Current through November 28, 2024
(a) The department
will pay for environmental modification services that
(1) are provided in accordance with the
department's
Environmental Modification Services Conditions of
Participation, adopted by reference in
7
AAC 160.900;
(2) are approved under
7
AAC 130.217 and
7
AAC 130.218 as part of the recipient's support plan ;
and
(3) receive prior
authorization.
(b) The
department will consider services to be environmental modification services if
the services
(1) result in physical
adaptations to
(A) a recipient's residence
that the recipient owns;
(B) rental
property that is the recipient's residence, if the owner of the property
consents to the physical adaptations; or
(C) the residence of each parent or guardian
that has joint custody of a recipient, if the recipient lives in each residence
for any period of time;
(2) are necessary to
(A) meet the recipient's needs for
accessibility identified in the recipient's support plan;
(B) protect the health, safety, and welfare
of the recipient; and
(C) further
the independence of the recipient in the recipient's residence and
community;
(3) are
rendered by a home and community-based waiver services provider that is, or may
subcontract with,
(A) a construction
contractor registered and bonded under AS 08.18; or
(B) an Alaska Native entity or a nonprofit
subsidiary of one or more Alaska Native entities that operates as a housing
authority; the Alaska Native entity must provide a resolution approved by its
governing body that waives the entity's sovereign immunity from suit with
respect to claims by the state arising out of activities related to the
environmental modification services; and
(4) include the purchase and installation of
all materials, supplies, and equipment required for the environmental
modification.
(c) The
department will pay not more than a total of $18,500 for all environmental
modifications for a recipient during the three-year period, the first day of
which is July 1, 2013 and the last day of which is June 30, 2016, regardless of
the approval, beginning, or completion date of the recipient's first
environmental modification during that period. After that period ends, the
department will pay not more than a total of $18,500 for all environmental
modifications for a recipient during each subsequent three-year period, the
first day of which is July 1 of the first year and the last day of which is
June 30 of the third year.
(d) The
department will pay for an environmental modification in excess of a limit
established in (c) of this section if the expenditure
(1) is for the repair or replacement of a
previous environmental modification authorized by the department, does not
exceed $500, and is approved by the department before the expenditure is made;
or
(2) results solely from the cost
of shipping to a remote community or location, by the least expensive method,
the materials and supplies needed for an environmental modification; for
purposes of this paragraph, a site is in a remote community or location if it
is not connected by road or the Alaska marine highway system to Anchorage,
Fairbanks, or Juneau, except that a site is not a remote community or location
if it is on a road system that connects two or more communities or locations,
and the materials or supplies are available in one of them.
(e) The provider must complete the
environmental modification project not later than 90 days after the start of
construction or the initial payment made on a claim for services, whichever is
first. If the project has not been completed during the 90-day period and the
department has not authorized an extension of time for completion, the provider
shall repay each amount of money received from the department for the project.
The department will consider an environmental modification project to be
complete when the department makes final payment to the provider that received
prior authorization. The department will pay for an environmental modification
project only upon completion, except that to allow for the purchase of
materials, supplies, and equipment for the project, the department will
authorize payment of
(1) 25 percent or less
of the total amount approved for the project; and
(2) the cost of shipping that is allowed
under ( d)(2) of this section.
(f) In addition to payment for the
environmental modification services, the department will pay an administrative
fee under 7 AAC 145.520(e)
to a home and community-based waiver services provider that is acting in an
administrative capacity in providing the environmental modification services,
if that provider
(1) is an organized health
care delivery system under 42 C.F.R. 447.10;
(2) oversees the purchase of an environmental
modification for a recipient; and
(3) upon completion of the environmental
modification, verifies that the environmental modification is in compliance
with the applicable requirements of
AS
18.60.705(a),
8
AAC 70.025,
8
AAC 80.010, 13 AAC 50, 13 AAC 55, and any similar
municipal codes.
(g) Any
money approved by the department for environmental modification services but
unused when the environmental modification is completed will not be credited
to, and is not available for another use by, the recipient or the home and
community-based waiver services provider.
(h) The department will not authorize an
environmental modification service for a recipient that resides in an assisted
living home or foster home licensed under AS 47.32 unless the recipient is
receiving family home habilitation services under
7
AAC 130.265(b).
(i) The department will not be responsible
for removal of an environmental modification if the recipient ceases to reside
at a residence to or in which physical adaptations have been made under this
section.
(j) The department will
not pay for the following services under this section:
(1) an environmental modification that
(A) increases the square footage of an
existing residence;
(B) is part of
a larger renovation to an existing residence; or
(C) is included in construction of a new
residence;
(2) any
modification to a residential facility that is owned or leased by a home and
community-based waiver services provider;
(3) a general-utility adaptation,
modification, or improvement to the existing residence, unless necessary to
reduce the risk of serious injury or illness to the recipient and another
practical modification is not available; for purposes of this paragraph,
general-utility adaptations, modifications, or improvements include
(A) routine maintenance of, or improvements
to, flooring, bathroom furnishings, roofing, appliances, and central air
conditioning;
(B) heating system or
sewer system replacement;
(C)
changes or additions to cabinets or shelves that are not necessary to make the
cabinet or shelf accessible or functional for a recipient as part of an
environmental modification;
(4) an adaptation, modification, or
improvement to the exterior of the dwelling, or to an outbuilding, yard,
driveway, or fence, except for an adaptation, modification, or improvement to a
door, exterior stairs, or a porch, if necessary for ingress or egress for the
recipient;
(5) duplicate
accessibility modifications to the same residence;
(6) a hot tub, spa, sauna, or permanently
installed hydrotherapy device;
(7)
an installed backup generator system;
(8) elevator installation, repair, or
maintenance;
(9) a modification
that
(A) supplants equipment or items already
provided through any other means; and
(B) is primarily for the convenience of the
recipient or caregiver.
(k) Notwithstanding (a) of this section, the
department will not pay for an environmental modification that has prior
authorization if
(1) a recipient plans to
move or has moved from a residence or has died; or
(2) a residence in which the recipient Iives
for any period of time is for sale.
Authority:AS
47.05.010
AS 47.07.030
AS
47.07.040
