HOME MODIFICATION SERVICES PROVIDER IN ILLINOIS

IMPROVING SAFETY, ACCESSIBILITY, AND INDEPENDENCE THROUGH STRUCTURAL HOME ADAPTATIONS

Home Modification Services in Illinois support individuals with disabilities, chronic illnesses, or age-related limitations by making physical changes to their residences. These modifications promote safety, independence, and accessibility, helping individuals remain in their homes and avoid institutionalization. Home modifications are authorized under specific Illinois Medicaid Waiver programs.

​​​1. GOVERNING AGENCIES

Agency: Illinois Department of Healthcare and Family Services (HFS)

Role: Administers Medicaid waiver funding for Home Modification Services and oversees provider enrollment and reimbursement

Agency: Illinois Department of Human Services (DHS) — Division of Rehabilitation Services (DRS) and Division of Developmental Disabilities (DDD)

Role: Coordinates service authorizations, monitors project quality, and ensures modifications meet participant needs and regulatory requirements

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure Medicaid-funded Home Modification Services align with HCBS Settings Rule and participant-centered planning

2. HOME MODIFICATION SERVICE OVERVIEW

Home Modification Services provide physical adaptations to a participant’s home to enhance accessibility, ensure safety, and allow greater independence in daily living activities.

Approved providers may deliver:

• Installation of ramps, lifts, grab bars, or widened doorways

• Bathroom modifications (e.g., roll-in showers, accessible sinks, raised toilets)

• Kitchen modifications for improved usability (e.g., lowered countertops, accessible appliances)

• Installation of stairlifts, vertical lifts, or platform lifts

• Structural changes to improve wheelchair mobility or reduce fall risks

• Environmental control units for enhanced accessibility (e.g., voice-activated systems)

All services must be necessary to meet medical and functional needs as documented in the participant’s Individualized Service Plan (ISP) or Person-Centered Plan (PCP).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business entity with the Illinois Secretary of State

• Obtain EIN from the IRS and NPI (Type 2)

• Enroll as a Medicaid Waiver provider through the Illinois Medicaid Provider Enrollment Portal (IMPACT system)

• Obtain applicable contractor licenses (general contractor license if required by local jurisdiction)

• Maintain general liability, professional liability, and workers’ compensation insurance

• Develop policies addressing home assessment, project planning, construction quality, participant protection, and post-modification inspection

• Ensure subcontractors (if used) meet all licensure, insurance, and background screening requirements

4. ILLINOIS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application through the IMPACT system for Home Modification Services under the appropriate waiver programs

Application and Documentation Submission:

• Provide Articles of Incorporation, proof of EIN/NPI, contractor licensure (if required), insurance certificates, operational policies, and staff/subcontractor credentialing documentation

Program Readiness Review:

• DHS and/or HFS review provider readiness, including experience in accessible construction, project management processes, participant safety procedures, and billing compliance

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to deliver Home Modification Services and bill under designated waiver codes

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business Registration (Illinois Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Contractor licenses or registrations (where applicable)

• Proof of general liability, professional liability, and workers’ compensation insurance

• Home Modification Services Policy & Procedure Manual, including:

  • Participant intake, home assessment, and project authorization processes

  • Project planning, design standards, and code compliance procedures

  • Subcontractor management and quality assurance protocols

  • Participant rights, grievance handling, and HIPAA compliance

  • Incident reporting and safety protocols during construction

  • Medicaid billing and audit readiness documentation

6. STAFFING REQUIREMENTS

Role: Project Manager / Home Modification Specialist

Requirements: Background in construction, architecture, occupational therapy, or accessibility design; experience in ADA-compliant modifications preferred; background clearance

Role: Construction Workers / Subcontractors

Requirements: Licensed and insured according to local and state requirements; experience with residential accessibility projects; background clearance where required

All staff and subcontractors must complete:

• Participant safety and confidentiality training

• Infection control and environmental safety training

• Emergency response and incident reporting training

• Accessibility standards training (e.g., ADA guidelines, HCBS Settings Rule)

7. MEDICAID WAIVER PROGRAMS

Home Modification Services are available under the following Illinois Medicaid Waivers:

• Adults with Developmental Disabilities Waiver

• Children and Young Adults with Developmental Disabilities Waiver

• Persons with Brain Injury (BI) Waiver

• Persons with Disabilities (PD) Waiver

• Elderly Waiver (Community Care Program) — limited modifications under CCP

Approved providers may deliver:

• Environmental accessibility adaptations are essential for safe home living

• Home safety enhancements for fall prevention and mobility access

• Installation of specialized equipment supporting independence

8. TIMELINE TO LAUNCH

Phase: Business Formation, Licensure, and Insurance Preparation

Timeline: 1–2 months

Phase: Staff Hiring/Subcontractor Setup and Program Development

Timeline: 1–2 months

Phase: IMPACT Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Illinois Department of Healthcare and Family Services (HFS)

Website: https://www.hfs.illinois.gov/

Illinois Department of Human Services (DHS)

Website: https://www.dhs.state.il.us/

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — ILLINOIS HOME MODIFICATION SERVICES PROVIDER

WCG assists contractors, accessibility specialists, and community service agencies in launching Medicaid-compliant Home Modification Services under Illinois’ HCBS waiver programs.

Scope of Work:

• Business registration, Medicaid enrollment, and contractor compliance support

• Development of Home Modification Services Policy & Procedure Manual

• Staff credentialing templates, home assessment forms, and project tracking systems

• Medicaid billing setup and claims management support

• Website, domain, and marketing setup targeting case managers and waiver participants

• Accessible design standards, guidance, and project planning templates

• Quality assurance programs for modification tracking, inspection, and participant satisfaction

• Referral network development with waiver case managers and service coordinators

Continue To Our Client Portal To Get Started

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