The Veterans Affairs’ Home Improvements and Structural Alterations (HISA) grant provides financial assistance for home modifications in a disabled veteran’s home, the home of a relative, or a rental home, given it is the veteran’s primary residence. (In some cases, veterans in medical foster homes and group homes can also receive a HISA grant). Eligible disabilities can be service connected or non-service connected. Therefore, veterans with Alzheimer’s disease and other forms of dementia that exhibit moderate to severe mobility, coordination, and/or balance issues will likely qualify for the HISA grant if the need for home modifications is medically necessary.
Relevant to persons with dementia, the HISA grant can be used to make home modifications that help to improve a veteran’s ability to move within the home and prevent falls. For instance, wheelchair ramps can be built to allow access to/from the home, doorways can be widened to allow a wheelchair through, and in some rare, medically necessary cases, a walk-in bathtub can replace a standard bathtub.
HISA grants are awarded and administered via a veteran’s local regional VA Medical Center, specifically the Prosthetics and Sensory Aids (PSAS) Services Department.
In 2020, veterans with dementia who are eligible for the HISA grant are awarded a one-time benefit of either $6,800 (veterans with service connected disabilities) or $2,000 (veterans with non-service connected disabilities). This cash grant is a lifetime benefit, meaning a veteran can make approved home modifications until the funds are depleted.
Examples of allowable Home Improvements and Structural Alternations follows. Please note that this list is not exhaustive.
• Lowering kitchen and bathroom counters
• Lowering light switches / electrical outlets
• Lowering windows
• Addition of grab bars / hand rails
• Installation of wheelchair ramps providing access to enter / exit the home (ramps must be permanent)
• Widening of doorways for wheelchair access
• Improving sidewalks or driveways to allow for wheelchair use to/from the home
• Replacing standard bathtubs / showers with roll-in showers / walk-in bathtubs (when medically necessary)
• Replacing standard bathroom sinks with pedestal sinks
• Replacing carpeting with wood or vinyl flooring for easier wheelchair use
• Installing chair lifts
• Adding window shading / tinting
• Updating plumbing to support medical equipment / essential bathrooms
• Updating electrical to support life sustaining equipment / essential bathrooms
• Addition of interior / exterior lighting
Many of the above possible home modifications are relevant to persons with dementia. Due to the progression of the disease and the inevitable decline of functioning, many home modifications become medically necessary to provide a safe living environment. Since the symptoms of dementia vary based on the type and stage of dementia, necessary home modifications for persons with dementia are not identical across the board.
For example, a veteran with Parkinson’s disease dementia might exhibit stiffness of the muscles, be unsteady on his / her feet, and walk with short, shuffling steps. If the condition is not yet severe enough to warrant a wheelchair, the HISA grant might be beneficial to add handrails in the hallways, grab bars in the bathrooms, and a chairlift so the veteran does not have to walk up / down a stairway. As another example, a veteran in late-stage vascular dementia likely requires a wheelchair. In this case, the addition of a wheelchair ramp to access the home, widening of the doorways, and the addition of a pedestal sink in the bathroom might become invaluable. Therefore, the ability to match one’s home modification needs to one’s stage of dementia and level of functioning is a beneficial benefit of the HISA grant.
In order to be eligible for the HISA grant in 2020, veterans of all ages with dementia must meet the following eligibility criteria.
• Be disabled, whether it be service connected or non-service connected. For service connected disabilities, a veteran must have a minimum disability rating of 50%.
• Be eligible and enrolled in the VA’s health care system.
• Have a physician’s prescription from a VA doctor indicating home modifications (including which ones) are medically necessary due to a specified medical diagnosis. The veteran’s name, home address, telephone number, and social security number must be included. A diagnosis of dementia and consequent loss of movement, as well as the inability to complete other common daily living activities, can result in home modifications being medically necessary.
• For veterans who do not own the home in which they reside and wish to make home modifications, permission for home modifications must be granted by the home’s owner. This is done by providing a statement (signed and notarized) from the owner giving permission for the modification(s).
There are no specified income or asset limits for HISA grant eligibility. Furthermore, marital status does not impact a veteran’s eligibility.
Prior to applying for a HISA grant, a veteran with dementia must be eligible and enrolled for medical services via the VA. If a veteran is not currently enrolled in the VA health care system, he / she needs to apply. Information about applying can be found here.
For veterans who are enrolled in VA health care and wish to apply for the HISA grant, the following documents must be submitted to the Prosthetic and Sensory Aids Service Department of one’s local VA Medical Center. (For VA Medical Centers by region, click here).
1. A Veterans Application for Assistance in Acquiring Home Improvements and Structural Alterations (VA Form 10-0103) completed and signed.
2. A VA doctor’s order stating that home modifications (including which home modifications) are medically necessary. This must include the veteran’s medical diagnosis, such as Alzheimer’s disease, Lewy body dementia, Frontotemporal dementia, and Huntington’s disease.
3. Renters must include a signed and notarized statement by the owner authorizing home modifications of the rental property.
4. An itemized estimate of the home modification(s) cost in writing. The estimate must be done by a contractor who is licensed and bonded, and / or insured, and must include the price of labor, materials, inspections, and permits.
5. A photograph (in color) of the area(s) in the home in which one wants to modify.
Veterans with questions about applying for VA health care and / or the HISA grant, or require assistance with the application process, might find working with an accredited VA representative helpful. Learn more here.