M28C.IV.C.6 M28C.IV.C.6 Independent Living Plan

6.01 Independent Living Plan Overview

(Change Date August 15, 2013)

An Individualized Independent Living Plan (IILP) may be provided to claimants who cannot pursue an employment or vocational goal due to the limitations of their service-connected disability(ies) (SCD) to enhance activities of their daily living and independence from their family and community.

38 United States Code (U.S.C.) 3101, 38 Code of Federal Regulations (CFR) 21.35, and the M28C Glossary of Terms provide definitions to the most commonly used terms in VR&E related to Independent Living (IL).

a. Purpose

(Change Date August 15, 2013)

The purpose of IL services is to enable the claimant, to the maximum extent possible, to live independently and participate in family and community life. IL services are also provided to increase the claimant’s potential to return to work by providing services designed to lessen or accommodate the effects of the disability(ies).

b. Entitlement Criteria

(Change Date August 15, 2013)

38 U.S.C. 3102, 38 U.S.C. 3103, 38 U.S.C. 3109, 38 U.S.C. 3120, and 38 CFR 21.162 provide the statutory and regulatory guidance for the provision of a program of IL services.

The following criteria must be met to provide a program of IL services:

The claimant must have a service-connected disability rated at 20 percent or more.

The claimant must have a Serious Employment Handicap (SEH) resulting in substantial part from the SCD(s).

The Vocational Rehabilitation Counselor (VRC) must determine that the claimant’s achievement of a vocational goal is not currently reasonably feasible.

The claimant must have limitations in activities of daily living that impact his or her level of independence.

There must be a reasonable likelihood that the services to be provided will increase the claimant’s level of independence.

There must be a reasonable likelihood that the gains in independence will continue after completion of the program of IL services.

c. Duration

(Change Date August 15, 2013)

In accordance with 38 U.S.C. 3105(d)(2)(A) and 38 CFR 21.76, a program of IL services cannot exceed 24 months unless one of the following criteria are met:

The VRC determines that a longer period is necessary and likely to result in a substantial increase in the claimant’s level of independence in daily living. In this situation, an extension of up to six months is possible.

If the claimant served on active duty during the Post-9/11 Global Operations period and has a severe disability incurred or aggravated in such service, the VRC may request an extension of up to two six-month periods if the additional period(s) will result in a substantial increase in the claimant’s level of independence in daily living.

d. Extension Beyond 24 Months

1. VR&E Officer Concurrence

(Change Date March 31, 2014)

VR&E Officer concurrence is required for any request for an extension of IL services beyond 24 months. The VRC must document the extension request on Form Letter (FL) 28-521, Request for IL Extension. The VR&E Officer must document his or her decision on the FL 28-521, which must be filed in the claimant's VR&E record.

2. Vocational Rehabilitation Panel Review

(Change Date March 31, 2014)

A referral to the Vocational Rehabilitation Panel (VRP) is required for any request for an extension of IL services beyond 24 months approved by the VR&E Officer. The VRP must review requests for extensions of IL services beyond 24 months and make recommendations on whether this action is consistent with the needs of the claimant. See M28C.II.A.4 for additional information on the VRP.

3. Executive Director of VR&E Service Concurrence

(Change Date March 31, 2014)

The Executive Director of VR&E Service must approve all extensions beyond 36 months for IL services.

The memorandum must be submitted to the Executive Director of VR&E Service through the VR&E Officer and the RO Director.

e. Services

(Change Date August 15, 2013)

The services offered by the VR&E program are governed by 38 U.S.C. 3104. IL services are outlined in 38 CFR 21.160. IL services must be individualized and designed to assist the claimant achieve the maximum level of independence possible, and when feasible, to increase the claimant’s potential to return to work.

Additionally, the need for any supplies or equipment considered to address an IL need must be substantiated by results of both the preliminary and comprehensive IL assessments.

A variety of services are available to assist in meeting the claimant’s IL needs, to include:

1. Incidental Training

(Change Date August 15, 2013)

In accordance with 38 CFR 21.120, the IILP may include incidental training needed to achieve the goals of the IILP.

2. Subsistence Allowance

(Change Date August 15, 2013)

Subsistence allowance may be authorized when training is part of the rehabilitation plan and all criteria outlined in 38 CFR 21.260 and 38 CFR 21.266 are met.

3. Revolving Fund Loan

(Change Date August 15, 2013)

In accordance with 38 CFR 21.274, advances from the revolving fund may be authorized in an IILP when training is an approved objective of the claimant’s rehabilitation plan. Refer to M28C.V.B.8 for information about revolving fund loans (RFL).

4. Assistive Technology Assessment

(Change Date August 15, 2013)

An assistive technology (AT) assessment may be provided to determine if independence in daily living could be improved.

