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Ottawa has lost control of $150M program reimbursing veterans’ cannabis: audit

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OTTAWA — An internal audit by Veterans Affairs Canada suggests Ottawa has all but lost control as it shells out hundreds of millions of dollars for veterans’ medical marijuana each year without proper oversight, direction or evidence of health benefits.

Quietly published this week, the audit’s results come amid an explosion in the number of veterans seeking reimbursement for their medical pot, from around 100 in 2014 to more than 18,000 last year — with no end to the surge in sight.

The result: Veterans Affairs spent more than $150 million on medical marijuana last year — more than on all other prescription drugs combined. And that number is expected to grow to $200 million this year and $300 million by 2025-26.

Yet even as demand has grown exponentially, auditors found a continuing paucity of research about the medical benefits — and risks — of veterans using cannabis, especially those struggling with psychological trauma.

This has coincided with a lack of direction and control over who can get medical marijuana, what conditions the drug is being prescribed for, and how veterans are getting authorization for their CMP — cannabis for medical purposes.

“VAC has taken steps to operationalize its policy to provide veterans with access to reimbursement for their CMP treatment,” the audit reads. “However, there remain serious gaps in internal controls in the areas of veteran health and program management.”

Veterans Affairs started reimbursing a small number of former military personnel for their medical cannabis in 2008, at which point the approvals were granted on an extremely limited basis and with the approval of a medical specialist.

The move followed a series of court decisions more than 20 years ago that first allowed a legal exemption from criminal prosecution for the consumption of medical marijuana.

Then, in 2014, Health Canada relaxed its rules around who could authorize the use of medical marijuana to Canadians and for what conditions and circumstances. The new rules didn’t put a limit on the amount of pot that could be authorized, or the cost.

That change resulted in an explosion of claims and costs, despite the Liberal government’s decision in 2016 to limit claims to three grams per day at $8.50 per gram, with an allowance of up to 10 grams per day with medical authorization.

Auditors noted that what limited research information is available suggests individuals should use less than three grams of cannabis per day and have regular followups with their health-care providers.

Health Canada and the College of Family Physicians of Canada have also warned about the potential negative impact of marijuana use by individuals suffering from mental-health conditions, particularly post-traumatic stress disorder.

Yet the audit report says that Veterans Affairs has not provided any directions or restrictions on what kinds of health conditions are eligible for reimbursement of medical marijuana.

Virtually any medical condition is eligible. That includes PTSD, which auditors found was a diagnosis for “the vast majority” of veterans who have been reimbursed for medical cannabis.

At the same time, nearly 80 per cent of authorizations were for three grams of cannabis or more per day, while authorization letters from specialists for many veterans also “show very little sign of a strong physician-patient relationship.”

“Followup recommendations were vague, using wording such as ‘followup in six months or as clinically required,’” the report reads. “Just over half of the specialist letters we reviewed did not mention anything about followup.”

That wasn’t the only thing missing, as roughly one-third of files reviewed by the auditors did not have any record of which health-care provider had actually authorized the veteran to receive medical cannabis. And many files were missing other data.

One of the audit’s more troubling findings was that 11 health-care providers were responsible for authorizing nearly 40 per cent of all requests for medical weed, including one who had signed off on nearly 1,300 such requests.

“There (is a) small number of CMP physician authorizers with very large veteran patient loads bringing into question the robustness of the medical oversight,” the audit report reads.

It adds: “With limited guidance available on authorizing CMP, there is a risk that some health care practitioners may be over-prescribing the treatment.”

Despite these red flags, as well as the potential risk to veterans and taxpayers, auditors found the vast majority of requests for reimbursement were approved as the department focused on ensuring access rather than monitoring and control.

That included reimbursements for 45 veterans whose medical condition was listed as a substance-abuse disorder, and 46 who were also being reimbursed for anti-depressants, anti-psychotics, benzodiazepines, opioids and narcotics.

Auditors suggested the problems are the result of the department focusing too much on setting up the reimbursement process and ensuring access, noting that the entire program is being managed by the equivalent of 3.5 staff members.

“VAC can do more to identify trends in the CMP program that may be problematic and adjust policy to safeguard the health and well-being of veterans,” the report says.

“As demand for the CMP program continues to grow exponentially, VAC will need to properly manage resources and examine policy and program effectiveness.”

In response to the audit, Veterans Affairs officials say they are looking at a variety of changes in terms of which conditions are eligible for reimbursement, as well as limits on the daily amount that can authorized and for what types of products.

The department is also contemplating a new, more-detailed authorization form and additional safeguards for those requesting more than three grams per day. It is not clear when the changes may be rolled out.

This report by The Canadian Press was first published Sept. 14, 2022.

 

Lee Berthiaume, The Canadian Press

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Ottawa sending Canadian Forces to Newfoundland's southwest coast to help with Fiona cleanup – CBC.ca

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As residents continue to sift through the rubble where their houses used to stand, they can take a little comfort on Monday in knowing the Canadian Forces are on the way to help.

The federal government approved a request for assistance by the Newfoundland and Labrador government late on Sunday, which opens to door for Canadian Forces members to be deployed to the hardest hit regions and help out in any way they can.

Seamus O’Regan, federal minister of labour and one of seven MPs from N.L., said the Canadian Rangers will “immediately assess the situation,” and there are 100 members from three platoons ready to help out.

He also said naval ships HMCS Goose Bay and HMCS Margaret Brooke are in St. John’s and ready to help if needed.

The federal government also approved requests in Nova Scotia and Prince Edward Island, where the storm also caused significant damage to private property and public spaces.

Damage beyond comprehension, residents say

Canadian Forces members could have their hands full on Newfoundland’s southwest coast, where the devastation is still soaking in for local residents, many of whom have lost everything they owned.

It was the storm of a lifetime for people in places like Port aux Basques, which was hit with 134 km/h winds, 77 millimetres of rain and water levels rising over a metre. About 20 houses were swept away, and one woman was killed when a powerful storm surge swept her out of her home.

The body of the 73-year-old was recovered just before 4 p.m. on Sunday, according to the RCMP.

“My heart breaks for the family and friends of the woman from Port aux Basques who passed away when Hurricane Fiona made landfall,” Prime Minister Justin Trudeau said in a message posted to social media. “We’re keeping you in our thoughts — and we’ll continue to make sure you, and your fellow Newfoundlanders and Labradorians, have the support you need.”

Premier Andrew Furey called it “gut-wrenching news,” and sent condolence to the woman’s family and friends.

The trauma is still setting in for local residents, but the cleanup is already underway, with people taking it upon themselves to dig out their own houses, or help out their neighbours.

Simone Rennehan was sifting through the rubble on Sunday, both inside and outside her neighbour’s house. She looked for anything that wasn’t water-damaged and brought it back to her house to clean. She pulled out appliances, dishes, bicycles — anything that could be saved.

When asked by a reporter why she was doing it, she replied, “Because I’m a neighbour. You gotta try to help out when you can.”

Simone Rennehan was scouring her neighbour’s house in Port aux Basques, looking for anything she could clean and salvage for the family that lives there. (CBC)

Todd Anderson was at the waterfront in Port aux Basques on Sunday to take stock of the damage to his parents’ house. 

The basement was flooded, and the exterior had taken a beating, but he said the house seemed structurally sound. Around the house, however, neighbouring properties had been hit much worse.

“It’s a feeling of shock,” he said. “The magnitude of the damage is more than I can comprehend right now.… I’ve lived here for years and we’ve seen our share of storms, but nothing at all like this. It’s pretty overwhelming, actually.”

Todd Anderson points to his parents’ house on the shoreline in Port aux Basques. It suffered significant damage, but he’s hoping it can be salvaged. (Dan Arsenault/CBC)

His parents had been hesitant to leave before the storm, but were convinced by family members to go stay with their son. What they thought would be a one-night stay is now an indefinite relocation until their house can be examined by a professional.

About 200 people have been displaced from their homes, and many of those residents spent the weekend at an emergency shelter set up by the Salvation Army.

Burgeo, Burnt Islands dealing with catastrophic damage

Fiona’s intensity wasn’t just felt in Port aux Basques. There was also widespread damage in other places along the southwest coast.

Dana Strickland’s parents are two of the people left surveying the damage on Smalls Island in Burgeo. They were in their house, watching the storm through a window, when they noticed the front patio begin to get ripped away. Strickland said they quickly realized this storm was different.

“Dad said to Mom, ‘We’ve got to run.’ They just ran out of the house. They’re lucky to be alive.”

A man in coveralls stands in front of two buildings, both knocked off their foundation.
On Sunday, Burgeo residents surveyed the destruction left by post-tropical storm Fiona. (James Grudic/CBC)

The house they moved into on their wedding day 41 years ago is destroyed.

“They built a beautiful home together, a beautiful life for me and my sister and my daughter,” Strickland said. “We spent summers there. Every holiday — Christmas and Thanksgiving. It’s where we go. It’s home. We’ve got nowhere to go home anymore. It’s devastating.”

In Burnt Islands, just east of Port aux Basques, some areas suffered widespread damage. In a small cove known as Fox Roost, multiple buildings were flattened by the wind, waves and storm surge, including several sheds, fishing stages and houses.

The government wharf was also flattened, leaving behind a pile of splintered wood, with just the huge yellow beams that bordered the wharf left intact.

Some residents told CBC News even though their homes remained standing, they were afraid to stay — worried what the next storm could bring.

Read more from CBC Newfoundland and Labrador

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Canada dropping COVID-19 border rules, travel mask mandate – CTV News

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OTTAWA –

The federal government has announced it is dropping all COVID-19 border restrictions for anyone entering Canada, including: proof of COVID-19 vaccination, quarantine and isolation requirements as well as all pre- or on-arrival COVID-19 testing.

Canada is also making the ArriveCan application optional, and is lifting the mask mandate and health check requirements for travellers on planes and trains.

Declaring the imminent end of these restrictions—effective Oct. 1— marks a major milestone in Canada’s pandemic response.

Health Minister Jean-Yves Duclos, Minister of Public Safety Marco Mendicino, Transport Minister Omar Alghabra and other relevant ministers spoke about the lifting of pandemic precautions Monday morning in Ottawa.

“We’ve always maintained that the extraordinary measures we introduced at our borders and on airplanes, trains and boats were temporary and that we would adjust them as the situation changes. Today we’re doing just that,” Alghabra said. “We’re taking another step to returning to the normal travel that connects families, workers, and our communities.” 

Deciding to allow the special orders that for months have upheld Canada’s special pandemic authorizations under the Quarantine Act to expire means:

  • Foreign nationals won’t need to be vaccinated to enter the country;
  • Incoming travellers to major airports won’t be subject to random mandatory COVID-19 tests;
  • Unvaccinated Canadians will no longer have to isolate when they return and if someone is mid-isolation as of Oct. 1 they won’t have to complete the remainder;
  • Travellers will not have to monitor or report if they develop COVID-19 symptoms upon arrival;
  • Submitting public health information through the ArriveCan app prior to landing will become optional; and
  • It’ll no longer be mandatory to wear a face mask while travelling on planes or trains.

Cruise ship measures are also being lifted, though passenger and crew protection guidelines will remain to “align with the approach used in the United States.”

Officials said that while Canada is lifting the mask mandate, travellers are still “strongly recommended” to wear high-quality and well-fitting masks and make “informed decisions” when travelling.

The government is reminding travellers that they should not do so if they have COVID-19 symptoms, and they will have to still follow any provincial or territorial requirements.

COVID-19 will remain one of the communicable diseases listed in the Quarantine Act, and travellers who are sick upon arrival in Canada are being asked to inform a staff member or border services officer, as they “may then be referred to a quarantine officer who will decide whether the traveller needs further medical assessment,” according to a government statement.

Foreign nationals will still be required to meet the entry requirements under the Immigration and Refugee Protection Act, and will have to provide appropriate travel and immigration documentation in order to be eligible to enter Canada.

“The Government of Canada will maintain the ability to re-establish certain border measures should they be required in the future to protect Canadians from the importation of new variants of concern or other emerging public health threats,” Duclos said.

WHY IS CANADA DOING THIS NOW?

The government says the removal of these border measures is the result of modelling indicating that Canada has “largely passed” the peak of the Omicron wave of infections; Canada’s high vaccination and lower hospitalization and death rates; as well as the availability of boosters, rapid tests, and COVID-19 treatments.

However, in his opening remarks, Deputy Chief Public Health Officer Dr. Howard Njoo cautioned that Canada may be seeing “an early sign of a resurgence” of infections as the fall season begins and is advocating for staying on top of booster doses as well as continued mask-wearing in indoor and crowded settings.

