36C25518Q9495-002.pdf

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Department of Veterans Affairs Veterans Health Administration Washington, DC 20420

VHA DIRECTIVE 1107

Transmittal Sheet

March 10, 2017

VA FISHER HOUSES AND OTHER TEMPORARY LODGING

1. REASON FOR ISSUE: This Veterans Health Administration (VHA) directive provides policy for the provision of temporary lodging at VA Fisher Houses and other facilities.

2. SUMMARY OF MAJOR CHANGES: Major changes include:

a. Revisions of definitions and scope to conform with regulatory changes in Title 38 Code of Federal Regulations (CFR) Part 60. This includes replacement of VA Form 10- 0408A, VA Fisher House or Other Temporary Lodging Application, with a CPRS consult process for all Fisher House and Temporary Lodging requests. The directive also provides clarification related to temporary lodging referrals for Veterans and active duty Servicemembers following conscious sedation.

b. Incorporating the content of VHA Handbook 1110.01, VA Fisher House Program.

3. RELATED ISSUES: None.

4. RESPONSIBLE OFFICE: The Office of Care Management and Social Work Services (10P4C) is responsible for the content of this directive. Questions may be addressed to 202-461-6780.

5. RESCISSIONS: VHA Directive 1107, dated February 21, 2014, and VHA Handbook 1110.01, dated January 24, 2014, are rescinded.

6. RECERTIFICATION: This VHA directive is scheduled for recertification on or before the last working day of March 2022. This VHA directive will continue to serve as national VHA policy until it is recertified or rescinded.

Poonam Alaigh, M.D.

Acting Under Secretary for Health

DISTRIBUTION: Emailed to the VHA Publications Distribution List on March 16, 2016.

March 10, 2017 VHA DIRECTIVE 1107 i

CONTENTS

VA FISHER HOUSES AND OTHER TEMPORARY LODGING

1. PURPOSE

2. BACKGROUND

3. DEFINITIONS

4. POLICY

5. RESPONSIBILITIES

6. SITE SELECTION FOR A VA FISHER HOUSE

7. APPLICATION FOR A VA FISHER HOUSE

8. OPERATION OF VA FISHER HOUSES

9. REFERENCES

APPENDIX A

TEMPORARY LODGING CRITERIA ...........................................................................A-1

APPENDIX B

APPLICATION AND CRITERIA FOR VA FISHER HOUSE ACCOMMODATIONS .....B-1

APPENDIX C

VA FORM 10-0408 ...................................................................................................... C-1

VA FISHER HOUSES AND OTHER TEMPORARY LODGING

1. PURPOSE

This Veterans Health Administration (VHA) directive provides policy for the provision of accommodations at VA Fisher Houses and other temporary lodging. Temporary lodging in VA Fisher Houses may be provided to accompanying individuals of Veterans or active duty Servicemembers who are undergoing an episode of care. Veterans or active duty Servicemembers may be accommodated in VA Fisher Houses with their accompanying individuals only in limited circumstances of immediate need when no alternative temporary lodging is available. AUTHORITY: Title 38 United States Code (U.S.C.) 1708; Title 38 Code of Federal Regulations (CFR) Part 60.

2. BACKGROUND

a. The Department of Veterans Affairs (VA) is authorized under 38 U.S.C. 1708 to furnish temporary lodging in a Fisher House or other appropriate facility to certain individuals in connection with the examination or treatment of a Veteran. The Fisher House Foundation, a 26 U.S.C. 501(c) (3) charitable organization, was created in 1990 by Zachary and Elizabeth Fisher. The Foundation constructs and donates Fisher Houses to the Department of Defense (DoD) and VA for use by families of patients hospitalized in military and VA medical facilities. The Fisher House Foundation requires that all Fisher Houses be used to provide temporary accommodations to the accompanying individuals of Veterans and active duty Servicemembers, who require accommodations due to Veterans or active duty Servicemembers receiving health care from VA or DoD.

b. The VA Fisher House Program is coordinated by the National Fisher House and Family Hospitality Program Manager, Care Management and Social Work Services.

Coordination includes oversight of the selection, construction and operation of all VA Fisher Houses, regular communication with Fisher House Managers, liaison with the Fisher House Foundation, DoD Fisher House Program, and community stakeholders.

c. Temporary lodging is granted on a space-available basis, with some consideration given to the compatibility of the applicant(s) and the room(s) available.