5. Medical and Mental Health Services

(Change Date August 15, 2013)

The VRC must coordinate medical and mental health services with the Veterans Health Administration (VHA) as needed to ensure the claimant’s health conditions are treated and stabilized to the maximum extent possible. This includes services that address personal adjustment issues the individual or family may be experiencing as a result of the effects of the claimant’s disability(ies). Refer to 38 CFR 21.155 and M28C.V.A.4 guidance on delivery of services to a claimant’s family.

6. Identifying Appropriate Housing Accommodations

(Change Date August 15, 2013)

VR&E must work closely with other entities within VA to identify appropriate housing accommodations to ensure that the accommodations are necessary, feasible, and provided in an appropriate manner. See section 6.04 of this chapter for additional information on housing modifications and accommodations.

7. Coordination with Community-Based Resources

(Change Date August 15, 2013)

The VRC must coordinate the delivery of services with community-based resources when these services are available and required to address IL services.

8. Equipment to Increase Independence in Activities of Daily Living

(Change Date March 31, 2014)

VHA Rehabilitation and Prosthetics is the primary provider for equipment to increase independence in daily living. However, the equipment may be provided to increase activities of daily living (ADL), as indicated on the VA Form (VAF) 28-0791, Preliminary Independent Living Assessment, if such equipment is not provided by VHA. Examples of this type of equipment include, but are not limited to the following:

• Grab bars to increase independence and safety with bathing and toileting
• Shower chairs
• Raised toilet seats
• Shoehorns
• Grabbers to extend reach and mobility

f. Limitations

1. Number of New Independent Living Cases

(Change Date August 15, 2013)

Congress currently limits the number of new IL cases that can be initiated each year. The current limit is 2,700 new cases per year.

New IL cases that result from the claimant being displaced or adversely affected by a natural or other disaster do not count in the overall limit of new IL cases per year.

VR&E Service monitors new programs of IL services by tracking the number of cases entering independent living case status each year and notifying the VR&E offices of any necessary action when the statutory limit is nearing. Refer to 38 U.S.C. 3120(e) for additional information on the limitation of new IL cases.

2. Retroactive Induction and Reimbursements

(Change Date August 15, 2013)

Retroactive inductions and reimbursements must not be authorized during a program of IL services. Refer to M28C.IV.C.2 for information on retroactive induction criteria.

3. Mobility Aids

(Change Date August 15, 2013)

If the preliminary or comprehensive IL needs assessment indicates that the claimant my benefit from a mobility device, such as a wheelchair or mobility scooter, VAF 28-8861, Request for Medical Services-Chapter 31, must be sent to the prosthetics staff at the VA Medical Center (VAMC) to request a mobility assessment.

VAMC will determine the type of mobility device the claimant may need and will decide if the device or equipment can be provided by VHA.

The VA physician must concur on the need for a mobility device to ensure that the device is a medical need and not merely an expressed desire by the claimant. If the VA physician agrees that the mobility device is needed and the device cannot be provided through VHA, VR&E may provide the device as part of an IILP.

A tractor, mower, or similar equipment is not considered a mobility device or addresses an IL need since these are prohibited goods as outlined in M28C.IV.C.2.

4. Avocational Needs

(Change Date August 15, 2013)

During the preliminary IL assessment, the VRC must determine the impact of the claimant’s disability on avocational pursuits. The delivery of services to address avocational needs is limited. Refer to section 6.03 of this chapter for detailed information on the provision of services designed to address avocational pursuits.

5. Independent Living Services to Service members

(Change Date August 15, 2013)

Service members who are entitled to IL services under Public Law (Pub. L.) 110-181, National Defense Authorization Act of 2008, can only receive IL services that focus on the transition to civilian life, not retention in the military.

Services such as assisting the transitioning Service member with integrating into the home and community or identifying appropriate non-military housing resources, can be outlined in the IL plan.

In accordance with 38 U.S.C. 3101(2), services provided under Chapter 31 should not duplicate the efforts of any Department of Defense or VHA programs.

6. Long Term Training

(Change Date August 15, 2013)

Long term training, such as a college degree program, must not be authorized as part of an IILP. Training is limited to short term training programs that are specifically focused on improving a claimant’s independence in daily living.

7. Participation in Medical Marijuana Programs or Use of Legalized Recreational Substances

(Change Date March 31, 2014)

An IL program of services may not be denied based on a claimant’s participation in a state medical marijuana program or use of a legalized recreational substance. However, the VRC must evaluate feasibility of the IL goal prior to developing an IILP.

The VRC must consider state laws and any concerns related to the claimant’s use of medical marijuana or use of legalized recreational substances other than as prescribed.

