Federal Register / Vol. 76, No. 163 / Tuesday, August 23, 2011 / Rules and Regulations 52575 

and preservation of the hearing record. 

Hearings in connection with proposed 

adverse actions and appeals shall be 

held before one or more employees of 

the VA office having original 

jurisdiction over the claim who did not 

participate in the proposed action or the 

decision being appealed. All expenses 

incurred by the claimant in connection 

with the hearing are the responsibility 

of the claimant. 

* * * * * 

PART 20—BOARD OF VETERANS’ 

APPEALS: RULES OF PRACTICE 

■ 3. The authority citation for part 20 

continues to read as follows: 

Authority: 38 U.S.C. 501(a) and as noted 

in specific sections. 

Subpart H—Hearings on Appeal 

■ 4. Revise § 20.706 to read as follows: 

§ 20.706 Rule 706. Functions of the 

presiding Member. 

The presiding Member is responsible 

for the conduct of the hearing, in 

accordance with the provisions of 

subpart H of this part, administering the 

oath or affirmation, and ruling on 

questions of procedure. The presiding 

Member will assure that the course of 

the hearing remains relevant to the 

issue, or issues, on appeal and that there 

is no cross-examination of the parties or 

witnesses. The presiding Member will 

take such steps as may be necessary to 

maintain good order at hearings and 

may terminate a hearing or direct that 

the offending party leave the hearing if 

an appellant, representative, or witness 

persists in disruptive behavior. The 

presiding Member is not bound by the 

procedures described in § 3.103(c) of 

this chapter, as those procedures only 

apply to hearings before the agency of 

original jurisdiction. 

■ 5. Amend APPENDIX A TO PART 

20—CROSS-REFERENCES table by: 

■ a. Removing entries ‘‘20.1’’; ‘‘38 CFR 

3.103(a)’’; and ‘‘Statement of policy.’’. 

■ b. Revising entry 20.1304 to read as 

follows: 

APPENDIX A TO PART 20—CROSSREFERENCES 

Sec. Cross-reference 

Title of crossreferenced material 

or comment 

*******

20.1304 ................................................. 38 CFR 20.700–20.717 ...................................................................................... See also rehearings. 

*******

[FR Doc. 2011–21513 Filed 8–22–11; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

38 CFR Part 63 

RIN 2900–AN73 

Health Care for Homeless Veterans 

Program 

AGENCY: Department of Veterans Affairs. 

ACTION: Final rule. 

SUMMARY: This final rule establishes 

regulations for contracting with 

community-based treatment facilities in 

the Health Care for Homeless Veterans 

(HCHV) program of the Department of 

Veterans Affairs (VA). The HCHV 

program assists certain homeless 

veterans in obtaining treatment from 

non-VA community-based providers. 

The final rule formalizes VA’s policies 

and procedures in connection with this 

program and clarifies that veterans with 

substance use disorders may qualify for 

the program. 

DATES: Effective Date: September 22, 

2011. 

FOR FURTHER INFORMATION CONTACT: 

Robert Hallett, Healthcare for Homeless 

Veterans Manager, c/o Bedford VA 

Medical Center, 200 Springs Road, Bldg. 

12, Bedford, MA 01730; (781) 687–3187 

(this is not a toll free number). 

SUPPLEMENTARY INFORMATION: The 

HCHV program is authorized by 38 

U.S.C. 2031, under which VA may 

provide outreach as well as ‘‘care, 

treatment, and rehabilitative services 

(directly or by contract in communitybased treatment facilities, including 

halfway houses)’’ to ‘‘veterans suffering 

from serious mental illness, including 

veterans who are homeless.’’ One of 

VA’s National priorities is a renewed 

effort to end homelessness for veterans. 

For this reason, we are establishing 

regulations that are consistent with the 

current administration of this program. 

The primary mission of the HCHV 

program is to use outreach efforts to 

contact and engage veterans who are 

homeless and suffering from serious 

mental illness or a substance use 

disorder. Many of the veterans for 

whom the HCHV program is designed 

have not previously used VA medical 

services or been enrolled in the VA 

health care system. 

Through the HCHV program, VA 

identifies homeless veterans with 

serious mental illness and/or substance 

use disorder, usually through medical 

intervention, and offers communitybased care to those whose conditions 

are determined, clinically, to be 

managed sufficiently that the 

individuals can participate in such care. 

