52572 Federal Register / Vol. 76, No. 163 / Tuesday, August 23, 2011 / Rules and Regulations 

Civil Justice Reform 

This rule meets applicable standards 

in sections 3(a) and 3(b)(2) of Executive 

Order 12988, Civil Justice Reform, to 

minimize litigation, eliminate 

ambiguity, and reduce burden. 

Protection of Children 

We have analyzed this rule under 

Executive Order 13045, Protection of 

Children from Environmental Health 

Risks and Safety Risks. This rule is not 

an economically significant rule and 

does not create an environmental risk to 

health or risk to safety that may 

disproportionately affect children. 

Indian Tribal Governments 

This rule does not have tribal 

implications under Executive Order 

13175, Consultation and Coordination 

with Indian Tribal Governments, 

because it does not have a substantial 

direct effect on one or more Indian 

tribes, on the relationship between the 

Federal Government and Indian tribes, 

or on the distribution of power and 

responsibilities between the Federal 

Government and Indian tribes. 

Energy Effects 

We have analyzed this rule under 

Executive Order 13211, Actions 

Concerning Regulations That 

Significantly Affect Energy Supply, 

Distribution, or Use. We have 

determined that it is not a ‘‘significant 

energy action’’ under that order because 

it is not a ‘‘significant regulatory action’’ 

under Executive Order 12866 and is not 

likely to have a significant adverse effect 

on the supply, distribution, or use of 

energy. The Administrator of the Office 

of Information and Regulatory Affairs 

has not designated it as a significant 

energy action. Therefore, it does not 

require a Statement of Energy Effects 

under Executive Order 13211. 

Technical Standards 

The National Technology Transfer 

and Advancement Act (NTTAA) (15 

U.S.C. 272 note) directs agencies to use 

voluntary consensus standards in their 

regulatory activities unless the agency 

provides Congress, through the Office of 

Management and Budget, with an 

explanation of why using these 

standards would be inconsistent with 

applicable law or otherwise impractical. 

Voluntary consensus standards are 

technical standards (e.g., specifications 

of materials, performance, design, or 

operation; test methods; sampling 

procedures; and related management 

systems practices) that are developed or 

adopted by voluntary consensus 

standards bodies. 

This rule does not use technical 

standards. Therefore, we did not 

consider the use of voluntary consensus 

standards. 

Environment 

We have analyzed this rule under 

Department of Homeland Security 

Management Directive 023–01 and 

Commandant Instruction M16475.lD, 

which guide the Coast Guard in 

complying with the National 

Environmental Policy Act of 1969 

(NEPA) (42 U.S.C. 4321–4370f), and 

have concluded this action is one of a 

category of actions that do not 

individually or cumulatively have a 

significant effect on the human 

environment. This rule is categorically 

excluded, under figure 2–1, paragraph 

(34)(g), of the Instruction. This rule 

involves the establishment of a RNA. An 

environmental analysis checklist and a 

categorical exclusion determination are 

available in the docket where indicated 

under ADDRESSES. 

List of Subjects in 33 CFR Part 165 

Harbors, Marine safety, Navigation 

(water), Reporting and recordkeeping 

requirements, Security measures, 

Waterways. 

For the reasons discussed in the 

preamble, the Coast Guard amends 33 

CFR part 165 as follows: 

PART 165—REGULATED NAVIGATION 

AREAS AND LIMITED ACCESS AREAS 

■ 1. The authority citation for part 165 

continues to read as follows: 

Authority: 33 U.S.C. 1226, 1231; 46 U.S.C. 

Chapter 701, 3306, 3703; 50 U.S.C. 191, 195; 

33 CFR 1.05–1, 6.04–1, 6.04–6, 160.5; Pub. L. 

107–295, 116 Stat. 2064; Department of 

Homeland Security Delegation No. 0170.1. 

■ 2. Add § 165.T01–0727 to read as 

follows: 

§ 165.T01–0727 Regulated Navigation 

Area; Arthur Kill, NY and NJ. 