IL objectives must not include provision of medical marijuana or legalized recreational substances, or tools for its cultivation or consumption. IILPs may not include training or other services related to the medical marijuana industry or legalized recreational substances.

8. Independent Living Services in Foreign Countries

(Change Date March 31, 2014)

In accordance with 38 U.S.C. 3114, the provision of IL services is limited to the United States and its territories. IL services cannot be provided to claimants residing in foreign countries.

6.02 Independent Living Planning Process

(Change Date August 15, 2013)

The development of an IL plan requires sequential steps to ensure that the proposed plan is feasible, viable, and addresses the claimant’s IL needs.

The following activities must be completed prior to plan development.

a. Preliminary Independent Living Assessment

(Change Date May 7, 2021)

The VAF 28-0791, Pre and Post Independent Living Assessment, is used to determine if the claimant has any impairments to ADL and to identify IL needs. The questionnaire focuses on various ADL to determine activities that may limit the claimant’s independence in daily living and must completed jointly with the claimant. The claimant’s housing, emotional, spiritual, leisure, and avocational needs are also assessed to ensure that all aspects of the claimant’s IL needs are addressed.

The VRC must document the findings of the preliminary needs assessment on an electronic case note.

The preliminary IL assessment findings will assist the VRC to determine the appropriate next steps, which include:

1. Independent Living Services May be Warranted

(Change Date August 15, 2013)

If the preliminary IL assessment indicates the claimant may need IL services, the VRC must schedule the claimant for a comprehensive IL evaluation (CILA) to identify those specific needs. Refer to Section 6.02.b for more information on CILAs.

2. Independent Living Services are Not Warranted

(Change Date February 19, 2019)

If the preliminary IL assessment determines that the claimant has no IL needs, or the claimant was determined to have IL needs but is unable or unwilling to participate in an IL plan, the VRC must obtain VR&E Officer’s concurrence to close the case prior to taking the adverse action.

If the VR&E Officer concurs with the proposed case closure, then the VRC must notify the claimant of the proposed adverse action in writing using Vocational Rehabilitation (VR) letter VR-66, General Proposed Adverse Action Letter. The VRC must follow M28C.III.A.1 for case status movement during this notification period and case closure procedures.

Following the due process period, the VRC must notify the claimant of the case closure using VR-58 and VAF 20-0998. A copy of the notification must be sent to the claimant’s representative and incorporated in the claimant’s VR&E record. If the claimant has received planned services, the case manager must follow the case closure processes outlined in M28C.V.A.6.

b. Comprehensive Independent Living Assessment

(Change Date August 15, 2013)

If the PILA indicates that the claimant may have impairments in ADL or suggests the claimant may have unmet IL needs, the VRC must coordinate the completion of a Comprehensive Independent Living Assessment (CILA). The CILA must be completed by an individual certified to evaluate IL needs. In accordance with 38 U.S.C. 3120 and 38 CFR 21.294, the person or facility conducting the evaluation must have a “demonstrated ability” to provide IL services. This is customarily evidenced by specialized IL experience and/or training.

The CILA evaluation must examine further into the issues identified on the PILA, and any other issues that were not identified during the assessment process. It must identify issues that may cause potential barriers to live independently. The evaluation must be conducted in the claimant’s home. When feasible, the CILA should also address issues that could potentially increase the claimant’s ability to obtain and maintain suitable employment.

1. Relevant Information for the Comprehensive Assessment

(Change Date August 15, 2013)

The comprehensive IL assessment requires the analysis of information from a variety of sources, such as:

• Medical records
• Functional capacity testing
• Consultations with medical providers
• Social service evaluations and/or reports
• Home based healthcare reports
• Specialized IL assessments, such as occupational therapy or physical therapy evaluations
• Rehabilitation engineer reports
• Family members and caregivers (with the claimant’s permission)

2. Conducting the Comprehensive Assessment

(Change Date August 15, 2013)

The VRC may refer the claimant to a VA contract counselor to complete the CILA. A local contract agreement must be set in place to provide this service. The CILA may also be completed by VHA if those services are available at the local VHA facility.

The comprehensive evaluation must address specific issues, which may include, but is not limited to the following:

Mobility - Ability to move efficiently from place to place within the home and community, which includes accessible means of transportation, if appropriate.

Communication - Accurate and efficient transmission and/or reception of information, both verbally and non-verbally, which includes the claimant’s use of a telephone or adaptive equipment to communicate with family members, medical providers, friends, and others in the community.

Self-Care - Skills necessary to fulfill basic needs, such as access health care, safety, food preparation, hygiene, grooming, and money management.

Self-Direction - Ability to organize, structure, and manage activities in daily living. Adequate self-direction requires that the claimant be able to plan, initiate, and monitor behavior with respect to an identified outcome.

