Veterans Health Care Regulations (SOR/90-594)

Regulations are current to 2019-06-20 and last amended on 2019-04-01. Previous Versions

PART IIVeterans Independence Program (continued)

Services

 The veterans independence program consists of the following services:

  • (a) home care that is provided to or on behalf of a client at the client’s principal residence, namely,

    • (i) health and support services by a health professional, such as nursing care, therapy and personal care,

    • (ii) personal care services by a person other than a health professional,

    • (iii) housekeeping services, namely, those tasks or domestic chores to assist with daily living, which services normally include only routine housekeeping unless the health and safety of the client is at risk,

    • (iv) access to nutrition services, and

    • (v) maintenance of the grounds necessary to permit independent living at the principal residence, such as the mowing of lawns and the removal of ice, snow and leaves from the walkways, driveways and eavestroughs, providing:

      • (A) the maintenance is the responsibility of the client and would normally be performed by the client were the client’s ability to do so not impaired as a result of the health condition the assessment of which indicated the client’s eligibility for the service, and

      • (B) there are no relatives of the client living at the residence who are capable of performing such maintenance;

  • (b) ambulatory health care, namely, health services such as health assessments, diagnostic services and social and recreational services that are provided by a health professional, and transportation between the client’s residence and the health centre or other similar facility where the health services are provided;

  • (c) transportation to foster independence and to enable a client to participate in social activities, if an assessment referred to in paragraph 15(2)(b), subparagraph 17(c)(ii) or paragraph 18(2)(d) indicates that

    • (i) the client requires home care or ambulatory health care, and

    • (ii) social isolation is harmful to the client’s health;

  • (d) home adaptations to a client’s principal residence to enable the client to carry out the activities of daily living; and

  • (e) intermediate care in a community facility, other than in a contract bed.

  • SOR/93-309, s. 2
  • SOR/2003-362, s. 5

Costs

  •  (1) Subject to subsection (1.1) and section 34, the maximum rates at which the costs of veterans independence program services are payable are the following:

    • (a) for home care, $7,142.52 per client per year, which amount includes

      • (i) a maximum amount of $996.64 per year for maintenance of the grounds of the client’s principal residence, and

      • (ii) where the client is in receipt of an attendance allowance under subsection 38(1) of the Pension Act, an amount for personal care services referred to in subparagraph 19(a)(ii) that is in respect of not more than one week in any year plus 52 days in that year;

    • (b) for ambulatory health care, $830.52 per client per year;

    • (c) for transportation, $996.64 per client per year;

    • (d) for home adaptations, $4,152.63 per client per principal residence; and

    • (e) for intermediate care, $100.07 per client per day.

  • (1.1) Subject to section 34, the maximum rate at which the costs of veterans independence services referred to in section 16.1 are payable is $2400 per year, which amount includes the adjusted maximum amount referred to in subparagraph 20(1)(a)(i) per year for maintenance of the grounds of the client’s principal residence.

  • (2) The rates referred to in subsections (1) and (1.1) shall be adjusted in the same manner and on the same day as pensions are adjusted under Part V of the Pension Act.

  • (3) to (5) [Repealed, SOR/98-386, s. 10]

  • (6) [Repealed, SOR/2001-326, s. 6]

  • SOR/93-309, s. 3
  • SOR/98-386, s. 10
  • SOR/2001-157, s. 5
  • SOR/2001-326, s. 6
  • SOR/2008-41, s. 2

PART IIILong Term Care

Care in a Contract Bed

[SOR/2016-31, s. 4]
  •  (1) Subject to section 33.1, the following clients are eligible to receive adult residential care, intermediate care or chronic care in a contract bed:

    • (a) veteran pensioners;

    • (b) income-qualified veterans;

    • (c) overseas service veterans; and

    • (d) dual service veterans.

  • (2) Subject to section 33.1, a client who on August 31, 1990 was in receipt of adult residential care, intermediate care or chronic care in a departmental facility, as that term is defined in the regulations as they read on September 1, 1990, or a contract bed is eligible to receive care in a contract bed after August 31, 1990 for as long as the client continues, without interruption, to need adult residential care, intermediate care or chronic care.

