- protective awnings over ramps;
- wheelchair accessible showers;
- sink modifications;
- bathtub modifications;
- toilet modifications;
- water faucet controls;
- floor urinal and bidet adaptations;
- plumbing modifications and additions to existing structures necessary for accessibility adaptations;
- turnaround space modifications;
- sink modifications;
- sink cut-outs;
- turnaround space modifications;
- water faucet controls;
- plumbing modifications or additions to existing structures necessary for accessibility adaptations;
- worktable, work surface adjustments or additions;
- cabinet adjustments or additions;
- door widening;
- electrical wiring;
- grab bars and handrails;
- automatic door openers, doorbells, door scopes, and adaptive wall switches;
- fire safety adaptations and alarms;
- medically necessary air filtering devices;
- light alarms, doorbells for the hearing and visually impaired;
- floor leveling, only when the installation of a ramp is not possible;
- vinyl flooring or industrial grade carpet necessary to ensure the safety of the member, prevent falling, improve mobility, and adapt a living space occupied by a member who is unable to safely use existing floor surface;
- medically necessary steam cleaning of walls, carpet, support equipment and upholstery;
- widening or enlargement of garage and/or carport to accommodate primary transportation vehicle and to allow persons using wheelchairs to enter and exit their vehicles safely;
- installation of sidewalk for access from non-connected garage and/or driveway to residence, when existing surface condition is a safety hazard for the person with a disability;
- porch or patio leveling, only when the installation of a ramp is not possible;
- safety glass, safety alarms, security door locks, fire safety approved window locks, and security window screens; for example, for persons with severe behavioral problems;
- security fencing for residence, for those persons with cognitive impairment or persons whose safety would be compromised if they wandered;
- protective padding and corner guards for walls for members with impaired vision and mobility;
- recessed lighting with mesh covering and metal dome light covers to compensate for violent aggressive behavior; for example, for persons with autism or mental illness;
- noise abatement renovations to provide increased sound proofing; for example, for persons with autism or mental illness;
- door replacement for accessibility only;
- motion sensory lighting;
- intercom systems for individuals with impaired mobility; and
- lever door handles.
Ramps may be installed for improved mobility for use with scooters, walkers, canes, etc., or for members with impaired ambulation, as well as for wheelchair mobility. In some instances and according to supporting documentation, multiple modifications may be needed for accessibility and mobility, such as ramps and hand rails for members with impaired ambulation. There is no limit to the number of wheelchair ramps that can be authorized, provided the total cost does not exceed the cost limit. Documentation must support the justification for additional ramps as related to medical need or health and safety of the member.
Carbon monoxide detectors cannot be purchased under STAR+PLUS Home and Community Based Services (HCBS) program as a "fire safety adaptation and alarm."
Requests for items (or repair of items) or service calls that are considered routine home maintenance and upkeep cannot be approved.
Items that cannot be approved by the managed care organization (MCO) service coordinator include:
- carpeting (other than industrial grade);
- newly constructed carports, porches, patios, garages, porticos or decks;
- electric fences;
- landscaping and yard work or supplies;
- roof repair or replacement;
- gutters;
- leaky faucet repair;
- elevators;
- house painting;
- electrical upgrades and/or electrical outlets, unless needed to power adapted equipment or a safety hazard exists;
- air duct cleaning and maintenance; and
- pest exterminations.
Heating and cooling equipment may be approved as an adaptive aid. Installation of approved heating and cooling equipment is included in the cost of the adaptive aid. Support platforms are frequently used to provide support for cooling equipment installed in home windows. The support platforms attach in a clamp-like manner without fasteners. The cost and installation of support platforms are considered as an adaptive aid. The installation of heating and cooling equipment may require modification of the home (for example, additional wiring or widening of the windows). The modification of the home must be authorized as an MHM.
Flooring applications, including vinyl and industrial carpet, may not be authorized for adaptations or improvements to the home that are of general utility and are not of direct medical or remedial benefit to the member.
8630 Minor Home Modification Service Cost Lifetime Limit
Revision 21-2; Effective March 10, 2021
There is a cost lifetime limit of $7,500 per member for this service and $300 yearly for repairs. Once the $7,500 cost limit is reached, only $300 per year per member, excluding associated fees, will be allowed for repairs, replacement or additional modifications. The managed care organization (MCO) is responsible for obtaining cost effective modifications authorized on the member's individual service plan (ISP). The MCO may exceed the $7,500 cost limit; however, the MCO must not include costs over the lifetime limit on any cost reports, claims, encounters or financial statistical reports (FSRs).
If a member changes MCOs, the losing MCO must provide documentation to the gaining MCO related to any minor home modification (MHM) expenditures. Refer to Uniform Managed Care Contract (UMCC) Terms and Conditions, Section 5.06, Span of Coverage, for payment responsibilities.
8640 Landlord Approval for Minor Home Modifications
Revision 21-2; Effective March 10, 2021
When the member has a landlord or when the owner of the home is not the member, written approval prior to the initiation of any requested minor home modification (MHM) must be obtained by the managed care organization (MCO).