For example, although VA may require an applicant to share a room with another Veteran or active duty Servicemember’s accompanying individual, VA will not do so unless the persons affected are the same gender. NOTE: VA does not impose a general limit on the number of persons who may accompany a Veteran or active duty Servicemember, but VA may in specific cases provide lodging to only a specific number of persons due to space or resource limitations.

d. All costs associated with temporary lodging are borne by VA and not the Veteran, active duty Servicemember, or accompanying individual.

3. DEFINITIONS

a. Accompanying Individual. An accompanying individual is an individual who accompanies the Veteran or active duty Servicemember to provide familial support or the equivalent of familial support, to a Veteran or active duty Servicemember while the Veteran or active duty Servicemember is experiencing an episode of care. An accompanying individual includes relatives, close friends, or caregivers.

b. Compensation and Pension Examination. A Compensation and Pension (C&P) examination is an examination requested by the Veterans Benefits Administration to be conducted at a VA medical facility for the purpose of evaluating Veterans’ claims.

c. Episode of Care. Episode of care means a course of outpatient treatment or a period of hospitalization during which a Veteran or active duty Servicemember receives health care under 38 U.S.C. Chapter 17, or 38 U.S.C. 8111 or 8153. Examples of episodes of care include but are not limited to the following:

(1) An appointment at a VA medical facility to receive health care or a C&P examination.

(2) Extended outpatient treatment, such as treatment associated with organ transplant, chemotherapy, or radiation.

(3) Hospitalization for injury or illness; where death is imminent; or where a Veteran is unable to make medical decisions for themselves and the accompanying individual is authorized to make such decisions on the Veteran's behalf.

d. VA Fisher House. VA Fisher House means a housing facility that is located at or near a VA medical facility and was constructed by and donated to VA by the Fisher House Foundation (formerly the Zachary and Elizabeth M. Fisher Armed Services Foundation), or a facility that is treated as if it were Fisher House lodging under 38 CFR 60.3.

e. Other Temporary Lodging. Other temporary lodging includes:

(1) Lodging at a temporary lodging facility, other than a VA Fisher House, located at a VA medical facility (generally referred to as a “Hoptel”).

(2) A hotel or motel.

(3) Non-utilized beds at a VA medical care facility designated as lodging beds.

(4) Other donated lodging to be used on a temporary basis in accordance with 38 U.S.C. 1708.

4. POLICY

It is VHA policy that while a Veteran or active duty Servicemember is undergoing an episode of care, VA may provide temporary lodging at either a VA Fisher House or other temporary lodging facility, as appropriate.

5. RESPONSIBILITIES

a. VA Medical Facility Directors. VA medical facility Directors are responsible for:

(1) Ensuring that temporary lodging is provided to eligible Veterans and active duty Servicemembers, as well as accompanying individuals, as space and funding allow in accordance with this directive.

(2) Establishing a local written policy for the facility’s temporary lodging programs, and ensuring all facility staff is familiar with the policy. The local facility policy must outline eligibility and other criteria in accordance with this directive.

(3) Determining whether to utilize unused VA medical facility beds or rooms for temporary lodging. Utilizing unused VA medical facility beds or rooms for temporary lodging must not have a negative impact on the provision of patient care, such as creating a waiting list for inpatient admissions.

(4) Establishing policy and/or processes for provision of emergency medical care for Veterans, active duty Servicemembers and accompanying individuals staying in temporary lodging on VA grounds.

(5) Ensuring that decisions concerning temporary lodging are made by the person responsible for coordinating the temporary lodging program at the VA facility and that these decisions are based on determinations made by the VHA health care provider of the Veteran or active duty Servicemembers’ medical stability, self-care, and ability to stay unattended in an unsupervised setting.

(6) Ensuring that domiciliary [Mental Health Residential Rehabilitation Treatment Program (MH RRTP)] beds or other forms of residential treatment or transitional housing (community-based homeless programs, etc.) are not used for temporary lodging. NOTE: MH RRTPs are active treatment programs with admission with 24/7 supervision to support comprehensive bio-psychosocial treatment.

(7) Ensuring that a CPRS consult is utilized to address requests for temporary lodging.

