Horizontal Evaluation of Program Alignments Summary
Audit and Evaluation Division – Veterans Affairs Canada
February 2022
Evaluation Questions and Results
1. Are there opportunities to streamline processes by using alignments between the Table of Disabilities (ToD) medical impairment criteria for Pain and Suffering Compensation (PSC), and the health-related assessment criteria for the Additional Pain and Suffering Compensation (APSC) and Caregiver Recognition Benefit (CRB) programs for Canadian Armed Forces Veterans with more significant disabilities and impairments?
The evaluation found that there are opportunities for enhanced alignments between the ToD medical impairment criteria for certain conditions and the existing APSC health-related assessment criteria. By aligning these criteria, this could provide earlier access to the program for CAF Veterans with more significant levels of disability and impairment, while reducing their application burden. These alignments would also reduce administrative burden on VAC program decision makers.
2. Are there unintended impacts occurring between VAC programs?
The evaluation examined possible alignments between the CRB and the APSC, to better understand if any unintended cross-program impacts existed. Despite the differences in the program intents and design, the evaluation team found that for certain conditions assessed in the ToD chapters/tables , there are alignments opportunities between the CRB and APSC health-related assessment criteria.
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.
Recommendations
| Recommendation 1: | Management Responses and Action Plans |
|---|---|
| It is recommended that: | |
| 1a. The Assistant Deputy Minister (ADM) of Service Delivery explore opportunities to better align the Table of Disabilities (ToD) chapters/tables 9.1 (hearing loss), 17 (musculoskeletal), 21 (psychiatric), and other conditions, as determined by Medical Advisory, with the existing health-related assessment criteria for the Additional Pain and Suffering Compensation (APSC), to facilitate program access for Canadian Armed Forces (CAF) Veterans assessed with more significant levels of disability and impairment. | 1a. The VAC Table of Disabilities (TOD) was published in 2006 and is used to assess the severity of a Veteran’s awarded medical condition. A plan to review and modernize the TOD to ensure that it continues to be based on up to date scientific research and medical practices and advances in the assessment field is underway. As part of this review, VAC will apply a GBA+ lens to review the TOD to ensure equity from a sex, gender and intersectional perspective. The work will be done in 3 phases over a several years. Concurrent with modernization of the TOD, alignment with VACs Additional Pain and Suffering Program (APSC) program policy and processes will be explored. |
| 1b. The ADM of Service Delivery, in consultation with the ADM of Strategic Policy and Commemoration, explore opportunities to streamline entitlement decisions for the Additional Pain and Suffering Compensation (APSC) (Recommendation 1a) by using the information captured during the initial/reassessment PSC entitlement decision. | 1b. Modifications to the Table of Disabilities (ToD) will be based on information and guidance obtained from the review and through consultations. As changes are expected, once this work is completed and the identified chapters are updated, the Centralized Operations Division (COD) will consult with the Strategic Policy and Commemoration Branch and the Chief Financial Officer and Corporate Services Branch to explore the development of a pilot to test the functionality and benefits of streamlining entitlement decisions for the Additional Pain and Suffering Compensation (APSC), while ensuring adherence to departmental authorities related to privacy and funding. This phase will include exploring system capacity and process requirements. The goal of the pilot will be to ensure that the streamlining approach provides a fair and consistent outcome. If the ToD is aligned with VAC’s APSC Program, then COD will conduct a six month pilot to test the alignment. The length of the pilot will ensure that a sufficient amount of data is collected/available to properly evaluate the effectiveness. |
| Recommendation 2: | Management Responses and Action Plans |
|---|---|
| It is recommended that: | |
| 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. | The Chief Data Officer (CDO) and the Chief Information Officer (CIO) will:
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About the Evaluation
Scope and Methodology:
- The Horizontal Evaluation of Program Alignments was conducted in accordance with Veterans Affairs Canada’s (VAC) approved 2019-2024 Evaluation Plan. The plan was developed to align with the 2016 Policy on Results and meets the policy requirement for the department to periodically evaluate organizational spending on programs and services.
- The objective of this formative evaluation was to look for alignments between the existing ToD medical impairment criteria for the PSC, and the health-related assessment criteria of the APSC and CRB programs. Such alignments could:
- identify opportunities to be more efficient;
- determine if unintended impacts are occurring among these VAC programs; and
- inform/promote equitable program access for all VAC clients.
Constraints and Limitations:
- On 1 April 2019, VAC implemented significant changes through the Pension for Life (PFL) initiative. PFL included the launch of new programming (PSC, APSC and the Income Replacement Benefit) and the implementation of a new client management system called GCcase.
- The implementation of the GCcase system required considerable input from and impact on operational decision makers. Evaluation requests to operational staff were concise so as to minimize workload impacts.
- Any potential changes to the assessment process for any program can have significant cost implications that require approval from the Minister of Finance. As a result, any potential changes that are explored by the Department will require an accrual costing completed by the Office of the Chief Actuary and if new funding is required, any proposed changes must be submitted to the Department of Finance for consideration as part of the Federal Budget process.