(a) Environmental modifications are modifications made by a provider to a beneficiary’s place of residence that:

1. (1) Are necessary to ensure the health, welfare, and safety of the beneficiary; or
2. (2) Enable the beneficiary to function with greater independence and without which the beneficiary would require institutionalization.

(b) Environmental modifications include without limitation:

1. (1) Wheelchair ramps;
2. (2) Widening doorways;
3. (3) Modifications relating to a beneficiary’s access to and use of a bathroom;
4. (4) Installation of specialized electrical or plumbing systems to accommodate a beneficiary’s medical equipment;
5. (5) Installation of sidewalks or pads for beneficiaries with mobility deficits; and
6. (6) Fencing to prevent the elopement and wandering of beneficiaries.

(c) Environmental modifications do not include:

1. (1) Repairs that are of general utility and not for a beneficiary’s medical or rehabilitative need;
2. (2) Modifications that are of aesthetic value only; and
3. (3) Modifications that add to the total square footage of the residence.

(e) A provider of environmental modifications must maintain the following documentation in a beneficiary’s service record:

1. (1) If the residence is rented or leased, the written consent of the property owner to perform the environmental modifications;
2. (2) An original photo of the site where environmental modifications will be done;
3. (3) A to-scale sketch plan of the proposed environmental modification project;
4. (4) Any necessary inspections, inspection reports, and permits required by federal, state, and local laws either prior to commencing work or upon completion of each environmental modification to verify that the repair, modification, or installation was completed;
5. (5) The date or dates of the environmental modification installation;
6. (6) The name of the individual/company performing the environmental modification, and copies of their licenses and bonding information, if applicable;

7. (7) The signature of the legal guardian or beneficiary, if no legal guardian is appointed, at job completion certifying:

   1. (A) The environmental modifications authorized are complete;
   2. (B) The property was left in satisfactory condition; and
   3. (C) Any incidental damages to the property were repaired; and
8. (8) An itemized invoice or statement of all expenses including materials and labor associated with the environmental modification.