What are home modifications?



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HOME MODIFICATION PROGRAMS

What are home modifications?

The term “home modifications” refers to any adaptations made to a house or apartment to make it more accessible for people with disabilities. Home modifications help to increase independence through easier entrance to and mobility within the home. Ramps, widened doorways, doorbells that provide visual signals, and stair glides are all examples of home modifications. Home modifications may be included in the definition of assistive technology.



What are home modification programs?
Home modification programs provide assistance to adults with disabilities and / or families with children who have disabilities and own, or in some cases, rent their homes. There are different types of home modification programs throughout Pennsylvania, and each one has eligibility requirements. Although program guidelines vary, eligibility is primarily based on the presence of a disability, the type of disability (including the age when the disability began), occupancy of the home, geographical location, and/or household income. In addition, eligibility criteria and implementing agencies change from time to time; so you will want to be sure you have current information.
Very few people find that one program can provide all of the resources necessary to make the home accessible. You may need to piece together a variety of available resources in order to have your needs met. Some home modification programs provide assistance in the form of grants and some provide materials and labor. Others provide only loans that need to be repaid. In addition, not all home modification programs are available in every county, so it is important to research the resources that are specific to your county and local area.
You may need to consider coordinating local community resources for projects, for example, obtaining materials from building supply companies at no cost or at low cost and “voluntary labor” from community and civic organizations. Some Centers for Independent Living may be willing or able to assist in this coordination.


Is Medicaid (Medical Assistance / MA) a resource for home modifications?

Medical Assistance is the state-administered health care program for people who have low incomes, and is financed by a combination of federal and state funding. Typically, only those services that are “medically necessary” are covered. Most of the time, home modifications like stair lifts and ramps are NOT considered “medically necessary”. However, in some circumstances and for some people with certain disabilities, the federal government allows the state to make exceptions and “waive” the rules in order to provide home and community-based services and to prevent placement in a nursing home or other institution. These specially approved home and community-based services, which may include home modifications, are called “waiver programs”.



What are the Medicaid-funded home and community based services that may include home modifications?

Medicaid-funded home and community-based services are “a set of medical and non-medical services designed to help people with disabilities and older Pennsylvanians live independently in their homes and communities.” Medicaid-funded home and community-based services available in Pennsylvania that include resources for home modifications include:




  1. Consolidated Waiver for Individuals with Mental Retardation, Department of Public Welfare, Office of Developmental Programs, 1-888-565-9435 or

    1-866-388-1114 (TTY)



  2. Person / Family Directed Support Waiver for People with Mental Retardation, Department of Public Welfare, Office of Developmental Programs, 1-888-565-9435 or 1-866-388-1114 (TTY)

  3. CSPPD / OBRA Home and Community-Based Waiver, Department of Public Welfare, Office of Social Programs, 800-767-5042.

  4. Independence Waiver, Department of Public Welfare, Office of Social Programs, 800-757-5042.

  5. Long-Term Care Capitated Assistance Program (LTCCAP) Waiver, Department of Public Welfare, Office of Medical Assistance Programs, 717-772-2525.

  6. CommCare Waiver, Department of Public Welfare, Office of Social Programs, 800-757-5042

  7. Aging or 60+ Waiver, also known as PDA Waiver, PA Department of Aging, Waiver, 866-286-3636 or your local Area Agency on Aging.

As previously noted, these programs may change at any time.


See the chart at the end of this Funding Fact Sheet for a brief summary of these and related programs.
Are Medicare and other healthcare insurances resources for home modifications?

Although Medicare and most other healthcare insurances do not pay for home modifications, there are exceptions. For example, Health Partners Medicare Silver Plan, (a Medicare HMO) provides a benefit called Home safety. It consists of home inspection for safety and health-related concerns and up to $1,500 in recommended improvements once in a lifetime. Other health care insurances may pay for handrails in your bathtub and/or shower if your diagnosis requires it and your doctor prescribes it. You can call your healthcare insurance plan to see if it provides home safety or home modification benefits.


