Evaluation of the Veterans Independence Program Veterans Affairs Canada Summary

Evaluation of the Veterans Independence Program Veterans Affairs Canada Summary

Audit and Evaluation Division – Veterans Affairs Canada

March 2022

Evaluation Results

Relevance and Need

There is a continued need for the Veterans Independence Program (VIP) to support independence at home for Veterans and other clients. The VIP aligns with Government of Canada priorities and federal roles and responsibilities. VIP elements are comprehensive and comparable to similar programs in other jurisdictions. Home care is a key component along the continuum of care for aging Veterans and VIP helps people to fulfil their desire to remain at home as long as possible.

Performance and Efficiency/Economy

The evaluation confirmed VIP is meeting its outcome of supporting Veterans to remain independent in their home. Program recipients are satisfied with VIP and agree it meets their needs. VIP was found to delay entry into Long-term Care for older Veterans and has additional benefits such as improved quality of life and reduced reliance on informal caregivers.

Opportunities to improve the Program

VIP is seeing more applications for VIP related to mental health needs and other needs not related to aging. In 2020, to begin to address this, VAC piloted a set of VIP functional guidance documents designed to improve clarity and ease-of-use. Frontline staff who participated in this pilot reported spending less time searching for information. A strong next step would be to further clarify functional guidance specific to mental health needs, temporary needs and the needs of younger Veterans.

While some VIP elements, such as the use of the Grant Determination Tool, have contributed to efficiency, there is an opportunity to improve the precision of this tool and to enhance efficiency and capacity through additional and clarified guidance and tools.

Evidence indicates clients are satisfied with information they receive and their interactions with VAC staff or representatives. The frequency of follow-up with VIP clients was decreased and is perceived to be inadequate for more vulnerable clients.

There is also an opportunity to determine if there are unintended gender-related impacts occurring relating to VIP services eligibility for primary caregivers. 

Unintended Impacts

Assessing the needs of clients has evolved since the early nineties when there were home visits and the advent of over-the-phone follow-ups happening every three years. In the evaluation, staff expressed these factors are of concern for elderly clients given assessment tools, though a flexible mix, can lack specificity on the impacts of the aging process.

Despite having funds for support services through VIP, it is becoming harder for some VIP clients to access and retain these services, in particular for those in more remote communities. This is, in part, due to various pressures on the Canadian health care infrastructure including the repercussions of the COVID-19 pandemic.

Evaluation Results
Recommendation Management Response and Action Plan
Recommendation #1:

The Director General, Service Delivery and Program Management, work in collaboration with the Director General, Policy and Research to enhance employee training and update the functional guidance for VIP to address the evolving needs of VIP clients. Particular attention should be paid to:
  • Guidance in support of VIP applications related to mental health issues; and
  • Situations where VIP is required for short-term or temporary needs.
 The Service Delivery and Program Management Division is committed to working with Policy, Health Professionals, and Field Operations Divisions to strengthen functional guidance and training materials to address the evolving needs of VIP clients, including those related to mental health issues and short-term/temporary VIP needs. To accomplish this, SDPM will leverage the pilot project, which SDPM and Policy have underway, aimed at clarifying, simplifying, and streamlining functional direction provided to the field.
Recommendation #2:

The Director General, Policy and Research conduct reviews to determine if there are unintended gender-related impacts occurring relating to VIP services eligibility for primary caregivers.

The Director General, Policy and Research Division, will conduct a review to determine if there are unintended gender-related impacts occurring that relate to VIP eligibility for Primary Caregivers:

We continue to implement and consider all aspects of GBA+ to ensure that our policies, programs and initiatives are free of bias. Currently, gender bias is evident in the design of some of the provisions of  VIP services. When VIP was designed, the vast majority of Veterans that VAC was serving were male. Based around cultural stereotypes, women were seen as homemakers and caregivers, while men were more likely to be seen as the main financial provider of the family with responsibilities for such things as home and yard maintenance and transportation.

The Department created the Office of Women and LGBTQ2 Veterans in July 2019. In June 2020 the Department began a pilot project that involves updating all VIP policies and business processes in accordance with a functional direction.
Recommendation #3:

The Director General, Service Delivery and Program Management, work in collaboration with the Director General, Policy and Research to review and enhance the tools and processes to assess client needs. Priority areas include:
  • Development of a tool/instrument and associated process to support evidence-based and consistent assessment of personal care needs;
  • Identify and undertake more frequent follow-up with vulnerable clients; and
  • Assess the precision of the GDT and its relative adaptability in view of evolving client needs, and the adequacy of the process for rate adjustments.
 Service Delivery and Program Management is committed to collaborating with colleagues in Policy and Research and across the Department to review and enhance the tools and processes to assess client needs. This will include collaborating with colleagues to determine the tools and processes required to support assessment of appropriate levels of Veterans’ personal care needs, to reinstate annual follow ups for VIP recipients, and to review the GDT to ensure it is meeting the evolving needs of Veterans.

Program Description

  • VIP was established by VAC in to help eligible recipients remain in their homes and communities by providing financial assistance toward services that support their independence and health.
  • In 2019-20, 83,855 Veterans, survivors and primary caregivers received VIP and program expenditures were approximately $339.2M, with nearly 79% going to grants for housekeeping and grounds maintenance.
  • Veterans, primary caregivers and survivors are eligible to receive housekeeping and grounds maintenance services under VIP. Veterans can also receive meal delivery, nursing services, personal care, ambulatory healthcare, transportation to social and community activities or services, care in a nursing home and home adaptations.

About the Evaluation

Scope and Methodology

  • The VIP evaluation was conducted as part of the VAC’s 2019-24 Departmental Evaluation Plan in accordance with Treasury Board’s Policy on Results.
  • The scope includes VIP activities between 2015-16 to 2019-20 with the exception of Intermediate Care. This component was part of the 2019 VAC evaluation of the Long-Term Care Program.
  • Evaluators assessed the relevance, performance, effectiveness, economy, and efficiency of the VIP over the period April 1, 2016 to March 31, 2020.
  • The methodology incorporated multiple lines evidence including a survey and focus groups with frontline employees as well as a survey with VIP recipients.

Constraints and Limitations

  • Travel restrictions imposed due to the Covid-19 pandemic limited fieldwork. As well, certain administrative and performance data were not readily available.  
  • To mitigate, surveys of frontline employees and recipients of VIP were conducted to build on information gathered through in-person staff and stakeholder interviews.
  • For the recipient survey, a predominantly online approach via My VAC Account was deployed and given the profile of these online clients, the survey responses underrepresent older Veterans, survivors and primary caregivers.

Evaluation Report

Evaluation of the Veterans Independence Program Final - March 2022

 
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