The VD HCBS Program serves eligible Veterans of any age that are at risk of nursing home admission, which is defined by the Veterans Administration Medical Center (VAMC) as someone in need of assistance with at least four (4) Activities of Daily Living.  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 prior to 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.