(8) Ensuring that a CPRS consult is utilized to address requests for Fisher House accommodations.

(9) Overseeing the operation and maintenance of the VA Fisher House.

(10) Staffing the VA Fisher House with a full-time manager and adequate support staff to maximize the availability of the Fisher House at all times, including evenings, weekends and holidays. Support staff includes a full-time Assistant Manager(s), full-time Program Support Assistant(s), and full-time dedicated housekeeping staff. NOTE:

Fisher House Support Staff requirements are contingent upon the size and occupancy rates of the Fisher House.

(11) Ensuring routine upkeep of the VA Fisher House, including 24-hour availability for emergency repairs and housekeeping.

(12) Funding daily operation costs of the VA Fisher House.

(13) Funding travel for the VA Fisher House Manager or local VA Fisher House Staff designee, to attend the annual VA-DoD Fisher House Manager’s Training, sponsored by the Fisher House Foundation.

(14) Ensuring that centralized funding provided to the facility for the purpose of Fisher House refurbishment is utilized.

b. VHA Health Care Providers. VHA health care providers are responsible for determining the current medical stability of the Veteran or active duty Servicemember, and determining whether the Veteran or active duty Servicemember is capable of self-care at the time of temporary lodging, or has an accompanying individual who can provide care. This determination includes whether the Veteran can be lodged in an unsupervised setting. Determination of medical stability, self-care, and staying in an unsupervised setting are to be documented in the Veteran’s medical record in CPRS. In the event that the VHA health care provider is a supervised health professions trainee, the documentation is subject to the provisions of VHA Handbook 1400.01, Resident Supervision, or VHA handbook 1400.04, Supervision of Associated Health Trainees.

c. VHA Staff Overseeing Temporary Lodging Programs. VHA staff overseeing temporary lodging programs must ensure:

(1) Temporary lodging facilities on VA grounds are safe, clean and free from hazards.

(2) Veterans, active duty Servicemembers, and accompanying individuals being lodged are provided an orientation to the lodging facility, including fire and safety information and who to call in an emergency.

(3) Adequate privacy in the temporary lodging facility.

d. VA Fisher House Manager. VA Fisher House Managers are responsible for:

(1) Overseeing daily operations, including accepting and processing applications for accommodations, arranging for lodging stays, orientation of Fisher House guests, tracking utilization, budgeting and operating costs, preparing reports for the VA Fisher House Program and for the Fisher House Foundation, and supervising employees, volunteers, and students working in the VA Fisher House.

(2) Managing and operating the VA Fisher House in a fiscally responsible manner, ensuring that the needs of Fisher House guests are met.

(3) Ensuring the VA Fisher House is safe, clean, and free from hazards, including adequate housekeeping and maintenance of the facility.

(4) Ensuring individuals accommodated in VA Fisher Houses receive orientation to the House, including fire and safety information and who to call in an emergency.

(5) Completing reports on costs, utilization, and operation of the VA Fisher House to the Fisher House Foundation and to the National VA Fisher House Program Manager in a timely manner.

e. VA Fisher House Guests. VA Fisher House guests are responsible for abiding by the rules of the Fisher House and all medical facility rules and policies, including the following:

(1) No medical or nursing services will be provided in the VA Fisher House.

(2) Individuals with a communicable disease (e.g., influenza) which may be transmitted through common contact must not be accommodated in a VA Fisher House.

(3) No overnight guests other than registered VA Fisher House guests are allowed in VA Fisher Houses unless approved by the Fisher House Manager.

(4) All children under the age of 18 must be supervised by a family member at all times.

(5) Animals are prohibited in VA Fisher Houses, except service dogs, as defined in VHA Directive 1188: Animals on Veterans Health Administration (VHA) Property. Dogs that facilitate therapy, provide companionship, emotional support, or are considered pets are not service dogs and must not be accommodated in VA Fisher Houses.

(6) Alcoholic beverages and illegal drugs are prohibited on VA grounds.

(7) Weapons and explosives are prohibited on VA grounds.

(8) Gambling is prohibited on VA grounds.

(9) Soliciting, vending, and selling merchandise are prohibited on VA grounds.

(10) Sexual misconduct, destroying property, and creating a disturbance are prohibited on VA grounds.