Interpersonal Skills - Ability to interact in a socially acceptable manner with family, service providers, neighbors, and others encountered in routine interactions in the community.

Productive Activities - Ability to perform activities which contribute to family and/or community.

The VRC must document the findings of the CILA in the VR&E record or by uploading the contractor report.

3. Reviewing Results of the Comprehensive Assessment

(Change Date August 15, 2013)

The VRC may utilize the VRP to assist with reviewing the results of the comprehensive IL assessment to ensure that the evaluation has identified the issues that need to be addressed in the IILP. The VRP can provide technical assistance in the development of the IILP to ensure that the proposed plan of services will enable the claimant to achieve maximum independence. Refer to 38 CFR 21.60, 38 CFR 21.62, and M28C.II.A.4 for additional information on the use of the VRP.

The VRC must review the findings of the CILA, including the VRP’s recommendations if applicable, with the claimant. The information gathered during the CILA must be used in the development of the ILLP, unless the reasons for not including them have been established and documented.

6.03 Avocational Options

(Change Date August 15, 2013)

During the preliminary IL assessment, the VRC must also examine the impact of the claimant’s disability on avocational pursuits. If the preliminary and/or comprehensive IL evaluation indicates that the claimant has limitations in the pursuit of avocational interests, the VRC may address the need in the IILP. Refer to the M28C Glossary of Terms for definitions, including “avocational.”

Services may be provided in support of an avocational activity that the claimant can no longer perform due to the effects of his or her disability(ies). For example, the claimant may have been active in sports but is no longer able to perform this activity due to physical limitations. In this situation, the VRC may provide resources for community adaptive sports or adaptive equipment to enable the claimant to continue the activity to increase the claimant’s community involvement, functional ability, and mobility.

a. Eligibility Criteria

(Change Date August 15, 2013)

The following criteria must be met to provide IL services for pursuing an avocational interest:

The disability condition(s) limits or prevents participation in the avocational interest.

The activity must have been previously performed for a significant amount of time or over a 12-month period.

A medical and/or mental health provider must provide documentation that support continuing or re-engaging in the activity is not currently contraindicated with the claimant’s disability condition(s).

An expert consultation must identify accommodations required to enable continued support of the activity, which must be completed by a qualified person, such as an occupational therapist.

The pursuit of the avocational interest must improve the claimant’s independence in daily living in a measurable and verifiable manner.

The claimant must have the ability and resources to sustain the activity after the period of rehabilitation services are completed.

The VRC must document this information in the claimant’s VR&E record or in an electronic case note.

b. Limitations

1. Number of Avocational Needs

(Change Date August 15, 2013)

The services related to an avocational activity are limited to only one type of activity. If adaptive sports equipment will be provided for one avocational activity, then additional services for other avocational activities must not be provided even if the claimant expresses interest in other activities.

2. Updating or Replacing Existing Equipment

(Change Date August 15, 2013)

The VRC must not update or replace existing equipment that enables the claimant’s participation in an avocational activity. For example, providing an updated computer program is prohibited unless if it is required to meet the goals of the IILP.

6.04 Home Modification and Home Adaptation Options

(Change Date April 23, 2021)

It is important to note that there is a difference between "home modifications" and "home adaptations". VR&E no longer has the authority to provide home adaptations. These services are provided in coordination with the Specially Adapted Housing (SAH) program. However, VR&E may provide home modifications. Home adaptation is defined as a project to adapt a housing unit including any component of construction for which any of the following requirements apply and/or are needed for completion to ensure that the housing unit is suitable or fit for the residential living needs of an eligible claimant:

• A technical drawing
• A permit, if required by local or State laws or building codes
• The use of a licensed contractor to complete the home adaptation

A required compliance inspection under current SAH policy.

If the identified IL need does not meet the definition of a home adaptation as determined in writing by the Regional Loan Center (RLC), services may be provided to meet the need of a home modification using the government purchase card (GPC), local contracts, and/or the acquisition process.

Refer to M28C.V.B.4 for additional guidance on the use of the GPC and M28C.V.A.3 for the purchase of supplies and equipment. In these instances, all current cost approval limits will remain in effect, as provided in M28C.V.B.1 and M28C.IV.C.2.

a. Housing Grants for Claimants with Disabilities

VA administers five grant programs to assist Service members and Veterans with disabilities in obtaining necessary home modifications as follows:

1. VR&E Housing Adaptation Grant

(Change Date October 1, 2020)

Pub. L. 115-177 created a new section in 38 U.S.C. 2102B, which established a new grant authority referred to as the “VR&E Housing Adaptation Grant”. 38 U.S.C. 2102B provides the authority to transition home adaptations as part of a rehabilitation plan from VR&E to Loan Guaranty (LGY), specifically to the SAH program.

