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Minnesota Department of Human Services Community-Based Services Manual (CBSM)
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Environmental accessibility adaptations

Page posted: 10/1/03

Page reviewed: 11/8/17

Page updated: 11/8/17

Legal authority

Federally approved BI, CAC, CADI, DD and EW waiver plans, Alternative Care (AC) program (Minn. Stat. §256B.0913)

Definition

Environmental accessibility adaptations (EAA): Physical adaptations to a person’s primary home or primary vehicle to ensure his/her health and safety or that enable him/her to function with greater independence.

Eligibility

A person is eligible to receive this service if the home or vehicle modification is:

  • • For the person’s direct and specific benefit
  • • Necessary to ensure his/her health and safety or to enable him/her to function with greater independence
  • Necessary to meet his/her assessed needs.
  • Covered services

    EAA includes assessments and installations of home and vehicle modifications. See specific sections for services covered under each part. For additional guidance and clarification (e.g., new construction, used vehicle modifications, etc.), see:

    Home modifications/assessment

    This part of the EAA service covers the assessment to determine a person’s home modification needs.

    Home modifications/installation

    This part of the EAA service covers labor, portable or permanent equipment, materials, devices and systems that are integral to the home modification project. Examples include, but are not limited to:

  • • Modification of bathrooms and kitchens, including grab bars
  • • Ramps
  • • Widening of doorways
  • • Adaptive couches, chairs, tables and beds (DD only)
  • • Adaptive bikes and strollers (DD only)
  • • Alarm/monitoring systems and other requirements of applicable life safety and fire codes (if any)
  • • Floor coverings (e.g., allergy friendly or accessibility flooring)
  • • Specialized electric and plumbing systems (necessary to accommodate medical equipment and supplies)
  • • Modification to meet egress requirements that are not the homeowner’s responsibility and are related to a person’s assessed needs
  • • Monitoring technology (for additional policy on monitoring technology, see CBSM – Monitoring technology usage)
  • • Shatterproof windows.
  • Vehicle modification/assessment

    This covers the assessment to determine a person’s vehicle modification needs.

    Vehicle modification/installation

    This covers labor, equipment, materials, devices and systems that are integral to the vehicle modification project. Examples include, but are not limited to:

  • • Adapted seat devices
  • • Door handle replacements
  • • Door widening
  • • Handrails and grab bars
  • • Lifting devices
  • • Roof extensions
  • • Wheelchair securing devices.
  • Non-covered services

    Environmental accessibility adaptations do not cover modifications that:

  • • Add to the total square footage of the home (for an exception, see the additional square footage section)
  • • Are for comfort or convenience
  • • Are not for the direct and specific benefit of the person
  • • Are the responsibility of the homeowner (e.g., maintenance, repair, building code compliance, etc.).
  • Examples of non-covered services include, but are not limited to:

  • • Carpeting
  • • Central air conditioning
  • • Household appliances
  • • Kitchen/laundry appliances
  • • Roof repair
  • • Swimming pools.
  • Service limits

    The following service limits do not apply when the person receives an approved modification based on additional square footage.

    AC and EW

    Under the AC program and EW, the person may receive up to $20,000 of environmental accessibility adaptations per service-agreement/waiver year.

    BI, CAC, CADI and DD

    Under the BI, CAC, CADI and DD waivers, the person may receive up to $40,000 of environmental accessibility adaptations per service-agreement/waiver year.

    Exception

    The lead agency may request an exception from DHS to exceed the annual limit for a person on the BI, CAC, CADI or DD waiver. Approved exceptions allow the lead agency to authorize an additional $40,000. This additional $40,000 comes from the person’s EAA budget for the following service-agreement year. Given an approved exception, the person may receive a maximum of $80,000 of environmental accessibility adaptations during a two-year period.

    Criteria
    DHS may approve an exception when the following criteria are met:

  • • Modification(s) are cost-effective and necessary during the current service-agreement year for the person to live in the most integrated community setting
  • • Other options have been explored and will not provide the person reasonable access to community integration and functional use of the house.
  • Process
    The lead agency completes Exception request for Environmental Accessibility Adaptations exceeding $40,000 for CAC, CADI, BI and DD Waivers, DHS-5504B (PDF) and submits to DHS via secure fax.

