In 2012, Veterans Affairs Canada (VAC) and Service Canada entered into a Partnership whereby Service Canada would use their web, in-person and telephone services to provide general information on VAC’s benefits and services to individuals who visit Service Canada’s website, visit a Service Canada Centre or call VAC’s toll-free line. In addition, Service Canada would accept and review applications for the Disability Benefits Program and the Veterans Independence Program (VIP). The intention of the Partnership was that Veterans would have broader access to VAC’s services on the web, in-person and on the phone. By having Service Canada answer general inquiries on VAC’s behalf, it was expected that VAC would be able to re-focus their resources on more complex cases. The Partnership was also intended to increase points of access for VAC Services, particularly for residents in rural and remote areas. In addition, Service Canada would use their expertise and experience with all Government of Canada programs and bundle VAC’s information with a broader array of related Government of Canada programs and services. In February 2014 the Partnership was expanded to include employee hosting services, whereby Service Canada would provide office and meeting space for a VAC representative to be co-located in the Service Canada Centre closest to each of the VAC area offices that were closing. As part of the approval of the Partnership, an evaluation was required which would assess whether applicable service standards for Veterans had improved, whether resources were effectively refocused on improving case management and if efficiencies had materialized that could provide longer term operational savings without reducing the level of service to Veterans. The evaluation would also determine if there was compliance with the documented agreement between VAC and Service Canada, and identify any areas for improvement.

Veterans Affairs Canada (VAC) provides a wide range of health care benefits and services to eligible program recipients as specified under the authority of the Veterans Health Care Regulations. These entitlements are made available under the Treatment Benefits Program and Veterans Independence Program (VIP). The objective of these programs is to ensure program recipients are provided, according to their treatment eligibility, with reasonable and timely services that the Department considers to be an appropriate response to their assessed health needs. This audit was recommended for Deputy Minister approval by VAC’s Departmental Audit Committee on September 17, 2010. The objectives of the Federal Health Claims Processing System (FHCPS) Service Provider Audit were as follows: 1. To assess the adequacy of the service provider registration process; 2. To assess the adequacy of the requirements for service providers; 3. To determine compliance with service provider requirements; 4. To assess the efficiency of the appointment of service providers.

The Federal Health Claims Processing System is the automated system that processes health claims for Veterans Affairs Canada, the Department of National Defence and the Royal Canadian Mounted Police. To administer this large and complex system, Public Works and Government Services Canada contracts the services of a private health insurer, Medavie Blue Cross. Of the three departments, Veterans Affairs Canada is the largest user accounting for 87% of the total volume of claims processed. In 2010/11, there were 13.5 million claims processed for Veterans Affairs Canada at a value of $640 million. To protect the financial integrity of the claims processed, Medavie Blue Cross is contractually obligated to conduct investigative services of the 170,000 health care providers registered to deliver benefits or services to Veterans. The National Investigative Unit, within Medavie Blue Cross, conducts various audit activities to ensure that the health care providers are complying with the requirements. These activities include: * analyzing claims data to identify providers whose billing practices may not comply with the requirements; * distributing letters to Veterans to verify that benefits and services billed were actually received; * mail audits requesting providers to submit additional documentation to support a claim submitted; and * on-site audits where investigators will travel to the health care provider's business to meet with the staff and review the supporting documentation on location. The purpose of these audit activities is to identify potential recoveries, educate health care providers on the billing requirements and act as deterrent to improper billing practices.

This evaluation of the Health Care Benefits and Services Program was conducted in accordance with Veterans Affairs Canada's (VAC) approved multi-year, risk-based Evaluation Plan 2012-2017. The Health Care Benefits and Services Program, commonly referred to as the Treatment Benefits Program, provides Veteran recipients with access to extended health care. There are 14 benefits and services groups comprising a wide range of offerings. An overview of the benefits and services can be found in Appendix A. The evaluation examined the relevance and performance of the Program, and was conducted in accordance with Treasury Board policy requirements and related Treasury Board Secretariat guidance material. The evaluation findings and conclusions are based on the analysis of multiple lines of qualitative and quantitative evidence.

Since 1981, Veterans Affairs Canada has administered a community-based, national program to eligible Veterans, their families, and other primary care-givers. These services include home care, home adaptations, ambulatory health care, and intermediate nursing home care. Now known as the Veterans Independence Program, it offers self-managed care in co-operation with provinces and regional health authorities. The program allows eligible Veterans, their families, and other primary care-givers to focus on maintaining their health, independence, and their quality of life. Every effort is being made to integrate the Veterans Independence Program administration with provincial and local resources to ensure a cost-efficient choice of service is available and to avoid duplication of service delivery. Veterans Affairs Canada is responsible for setting up and amending the contribution arrangements while an external Contractor, Medavie Blue Cross, is responsible for processing the claims. In the Spring of 2011, Senior Management requested an audit of the Veterans Independence Program reimbursement process to identify opportunities to further improve the process. This audit builds off the results of a 2010 audit of Veterans Independence Program and is focused on a single objective to assess the efficiency and effectiveness of the reimbursement process. The scope covered the period from November 2010 to April 2011.

The Veterans Affairs Canada Health Care Benefits Program provides eligible Veterans and other qualified individuals with benefits and services, such as medical, surgical and dental care, prosthetic devices and home adaptations, through 14 Programs of Choice. Under the Veterans Health Care Regulations and Canadian Forces Members and Veterans Re-establishment and Compensation Act, eligible Veterans and other qualified individuals have access to benefits and services, such as medical, surgical and dental care, prosthetic devices and home adaptations. Related Health Services are services provided by health care professionals other than physicians, dentists and nurses. Examples of these types of services include occupational therapy, physiotherapy, massage therapy, chiropractic, acupuncture, speech language pathology and psychological counseling. The objective of this audit was to assess Veterans Affairs Canada’s management control framework, and compliance with applicable policies and processes, and to identify any potential opportunities to improve efficiency of decision making for Related Health Services. The scope covered transactions processed from April 1, 2012 to March 31, 2013.

Treasury Board, which sets the guidelines for all government departments in Canada, defines a service standard as "a public commitment to a measurable level of performance [that] clients can expect under normal circumstances." These standards help Canadians by formalizing the kind of service that they can expect from any department. The standards also help VAC staff, by giving them targets to aim for—both in terms of their own performance, and of letting the public know what to expect. At present, Veterans Affairs Canada has twenty-two service standards, which cover all the key programs and services that the Department provides to Veterans. These service standards are published on the Website; in the future, the Department also plans to add the performance of each service standard. The purpose of this audit was to assess the process for reviewing and developing service standards, as well as the accuracy of data being reported. The scope of the audit included all twenty-two standards, and covered practices in the 2011/2012 fiscal year. The audit started in October 2011, and the analysis was completed in February 2012.

The Long Term Care Program works in cooperation with provinces/territories, health authorities and long term care facilities to financially support eligible Veterans in an appropriate long term care setting. Veterans Affairs Canada provides funding for qualified Veterans who occupy a contract bed or those in a community bed. As of March 31, 2011, there were 9,376 recipients of funding support from Veterans Affairs Canada in non-departmental institutions across Canada. 2,782 recipients were in contract beds and 6,594 were in community beds. These numbers are forecasted to decline between 2012 and 2020 when there will be a decline in demand for Long Term Care. Forecasts estimate that there will be 5,780 Veterans in long term care in five years (2016-2017). The purpose of this audit was to provide assurance that the management control framework governing the Long Term Care Program is effective and the internal controls surrounding the program are adequate and functioning well. The scope included Long Term Care recipients in community beds and contract beds governed by a Memorandum of Understanding with provincial health authorities, from April 1, 2010 to March 31, 2011.

The Career Transition Services (CTS) Program evaluation was conducted in accordance with Veterans Affairs Canada’s (VAC) approved Multi-Year Risk-Based Evaluation Plan 2012-17. The Terms and Conditions of CTS were valid until March 31, 2016. The Career Transition Services Program was established in 2006 under the authority of the Canadian Forces Members and Veterans Re-establishment and Compensation Act. Policies and practices have been modified over the years but its essential mission has remained unchanged; i.e., to provide eligible Veterans and survivors with practical help finding a job as they transition from military to civilian life. CTS reimburses costs for services such as career counselling, job-search training and job-finding assistance for eligible Veterans and survivors to a lifetime maximum of $1,000 (including tax). The current program design differs from that originally established in 2006 with respect to eligibility, dollar limits and service providers. The evaluation examined the relevance and performance of the Career Transition Services Program, and was conducted in accordance with Treasury Board of Canada Secretariat (TBS) policy requirements and related TBS guidance. The evaluation findings and conclusions are based on the analysis of multiple lines of qualitative and quantitative evidence.

This evaluation of the Intermediate and Long Term Care Programs was conducted in accordance with the approved Veterans Affairs Canada Multi-Year Risk-Based Evaluation Plan 2012-2017. The Veterans Independence Program Intermediate Care (VIP IC) Program and the Long Term Care (LTC) Program, hereinafter referred to as "the Programs", support eligible Veterans and other individuals who require facility-based long term care. There are two types of beds under the Programs: community beds and contract beds. Community beds are beds in a facility operated by health authorities, private and not-for-profit sectors. Contract beds are beds that are set aside in a community facility pursuant to a contractual arrangement between the facility and VAC. Eligibility for these bed types varies. Community beds fall under both the VIP IC Program and the LTC Program, while Contract beds fall solely under the mandate of the LTC Program. The evaluation examined the relevance and performance of the Programs, and was conducted in accordance with Treasury Board policy requirements and guidance material. The evaluation findings and conclusions are based on the analysis of multiple lines of qualitative and quantitative evidence.