The Home Improvements and Structural Alterations Benefits Program: Veterans With Disabilities and Home Accessibility

Abstract

The United States has a limited and inadequate supply of housing to meet the accessibility needs of those with physical disabilities. As it pertains to the built environment, accessibility means that an environment can be approached and used independently by individuals with diverse disabilities (DeJong, 1979; University of Washington, 2015). The U.S. "accessibility movement" is grounded in the realization that community participation (e.g., leisure activity, voting, residence, etc.) for individuals with disabilities is nearly impossible without the eradication of attitudinal and environmental barriers preventing full participation (DeJong, 1979). An analysis of the 2011 American Housing Survey (AHS) data reinforced that the needs of individuals with disabilities are not well matched to the housing in which they live or available in the housing market (Bo'Sher, Chan, Ellen, Karfunkel, & Liao, 2015). While one third of the current housing stock may be modifiable for individuals with mobility impairments, currently less than 5% would be accessible to those with moderate mobility impairments, and only 0.15% accessible to those utilizing mobility devices. With the rising numbers of older adults, an aging society will witness growth in physical and cognitive impairments among seniors living in the community. In addition, deinstitutionalization trends will result in growing numbers of individuals with developmental disabilities transitioning from institutionalized care to community living. Hence, aging population trends and the deinstitutionalization movement, in addition to growing numbers of Veterans with disabilities, will increase the demand for accessible homes.

Serving Rural Veterans with Disabilities: A National Survey of Centers for Independent Living

“…Moreover, respondents overwhelmingly referred to a need for home modification support. Recent research shows that VHA programs—such as HISA that provides home repair to enable Veterans with special needs to return to their homes after hospitalization—or Veterans Benefits Administration programs that facilitate home modifications, may be underutilized by Veterans in the community [ 30 ].…”

Home Modifications for Rural Veterans With Disabilities

“…HISA was initially developed by VA to improve veterans' transition from acute medical care to home. 7,8 However, to obtain HISA grants currently, there is an average 3 to 6 months application process. 7 Through the HISA program, VWDs can be prescribed the following HMs, including (but not limited to): flooring replacement, permanent ramps, roll-in showers, installation of central airconditioning systems, improved lighting, kitchen/bathroom modifications, and home inspections.…”

“…The HMs prescribed depend on an assessment of medical need by health care providers (HCPs). 8 As time passed and the veteran population aged, the program now primarily helps ensure the ability to enter into essential areas and safety in the home. 5 The amount of a HISA payment is based on whether a veteran' s health condition is related to military service as defined by the VHA service connection medical evaluation process.…”

Home Environment, Living Alone, and Trajectories of Cognitive Function Among Older Adults With Functional Limitations

“…The effects have been limited because the policy applies only to new or renovated multifamily housing of four units or more. Currently, less than 5% of housing units are accessible to those with moderate mobility impairments and only 0.15% to those utilizing mobility devices (Semeah et al, 2017).…”