The VR&E Housing Adaptation Grant is not a traditional SAH grant. A claimant qualifying for the grant is not required to exhaust any other benefit first to include Home Improvements and Structural Alterations (HISA) or SAH funding, and does not need to apply for SAH to be found in need of the VR&E grant. However, this grant counts toward the six-time usage rules for SAH grants. There is a waiver with this grant that provides the authority to exceed the calendar limit on the amount of monies one can receive from traditional SAH grants.

Pub. L. 115-177 also amended 38 U.S.C. 3104(d) to prohibit the provision of home adaptations under the authority of Chapter 31. In accordance with 38 U.S.C. 3104(d), effective October 1, 2018, VR&E is prohibited from providing home adaptations, as defined below

(a) Process

(Change Date October 7, 2022)

If the in-home Comprehensive Independent Living Assessment (CILA) indicates that home adaptations are needed, the VRC must develop the VAF 2105, SAH/VRE Home Adaptation Referral Memo for approval by local leadership. After local leadership approves the referral memo, the VRC will send the referral memo via email to the VR&E IL Coordinator and IL mailbox at VBAVREIndependentLiving@va.gov, and the RLC of jurisdiction when the updated mailboxes are available.

The email must include the following information:

• VRC and VR&E Officer name and contact information
• Claimant’s name, file number, and contact information including county of residence
• The CILA, completed within the past six-month period, with a focus on all identified home adaptations noted

VAF 2105, SAH/VR&E Home Adaptation Grant Memo, including a description of the claimant’s accessibility and mobility needs and an outline of part(s) of the identified home adaptation. For example, the project will require the services of a licensed contractor.

The VA RLC jurisdictions have been revised and provided below. Email addresses for these jurisdictions will be provided once they are available.

Mid-Atlantic Serving: Virginia, West Virginia, Kentucky, Tennessee, North Carolina, Indiana, Illinois, Missouri

Southeast Serving: South Carolina, Georgia, Florida, Alabama, Mississippi, Louisiana, Puerto Rico, Virgin Islands

Northeast Serving: Ohio, Michigan, Pennsylvania, New York, Connecticut, Rhode Island, Massachusetts, Vermont, Maine, New Hampshire, Delaware, Maryland, District of Columbia

Mid-South Serving: Texas, Oklahoma, Arkansas, Kansas, Colorado, Wyoming, Utah, Arizona, New Mexico, Hawaii

Northwest Serving: California, Nevada, Oregon, Idaho, Washington, Alaska, Montana, North Dakota, South Dakota, Nebraska, Iowa, Minnesota, Wisconsin

The VRC must upload a copy of this email to the claimant’s VR&E record.

The VR&E home adaptation grants are managed through LGY's Specially Adapted Housing Special Home Adaptation (SAHSHA) records management system. In this regard, the VRC and local station manager must register in the LGY hub and complete the TMS course titled VRE Housing Adaptation Grant & SAHSHA System Training (# VA 4633274) to learn how to manage their referral in SAHSHA. Upon completion of this course, they are to send confirmation of completion to the VR&E IL Coordinator via email.

The assigned RLC will review the incoming VR&E 2102B Housing Adaptation Grant Referral. The RLC will assign an SAH agent to manage the home adaptation segment of the rehabilitation plan in collaboration with the VRC. The RLC will upload the CILA and referral memo to SAHSHA. Upon development of the IL grant record in SAHSHA, VR&E staff members shall be granted access to the system after completion of the required training.

Additionally, the SAH agent shall undertake the following activities:

Coordinate with the referring VRC on the initial meeting with the claimant regarding the grant referral. Resolve any queries with the VRC regarding the required home adaptations.

Following notification and verification of the comprehensive evaluation being uploaded in SAHSHA, the SAH agent and VRC shall conduct an in-home adaptation evaluation within 30 business days from the date the plan is uploaded into the system.

Complete a home suitability and feasibility study of the requested adaptations. This evaluation is documented on the VA Form 26-1858a. If feasible, the VRC is encouraged to attend this initial meeting with the assigned agent. The agent will include photos of the property. The report will cover all the necessary items required for SAH paraplegic cases.

The Minimum Property Requirements (MPR) may also be considered if the claimant is entitled to SAH benefits or their medical conditions determine that the requirement is necessary. If the claimant is not eligible for SAH grants, then an MPR will not be required.

The claimant is required to meet the SAH guidelines on home ownership. SAH will review all title documents.

This grant process is a Veteran’s choice program, meaning the Veteran is required to locate a builder who is willing to work within the grant process. The builder must provide the following documents to the SAH agent:

• Detailed plans and specifications
• A comprehensive list of materials required
• Cost disbursement schedule
• (b) Approval

(Change Date October 7, 2022)

The VR&E Officer may approve the cost of all rehabilitation plans that include VR&E home adaptations up to the current VR&E grant amount.

