Needing assistance is defined as the Veteran can complete up to 25% of an ADL task on his or her own. The Veteran must be enrolled in the VAMC Health Care System and receive his or her primary care at the Jamaica Plain or West Roxbury VA facility. The Veteran must have a primary care team, meet the eligibility criteria for home and community-based services as determined by the VA, and receive a referral from the VA Medical Center. Although the Veteran directs his or her in-home and community-based services, the VAMC determines the monthly Spending Plan amount and must approve the Spending Plan before implementation.  The Veteran recruits, hires, trains, supervises, and discharges his or her workers and arranges other approved goods and services that are part of the approved Spending Plan.

Veterans Directed HCBS program is open to all US Veterans enrolled in the VA health care system that require a nursing home level of care. These programs are at various stages of development in different states and often participation requirements change as a program matures. It is recommended that the applicant check with their local Area Agency on Aging to determine final eligibility.