Environmental accessibility adaptations (EAA) – home and vehicle modifications
Page posted: 10/1/03 | Page reviewed: 1/23/23 | Page updated: 3/18/26 | |
Legal authority | Federally approved BI, CAC, CADI, DD and EW waiver plans, federally approved AC 1115 demonstration | ||
Definition | Environmental accessibility adaptations (EAA): Physical adaptations to a person’s primary home or primary vehicle to ensure the person’s health and safety or enable them to function with greater independence. | ||
Eligibility | A person is eligible to receive EAA if the home or vehicle modification is: | ||
Covered services | EAA includes assessments and installations of home and vehicle modifications. Refer to the specific sections on this page for services covered under each part: | ||
Non-covered services | Refer to the specific sections on this page for services not covered under each part: | ||
Service limits | Alternative Care (AC) and Elderly Waiver (EW)Under AC and EW, a person may receive up to the current service limit on Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF) of EAA per waiver year. For EAA, a waiver year is calculated based on a 365-day period, which is determined by counting back from the service agreement header end-date. The year may include previous service agreements if the 365 days crosses previous service agreements. Once the person reaches the service limit, additional spending must wait until the next waiver year. This includes combined costs for all of the following: The amount authorized for EAA and all other AC/EW services must fit within the person’s case mix budget cap. Annual service limit increasesEach Jan. 1, the AC and EW EAA service limit increases based on the “all items index” within the Bureau of Labor Statistics Consumer Price Index. For more information and the current service limit rate for each year, refer to Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF). ExceptionsThere are no exceptions to the AC and EW EAA service limit. Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI) and Developmental Disabilities (DD) waiversUnder BI, CAC, CADI and DD, a person may receive up to $40,000 of EAA per year, based on the service agreement header end-date. This includes combined costs for all of the following: For this purpose, a year is calculated based on a 365-day period, which is determined by counting back from the service agreement header end-date. It may include previous service agreements if the 365 days crosses previous service agreements. Once the person reaches the service limit, additional spending must wait until the next year, or the lead agency may request an exception. Exception to exceed annual limitThe lead agency may request an exception from DHS to exceed the annual limit for a person on BI, CAC, CADI or DD. 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. If DHS approves the exception, the person may receive a maximum of $80,000 of EAA during a two-year period. The person cannot have any additional exceptions beyond $80,000 within the two-year period. Criteria DHS may approve an exception when the following criteria are met: Functional use of the home Increasing functional use of the home means modifying the person’s home to allow access to and use of common areas typically used by the person or other members of the household. Examples may include, but are not limited to: Increased community access Increased community access means the modifications allow the person to leave home to participate in the community. Examples may include, but are not limited to: Process The lead agency must: Exception for additional square footageThe $40,000 service limit does not apply to approved additional square footage projects. For information about service limits for additional square footage projects, refer to CBSM – EAA additional square footage. | ||
Authorization, rates and billing | EAA services are market rate services. For more information, refer to CBSM – Market rate services (BI, CAC, CADI, DD), CBSM – Rate methodologies for AC, ECS and EW service authorization and Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF). Discharging from an institutionThe lead agency may give approval for a provider to begin a modification before the person discharges from an institution if both of the following are true: The lead agency authorizes EAA services in MMIS after the person enrolls in a waiver/AC. Unforeseen circumstancesIf the person does not enroll in a waiver/AC for an unforeseen reason (i.e., death or a significant change in condition) and meets certain criteria, the lead agency may request reimbursement for expense(s) it incurred in anticipation of the person enrolling. For more information, refer to CBSM – Waiver/AC reimbursement for unforeseen circumstances. Unexpected exits (AC and EW only)If the person unexpectedly exits AC or EW prematurely (i.e., due to death, a move to a nursing facility or a move to an institution) after the completion of an EAA home modification, the provider will receive payment for the full cost of work completed, up to the amount authorized by the lead agency. For more information, refer to CBSM – AC and EW budgets and case mix caps – Case mix budget exceptions. | ||
Additional resources | CBSM – Assistive technology | ||
EAA home modifications
Covered services | AssessmentThis part of the EAA service covers the assessment to: For information about when to authorize an EAA home modification assessment, refer to CBSM – Guide to home modifications under EAA. InstallationThis part of the EAA service covers installation, purchase, maintenance, repairs of modifications, labor, portable or permanent equipment, materials, devices and systems that are fundamental to the home modification project. This includes, but is not limited to: For additional guidance, refer to CBSM – Guide to home modifications under EAA and DHS – EAA frequently asked questions. |
Non-covered services | EAA does not cover home modifications that: 1. Add to the total square footage of the home (refer to CBSM – EAA additional square footage for an accessible bathroom exception). 2. Are for comfort or convenience. 3. Are not for the person’s direct and specific benefit. 4. Are the homeowner’s responsibility (e.g., maintenance, repair, building code compliance). 5. For AC and EW only, are provided in settings that are owned or leased by of waiver service providers, which may include: Examples of non-covered services include, but are not limited to: |
Additional square footage | The lead agency may use EAA to increase the square footage of an existing home only when the increase is necessary to build or modify a wheelchair- or scooter-accessible bathroom. The lead agency must receive DHS approval to do so. For more information, refer to CBSM – EAA additional square footage. |
