6.0 Evaluation Question 3:

Do current eligibility requirements provide equitable access for all Veteran applicants, regardless of biological sex, gender identity, sexual orientation or other identifying factors?

The evaluation team was unable to determine equitable program access as VAC currently does not capture sufficient intersectionality data or information to complete this analysis. The evaluation team was able to look at program access based on sex, official language, age, and geographic location.

6.1 Why GBA+ Analysis?

The 2019 Neutral Assessment of the Departmental Evaluation Function at VAC (3.2.6 Evaluation Standards) recommended the use of new approaches to evaluations including Gender-Based Analysis Plus (GBA+). “GBA+ is a gender and diversity approach to program and policy analysis and was designed to consider many factors in addition to sex and gender, such as race, ethnicity, religion, age, and disability” (Hankivshy & Mussell, 2018, p. 305). As such, the evaluation team developed questions and indictors to help determine whether program assessment criteria provides equitable program access for all Veteran applicants. According to the document Delivering Service Excellence: A Review of Veterans Affairs Canada’s Service Delivery Model, it is recognized that equitable treatment is based on individual need, and as such, equal treatment does not imply equitable treatment.

In order to respond to the evaluation question, the team looked at qualitative survey data from the planning phase staff survey (fall 2019) which aimed to identify challenges relating to program assessment criteria. This survey included questions to staff regarding barriers to program access relating to GBA+ factors. The employee feedback was analyzed and themes were identified. Themes from the survey indicated that female Veterans face challenges when linking military sexual trauma (MST) to their service. It was also suggested that women have a higher burden of proof for disability applications pertaining to MST. Additionally, the survey revealed there may be bias toward women in terms of the types of military occupation they held in relation to the benefits they seek.

Interviewees also commented that VAC forms should be updated to reflect the diversity of the client population. For example the downloadable online application forms for both the CRB and APSC programs do not ask the applicant’s sex or gender. In a study on welcoming sexual and gender minority veterans into VA (US Department of Veterans Affairs) care, it was suggested that “asking about sexual orientation and gender identity at intake conveys respect and provides information about the patient’s primary relationships, environmental support, and potential health risks”(Sherman et. Al, 2014, pp 8-9).

The evaluation team went on to support these survey findings with research and found that when examining access criteria across program and service areas, it is important to understand the unique and diverse needs of minority groups within the client base. This is true of the female and LGBTQ+ Veteran populations. Research suggests that these client groups are transitioning from military service with high levels of complex needs. In a qualitative study on injured female veterans’ experiences with community reintegration, it is stated that females often reported not being prepared to go home to civilian life. They did not feel they had the skills to reintegrate back into the community, particularly at the beginning of the transition, and that they had unrealistic expectations of the reintegration experience. (Hawkins & Crowe, 2017).

Female transition from military service is also reported to be more challenging due to loss of identity, income, and employment opportunities (Lee, Dursun, Skomorovsky, & Thompson, 2018). A scoping review of gender and veteran reintegration and transition found that despite not having as much combat exposure, female Veterans carry a mental health toll likely due to higher rates of MST (Eichler & Smith-Evans, 2018, p. 13). Statistics Canada reported in 2016 that “more than a quarter of all women in the military, or 27.3 per cent, reported sexual assault at least once over their military careers” (CBC, 2016). “Research also indicates a higher prevalence of mental and physical health conditions among LGBTQ Veterans compared to their non-LGBTQ counterparts” (Eichler & Smith-Evans, 2018, p. 13^ix). This research suggests women and LGBTQ+ veterans are leaving military service vulnerable, with high levels of stress and adjustment issues, and equal or greater trauma responses and health issues as their male counterparts. Gender and sexual orientation are factors to be considered when assessing and determining timely and equitable access to programs and services for our Veteran clients.