(11) Smoking is prohibited in VA Fisher Houses. NOTE: Guests must use designated smoking areas.

(12) Failure to abide by the VA medical facility and VA Fisher House rules may result in guests being asked to leave the VA Fisher House.

6. SITE SELECTION FOR A VA FISHER HOUSE

a. Periodically, VHA office of Care Management and Social Work Services solicits applications for construction of a new Fisher House from VA medical facilities through the VISN offices. VA medical facilities applies the selection criteria to the applications received and prioritizes them, and provides the Fisher House Foundation with a list of proposed sites for new VA Fisher Houses. The final determination for new sites is made by the Fisher House Foundation.

b. Information Needed Before Consideration:

(1) The availability of vacant land on which to build, preferably about 1.2 acres.

NOTE: All site preparation is the responsibility of the VA medical facility.

(2) A full description of the proposed location, including lot size and location in relation to the VA medical facility and the approximate walking time from the proposed site to patient treatment buildings. NOTE: Ideally, the proposed site is easily accessible to patient treatment buildings.

(3) A statement of commitment to provide for the operational costs, including all utilities, staffing and maintenance of the structure is required from each medical facility.

(4) A statement of commitment to provide one full-time equivalent (FTE) employee to supervise the facility (the Fisher House Manager), and additional staff to support Fisher House operations (Assistant Manager(s), Program Support Assistant(s), and Housekeeping staff).

(5) A brief statement describing patient treatment programs offered at the VA medical facility that are expected to be the primary sources of patients supported by the Fisher House. This statement is to include workload information (number of unique Veterans, number of outpatient visits, and the number of inpatient admissions, etc.).

(6) Any special construction issues, planned construction projects that may impact Fisher House construction, or needs for the proposed site need to be identified.

(7) Any other significant information that would assist VA in the site selection process.

(8) Letters of endorsement from Veteran Service Organizations and the Chief of Voluntary Service.

(9) Letters of endorsement from community stakeholders, state, and Federal officials.

(10) Any state grants or local financial and/or volunteer support for initial funding, as well as for continued operational support need to be described.

7. APPLICATION FOR A VA FISHER HOUSE

To apply for a VA Fisher House, the VA medical facility must complete an application (VA Form 10-0408 [see Appendix A] or successor issue) and send it through the respective VISN Office to the Deputy Under Secretary for Health for Operations and Management.

a. Elements of the Application. All applications for VA Fisher Houses must include:

(1) Letters of endorsement from Veteran Service Organizations and the facility Chief of Voluntary Service.

(2) Letters of endorsement from community leaders and state and Federal officials.

(3) Signature approvals of the VA medical facility and VISN Directors.

(4) Confirmation of at least 1.2 acres of land on the VA medical facility campus for Fisher House construction; or a detailed plan to acquire land within close proximity of the campus for Fisher House construction. The Fisher House Foundation in collaboration with the VA medical facility makes the final determination for the location of Fisher House construction.

b. The Process.

(1) The Deputy Under Secretary for Health for Operations and Management and Care Management and Social Work Services conduct a joint review of VA Fisher House applications, applying the selection criteria described. A list of recommended sites is provided to the Under Secretary of Health for concurrence and forwarded to the Secretary of Veterans’ Affairs for approval.

(2) Upon the Secretary’s approval, the Deputy Under Secretary for Health for Operations and Management provides the list of recommended sites to the Fisher House Foundation. NOTE: The final decision on sites for new VA Fisher Houses rests with the Fisher House Foundation.

(3) When a facility is selected by the Fisher House Foundation for a new VA Fisher House, the Foundation confirms its interest in building a Fisher House to the National VA Fisher House Program Manager and the Deputy Under Secretary for Health for Operations and Management.

(4) The Fisher House Foundation provides an offer with the anticipated time schedule for the construction project.

(5) The National VA Fisher House Program Manager notifies the facility and requests identification of a facility coordinator to serve as the point of contact for development of the project.

(6) The individual designated by the VA medical facility Director provides routine updates to the National VA Fisher House Program Manager describing progress and/or issues for the project. Near completion of the project, the facility coordinator notifies the National VA Fisher House Program Manager of the projected completion date and of the proposed dedication ceremony plans. NOTE: The selection and coordination of dedication ceremony participants is determined by the Deputy Under Secretary for Health for Operations and Management, in collaboration with the National VA Fisher House Program Manager.