Are there other programs that include home modifications?
Following is a list of programs that are national or statewide in scope that include Home Modifications.
Rebuilding Together, a nonprofit organization dedicated to assisting individuals who are low-income or who have disabilities repair or modify their home, has affiliates in Bradford, Harrisburg, Monroe County, Philadelphia, Pittsburgh, and Warren County. Contact information on these affiliates is available through the national office, 800-4-REHAB9 or www.rebuildingtogether.org
Pennsylvania Accessible Housing Program (PAHP) is a combined effort of the Department of Community and Economic Development (DCED) and the Department of Public Welfare (DPW). The Accessible Housing Program provides funds to enable low- and moderate-income people with disabilities to make necessary modifications to their current home that will make the home more accessible. Modifications to allow easy entry and exit from the house or unit and modifications that increase the ability of persons with disabilities to perform activities of daily living are included. The assistance is available to owners and renters, as long as a household member has a permanent disability and the household income meets the eligibility guidelines. Renters must obtain permission from their landlords for the specific modifications.
In the majority of counties the Accessible Housing Program provides monies to local governments and redevelopment authorities (not directly to individuals or families) in conjunction with organizations that provide housing services or services for people with disabilities. In some areas, the local government also appropriates money. The state coordinator of the Accessible Housing Program is Aldona Kartorie, (717-720-7409), and the day-to-day operations are handled by Denise Cuthbertson, (717-214-5341).
Contact your local government redevelopment authority or community development agency to see if this program is available in your area. These phone numbers are available in your phone book’s government “blue” pages or a listing of local offices can be found at the website for Pennsylvania’s Department of Community and Economic Development at www.NewPa.com Alternatively, you may call Denise Cuthbertson whose telephone number and affiliation are in the previous paragraph. Some areas

do not have an Accessible Housing Program. In those areas you may contact Self-Determination Housing Project of Pennsylvania, 610-873-9595, to obtain further information and to apply for the Pennsylvania Accessible Housing Program.



Pennsylvania Housing Finance Agency (PHFA) / Fannie Mae Disability Access Modification Program offers assistance to persons with disabilities, or persons who have family member(s) with disabilities living with them, who want to be homeowners. It provides fully amortizing, 30-year, fixed rate conventional first mortgages for the purchase of homes. In addition, there are second mortgage loans for financing accessibility modifications, through the Access Home Modification Program.

The following two programs are available only to people for whom PHFA holds the first mortgage.


The Access Home Modification Program, administered through the Pennsylvania Housing Finance Agency, provides mortgage loans to assist persons with disabilities or persons who have a family member(s) living in the household with disabilities who are purchasing a home that needs accessibility modifications. The amount of the Access Home Modification Loan may not be less than $1,000 or more than $10,000. This program provides a deferred payment loan, with no interest, and no monthly payment. The loan becomes due and payable upon payoff of the first mortgage, sale, transfer, refinance or non-owner occupancy of the property.
In addition, applicants with household incomes at or below $38,000 may also qualify for the Access Down payment and Closing Cost Assistance Loan Program. The mortgage shall not be less than $1,000 and no more than $15,000. This program provides a deferred payment loan, with no interest. The loan becomes due and payable upon payoff of the first mortgage, sales, refinance, transfer or non-owner occupancy of the property.
For more information about this program and PHFA mortgage loan programs, go to the PHFA website: www.phfa.org. To find participating lenders click on the link for housing “Housing Programs” and then “Single Family Homeownership.” If you do not have web access, call PHFA at (800) 822-1174 voice; (717) 780-3871 voice, (717) 780-1869 TTY.
The Office of Vocational Rehabilitation (OVR) is a state agency which provides employment related services to individuals with disabilities. Accessibility evaluation and limited home modifications may be provided as part of a program which leads to or helps maintain employment. OVR will only consider paying for those modifications which are required to enable person with a disability to get dressed and out of the house for training, education, and/or employment. Home accessibility evaluations are usually done at no cost to the family. Whether or not the family must contribute financially to the modifications depends on the family’s finances. To locate the OVR office nearest you, call 800-442-6351 or visit the OVR website at www.dli.state.pa.us/ovr


US Department of Agriculture, Rural Development 504 Loan / Grant Home Repair Program The United States Department of Agriculture (USDA) Rural Development Rural Housing Services administers the Rural Development 504 Loan/Grant Home Repair Program. This program provides assistance to those over age 62 and persons with disabilities who live in rural areas so that they can make repairs and modifications to their home to make it accessible. Those with low income who are unable to repay the loan may be eligible for a grant of up to $7,500. For more information, contact the local Rural Development office in your area. A listing can be found in the Blue Pages of your phone book. Additional information about this program and other Rural Housing Service programs can be found at the USDA Rural Development website, www.rurdev.usda.gov.




Area Agencies on Aging (referred to as AAA or County Agencies on Aging)

AAAs usually implement the Pennsylvania Department of Aging Waiver, referred to earlier and at the end of this document, as well as other programs that may provide money for home modifications for eligible individuals. Sometimes they provide services to adults with disabilities of all ages, including home modifications. To locate your local Area Agency on Aging, look in the blue pages of your telephone directory or contact the Pennsylvania Department of Aging at: Voice 717-783-1550, Fax: (717) 783-6842. Email them at aging@state.pa.us or visit their website at http://www.aging.state.pa.us/




Veterans Administration


Veterans who have specific service-connected disabilities may be entitled to a grant from the Department of Veterans Affairs for the purpose of constructing an adapted dwelling or modifying an existing one to meet the veterans needs. The goal of the Specially Adapted Housing (SAH) Program is to provide a barrier-free living environment which affords the veterans a level of independent living he or she may not normally enjoy.
There are two types of grants administered by VA which are available to assist severely disabled veterans to adapt housing to meet their special needs.