Asked how the government is reconciling concerns over the potential of an uptick in cases in the coming months with the decision to lift all entry and masking requirements, Duclos said that while COVID-19 is still very much present—suggesting looking no further than any hospital—the data indicates that the rate of importation of cases through the border is “insignificant.”

He cited “difficulties” airline staff have faced in trying to enforce measures like masking, saying Canada has decided to move away from a forced approach, suggesting most people will likely still opt to wear a mask.

Duclos also said that the government is leaving open “all possible options” in terms of reinstating public health measures, if needed.

Seeking to downplay suggestions already coming from Conservative MPs that the election of Pierre Poilievre as their new leader is the driving force behind this change given his advocacy for dropping COVID-19 mandates, Treasury Board President Mona Fortier told reporters on Monday that: “it’s not politicians who got us here today.”

“It’s Canadians who rolled up their sleeves to get vaccinated. You did your part, you got Canada to a better place,” she said.

WHAT IS THE FUTURE OF ARRIVECAN?

After months of defending the at-times glitchy application and insisting it was a “critical tool” despite pressure from the travel industry and opposition MPs to scrap it, on Monday ministers sought to defend changing their position.

“To be direct about it, now that ArriveCan will be optional, that will actually be a more straightforward change, because it will be at the choice of the traveller to use that technology,” said Mendicino.

The app however, is not going away entirely.

ArriveCan rolled out early in the pandemic to help the Canada Border Services Agency (CBSA) process travellers more efficiently. Its use and functions have evolved over the two years since.

While air carriers will no longer need to validate that travellers have filled out the vaccination and quarantine portions of form before boarding, the “advance declaration” feature will remain an option for Canadians who’d prefer to enter that information digitally.

By being able to submit customs and immigration declarations prior to arrival, the government says this option will save Canadians time at the airport.

“I know that there’s various anecdotes out there, some people who were very frustrated and others who have said that their experience was actually quite smooth,” Mendicino said.

“Early data shows that using the Advance CBSA Declaration in ArriveCAN cuts the amount of time a traveller spends at a kiosk by roughly one third, and over 30 per cent of travellers arriving at the airports are already using it,” said the government in a statement.

This feature is already available at Pearson as well as at the Vancouver and Montréal international airports. It will soon be offered at the Calgary, Edmonton, Winnipeg, Billy Bishop Toronto City, Ottawa, Québec City, and Halifax international airports “in the coming months.”

The government is also pledging that CBSA will continue looking for ways to speed up travellers’ entry, including exploring other optional features within ArriveCan to provide travellers with access to border wait times and other functions. 

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Joly to raise abortion, sexual violence in closing UN speech

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OTTAWA — Foreign Affairs Minister Mélanie Joly is urging countries to uphold women’s rights and abortion access while rooting out sexual violence, as the United Nations General Assembly comes to a close.

In a speech today in New York, Joly will summarize Canada’s priorities and concerns in foreign relations.

That includes being part of “a global coalition in support of equality” that will “defend against the growing attacks on women’s rights and freedoms,” according to drafted remarks in French.

“Sexual and reproductive health and rights for women and girls are being rolled back or denied in too many countries,” Joly’s drafted remarks say.

“Canada will always stand up for your right to choose.”

Though the drafted section on women’s rights does not mention the United States, Joly’s comments come after months of backlash to the U.S. Supreme Court allowing states to ban abortions, with some seeking to prosecute those who help women end their pregnancies in other jurisdictions.

Joly’s remarks instead mention women targeted by autocratic governments, such as the Taliban preventing Afghan girls from attending school. She calls out Myanmar’s military junta imprisoning female democracy activists and sexually assaulting Rohingya women.

The speech cites Iran’s crackdown on protesters seeking accountability after the death of Mahsa Amini, when morality police arrested her for “unsuitable attire” in allegedly wearing a hijab improperly. Joly also notes Ukrainian women have been subjected to sexual violence by occupying Russian forces.

Joly argues deliberate policy choices are resulting in rising violence against women, who are excluded from “the negotiating table, the boardroom, the classroom.”

The speech is likely to take place around noon local time, and will include some of the themes raised last week in New York by Prime Minister Justin Trudeau. His remarks surrounded climate change and international development.

This report by The Canadian Press was first published Sept. 26, 2022.

 

Dylan Robertson, The Canadian Press

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