Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 44 - ENVIRONMENTAL MODIFICATIONS AND SPECIALIZED EQUIPMENT FOR MEDICAID HOME AND COMMUNITY-BASED WAIVER SERVICES
Section 44-4 - Environmental Modifications - Scope and Limitations
Universal Citation: WY Code of Rules 44-4
Current through September 21, 2024
(a) Environmental modifications to a participant's residence shall meet at least two of the following criteria:
(i) Be functionally
necessary;
(ii) Contribute to a
person's ability to remain in or return to his or her home and out of an
intermediate care facility for individuals with an intellectual or
developmental disability (ICF/IID) or other institutional setting;
and
(iii) Be necessary to ensure
the person's health, welfare, and safety.
(b) Environmental modifications may include, but are not limited to:
(i) The installation
of ramps;
(ii) The installation of
grab-bars;
(iii) Widening of
doorways;
(iv) A bathroom
modification that is the most cost effective option to meet the needs of the
participant.
(v) Installation of
specialized electric or plumbing systems necessary to accommodate specialized
medical equipment or supplies, which are necessary for the welfare of the
participant;
(vi) Modifications
that address accessibility limitations;
(vii) Modifications that address fire code
requirements; and
(viii) Fences for
health or safety concerns.
(A) Fences shall
not take the place of required supervision of the participant.
(B) Payment for fences shall not exceed the
cost for 200 linear feet of the material needed to ensure the safety of the
participant, and shall be consistent with the neighborhood standard.
(c) Environmental modifications that shall not be covered include, but are not limited to:
(i) Modifications to a residence that are of
general utility or are primarily for the convenience of persons other than the
participant, such as caregivers or family members;
(ii) Modifications to a residence that are
not of direct medical or functional benefit to the participant;
(iii) Installation or replacement of
carpeting;
(iv) Roof repair or
replacement;
(v) Central air
conditioning;
(vi) New carports,
porches, patios, garages, porticos, decks, or repairing such
structures;
(vii) Pools, spas, hot
tubs, or modifications to install pools, spas, or hot tubs;
(viii) Landscaping or yard work, landscaping
supplies, pest exterminations, or removal of yard items;
(ix) Modifications that are part of new
construction costs;
(x)
Modifications that add to the square footage of the home except bathroom
modifications as specified in (b)(iv) of this Section;
(xi) Window replacements;
(xii) Repairs or replacement of structural
building components;
(xiii)
Modifications to a residence when the cost of such modifications exceeds the
value of the residence before the modification; and
(xiv) Any adaptations that are covered by
another source, such as a state independent living center or a vocational
rehabilitation provider.
(d) Covered modifications of rented or leased homes shall be those extraordinary alterations that are uniquely needed by the individual, and for which the property owner would not ordinarily be responsible.
(i) Such modifications shall
require written approval from the homeowner or landlord.
(ii) Modifications shall include the minimum
necessary to meet the functional requirements of the participant.
(iii) A participant shall not purchase home
accessibility adaptations to adapt living arrangements that add value to a home
that is owned or leased by providers of waiver services.
(e) The homeowner shall be responsible for general maintenance of environmental modifications.
(f) All services shall be provided in accordance with State or local building codes.
Disclaimer: These regulations may not be the most recent version. Wyoming may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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