Veterans Health Care Regulations (SOR/90-594)

Regulations are current to 2019-07-01 and last amended on 2019-04-01. Previous Versions

PART IIVeterans Independence Program (continued)

Continuation of Services

  •  (1) Subject to subsection (2), the primary caregiver of a client is entitled to any of the services referred to in subparagraphs 19(a)(iii) and (v) that the client was receiving under the Department of Veterans Affairs Act at the time the client died or began residing in a health care facility if

    • (a) the primary caregiver is assessed within one year after the earlier of client's death and the client's admission into the health care facility, or presents evidence relating to their health condition during that period on the basis of which an assessment can be made;

    • (b) the assessment and all subsequent assessments indicate that the provision of the services is necessary for health reasons and to assist the primary caregiver to remain self-sufficient at their principal residence; and

    • (c) the primary caregiver is resident in Canada.

  • (1.1) Despite subsection (1), the primary caregiver of a client who died or began residing in a health care facility during the period beginning on October 14, 2008 and ending on December 31, 2009 is entitled to the services in accordance with subsection (1) that the client would have been entitled to receive if paragraph (d) of the definition overseas service veteran and paragraph (e) of the definition veteran in section 2 had come into force on October 14, 2008 provided that

    • (a) the client is an allied veteran described in paragraphs 37(4)(c.1) and (d.1) or subsection 37(4.1) or (4.2) of the War Veterans Allowance Act;

    • (b) the client is not an allied veteran described in paragraph (g) of the definition veteran in section 2; and

    • (c) the primary caregiver applies to the Minister for the services no later than December 31, 2010.

  • (2) The primary caregiver is entitled to the services to the extent that they are not available to the primary caregiver as an insured service under a provincial health care system or a private insurance policy.

  • (3) In this section, primary caregiver, in relation to a client, means the adult person who, immediately before the client died or was admitted into a health care facility,

    • (a) was primarily responsible, without remuneration, for ensuring that care was provided to the client; and

    • (b) for a continuous period of at least one year, resided in the principal residence of the client and maintained the client or was maintained by the client.

  • SOR/2001-326, s. 3
  • SOR/2003-231, s. 1
  • SOR/2003-407, s. 1
  • SOR/2005-39, s. 1
  • SOR/2009-334, s. 2
  •  (1) The survivor of a person — who was an income-qualified civilian, an income-qualified veteran, a veteran pensioner or a civilian pensioner and who, at the time of their death, was not in receipt of the services referred to in subparagraphs 19(a)(iii) and (v) — is eligible to receive those services if

    • (a) an assessment and all subsequent assessments indicate that the provision of the services is necessary for reasons related to the health of the survivor and to assist the survivor to remain self-sufficient at their principal residence;

    • (b) the survivor is in receipt of the guaranteed income supplement under the Old Age Security Act or an amount is deductible in respect of the survivor under section 118.3 of the Income Tax Act in computing an individual’s tax payable under Part I of that Act;

    • (c) the services are not available as an insured service under a provincial health care system or a private insurance policy;

    • (d) the survivor is not eligible to receive any services under section 16; and

    • (e) the survivor is resident in Canada.

  • (2) In this section, survivor means, in relation to the person, the adult individual who, immediately before the person died or, if the person died in a health care facility, immediately before the person was admitted into the health care facility,

    • (a) was primarily responsible, without remuneration, for ensuring that care was provided to the person; and

    • (b) for a continuous period of at least one year, resided in the principal residence of the person and maintained the person or was maintained by the person.

  • SOR/2008-41, s. 1

 Subject to section 33.1, income-qualified veterans who are under 65 years of age are eligible to receive the veterans independence program services referred to in paragraphs 19(a) to (d) or, where it is not reasonably practicable for those services to be provided at their principal residence, the care referred to in paragraph 19(e), to the extent that those services or that care is not available to them as an insured service under a provincial health care system, if

  • (a) they are resident in Canada;

  • (b) as of August 31, 1990, they were the subject of an assessment based on current data that indicated that

    • (i) the provision of those services would assist them to remain self-sufficient at their principal residence, or

    • (ii) the provision of that care was appropriate in the circumstances; and

  • (c) they continue after August 31, 1990, without interruption

    • (i) to qualify as income-qualified veterans, and

    • (ii) to be the subject of an assessment that indicates that the provision of those services would assist them to remain self-sufficient at their principal residence or that the provision of that care is appropriate in the circumstances.

  • SOR/98-386, s. 7
  • SOR/2001-326, s. 4
  •  (1) A client described in section 15, 17 or 18 who, on June 30, 1993, is in receipt of adult residential care in a community facility other than in a contract bed, may continue to receive that care for as long as

    • (a) the provision of those services is uninterrupted; and

    • (b) the client meets the requirements set out in that section.

  • (2) A client described in section 15, 17 or 18 whose request for the care referred to in subsection (1) is approved on or after June 30, 1993, may receive that care if the request is submitted before that day.

  • (3) Clients referred to in subsections (1) and (2) are subject to the provisions of sections 29 and 33.1.

  • SOR/93-309, s. 1
  • SOR/98-386, s. 8

Exceptional Health Needs

  •  (1) Subject to subsections (2) and (3) and sections 20 and 33.1, the following clients are eligible to receive the veterans independence program services referred to in paragraphs 19(a) to (d) or, where it is not reasonably practicable for those services to be provided at their principal residence, the care referred to in paragraph 19(e), to the extent that those services or that care is not available to them as an insured service under a provincial health care system:

    • (a) veteran pensioners;

    • (b) overseas service veterans;

    • (c) dual service veterans;

    • (d) overseas service civilians; and

    • (e) veterans to whom paragraphs (a) and (b) of the definition “Canada service veteran” in section 2 apply.

  • (2) Payments shall be made in respect of services or care provided under subsection (1) to or in respect of a client referred to in that subsection for any period of 12 months commencing on October 1 of any year, or for any lesser period within those 12 months, if

    • (a) the client is resident in Canada;

    • (b) the client has exceptional health care needs that require services or care referred to in paragraphs 19(a) to (e);

    • (c) a determination in respect of that period has been made under section 31.2 that the client’s income is insufficient to enable the client to pay for those services or that care; and

    • (d) an assessment indicates that the provision of those services would assist the client to remain self-sufficient at the client’s principal residence or the provision of that care is necessary for health reasons.

  • (3) The following amounts are not payable under this section:

    • (a) the amount by which the client’s monthly income as computed under section 31.2 exceeds the income factor applicable to the client under that section; and

    • (b) that part of the amount payable for intermediate care under these Regulations, calculated monthly, that is equal to the maximum monthly amount that the client is required to pay for the cost of accommodation and meals, as determined under section 33.1.

  • SOR/92-406, s. 5
  • SOR/94-791, s. 1
  • SOR/98-386, s. 9
  • SOR/2001-326, s. 5
 
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