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

Abstract

Inaccessible home environments can negatively affect the health-related quality of life of individuals with disabilities, increase the number of home accidents, diminish activities of daily living, and increase avoidable institutionalization. Appropriate home modification (HM) can change the home environment by making it more accessible. Accessible environments can be approached and used independently by individuals with diverse disabilities. This article provides a general overview of the Home Improvements and Structural Alterations (HISA) program, a Veterans Health Administration (VHA) program within the U.S. Department of Veterans Affairs (VA). Established in 1973, HISA provides HM for Veterans with disabilities, facilitates continued treatment, and promotes access to essential facilities within the home. The program is unique given the decisive role medical practitioners and nonmedical persons play in the process of facilitating accessibility for Veterans with disabilities. However, little is known about the HISA benefits program. This article describes the structure and process of the HISA program, compares the program with other VA HM programs, and discusses potential research needs in VA’s HM applications. This explanation can inform both VA and non-VA health care professionals about the benefits and challenges of an innovative HM program and suggest ways to further advance HM policies.