Appendix 1
Appendix 2
Appendix 3

APPENDIX 1

Witnesses and Individuals Met during the Course of this Study

First Report, March 1998 

The Subcommittee travelled to North York, Ste-Anne de Bellevue and Charlottetown and held in camera meetings on December 17, 18 and 19, 1997

At the Sunnybrook Health Science Centre, North York, the following people were heard:

Mr. Llew Anderson
Resident, President of the Veterans Committee

Mr. Tom Brent
Chair, Board of Trustees

Mr. Tom Closson
Chief Executive Officer Program

Mr. Ian Douglas, C.M., Q.C.
Trustee Emeritus, Member of Veterans Committee

Dr. Peter Norton, M.D.
Vice President (Medical) for the Ageing Program

Mr. Arthur Plumb
Resident, Past President of the Veterans Committee

Ms. Marilyn Rook
Vice President (Operations) for the Ageing Program

At Ste-Anne's Hospital in Ste-Anne de Bellevue, Québec, the following people were heard:

Ms. Judith Cohen
Nurse Clinician

Mrs. Thérèse Dufresne
Chief of Dietary Services

Mrs. Rachel Corneille Gravel
Executive Director

Dr. Bernard Groulx
Department of Psychiatry

Dr. Pierre Paquette
Director of Professional Services

Mrs. Suzanne Lalonde
Regional Director General - Quebec, Veterans Affairs Canada

In Charlottetown, the following officials from the Department of Veterans Affairs were heard:

Mr. J.D. Nicholson
Deputy Minister

Mr. Dennis Wallace
Assistant Deputy Minister, Veterans Services

Mr. Darragh Mogan
Director General of Health Care

Ms. Debbie Gallant
RVCN Project Member

Mr. John Conlin
District Director, Toronto Area Office

Mr. Simon Coakeley
Executive Director, Ste Anne's Transfer Project

Report, February 1999

The Subcommittee met with the following individuals during visits to various facilities across Canada:

June 1998

The Perley and Rideau Veterans Health Centre, Ottawa

Mr. Andrew Fenus, Vice-Chairman, Board of Directors
Colonel (Retired) Fred Hannington, Board Director
Colonel (Retired) Murray Johnston, Board Director
Colonel (Retired) John Gardam, Chair, Veterans' Liaison Committee
Mr. Greg Fougère, Executive Director and Chief Executive Officer
Ms. Janet Morris, Assistant Executive Director

November 1998

Deer Lodge Centre, Winnipeg, Manitoba:

Mr. Tim Duprey, Chief Executive Officer
Ms. Margo Christie, Director of Care
Ms. Nykola Dubenski, Public Relations
Mr. Kevin Scott, Director Recreation Services
Ms. Pam Robb, Director, Social Work
Dr. David Murray, Medical Director
Mr. Frank Krupka, Dietetic Services Director
Mr. John Walker, Director, Health Care Systems, Veterans Affairs Canada
Ms. Diane Petersen-Razos, Director, Manitoba District, Veterans Affairs Canada
Mr. Larry Bredesen, Deputy Regional Director General, Prairie Region, Veterans Affairs Canada

Colonel Belcher Veterans' Care Centre, Calgary, Alberta:

Ms. Lynne Mansell, Senior Operating Officer
Ms. Mary Sangha, Administrative Leader
Ms. Cynthia Watson, Manager, Programs & Services
Residents

The Lodge at Broadmead, Victoria, B.C.:

Mr. Bruce Goldsmith, Chief Executive Officer
Ms. Peggy Mika, Vice Chairperson, Board of Directors of the Tillicum and Veterans Care Society Operating TLAB
Mr. Merv Dutchak, Director of Plant Services
Ms. Gloria Parker, Director of Care
Mr. Andrew Butler, Regional Manager, Fraser Valley, Thompson West Koutneys, MOH
Ms. Martha McDougall, Director, Lifestyles and Community Services
Mr. Ken Parkinson, District Director, Veterans Affairs Canada

Brock Fahrni Pavilion, Vancouver, B.C.:

Ms. Bev Inglis, Nurse Manager
Ms. Eileen Kosarek, Social Worker
Ms. Manorma Bhate, Dietician
Mr. Graham Williams, District Director, Vancouver, Veterans Affairs Canada.

George Derby Centre, Burnaby, B.C.:

Ms. Janice Mitchell, Administrator
Ms. Janet Neil, Unit Manager (Direct Care)
Ms. Noreen Donnelly, Director of Volunteer/Leisure Services
Ms. Haria Soares, Director, Support Services
Mr. Graham Williams, District Director, Vancouver, Veterans Affairs Canada

December 1998

Parkwood Hospital, London, Ontario:

Ms. Anne Hubbell, Chair, Board of Directors
Mr. Michael Boucher, Vice-President
Ms. Jill MacLean, Director, Veterans Care Program
Ms. Maggie Gibson, Psychologist, Veterans Care Program
Ms. Nancy Bowers Ivanski, Therapeutic Recreation Specialist
Ms. Beth Schroeder, Patient Relations
Ms. Deb McKinley, Food and Nutrition Services
Mr. Bob Shirrefs, President, Residents Council

Sunnybrook & Women's College Health Sciences Centre (Sunnybrook Campus), North York, Ontario:

