Environmental Modifications

Environmental Modifications: Definition

Environmental Modifications (E-mods) are internal and external physical adaptations to the home, which are necessary to ensure the health, welfare and safety of the waiver participant. These modifications enable the waiver participant to function with greater independence and prevent institutionalization.

Making Homes that Work: George Braddock Creative Housing Solutions

Session I. The Environment Matters

Session II. The Broken Environment 

Session III. The Caregiving Environment

Session IV. The Autism Friendly Environment 

General Resources

IDEA Center Resources: The IDEA Center (Center for Inclusive Design and Environmental Access) of the University at Buffalo is going to be providing us a webinar on who they are and the work that they do, specifically related to universal design. 

Wounded Warrior:
IDEA Center Wounded Warrior
Washington Post Article - Michael Graves Army Partner to Design Homes for Wounded Soldiers
Wounded Warrior Home Page
CBG Building Company Wounded Warrior Home Project

Funding Sources:

New York State:

E-mods must be provided where the waiver participant lives. If a waiver participant is moving to a new location which requires modifications, the modifications may be completed prior to the waiver participant's move. If an eligible individual is residing in an institution at the time of the application, the modifications may be completed no more than thirty (30) days prior to the waiver participant moving into the modified dwelling. All modifications must meet State and local building codes.

Modifications may also be made to a vehicle if it is the primary means of transportation for the waiver participant (referred to as vehicle modifications). An E-mod may alter the basic configuration of the waiver participant's home only if this alteration is necessary to successfully complete the modification. All environmental and vehicle modifications must be included in the SP and provided by agencies approved by DOH.

Allowable E-mods

E-mods in the home include the purchase and/or installation of:

  • Ramps

  • Lifts: hydraulic, manual or electric, for porch, bathroom or stairs (Lifts may also be rented if it is determined that this is more cost-effective.)

  • Widened doorways and hallways

  • Hand rails and grab bars

  • Automatic or manual door openers and doorbells

Bathroom and kitchen modifications, additions or adjustments to allow accessibility or improved functioning, include:

  • Roll-in showers

  • Sinks and tubs

  • Water faucet controls

  • Plumbing adaptations to allow for cutouts, toilet/sink adaptations

  • Turnaround space changes/adaptations

  • Worktables/work surface adaptations

  • Cabinet and shelving adaptations

Other home adaptations include:

  • Medically necessary heating/cooling adaptations required as part of a medical treatment plan. (Any such adaptations utilized solely to improve a person's living environment are not reimbursable under the waiver.)

  • Electrical wiring to accommodate other adaptations or equipment installation.

  • Specialized electric and plumbing systems that are necessary to accommodate the medical equipment and supplies that have been determined medically necessary.

  • Other appropriate E-mods, adaptations or repairs necessary to make the living arrangements accessible or accommodating for the participant's independence and daily functioning and provide for emergency fire evacuation and necessary to assure the waiver participant's health, welfare or safety.


United States Department of Agriculture Rural Development Home Modification Loan Program

What does this program do? 

Also known as the Section 504 Home Repair program, this provides loans to very-low-income homeowners to repair, improve or modernize their homes or grants to elderly very-low-income homeowners to remove health and safety hazards.

Who may apply for this program?

To qualify, you must:

  • Be the homeowner and occupy the house

  • Be unable to obtain affordable credit elsewhere

  • Have a family income below 50 percent of the area median income 

  • For grants, be age 62 or older and not be able to repay a repair loan

What is an eligible area?

Applicants may check the address of their home to determine eligibility.

How may funds be used?

  • Loans may be used to repair, improve or modernize homes or remove health and safety hazards

  • Grants must be used to remove health and safety hazards

Learn more about the program