We have assisted homeless veterans 

with substance use disorders through 

this program because, based on our 

practical understanding and experience, 

the vast majority of homeless veterans 

have substance use disorders. Treating 

substance use as a mental disorder is 

consistent with the generally accepted 

‘‘disease model’’ of alcoholism and drug 

addiction treatment, as well as the 

modern use of medical intervention to 

treat the condition. We believe that if a 

substance use disorder is a contributing 

cause of homelessness, then that 

disorder is serious; therefore, it is 

consistent to include such veterans in a 

program designed for ‘‘veterans 

suffering from serious mental illness, 

including veterans who are homeless.’’ 

38 U.S.C. 2031(a). 

Veterans who are identified and who 

choose to participate in this form of care 

as part of their treatment plan are then 

referred by VA to an appropriate nonVA community-based provider. In some 

cases, VA will continue to actively 

medically manage the veteran’s 

condition, while in other cases a VA 

clinician may determine that a veteran 

can be sufficiently managed through 

utilization of non-medical resources, 

such as 12-step programs. 

To provide the community-based 

care, the HCHV program contracts with 

non-VA community-based providers, 

such as halfway houses, to provide to 

these veterans housing and mental 

health and/or substance use disorder 


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treatment. VA provides per diem 

payments to these non-VA communitybased providers for the services 

provided to veterans. The services 

provided under these contracts are 

typically short-term, because during 

their stay veteran-participants are 

connected with other resources 

designed to provide longer-term 

housing. These contracts, and the per 

diem payment, are governed by the 

Federal Acquisition Regulations, and 

the VA supplements thereto contained 

in the Department of Veterans Affairs 

Acquisition Regulation, 48 CFR chapter 

8. These are the rules that specifically 

govern requirements exclusive to VA 

contracting actions. 

On December 20, 2010, we proposed 

to establish a new 38 CFR part 63 for the 

HCHV program because the program is 

unique and may be distinguished from 

therapeutic housing or other VA 

programs designed to end homelessness. 

75 FR 79323. We included a 60-day 

comment period and invited interested 

persons to submit written comments on 

or before February 18, 2011. We 

received five comments from members 

of the public. 

A commenter stated that she 

supported this rulemaking and that the 

HCHV ‘‘program has a solid 

foundation.’’ The commenter further 

stated that the program ‘‘should be 

successful in finding and helping these 

veterans in need.’’ We agree that this 

rulemaking will help VA better serve 

homeless veterans that have serious 

mental illness or substance use 

disorders. 

Another commenter stated that we 

should minimize the paperwork burden 

on veterans by designing and 

implementing a single information 

technology program that agencies can 

use to share information about the 

veteran. Although we generally agree 

that technology increases the 

possibilities for reduced paperwork 

from veterans and increased 

information-sharing within the 

government, this comment is outside 

the scope of this rulemaking. The 

proposed rule addressed contracting 

with non-VA community-based 

providers to furnish services to certain 

homeless veterans while the comment 

addresses information sharing. We note 

that the only collection of information 

required by this rulemaking places 

obligations on the non-VA community 

based providers with whom VA would 

contract, not homeless veterans. 

Veterans will only have to meet the 

eligibility criteria in § 63.13(a). 

The same commenter suggested that 

VA form ‘‘contract[s with] facilities that 

have multiple uses under one roof, 

providing shelters, social and health 

services * * *, and medical services’’ in 

a single facility, so that ‘‘the homeless 

veteran will only have to go to one 

facility to receive treatment and or live.’’ 

The commenter suggests that such a 

facility would eliminate the burden of 

travelling to different locations and 

repeating paperwork at each one. 

Section 63.10(a) authorizes VA to 

‘‘award per diem contracts to non-VA 

community-based providers who 

provide temporary residential 

assistance’’ and ‘‘who can provide the 

specific services’’ covered by the HCHV 

program regulations. In turn, § 63.15 

identifies covered services as including 

therapeutic and rehabilitative services; 

structured group activities, such as 

group therapy and professional 

counseling; and residential room and 

board. Thus, the HCHV program offers 

veterans the opportunity to have many 

of their needs met at one particular 

facility; however, medical needs must 

be addressed at an appropriate medical 

facility. Moreover, rather than restrict 

the location of services to ‘‘one facility,’’ 

we encourage non-VA community-based 

providers to utilize community services 

because, based on our experience, we 

believe that the use of community 

resources is vital to the success of 

homelessness programs and in helping 

veterans return to the community as 

healthy, productive citizens. We also 

note that VA social workers and 

caseworkers work closely to place 

veterans in the HCHV program, 

providing assistance with any 

paperwork and/or logistical burdens. 

Additionally, the rule clearly requires 

the contract facility to assist veterans in 

obtaining community resources and 

assistance, and applicants are scored 

based in part on proximity to public 

transportation and community 

interaction. Thus, we believe that this 

population of veterans is better served 

by organizations that encourage 

involvement in the community, rather 

than those that treat the population in 

a more institutionalized fashion by 

providing all services under one roof. 

We make no change based on the 

comment. 

A commenter asked what happens to 

homeless veterans who do not meet the 

eligibility requirements for the HCHV 

program and recommended that the 

program be open to all homeless 

veterans. 

The proposed rule addressed 

homeless veterans, who are seriously 

mentally ill and/or have substance use 

disorders, while the comment addresses 

other veterans who do not meet the 

eligibility criteria of the HCHV program. 

These criteria are prescribed by 38 

U.S.C. 2031, which we interpret as 

authorizing VA authority to provide 

care to veterans who are both homeless 

and seriously mentally ill. Section 2031 

does not authorize the broader program 

proposed by the commenter. We discuss 

this interpretation in greater detail in 

response to a later comment, and make 

no change based on this comment. 

However, we note that to the extent 

some homeless veterans will not be 

covered by this program because they 

are not seriously mentally ill, they will 

be eligible for a wide variety of VA 

programs designed to reduce or 

eradicate homelessness in our Nation’s 

veteran population, many of which are 

not specifically targeted to veterans that 

have serious mental illness. These 

include housing support programs such 

as the Grant and Per Diem Program, the 

Department of Housing and Urban 

Development and VA Supported 

Housing program, and the Supportive 

Services for Veteran Families program. 

A commenter requested that VA 

prescribe rules regarding assistance for 

covered veterans after they receive the 

prescribed 6 months of treatment and 

regarding veterans who are not 

rehabilitated by the 6-month course of 

treatment. 

The proposed rule addressed VA’s 

authority to contract with non-VA 

community-based providers in the 

administration of the HCHV program, 

which is designed to address the shortterm, immediate needs of this veteran 

population, while, simultaneously, 

efforts are made to connect the 

population with resources that can 

provide assistance with permanent 

housing and other long-term needs that 

the HCHV program is not equipped to 

address. 

VA anticipates that the vast majority 

of veterans who are the subject of a 

contract with a non-VA community 

based provider under this program will 

have transitioned to a longer term 

support structure at the end of the 6- 

month period prescribed by this rule. At 

that point, the veteran will likely still be 

receiving other VA benefits and 

services. It is possible that in some 

situations, VA will need additional 

time, beyond 6 months, to connect a 

veteran with a particularly challenging 

case to other services, whether provided 

by VA or not. In such a situation, the 

rule envisions the possibility of 

extending the contract period for 

‘‘extraordinary circumstances’’ in 

§ 63.10(c)(2). Therefore, we make no 

change based on this comment. 

A commenter expressed concern that 

the proposed regulation ‘‘would enact a 

more restrictive interpretation regarding 

eligibility than Congress intended’’ 


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under 38 U.S.C. 2031(a) because it 

requires a veteran to be both homeless 

and have a serious mental disorder. The 

commenter argues, using statutory 

interpretation and arguments based on 

the legislative history of section 2031, 

that (1) ‘‘a veteran’s homeless condition 

is sufficient for assistance’’ without 

regard to the veteran having a serious 

mental illness; and (2) that the proposed 

rule would make the statutory 

homelessness requirement 

‘‘surplusage.’’ The commenter cautions 

that if VA does not adopt their 

construction, a ‘‘costly adverse judicial 

determination’’ could result. 

As the commenter points out, judicial 

review of an agency’s construction of a 

statute it administers is governed by 

Chevron, U.S.A. Inc. v. Natural 

Resources Defense Council, Inc., 467 

U.S. 837 (1984). To state the law very 

briefly, Chevron envisions a two-step 

analysis. If the statute is plain, and the 

intent of Congress is clear, that is the 

end of the matter. If, however, the 

statute is ambiguous on the point at 

issue, a reviewing court asks whether 

the agency’s construction is reasonable. 

We believe the statute is plain on this 

point. Section 2031(a) provides in 

pertinent part: 

In providing care and services under [38 

U.S.C. 1710] to veterans suffering from 

serious mental illness, including veterans 

who are homeless, [VA] may provide 

(directly or in conjunction with a[nother] 

governmental or other entity)—(1) outreach 

services; (2) care, treatment, and 

rehabilitative services (directly or by contract 

in community-based treatment facilities, 

including halfway houses); and (3) 

therapeutic transitional housing assistance 

* * * 

The statute clearly identifies homeless 

veterans as a subset of veterans who 

may be suffering from serious mental 

illness and therefore in need of medical 

care pursuant to 38 U.S.C. 1710. Under 

the plain language of the statute, 

Congress excluded homeless veterans 

who do not need medical care for a 

serious mental illness. Congress has 

authorized other programs to assist that 

segment of the homeless veteran 

population. The reference to section 

1710 makes clear that programs 

authorized by section 2031 are for 

veterans suffering from serious mental 

illness only. 

Even if the statute is ambiguous, our 

interpretation that it applies to veterans 

who are homeless and have a serious 

mental illness is consistent with 

Congress’ intent. Congress initially 

enacted what is now section 2031 at 38 

U.S.C. 1711. Veterans Health Programs 

Improvement Act of 1997, Public Law 

105–114, Title II, § 202(a). This section 

was amended and renumbered without 

substantive change into current section 

2031. Homeless Veterans 

Comprehensive Assistance Act of 2001, 

Public Law 107–95, § 5(b)(2). A separate 

House bill which preceded Public Law 

105–114 contained language that is for 

all relevant purposes identical to 

current section 2031. H.R. 2206 § 2(a), 

105th Cong. (1997). 

The deliberations surrounding this 

prior bill clearly illuminate 

Congressional understanding of the 

language now found in section 2031. H. 

Rep. No. 105–293 (1997). Congress 

found there to be substantial ‘‘overlap 

and redundancy’’ among many prior VA 

statutory authorities ‘‘targeted primarily 

to providing psychiatric residential 

treatment to homeless, mentally ill 

veterans.’’ Id. at 10 (emphasis added). 

Congress therefore undertook to 

consolidate the authorities for three 

programs, including the contract 

halfway-house care program for veterans 

suffering from alcohol and drug 

dependence, the community-based 

residential care program for homeless 

chronically mentally ill veterans, and a 

program providing transitional 

therapeutic housing, into one statute. Id. 

at 12. Congress plainly intended current 

section 2031 to authorize psychiatric 

residential treatment to homeless 

veterans who are also mentally ill; all 

three authorities combined into current 

section 2031 dealt with treatment for 

veterans suffering from some kind of 

mental illness or otherwise requiring 

therapeutic residential treatment. 

Furthermore, the legislative history 

presented in support of the comment is 

not persuasive. The commenter argues 

that Congress intended to reach veterans 

who are homeless without regard to 

their having a serious mental illness 

based on an interpretation of a prior 

version of the statute using definitions 

from 24 CFR 91.5, which are regulations 

promulgated by the Department of 

Housing and Urban Development 

(HUD), which is not charged with 

interpreting VA statutes. Thus, HUD’s 

definitions are simply inapplicable. 

Additionally, the commenter’s 

argument, even taken at face value, 

would at most affect the proper 

understanding of the term ‘‘homeless’’ 

and would not on its own dictate the 

proper interpretation of section 2031. 

The commenter notes that former 38 

U.S.C. 2001 indicates that 38 U.S.C. 

chapter 20 used to address ‘‘chronic 

homelessness,’’ which required as a 

criterion serious mental illness or some 

other kind of disability. The commenter 

argues this has been replaced with the 

more general term, ‘‘homeless.’’ Even if 

true, this analysis would only affect the 

proper understanding of the term 

‘‘homeless,’’ implying that term does 

not necessarily include serious mental 

illness. However, under our 

interpretation of section 2031, serious 

mental illness is a freestanding 

criterion. Since serious mental illness is 

a separate requirement in the statute, we 

do not believe the commenter’s 

argument affects our construction of the 

proper scope of this program. Our 

interpretation is reasonable because 

Congress could not have intended that 

homelessness alone indicates a severe 

mental illness requiring the kind of care 

authorized by sections 2031 and 1710. 

As the commenter points out, up to 20 

percent of homeless veterans are 

homeless for reasons other than mental 

illness. This fact is irreconcilable with 

the idea that ‘‘homeless’’ is a subset, or 

type of, serious mental illness, which is 

the construction urged by the 

commenter. As for the comment that our 

rule would make homelessness 

surplusage, we must, again disagree. 

Pursuant to § 63.3(a)(1), eligibility is 

predicated on the veteran being 

homeless, and under § 63.10(a), 

contracts are authorized only to non-VA 

community-based providers who 

provide temporary residential assistance 

for homeless persons. 

Finally, we note that the program as 

implemented by VA and described in 

this rule will reach most homeless 

veterans, up to 80 percent. As stated in 

the proposed rule, chronic 

homelessness is generally caused by 

substance abuse or serious mental 

illness. Congress determined for 

purposes of this program that VA 

should allocate some of its mental 

health care resources to target 

homelessness caused by serious mental 

illness. As described above, we do not 

interpret current law as authorizing VA 

to focus mental health care resources on 

those who are not mentally ill. 

