ENVIRONMENTAL ACCESSIBILITY SERVICES PROVIDER IN ALABAMA

Fatumata Kaba
Jun 30
3 min read

SUPPORTING INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES THROUGH HOME MODIFICATIONS FOR SAFETY AND INDEPENDENCE

Environmental Accessibility Services in Alabama are designed to support individuals with intellectual and developmental disabilities (IDD) by providing physical adaptations to their home environments. These adaptations enable greater independence, promote safety, and reduce barriers to daily living activities. Services are authorized under Alabama’s Home and Community-Based Services (HCBS) Medicaid Waivers and must follow the standards established by the Alabama Department of Mental Health (ADMH).

1. GOVERNING AGENCIES

Agency: Alabama Department of Mental Health (ADMH)

Role: Approves Environmental Accessibility Services providers and ensures compliance with state and waiver requirements

Agency: Alabama Medicaid Agency

Role: Manages Medicaid enrollment and reimbursement for approved environmental modification services

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure that modifications meet HCBS waiver compliance standards

2. ENVIRONMENTAL ACCESSIBILITY SERVICE OVERVIEW

Environmental Accessibility Services involve physical adaptations to a participant’s primary residence to ensure the health, welfare, and safety of the individual or to increase independence in the home. These adaptations are one-time or occasional and must be medically necessary and included in the individual’s person-centered plan. Services may include:

Installation of wheelchair ramps and handrails
Widening of doorways for accessibility
Bathroom modifications such as roll-in showers or grab bars
Installation of specialized lighting or alert systems
Modification of kitchen cabinets or counters for accessibility
Structural changes to accommodate mobility aids

All modifications must be pre-approved, cost-effective, and completed by qualified contractors in accordance with ADA and local building codes.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Alabama Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Maintain a physical office in Alabama or operate a mobile-based model
Establish partnerships with licensed contractors and construction professionals
Demonstrate knowledge of ADA standards, building permits, and safety regulations
Implement quality assurance, inspection, and cost-tracking systems

4. ADMH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Request the Environmental Accessibility Services Provider Application Packet from ADMH
Submit a service delivery model outlining scope of modifications, contractor vetting, and budget control
Include examples of past modifications, risk assessments, and cost estimate processes

Background & Credentialing:

Background checks for staff involved in home access or direct consumer interaction
Verification of general contractor licensing, liability insurance, and construction compliance
Training in ADA compliance, client communication, and safety assessment

Program Readiness Review:

Evaluation of modification planning, inspection checklists, and documentation templates
Review of internal controls for budget tracking, client approvals, and contractor invoicing
Policies for emergency repairs, disputes, and service timelines

Approval & Medicaid Enrollment:

Once approved by ADMH, enroll with Alabama Medicaid as an Environmental Accessibility Services provider
Add approved service codes to Medicaid billing lines

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC Certificate
IRS EIN Letter
NPI confirmation
Proof of office or service location in Alabama
Contractor licenses and liability insurance certificates
ADMH-Compliant Policy & Procedure Manual including:
- Environmental assessment and referral process
- Contractor selection and bid procedures
- Documentation of consumer consent and service delivery
- Safety protocols and ADA compliance checks
- Emergency response, fraud prevention, and complaint resolution policies
- Inspection reports, before-and-after photos, and completion checklists
Signed consumer agreements and authorization forms

6. STAFFING REQUIREMENTS

Role: Program Coordinator

Requirements: Background in construction project management, disability services, or accessibility design

Role: Licensed Contractors/Subcontractors

Requirements: Must be insured, bonded, and hold valid construction licenses; experience with ADA-compliant home modifications preferred

All staff and contractors must complete:

ADMH orientation and HCBS waiver training
Annual training in disability rights, safety standards, and documentation protocols
Compliance with confidentiality and client service expectations

7. MEDICAID WAIVER SERVICES

The following Alabama Medicaid Waivers authorize Environmental Accessibility Services: