HOME MODIFICATION SERVICES PROVIDER IN OREGON

Fatumata Kaba
Oct 6
4 min read

ENHANCING ACCESSIBILITY, FUNCTIONALITY, AND SAFETY THROUGH STRUCTURAL ADAPTATIONS FOR OREGONIANS RECEIVING MEDICAID

Home Modification Services in Oregon are Medicaid-funded supports that allow individuals with disabilities, aging-related conditions, or chronic illnesses to remain safely in their homes by adapting their living environment. These services are essential for promoting independence and preventing institutional placement. Authorized under the Oregon Health Plan (OHP), K Plan (1915(k)), and HCBS Waivers, modifications range from simple safety enhancements to complex construction projects.

1. GOVERNING AGENCIES

Agency: Oregon Department of Human Services (ODHS) – Aging and People with Disabilities (APD), Developmental Disabilities Services (DDS)

Role: Authorizes home modifications through service coordinators and case managers. Coordinates funding approval through local CDDPs, brokerages, and APD offices.

Agency: Oregon Health Authority (OHA)

Role: Oversees Medicaid provider enrollment, funding rules, and program compliance.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight and ensures that Oregon’s HCBS programs meet Medicaid standards.

Agency: Oregon Secretary of State (SOS)

Role: Registers and certifies businesses operating in Oregon.

Agency: Oregon Construction Contractors Board (CCB)

Role: Licenses residential and commercial contractors performing structural work.

2. HOME MODIFICATION SERVICES OVERVIEW

These services allow clients to live in a more accessible, safer, and functional home environment, tailored to their physical and health-related needs.

Approved providers may deliver:

ADA Accessibility Modifications: Ramps, widened doors, handrails, and barrier removal.
Bathroom and Kitchen Adaptations: Roll-in showers, grab bars, lowered counters, faucet and cabinet modifications.
Flooring and Threshold Adjustments: Anti-slip flooring, smooth transitions, and level entryways.
Environmental Controls: Installation of switches, smart home tech, alarms, and visual/auditory enhancements.
Structural Enhancements: Stair lifts, ceiling track systems, porch lifts, and emergency exits.
Home Assessments and Estimates: On-site evaluations, contractor coordination, and cost reviews.
Post-Completion Monitoring: Ensuring that modifications meet client needs and Medicaid requirements.
Documentation: Service authorization records, estimates, completion forms, and Medicaid billing logs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Oregon Secretary of State.
Obtain EIN and Type 2 NPI.
Enroll with Oregon Medicaid via the OHA Provider Portal.
Apply as an approved vendor through local CDDPs, APD, or brokerages.
If performing physical construction, obtain contractor licensure via the Oregon Construction Contractors Board (CCB).
Maintain liability insurance, workers’ compensation, and bonding (if applicable).
Develop a Home Modification Services Policy & Procedure Manual tailored to Medicaid guidelines and construction best practices.

4. OREGON PROVIDER ENROLLMENT PROCESS

Step 1: Register your LLC or corporation, secure EIN and NPI.

Step 2: Enroll in the Oregon Health Plan as a Medicaid provider.

Step 3: Apply for vendor status through APD, CDDP, or brokerage offices.

Step 4: If applicable, obtain CCB licensing and verify subcontractor credentials.

Step 5: Submit policy manual, sample estimates, and service flow documentation.

Step 6: Begin receiving service referrals and project authorizations.

5. REQUIRED DOCUMENTATION

Articles of Incorporation
EIN and NPI confirmation
CCB license and bonding documents (for construction)
Business insurance certificates (general liability and workers’ comp)
Medicaid vendor enrollment confirmation
Home Modification Policy & Procedure Manual including:
- Assessment and site visit procedures
- Safety and ADA compliance standards
- Project timeline estimates and authorization process
- Change order policies and billing reconciliation
- Post-completion review protocols
- Client consent forms and complaint resolution processes
- HIPAA compliance and privacy safeguards

6. STAFFING REQUIREMENTS

Role: Home Modification Specialist / Project Manager

Requirements: Experience with accessibility design and Medicaid-funded adaptations.

Role: Licensed Contractor / Subcontractor

Requirements: CCB license, construction experience, and background clearance.

Role: Administrative Coordinator

Requirements: Oversees referral intake, billing, vendor logs, and client records.

All staff must complete:

HIPAA and client confidentiality training
Medicaid billing documentation and EVV logging (if applicable)
ADA design standards education (recommended)
Safety and injury prevention procedures
Annual credential renewals and training refreshers

7. MEDICAID WAIVER PROGRAMS

Home Modification Services are available through:

K Plan (1915(k)): Covers accessibility-related modifications to support ADL/IADL performance.
Comprehensive & Support Services Waivers (IDD): Funds home adaptations that allow individuals with IDD to remain at home.
APD HCBS Waivers: For seniors and adults with physical disabilities.
Children’s DD Waiver: Provides home modifications for medically fragile or mobility-limited youth.

8. TIMELINE TO LAUNCH

Phase: Business Formation & Manual Development

Timeline: 1–2 months

Phase: Medicaid Enrollment & Vendor Approval

Timeline: 2–3 months

Phase: CCB Licensing & Contractor Credentialing

Timeline: 30–60 days

Phase: Referral Activation & Project Fulfillment

Timeline: Begins once service authorizations are issued by case managers

9. CONTACT INFORMATION

Oregon Health Authority – Provider Enrollment

Website: https://www.oregon.gov/oha/HSD/OHP/Pages/Providers.aspx

Oregon Department of Human Services (ODHS)

Website: https://www.oregon.gov/dhs

Oregon Construction Contractors Board (CCB)

Website: https://www.oregon.gov/ccb

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

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

WCG helps providers establish compliant, well-documented home modification programs designed to meet the accessibility needs of Medicaid recipients in Oregon.

Scope of Work: