Response to Parliamentary Committees and External Audits

House of Commons

ACVA

In December 2016, the House of Commons Standing Committee on Veterans Affairs (ACVA) tabled its 3^rd Report, Reaching Out: Improving Service Delivery to Canadian Veterans. The Report made 18 recommendations for improvements compiled under three broad themes: a negative departmental culture; transitioning from military to civilian life; and the delivery of specific services.

• The Government’s Response to the Committee was tabled on April 6, 2017, and provided a recommendation-by-recommendation update on progress made to address the Committee’s concerns.

PACP

In May 2016, the House of Commons Standing Committee on Public Accounts (PACP) tabled its 1^st Report, Chapter 3, Mental Health Services for Veterans, of the Fall 2014 Report of the Auditor General of Canada, previously presented in the Second Session of the 41^st Parliament as the 15^th Report of the Committee. Although the Committee requested a Government Response to its previous report, tabled in May 2015, the request died on the Order Paper with the dissolution of Parliament in August 2015.

• The Committee made one recommendation in its report for Veterans Affairs Canada and the Department of National Defence to provide the Committee with an update on the progress that each department had made in addressing the Auditor General’s recommendations.
• The Government’s Response, tabled on September 19, 2017, provided an update on progress made in addressing the Auditor General’s recommendations and provided the Committee with an outline of the mental health supports and services available to Veterans and their families.

In October 2016, PACP tabled its 16^th Report, Report 4, Drug Benefits – Veterans Affairs Canada, of the Spring 2016 Reports of the Auditor General of Canada.

• The Committee made recommendations for Veterans Affairs Canada to review and report back in a number of key areas, including:
  1. why Veterans Affairs Canada reimbursed Veterans for cannabis for medical purposes since 2007 without having conducted an evidence-based review;
  2. why so many authorizations were made by so few doctors;
  3. how the Department has enhanced its drug formulary decision making framework, procedures, and alignment with the Canadian Armed Forces drug list;
  4. how the Department has enhanced its cost-effectiveness strategies;
  5. the new Reimbursement Policy for Cannabis for Medical Purposes and the scientific evidence upon which it is based; and
  6. how the Department has improved its drug utilization monitoring process.
• The Government Response, tabled on February 13, 2017, provided a theme-based update on the progress made in addressing the recommendations, and included a copy of the Veterans Affairs Canada’s Reimbursement Policy for Cannabis for Medical Purposes, effective as of November 22, 2017.

Senate

In February 2016, the Subcommittee on Veterans Affairs (VEAC) to the Senate Standing Committee on National Security and Defence (SECD) began a study on the services and benefits provided to members of the Canadian Forces; to veterans; to members and former members of the Royal Canadian Mounted Police and families.

• The Subcommittee has not produced a report on this study. As a result no Government Responses have been requested.

In March 2017, VEAC began a study on issues relating to creating a defined, professional and consistent system for veterans as they leave the Canadian Armed Forces.

• The Subcommittee has not produced a report on this study. As a result no Government Responses have been requested.

2016 Spring Reports of the Auditor General of Canada:

Report 4—Drug Benefits—Veterans Affairs Canada

• This audit focused on whether Veterans Affairs Canada managed the drug component of its Health Care Benefits Program to contribute to the health of its Veteran population by:
  • providing coverage for drugs based on evidence;
  • using cost-effectiveness strategies; and
  • monitoring the utilization of drugs covered.

Recommendations and response:

• Veterans Affairs Canada should implement a decision-making framework that specifies the type of evidence and how it is considered. The Department should use this framework to decide which drugs to pay for and to what extent it will pay for them. The framework should also include requirements that the Department update the drug benefits list on a timely basis.
  • Corrective Action (or Current Status): A drug utilization process is being integrated into VAC's Formulary Review Committee. Expected completion date is end of September, 2017.
• Development of a Decision Making Framework. Continue consulting with federal drug partners, e.g., CAF, RCMP, and Health Canada, to inform the development of the framework.  
  • Corrective Action (or current status): CAF and VAC professionals have been meeting on a regular basis to work on the alignment of CF-VAC Drug Formularies since summer 2016. In addition, both departments continue to align drugs from their respective formularies on a regular basis by attending each other's Formulary Review Committee meetings.
• Veterans Affairs Canada should develop a well-defined approach to drug utilization monitoring that services the needs of Veterans and helps the Department manage its drug benefits program. Establish a comprehensive VAC drug utilization evaluation and monitoring program. 
  • Corrective Action (or current status): A new VAC drug utilization monitoring service has been put in place and is reported on an ongoing basis to the VAC Formulary Review Committee.

2016 Fall Reports of the Commissioner of the Environment and Sustainable Development:

Report 3—Departmental Progress in Implementing Sustainable Development Strategies

• This audit examined whether the Department of Justice Canada, National Defence, Parks Canada, Public Services and Procurement Canada, and Veterans Affairs Canada adequately:
  • applied the Cabinet Directive on the Environmental Assessment of Policy, Plan and Program Proposals and its related guidelines to policy, plan, and program proposals submitted for approval to an individual minister or to Cabinet, including Treasury Board;
  • reported on the extent and results of their strategic environmental assessment practices as required by the Cabinet directive and its related guidelines; and
  • met their departmental sustainable development strategy commitments and the Federal Sustainable Development Strategy commitment to strengthen their strategic environmental assessment practices.

Recommendations and response:

• The Department of Justice Canada, National Defence, Public Services and Procurement Canada, and Veterans Affairs Canada should apply the Cabinet Directive on the Environmental Assessment of Policy, Plan and Program Proposals to all policy, plan, and program proposals submitted for approval to their individual ministers or to Cabinet, as required.
  • A management Action Plan for this recommendation is under development.
• The Department of Justice Canada, National Defence, Parks Canada, Public Services and Procurement Canada, and Veterans Affairs Canada should ensure that when they assess proposals, they do so in a timely manner, as required by the Cabinet Directive on the Environmental Assessment of Policy, Plan and Program Proposals and its related guidelines.
  • A management Action Plan for this recommendation is under development.
• National Defence and Veterans Affairs Canada should report consistently on the extent and results of their strategic environmental assessment practices, as required by the Cabinet Directive on the Environmental Assessment of Policy, Plan and Program Proposals and its related guidelines
  • A management Action Plan for this recommendation is under development.

There were no audits in 2016–17 requiring a response.