterans.
As with any transfer, there are always some growing pains. The transfer agreement was very clear on what they were supposed to deliver, but we do meet with them. I don't personally, but Mr. Butler and I have two of our top DGs meeting with them on a regular basis to ensure that they are meeting everything that's under the transfer agreement.
Thanks for being here.
I have to carry on with the question about marijuana, and it's really important to me that you understand the impetus behind this. It's coming from multiple letters that I am receiving, not from veterans themselves necessarily but also from caregivers—a lot of times, family members. Their concern is extreme, and they talk very clearly of the difference between their loved one's condition on multiple pharmaceuticals versus using medicinal marijuana.
We know that this is very different from the recreational marijuana that is going to be available to Canadians. It's a totally different product. It does not provide the hallucinations; it provides painkilling. I've been studying it extensively because I want to know what the difference is. These individuals are saying, “You're taking away my loved one, who is finally in a condition where we can talk to each other again.” These are real situations. The reason they've needed the amounts they're talking about is that they don't sit and smoke it. They make creams. They use it in meals, because it absorbs better and you don't destroy your lungs.
What I'm hearing is all very rational. We're prepared to say we're lowering it, but I don't understand what process was taken to determine how that should happen.
When you compare the side effects of being on 1,000 pills a month—and believe me, these women document—we're not dealing with pie-in-the-sky ideas here. They know exactly what they're giving and how much it's costing. For some of them it's $100 per dosage per day. We're talking about the difference in side effects, difference in cost, and the difference in having their loved ones being able to work on other things in their lives because they're no longer in that level of pain.
I don't understand how we came to the decision of three grams. The minister said that he spoke to veterans, but he didn't say how many veterans who are taking medicinal marijuana he spoke to, or how many caregivers. I need more clarification on where we're at with this issue.
Thanks so much for that question and the evident passion behind it. I think you reflect the challenges that the department has had in dealing with the issue.
What I would tell you is that the consultations were actually quite extensive. We are very concerned and focused in the department on establishing evidence-based policy. There was extensive consultation with medical experts and the literature, and the minister commented on the fact that even the college of physicians has made it absolutely clear to its membership that three grams a day is the upper limit of what it perceives to be a safety factor for the use of marijuana.
Those kinds of considerations very much influence what we were doing. We have to be concerned, obviously, with the health and well-being of veterans. The policy was framed in that context. We wanted to focus on it if we are going to reimburse, and that's all we do. The Department of Veterans Affairs treatment program only reimburses. We do not prescribe. We do not authorize.
The issue you are raising is a fundamental challenge that we have in the Canadian context and abroad, because there is very little research to show from a scientific perspective what efficacy is achieved through this. We have to formulate a policy based on weighing the anecdotal evidence that we heard from veterans and their partners with where the scientific evidence seems to be. Those two do not necessarily map together very well.
Again, we were charged with developing a reimbursement policy rooted in the health and well-being of veterans. Given those concerns and the recommendations of numerous professionals in the field, we landed on the three grams.
Yes, I understand that.
However, I would say that we know that in Israel it has been used for 50 years. There are places in the world, again similar to mefloquine, where we seem to be way behind in getting the evidence and going beyond what we see, hear, and experience here in Canada versus what is happening in other places in the world as well.
I have to say, if they are doctors, and they have the opportunity to prescribe something, they should get the information on it and then know that it is not addictive in the same way as pharmaceuticals are. It doesn't cost these people, and it gives a better result. Why aren't we going in that direction?
In the paper the other day, the individual in charge of basically creating the OxyContin issue is now moving into running one of our medical marijuana companies.
Thank you very much for that question.
Over 90% of Veterans Affairs Canada's budget goes directly to veterans for benefits and/or services. Those benefits and services are event driven in that a disability or an illness triggers entitlement and eligibility for certain benefits.
We also have the fact that we have to look and project out over the entire lifespan of veterans. We have a lot of actuarial work that takes place to look at those long-term forecasts. We also have in-year cash forecasts that are more near term that we need to look at, both in tandem.
What we do is we work very closely with the office of the chief actuary and every year we update our client forecast, so there are vast amounts of data that, together with the actuarial staff, we look at and we attempt to make the best forecast possible.
I would add that the event-driven nature of our expenditures is such that our benefits and our services are in special purpose allotments. The technical term is quasi-stats, but it does indicate that they're event driven. In any given fiscal year, whether we have 10 veterans who come forward or 10,000, we assure through our forecast that every veteran receives the benefits and services to which they are entitled.
It doesn't create an issue. Under the superannuation act—and I know because I used to be the DG of superannuation at one point in my career—there is a limit that you can accumulate in your pension, but not all veterans have 35 years of service. They can either opt to be in or out of the pension. We work each case individually with the veteran.
We try to hire the veterans as indeterminate staff. The majority that we are bringing in are indeterminate. There are some temporary positions, but I don't think we have many veterans in those temporary positions. We may have some, but not a lot.
The bigger challenge we have is for the veteran to understand the public service. You have an interview when you join the armed forces. As General Natynczyk is fond of saying, he's had two interviews, one when he joined and one when he became the chief of defence staff. The rest of your career is managed by the armed forces. In the public service the culture is very different. We have more issues in making sure they understand how to navigate the system of the public service, as opposed to the benefits side. I think Mr. Butler talked about it.
They're entitled to their benefits. I've been talking to a lot of the federal counsels. Just because somebody has PTSD does not mean they cannot work for the federal government. When you read the paper you get a certain segment, but a lot of veterans are very functional. There's no issue. They want to work. They can work. They are able and capable. I've been talking a lot to our federal colleagues to make sure there is no stigma attached to any of this.
In the case of Kelowna, there are 3,500 clients managed there. Those are not case-managed clients. That's your general client group, and there are 88 case-managed veterans in the area that the office would take. Prince George has 1,200; 64 are case managed. Saskatoon has approximately 29. I can give you precise numbers but they would fluctuate a bit. However, 71 are case managed. In the case of Surrey, which we have not opened yet, it's a brand new office that's coming with 7,441 and about 200 are case managed. Brandon has 2,400 clients, and 123 are case managed. Thunder Bay has 1,692, and 57 are case managed. Windsor has 2,776 with 126 that are case managed. Sydney has 2,181 clients, and 145 are case managed. Charlottetown has 2,100, with 100 case managed. Corner Brook has 943 clients, and 118 are case managed.
We can't forget the north. The minister and the deputy spoke about the north. We have 300 clients identified in the north. Fifteen are case managed. We actually suspect this will go up a lot because the Rangers, who patrol the north on a yearly basis for Canada, for the armed forces, although they fall into different categories, when they are on patrol they are eligible for VAC benefits if they get injured. We don't have a lot of those people, so that's the outreach we're really doing for the Ranger groups. As an example, one of my DGs was up there in April, outside of Iqaluit somewhere, and they went into a very small village and there were three veterans. One of the elders said, “You should talk to this one here; he's having issues”, and this was not somebody anywhere on our radar. We think that number will go up, but at the moment those are the numbers.
We are in the process of going out. It's on the market right now for a consultant to actually do exactly what you're talking about.
We're also looking at whether there are better ways to capture the information when a veteran leaves one of our offices or makes a phone call. We're looking at that to gather the information, because we hear about the people who are not happy about our services, but I also receive emails and letters from people who are quite happy with our services. We never hear about those, so we do want to go out to make sure that we get the right things.
We haven't been doing public opinion research, but it's on the market, I believe as of yesterday, for 15 days, to get a consultant to go out to survey, hopefully, a very good percentage of the 670,000 veterans we have out there.