Ms. Kerry Marshall, Acting President and CEO
Ms. Anne Morris, Operations Director, Physical and Cognitive Support
Dr. Evelyn Williams, Director, Long-term care and Medical Director, Physical Support, Patient Service Unit.
Messrs. J. Ross LeMesurier and Ian Douglas, Members of the Veterans Committee of the Board of Trustees
Mr. John Conlin, District Director, Veterans Affairs Canada
Mr. Llew Anderson, Resident, President of the Veterans Committee
Mr. Arthur Plumb, Resident, Past President of the Veterans Committee

January 1999

Camp Hill Hospital of QE II Health Sciences Centre, Halifax, Nova Scotia:

Dr. Barry Clark, Director Long-Term Care
Ms. Helen Cameron, Co-ordinator, Centre for the Elderly
Ms. Deborah Vanderwater, Director of Nursing
Ms. Shirley MacIntosh, Director of Food Services
Mr. Jim Clark, Director of Fire and Safety
Mr. Andrew Ritcey, Director of Recreation Services

The Subcommittee also travelled to Charlottetown, P.E.I, and met with the following officials of the Department of Veterans Affairs:

Mr. J.D. Nicholson, Deputy Minister
Mr. Brian D. Ferguson, Assistant Deputy Minister, Veterans Services
Mr. Darragh Mogan, Director General, Health Care Division
Ms. Orlanda Drebit, Director, Health Services
Mr. Bob Atkinson, Director General, Transition Management and Project Leader, Review of Veterans Care Needs
Mr. John Walker, Director, Health Care Systems
Ms. Sandra Gaudet, Director General, Program Coordination
Ms. Judith Holman, Executive Writer
Ms. Doris Boulet, Director General, Benefits Division
Mr. Bernard Butler, Director, Pension and Operational Services
Mr. Brian Chambers, Chairman, Veterans Review and Appeal Board (VRAB)
Ms. Dale Sharkey, Executive Director, VRAB
Mr. John Brehaut, Special Advisor, VRAB
Ms. Patsy Bolger-Gallant, Senior Communication Officer

The Subcommittee recommends:

That Veterans Affairs Canada ensure that all service providers at the provincial and community levels are informed that veterans are entitled to priority in receiving such additional services and benefits as may be provided under federal legislation, federal contracts with the provincial health care system, or with the individual institution.

That Veterans Affairs Canada prepare a discussion document setting out in concrete terms the conclusions to be drawn from the studies it has undertaken on the future of veterans health care. The document should

• present a demographic analysis of ageing and dependency trends;

• evaluate the increased demands on programs that might arise as overseas service veterans, not currently in receipt of benefits, age and become less independent; and

• be prepared without delay and circulated to veterans organizations and the Subcommittee as soon as possible.

That Veterans Affairs Canada adopt an integrated approach to the health care needs of the spouse of a severely disabled veteran in the years following the death or permanent institutionalisation of the veteran.

That the Department establish a detailed federal standard of care for implementation in long-term care facilities. This standard must meet the needs of veterans to the same or a higher degree than was the case before the Department transferred its facilities to the provinces. Regardless of whether the standard is expressed in terms of patient outcomes or in terms of hours of care per resident per day etc., it must be readily understandable;

That the standards referred to above specify that all chronic care palliative care wards in which the Department contracts for veterans beds be equipped with a sprinkler system; and

That the Department negotiate updated Transfer Agreements with the provinces that enshrine the departmental standards referred to above.

That the Department make formal visits to facilities where veterans reside at least twice a year, and that its officials make informal visits as frequently as possible.

That the Department immediately take the lead in finding a way to equip the veterans on K Wing of the Sunnybrook Hospital with electric beds.

That the Department review with officials of Sunnybrook Hospital the staffing levels on Kilgour Wing and ensure that these are adequate to meet the needs of the veterans resident there.

That the Department, as part of the standards referred to above, ensure that a high percentage of nursing staff that deal with cognitively impaired veterans hold credentials that prevent their being "bumped" by nurses that have no training or experience in the field of cognitive support.

That the Department, as part of the standards referred to above, specify that all contract hospitals with veterans’ beds have clear and precise guidelines about handling patients who have fallen and the circumstances under which a doctor must physically check them before they are moved or put back in bed and that all staff members be made aware of and respect these guidelines.

That the Department, as part of the standards referred to above, specify that cognitively impaired residents with aggressive patterns of behaviour should not be mixed with physically or cognitively impaired residents.

That the Department ensure continued support for the psychiatric and psychogeriatric programs at Ste Anne’s Hospital.

That the Department continue to support further research and development at Ste Anne’s Hospital into advanced nutritional care for Dysphagia, and that the Ste Anne techniques and products be made available at hospitals under contract to the Department.

That the Department ensure that the principle of merit, not seniority, remain the basis of staffing actions at Ste Anne’s Hospital.

That the Department indefinitely postpone the transfer of Ste Anne’s Hospital to the Province of Quebec, that the Department amend veterans legislation to permit the spouses of disabled veterans to occupy beds reserved for veterans, and that Ste Anne’s Hospital be gradually modernized to this end.

APPENDIX 3

Message from the Department of Veterans Affairs

Veterans Affairs     Received by fax February 18, 1999
Canada

P.0. Box 7700
Charlottetown, P.E.I.
CIA 8M9