Veterans Health Care Regulations (SOR/90-594)

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

PART IIILong Term Care (continued)

When Income Insufficient for Chronic Care To Be Affordable

  •  (1) Subject to subsections (2) and (3) and sections 23 and 33.1, the following clients are eligible to receive chronic care 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:

    • (a) veteran pensioners;

    • (b) overseas service veterans;

    • (c) dual service veterans;

    • (d) 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 the care provided under subsection (1) to or in respect of a client referred to in that subsection for the period of 12 months commencing on October 1 of any year, or for any lesser period within those 12 months, if 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 that care.

  • (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 chronic 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/2001-326, s. 8
  • SOR/2003-362, s. 9

Costs

  •  (1) Subject to section 34, the maximum rate at which the cost of chronic care in a community facility other than in a contract bed is payable is $167.89 per client per day, as adjusted in accordance with subsection (2).

  • (2) The rate referred to in subsection (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  • (3) to (6) [Repealed, SOR/98-386, s. 13]

  • SOR/98-386, s. 13
  • SOR/2001-157, s. 8

Priority of Admission

  •  (1) Priority of admission to a contract bed shall be based on health need and, if the health needs of any clients are similar, admission shall be given to the clients in accordance with the following order of priority:

    • (a) first, to veteran pensioners who need care for a war-related pensioned condition;

    • (b) second, to veteran pensioners who are seriously disabled and to income-qualified veterans;

    • (c) third, to overseas service veterans and dual service veterans; and

    • (d) fourth, to veterans described in paragraph (h) of the definition “veteran” in section 2.

  • (2) Priority of receipt of benefits or care under section 21.1, 22 or 22.1 in respect of the same community facility shall be based on health need and, where the health needs of any clients are similar, priority shall be given in the following order:

    • (a) first, to veteran pensioners, civilian pensioners, special duty service pensioners and military service pensioners who need care for a pensioned condition and former members and reserve force members who need care for a condition in respect of which they are entitled to a disability award or entitled to pain and suffering compensation;

    • (b) second, to veteran pensioners who are seriously disabled, to civilian pensioners who are seriously disabled, to veteran pensioners, to income-qualified veterans, to income-qualified civilians and to Canada service veterans;

    • (c) third, to overseas service veterans and dual service veterans; and

    • (d) fourth, to veterans described in paragraph (h) of the definition “veteran” in section 2.

  • SOR/92-406, s. 8
  • SOR/2001-157, s. 9
  • SOR/2001-326, s. 9
  • SOR/2003-362, s. 10
  • SOR/2006-50, s. 78
  • SOR/2012-289, s. 7
  • SOR/2016-31, s. 7
  • SOR/2018-177, s. 22

 [Repealed, SOR/2016-31, s. 8]

 [Repealed, SOR/2016-31, s. 8]

PART IVGeneral

Premiums and Fees

 Income-qualified veterans, income-qualified civilians, Canada service veterans and former members or reserve force members to whom a Canadian Forces income support benefit is payable under Part 2 of the Veterans Well-being Act are eligible to receive the cost of the premium or fee that is required to be paid in relation to

  • (a) the insured health services of the province in which they are resident; or

  • (b) municipal or provincial benefits, services or care similar to the benefits, services or care described in these Regulations.

  • SOR/2001-157, s. 10
  • SOR/2006-50, s. 79
  • SOR/2012-289, s. 8
  • SOR/2017-161, s. 10

Miscellaneous Costs of Transportation

 A veteran pensioner, a civilian pensioner, a special duty service pensioner and a former member or reserve force member who has a disability for which they are entitled to a disability award or pain and suffering compensation in respect of special duty service is eligible to receive, in accordance with section 7, the costs of transportation in Canada of an escort if

  • (a) the escort accompanies the pensioner or member on an annual vacation or on other travel approved by the Minister;

  • (b) the means of transportation is other than by automobile; and

  • (c) their pensioned condition or disability, as the case may be, is total blindness or one that otherwise requires an escort when travelling.

  • SOR/95-440, s. 8
  • SOR/2001-157, s. 11
  • SOR/2003-362, s. 13
  • SOR/2006-50, s. 80
  • SOR/2012-289, s. 9
  • SOR/2018-177, s. 23

 A client is eligible to receive in accordance with section 7, but subject to paragraph 34(2)(c), the costs of transportation in Canada incurred by them when they are transferred for medical reasons from one health care facility to another if they are eligible to receive care in a contract bed or are eligible to receive any part of the cost of intermediate care under Part II or chronic care under Part III.

