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.

Healthcare professional service contractors are individuals with “significant training, qualifications and expertise in a professional field.” With the support of Public Works and Government Services Canada, these contractors are used to obtain expert knowledge and to complement the existing workforce. At Veterans Affairs Canada (VAC), these healthcare professional service contractors review or conduct assessments of Veterans' health needs for services or benefits as well as provide consultation with VAC staff. During the 2012/13 fiscal year, there were 55 healthcare professional service contracts for Occupational Therapists, Nurses, Doctors and a Dentist, excluding those at Ste. Anne’s Hospital. The purpose of the audit was to provide assurance that the departmental activities relating to healthcare professional service contracts were conducted in compliance with VAC procedures, and Treasury Board (TB) policies and regulations. Overall governance and the payment process were also assessed. Fieldwork was conducted from April to July 2013.

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.

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.

This Rehabilitation Services Evaluation was conducted in accordance with Veterans Affairs Canada's (VAC) approved Multi-year Risk Based Evaluation Plan 2013-2018. Established in 2006, the Canadian Forces Members and Veterans Re-establishment and Compensation Act (hereinafter referred to as the New Veterans Charter or NVC), shifts the Department's focus from one of disability to one of wellness and responds to Canada's commitment to injured Canadian Armed Forces (CAF) members and Veterans. As part of the NVC, the Rehabilitation Services and Vocational Assistance Program (hereinafter referred to as the Program) provides eligible Veteran recipients and their spouse/survivor(s) with one or more of the following types of rehabilitation services: medical, psychosocial, or vocational. In fiscal year 2012-13, the Program funded $18.4 million in benefits and services. The intent of the Program is to support the reasonable restoration of functioning in the following five major areas: mental and physical functioning; social adjustment; family relationships; financial security, employment and personal productivity; and community participation. Recipients are primarily Veterans who were recently medically-released from the CAF, or CAF Veterans who have a health problem resulting primarily from service which is creating a barrier to their re-establishment in civilian life. Veterans often present with complex co-morbid conditions which require the use of the various available medical and psychosocial rehabilitation benefits and services. The evaluation examined the relevance and performance of the Rehabilitation Services and Vocational Assistance Program and was conducted in accordance with Treasury Board (TB) requirements and TB Secretariat guidance material. The evaluation findings and conclusions are based on the analysis of multiple lines of evidence.

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.

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.

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. Program of Choice 13 – Special Equipment – includes any device or aid which is designed to enable the user to cope with the effects of a disease, disorder or injury, by facilitating medical stabilization, assisting in the performance of activities of daily living and restoring their function. Examples include emergency call devices, wheelchairs, walkers, power mobility devices, transfer/lift devices, and ergonomic equipment. The objective of this audit was to assess Veterans Affairs Canada’s management control framework and compliance with applicable policies and processes. The scope covered April 1, 2012, to March 31, 2013.

Veterans Affairs Canada has 60 points of service or responsibility centres, including regional and district offices that provide a wide range of services and programs. District offices provide direct service for programs, with regional offices providing functional direction and oversight. The three largest points of direct service are the Quebec, Halifax and Edmonton district offices which combined serve almost one-third of participants in the Rehabilitation Program. All three District Offices have approximately three client service teams and a varied mix of program participants. This audit was the second of two phases and was developed at the request of senior management to assess the internal controls surrounding the delegated authorities, the adequacy of the management control framework and to identify opportunities to improve efficiency. The first phase of the cyclical audit which was completed October 2010, focussed on operations in the Quebec District Office. This site was chosen because new delegated authorities were being piloted there. The audit team used the results from the Quebec audit to focus and inform the planning for the second phase, which focussed on operations in the Halifax and Edmonton district offices.

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.