(a) Regulated Area. The following area 

is a regulated navigation area: all waters 

of the North of Shooters Island Reach, 

Elizabethport Reach, and Gulfport 

Reach in the Arthur Kill; bounded in the 

northeast by a line drawn from position 

40° 38′48.637′′ N, 074° 09′18.204′′ W; to 

a point in position 40°38′37.815′′ N, 

074° 09′20.245′′ W; and bounded in the 

southwest by a line drawn from position 

40° 37′15.643′′ N, 074° 12′15.927′′ W; to 

a point in position 40° 37′15.779′′ N, 

074° 12′08.0622′′ W. All geographic 

coordinates are North American Datum 

of 1983 (NAD 83). 

(b) Regulations. 

(1) The general regulations contained 

in 33 CFR 165.13 apply. 

(2) All vessels must remain at least 

150 feet from all drilling and blasting 

equipment; if a vessel must pass within 

150 feet of drilling and blasting 

equipment for reasons of safety, they 

shall contact the dredge and/or blasting 

barge on Channel 13. 

(3) No vessel shall enter or transit any 

work area where drill barges and/or 

dredges are located without the 

permission of Vessel Traffic Service 

New York (VTSNY) Director. 

(4) No vessel may be underway within 

1,500 feet of the blasting area during 

blasting operations. 

(5) No vessel shall enter an area of 

drilling or blasting when they are 

advised by the drilling barge or VTSNY 

that a misfire or hang fire has occurred. 

(6) Vessel Movement Reporting 

System (VMRS) users are prohibited 

from meeting or overtaking other vessels 

when transiting alongside an active 

work area where dredging and drilling 

equipment are being operated. 

(7) Each vessel transiting in the 

vicinity of a work area where dredges 

are located is required to do so at 

reduced speed to maintain 

maneuverability while minimizing the 

effects of wake and surge. 

(8) The VTSNY Director may impose 

additional requirements through VTS 

measures, as per 33 CFR 161.11. 

(c) Effective Period. This rule is 

effective from 8 a.m. on August 12, 2011 

until 5 p.m. on April 1, 2014. 

Dated: 12 Aug 2011. 

J.B. McPherson, 

Captain, U.S. Coast Guard, Commander, First 

Coast Guard District, Acting. 

[FR Doc. 2011–21460 Filed 8–22–11; 8:45 am] 

BILLING CODE 9110–04–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

38 CFR Parts 3 and 20 

RIN 2900–AO06 

Rules Governing Hearings Before the 

Agency of Original Jurisdiction and the 

Board of Veterans’ Appeals; 

Clarification 

AGENCY: Department of Veterans Affairs. 

ACTION: Final rule. 

SUMMARY: The Department of Veterans 

Affairs (VA) is amending its hearing 

regulations to clarify that the provisions 

regarding hearings before the Agency of 

Original Jurisdiction (AOJ) do not apply 

to hearings before the Board of Veterans’ 

Appeals (Board). 

DATES: Effective Date: This rule is 

effective August 23, 2011. 


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Federal Register / Vol. 76, No. 163 / Tuesday, August 23, 2011 / Rules and Regulations 52573 

FOR FURTHER INFORMATION CONTACT: 

Laura H. Eskenazi, Principal Deputy 

Vice Chairman, Board of Veterans’ 

Appeals (012), Department of Veterans 

Affairs, 810 Vermont Avenue, NW., 

Washington, DC 20420, (202) 461–8078. 

(This is not a toll-free number.) 

SUPPLEMENTARY INFORMATION: This 

document amends 38 CFR parts 3 and 

20 to clarify existing hearing practices 

and procedures before the AOJ and the 

Board. Specifically, VA is amending 

§ 3.103(a) and (c) to clarify that the 

hearing procedures outlined in § 3.103 

apply to hearings held before the AOJ 

and not to hearings held before the 

Board. VA is also amending § 20.706 to 

further clarify that Board Members 

presiding over a hearing on appeal are 

not bound by the hearing procedures in 

§ 3.103(c) and must conduct hearings in 

accordance with part 20, subpart H, 

which contains provisions governing 

Board hearing practice and procedure. 

