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I might clarify that the deck was provided for your information. I'm not going to go through it in detail. I will have opening remarks and cover some of the content there.
Mr. Chair and committee members, it's a pleasure to appear before you today with my colleague, Darragh Mogan, who is director general of policy and research, in order to provide an update on the new Veterans Charter. We are committed to keeping you informed on how well the charter is meeting the unique needs of our modern-day veterans and their families. It's hard to believe, but it's already more than three years since we implemented this very important suite of programs and services.
As I mentioned, I provided you with a document that contains detailed information about the development of the new Veterans Charter and the progress since implementation in 2006. The document also contains a couple of case scenarios that, although they are not intended to be a representation of all our client cases, illustrate how the programs of the new Veterans Charter can and do make positive changes in the lives of modern-day veterans and their families.
The charter's programs can be summed up in one word: wellness. They give modern-day veterans the tools and opportunities they need to build better lives for themselves and their families after their career in the military has ended. The charter offers personalized case management, access to health services and health insurance, rehabilitation, job placement, financial support, and a lump sum disability award. In short, it offers opportunity with security.
The new Veterans Charter has laid an excellent foundation for meeting the needs of our modern-day veterans, and in fact was recently described as follows in a review carried out for the Australian Department of Veterans' Affairs:
The New Veterans Charter in Canada is the closest to a “wellness approach” of the systems we reviewed. It is based on enabling and rewarding a return to the best life possible.
Having said that, the new Veterans Charter has always been described, as you mentioned earlier, Mr. Chair, as a living charter. Plainly put, this means the new Veterans Charter is not set in stone. Our programs and services have evolved and will continue to evolve to meet our CF clients' ever-changing needs as they arise.
Over the past three years, VAC has made changes to maximize efficiency within its existing authority and has been exploring and analyzing the potential gaps that were identified through various sources. In addition to the Veterans Affairs Canada internal assessments of the programs, we have collaborated with the Department of National Defence and the Canadian Forces through various forums, have consulted with stakeholders, including veterans organizations, and worked with advisory groups, including the new Veterans Charter advisory group and a special needs advisory group. Additionally, the department has examined other sources, including information on best practices of other countries.
We know that approximately 6,200 CF regular force members were released in 2008-09, and of these, 1,060 were medical releases. Additionally, we are cognizant of the fact that Canada's combat role in Afghanistan will end in 2011, and it is anticipated that there will be an increased number of VAC clients at that time.
As of October 1, 2009, the new Veterans Charter advisory group report has been received by Veterans Affairs Canada. It has as a major theme early introduction to rehabilitation services as key to a successful transition. Indeed, the National Institute of Disability Management and Research reports that an injured worker has only a 50% likelihood of going back to work after being laid off for six months, with this percentage dropping dramatically to 20% after one year.
In addition to considering amendments to the programs of the new Veterans Charter, it will be imperative that VAC work with DND to ensure that potential VAC clients receive the necessary intervention as early as possible, to ensure that clients are able to achieve optimal outcomes and make a successful transition to civilian life. In other words, intervention must occur as soon as possible, prior to an individual's release from military service after injury or illness.
Let me review some of the points contained in the handout you have received.
First, it is clear that prior to the introduction of the new Veterans Charter on April 1, 2006, programs existing at that time were not responding to Canadian Forces veterans' needs for recovery and rehabilitation. These needs arose from both physical and operational stress injuries. At that time, the only gateway to VAC services was by obtaining a pension. Most pensions were awarded for amounts insufficient to provide an adequate income, as they were constructed to provide compensation for pain and suffering received in service to Canada and not as income replacement. Thus, we could offer a disability pension and associated treatment benefits, but we could not offer an income stream into the future. In addition, no rehabilitation was available. Real needs were not being met, as too many pensioned and non-pensioned CF veterans were not successfully transitioning from military to civilian life. We recognized that a new wellness model based on modern disability management principles was required.
The details of the program that came into effect as the Canadian Forces Members and Veterans Re-establishment and Compensation Act are described in the handout provided to you.
A key feature of this package of services is that there is direct access to rehabilitation services—physical, psycho-social, and vocational—without the requirement to apply for and receive a disability award.
Let me discuss briefly the introduction of a disability award, which has replaced the pension. The disability award is one part of a dual award system aimed at providing both a payment for pain and suffering and an economic payment to cover any employment earnings loss incurred while undertaking a rehabilitation program. The earnings loss is calculated at 75% of the veteran's pre-release income and is indexed. If the member is incapacitated, the payment continues until the member turns 65. Seriously wounded veterans are also eligible for a permanent incapacity allowance, which recognizes that there are challenges in seeking stable, continuing employment. If the member is killed in service, the surviving spouse receives the earnings loss payment until the member would have turned 65.
