CBSM - Guide to home modifications under the environmental accessibility adaptations (EAA) service (2024)

Page reviewed: 4/24/24

This resource applies to people who use the following programs:

·Alternative Care (AC).

·Brain Injury (BI) Waiver.

·Community Access for Disability Inclusion (CADI) Waiver.

·Community Alternative Care (CAC) Waiver.

·Developmental Disabilities (DD) Waiver.

·Elderly Waiver (EW).

Overview

Home modification assessment and installation are covered services under the EAA waiver service. For complete policy information, refer to CBSM – EAA.

Lead agencies can use this guide during the home modification assessment, authorization and installation process to help people they support who have accessibility modification needs in their primary residence. Lead agencies also can take the TrainLink – EAA Home Modification Training.

This guide is not suitable for all home modification projects, including small projects (e.g., grab bars) or projects that include additional square footage (refer to CBSM – EAA additional square footage).

How to discuss the process with the person and others

At the beginning of and throughout the home modification process, the lead agency should discuss the assessment, authorization and installation process with:

·The person receiving services.

·Providers (e.g., home assessment provider, contractor).

·Others as appropriate (e.g., family, landlord, home owner).

This discussion should include:

·The person's eligibility and need for a modification.

·The lead agency's responsibility to review and authorize all home modification projects before any work can be performed (i.e., prior authorization).

·The requirements and role of an assessment.

·How to select a provider (e.g., do research, get more than one bid).

·Roles of the person, home owner, lead agency and contractor.

·How to document the landlord's agreement to complete the project, if applicable.

·How long it may take to complete the project.

·The impact on the person during construction.

·What to do if the person has concerns about the quality of work during the project.

The lead agency can reference EAA Home Modification Training – What to expect checklist (PDF) during the discussion with the person.

When to authorize an EAA home modification assessment

If the lead agency determines the project is complex, an EAA assessment professional (e.g., occupational therapist, aging-in-place specialist, accessibility specialist, physical therapist) can help:

·Determine the modification to make the person's home safe and accessible.

·Determine if the modification will meet Americans with Disabilities Act (ADA) requirements (refer to United States Access Board – ADA accessibility guidelines).

·Recommend cost-effective options to meet the person’s accessibility needs.

·Review project bids and assess if they will meet the person’s accessibility needs and project requirements.

The lead agency should consider using the EAA home modification assessment service when they need support in the above areas to determine a person’s home modification needs. For more information about the service, refer to CBSM – EAA.

To learn more about the EAA assessment process, refer to TrainLink – EAA Home Modification Training and EAA Home Modification Training – Pre-assessment inventory (PDF).

How to coordinate, review and accept bid(s)

The assessment professional, person, family or case manager can solicit comparable, itemized bid(s). The lead agency must review the bid(s) to ensure:

·The modification makes the person's home safe and accessible.

·The bid(s) show the cost of materials.

·The bid(s) do not include items that do not meet criteria for approval, are upgrades (refer to upgrades section) or are paid/covered by other sources.

·The bid(s) do not include items that are homeowner responsibilities (e.g., maintenance, repairs, building code compliance).

·The modification is the most cost-effective option to meet the person's accessibility needs (refer to accepting a bid section).

·The providers are qualified to complete the home modification project (e.g., licensed contractors, plumbers, electricians).

The following resources can help during this process:

·EAA Home Modification Training – Bid checklist (PDF)

·EAA Home Modification Training – Pre-construction checklist (PDF)

·Minnesota Department of Labor and Industry (DOLI) – A consumer's guide to hiring a residential building contractor (PDF)

·Minnesota Attorney General – Home building and remodeling (PDF).

Upgrades

EAA 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.

Accepting a bid

The lead agency should accept the bid from a qualified provider that offers the most cost-effective item(s) to meet the person’s assessed needs. The most cost-effective bid is not necessarily the lowest bid. For example, the provider with the lowest bid may have a history of low-quality work or be unable to begin or complete the project promptly.

The lead agency works with the provider to finalize the bid and keeps a copy in the person's record.

Verifying a provider's qualifications

The lead agency must:

·Verify the provider has the credentials and licensing necessary to complete the home modification project.

·Work with a DHS-enrolled provider or lead agency approval-option provider that meets EAA provider standards and qualifications.

If the lead agency works with a vendor who is not enrolled in Minnesota Health Care Programs (MHCP), they must follow instructions on CBSM – Lead agency oversight of waiver/AC approval-option service vendors.

For information about EAA provider standards and qualifications, refer to CBSM – EAA.

How to authorize in MMIS

The lead agency must determine the payment schedule with the provider. The lead agency has the option to authorize the home modification project on multiple line items in MMIS. Doing so may help the lead agency oversee the project’s integrity. For example:

·Line 1: Materials and permits.

·Line 2: Payment to start work or down payment.

·Line 3: Completion and inspection or final payment.

Initially, the lead agency approves line 1 for materials and permits. The lead agency keeps line 2 in pending status until the work begins. The lead agency keeps line 3 in pending status until the provider’s work is completed and verified by a city inspection, assessment professional or the case manager, and the person confirms the project meets their needs.

Note: The time span for multiple MMIS line items cannot overlap.

How to address problems with the provider or project

The lead agency can use the following resources if they have concerns about a provider’s integrity:

·To make a complaint against a contractor’s license, contact Minnesota Department of Labor and Industry, or contact the building official designated by the municipality (e.g., city, county, tribal nation).

·To make a complaint about a provider’s qualifications, contact the MHCP Provider Resource Center.

·To report potential fraud, follow the instructions on DHS – How to submit tips.

·To make a claim against the contractor’s bond or seek help with restoration costs, consult with the county attorney.

·To file a complaint with the Better Business Bureau, refer to Better Business Bureau – File a complaint.

·For project integrity guidelines, refer to Minnesota Attorney General – Home building and remodeling (PDF).

·For guidance during inspection of the completed project, refer to EAA Home Modification Training – Final walkthrough checklist (PDF).

Questions

If you have a general home modification policy question:

1. Take the TrainLink – EAA: Home Modification training, which includes the following resource documents:

·Workflow chart (PDF)

·What to expect checklist (PDF)

·Pre-assessment inventory (PDF)

·Bid checklist (PDF)

·Pre-construction checklist (PDF)

·Final walkthrough checklist (PDF).

2. Review CBSM – EAA.

3. Review DHS – EAA FAQs.

4. Search PolicyQuest to see if DHS has answered a similar question.

If you have a specific question not answered by the resources above, use the DSD Contact Form (for people who receive BI, CAC, CADI or DD waiver services) or email dhs.aasd.hcbs@state.mn.us (for people who receive AC or EW services).

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