  • (3) Subsection (2) does not apply to a client who is discharged from a departmental facility, as that term is defined in the regulations as they read on September 1, 1990, pursuant to section 26, as it read immediately before the coming into force of this subsection, or whose discharge from a contract bed is recommended pursuant to that section.

  • (4) Subject to section 33.1, veterans described in paragraph (h) of the definition veteran in section 2 are eligible to receive intermediate care or chronic care in a contract bed if an assessment indicates that their health care needs have increased and that they require specialized care that cannot adequately be provided in a community facility other than in a contract bed.

  • (5) Despite subsection (1), an income-qualified veteran or an overseas service veteran, who 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 and who is not an allied veteran described in paragraph (g) of the definition veteran in section 2, is not eligible to receive the care referred to in subsection (1).

  • SOR/92-406, s. 6
  • SOR/98-386, s. 11
  • SOR/2001-157, s. 6
  • SOR/2001-326, s. 7
  • SOR/2003-362, s. 6
  • SOR/2009-334, s. 3
  • SOR/2016-31, s. 5

Care in a Community Facility

 Subject to section 33.1, veterans described in paragraph (h) of the definition “veteran” in section 2, who are admitted for the first time for intermediate or chronic care to a community facility other than in a contract bed after this section comes into force, are eligible to receive the cost to them of that care to the extent that it is not available to them as an insured service under a provincial health care system.

  • SOR/2003-362, s. 7

 Subject to section 33.1, an overseas service veteran is eligible to receive the cost to them of intermediate care or chronic care in a community facility to the extent that it is not available to them as an insured service under a provincial health care system if they have applied to the Minister for admission to a contract bed and are not admitted because there is no vacancy in a contract bed within a reasonable distance of the community in which they normally reside.

  • SOR/2012-42, s. 3
  • SOR/2012-289, s. 5(F)
  • SOR/2016-31, s. 6

Chronic Care in a Community Facility

  •  (1) Veteran pensioners, civilian pensioners and special duty service pensioners are eligible to receive, in respect of a war-related pensioned condition, the cost to them of chronic care

    • (a) received in Canada in a community facility, other than in a contract bed; and

    • (b) received in a health care facility outside Canada that is of a standard equivalent to the care that would have been provided under paragraph (a), provided that the cost of such care does not exceed the usual cost of chronic care in the jurisdiction in which the care is received.

  • (1.1) Seriously disabled veteran pensioners and seriously disabled civilian pensioners are eligible to receive the cost to them of chronic care received in Canada in a community facility, other than in a contract bed, to the extent that the chronic care is not available to them as an insured service under a provincial health care system.

  • (1.11) Subject to section 33.1, a veteran pensioner or a civilian pensioner, in respect of whom the aggregate of all of their disability assessments under the Pension Act and the Veterans Well-being Act is equal to or greater than 48%, is eligible to receive the cost to them of chronic care received in Canada in a community facility, other than in a contract bed, to the extent that the chronic care is not available as an insured service under a provincial health care system.

  • (1.2) Military service pensioners, former members and reserve force members are eligible to receive, in respect of a pensioned condition or a disability for which they are entitled to a disability award or entitled to pain and suffering compensation, the cost to them of chronic care

    • (a) received in Canada in a community facility, other than in a contract bed; and

    • (b) received in a health care facility outside Canada that is of a standard equivalent to the care that would have been provided under paragraph (a), provided that the cost of such care does not exceed the usual cost of chronic care in the jurisdiction in which the care is received.

  • (2) Subject to section 33.1, income-qualified veterans, Canada service veterans and income-qualified civilians are eligible to receive the cost to them of chronic care received in Canada in a community facility, other than in a contract bed, to the extent that the chronic care is not available to them as an insured service under a provincial health care system.

  • SOR/92-406, s. 7
  • SOR/98-386, s. 12
  • SOR/2001-157, s. 7
  • SOR/2001-326, s. 8
  • SOR/2003-362, ss. 8, 13
  • SOR/2006-50, s. 77
  • SOR/2012-289, s. 6
  • SOR/2017-161, s. 10
  • SOR/2018-177, s. 22
 
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