While the main focus of the new Veterans Charter is its wellness programs, the financial payment scheme is heavily weighted to provide the most financial support to those most seriously injured, while providing a safety net of rehabilitation services should injuries be missed upon release from the Canadian Forces.
[Translation]
We, at Veterans Affairs Canada, are going to continue our efforts to develop our services for veterans.
[English]
We feel that the charter is making a difference. We also feel that it needs to be continually reviewed as a living charter. We at Veterans Affairs Canada are continuing our work to ensure that the charter evolves to meet the changing needs of our clients and to develop approaches that result in positive client outcomes.
Thank you for the opportunity to provide you with this update. I would be pleased to take any questions now with my colleague Darragh.
You're quite correct that there has been slower-than-anticipated take-up of the job placement program, which is a key part of the charter. I should mention that there are two ways job placement actually takes place within the context of the charter. If someone is going through rehabilitation, as part of the vocational rehabilitation component, job placement efforts are made on behalf of the graduates of the program. The job placement program that is standing out as a program in its own right is the program that was designed for all releasing members to access, regardless of whether they required rehabilitation.
We've done an analysis with our colleagues at the Department of National Defence, and there were some misunderstandings, I think, from people at the beginning of the introduction of the program about its availability to them. With DND, we've been working through means to communicate better, putting articles in the internal magazine that goes out to all military personnel, and making other efforts in that regard.
The other thing is that I think at the time when we introduced it, there was kind of a burgeoning economy and people may not have been aware that this was available to them. So basically what we're doing is implementing a few changes to the program and its accessibility, and we hope to see a greater take-up. For anybody who has gone through it, all of our evidence is that it's an excellent program.
:
Thank you very much, Mr. Chairman.
Thank you gentlemen for coming today.
I have comments on just a couple of issues. First of all, I think the charter has improved the quality of life of veterans and their families; but as in everything, things need to change. One of the things I'd like to see—and this, of course, would require legislative change—is to see the RCMP fully incorporated into some sort of a charter, because right now, if RCMP veterans go to DVA for any assistance they require, they don't qualify for things like the VIP program, etc. So I think a discussion on their inclusion will eventually have to take place.
I also have here information on what the British do for their HM Armed Forces personnel. They've doubled the upfront payment to £570,000 for the most severe injuries or death. That's quadruple what we give. This is one of the things I'd like to see changed. I know we work side-by-side in Afghanistan. The guys are sitting there, thinking: well, if you go, your family gets this; if I go, my family gets that. So maybe it's something to look at in the future.
As well, what's most important is that this or any other lump sum payment does not affect eligibility for any other payment schemes they get. So there must be no deductions, no clawbacks, for example.
One of the problems we have is that the charter will move along and eventually will change to benefit the modern day veterans, yet we still have outlying problems from before. We still have many veterans who are getting the SISIP clawback deducted from their medical payments, or deducted from other payments. That's still a problem.
We have veterans who are still concerned about the marriage after 60 act. If they're married and remarry at 59 and live for 20 years and die, then their second spouse gets the pension. But if they marry at 60 and live 20 years and die, the second spouse gets nothing.
These are old hangover problems that our veterans are still dealing with.
Also, there is the issue with the amount of money a pensioner leaves when he dies. The spouse only gets 50%. That should be bumped up, because in many cases the spouses then dip right into the poverty world.
The Veterans Charter I think is doing an admirable job, but there's no question it needs to be improved.
I have three questions for you.
When military personnel leave the service because of either a physical or mental injury and go into the other public service for jobs, some of those people in those jobs are looking at these guys and thinking, hmmm, if you're not good enough for the military, what are you doing in here? So there needs to be more sensitivity training in the rest of the public service to let them know these men and women are coming from the military and that they should not be treated with kid gloves, but with understanding that they may be going through PTSD issues or some things of that nature. That's one question.
Two, there is the concern about the future of veterans when Sainte-Anne's gets privatized. Or, if it doesn't get privatized, what's going to happen to the thousands upon thousands of veterans who will need hospital care when World War II and Korean veterans pass on? What's going to happen to the modern day veteran in that regard?
Three, we have 220,000 clients at DVA and 750,000 to 800,000 retired RCMP and military personnel, meaning that two-thirds of the people who have served aren't your clients. What are you doing, especially in Veterans Week, to get the message of the charter out to everybody in Canada to say if you're a veteran or the spouse of a veteran, we may be able to help you? Not just through the Internet or through the legions, what are you doing to get that message out there through the newspapers and television and radio to let them know these benefits are out there for them? This type of message went out, by the way, to all of the British papers, so every single person there would have seen it.
Thank you.
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When Veterans Affairs, in 1946, acquired a lot of this large hospital capacity, there wasn't anything out there in the community at all. With the coming in of medicare, social safety nets, established programs, financing of things that all parties support over the years, there are now 220,000 to 235,000 long-term-care beds. In terms of making a selection about where they're going to go when they need long-term care, home would be the best place to go if they can do it, of course, but if they need to go into an institution, as it were--to use a pun, given this committee--they'll vote with their feet. They'll go into the community eight to nine times out of ten. We have a lot of experience to show that. We feel the Canadian Forces veterans are probably like the traditional veterans: if you give them the choice to go into the community, that's where they'll probably go.
Second, we would need a parliamentary change. We need a significant regulatory change to re-establish for Canadian Forces veterans what the traditional veterans had. We have to remember, there was no choice back in 1946 for traditional veterans.
Mr. Stoffer, you raise the British experience. I notice that Mr. Allard is here from the Royal Canadian Legion, so he's had a look at the paper we've prepared on this and made some corrections to it. Generally, what has happened is the British went to a lump sum system the year before the new Veterans Charter came in. The tariff doubled it to £500,000 to £560,000. My son lives in England, and I know that the price of a gallon of gas there is almost two and a quarter times what it is here. He paid $800,000 for a small home where he lives in northern England--and it's a very small home. So the cost of living is a little different.
Secondly, if you look at the top four tariffs that the Ministry of Defence has, for the most severely disabled, there may have been one or two awards. There have been none at the top tariff yet, despite the fact that their military is three times as large as ours and they've had bigger deployments since 1990.
I have great respect for what the Ministry of Defence in Britain does. The job placement program we adopted holus-bolus, and I think it has the elements of success. I think the apples-to-apples comparison suggests that in terms, at least, of the amount of the disability award, things are not quite what they would seem with that direct dollar-per-pound comparison.
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Thank you for that question, because it's such an important issue for us. So many individuals who are injured are injured with operational stress injuries, and those don't go away overnight. Basically what we have in place.... I won't talk about DND's process; they have excellent services while they are in service.
When they arrive at our door, we have both a clinical and a non-clinical support system. One is in partnership with DND, which is called the operational social support network or the peer support group, OSISS. I don't know if your committee has been briefed on that recently. That peer support network was founded by DND, but about 70-plus percent of the people who go to that network for peer support assistance are veterans. It caught on in a very major way with veterans.
That peer support group counsels individuals, and the peers who run these support groups are people who suffer from operational stress injuries. Our Sainte-Anne's hospital provides the clinical support to that peer network so that individuals don't get overburdened while suffering from an OSI and helping others who are suffering from OSIs. That group is used as a means to listen and assess problems that have arisen among the people who go to the groups, and they are referred to our services when the individuals are ready for them.
On the clinical side, we have established ten operational stress injury clinics, where clinicians, in a team setting, work with veterans who are diagnosed through those clinics and a treatment plan is established for them. Through our case managers in the department, the treatment plan is monitored, with continuous feedback on the treatment plan and the case, in an attempt to stay on top of the issue.
This differs quite dramatically from the way the department dealt with cases like this in the past.
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There's quite a lot of additional assistance, if required. In a sense the charter has moved to a model of independence. It is an attempt to have people transition from military life and become independent contributing citizens of Canada not requiring support in the future to actually achieve that.
In that regard, the lump sum is paid as a recognition of pain and suffering. The other programs that come into effect immediately, or even before a lump sum, because you don't have to have a lump sum payment to access them, are meant to assist in that independence, getting back to civilian life. If they need rehabilitation, psycho-social, medical, and/or vocational, they get 74% of their earnings until they're finished that program. If they can't come off that program because they're totally incapacitated, that payment index stays until they're 65. If it's someone who was killed in service, the spouse is entitled to that payment. That's another payment that's available.
If someone is severely injured, there's also a permanent incapacity allowance. That's a regular payment that's paid in recognition that some of these individuals are going to have intermittent work. In other words, they might find a job, they're off our books, but they run into a problem later and they have to go back. So there's a permanent incapacity allowance that's paid for the most severely injured.
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Yes. You've raised a really important point. As was mentioned earlier, not all the psychological illnesses conveniently arrive at our door when individuals leave the military, or even when they get back. They're late onset. Sometimes situations arise that no one can control.
So the one thing about the new Veterans Charter, you may not get a lump sum at all, you may not need it, but it's like medicare: it's always there if it's needed. And if you need it more than once, twice, three, four, five, how many times you need it in your life, it's always there. It's a statutory guarantee.
Every person leaving the military gets a transition interview. And I think we've got to the level of sophistication now that we can see the early warning signs that we may need to follow up on an individual, and we do.
These are well-trained, capable individuals coming back, and they're great assets to Canada when they leave. We've got to be careful we don't overdo it. But if we see an early warning system, if it's a family problem, if we see that somebody is showing signs of a potential problem that we've seen before, we'll follow up with that individual after they leave. And it will be based on the transition interview or an indication from the base surgeon when they leave. But we have to respect their privacy, and we do. We go to great lengths to do that.
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I guess there are a lot of parallels to my way of thinking in a community that I've spent a lot of time in, the community of people with special needs, often with disabilities that aren't so severe that they cannot work 20 hours a week. They may not be able to work 40 hours a week. In this case, they're generally in fairly menial work, but having said that, I will say that it improves their self-image so much. It helps them so much.
Often the way to get them into a work environment is to provide an incentive to the employer to consider this person in that work environment. I'm not suggesting subsidizing wages, but even a tax incentive program of some sort can facilitate this. To me, it's just another tool in your tool box.
I'm suggesting that the program look at this possibility because there are a lot of people who do desire to work, although maybe not full time because they're not able to focus that long. Maybe it's a way to still get them out there and into meaningful work. Again, there are all the self-image benefits that go along with that. As for overcoming other problems, an employer may say they need someone full time, not part time, or that type of thing. This is just another idea.
I also wanted to comment on the chart. In the deck, it's on page 13.
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Now I'm rattled. I don't know what to do.
Welcome, Mr. Ferguson and Mr. Mogan. It's good to see you again.
As just a general thing, because the committee wants to look at the charter itself and do a review, one of the things I've learned in this short year of being associated with the department is that there's an incredible amount of activity that goes on, and often the overlaps take place. You can tell from the questions, which sometimes go into an area that's totally separate, and so on.
One of the things I want to focus on for a moment and get some comments on from you as we try to move forward is that there's an evaluation process under way, and I think it's important that we're made very clear what that is so that we're not duplicating effort. But the committee does want to take a look at the review, and certainly when I started off, in my briefing last November, one of the first things we ran into was the discussions with the legion about this living document. It still sticks in my mind that there were many players who participated very actively in the creation of the original document, and I think the committee would probably like to hear from the appropriate groups that were early participants. So it would be helpful to know what the list looks like, so we can make sure that we at least include those who should be here.
The other thing, though—and perhaps you can help us out a bit here—is whether there are some things where we'd add to a problem, as opposed to a solution, if we delve in them too deeply right now. In other words, is there a point to waiting until the evaluation process is complete before we get into that?
I'm not looking for us to avoid it. I just don't want us to get involved in duplicating effort if in fact we're going to get a report in a few months that's going to clarify something.
Can you comment on that? As we move forward looking at this, I'm sure every member here wants to be helpful. We all have our individual frustrations, including, I know, professionals in the department, but I think we have something good going here as a basic premise. The process is a good one. The charter has some excellent opportunity to even improve on what it's doing right now, but we want to make sure that we're being helpful, as opposed to simply adding a parallel track going down the road.
Do you have some general comment as we move forward as to things that we perhaps should be considering ourselves as a committee?
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I have two main questions.
Generally, I find that the Veterans Charter still offers a range of services—health services, psychosocial services and so on—for people who need them.
However, I find there is one weakness, even though there are many services for veterans and they are managed by a large federal institution. People who live in remote rural communities often use services in their community because they sometimes have to travel very far to obtain services. Their first reaction is to look for services in their community. However, in cases of post-traumatic stress or other psychological disorders, for example—because physically, it is always easier to get care, for a sore arm, for instance—they do not always have the resources and specialists to meet their needs.
What are you doing at the Department of Veterans Affairs to raise awareness among stakeholders in rural communities, to train specialists who are familiar with problems related to veterans? We often hear veterans say they need a veteran to help them, that is, someone who has been through the same experience. What are you doing on that front?
And to quickly conclude, a second question. Actually, it is more of a request. We have debated the issue. Mr. Stoffer and I have talked about it. The issue is the role of the services provided by the federal government relative to the services provided by the provinces and by Quebec, and the division of tax revenue to cover those services. Do you have any documents that give a detailed explanation of this type of situation, for example, a person who is 65 years old, lives in a rural area and is receiving long-term care? Do you have any documents you could submit to this committee that would explain this type of situation?