GBA+ is also extremely important for addressing systemic racial and gender discrimination that is prevalent in many systems, particularly those that are rooted in authoritative masculinity. The Truth and Reconciliation Commission’s Summary (2015) report stated, “for governments, building a respectful relationship involves dismantling a centuries-old political and bureaucratic culture in which, all too often, policies and programs are still based on failed notions of assimilation” (p. 21). Without comprehensive GBA+ analysis, the department will not be able to address these recommendations.

In addition to the academic research, a review of internal documents also informed the evaluation question. In particular, the 2018-2019 Office of Veterans Ombudsman (OVO) Annual Report highlighted that despite only making up 11% of the client population, female veterans were lodging over 17% of the complaints. The Report goes on to say that “the analyses, based on two random samples of completed disability benefit application files, revealed that not all groups of Veterans are treated equitably, and many applicants waited longer than the standard 16 weeks for a decision. For instance, women waited longer than men, and Francophone applicants waited longer than Anglophone applicants” (p.10). In addition, one of the action items in the OVO Report Card 2018-2019 was for VAC to be able to grant equitable access to decisions in a timely manner regardless of the applicant’s gender and language.

6.2 GBA+ Evaluation Data Analysis

After consideration of the above-mentioned information highlighting areas of issue for these minority Veteran groups, VAC’s administrative client data available in CSDN was analyzed. Specifically, program access and reach based on available personal identifiers.

The data confirmed that women^{Footnote 15} were in receipt of CIA at similar rates to men, but women were applying at a slightly higher rate. For the CRB program, women Veterans were in receipt of the CRB program at a slightly lower rate in comparison to men and also were applying at a slightly lower rate. Without direct feedback from Veterans the evaluation team is unable to explain the reasons relating to program application.

French and English clients were in receipt of CIA at roughly the same rates however, French clients were applying at a higher rate than English clients. For the CRB program, English clients were in receipt of and applying for the program at a higher rate than French clients. When examining field office location and age breakdowns, some differences were found in the data. The evaluation team notes that this could be due to the complexity of program access criteria, the decision-making guidance available to front line staff, or staff workload pressures. It is anticipated that through the responses to Recommendation 1a and 1b, some of these differences will be rectified.

Overall, the evaluation team was unable fully analysis the question regarding equitable program access, as VAC currently does not capture sufficient intersectionality data or information to complete this analysis.

6.3 GBA+ To Improve Results

The Status of Women Canada (2015) state that by demanding a wider and more heterogeneous sampling, GBA+ encourages a participatory approach that can inform management’s response regarding program and policy improvements. It also encourages a more rigorous, expansive, and systematic use of comparison groups to provide baseline data. Identifying gaps through GBA+ provides more comprehensive analysis of impacts and outcomes, leading to improved accuracy and precision within policy and program development and design.

Although GBA+ has been adopted in many departments, it rarely becomes more than just a framework that is never fully actioned (Hankivshy & Mussell, 2018v^v). This may be because the changes required do not align with the current culture of the organization resulting in opposition and barriers to implementation (Johnstone & Momani, 2019).

GBA+ analysis has the potential to generate and depict a more accurate analysis of lived experiences for the entire VAC client population. Audit and Evaluation will be challenged to conduct GBA+ analysis, as per the Neutral Assessment of the Departmental Evaluation Function at Veterans Affairs Canada (3.2.6 Evaluation Standards), the VAC GBA+ Strategy (Pillar 6), and per the Departmental commitment to VAC’s Gender Based Analysis Plus (GBA+) Strategy, because the data collected by the Department is not conducive to such. This issue has been highlighted in the VAC GBA+ Strategy, Pillar 2.

Recommendation 2 – The Chief Data Officer, with support from the Chief Information Officer, take the necessary steps to ensure VAC has access to all data required, either through direct collection or through information sharing agreements with other partners, including Statistics Canada, to carry out intersectional analysis including data related to race, indigeneity, socioeconomic status, gender, gender identity, sexual orientation, age, spirituality/religion, language, and education. This will support VAC’s Gender-based Analysis Plus (GBA+) Strategy and equity-based program and policy design, delivery, evaluation and reporting practices.