8. OPERATION OF VA FISHER HOUSES

a. Once the Fisher House Foundation donates a Fisher House to VA, the VA medical facility is responsible for the operation and maintenance of the Fisher House. It is the expectation of Fisher House Foundation that the Fisher House will be maintained in pristine condition. Funding of operation and maintenance is a line item in the medical facility budget. Centralized funding is established by VA Central Office for major costs of refurbishing and redecorating VA Fisher Houses and for replacing major appliances.

NOTE: VA medical facilities with VA Fisher Houses are encouraged to work through

Voluntary Service in requesting donations from community and Veterans’ groups for such things as comfort items, non-perishable food items, linens, and housewares to support the VA Fisher House.

b. Fisher House Staff: It is the expectation of Fisher House Foundation that the Fisher House will be available to serve all eligible individuals in their time of need.

Accordingly, Fisher House staffing levels must be sufficient to ensure that the Fisher House is available at all times, including evenings, weekends, and holidays to Veterans, active duty Servicemembers, and their accompanying individuals when they are in need of accommodations. Exact staffing models for Fisher Houses may vary by facility;

however, staffing decisions must optimize available Fisher House resources. Each VA Fisher House is staffed with a full-time Fisher House Manager who is a VA employee and has an office located in the Fisher House. Additional VA Fisher House staff include: Assistant Fisher House Manager(s), Housekeeping staff, and Program Support staff. Refer to Diagram 1 below for Fisher House Staffing ratios.

Diagram 1: Fisher House Staffing Matrix.

NOTE: The staffing matrix was developed to identify optimal staffing levels for successful Fisher House operations; and to maximize the availability of the Fisher House at all times, including evenings, weekends and holidays. It is the expectation of the National VA Fisher House Program and Fisher House Foundation that the Fisher House will be available for Veterans and their families when they need temporary accommodations. VA facilities may need to modify housekeeping staffing ratios based upon the volume of Fisher House guests and occupancy levels.

Number of Fisher House Suites

Fisher House Manager

Fisher House Assistant Manager

Fisher House Program Support Assistant

Fisher House Housekeeping Staff

7-9 Suite Fisher House

1.0

FTEE

1.0

FTEE

1.0 FTEE 3.0 FTEE

10-12 Suite Fisher House

1.0

FTEE

1.0

FTEE

1.0 FTEE 3.0-4.0 FTEE

16 Suite Fisher House

1.0

FTEE

1.0

FTEE

2.0 FTEE 3.0-4.0 FTEE

20 Suite Fisher House

1.0

FTEE

1.0

FTEE

3.0 FTEE 4.0-4.5 FTEE

21 Suite Fisher House

1.0

FTEE

1.0

FTEE

3.0 FTEE 4.0-4.5 FTEE

21+ Suites (More than 1 Fisher House)

1.0

FTEE

2.0

FTEE

4.0-6.0 FTEE 4.0-6.0 FTEE

c. No fees may be charged to Veterans, active duty Servicemembers, or their accompanying individuals for accommodations in VA Fisher Houses. However, the VA medical facility may accept donations into a General Post Fund (GPF) established specifically for the purpose of supporting the VA Fisher House.

9. REFERENCES

a. 38 U.S.C. 1708.

b. 38 CFR Part 60.

A-1

APPENDIX A

TEMPORARY LODGING CRITERIA

a. Eligibility. The following individuals are eligible to apply to stay in temporary lodging:

(1) A Veteran or Servicemember experiencing an episode of care, as defined in paragraph 3.c of this directive.

(a) Veterans or Servicemembers must be determined medically stable, capable of self-care or accompanied by an individual able to provide such care, and able to stay in an unsupervised setting. VA does not provide nursing or other medical care in temporary lodging facilities. Veterans or active duty Servicemembers receiving conscious sedation during a procedure may not receive overnight accommodations in Temporary Lodging post procedure unless they are supervised by an accompanying individual.

1. Veterans or active duty Servicemembers with a Category I Behavioral Patient Record Flag (BPRF) in the Computerized Patient Record System (CPRS) may be considered for temporary lodging. The Temporary Lodging Coordinator should consult with the local Disruptive Behavior Committee (DBC) who assessed the Veteran or active duty Servicemember and request their re-evaluation to determine if temporary lodging accommodations are appropriate.