  • SOR/93-309, s. 4
  • SOR/95-440, s. 9
  • SOR/98-386, s. 14(F)
  • SOR/2016-31, s. 9

 When the following clients are critically ill and the client’s attending physician is of the opinion that a visit by their spouse or common-law partner, another family member or another person designated by the client would be beneficial to the health of the client, the spouse or common-law partner, other family member or other person is eligible to receive, in accordance with section 7, the costs of transportation in Canada incurred to visit the client:

  • (a) a client who is in receipt of intermediate care or chronic care under Part II or III; and

  • (b) if in receipt of acute care in a hospital, a veteran pensioner, a civilian pensioner, a Newfoundland Special Award pensioner, a Red Cross pensioner, a flying accident pensioner, a dual service veteran, an income-qualified veteran, an income-qualified civilian, a Canada service veteran, a special duty service pensioner, a military service pensioner and a former member or reserve force member who is entitled to a disability award or entitled to pain and suffering compensation.

  • SOR/95-440, s. 9
  • SOR/2001-326, s. 10
  • SOR/2003-362, s. 13
  • SOR/2006-50, s. 81
  • SOR/2012-289, s. 10
  • SOR/2018-177, s. 22

Continuation of Benefits, Services and Care

 Where a client who is in receipt of any benefit, service or care under these Regulations ceases to be eligible for it, the benefit, service or care shall be continued for a reasonable period in order to allow the client to make alternate arrangements.

  •  (1) Despite any other provision of these Regulations, an income-qualified veteran, income-qualified civilian or Canada service veteran who is in receipt of any benefit, service, care, premium or fee under paragraphs 3(3)(a) or (c) or 3(4)(c), subsection 15(2), section 17 or 17.1, subsection 21(1) or 22(2) or section 27 is eligible to receive that benefit, service, care, premium or fee for life, regardless of any change in the income of the veteran or civilian or their spouse or common-law partner, in the veteran’s or civilian’s income factor or in the class of recipient to which the veteran or civilian belongs, provided that the veteran or civilian continues to meet the requirements set out in the provision under which that benefit, service, care, premium or fee is received.

  • (2) Subject to subsection (3) but despite any other provision of these Regulations, a veteran or a civilian not referred to in subsection (1) who, at the time this section comes into force, is in receipt of any benefit, service, care, premium or fee referred to in that subsection is eligible to continue to receive that benefit, service, care, premium or fee for life, regardless of any change in the income of the veteran or civilian or their spouse or common-law partner, in the veteran’s or civilian’s income factor or in the class of recipient to which the veteran or civilian belongs, provided that the veteran or civilian otherwise continues to meet the requirements set out in the provision under which that benefit, service, care, premium or fee is received.

  • (3) Subsection (2) does not apply if the veteran or civilian

    • (a) is in receipt of the benefit, service, care, premium or fee solely in respect of a pensioned condition;

    • (b) is in receipt of the benefit, service, care, premium or fee solely as a result of being eligible to receive, in respect of a pensioned condition, another benefit, service, care, premium or fee under these Regulations;

    • (c) is in receipt of the benefit, service, care, premium or fee as a result of a determination of insufficient income in accordance with paragraph 18(2)(c) or subsection 22.1(2); or

    • (d) is in receipt of adult residential care, intermediate care or chronic care in a contract bed under paragraph 21(1)(a), (c) or (d).

  • (4) A veteran or civilian who, under subsection (1) or (2), receives any benefit, service, care, premium or fee set out in a provision referred to in subsection (1) is deemed, for the purposes of any other provision in these Regulations, to receive it under the provision referred to in subsection (1).

  • (5) For the purposes of subsections (1) and (2), “income factor” and “class of recipient”, in relation to a veteran or civilian, means the income factor and class of recipient set out in the schedule to the War Veterans Allowance Act that are applicable to that person, or that would be applicable to that person if the person were a recipient under that Act.

  • SOR/2001-326, s. 11
  • SOR/2012-289, s. 11
  • SOR/2016-31, s. 10
 
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