a. HISA grants provide for medically necessary improvements and/or structural changes to the veteran's residence for the following purposes:
(1) Allowing entrance to, or exit from, the veteran's residence.
(2) Use of essential lavatory and sanitary facilities.
(3) Allowing accessibility to kitchen or bathroom sinks or counters.
(4) Improving entrance paths or driveways in immediate area of the home to facilitate access to the home by the veteran.
(5) Improving plumbing or electrical systems made necessary due to installation of dialysis equipment in the home.
b. All improvements must adhere to the Minimum Property Requirements (MPRs) as outlined in Department of Veterans Affairs (VA) Pamphlet 26-13, Handbook for Design, and VA Manual M26-12, Chapter 7, Section B. All improvements must meet, or exceed, local building authority requirements.
c. Improvements can include, but are not limited to:
(1) Door Latches. Door latch handles must be easy to operate and grasp.
(2) Entrances. The minimum width of all doors needs to be 3 feet (36 inches). In renovation work where 3 foot openings are impossible, an opening of 2 feet 8 inches (32 inches) is acceptable; however, ingress and egress doorways, h must always be a minimum of 36 inches. A maneuvering area with a minimum length of 4 feet 6 inches (54 inches) must be provided on each side of all doors.
(3) Electrical Outlets and Wall Switches. Wall mounted outlets must be located at a maximum height of 4 feet (48 inches) and a minimum height of 1 foot, 6 inches (18 inches).
(4) Handrails. The primary functions of hand rails are to act as a safety barrier to protect the user from a fall, to aid with balance, or to allow a wheelchair user a means for propulsion. The railing can be of wood or metal that is a minimum 1.5 inches in diameter with a 1.5 - 2 inch clearance from the wall. The railing needs to be smooth, continuous, and uninterrupted in the vertical or horizontal plane. If used with a ramp, handrails must be provided on both sides.
(5) Ramps. Permanent ramping constructed of wood or concrete must be built according to VA Minimum Property Requirements (see subpar. 3b).
(6) Windows. Windows must have a maximum sill height of 2 feet, 9 inches (33 inches). Window controls must be accessible and easy to operate. Controls for windows are to be located at a maximum height of 3 feet, 6 inches (42 inches). Controls for curtains and blinds need to be similarly accessible. NOTE: Window tint or shades can be provided if prescribed and sufficient medical justification substantiates the need to block harmful sunrays from entering the primary living quarters.
(7) Central Air. Central air systems may be provided, when prescribed to an eligible veteran suffering from a spinal cord injury, neurological conditions, and severe respiratory or coronary disease, which are substantially worsened by exposure to heat and humidity, and where the absence of a controlled environment subjects the veteran to health-threatening circumstances. NOTE: Room air conditioners are provided, if necessary, and are charged as a prosthetic item. If the need for a central air conditioning system exists, the medical justification must be sufficient to substantiate cooling an area beyond the primary living quarters (see VHA Handbook 1173.08).
(8) Flooring. New or improved flooring can be provided for veterans when it is necessary for the veteran to navigate the interior of the home in order to access essential sanitary and lavatory facilities, e.g., if a veteran has a manual wheelchair and his home has carpeting that doesn't allow for optimum operation of the wheelchair, the HISA Grant may be used to remove the carpeting and replace it with vinyl or wood flooring or thinner carpet.