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.

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.

Vocational Rehabilitation Services is a component of the Veterans Affairs Rehabilitation Program. It provides vocational assistance services and benefits to eligible Veterans who have a health problem, and their families, to assist them in their re-establishment to civilian life. Vocational services and benefits include vocational assessments, employability skills, training, career exploration, job placement and follow-up support. The purpose of the audit was to provide assurance that financial controls were working as intended, to deliver results in accordance with related authorities. This is the first audit of Vocational Rehabilitation since its inception in 2006.

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.

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.

The War Veterans Allowance (WVA) Program, which began in 1930, provides monthly financial support to low-income war service Veterans and civilians (e.g., Overseas Welfare Workers, Auxiliary Services Personnel) or their survivors/dependents to help them meet their basic needs. This evaluation was conducted in accordance with Section 42.1 of the *Financial Administration Act* which requires that every federal department conducts a review of the relevance and effectiveness of each ongoing program of grants and contributions programs every five years.

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.

In the approved 2008-2011 Audit and Evaluation Plan, Veterans Affairs Canada (VAC) identified the Residential Care Program at Camp Hill Veterans Memorial Building (CHVMB) for audit. The Chief Audit Executive of VAC engaged Audit Services Canada (ASC) to plan and conduct the audit. CHVMB is a part of the Queen Elizabeth II Health Sciences Centre under the Capital District Health Authority (CDHA) of the Province of Nova Scotia. It is the largest Veterans facility in the Atlantic Region providing, under contract with VAC, long-term beds on a priority access basis to eligible Veterans under VACs Residential Care Program. This audit focused on VACs controls to manage CDHAs delivery of the Residential Care Program at CHVMB.

Approval of a disability pension or award application requires the establishment of a relationship between the claimed disability or injury and service. Service and health records (SHR) that are held at the Department of National Defence (DND), the Royal Canadian Mounted Police (RCMP), or at Library and Archives Canada (LAC) are the primary means to establish this relationship. The digitization of SHRs was implemented to improve internal processes and expedite service to Veterans seeking disability benefits. The objective of the audit was to assess the management control framework, determine compliance with applicable policies and processes, and assess turnaround times and identify opportunities to improve efficiency.

Policies related to Rehabilitation.