Veterans State Adult Day Health Care
To provide a community-based program designed to meet the needs of adults with impairments through individual plans of care. This type of structured, comprehensive, nonresidential program provides a variety of health, social, and related support services in a protective setting. By supporting families and caregivers, an adult day services program enables the person to live in the community. An adult day services program assesses the needs of the persons served and offers services to meet those needs. The persons served attend on a planned basis. Nothing in this generic description of adult day services may be construed to modify the specific services or eligibility requirements referenced in the definition of adult day care and adult day health.
Last Known Status
Agency: Department of Veterans Affairs
Office: VA Health Administration Center
Types of Assistance
Uses and Use Restrictions
Adult day health is a supervised daytime program providing skilled nursing and rehabilitative therapy services in addition to core services outlined in Public Law 106-117 Section 101. (1) Adult day health services are only appropriate for adults with medical or disabling conditions that require the intervention or services of a registered nurse or licensed rehabilitative therapist acting under the supervision of the client's physician. (2) The adult day health center must offer and provide on site the following services: (a) All core services under PL 106-117 Section 101; (b) Skilled nursing services other than routine health monitoring with nurse consultation; (c) At least one of the following skilled therapy services: physical therapy, occupational therapy, or speech-language pathology or audiology, as those services are defined under PL 106-117 Section 101 respectively; and (d) Psychological or counseling services, including assessing for psycho-social therapy need, dementia, abuse or neglect, and alcohol or drug abuse; making appropriate referrals; and providing brief, intermittent supportive counseling. (a) The following personal care services as defined in PL 106-117 Section 101, "personal care services," or its successor: (i) Ambulation; (ii) Body care; (iii) Eating; (iv) Positioning; (v) Self-medication; (vi) Transfer; (vii) Toileting; (viii) Personal hygiene at a level that ensures client safety and comfort while in attendance at the program; and (ix) Bathing at a level that ensures client safety and comfort while in attendance at the program. (b) Social services on a consultation basis, which may include: (i) Referrals to other providers for services not within the scope of Medicaid reimbursed adult day care services; (ii) Caregiver support and education; or (iii) Assistance with coping skills. (c) Routine health monitoring with consultation from a registered nurse that a consulting nurse acting within the scope of practice can provide with or without a physician's order. Examples include: (i) Obtaining baseline and routine monitoring information on a client's health status, such as vital signs, weight, and dietary needs; (ii) General health education such as providing information about nutrition, illnesses, and preventive care; (iii) Communicating changes in the client's health status to the client's caregiver; (iv) Annual and as needed updating of the client's medical record; (v) Assistance as needed with coordination of health services provided outside of the adult day care program. (d) General therapeutic activities that an unlicensed person can provide or that a licensed person can provide with or without a physician's order. These services are planned and provided as an integral part of the client's plan of care and are based on the client's abilities, interests and goals. Examples include: (i) Recreational activities; (ii) Diversionary activities; (iii) Relaxation therapy; (iv) Cognitive stimulation; (v) Group range of motion or conditioning exercises. (e) General health education that an unlicensed person can provide or that a licensed person can provide with or without a physician's order, including but not limited to topics such as: (i) Nutrition; (ii) Stress management; (iii) Disease management skills; (iv) Preventive care. (f) A nutritional meal and snacks provided each four-hour period at regular times comparable to normal meal times, including modified diet if needed and within the scope of the program, as provided under Public Law 106-117 Section 101; (g) Supervision and/or protection for clients who require supervision or protection for their safety; (h) Assistance with arranging transportation to and from the program; and (i) First aid and provisions for obtaining or providing care in an emergency.
Veterans Millennium Health Care and Benefits Act, Public Law 106-117.
52.50 Eligible veterans. A veteran is an eligible veteran under this part if VA determines that the veteran meets the definition of a veteran in 38 U.S.C. 101, is not barred from receiving this VA care under 38 U.S.C. 5303, 5303A, needs adult day health care, and is within one of the following Categories listed below: Public Law 106-117 Section 101, Adult Day Health-Eligibility. (a) Veterans with service-connected disabilities; (b) Veterans who are former prisoners of war; (c) Veterans who were discharged or released from active military service for a disability incurred or aggravated in the line of duty; (d) Veterans who receive disability compensation under 38 U.S.C. 1151; (e) Veterans whose entitlement to disability compensation is suspended because of the receipt of retired pay; (f) Veterans whose entitlement to disability compensation is suspended pursuant to 38 U.S.C. 1151, but only to the extent that such veterans continuing eligibility for adult day health care is provided for in the judgment or settlement described in 38 U.S.C. 1151; (g) Veterans who VA determines are unable to defray the expenses of necessary care as specified under 38 U.S.C. 1722(a); (h) Veterans of the Mexican Border period or of World War I; (i) Veterans solely seeking care for a disorder associated with exposure to a toxic substance or radiation or for a disorder associated with service in the Southwest Asia theater of operations during the Gulf War, as provided in 38 U.S.C. 1710(e); (j) Veterans who agree to pay to the United States the applicable co-payment determined under 38 U.S.C. 1710(f) and 1710(g), if they seek VA (Department of Veterans Affairs) hospital, nursing home, or outpatient care. (Authority: 38 U.S.C. 101, 501, 1741, 1743).
A veteran eligible for care in a VA facility needing adult day health care and meeting one of the following conditions: (a) has a service-connected disability for which such care is being provided; (b) has a non-service connected disability and sates under oath his inability to defray the expenses of necessary adult day health care; (c) was discharged or related from active military, naval and air services for a disability incurred or aggravated in the line of duty; or (d) is in receipt of, or but for the receipt of retirement pay would be entitled to receive disability compensation. A veteran must also meet State admission criteria.
No Credentials or documentation are required. This program is excluded from coverage under OMB Circular No. A-87.
Application and Award Process
Preapplication coordination is not applicable. Environmental impact information is not required for this program. This program is excluded from coverage under E.O. 12372.
This program is excluded from coverage under OMB Circular No. A-102. This program is excluded from coverage under OMB Circular No. A-110. Letter of application from State addressed to the Chief Consultant, Geriatrics and Extended Care (114) Department of Veterans Affairs, 810 Vermont Avenue, N.W. Washington DC 20420.
Recognition by the Secretary of Veterans Affairs for purposes of VA aid pursuant to Title 38 U.S.C. Section 1741.
Range of Approval/Disapproval Time
From 30 to 60 days. From 30 to 60 days.
Formula and Matching Requirements
Statutory formulas are not applicable to this program.
Matching Requirements: 38 U.S.C. 1741, For each veteran provided adult day health care, formula payments to the State are $68.13 per diem, or one-half the cost of care, whichever is less.
MOE requirements are not applicable to this program.
Length and Time Phasing of Assistance
There is no length limitation; grant payments are made monthly to the state. Method of awarding/releasing assistance: lump sum.
Post Assistance Requirements
Cost records on which quarterly statements are based and attendance records to support report for days of care provided to veteran.
(Formula Grants) FY 11 Not Separately Identifiable; FY 12 Not Separately Identifiable; and FY 13 Not Separately Identifiable
Range and Average of Financial Assistance
$22,686 to $165,077; average $93,882.
Regulations, Guidelines and Literature
VA Manual M-1, Part I, Chapter 3, State Veterans Homes, and M-5, Part VIII.
Regional or Local Office
See Regional Agency Offices. See Appendix IV of the Catalog for Veterans Hospital Facilities.
Thomas Graves Department of Veterans Affairs, Washington, District of Columbia 20420 Phone: 202-461-6771
Examples of Funded Projects
Criteria for Selecting Proposals