The Specially Adapted Housing Grant (SAH) is available to disabled veterans who are entitled to a wheelchair accessible home especially adapted for their needs.

The Special Home Adaptations Grant (SHA) is available to veterans who are entitled to adaptations because of blindness in both eyes with 5/200 visual acuity or less, or because of the loss of, or loss of use of, both hands.
For more information, visit the VA website at http://vip.vba.va.gov/ , contact your local VA office, or call Voice 800-827-1000, TTY 800-829-4833, to get contact information about your local office. You may also apply for these grants by completing VA Form 26-4555 and submitting it to your local VA office.
An eligible veteran might also be entitled to the Home Improvement and Structural Alterations (HISA) benefit for a service connected or non-service connected disability. The Prosthetics and Sensory Aids Service at your nearest VA health care facility will furnish additional information concerning this benefit upon request. To take advantage of this benefit, your VAMC Primary Care Physician must refer you to Rehabilitation for an evaluation of your needs. Alternatively, you may apply for the HISA benefit by completing a VA Form 10-0103, Application for Assistance in Acquiring Home Improvement and Structural Alterations, and submitting it to your local VA medical center.

Foundations, Disability-Specific Organizations, and Civic Organizations, such as Multiple Sclerosis Foundation, the United Spinal Association, churches or synagogues, or service organizations, such as Lions Club and Rotary Clubs may provide funding and/or labor for home modifications. Stores such as Lowe’s or Home Depot may provide materials. It is unlikely that a single organization will be able to provide the total amount needed to make your home accessible, so you may need to put together assistance from several sources. PIAT can provide you with a list of these organizations and suggested sources, upon request.

Pennsylvania Assistive Technology Foundation (PATF) provides low-interest cash loans to people with disabilities and older adults so that they can buy the assistive technology devices and services they need. If the loan request is for less than $1,000, low income borrowers may be eligible for a grant of up to one-half of the loan request. Examples of home modifications financed by PATF include: ramps, bathrooms and kitchen modifications, strobe fire alarms, stair glides, and environmental control units.

Any Pennsylvania resident who needs assistive technology is eligible to apply for a loan. Family members may apply on behalf of children or other family members with disabilities, as well as advocates, guardians and authorized representatives as long as the device or service is for the use by a person with disabilities. Most loans are between $500 and $25,000. Under appropriate circumstances, even larger amounts may be borrowed. A person’s ability to repay the amount requested will determine whether the loan will be approved. PATF often lends money to borrowers who would not qualify for traditional bank loans. PATF also provides free consumer credit counseling and information about other possible funding resources within Pennsylvania. For more information, contact PATF at 888-744-1938 toll-free voice; 484-674-0506 voice/TTY; 484-674-0510 FAX; patf@patf.us e-mail; or www.patf.us website.



Where can I find help in sorting through this maze of funding sources?

Pennsylvania’s Initiative on Assistive Technology, a program of the Institute on Disabilities at Temple University, and its subcontractors across the state are available to help you understand, get further information, contact and apply for funding sources that are appropriate for you and / or your family member(s). They can also tell you about any local programs that are not listed here. To obtain contact information about your ATRC, contact PIAT via the contact information at the end of this fact sheet.


You may also visit the Home Modifications Website at http://homemods.jevs.org or call the toll free Long Term Care Helpline at 866-286-3636.
What if I disagree with the decisions of the home modification programs?
If you disagree with decisions regarding eligibility or limits on modifications to be provided through the program, you may request reconsideration. If the decision with which you disagree is in writing, look for a written appeals process. If you do not have the appeals process in writing, it is best to contact the coordinator of the program for which you applied for information on how to file an appeal.
In some cases, the Disability Rights Network of Pennsylvania may be able to assist you. They can be contacted at 1-800-692-7443 [Voice], 1-877-375-7139 [TDD], or intake@drnpa.org.
If you feel that you have been discriminated against, there are resources to assist you. The Commonwealth of Pennsylvania has a Human Relations Law that prohibits discrimination in housing. The Pennsylvania Human Relations Commission office can assist you with filing an appeal. To locate the office in your region, go to their website at www.phrc.state.pa.us or contact the Central office at:

301 Chestnut Street, Suite 300

Harrisburg, PA 17101

717-787-4410 Voice

717-783-9308 TTY

 

The U.S. Dept. of Housing and Urban Development (HUD) will also help you file a complaint if you feel that you have been discriminated against in housing on the basis of your race, color, religion, national origin, sex, familial status or disability. You can contact the local HUD office of fair housing by calling 215-656-0647; or call the HUD housing discrimination hotline, 800-669-9777. You can even file a housing discrimination complaint on line. Go to the HUD website at www5.hud.gov and follow the link. Fill out the form and click the “submit” button. Someone from HUD will get in touch with you soon.


