Vol. 138, No. 51 — December 18, 2004

Regulations Amending the Veterans Health Care Regulations

Statutory authority

Department of Veterans Affairs Act

Sponsoring department

Department of Veterans Affairs

REGULATORY IMPACT
ANALYSIS STATEMENT

(This statement is not part of the Regulations.)

Description

The Veterans Health Care Regulations govern health care programs for Canadian veterans and other specific groups who served in close support of the armed forces. The Regulations provide for benefits and services such as pharmaceutical products, medical and dental treatment, home-based care under the Veterans Independence Program, and long-term institutional care. To govern the provision of these benefits and services, the Regulations stipulate program policies, eligibility criteria, and other terms and conditions.

The Veterans Independence Program was introduced in 1981, initially under the name "Aging Veterans Program." It evolved and was expanded gradually over the years. This home care program offers to veterans and other eligible persons self-managed care, in co-operation with provincial and regional health authorities, to foster their independence in their own homes and communities.

Services under the Veterans Independence Program are provided conditional to an assessment indicating that they are required for health reasons and to help the recipient live a self-sufficient life in their own home. As well, the services are designed to complement those services covered under provincial health insurance systems and/or offered in the community, rather than replacing or duplicating them.

The proposed amendment to section 16 of the Regulations extends to primary caregivers of eligible veterans eligibility for two components of the Veterans Independence Program, namely, housekeeping services and grounds maintenance services. These services would be provided to the primary caregiver after the veteran's admission to a health care facility or after the veteran's death, on the condition that the veteran qualified for and received the service at that time. The goal of this amendment, and of its underlying policy, is to support the independence of those who have ensured the care of Canada's veterans in their final years.

In addition to veterans, the proposed amendment also extends services to primary caregivers of the following clients (if they received the services at the time of their death or admission to a health care facility): merchant navy veterans, special duty service pensioners, military service pensioners (former members of the Canadian Forces entitled to a pension under the Pension Act for disability related to military service other than in war time or special duty service), and former members of certain civilian groups.

In previous regulatory amendments regarding the same subject matter, made in June and December 2003, the Government had sought to address survivors' and caregivers' requirements for housekeeping and grounds maintenance by offering these services to survivors and caregivers of veterans who had passed away after August 1990. The veteran community, members of Parliament, and other stakeholders have since been making convincing arguments in favour of more inclusive eligibility rules. As a result, Veterans Affairs Canada conducted a review of its policies toward veterans' caregivers. It culminated with this regulatory proposal, made in consideration of the caregivers' contribution to the well-being of veterans, their overall average old age, and their own home care needs.

More specifically, it is proposed with this amendment to extend housekeeping and grounds maintenance services to primary caregivers of all veterans who were receiving housekeeping or grounds maintenance services from Veterans Affairs Canada at the time of their death. Two restrictions found in the present Regulations would be removed. First, the requirement that the veteran had passed way after August 1990 would be removed, so that the former primary caregiver would receive the services even if the veteran had died in or before August 1990. Second, the restriction that services are not provided to the primary caregiver while the veteran is in a long-term health care facility would also be removed, allowing the former primary caregiver to receive the services immediately after the veteran's admission to a long-term health care facility.

The proposed amendment also changes the program's focus to better target the needs of voluntary primary caregivers. Many caregivers experienced significant strain as a result of providing care over an extended period of time. In addition, the extension of housekeeping and grounds maintenance services would recognize that primary caregivers have always played a critical role, often at a considerable personal sacrifice, in the continued independence of veterans in the final years and days of their lives. While it is anticipated that veterans' spouses and common-law partners would often apply and become eligible for the benefits, the Regulations would require that they, in order to be eligible, had been living with the veteran for at least one year and had been the person primarily responsible for ensuring that care was provided to the veteran.

In addition to the foregoing, another minor change is proposed to section 34.1, to clarify the provisions which stipulate the time limit for submitting claims for reimbursement.

Alternatives

This proposed amendment would provide for important policy improvements to veterans programs. As the Veterans Independence Program is governed by the provisions of Part II of the Veterans Health Care Regulations, an amendment to the Regulations is required for the implementation of any important policy changes to this program.