Additionally, Congress has determined 

that veterans who are homeless for other 

reasons will qualify for other VA 

programs and services. See, e.g., 38 

U.S.C. 2021–23, 2041–44. This 

reinforces our view that section 2031 is 

intended to reach seriously mentally ill 

homeless veterans because this 

population is not specifically identified 

elsewhere in 38 U.S.C. chapter 20. 

The commenter also hypothesizes that 

the additional expenditure of resources 

that would be required by the 

commenter’s interpretation of the law, 

expanding the program to cover 

homelessness regardless of mental 

illness, would be offset by savings in 

clinician time. The commenter argues 

that clinicians would not need to make 

any determination regarding mental 


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illness if the program covered every 

homeless veteran. As we explain above, 

we do not interpret section 2031 to 

authorize VA to allocate its limited 

mental health care resources to veterans 

who are not mentally ill. Therefore, the 

question of whether or not the reduction 

in ‘‘billable time’’ realized by not 

determining whether a veteran is 

seriously mentally ill adds up to more 

or less than the cost of paying per diem 

on behalf of that veteran for up to 6 

months is not relevant. 

The commenters also cited the 

numbers of homeless veterans who are 

not eligible for the HCHV program. We 

make no change based on the 

commenter’s request that we amend the 

rules ‘‘to include a specific reference to 

programs’’ that address homeless 

veterans who are not seriously mentally 

ill. We have identified several such 

programs in this notice, but it would be 

unwise to include a definitive statement 

in the rule since VA’s list of programs 

targeted at this difficult problem is 

constantly evolving, and it would be a 

needless waste of resources to have to 

amend and update 38 CFR part 63 every 

time VA altered or added an unrelated 

program. Further, the purpose of this 

rulemaking is to prescribe rules that 

govern a specific program. It is not 

intended as a general notice regarding 

the various benefits and services that 

may be available to homeless veterans. 

VA uses outreach and other methods to 

advise veterans regarding the benefits 

that may be available to them. 

Although we are not making any 

changes to the rule based on the 

comments, we do make one minor 

administrative change. We are inserting 

a comma after the word ‘‘training’’ in 

the first sentence of § 63.15(b)(1). This 

fixes a typographical error of omission 

in the proposed rule. We are not altering 

the substantive content of the paragraph 

by making this change. 

VA appreciates the comments 

submitted in response to the proposed 

rule. Based on the rationale stated in the 

proposed rule and in this document, the 

proposed rule is adopted with the 

technical change noted above. 

Paperwork Reduction Act 

This final rule at § 63.15(e)(3) 

contains a new collection of information 

under the Paperwork Reduction Act of 

1995 (44 U.S.C. 3501–3521) that 

requires approval by the Office of 

Management and Budget (OMB). On 

December 20, 2010, in the proposed rule 

published in the Federal Register, we 

requested public comment on the new 

collection of information. We received 

no comments concerning the new 

collection of information. OMB has 

approved the information collection 

requirement for § 63.15(e)(3) as a 

revision to OMB Control Number 2900– 

0091. 

Regulatory Flexibility Act 

The Secretary hereby certifies that 

this final rule will not have a significant 

economic impact on a substantial 

number of small entities as they are 

defined in the Regulatory Flexibility 

Act, 5 U.S.C. 601–612. The reason for 

this certification is that only a small 

portion of the business of health care 

providers, suppliers, or similar entities 

concerns VA beneficiaries. Therefore, 

pursuant to 5 U.S.C. 605(b), this final 

rule is exempt from the initial and final 

regulatory flexibility analysis 

requirements of sections 603 and 604. 

Executive Order 12866 

Executive Order 12866 directs 

agencies to assess all costs and benefits 

of available regulatory alternatives and, 

when regulation is necessary, to select 

regulatory approaches that maximize 

net benefits (including potential 

economic, environmental, public health 

and safety, and other advantages; 

distributive impacts; and equity). The 

Executive Order classifies a ‘‘significant 

regulatory action,’’ requiring review by 

OMB unless OMB waives such a review, 

as any regulatory action that is likely to 

result in a rule that may: (1) Have an 

annual effect on the economy of $100 

million or more, or adversely affect in 

a material way the economy, a sector of 

the economy, productivity, competition, 

jobs, the environment, public health or 

safety, or State, local, or tribal 

governments or communities; (2) create 

a serious inconsistency or otherwise 

interfere with an action planned or 

taken by another agency; (3) materially 

alter the budgetary impact of 

entitlements, grants, user fees or loan 

programs or the rights and obligations of 

recipients thereof; or (4) raise novel 

legal or policy issues arising out of legal 

mandates, the President’s priorities, or 

the principles set forth in the Executive 

Order. 

