Veterans Health Care Regulations (SOR/90-594)

Continuation of Services

• 16 (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.

• 16.1 (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.

17 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.

• 17.1 (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.

Exceptional Health Needs

• 18 (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) [Repealed, SOR/2022-69, s. 7]

  • (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.

Services

19 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.

Costs

• 20 (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, $11,842.40 per client per year, which amount includes

    • (i) a maximum amount of $1,652.41 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, $1,377.02 per client per year;

  • (c) for transportation, $1,652.41 per client per year;

  • (d) for home adaptations, $6,775.43 per client per principal residence; and

  • (e) for intermediate care, $165.91 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 $3,198.80 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]