Veterans Affairs Canada (VAC) is in the process of implementing risk management with the goal of it becoming a natural part of Departmental culture. Ensuring effective learning from experience by undertaking regular reviews of the risk management process is significant to the advancement of the maturity of this process at VAC. Thus, this review of the adequacy of corporate risk management at VAC has been undertaken. The results of the review are one year after the development of a Risk Management Framework within VAC. The maturity of the implementation and functioning of VAC’s risk management policies and practices remains a work-in-progress. The Department must plan for the long-term; recognizing that effective implementation of risk management will take time. Critical to the success of full implementation is development of risk management capacity gaps, effective communication, training and development of internal expertise, identification, definition and clarity of roles.

As part of the ongoing monitoring and evaluation of service delivery, a cyclical audit was conducted to review the activities of the Quebec District Office (DO), the management control framework and the information used for decision making purposes. The Quebec DO was selected based on criteria set by senior management. The objectives of the 2009-2010 audit are: * Examine the application and implementation of new delegated authorities for Area Counsellors (ACs) (Fall 2009); * Verify the efficiency of the delivery of the rehabilitation program and the integrity of internal controls over its adjudication; * Verify internal controls over the award and delivery of Veterans Independence Program’s (VIP) home care services to Canadian Forces (CF) Veterans; * Assess the adequacy of the management control framework for long term care (i.e. oversight, functional direction, reporting and internal controls). The audit focussed primarily on the implementation of the new delegation of authority at the Quebec DO and on delivery of the Rehabilitation, VIP and Long Term Care (LTC) Programs.

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.

The Employee Compensation Audit was part of the 2009/2010 Veterans Affairs Canada Audit Plan approved by the Deputy Minister (DM). As part of the design process, a preliminary survey was conducted to determine the areas of pay that have the highest level of risk for the department. As a result, Regular pay, Overtime Pay and Acting Pay were included in the audit.

The audit of health related travel began in May 2009. The objectives of the audit were to assess compliance with governing regulations and policy; to assess the adequacy and accuracy of management information; and, to assess the control framework and test controls and verification processes. The scope of the audit included all aspects of processing health related travel claims, including remuneration of an escort, to ensure that control frameworks are in place, the process complies with governing authorities and required management reporting is accessible and useful.

The evaluation of the Financial Benefits Program was conducted in accordance with the Veterans Affairs Canada Multi-Year Risk-Based Evaluation Plan 2014-19. The program was last evaluated as part of an overall New Veterans Charter Evaluation in 2010-11. The Financial Benefits Program was established in 2006 under the authority of the Canadian Forces Members and Veterans Re-establishment and Compensation Act, with subsequent amendments expanding eligibility and adding programs. It provides economic support to eligible Canadian Armed Forces Veterans, survivors, and dependents in recognition of the economic impact that a career ending and/or service-related injury or death can have on a Veteran’s ability to earn income, advance in a career or save for retirement. As per Treasury Board Secretariat policy requirements and guidance, this evaluation examined the Financial Benefits Program’s relevance and performance. The evaluation findings and conclusions are based on the analysis of multiple lines of qualitative and quantitative evidence.

The purpose of this evaluation is to assess both the relevancy and performance of the Residential Treatment Clinic for Operational Stress Injuries (RTCOSI - hereinafter referred to as the RTC) at Ste. Anne's Hospital. The recent commencement of the RTC's operation in February 2010, has limited the assessment of performance to the immediate outcome of program reach. Veterans Affairs Canada (VAC) defines an operational stress injury (OSI) as any persistent psychological difficulty resulting from operational duties performed while serving in the Canadian military or executing duties serving as a member of the RCMP. Psychological difficulties may include, for example, a diagnosis of post traumatic stress disorder (PTSD), major depression, alcohol/substance abuse, chronic pain, or various anxiety disorders.

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 Ex Gratia Payments Audit was recommended for inclusion in the Veterans Affairs Canada (VAC) Multi-Year Risk-Based Internal Audit Plan 2010-2013 by VAC’s Departmental Audit Committee (DAC) on March 18, 2010. The purpose of the audit was to examine the adequacy of controls put in place for the processing of applications for ex gratia payments. The audit fieldwork was substantially completed on December 15, 2010. Ex gratia payments are one-time payments for a fixed duration of time and stringent pre-set eligibility and entitlement criteria are applied. In recent years, VAC has budgeted $135M for these programs. The majority of the work in this audit focused on the most recent payment, i.e., Agent Orange ex gratia payments. In September 2007, the Minister of Veterans Affairs announced a $20,000 ex gratia payment related to the testing of unregistered US military herbicides, including Agent Orange, at Canadian Forces Base Gagetown in 1966 and 1967.

In 2011, Veterans Affairs Canada initiated a five-year Transformation Agenda to respond to the changing needs and expectations of the Veteran population. The goal was to fundamentally change how the Department delivers programs and services. The targeted efforts of the Department included overhauling service delivery, simplifying processes and cutting red tape for Veterans. To simplify the process for Veterans and expedite decision making, Veterans Affairs Canada case managers were given the responsibility to make medical/psychosocial decisions for Rehabilitation Program participants and to properly document these decisions. By delegating this new authority to the level closest to program recipients, case managers were expected to be more efficient and effective in responding to Veterans' needs and be more empowered in their position. To assist staff in making these decisions, the Department developed training courses for staff and introduced tools such as the six-step decision-making model. Recent internal audits have identified risks relating to the absence of quality assurance on decisions and the lack of supporting documentation on files. Veterans Affairs Canada must ensure that there are sufficient internal controls and that staff are complying with the directives of the Department when making decisions. Through interviews, documentation review, and an analysis of 120 sample files, this audit provides assurance that the delegated decision-making controls are working as intended to deliver planned results in accordance with related authorities.