1340.00 Home Modification, Adaptive and Household Equipment Policy
Table of Contents
To meet the functional needs of a consumer in the home within the context of an Individualized Plan for Employment, ACCES-VR may provide modest home modifications, and may purchase adaptive equipment and household equipment. For example:
Home Modification - Minor structural changes such as widening doorways and construction of ramps.
Adaptive Equipment - Equipment which may require installation but usually does not result in permanent structural changes, and can be used elsewhere such as stair glides and lifts.
Household Equipment - Equipment for household chores which is specially designed, selected or altered to enable the consumer to perform homemaker duties despite the handicap.
Counselors are responsible for the following in providing home modification, adaptive equipment and household equipment services:
Evaluative services necessary to determine whether a consumer will benefit from ACCES-VR services may be provided during Status 02 or a period of Extended Evaluation (Status 06). Home modification or adaptive and/or household equipment can be provided only to consumers in status 10 or beyond.
Counselors must consider the extent and type of services to be provided within the context of the vocational objective. Independence in self-care and other activities of daily living cannot be considered a vocational goal. Household equipment cannot be provided unless the vocational objective is homemaker or the consumer is to function both as a homemaker and in competitive or sheltered employment.
- Competitive Employment: Home modification and/or adaptive equipment may be provided to a consumer for the primary purpose of obtaining access to the house or apartment, or to make features of the residence more accessible i.e., those home features that are critical to participation in job preparation services or necessary for employment of the consumer.
- Sheltered Employment (Including Homebound Work): The same as for competitive employment.
- Homemaker: Consumers whose vocational objective is homemaker may be provided with household equipment as well as home modification and adaptive equipment.
- Self Employment at Home: Consumers who will operate a business out of their residence may be provided with the necessary home modification and adaptive equipment to function in that capacity; however, the counselor must determine whether that goal is feasible and in accordance with existing policies on self-employment.
- Unpaid Family Worker: The same as for competitive employment.
- The functional needs of the consumer in the home situation must be evaluated by an approved evaluator. See Manual Section 1345.00 for details on Class I, II, and III Evaluators. Equipment vendors cannot be used as evaluators, but their advice may be considered.
- The evaluator may suggest specific vendors or equipment, but the decision (bids may be required) is made by the counselor. ACCES-VR is not bound to any recommendation made by an evaluator.
- The counselor must provide the evaluator with:
- Consumer medical information including the diagnosis, prognosis and functional limitation.
- Consumer identifying information including name, address, telephone number.
- Consumer vocational objective, which may be stated in broad terms, such as: sheltered workshop, competitive employment, homemaker, etc.
- The counselor must be familiar with the consumer's home situation. A joint visit must be made with the evaluator.
- The home evaluator must provide a written report specifying the types of equipment and modifications recommended, the reasons for the recommendations, and any available options or alternatives. All recommendations for modifications made by the evaluator must be in compliance with ANSI-A117.1 1980 standards and also comply with local ordinances and building codes. Recommendations must be detailed and include drawings in preparation for the bidding process. This may require services of an architect or individual capable of drawing plans and writing specifications. The evaluator must take into consideration:
- The consumer's vocational objective.
- Permanence of residence and whether consumer resides at the premises all year or only sporadically.
- Whether the consumer or consumer's family owns the premises.
- ACCES-VR will not pay for any work that has been initiated, equipment that has been delivered, or equipment that has been installed prior to the final approval of the Individualized Plan for Employment and issuance of an approved VES-301 (Authorization/Voucher).
- The consumer may suggest a vendor; however, vendor selection must adhere to established ACCES-VR policy and procedures. ACCES-VR is not bound to provide services through a vendor with whom the consumer has signed a contract.
- ACCES-VR will not provide home evaluations or home modifications if the consumer is having a house custom built. The counselor may, however, advise the consumer.
- Modifications and/or equipment installation may be done to a house only if the owner of the building has given written permission and the consumer has given written assurance that the building is intended to be the consumer's long-term residence.
- ACCES-VR will not restore a residence to its previous state or condition. This statement must appear in all agreements with owners, landlords, and consumers.
- ACCES-VR will purchase household equipment only if present equipment cannot be altered or new equipment would cost less than alterations and the consumer is to function as a homemaker.
- Interior modifications and adaptive equipment are limited to such things as widening of doorways, removal of obstructions for entry into necessary rooms, interior stairway lifts, installation of shower stalls, reconstruction of bathrooms, installation of utilities, and conversion of garages into living space. For homemakers only, these services include positioning and/or installation of household equipment, lowering of kitchen cabinets, and redesign of work area.
- Exterior modifications and adaptive equipment are limited to ramps or lifts to facilitate access to the residence.
- Home additions are not allowed.
- Recommendations by evaluators are not binding upon ACCES-VR.
- Consumers and/or vendors are not permitted to make changes in specifications or plans without written approval from ACCES-VR.
Qualifications for home modification evaluators are:
- Possession of a current, valid license for the profession of occupational therapy or physical therapy and at least one year of experience in the field of rehabilitation including experience with homemaker/home modification evaluation and services. or
- Practice in related rehabilitation profession, e.g., rehabilitation nurse, rehabilitation engineer, etc., with:
- A bachelor's degree, and
- Two years of experience in the field of rehabilitation including experience with homemakers/home modification evaluations and services. A masters degree of 30 graduate credit hours in rehabilitation may be substituted for one year of experience.
- Possession of a current, valid license as an architect and at least one year of experience in evaluating and modifying structures to meet accessibility standards for persons with disabilities.
- Possession of a current, valid license as a contractor or substantiation that the contractor meets all local contractor requirements for the job tasks; also the contractor must have at least one year of experience in evaluating and modifying structures to meet accessibility standards for persons with disabilities.
- Refer to Service Purchases Requiring Bids, Section 1530.10 of the NYS VR Manual.
- No IPE's or combination of original IPE's and amendments may exceed $7,500 for these combined services for an individual consumer.
- All IPE's must be approved by the Senior Counselor and Director of Counseling/District Office Manager.
The counselor, evaluator and a qualified inspector must re-visit the consumer's residence after the work has been completed to insure that work has been completed in accordance with specifications and that it complies with ANSI standards/building codes and meets consumer's needs.
The counselor will:
- Determine if home modification, adaptive equipment, household equipment is essential for consumer to achieve vocational objective.
- Discuss services with consumer and determine probability of long-term residence.
- Obtain written functional evaluation of consumer's needs in home situation. Secure recommendations, plans and specifications.
- Determine services to be provided.
- If consumer or family does not own residence, obtain written permission from actual owner. Insert in case record folder.
- Identify potential vendors and follow bidding procedures.
- With consumer, develop Individualized Plan for Employment (IPE) Form VES-05.
- Route IPE to Senior Counselor and Director of Counseling/District Office Manager for approval.
- Arrange for services to be provided.
- Notify consumer and vendor(s) that no changes in specifications or plans are permitted without written approval from ACCES-VR.
- Perform follow-up visit including inspection at consumer's residence when services completed. Make case note on visit and get report from evaluator and inspector confirming that work was completed in accordance with recommendations and, also meets ANSI standards as well as building codes. Approve voucher(s) for payment to vendor(s).