    Additional square footage

    The lead agency may use this service to increase the square footage of an existing home only when the increase is necessary to build or modify a wheelchair accessible bathroom. The lead agency must receive DHS approval to do so. For more information, see CBSM – EAA – Additional square footage.

    Secondary information

    See CBSM – Additional information about EAA for policies about the following:

  • • New construction/unfinished rooms
  • • Primary place of residence/vehicle
  • • Repairs
  • • Stand-alone equipment
  • • Upgrades
  • • Used vehicle modifications.
  • Provider standards and qualifications

    Please note:

  • • Assessments for home and vehicle modifications are DHS-enrollment required services
  • • Installations of home and vehicle modifications are approval-option: direct-delivery services.
  • • Expenses for home and vehicle modifications are approval-option: purchased-item services.
  • For more information on enrollment requirements, see CBSM – Waiver/AC service provider overview.

    Home modifications/assessments

    To perform an assessment for home modifications, the individual or agency provider must have at least one year of experience with home modification assessments and be one of the following:

  • • A certified aging-in-place specialist
  • • A certified accessibility specialist certified through the Minnesota Department of Labor and Industry
  • • An occupational therapist currently registered by the American Occupational Therapy Association to perform assessment/evaluation functions.
  • Home modifications/installations

    To install a home modification, the individual or agency provider must be qualified by professional certification or references to install, repair and/or maintain the home modification. The provider must install the home modification in accordance with applicable state and local building codes.

    A provider who meets the definition of residential building contractor as defined in Minn. Stat. §326B.802 subd. 11 must have a license as a residential building contractor.

    A provider who exclusively does small installation projects (e.g., grab-bars, ramps) is exempt from licensure when the skills he/she performs meet the definition of “special skill” as defined in Minn. Stat. §326B.802, subd.15.

    Vehicle modifications/assessments

    To perform an assessment for vehicle modifications, the individual or agency provider must meet one of the following four sets of requirements:

    1. Be a certified driver rehabilitation specialist
    2. Be an occupational therapist with a specialty certification in driving and community mobility
    3. Have five years of full-time experience in the field of driver rehabilitation
    4. Have a four-year undergraduate degree in a health-related field with all of the following:
    a. One year of full-time experience in the area of his/her study
    b. Continued education in the area of driving mobility and rehabilitation through the Association for Driver Rehabilitation Specialists, Rehabilitation Engineering and Assistive Technology Society, the American Occupational Therapy Association or any programs that have been approved by these entities
    c. Supervision by one of the following:

  • • Certified driver rehabilitation specialist
  • • Occupational therapist with a specialty certification in driving and community mobility
  • • Person with two years of full-time experience in the field of driver rehabilitation.
  • Vehicle modifications/installation

    To install a vehicle modification, the individual or provider agency must:

  • • Follow the Society of Automotive Engineers’ recommended practices
  • • Install equipment according to the manufacturer’s requirements and instructions
  • • Meet state and federal Americans with Disabilities Act (ADA) requirements
  • • Meet 49 C.F.R. §500 to 599 (requirements specific to vehicle modifications are in 49 C.F.R. §595)
  • • Be registered as a “vehicle modifier” with the National Highway Traffic Safety Administration.
  • Authorization, rates and billing

    Environmental accessibility adaptations are market-rate services. For more information, see Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF).

    Environmental accessibility adaptations may be authorized and provided before a person’s discharge from an institution if:

  • • The person: is expected to be discharged and enrolled on the waiver
  • • The service is necessary for the person to return to the community.
  • The lead agency only may bill the waiver for service after the person enrolls.

    Unforeseen circumstances

    If the person does not enroll on the waiver for an unforeseen reason (i.e., death or a significant change in condition), the lead agency may request reimbursement for expense(s) it incurred in anticipation of the person enrolling. For more information, see CBSM — Waiver/AC reimbursement for unforeseen circumstances.

    Additional resources

    CBSM – Additional square footage
    CBSM – Guide to home modifications under the environmental accessibility adaptations (EAA) service

    CBSM – Monitoring technology usage

    CBSM – Waiver general process and procedures (BI, CAC, CADI, DD)

    CBSM – Waiver/AC reimbursement for unforeseen circumstances

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    © 2017 Minnesota Department of Human Services Updated: 11/7/17 10:12 PM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 11/7/17 10:12 PM