In Appendix A to part 20, VA is 

removing the cross references to § 3.103. 

VA has determined these clarifying 

changes are necessary because of a 

recent decision by the United States 

Court of Appeals for Veterans Claims 

(Court) in Bryant v. Shinseki, 23 Vet. 

App. 488 (2010), that applied the 

provisions of § 3.103(c)(2) to a Board 

hearing. The Bryant Court held that the 

provisions of § 3.103(c)(2) require a 

‘‘Board hearing officer’’ to ‘‘fully explain 

the issues still outstanding that are 

relevant and material to substantiating 

the claim’’ and to ‘‘suggest that a 

claimant submit evidence on an issue 

material to substantiating the claim 

when the record is missing any 

evidence on that issue or when the 

testimony at the hearing raises an issue 

for which there is no evidence in the 

record.’’ Id. at 496–97. The Court 

concluded with respect to one of the 

service connection claims on appeal 

that the Veteran had been prejudiced 

because the presiding ‘‘Board hearing 

officer’’ had not explained matters 

material to the outcome of the claim and 

had not suggested that the Veteran 

could secure evidence regarding a nexus 

between his current disability and 

service. Id. at 499. The Court found 

prejudice existed because evidence of a 

nexus was not of record at the time of 

the hearing and remained lacking at the 

time of the decision. Id. 

In reaching its conclusions, the Court 

relied in part on its previous holding in 

Douglas v. Derwinski, 2 Vet. App. 435 

(1992), which held that the provisions 

of § 3.103(c) applied to hearings before 

the Board. Bryant, 23 Vet. App. at 494 

(citing Douglas, 2 Vet. App. at 442). At 

the time the Court decided Douglas, the 

Board’s Rules of Practice provided that 

hearings on appeal could be held: ‘‘(a) 

[b]efore a section of the Board of 

Veterans’ Appeals in Washington, DC[;] 

(b) * * * before a traveling section of 

the Board of Veterans’ Appeals during 

regularly scheduled visits to [VA] 

facilities[;] [or] (c) [b]efore appropriate 

personnel in the [VA] regional or other 

office nearest the appellant’s residence, 

acting as a hearing agency for the Board 

of Veterans’ Appeals.’’ 38 CFR 19.160 

(1991). Under the former rules, if an 

appellant chose to have a hearing before 

employees of the AOJ acting as a 

hearing agency for the Board, then he or 

she was not entitled to a subsequent 

hearing before a Board Member. See id.; 

see also Veterans Benefits 

Administration, M21–1 Adjudication 

Procedures Manual, § 18.17g (1991) (‘‘A 

formal hearing on appeal at a regional 

office will be in lieu of such a hearing 

before the [Board], except in the 

unusual case in which a special 

appearance by the claimant before the 

[Board], or the special attention of an 

accredited organization’s headquarters 

in Washington, DC, is requested by the 

appellant.’’). 

Not long after the Court decided 

Douglas, the Board amended its hearing 

regulations to terminate the practice of 

AOJ personnel holding appellate 

hearings on the Board’s behalf. The final 

rulemaking noted that the Board was 

implementing these changes because it 

had decided ‘‘a clear demarcation 

should exist between the conduct of 

hearings by the Board and hearings 

conducted by [Veterans Benefits 

Administration] employees at regional 

offices.’’ 58 FR 27934, 27934 (May 12, 

1993). As a result of this procedural 

modification, an appellant now has the 

opportunity to appear for a hearing with 

the AOJ at any time prior to when his 

or her appeal is certified to the Board. 

38 CFR 3.103(a); Your Rights to Appeal 

Our Decision, VA Form 4107 (Sept. 

2009). The appellant also has a right to 

appear at a separate hearing on appeal 

before a Board Member. 38 CFR 

20.700(a); see VA Form 4107 (stating 

that a hearing before the AOJ is separate 

from any hearing an appellant may later 

request before the Board); see also 

Gambill v. Shinseki, 576 F.3d 1307, 

1315, 1316 (Fed. Cir. 2009) (Bryson, J., 

concurring) (explaining that an 

appellant has a right to appear at 

hearings before the AOJ and the Board). 

The 1993 regulatory changes reflected 

VA’s intent to clearly distinguish 

hearings before AOJs from hearings 

before the Board, including the duties of 

the respective VA personnel conducting 

the hearing. As a result of these changes, 

it has become standard VA practice and 

procedure that hearings before AOJs are 

governed by § 3.103 and hearings before 

the Board are governed by relevant 

provisions in part 20. The Court’s 

holding in Bryant brought to light that 

the pertinent regulations do not clearly 

reflect VA’s intent. Therefore, VA has 

decided to make clarifying changes to 

§§ 3.103 and 20.706 to ensure that the 

distinction between the duties of AOJ 

hearing officers and Board Members 

(also known as Veterans Law Judges 

(VLJs), see § 19.2(b)) is clear on the face 

of the pertinent regulations and will not 

result in further confusion. 

In part 3, VA is revising § 3.103(a) to 

clarify that the provisions governing 

hearings in § 3.103 only apply to 

hearings conducted before the AOJ and 

that the provisions in part 20 govern 

hearings before the Board. VA is also 

removing the following language from 

§ 3.103(c)(1): ‘‘subject to the limitations 

described in § 20.1304 of this chapter 

with respect to hearings in claims which 

have been certified to the Board of 

Veterans Appeals for appellate review.’’ 

This language is not necessary since the 

revision to paragraph (a) clarifies that 

§ 3.103 does not apply to Board 

hearings. VA is also revising paragraph 

(c)(1) to change references to ‘‘original 

determinative authority’’ to ‘‘VA office 

having original jurisdiction’’. This 

language is consistent with other 

portions of § 3.103(c)(1). 

In part 20, VA is amending § 20.706 

to state that the conduct of hearings by 

presiding Board Members or VLJs is 

governed by subpart H of part 20 and 

that Board Members are not bound by 

the hearing provisions of § 3.103(c). In 

Appendix A, VA is removing two cross 

references to § 3.103 listed for §§ 20.1 

and 20.1304 to ensure they do not cause 

any confusion regarding the correct 

applicability of § 3.103. 

Administrative Procedure Act 

This document merely clarifies 

current procedures for obtaining and 

conducting a hearing on a claim for VA 

benefits before the VA agency of original 

jurisdiction or the Board. It does not 

create new procedure, and no 

substantive change is intended. 

Accordingly, this document is being 

published as a final rule pursuant to 5 

U.S.C. 553(b)(A), which excepts 

procedural rules from the APA’s noticeand-comment and delayed effective date 

requirements. 

Paperwork Reduction Act 

This document contains no provisions 

constituting a collection of information 

under the Paperwork Reduction Act (44 

U.S.C. 3501–3521). 


rmajette on DSK89S0YB1PROD with RULES
52574 Federal Register / Vol. 76, No. 163 / Tuesday, August 23, 2011 / Rules and Regulations 

Regulatory Flexibility Act 

The initial and final regulatory 

flexibility analysis requirements of 

sections 603 and 604 of the Regulatory 

Flexibility Act, 5 U.S.C. 601–612, are 

not applicable to this rule because a 

notice of proposed rulemaking is not 

required for this rule. Even so, the 

Secretary of Veterans Affairs 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. This 

rule will affect only individual VA 

beneficiaries and will not directly affect 

small entities. 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—Regulatory 

Planning and Review 

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 

the Office of Management and Budget 

(OMB) unless OMB waives such 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. 

VA has examined the economic, 

interagency, legal, and policy 

implications of this rulemaking and has 

concluded that it is not a significant 

regulatory action under the Executive 

Order. 