2. Veterans or active duty Servicemembers with a Suicide Risk Flag in CPRS may be considered for temporary lodging accommodations. The Temporary Lodging Coordinator must consult with the Behavioral Health Team and request re-evaluation to determine if temporary lodging accommodations are appropriate.

(b) A Veteran or Servicemember cannot stay in the VA Fisher House unless there is an immediate need and there is no alternative temporary lodging and their accompanying individual also stays in the VA Fisher House.

(2) An accompanying individual, as defined in paragraph 3.a., of a Veteran or active duty Servicemember.

(a) An accompanying individual cannot stay in temporary lodging that is not a VA Fisher House, unless the Veteran or Servicemember is also lodging in the non-VA Fisher House facility.

(b) Minor children may not be accommodated in temporary lodging facilities on VA grounds, except in free standing temporary lodging facilities and VA Fisher Houses.

Minor children must be supervised at all times by an adult accompanying individual.

(3) An applicant for temporary lodging (a Veteran, Servicemember, or accompanying individual) may not be granted lodging unless they must travel either 50 or more miles or at least 2 hours from their home to the VA medical facility. The VHA facility Director may make an exception to distance or time provisions based on exceptional circumstances, such as condition of the Veteran or active duty Servicemember, APPENDIX A

A-2 inclement weather, road conditions, or the mode of transportation used by the Veteran or active duty Servicemember.

(4) All applicable preceding criteria may be waived for individuals who must be present on site for evaluation, donation, and care related to their status as an organ donor for a Veteran. Accompanying individuals of these donors may also be provided temporary lodging at all phases of the organ transplant process.

b. Duration of Temporary Lodging and Other Services.

(1) Temporary lodging may be provided while the Veteran or Servicemember is undergoing an episode of care (see paragraph 3.c., e.g. while the Veteran is hospitalized, or if the Veteran is admitted to a VA medical facility while undergoing an outpatient episode of care for which temporary lodging was already provided), or as extended by the appropriate VA clinician or social worker based on an emergency situation or unforeseen circumstances. Generally:

(a) Temporary lodging may be provided the night before the day of the scheduled care if, the Veteran leaving home after 8:00 a.m. would be unable to arrive at the VA medical facility by the time of the scheduled appointment.

(b) Temporary lodging may be provided the night of the scheduled care, if, after the appointment, the Veteran would be unable to return home before 7:00 p.m.

(2) Temporary lodging may be provided to accompanying individuals for the duration of the episode of care subject to limitations described in this section.

(3) When non-VA temporary lodging facilities are used, VA staff should make arrangements for transportation to and from the VHA facility for those Veterans or active duty Servicemembers without a means of transportation. Transportation may be made using non-VA resources or VA resources, if the Veteran or Servicemember is otherwise eligible for such transportation under 38 U.S.C. 111A. NOTE: Making travel arrangements does not involve paying for travel or providing travel, except as authorized by 38 U.S.C. 111 or 111A.

(4) VA medical facilities may provide meals or vouchers for meals in the Veterans Canteen Service for Veterans staying in temporary lodging. Meals for accompanying individuals staying in temporary lodging are to be at the expense of the family member or caregiver, or provided through donated funds in a General Post Fund account.

c. Application Process for Temporary Lodging.

(1) To receive temporary lodging, a Veteran, active duty Servicemember, or accompanying individual must contact the VA Health Care Team coordinating the episode of care during which temporary lodging is requested. A member of the VA Health Care Team managing the episode of care (Provider, RN Care Manager, Social Worker or Case Manager etc.) completes the appropriate Temporary Lodging consult

APPENDIX A

A-3 template in CPRS. The consult is received and reviewed by the following VA Staff to determine eligibility:

(a) For VA Fisher House lodging, to the Fisher House Manager at the VA medical facility of jurisdiction.

(b) For other temporary lodging, to the Temporary Lodging Program Coordinator at the VA medical facility of jurisdiction.

(2) Requests are generally processed in the order that they are received by VA, and temporary lodging is then granted on a first come, first served basis. However, in extraordinary circumstances, such as imminent death, critical injury, or organ donation, applications may be processed out of order. VA will continue to accept 10-0408A until the updated Federal Regulation is published.