The economic, interagency, 

budgetary, legal, and policy 

implications of this regulatory action 

have been examined and it has been 

determined not to be a significant 

regulatory action under Executive Order 

12866. 

Unfunded Mandates 

The Unfunded Mandates Reform Act 

of 1995 requires, at 2 U.S.C. 1532, that 

agencies prepare an assessment of 

anticipated costs and benefits before 

issuing any rule that may result in the 

expenditure by State, local, and Tribal 

governments, in the aggregate, or by the 

private sector, of $100 million or more 

(adjusted annually for inflation) in any 

given year. This final rule would have 

no such effect on State, local, and Tribal 

governments, or on the private sector. 

Catalog of Federal Domestic Assistance 

Program 

The Catalog of Federal Domestic 

Assistance numbers and titles for the 

programs affected by this document are: 

64.007, Blind Rehabilitation Centers; 

64.009, Veterans Medical Care Benefits; 

64.019, Veterans Rehabilitation Alcohol 

and Drug Dependence. 

Signing Authority 

The Secretary of Veterans Affairs, or 

designee, approved this document and 

authorized the undersigned to sign and 

submit the document to the Office of the 

Federal Register for publication 

electronically as an official document of 

the Department of Veterans Affairs. John 

R. Gingrich, Chief of Staff, Department 

of Veterans Affairs, approved this 

document on July 27, 2011, for 

publication. 

List of Subjects in 38 CFR Part 63 

Administrative practice and 

procedure, Day care, Disability benefits, 

Government contracts, Health care, 

Homeless, Housing, Individuals with 

disabilities, Low and moderate income 

housing, Public assistance programs, 

Public housing, Relocation assistance, 

Reporting and recordkeeping 

requirements, Veterans. 

Dated: August 17, 2011. 

Robert C. McFetridge, 

Director of Regulation Policy and 

Management, Office of the General Counsel, 

Department of Veterans Affairs. 

For the reasons stated in the 

preamble, VA amends 38 CFR chapter I 

by adding part 63 to read as follows: 

PART 63—HEALTH CARE FOR 

HOMELESS VETERANS (HCHV) 

PROGRAM 

Sec. 

63.1 Purpose and scope. 

63.2 Definitions. 

63.3 Eligible veterans. 

63.10 Selection of non-VA communitybased providers. 

63.15 Duties of, and standards applicable 

to, non-VA community-based providers. 

Authority: 38 U.S.C. 501, 2031, and as 

noted in specific sections. 

§ 63.1 Purpose and scope. 

This part implements the Health Care 

for Homeless Veterans (HCHV) program. 

This program provides per diem 

payments to non-VA community-based 

facilities that provide housing, as well 


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as care, treatment and/or rehabilitative 

services, to homeless veterans who are 

seriously mentally ill or have a 

substance use disorder. 

(Authority: 38 U.S.C. 501, 2031(a)(2)) 

§ 63.2 Definitions. 

For the purposes of this part: 

Clinician means a physician, 

physician assistant, nurse practitioner, 

psychiatrist, psychologist, or other 

independent licensed practitioner. 

Homeless has the meaning given that 

term in section 103 of the McKinneyVento Homeless Assistance Act (42 

U.S.C. 11302(a)). 

Non-VA community-based provider 

means a facility in a community that 

provides temporary, short-term housing 

(generally up to 6 months) for the 

homeless, as well as services such as 

rehabilitation services, community 

outreach, and basic mental-health 

services. 

Participant means an eligible veteran 

under § 63.3 for whom VA is paying per 

diem to a non-VA community-based 

provider. 

Serious mental illness means 

diagnosed mental illness that actually or 

potentially contributes to a veteran’s 

homelessness. 

Substance use disorder means 

alcoholism or addiction to a drug that 

actually or potentially contributes to a 

veteran’s homelessness. 

(Authority: 501, 2002, 2031) 

§ 63.3 Eligible veterans. 

(a) Eligibility. In order to serve as the 

basis for a per diem payment through 

the HCHV program, a veteran served by 

the non-VA community-based provider 

must be: 

(1) Homeless; 

(2) Enrolled in the VA health care 

system, or eligible for VA health care 

under 38 CFR 17.36 or 17.37; and 

(3) Have a serious mental illness and/ 

or substance use disorder, 

(i) That has been diagnosed by a VA 

clinician, 

(ii) Is ‘‘clinically managed’’ as 

determined by a VA clinician (clinical 

management of a condition may be 

achieved through non-medical 

intervention such as participation in a 

12-step program), and 

(iii) Impacts the veteran’s ability for 

self-care and/or management of 

financial affairs as determined by a VA 

caseworker (i.e., a clinician, social 

worker, or addiction specialist). 

