Background
The evaluation of the Veterans Independence Program (hereinafter called the “Program”) was conducted in accordance with the Veterans Affairs Canada (VAC) 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.
Overall Results
Relevance
The evaluation confirms a continuing need for the Program.
The Program directly supports VAC’s mandate and is aligned with the priorities of the Government of Canada, as well as the strategic plans of the Department. There were no issues identified with overlap or duplication between the Program and similar programs administered by the provinces. VAC and the provinces take external supports into consideration when calculating need.
Performance – Effectiveness
The effectiveness and success of the Program is measured through the use of a Performance Measurement Strategy (PMS) that includes a logic model with outcomes. The immediate outcome of the Program is the outcome over which the Department has the most influence. Yet the evaluation team found that performance indicators for the immediate outcome of the Program do not adequately measure outcome achievement.
The immediate outcome is currently measured in two different ways:
- an individual is eligible therefore he/she has access to Program services; and
- an eligible individual can find a service provider, therefore, he/she has access.
The Department does not have control over whether a service provider is available to provide services to an eligible Program recipient. The performance indicators must be revised to better measure the achievement of the immediate outcome.
The evaluation team found the intermediate and ultimate outcomes for the program are being met.
Performance – Economy and Efficiency
There were 96,722 Program recipients in 2014-15. Total program expenditures for the year were $363M. At the time of the evaluation, the Department did not have the capability to accurately measure the full cost of its individual outputs found in the logic model. Program costs must be tracked and reported on in order to better measure program efficiencies.
In an attempt to determine administration cost trends, the evaluation team used the existing departmental allocation model, which does not measure the full cost of individual inputs and outputs. However, when applied consistently, the model indicates that administration costs have trended downward from 18% in 2011-12 (the first year of the evaluation period) to 12.3% in 2014-15.
It was difficult to compare Program administration costs to international Veterans programs or provincial home care programs as the models were dissimilar and administration costs were calculated differently for each program.
There were no issues identified with overlap or duplication regarding the internal administration of the program and decisions were found to be made in a timely manner.
In January 2013, the Department changed the payment model for the housekeeping and grounds maintenance components of the Program from a contribution to a grant. Available preliminary data was not sufficient to evaluate the efficiency of the new payment model.
Unintended Outcomes
A Grant Determination Tool (GDT) was developed and implemented by the Department to assist in calculating the level of need for housekeeping and grounds maintenance. The tool is used by both the Department and the Health Claims Processor. The evaluation determined that the tool ensures consistency and equitable treatment for recipients across the country. However, the evaluation found that the tool will not produce a result whereby a recipient can receive between 4 and 14 hours of housekeeping services (i.e. the tool can provide up to 4 hours of services, or 14 hours of service, but nothing in between). The tool must be refined to provide more flexibility in the hours of service provided.
Recommendations
The evaluation findings resulted in the following recommendations:
Recommendation 1:
It is recommended that Director General of Service Delivery and Program Management:
- revise the performance indicators to better measure the achievement of the immediate outcome;
- accurately measure the cost of inputs and outputs for the Program; and
- report on results.
Recommendation 2:
It is recommended that the Director General of Service Delivery and Program Management refine the tool used to determine housekeeping hours to ensure benefit recipients receive adequate support.