If the total amount of the home adaptation under the VR&E Housing Adaptation Grant exceeds the current VR&E grant limit, a waiver is required.

The Executive Director of VR&E Service, in collaboration with the Executive Director of LGY Service, must approve the waiver before the rehabilitation plan is signed. The VR&E Officer, or designee, must submit a draft of VAF 28-0953, Executive Director’s Checklist for Waiver of Veteran Readiness and Employment (VR&E) Housing Adaptation Grant Amount, and all required documentation noted on the checklist to the Executive Director of VR&E Service for approval through the VR&E IL Mailbox.

The Executive Directors of VR&E Service and LGY Service will review the information and provide a written response to the RO Director for the approval request, with a copy to the VR&E Officer and SAH agent of record within 30 business days from receipt of the drafted VAF 28-0953.

The concurrence process must be completed before the VRC and claimant sign the rehabilitation plan. Once the plan is signed, the VRC must provide a copy of the signed rehabilitation plan to the SAH agent. At this point, the home adaptation may begin.

(c) Completion of Home Adaptation

(Change Date October 1, 2018)

Following completion of the home adaptation objective of the rehabilitation plan, the SAH agent will advise the VRC of project completion, and both will perform a final in-home review to verify all aspects of the identified home adaptations are completed accurately. The SAH agent will be responsible for obtaining a satisfaction letter and final payment to the contractor who completed the home adaptation.

2. Home Improvements and Structural Alterations Grant

(Change Date August 15, 2013)

Service members and Veterans may receive assistance for home improvement and structural alterations necessary for the continuation of treatment or for access to the primary residence, with some exclusions. A claimant may receive a Home Improvements and Structural Alterations Grant (HISA) grant in conjunction with either a SAH or a SHA grant, if eligible. The HISA program is managed by VHA's Rehabilitation and Prosthetic Services.

Lifetime HISA benefits limits are:

$6,800 for a Veteran or Service member with a service-connected disability and for Veterans with a non-service-connected condition rated 50% or more service-connected.

$2,000 for a Veteran with a non-service-connected disability

Refer to HISA website for additional information about HISA grants.

b. Coordinate with Other VA Programs

(Change Date April 23, 2021)

The claimant can apply for SAH, Special Home Adaptation (SHA), and Temporary Residence Adaptation (TRA) grants online at va.gov or by completing and submitting VAF 26-4555, Veterans Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant to VBA.

To apply for a HISA grant, the claimant must have a prescription from a VA or fee-basis physician, in addition to completing and submitting VAF 10-0103, Veterans Application for Assistance in Acquiring Home Improvement and Structural Alterations, to VHA.

c. Verify Title Information

(Change Date October 1, 2018)

To qualify for home modifications that require construction under a VA program, such as VR&E Housing Adaptation Grant, SAH, SHA, TRA, or HISA, or as a part of an IILP, the claimant must provide evidence of title information per 38 CFR 36.4402. This ensures that the title is good and marketable, with no liens attached to the property and verifies the ownership of the property.

1. Name on the Title

(Change Date March 31, 2014)

The VRC must verify that the title of the home to qualify for home modifications that require construction as part of an IILP.

Verification is conducted using one of the following:

• Claimant only
• Claimant and spouse
• Claimant and family member
• Claimant and non-family member

Claimant’s family member, or a non-family member, when the claimant resides or intends to reside in the property but is not listed on the title.

The VRC must inform and ensure that the claimant understands that there is a limit to the amount of money that he or she can receive from VA grant programs. Once this limit has been met, VA grant programs will no longer provide assistance with home modifications if the claimant moves to another residence.

Although there is no such limitation on the delivery of services by VR&E, the VRC must still follow the procedure to ensure that the claimant remains in the home on a permanent basis following the modification. The claimant must be confident that this housing arrangement will be permanent prior to the modification to the home. This process is necessary to ensure public funds are allocated in a responsible manner.

2. Good and Marketable Title

(Change Date March 31, 2014)

A good and marketable title has no clouds or encumbrances attached to it and can be transferred.

Definitions:

Good and marketable title - a title that a prudent buyer would accept.

Cloud on a title - a defect in the title that prevents an owner from providing a good and marketable title. For example, a lien remains on the title after the owner has paid the lien amount.

Encumbrance - an interest in the property held by someone other than the owner that affects the title or the use of the property. For example, the Internal Revenue Service has placed a lien on the property for non-payment of taxes.

The claimant must provide verification that the title is good and marketable before the VRC can proceed with the development of the home modification plan. If the clamant qualifies for a VA grant program, such as SAH, SHA, TRA, or HISA, a representative from one of those programs will assist with the provision of this information. However, if the claimant solely depends on VR&E for the provision of home modifications as part of an IILP, then the claimant must obtain this information and provide it to the VRC.