For more information or assistance, or to obtain this fact sheet in alternate formats, you may contact:

Pennsylvania’s Initiative on Assistive Technology (PIAT)

The Institute on Disabilities

Temple University

1601 N. Broad Street

University Services Building – Suite 610

Philadelphia, PA 19122-6090

Website: http://disabilities.temple.edu

Email: fundat@temple.edu

Telephone: Voice 215-204-5397

Toll-free voice within PA: 800-204-7428

Toll-free TTY within PA: 866-268-0579

Fax: 215-204-9371
Are we missing any programs? Do you find that contact information has changed? Please contact us at fundat@temple.edu, 800-204-7428, (Voice), or

866-268-0579 (TTY) so we can keep this fact sheet as up to date as possible!

The contents of this handout were developed by Pennsylvania's Initiative on Assistive Technology (PIAT) a program of the Institute on Disabilities at Temple University. PIAT is funded through a grant from the US Department of Education, Rehabilitation Services Administration, under the Assistive Technology Act of 1998, as amended. The contents do not necessarily represent the policy of the US Department of Education, and you should not assume endorsement by the Federal government.



Waivers and Related Programs that Provide Funding for Home Modifications

Name of Program/

State Agency

Eligibility: Age


Eligibility: Disability

Eligibility: Income


Coverage

Comments


PDA (PA Department

of Aging) OPTIONS

Program


60 or over

Just requiring or requesting assistance

Cost-share based on income

May include bathroom equipment, home modifications, etc.

Must be assessed by Area Agency on Aging. Home modification must be a part of a package of services.


PDA Family Caregiver

Support Program



Must be caregiver for an older relative 60+

The older person requires assistance with one or more activities of daily living or has diagnosis of dementia

Reimbursement dependent on level of household income

Includes bathroom modifications, ramps, stair glides

Lifetime limit of $2000; apply through Area Agency on Aging. Home modification must be a part of a package of services.


PDA Waiver

60 or over

Nursing Facility Clinically Eligibility (NFCE) but prefer s to live and receive services in the community

$2000 resource limit, income limit 300% federal benefit rate. County Assistance Office makes final determination

Includes environmental modifications

$2000 limit per 12 month period, apply through Area Agency on Aging. Home modification must be a part of a package of services


Longterm Care

Capitated Assistance

Program (LTCCAP)


60 or older

Eligible for nursing facility services

$2000 resource limit, income limit 300% federal benefit rate

Environmental accessibility adaptations

Limited to certain parts of Philadelphia and Allegheny Counties. Call 717-772-2525. .

OBRA Home and

Community-Based

Waivers (Office of

Social Programs,

Department of Public

Welfare) (also known

as Community

Services Program for

Persons with Physical

Disabilities)



18 - 60

Disability manifests itself before the age of 22



Nursing home resident with significant physical, developmental disability; functional limitations in at least 3 activities of daily living.

Medical Assistance-eligible

Modifications necessary to relocate to the community (minor physical adaptations to the home)

Cap of $10,000 for minor physical adaptations/

environmental accessibility adaptations per site; prior authorization required. Waiver designed for individuals residing in nursing facility and determined to be inappropriately placed.



Independence Waiver

(Office of Social Programs, Department of Public Welfare)



18 to 60

Significant physical disability (other related conditions); primary diagnosis not mental health or mental retardation. Cannot be ventilator dependent; nursing home eligible.

Medical Assistance eligible

Environmental accessibility adaptations

Cap of $10,000 for environmental accessibility per site; prior authorization required. Must be able to be appropriately served in the community at a cost not exceeding 80% of average MA payment for nursing facility services. Designed to divert nursing home placement. Call 1-800-757-5042 for more information.

Consolidated Waiver for Individuals with Mental Retardation

3 and older

Mental Retardation

$2000 resource limit (for adults); 300% federal benefit rate

Environmental accessibility adaptations

    Call 1-888-565-9435 or

    1-866-388-1114 (TTY)



for more information

Person/Family Directed Support Waiver

3 and older

Mental Retardation

$2000 resource limit (for adults); 300% federal benefit rate

Environmental accessibility adaptations

    Call 1-888-565-9435 or

    1-866-388-1114 (TTY)



for more information


Home Modifications Programs

Rev 8/07

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