ENVIRONMENTAL MODIFICATION SERVICES PROVIDER IN TENNESSEE

Fatumata Kaba
3d
3 min read

CREATING SAFE, ACCESSIBLE, AND FUNCTIONAL LIVING ENVIRONMENTS FOR INDIVIDUALS WITH PHYSICAL, MEDICAL, OR DEVELOPMENTAL NEEDS

Environmental Modification Services in Tennessee support individuals with disabilities or chronic health conditions by funding and implementing physical changes to their homes. These modifications help individuals remain safe, independent, and integrated within their communities. Covered under TennCare Waivers such as ECF CHOICES, 1915(c) Waivers, and the Katie Beckett Program, these services must be medically necessary and directly related to the individual’s functional limitations.

1. GOVERNING AGENCIES

Agency: TennCare (Tennessee Medicaid)

Role: Authorizes and reimburses Environmental Modifications as part of waiver programs.

Agency: Department of Intellectual and Developmental Disabilities (DIDD)

Role: Approves provider qualifications, ensures project alignment with the participant’s ISP, and monitors service delivery.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Provides federal regulatory guidance for waiver-covered home modifications.

2. ENVIRONMENTAL MODIFICATION SERVICES OVERVIEW

Environmental Modifications must support health, safety, or functional independence in the home. Projects are reviewed and authorized on a case-by-case basis and are subject to caps and scope limits.

Examples of allowable modifications include:

Ramps and Widened Doorways for wheelchair access
Roll-in Showers, Grab Bars, and Bathroom Renovations
Lowered Countertops or Accessible Sinks
Non-slip Flooring or Flooring Replacement
Stair Lifts or Vertical Platform Lifts (VPLs)
Smart Home Accessibility Devices (if tied to functional need)
Fencing (for safety when justified in ISP)
Fire Alarms with Visual or Vibration Alerts

Unallowable modifications typically include: general home repairs, remodeling not tied to function, or upgrades for aesthetics.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business with the Tennessee Secretary of State
Obtain EIN and Type 2 NPI
Enroll with TennCare and/or DIDD as a Medicaid waiver provider under the Environmental Modification category
Maintain contractor licensure in Tennessee (e.g., Home Improvement or Residential Contractor license, if required for project type)
Carry general liability and workers’ compensation insurance
Develop an Environmental Modification Policy & Procedure Manual

4. TENNESSEE PROVIDER ENROLLMENT PROCESS

Step 1: Form a business entity and acquire EIN/NPI

Step 2: Apply to DIDD or TennCare for enrollment as an Environmental Modification provider

Step 3: Submit required credentials, contractor licenses, insurance, and policies

Step 4: Participate in ISP meetings or home assessments with support coordinators

Step 5: Upon authorization, complete projects per Medicaid guidelines and submit for reimbursement

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, NPI
Proof of contractor licensure (if applicable)
Certificates of liability and workers’ comp insurance
Environmental Modification Services Policy & Procedure Manual including:
- Scope of allowable projects
- Pre- and post-installation inspection protocols
- Participant rights, safety policies, and consent forms
- Cost estimating and documentation procedures
- Billing and reimbursement standards
- Communication procedures with support coordinators and ISPs

6. STAFFING REQUIREMENTS

Role: Project Manager / Coordinator

Requirements: Construction or home modification experience, project oversight, Medicaid documentation knowledge

Role: Licensed Contractor / Installer

Requirements: State license or trade certification based on project (e.g., plumber, electrician)

Optional Role: Occupational Therapist (for assessments)

Requirements: State licensure; may assist in determining needs or recommending modifications

All staff must complete:

HIPAA and person-centered planning training
ISP coordination training
Safety, hazard assessment, and documentation standards
TennCare compliance procedures

7. MEDICAID WAIVER PROGRAMS

Environmental Modifications are covered under:

ECF CHOICES Waiver – Based on safety, accessibility, or independence needs
1915(c) Waivers – For adults with I/DD or medically fragile conditions
Katie Beckett Program – For children with complex needs requiring home adaptation
EPSDT (under 21) – When medically necessary and prescribed by a physician

8. TIMELINE TO LAUNCH

Phase: Business Registration & Credentialing

Timeline: 1–2 months

Phase: TennCare/DIDD Enrollment

Timeline: 2–3 months

Phase: Staff Hiring, Policy Manual Finalization

Timeline: 30–60 days

Phase: Service Start & Project Implementation

Timeline: Upon authorization and service plan inclusion

9. CONTACT INFORMATION

TennCare (Tennessee Medicaid Program)

Website: https://www.tn.gov/tenncare

Tennessee Department of Intellectual and Developmental Disabilities (DIDD)

Website: https://www.tn.gov/didd

Tennessee Board for Licensing Contractors

Website: https://www.tn.gov/commerce

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

ENVIRONMENTAL MODIFICATION SERVICES PROVIDER IN TENNESSEE

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — TN ENVIRONMENTAL MODIFICATION PROVIDER

WCG helps contractors, construction professionals, and community organizations become Medicaid-approved providers for home modifications supporting waiver participants.

Scope of Work: