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Summary for the Evaluation of the Caregiver Recognition Benefit

Summary for the Evaluation of the Caregiver Recognition Benefit

Audit and Evaluation Division – Veterans Affairs Canada
July 2020

Evaluation Results

1. Relevance and reach

The evaluation of the Caregiver Recognition Benefit (CRB) (hereafter referred to as the “Program”) found that there is a continued need now and in the future, for the program to recognize caregivers for the informal support they provide seriously disabled Veterans.

In addition, the evaluation determined that the program aligns with federal roles and responsibilities and Government of Canada priorities.

2. Performance and Efficiency/Economy

The evaluation found that program recipients are receiving timely access to their CRB payments and the program meaningfully recognizes the caregiver for their role in supporting the Veteran they care for.

3. Opportunities to improve the Program

The program has evolved since its inception to better meet the needs of caregivers and to address concerns from stakeholders, however, further opportunities exist to reach the intended program recipients.

Improvements to the program policy are required to better explain and define eligibility criteria and to provide direction on how the policy requirements are to be assessed.

Further direction is required on the acceptable age of source documents used for the program to ensure decisions reflect the Veteran’s current health needs.

Opportunities exist to improve decision letters and to advise Veterans and caregivers when they should reapply for the program and what other resources are available to them such as the Caregiver Zone.

Recommendations Management Responses and Action Plans
Recommendation 1:
It is recommended that:
  1. The Director General, Service Delivery and Program Management use existing program information/data to identify the Department’s seriously disabled Veterans who have not applied for the CRB and could be eligible for the program.
  2. Subsequent to identification of the additional potential recipients, the Director General, Service Delivery and Program Management work in collaboration with the Director General, Centralized Operations Division to determine who may be eligible, and reach them by using application waivers, where possible.
  3. Subsequent to identification and eligibility confirmation of the additional intended recipients and program policy revisions, the Director General, Service Delivery and Program Management work to develop guidance and a resulting process, including the necessary tool and system changes, to ensure the program continues reaching the most seriously disabled Veterans, and where appropriate, to utilize application waivers.
 With respect to Recommendation 1, the Director General, Service Delivery and Program Management will:
  1. Work in collaboration with Centralized Operations Division, Field Operations, and Policy to:
    1. Conduct analysis and identify criteria for locating, based on the existing policy direction, the most seriously disabled Veterans who are already VAC clients and who have not applied for CRB;
    2. Develop reporting mechanisms to collect this information.
    3. Analyze and, if necessary, update criteria and reporting based on the clarified policy direction resulting from Recommendations 2 and 3 to enable identification of any further client cases to be reviewed.
  2. Work with Centralized Operations Division, Field Operations, and IT to:
    1. Establish and implement a process to determine who may be eligible and, where applicable, pursue options to waive CRB applications.
    2. Pursue options to waive CRB applications for clients identified through a) i and ii.
  3. Work in collaboration with Centralized Operations Division, Field Operations, and Policy to develop ongoing guidance and develop tools and system changes to allow VAC to proactively identify potential CRB clients and where applicable, implement application waivers, based on the clarified policy direction resulting from Recommendations 2 and 3.
Recommendation 2:
It is recommended that:
  1. The Senior Director, Program Policy undertake immediate efforts to update the CRB Policy to include evidence based medical direction and definitions with respect to each individual eligibility criteria, including details on:
    1. The heath needs/impairments that should be considered when determining a Veteran has a “level of care and supervision consistent with admission to an institution (eligibility criteria i);”
    2. Details on the difference between “daily physical assistance (criteria ii)” and “ongoing direction and supervision (criteria iii)” and how should these differences be approached when assessing the Veteran for needs associated with the activities of daily living;
    3. The health needs/impairments (including those relating to mental health) that should be considered when determining that a Veteran requires “daily supervision and is not considered safe to be left alone (eligibility criteria iv).”
  2. Subsequent to program policy revisions, the Director General, Service Delivery and Program Management Division update the CRB Business Process to provide specific guidance to decision makers on what recent/new evidence sources are to be used to assess eligibility criteria. If evidence sources/methods currently available to the department are not sufficient to assess the CRB criteria, a revised and/or new application/assessments/sources may need to be created.
  3. Subsequent to program policy revisions, the Director General, Service Delivery and Program Management promote/raise awareness of the revised program policy to Veterans and their caregivers.
 With respect to Recommendation 2 a) i), ii) and iii): the Senior Director, Program Policy will:
  1. Conduct research, including medical research and consultations, and environmental scans and draft recommendations for amendments to the Caregiver Recognition Policy to more clearly provide direction as to when the eligibility criteria i) to iv) are met as outlined in the Recommendation;

    Update the Caregiver Recognition Policy to provide clear policy direction to staff as well as Veterans and their caregivers as to what is required in order to determine when eligibility criteria i) to iv) are met.

With respect to Recommendation 2 b) and c), the Director General, Service Delivery Program Management will:

  1. Work in collaboration with Centralized Operations Division, Health Professionals, Field Operations, and Policy to update functional direction, including business processes, based on program policy revisions to support the assessment of eligibility criteria and decision making. Where necessary and following analysis of required changes, tools used throughout the process will be updated, or new tools created.
  2. Subsequent to program policy revisions, work in collaboration with the Communications Division to promote/raise awareness of the revised program policy to Veterans and their caregivers.
Recommendation 3:
It is recommended that:
  1. The Senior Director, Program Policy update the CRB policy to provide specific guidance on the acceptable age of source documents, particularly for potentially unfavourable decisions, to ensure the Veteran’s current health situation is reflected in the decision making process.
  2. Subsequent to program policy revisions, the Director General, Service Delivery and Program Management work in collaboration with the Director General, Centralized Operations Division to complete process, tool and/or system updates to ensure age appropriate source documents are used in the CRB decision making process.
 With respect to Recommendation 3 a) the Senior Director, Program Policy will:
  1. Conduct intra-departmental consultations and amend the Caregiver Recognition Policy to provide specific guidance on the acceptable age of source documents, particularly for potentially unfavourable decisions, to ensure the Veteran’s current health situation is reflected in the decision making process.

With respect to Recommendation 3 b), the Director General Service Delivery Program Management will:

  1. Work in collaboration with Centralized Operations Division, Field Operations, and IT to update processes, tools, and systems to support the use of age appropriate documents in decision making.

Program Description

  • Established April 1, 2018, The Caregiver Recognition Benefit (CRB) is a monthly, tax-free benefit (indexed annually) that formally recognizes the contribution that informal caregivers make to the health and well-being of seriously disabled Veterans with service-related physical and/or mental health condition(s) who require continuous provision of care.
  • The benefit is paid directly to an eligible Veterans’ informal caregiver.
  • The CRB replaced the former Family Caregiver Relief Benefit (FCRB) which was originally established in 2015.
  • As of September, 2019, there were 723 recipients of the program.

About the Evaluation

Scope and Methodology:

  • This evaluation has been conducted due to departmental risk and need. During the preparation of VAC’s Departmental Evaluation Plan 2019-24, the CRB was identified (through interviews and a documentation review) as a program that would benefit from an evaluation, primarily to assess program performance and effectiveness. In addition, this evaluation was conducted in accordance with Treasury Board of Canada’s Policy on Results.
  • The evaluation focussed primarily on the time period of April 1, 2018 to September 30, 2019 (post implementation for the CRB).
  • The objective of this evaluation was to assess the relevance, performance, effectiveness, economy and efficiency of the CRB.

Constraints and Limitation:

  • The CRB is a relatively new program, replacing the previous FCRB: neither have been previously evaluated.
  • The evaluation team conducted the CRB Survey to better understand the experiences and perspectives of caregivers. The 705 caregivers in receipt of the benefit as of September 30th, 2019 were contacted. This was the first time contacting and requesting feedback from the caregivers limiting ability to complete trend analysis.
  • The evaluation team did not assess other interventions that may be available for supporting caregivers.

Evaluation Report

Evaluation of the Caregiver Recognition Benefit (Final - July 2020)

 
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