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 an 

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 rule would have no 

such effect on State, local, and tribal 

governments, or on the private sector. 

Catalog of Federal Domestic Assistance 

Numbers and Titles 

The Catalog of Federal Domestic 

Assistance program numbers and titles 

for this rule are 64.100, Automobiles 

and Adaptive Equipment for Certain 

Disabled Veterans and Members of the 

Armed Forces; 64.101, Burial Expenses 

Allowance for Veterans; 64.102, 

Compensation for Service-Connected 

Deaths for Veterans’ Dependents; 

64.103, Life Insurance for Veterans; 

64.104, Pension for Non-ServiceConnected Disability for Veterans; 

64.105, Pension to Veterans Surviving 

Spouses, and Children; 64.106, 

Specially Adapted Housing for Disabled 

Veterans; 64.109, Veterans 

Compensation for Service-Connected 

Disability; 64.110, Veterans Dependency 

and Indemnity Compensation for 

Service-Connected Death; 64.114, 

Veterans Housing—Guaranteed and 

Insured Loans; 64.115, Veterans 

Information and Assistance; 64.116, 

Vocational Rehabilitation for Disabled 

Veterans; 64.117, Survivors and 

Dependents Educational Assistance; 

64.118, Veterans Housing—Direct Loans 

for Certain Disabled Veterans; 64.119, 

Veterans Housing—Manufactured Home 

Loans; 64.120, Post-Vietnam Era 

Veterans’ Educational Assistance; 

64.124, All-Volunteer Force Educational 

Assistance; 64.125, Vocational and 

Educational Counseling for 

Servicemembers and Veterans; 64.126, 

Native American Veteran Direct Loan 

Program; 64.127, Monthly Allowance 

for Children of Vietnam Veterans Born 

with Spina Bifida; and 64.128, 

Vocational Training and Rehabilitation 

for Vietnam Veterans’ Children with 

Spina Bifida or Other Covered Birth 

Defects. 

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 August 16, 2011, for 

publication. 

List of Subjects 

38 CFR Part 3 

Administrative practice and 

procedure, Claims, Disability benefits, 

Health care, Pensions, Radioactive 

materials, Veterans, Vietnam. 

38 CFR Part 20 

Administrative practice and 

procedure, Claims, Veterans. 

Dated: August 18, 2011. 

Robert C. McFetridge, 

Director of Regulation Policy and 

Management, Office of the General Counsel, 

Department of Veterans Affairs. 

For the reasons set forth in the 

preamble, VA amends 38 CFR parts 3 

and 20 as follows: 

PART 3—ADJUDICATION 

Subpart A—Pension, Compensation, 

and Dependency and Indemnity 

Compensation 

■ 1. The authority citation for part 3, 

subpart A continues to read as follows: 

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

otherwise noted. 

■ 2. Amend § 3.103 by: 

■ a. Revising the last sentence of 

paragraph (a) and adding a new 

sentence after the last sentence. 

■ b. Revising paragraph (c)(1). 

The revisions read as follows: 

§ 3.103 Procedural due process and 

appellate rights. 

(a) * * * The provisions of this 

section apply to all claims for benefits 

and relief, and decisions thereon, within 

the purview of this part 3, except that 

the provisions of this section governing 

hearings apply only to hearings 

conducted before the VA office having 

original jurisdiction over the claim. 

Hearings before the Board of Veterans’ 

Appeals are governed by part 20 of this 

chapter. 

* * * * * 

(c) * * * (1) Upon request, a claimant 

is entitled to a hearing at any time on 

any issue involved in a claim within the 

purview of part 3 of this chapter. VA 

will provide the place of hearing in the 

VA office having original jurisdiction 

over the claim or at the VA office 

nearest the claimant’s home having 

adjudicative functions, or, subject to 

available resources and solely at the 

option of VA, at any other VA facility 

or federal building at which suitable 

hearing facilities are available. VA will 

provide one or more employees of the 

VA office having original jurisdiction 

over the claim to conduct the hearing 

and to be responsible for establishment 


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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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