Secondary information | Services under all waiver/AC programs must meet the requirements listed in the services section of CBSM – Waiver and Alternative Care programs overview. Primary homeThe modification can be made only to the person’s primary home in Minnesota. This limit does not prevent future modifications. For example, if the person moves, the person’s new home can be modified. Examples of a primary homeExamples of a primary home include: A vacation home is not considered a primary home. Exception to primary home requirementThe lead agency may authorize a modification to a home that is not the person’s primary home when the modification meets all of the following requirements: The lead agency must document in the person’s support plan that the modification meets these requirements. New construction/unfinished roomsFor new construction or unfinished rooms in existing homes, EAA only covers the additional costs directly related to the person’s assessed needs. It does not cover the typical costs related to building or finishing a room. This policy includes creating an accessible bathroom or any other type of room to meet a person’s assessed need in an existing, unfinished area within the home. UpgradesEAA covers the most cost-effective modification that meets the person’s assessed needs. The person may choose upgrades as long as the item continues to meet their needs (e.g., upgrade from linoleum to marble tiles). The person must pay out of pocket for any difference and additional labor costs associated with the upgraded materials. Costs for materials and installation related to upgrades must be in a separate, private pay agreement between the person and the provider. RepairsEAA covers repairs to EAA modifications and equipment only when they are cost-effective given the condition of the item and compared to replacement of the item. Standalone equipmentThe lead agency authorizes standalone equipment (e.g., shower chair, portable ramp used exclusively in the community) that is not part of a larger home modification project differently, depending on the program: |
Provider standards and qualifications | Assessments for home modifications are DHS-enrollment required services. Installations of home modifications are approval-option: direct-delivery services. For more information about enrollment requirements, refer to CBSM – Waiver/AC service provider overview. AssessmentsTo perform an assessment for home modifications, the individual or provider agency must have at least one year of experience with home modification assessments and be one of the following: InstallationsTo install a home modification, the individual or provider agency 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 bar, ramp) is exempt from licensure when the skills they perform meet the definition of “special skill” as defined in Minn. Stat. §326B.802, subd. 15. Conflict of interestAn assessment provider who completes an evaluation of the person’s home cannot bid on the same project unless there are no other installation providers within the person’s region. The lead agency must document in the person’s support plan that there are no other installation providers within the person’s region. |
EAA vehicle modifications
Covered services | AssessmentThis part of the EAA service covers the assessment to determine the person’s vehicle modification needs. InstallationThis part of the EAA service covers labor, equipment, materials, devices and systems for the primary vehicle that are fundamental to the vehicle modification project. Examples include, but are not limited to: EAA covers vehicle modifications, regardless of the age of the vehicle, if the vehicle modification provider determines the vehicle: For additional guidance, refer to DHS – EAA frequently asked questions. |
Non-covered services | EAA does not cover vehicle modifications that are: EAA only covers the cost of the modification, not the cost of the vehicle. |
Secondary information | Services under all waiver/AC programs must meet the requirements listed in the services section of CBSM – Waiver and Alternative Care programs overview. Primary vehicleThe modification can be made only to the person’s primary vehicle. This limit does not prevent future modifications. For example, if the person replaces a primary vehicle, the replacement vehicle can be modified. Examples of a primary vehicleA primary vehicle provides the person with their main means of transportation. Examples of a primary vehicle include: Exception to primary vehicle requirementThe lead agency may authorize a modification to a vehicle that is not the person’s primary vehicle when the modification meets all of the following requirements: The lead agency must document in the person’s support plan that the modification meets these requirements. Used vehicle modificationsThe lead agency may use EAA to purchase used vehicle modifications (e.g., used ramp, hand controls/steering) and pay for related assessment(s). This service only covers the cost of the used modification, not the cost of the vehicle. ProcessA qualified vehicle modification assessment professional must evaluate the used modification to determine that it meets the person’s assessed need(s). The used vehicle modification must be purchased from a qualified vehicle modification installation professional. The installation professional must evaluate the used vehicle modification to determine it is: For information about qualifications, refer to the provider standards and qualifications section on this page. UpgradesEAA covers the most cost-effective modification that meets the person’s assessed needs. The person may choose upgrades as long as the item continues to meet their needs (e.g., upgrade from vinyl to leather seats). The person must pay out of pocket for any difference and additional labor costs associated with the upgraded materials. Costs for materials and installation related to upgrades must be in a separate, private pay agreement between the person and the provider. RepairsEAA covers repairs to EAA modifications and equipment only when they are cost-effective given the condition of the item and compared to replacement of the item. Standalone equipmentThe lead agency authorizes standalone equipment that is not part of a larger vehicle modification project differently, depending on the program: |
Provider standards and qualifications | Assessments for vehicle modifications are DHS-enrollment required services. Installations of vehicle modifications are approval-option: direct-delivery services. For more information about enrollment requirements, refer to CBSM – Waiver/AC service provider overview. AssessmentsTo perform an assessment for vehicle modifications, the individual or provider agency 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 and all of the following: InstallationTo install a vehicle modification, the individual or provider agency must: |
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