The principal alternative is the status quo, meaning the continuation of the present Regulations and the existing policies they stipulate. This alternative was rejected in light of the strong consensus on the need for the change and in the context of the opportunity for positive change and improvement.

Benefits and costs

The proposed amendment would extend, to some of the individual Canadians with the most pressing health needs, home care benefits having a value of $27.5 million for the initial five-year period of its implementation. Additional resource requirements of $4.2 million have been identified for the administration of the program by Veterans Affairs Canada over the same period. The program enhancement would be funded from public resources.

In keeping with Veterans Affairs Canada's mandate, this proposal advances the evolution of veterans' programs and demonstrates that the Government is committed to satisfying changing needs. It also represents an opportunity to further repay a debt of gratitude to these special Canadians.

Many veterans have been cared for by individuals who are now elderly. Most of the primary caregivers considered in this proposed amendment are in their 70s and 80s. These caregivers have health concerns of their own and the provision of Veterans Independence Program services is a way to alleviate them. The services would assist these caregivers to remain healthy and independent in their own homes or communities.

This regulatory proposal would also ensure equitable treatment of all primary caregivers who benefited from and came to rely upon the home care services provided to eligible veterans, regardless of when or where the eligible veterans passed away. Over the next five years, approximately 4 000 primary caregivers are expected to benefit from the proposed amendment.

Consultation

This amendment corresponds to a pressing desire of the veteran population for more complete programs for those who care for them. Many primary caregivers of veterans have communicated with Veterans Affairs Canada to ask for the services that would be extended by this amendment. In addition, the Royal Canadian Legion approved, at its June 2004 Dominion Convention, a number of resolutions calling for improvements to the Veterans Independence Program.

Also of relevance is considerable media attention and an effective public campaign mounted in support of this proposed amendment. Many letters were received by Veterans Affairs Canada to this effect, a large proportion of which were from members of Parliament, of all parties, writing on behalf of their constituents. The correspondence received often expressed the view that policies outlined in the present Regulations may be unfair or arbitrary, and ought to be revisited. Similar concerns were also expressed by parliamentary committees during their Spring 2004 proceedings.

By taking those concerns into consideration, the Government was able to identify and target the necessary improvements that would be most responsible and welcomed by all stakeholders.

The principal veterans' organizations were consulted regarding this regulatory proposal and have expressed a high level of support. These consultations included meetings between representatives of those organizations and Veterans Affairs Canada officials.

The Minister of Veterans Affairs will make a public announcement and issue a news release about the Government's plans for this proposed policy change. It is anticipated that the announcement will generate media interest and be covered by news reports. Veterans Affairs Canada is also planning an information campaign to reach potentially eligible persons and ensure that those who qualify start getting information and actual services as quickly as possible.

In the context of the positive support expressed by veterans' organizations, the interest of a large number of callers who intended to apply for the benefit, and of a consensus on the merits of the proposal, the text of the proposed amendment is now being made public. Canadians have an opportunity to comment and make suggestions. All feedback received will be thoroughly considered.

Overall, it is anticipated that individual veterans and their primary caregivers will overwhelmingly welcome the proposed amendment.

Compliance and enforcement

Potentially eligible persons may contact Veterans Affairs Canada and signal their interest in the program. Once the Regulations are approved, the Department would provide these persons with application forms and process these forms as they are returned.

Veterans Affairs Canada determines the eligibility of individuals who apply for Veterans Independence Program benefits. Applicants' needs are identified by a multi-disciplinary team using a client-centered service approach. It is then determined whether unmet needs can be filled using departmental programs, the provincial health system, regional community resources, or a combination thereof. Emphasis and priority are placed on clients with the greatest level of risk to health or of institutionalization.

Veterans Independence Program services may be delivered by the client's service provider of choice. Claims are processed by a third-party contractor in accordance with the Regulations and other parameters established by Veterans Affairs Canada.

As part of the Veterans Independence Program for primary caregivers, periodic assessments are conducted to determine whether the provision of the services continues to be required for the client to remain self-sufficient at their residence and whether the provision of the services is necessary for health reasons.

The proposed amendment stipulates that the needs of the primary caregiver are to be assessed initially within one year after the veteran's death (or admission to a health care facility) and on a periodic basis thereafter. Alternatively, the initial assessment may be conducted at a later date, provided it is based on evidence relevant to the period of the veteran's death (or of admission to a health care facility). The results of prior assessments, conducted since 1981, will be useful to help Veterans Affairs Canada determine the eligibility of most primary caregivers rather than requiring new additional information from applicants.

Contact

Alex Robert, Chief, Legislation (Regulations), Policy Planning and Liaison, Veterans Affairs Canada, 161 Grafton Street, Charlottetown, Prince Edward Island C1A 8M9, (902) 566-8189 (telephone), (902) 368-0437 (facsimile), alex.robert@vac-acc.gc.ca (electronic mail).

PROPOSED REGULATORY TEXT

Notice is hereby given that the Governor in Council, pursuant to paragraph 5(a) (see footnote a) of the Department of Veterans Affairs Act (see footnote b), proposes to make the annexed Regulations Amending the Veterans Health Care Regulations.

Interested persons may make representations with respect to the proposed Regulations within 30 days after the date of publication of this notice. All such representations must cite the Canada Gazette, Part I, and the date of publication of this notice, and be addressed to Alex Robert, Chief, Legislation (Regulations), Policy Planning and Liaison, Veterans Affairs Canada, 161 Grafton Street, Charlottetown, Prince Edward Island, C1A 8M9 (tel.: (902) 566-8189; fax: (902) 368-0437; e-mail: alex.robert@vac-acc.gc.ca).

Persons making representations should identify any of those representations the disclosure of which should be refused under the Access to Information Act, in particular under section 19 and 20 of the Act, and should indicate the reasons why and the period during which the representations should not be disclosed. They should also identify any representations for which there is consent to disclosure for the purpose of the Act.

Ottawa, December 6, 2004

EILEEN BOYD
Assistant Clerk of the Privy Council

REGULATIONS AMENDING THE VETERANS
HEALTH CARE REGULATIONS

AMENDMENT

1. Sections 16 of the Veterans Health Care Regulations (see footnote 1) is replaced by the following:

16. (1) Subject to subsection (2), the primary caregiver of a client is entitled to any of the services referred to in subparagraphs 19(a)(iii) and (v) that the client was receiving under the Department of Veterans Affairs Act at the time the client died or began residing in a health care facility if

(a) the primary caregiver is assessed within one year after the earlier of client's death and the client's admission into the health care facility, or presents evidence relating to their health condition during that period on the basis of which an assessment can be made;

(b) the assessment and all subsequent assessments indicate that the provision of the services is necessary for health reasons and to assist the primary caregiver to remain self-sufficient at their principal residence; and

(c) the primary caregiver is resident in Canada.

(2) The primary caregiver is entitled to the services to the extent that they are not available to the primary caregiver as an insured service under a provincial health care system or a private insurance policy.

(3) In this section, "primary caregiver", in relation to a client, means the adult person who, immediately before the client died or was admitted into a health care facility,

(a) was primarily responsible, without remuneration, for ensuring that care was provided to the client; and

(b) for a continuous period of at least one year, resided in the principal residence of the client and maintained the client or was maintained by the client.

2. Subsection 34.1(4) of the Regulations is replaced by the following:

(4) A claim for reimbursement or payment must be made by or on behalf of the person within 18 months of the day on which the expenditure was incurred.

COMING INTO FORCE

3. These Regulations come into force on the day on which they are registered.

[51-1-o]

Footnote a

S.C. 2000, c. 34, s. 13(2)

Footnote b

S.C. 2000, c. 34, par. 95(a)

Footnote 1

SOR/90-594

NOTICE:
The format of the electronic version of this issue of the Canada Gazette was modified in order to be compatible with hypertext language (HTML). Its content is very similar except for the footnotes, the symbols and the tables.

	Top of page
Maintained by the Canada Gazette Directorate	Important notices