Sec. 7 AAC 130.300 - Environmental modification services
§ 7 AAC 130.300. Environmental modification services
(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.(Eff. 2/1/2010, Register 193; am 7/1/2013, Register 206; am 7/1/2015, Register 214, July 2015; am 11/5/2017, Register 224, January 2018; am 3/3/2021, Register 238, July 2021)
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