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.

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.

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 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.

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 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.

The Third-Party Administered Accounts 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 Department's responsibilities, both in making expectations clear to administrators and in monitoring their performance. Third-party administration refers to the arrangements put in place when a client requires assistance in managing their personal or financial affairs. VAC will direct an award be payable to a third party only when considered absolutely necessary in the interests of the client. The Department investigates the particular circumstances related to that client before making a decision for administration.

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.

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.