B-1

APPENDIX B

APPLICATION AND CRITERIA FOR VA FISHER HOUSE ACCOMMODATIONS

1. APPLICATION FOR VA FISHER HOUSE ACCOMMODATIONS

a. In order to receive temporary lodging, a Veteran, active duty Servicemember, or accompanying individual must contact a member of the VA Health Care Team that is coordinating the related episode of care and request Fisher House accommodations. A member of the VA Health Care Team will complete the electronic consult in CPRS to request Fisher House accommodations for the individual. The Fisher House Manager receives all consults and will review for eligibility.

b. Requests for VA Fisher House accommodations are processed in the order that they are received by VA, and VA Fisher House accommodations are granted on a first-come, first-serve basis; however, in extraordinary circumstances, such as imminent death, critical injury, or organ donation, request may be processed out of order.

2. CRITERIA FOR ACCOMMODATIONS IN A VA FISHER HOUSE

a. In order to receive accommodations in a VA Fisher House, the accompanying individual, active duty Servicemember or Veteran (if also staying at the VA Fisher House) must:

(1) Be medically stable and capable of self-care or be accompanied by an individual able to provide the necessary care. VA does not provide nursing or other medical care in VA Fisher Houses.

(2) Be required to travel 50 or more miles or at least 2 hours from their home to the VA medical facility. Exceptions to these distance or time provisions may be made based on exceptional circumstances, such as inclement weather, road conditions, or the mode of transportation used.

(3) Be able to stay in an unsupervised setting.

(4) Must be actively involved in the hospitalized Veteran or active duty Servicemember’s treatment plan, and provide ongoing bedside support during the episode of care.

b. Decisions concerning VA Fisher House accommodations are to be made by the VA medical facility’s Fisher House Manager. If space is unavailable, referrals for temporary accommodations may be made to the Veteran or active duty Servicemember’s social worker or case manager.

c. VA Fisher Houses are not used to accommodate unaccompanied Veterans or active duty Servicemembers, or individuals in need of transitional or permanent housing.

d. Veterans or active duty Servicemembers with a Category I Behavioral Patient Record Flag (BPRF) in Computerized Patient Record System (CPRS) may be

APPENDIX B

B-2 considered for VA Fisher House accommodations. The Fisher House Manager is to consult with the local Disruptive Behavior Committee (DBC) who assessed the Veteran or active duty Servicemember, and to request their re-evaluation to determine if VA Fisher House accommodations are appropriate.

e. Veterans or active duty Servicemembers with a Suicide Risk Flag may be considered for VA Fisher House accommodations just as they would be otherwise. The Fisher House Manager may consult with the facility Suicide Prevention Coordinator to determine if there are any current follow-up requirements or a need for continued re-evaluation during the VA Fisher House stay.

f. VA does not impose a general limit on the number of persons who may accompany a Veteran or active duty Servicemember, but VA may in specific cases provide accommodations to only a specific number of persons due to space or resource limitations.

g. VA Fisher House accommodations for accompanying individuals of Veterans in a Polytrauma Transitional Rehabilitation Program (PTRP) will be based upon the need for continued active participation in the patient’s episode of care.

(1) Once a rehabilitation patient successfully transfers from acute rehabilitation to the Polytrauma Transitional Rehabilitation Program (PTRP), goals are focused on gaining additional independence and autonomy in functioning. As a result, the need for the accompanying individual’s continuous involvement and presence at the bedside may change, as will their need for continued VA Fisher House accommodations.

(2) Return visits by accompanying individuals during the patient’s PTRP stay may be needed. Accommodation in the VA Fisher House for accompanying individuals should be on a first-come, first-serve basis.

C-1

APPENDIX C

VA FORM 10-0408

Department of Veterans Affairs (VA) Form 10-0408 can be found on the Veterans Health Administration (VHA) Forms http://www.va.gov/vaforms or at http://vaww.va.gov/vaforms. This is to be used for local reproduction. Since this is a low use form, it is not stocked by the Hines Service and Distribution Center (formerly known as the Forms and Publications Depot).

Use Adobe Acrobat 5.05 or later to view this form. To print this form, the printer must be set to “print as image” and “fit to page.”

http://www.va.gov/vaforms http://vaww.va.gov/vaforms