(b) Priority veterans. In allocating 

HCHV program resources, VA will give 

priority to veterans, in the following 

order, who: 

(1) Are new to the VA health care 

system as a result of VA outreach 

efforts, and to those referred to VA by 

community agencies that primarily 

serve the homeless population, such as 

shelters, homeless day centers, and soup 

kitchens. 

(2) Have service-connected 

disabilities. 

(3) All other veterans. 

(c) VA will refer a veteran to a nonVA community-based provider after VA 

determines the veteran’s eligibility and 

priority. 

(Authority: 38 U.S.C. 501, 2031) 

§ 63.10 Selection of non-VA communitybased providers. 

(a) Who can apply. VA may award per 

diem contracts to non-VA communitybased providers who provide temporary 

residential assistance for homeless 

persons with serious mental illness, 

and/or substance use disorders, and 

who can provide the specific services 

and meet the standards identified in 

§ 63.15 and elsewhere in this part. 

(b) Awarding contracts. Contracts for 

services authorized under this section 

will be awarded in accordance with 

applicable VA and Federal procurement 

procedures in 48 CFR chapters 1 and 8. 

Such contracts will be awarded only 

after the quality, effectiveness and safety 

of the applicant’s program and facilities 

have been ascertained to VA’s 

satisfaction, and then only to applicants 

determined by VA to meet the 

requirements of this part. 

(c) Per diem rates and duration of 

contract periods. 

(1) Per diem rates are to be negotiated 

as a contract term between VA and the 

non-VA community-based provider; 

however, the negotiated rate must be 

based on local community needs, 

standards, and practices. 

(2) Contracts with non-VA 

community-based providers will 

establish the length of time for which 

VA may pay per diem based on an 

individual veteran; however, VA will 

not authorize the payment of per diem 

for an individual veteran for a period of 

more than 6 months absent 

extraordinary circumstances. 

(Authority: 38 U.S.C. 501, 2031) 

§ 63.15 Duties of, and standards 

applicable to, non-VA community-based 

providers. 

A non-VA community-based provider 

must meet all of the standards and 

provide the appropriate services 

identified in this section, as well as any 

additional requirements set forth in a 

specific contract. 

(a) Facility safety requirements. The 

facility must meet all applicable safety 

requirements set forth in 38 CFR 

17.81(a). 

(b) Treatment plans and therapeutic/ 

rehabilitative services. Individualized 

treatment plans are to be developed 

through a joint effort of the veteran, 

non-VA community-based provider staff 

and VA clinical staff. Therapeutic and 

rehabilitative services must be provided 

by the non-VA community-based 

provider as described in the treatment 

plan. In some cases, VA may 

complement the non-VA communitybased provider’s program with added 

treatment services such as participation 

in VA outpatient programs. Services 

provided by the non-VA communitybased provider generally should 

include, as appropriate: 

(1) Structured group activities such as 

group therapy, social skills training, 

self-help group meetings or peer 

counseling. 

(2) Professional counseling, including 

counseling on self care skills, adaptive 

coping skills and, as appropriate, 

vocational rehabilitation counseling, in 

collaboration with VA programs and 

community resources. 

(c) Quality of life, room and board. 

(1) The non-VA community-based 

provider must provide residential room 

and board in an environment that 

promotes a lifestyle free of substance 

abuse. 

(2) The environment must be 

conducive to social interaction, 

supportive of recovery models and the 

fullest development of the resident’s 

rehabilitative potential. 

(3) Residents must be assisted in 

maintaining an acceptable level of 

personal hygiene and grooming. 

(4) Residential programs must provide 

laundry facilities. 

(5) VA will give preference to 

facilities located close to public 

transportation and/or areas that provide 

employment. 

(6) The program must promote 

community interaction, as demonstrated 

by the nature of scheduled activities or 

by information about resident 

involvement with community activities, 

volunteers, and local consumer services. 

(7) Adequate meals must be provided 

in a setting that encourages social 

interaction; nutritious snacks between 

meals and before bedtime must be 

available. 

(d) Staffing. The non-VA communitybased provider must employ sufficient 

professional staff and other personnel to 

carry out the policies and procedures of 

the program. There will be at a 

minimum, an employee on duty on the 

premises, or residing at the program and 

available for emergencies, 24 hours a 

day, 7 days a week. Staff interaction 

with residents should convey an 

attitude of genuine concern and caring. 


rmajette on DSK89S0YB1PROD with RULES
52580 Federal Register / Vol. 76, No. 163 / Tuesday, August 23, 2011 / Rules and Regulations 

(e) Inspections. (1) VA must be 

permitted to conduct an initial 

inspection prior to the award of the 

contract and follow-up inspections of 

the non-VA community-based 

provider’s facility and records. At 

inspections, the non-VA communitybased provider must make available the 

documentation described in paragraph 

(e)(3) of this section. 