Evidence of a good and marketable title can be obtained via a title company or attorney. There will be a cost associated with obtaining this information. If the claimant provides the necessary information, the VRC can reimburse for the cost of obtaining this information, per M28C.V.B.6.

d. Pre-Solicitation Requirements for the Home Modification Process

(Change Date March 31, 2014)

The procurement process for obtaining home modification services through acquisition is a two-step process. The procedures outlined in this section represent the first step, and the procedures outlined in section 6.05.h of this chapter represent the second step of the process.

Once the required home modification has been identified and determined feasible, the VRC must work closely with the Contracting Officer to complete a series of steps to ensure that the solicitation process is completed accurately and within regulations set forth in the Federal Acquisition Regulation (FAR) and Veterans Affairs Acquisition Regulations (VAAR).

The VRC and Contracting Officer work together to obtain the following information, which outlines the procedure to complete the first step in the procurement process.

Develop a Statement of Work that clearly defines all aspects of the proposed home modification.

Complete VAF 90-2237, Request, Turn-in and Receipt for Property or Services.

Complete Appendix A of VA Handbook 6500.6, Checklist for Information Security in the Initiation Phase of Acquisitions.

The Contracting Officer will secure the services of a Construction Management Service (CMS). The CMS provides an estimate of construction costs and develops a technical description of the work that will be suitable for obtaining bids from construction contractors.

If the cost of CMS is less than the Micro-Purchase Threshold, per FAR 2.101, the Contracting Officer will request that VR&E pay the CMS via a government purchase card, per FAR 13.301. The current Micro-Purchase Threshold for these types of services is $2,000.

If the cost of CMS is more than the Micro-Purchase Threshold, the Contracting Officer will issue a purchase order to pay for the service.

6.05 Independent Living Plan Development

The following information outlines the development of an IILP.

a. Analysis and Concurrence of Proposed Home Modification Plan

(Change Date October 1, 2018)

If a home modification is a part of the proposed IILP and the project is not part of the VR&E Housing Adaptation Grant, the VRC must complete an analysis of the home modification plan for review and concurrence by the VR&E Officer, Regional Officer (RO) Director, and/or Executive Director of VR&E Service, as applicable. The required level of review and concurrence depends on the cost of the proposed modification(s), per section 6.02 of this chapter.

This analysis must address the questions outlined in section 6.04 of this chapter and must include any additional supporting documentation relevant to the claimant’s request for home modification. Supporting documentation must include professional drawings of the proposed modifications. The drawings, which may be blueprints or technical drawings, must define the rooms and surrounding areas where the construction will take place. The analysis should clearly identify the viability of the home modification.

Prior to submitting the plan for review and concurrence, the VRC must:

Summarize information from the home modification plan into a written report in the claimant’s record, or an electronic case note.

Ensure the written report from the SAH/SHA agent who assisted in reviewing the home modification plan, if applicable, is placed in the claimant’s VR&E record.

Ensure all documentation from the CMS, if applicable, is placed in the claimant’s VR&E record.

The VRC must submit the analysis and supporting documentation to the VR&E Officer for review and concurrence. If additional levels of review are required based on cost, the VR&E Officer will forward to the next concurrence level, as indicated.

b. Develop the Independent Living Plan

(Change Date August 15, 2013)

All rehabilitation plans have common elements, but the VRC must ensure that the elements or services correspond with the claimant’s identified needs. Refer to M28C.IV.C.2 for the required elements of all rehabilitation plans.

c. Determine Case Management Level

(Change Date August 15, 2013)

Refer to M28C.IV.C.2 for information regarding the required case management level, appointments, and contacts that must be followed for an IILP.

d. CWINRS Update

(Change Date August 15, 2013)

CWINRS requires updates to the claims processing and disposition tabs prior to the development of the rehabilitation plan. Refer to M28C.IV.C.2 for detailed information on CWINRS Actions regarding rehabilitation plan development.

e. Independent Living Plan Concurrence

(Change Date July 14, 2022)

In accordance with 38 CFR 21.162, the VR&E Officer must approve all IILPs before the VRC and claimant sign the plan. The VRC must submit the drafted VAF 28-10214, Rehabilitation Plan; VAF 28-0814, Checklist for Independent Living Plan Approval; and any additional relevant information, to include professional drawings if proposed home modification is a part of the IILP to the VR&E Officer for approval.

The VRC must ensure all levels of required approval or concurrence are completed prior to signing the IILP. Refer to section 6.02 of this chapter for more information pertaining to roles and responsibility related to IILP approval.

f. Independent Living Plan Non-Concurrence

(Change Date February 19, 2019)

If an IILP and/or associated cost is not approved for any of the concurrence levels, the VRC must perform one of the following tasks:

• Make the recommended corrective action(s) to revise the IILP and resubmit for approval, or

Consider alternative rehabilitation options, if revision will not result in an approval.

In accordance with 38 U.S.C. 3107, if the IILP is not approved, and the claimant does not agree with the newly developed and proposed plan, the claimant may request a review of the plan at the RO level or appeal the development of the plan. In this situation, the claimant must submit the appropriate form to request the type of review or appeal he or she wishes to pursue. Refer to M28C.III.C.3 for detailed information.

g. Complete the Orientation for Home Modification Process

(Change Date August 15, 2013)

If home modification is part of the IILP, then the orientation must also include the following discussions:

• Where will the claimant reside during the construction if it is necessary to vacate the home during the modification process?
• Is the claimant prepared for possible delays in the construction process?
• How will issues that arise and are identified during the construction process be addressed?
• Does the claimant understand the coordination of services will require communication and cooperation with different entities?
• Does the claimant understand his or her roles and responsibilities?

Any other questions specific to the claimant’s home modification plan.

h. Procure Home Modifications

(Change Date March 31, 2014)

The procedures outlined here are step two of the procurement processes for procuring home modifications. Step one of the process was discussed above in section 6.04 of this chapter

If home modifications are part of the IILP and the cost of the modification is greater than the Micro-Purchase Threshold for construction, currently $2,000, the VRC must work closely with the Contracting Officer to secure the acquisition of these services. The VRC must complete the following activities:

1. Submit Information to the Contracting Officer

(Change Date March 31, 2014)

The documents that must be submitted include much of what was submitted to the Contracting Officer when the services of the CMS were obtained (as described above), with the addition of a few other documents. The VRC must submit the required information to the Contracting Officer to initiate support, including:

• VAF 90-2237, which confirms that funding is available
• Documentation of VR&E approval of funds, as indicated by the document on which the appropriate approval was provided

Description of the work to be performed, as outlined in the information provided by the CMS.

Copy of VA Handbook 6500.6, Appendix A, checklist that was submitted when the services of the CMS were obtained.

Copy of the signed IILP, with the redaction of the claimant’s social security number.

Draft a waiver request for the RO Director to submit to the Executive Director of VR&E Service if quotes for construction are over $15,000.

2. Contracting Officer Activities

(Change Date March 31, 2014)

The Contracting Officer will complete the following activities to ensure that the procurement of home modification services is performed accurately and within the guidelines set forth in the FAR and VAAR:

• Issue a solicitation for bids
• Obtain quotes for the home modification

Notify the VRC if quotes are over $15,000, so a waiver can be requested prior to contract award.

Make an award for the completion of the home modification

Monitor the process to ensure that the contractor is paid in an accurate and timely manner

Perform a final site visit to sign off on project completion

i. Administer the Plan

(Change Date August 15, 2013)

The VRC must implement the services identified in the plan and must document all case activity in electronic case notes. The VRC, or a VA contract counselor, provides the claimant case management services to ensure that the objectives of his or her rehabilitation plan are being addressed and completed.

Additionally, the VA contract counselor must discuss with the VRC any concerns with the claimant and identifies appropriate action(s) to address the concerns. The VRC must document the concerns and corresponding actions in an electronic case note. This will ensure the claimant’s successful completion of his or her rehabilitation program.

Refer to M28C.V.A for detailed information on plan implementation.

j. Evaluate and Amend the Plan

(Change Date November 7, 2014)

The VRC must review and evaluate the claimant’s progress toward completion of the objectives of the rehabilitation plan. In accordance with 38 CFR 21.94 and M28C.IV.C.2, if additional services are needed to achieve the goal of the plan, the VRC must adjust or amend the plan accordingly. If the amendment to the plan includes additional construction costs, the VRC must obtain the proper level of approval. Refer to M28C.III.A.1 for information on case status during plan redevelopment.

6.06 Outcomes of Independent Living Plans

a. Rehabilitation

(Change Date November 4, 2013)

Refer to M28C.V.A.6 for information for declaration of rehabilitation and procedures for case closure.

The VRC must use VAF 28-0791, Pre and Post Independent Living Assessment at Case Closure, when determining rehabilitation closure following provision of services under an IILP.

b. Discontinued

(Change Date August 15, 2013)

If the claimant decides not to pursue IL services, does not respond to attempts by the VRC to participate in the rehabilitation plan, demonstrates non-cooperative behaviors, or does not complete planned services within the allowable timeline then it may be necessary to discontinue the case. Refer to M28C.V.A.6 for information for procedures on case closure for discontinuance

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