1. GOVERNING AGENCIES

Agency: Missouri Department of Health and Senior Services (DHSS)

Role: Administers Medicaid and HCBS Waiver programs, including home modification services

Agency: Missouri Department of Social Services (DSS)

Role: Oversees Medicaid provider enrollment and service authorization

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight and ensures waiver compliance

2. HOME MODIFICATION SERVICE OVERVIEW

Home Modification Services focus on making structural changes and adaptations to the home environment. These services are tailored according to the Individual Service Plan (ISP) or Person-Centered Plan (PCP) and may include:

• Installation of ramps and widened doorways for wheelchair access
• Bathroom modifications (e.g., roll-in showers, grab bars)
• Kitchen modifications (e.g., lowered countertops, adaptive appliances)
• Safety enhancements (e.g., non-slip flooring, handrails)
• Environmental control installations (e.g., adaptive lighting, voice-activated systems)
• Repairs or adjustments to maintain accessibility features

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Missouri Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Enroll as a Medicaid provider with the Missouri Department of Social Services
• Obtain a Contractor License from the Missouri Division of Professional Registration (if required)

Maintain liability insurance and documentation of compliance with building codes

4. MEDICAID PROVIDER ENROLLMENT PROCESS

Step 1: Pre-Application Contact

• Contact the Missouri Department of Social Services to understand home modification provider requirements

Step 2: Application Submission

• Submit business registration, contractor license, liability insurance, and project proposals

Step 3: Compliance Verification

• Ensure modifications meet safety standards and building regulations

Step 4: Approval and Medicaid Number Assignment

• Once approved, receive a Medicaid provider number and authorization to deliver services

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business Name Registration
• IRS EIN Letter
• NPI confirmation
• Contractor License (if applicable)
• Liability insurance certificate

Policy & procedure manual including:

• Assessment and planning protocols for modifications
• Installation and construction safety guidelines
• Documentation of completed modifications and inspections
• Client consent forms and satisfaction surveys
• Staff training and certification records

6. STAFFING REQUIREMENTS

Role: Home Modification Project Manager

Requirements: Experience in construction management or residential accessibility projects

Role: Licensed Contractor / Technician

Requirements:

• Valid contractor’s license in the state of Missouri
• Background check and insurance verification
• ADA compliance training and experience with accessibility installations

Training Requirements:

• Safety practices in residential modifications
• ADA compliance and universal design principles
• Risk management and client safety
• Documentation and client interaction best practices

7. MEDICAID WAIVER SERVICES

Home Modification Services in Missouri are available through:

• Aged and Disabled Waiver (ADW)
• Independent Living Waiver
• Medically Fragile Adult Waiver

Approved providers may deliver:

• Structural changes to improve accessibility
• Safety adaptations to reduce fall risks
• Maintenance and repair of existing modifications

8. TIMELINE TO LAUNCH

Phase: Business Formation

Timeline: 1–2 weeks

Phase: Medicaid Provider Enrollment

Timeline: 60–90 days

Phase: Staff Hiring and Licensing

Timeline: 30–45 days

Phase: Equipment and Safety Compliance

Timeline: 2–4 weeks

9. CONTACT INFORMATION

Missouri Department of Health and Senior Services (DHSS)

Website: https://health.mo.gov

Missouri Department of Social Services (DSS)

Website: https://mydss.mo.gov

Missouri Division of Professional Registration

Website: https://pr.mo.gov

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10. SCOPE OF WORK

• Business registration and licensing assistance
• Medicaid provider enrollment
• Policy & procedure manual for modification service operations
• Templates for project planning, client consent forms, and inspection logs
• Website, domain, and email setup
• Staff credentialing and training documentation
• Client intake packet and modification planning forms
• Risk management and safety compliance protocols
• Referral networking with housing agencies and community organizations