(2) If problems are identified as a 

result of an inspection, VA will 

establish a plan of correction and 

schedule a follow-up inspection to 

ensure that the problems are corrected. 

Contracts will not be awarded or 

renewed until noted deficiencies have 

been eliminated to the satisfaction of the 

inspector. 

(3) Non-VA community-based 

providers must keep sufficient 

documentation to support a finding that 

they comply with this section, including 

accurate records of participants’ lengths 

of stay, and these records must be made 

available at all VA inspections. 

(4) Inspections under this section may 

be conducted without prior notice. 

(f) Rights of veteran participants. The 

non-VA community-based provider 

must comply with all applicable 

patients’ rights provisions set forth in 38 

CFR 17.33. 

(g) Services and supplies. VA per 

diem payments under this part will 

include the services specified in the 

contract and any other services or 

supplies normally provided without 

extra charge to other participants in the 

non-VA community-based provider’s 

program. 

(Authority: 38 U.S.C. 501, 2031) 

(The Office of Management and Budget has 

approved the information collection 

requirement in this section under control 

number 2900–0091.) 

[FR Doc. 2011–21407 Filed 8–22–11; 8:45 am] 

BILLING CODE 8320–01–P 

POSTAL SERVICE 

39 CFR Part 912 

Procedures To Adjudicate Claims for 

Personal Injury or Property Damage 

Arising Out of the Operation of the U.S. 

Postal Service 

AGENCY: Postal Service. 

ACTION: Final rule. 

SUMMARY: This rule amends the Postal 

Service’s regulations concerning tort 

claims to update the mailing address of 

the National Tort Center. 

DATES: Effective Date: August 23, 2011. 

ADDRESSES: Written communications 

should be directed to: General Law 

Service Center, USPS National Tort 

Center, 1720 Market Street, Room 2400, 

St. Louis, MO 63155–9948. 

FOR FURTHER INFORMATION CONTACT: 

Ruth A. Przybeck, Chief Counsel, Torts, 

(314) 345–5820. 

SUPPLEMENTARY INFORMATION: 

Amendment of 39 CFR part 912 is 

necessary to update the mailing address 

of the National Tort Center. This rule is 

a change in agency rules of procedure 

that does not substantially affect any 

rights or obligations of private parties. 

Therefore, it is appropriate for its 

adoption by the Postal Service to 

become effective immediately. 

List of Subjects in 39 CFR Part 912 

Administrative practice and 

procedure; Claims. 

For the reasons set forth above, the 

Postal Service amends 39 CFR Part 912 

as follows: 

PART 912—[AMENDED] 

■ 1. The authority citation for 39 CFR 

part 912 continues to read as follows: 

Authority: 28 U.S.C. 2671–2680; 28 CFR 

14.1 through 14.11; 39 U.S.C. 409. 

■ 2. In § 912.4, remove the address 

‘‘Chief Counsel, National Tort Center, 

U.S. Postal Service, P.O. Box 66640, St. 

Louis, MO 63141–0640’’ and add ‘‘Chief 

Counsel, Torts, General Law Service 

Center, USPS National Tort Center, 1720 

Market Street, Room 2400, St. Louis, 

MO 63155–9948’’ in its place. 

■ 3. Amend § 912.9 as follows: 

■ a. In paragraph (b), remove the 

address ‘‘Chief Counsel, National Tort 

Center, U.S. Postal Service, P.O. Box 

66640, St. Louis, MO 63141–0640’’ and 

add ‘‘Chief Counsel, Torts, General Law 

Service Center, USPS National Tort 

Center, 1720 Market Street, Room 2400, 

St. Louis, MO 63155–9948’’ in its place. 

■ b. In paragraph (c), remove the 

address ‘‘Chief Counsel, National Tort 

Center, U.S. Postal Service, P.O. Box 

66640, St. Louis, MO 63141–0640’’ and 

add ‘‘Chief Counsel, Torts, General Law 

Service Center, USPS National Tort 

Center, 1720 Market Street, Room 2400, 

St. Louis, MO 63155–9948’’ in its place. 

Stanley F. Mires, 

Chief Counsel, Legislative. 

[FR Doc. 2011–21444 Filed 8–22–11; 8:45 am] 

BILLING CODE 7710–12–P 


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