The evaluation of the Veterans Independence Program was conducted in accordance with the Veterans Affairs Canada Multi-Year Risk-Based Evaluation Plan 2015-20. The evaluation covers the time period from April 1, 2010 to March 31, 2015, and was conducted between June 2015 and January 2016. The objective of the Program is to assist eligible recipients to remain in their homes and communities as long as possible by providing financial assistance towards services which support and promote independence and health. Depending on circumstances and health needs, the Program can contribute to services such as housekeeping, grounds maintenance, personal care, access to nutrition, and health and support services. When home care is no longer practical, the Program assists Veterans to remain in their communities through financial support for intermediate care in community facilities (i.e., nursing home care). The evaluation focused on the housekeeping and grounds maintenance components of the Program because: * these two components combine for 77% of total program expenditures; and * significant changes were made to the method of payment for these components during the period of the evaluation.

The Veterans Independence Program (VIP) was introduced in 1981 to respond to an aging demographic Veteran population and to help reduce long-term care (LTC) bed waitlists by providing care to Veterans at home. The national Veterans Affairs Canada (VAC) home care program assists qualified Veterans, still-serving Canadian Forces (CF) disability pensioners, surviving spouses/primary caregivers, and certain civilians to maintain their health, quality of life and independence in their own home for as long as possible. At the point where care in the home is no longer possible, the VIP will assist in providing care in long-term care facilities in the community of the Veteran. The VIP is not intended to duplicate or replace existing provincial/territorial or community services, but complements these programs to best meet the needs of Veterans. Under the VIP, a recipient may receive funds to help pay for: • ambulatory health care services (e.g., adult day programs); • access to nutrition (e.g., Meals on Wheels); • health and support services (e.g., nurses, occupational therapists); • personal care (e.g., bathing and dressing); • housekeeping (e.g., laundry, vacuuming, meal preparation); • grounds maintenance (e.g., grass cutting, snow removal); • social transportation (e.g., to activities, shopping, banking) • home adaptations; and • nursing home intermediate care. A goal of the evaluation was to provide timely and value added information to assist management and serve as a basis for decision-making regarding future program direction and design. The VIP evaluation team used multiple lines of evidence, including: statistical data, a literature review, research studies, survey results, file reviews, internal analysis reports, key informant interviews and peer reviews.

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.

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 Audit of the Veterans Independence Program (VIP) was approved by the Departmental Audit Committee in 2009. The objectives of the audit were to determine if: 1. up-to-date policies and procedures were in place to support program delivery; 2. program payments were accurately calculated and paid to eligible clients and approved providers; 3. regulatory and policy requirements were complied with; and 4. the quality assurance function provides an ongoing assessment of compliance requirements and identifies opportunities for improvement.

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.

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.

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 purpose of this audit is to provide assurance that departmental activities with respect to the processing of overpayments are in compliance with policies, procedures, and regulations. The audit reviewed the overpayments of four programs: Disability Award, Disability Pension, War Veterans Allowance, and Earnings Loss. An overpayment is any amount paid to a beneficiary to which there is no entitlement, or which exceeds entitlement and are "debts to the Crown". Veterans Affairs Canada is required to pursue and collect any outstanding amounts of overpayments.

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.