1. Program Definition and Services

Home Modification Services in Rhode Island provide physical adaptations to a participant’s primary residence to ensure accessibility, safety, and independence. The program aims to help maintain individuals with functional limitations in the community, averting the need for long-term institutional services and supports by removing structural barriers. Services include:

• In-Home Personal Care: Individual structural adaptations within the individual/family home (Installation of modular wheelchair ramps, widening of interior/exterior doorways, installation of vertical platform lifts or stair glides, and addition of entry/exit safety features like non-slip flooring or exterior handrails)
• Residential Personal Care: Physical modifications and environmental safety updates within approved community living spaces or personal bathrooms/kitchens (Roll-in shower conversions, grab bar placements, accessible toilet/sink integration, lowered kitchen countertops, voice-activated environmental controls, and smart-home safety devices)

2. Regulations

The program is governed by the following regulations:

• Rhode Island General Laws Chapter 5-65 (Contractors' Registration and Licensing Board Statutory Rules)
• Rhode Island State Building Code (SBC-1 through SBC-6, including ADA Standards for Accessible Design)
• Rhode Island Medicaid 1115 Comprehensive Demonstration Waiver
• Federal HCBS Settings Final Rule (42 CFR 441.301)

3. Licensing or Certification

Providers delivering structural modifications must be actively registered with the State of Rhode Island Contractors' Registration and Licensing Board (CRLB). For specialized modifications, contractors must hold valid trade licenses (licensed electricians or plumbers) issued by the Rhode Island Department of Labor and Training (DLT) while following all Home and Community-Based Services (HCBS) requirements.

4. Responsible State Agency

The Rhode Island Executive Office of Health and Human Services (EOHHS) and the Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH) Division of Developmental Disabilities are responsible for reviewing applications, authorizing specific home modification funding caps, and certifying home modification services providers.

5. Application Process

The application process is conducted through a coordinated portal loop. Providers must first secure active business credentials through the CRLB. Once registered as an approved state contractor, the agency completes final program enrollment and specialty asset registration through the electronic Rhode Island Medicaid Healthcare Portal.

6. Required Documentation

While specific documentation requirements vary based on the target waiver, providers typically need to submit:

• Active Rhode Island CRLB Contractor Registration Certificate
• Pre-education course certificates (completion of the mandatory 5-hour CRLB course for new registrants)
• Agency operational policies and procedures (detailing site evaluation methods, scope of work [SOW] building formats, safety compliance checklists, and warranty protocols)
• Proof of comprehensive general liability insurance (minimum $500,000 policy listing the RICRLB as the certificate holder) and workers' compensation insurance
• Clear, detailed structural line drawings, municipal permits, and clinician-backed justification letters (e.g., Occupational Therapist environmental assessments)

7. Timeline for Approval

The exact timeline for approval fluctuates based on state agency backlogs, individual project prior authorization (PA) reviews, and local municipal permit processing. Providers should expect the complete enrollment and project initiation track to take 2 to 4 months.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must establish their business entity with the Rhode Island Secretary of State, fulfill the state’s mandatory 5-hour contractor pre-education class, purchase required liability binders, and secure federal identification numbers (EIN and a Type 2 NPI if billing directly).

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Before receiving service requests, project coordinators and supervisors must complete billing orientation modules regarding Medicaid Prior Authorization (PA) request packages, HCBS environmental tracking rules, and Electronic Visit Verification (EVV) exemption limits for structural trades.

10. Additional Notes

• Providers must ensure that intensive care or adapted home settings meet all state accessibility, local zoning, and environmental safety guidelines
• In-Home Personal Care modifications must be performed directly by the certified agency's registered personnel or licensed, approved subcontractors
• All direct care and construction staff entering participant homes must conduct mandatory background clearances and fingerprinting screenings through the RI Attorney General's Bureau of Criminal Identification (BCI)
• Providers must maintain detailed records of face-to-face services for Medicaid documentation and billing, requiring explicit photographic proof of pre- and post-installation environments alongside signed participant satisfaction waivers

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