Service Delivery to Veterans

Opening Statement to the Standing Committee on Veterans Affairs

Mental Health Services for Veterans

(Chapter 3—2014 Fall Report of the Auditor General of Canada)

Access to Online Services

(Chapter 2—2013 Fall Report of the Auditor General of Canada)

Transition of Ill and Injured Military Personnel to Civilian Life

(Chapter 4—2012 Fall Report of the Auditor General of Canada)

14 April 2016

Michael Ferguson, CPA, CA
FCA (New Brunswick)
Auditor General of Canada

Mr. Chair, thank you for this opportunity to discuss our audit work relating to the Committee’s study of service delivery to veterans. Joining me at the table are Joe Martire, Principal and Dawn Campbell, Director, responsible for audits of Veterans Affairs Canada and National Defence and the Canadian Armed Forces.

For the benefit of new members, I would like to briefly explain the type of audits we are presenting to you today, which are performance audits.

Performance audits examine whether government programs are being managed with due regard for economy, efficiency, and environmental impact. We also look to see if there are means in place to measure the effectiveness of programs. However, while we may comment on policy implementation, we do not comment on the merits of the policy itself.

Since 2012, we have conducted two performance audits that focused on selected services and benefits provided to veterans. Veterans Affairs Canada was also part of a third audit that examined the delivery of online services by federal organizations.

Chapter 4, 2012 Fall Report—Transition of Ill and Injured Military Personnel to Civilian Life

In the fall of 2012, we reported on how National Defence and Veterans Affairs Canada managed selected programs, benefits and services to support eligible ill and injured Canadian Forces members and veterans in the transition to civilian life. We did not look at whether Canadian Forces members and veterans had received all benefits and services for which they were eligible. Neither did we examine the fairness of departmental services and benefits available, nor the quality of medical treatment and care provided.

There are a variety of support programs, benefits, and services in place to help ill and injured members of the military make the transition to civilian life. However, we found that understanding how the programs worked and accessing them was often complex, lengthy, and challenging.

The lack of clear information about programs and services, the complexity of eligibility criteria, and the dependence on paper-based systems were some of the difficulties expressed by both clients and staff.

We also found inconsistencies in how individual cases were managed, as well as problems in the sharing of information between the two departments. As a result, Forces members and veterans did not always receive services and benefits in a timely manner or at all.

We found that the interdepartmental governance framework to coordinate, harmonize, and communicate the various programs, services and benefits available to ill and injured Forces members and veterans needed strengthening.

National Defence and Veterans Affairs accepted all 15 of our recommendations, which included streamlining their processes to make programs more accessible for ill and injured Forces members and veterans.

Chapter 3, 2014 Fall Report—Mental Health Services for Veterans

In our fall 2014 report, we reported on Mental Health Services for Veterans. As at, March 2014, about 15,000 veterans were eligible to receive mental health support from Veterans Affairs Canada through the Disability Benefits Program. The proportion of the Department’s disability benefits clients with mental health conditions had increased from less than 2 percent in 2002 to almost 12 percent in 2014.

Our objective was to determine whether Veterans Affairs Canada had facilitated timely access to services and benefits for veterans with mental illness. We focussed on the timeliness of eligibility decisions made by Veterans Affairs Canada. We did not assess the appropriateness of the decisions made or the quality of care received.

For eligible veterans, the Department paid for various mental health services that were not covered by provincial health care plans. These services included specialized psychological care, residential treatment, and some prescribed medications.

We found that Veterans Affairs Canada had put in place important mental health supports. These included operational stress injury clinics, a 24/7 telephone service, and the Operational Stress Injury Social Support Program. However, the Department was not doing enough to facilitate veterans’ timely access to mental health services and benefits.

The Rehabilitation Program provides access to mental health care support for those veterans who are having difficulty transitioning to civilian life. Eligibility requirements are less stringent than those of the Disability Benefits Program, but treatment and benefits end once a veteran completes the program. We found that Veterans Affairs Canada was meeting its service standards for providing timely access to mental health services through the Rehabilitation Program.

The Disability Benefits Program provides life-long access to benefits, and requires that veterans provide evidence that they have a permanent mental health condition that was caused or aggravated by military service. We found that from the veterans’ perspective, about 20 percent had to wait more than 8 months, from the first point of contact, for the Department to confirm their eligibility to access the specialized mental health services paid for by the Department.

As in 2012, we found that a complex application process, delays in obtaining medical records from National Defence and the Canadian Armed Forces, and long wait times to access mental health care professionals in stress injury clinics continued to be some of the factors that slow down the decision as to whether veterans are eligible for support provided through the Disability Benefits Program.

In addition, we noted that 65 percent of veterans (843 of 1,297) who challenged denial of eligibility decisions for disability benefits were successful. While the Department knew that most successful challenges rely on new information or testimony, it had not analyzed how the process could be improved to obtain this information prior to rendering decisions upon first application.

Mr. Chair, Veterans Affairs Canada agreed with our recommendations and following our report, produced an action plan with implementation deadlines ranging from December 2014 to March 2016.

Chapter 2, 2013 Fall Report—Access to Online Services

Lastly, in the fall of 2013, we examined whether the online services offered by some federal organizations, including those by Veterans Affairs, were client-focused and supported by service delivery strategies with defined and measured benefits. We did not audit service standards.

We found that the government had introduced services to enable individuals to interact online with departments securely. However, multiple steps were required to set up a secure account and then enroll in a program. For example, a retired veteran wishing to interact with the Government of Canada online to access benefits and report taxes first had to first set up a secure account and then follow different enrolment processes with Human Resources and Skills Development Canada (Service Canada), Veterans Affairs Canada (VAC) and the Canada Revenue Agency (CRA). While a veteran would have had immediate access to a VAC account, the wait time to receive separate security codes in the mail from Service Canada and CRA was 5 to 10 days.

Mr. Chair, we hope that the findings in these audits will be useful to the Committee in its study. I should note however that we have not done other audit work since our reports were presented to Parliament and can therefore not comment on progress the departments have made since then. We encourage your Committee to ask department officials what progress they have made toward implementing our recommendations.

Lastly, the Committee may be interested to know that on May 3rd we will present a report to Parliament on the drug benefits program provided by Veterans Affairs Canada.

This concludes my opening remarks. We would be pleased to answer any questions the Committee may have. Thank you.