Environmental Assessment
Environmental Modifications (EM) are physical changes to a person’s home or primary vehicle that are necessary to support health, safety, or greater independence—such as ramps, grab bars, bathroom changes, or vehicle adaptations. In Virginia, EM can be funded through the CL, FIS, and BI waivers (up to 5,000 dollars per calendar year) when they are medically necessary, directly tied to ISP outcomes, and not covered by other programs.
VATN offers both waiver-based EM assessments and private pay EM consultations to help individuals, families, and teams identify the most appropriate, cost-effective modifications for real-life needs.
Environmental Assessments at VATN
Environmental modification assessments at VATN are completed by qualified clinicians (for example, OTs, PTs, behavior consultants) who understand disability, accessibility, and the DD waivers.
During an EM assessment, we:
-
Review the person’s mobility, self-care, safety, and daily routines
-
Observe the home and/or vehicle layout and access points
-
Identify barriers to safe, independent living or transportation
-
Recommend specific, medically necessary modifications (not general home improvements) that support the person’s ISP outcomes
Our role is to complete the clinical assessment and recommendations; we do not sell or install the modifications. This keeps the evaluation independent and aligned with waiver rules.
Environmental Assessment Packages
Waiver-Based EM Assessments
For individuals using the CL, FIS, or BI waivers:
-
EM must be medically or functionally necessary—not just “nice to have.”
-
Modifications must be to the primary residence or primary vehicle used by the person.
-
The combined cost of EM items and labor cannot exceed 5,000 dollars per calendar year.
-
EM cannot be used to bring a substandard dwelling up to basic code or to pay for items of general utility (for example, roof repairs, carpeting, central air, cosmetic upgrades, decks, or added square footage).
-
Modifications must be the least expensive option that safely meets the need.
After our assessment, your Support Coordinator uses our recommendations to request service authorization, and an enrolled EM provider completes the installation.
Private Pay EM Consultants
For families, schools, or agencies who are not using waiver funds—or who want support beyond what the waiver covers—VATN offers private pay EM consultations. These services can be helpful when:
-
You want recommendations before approaching contractors.
-
You are navigating landlord conversations or school/home responsibilities.
-
Your needs fall outside the strict waiver criteria but you still want disability-informed guidance.
Private pay consultations include the same assessment process and a written summary with recommendations but do not involve DMAS service authorization or waiver funding.
ENVIORNMENTAL ASSESSMENT INTAKE PROCESS
Report & Reccomendation
You receive a written report describing the person’s needs, recommended modifications, and how those modifications support health, safety, or independence. For waiver users, this report can be shared with your Support Coordinator and EM provider to request service authorization and guide installation.
VATN Private Pay EM Packages
Standard Home EM Assessment
Starting at $300
Home & Vehicle EM Assessment
Starting at $450
Consultation & Contractor Collaboration
Starting at $650
Home visit, functional and environmental assessment, and a written report with specific recommendations (for example, ramp type/placement, bathroom adaptations, doorway changes).
Combined assessment of primary residence and primary vehicle with a single integrated report and prioritized recommendation list.
EM assessment, written recommendations, plus one or more meetings with your chosen contractor/landlord/school to review recommendations and answer questions.
FREQUENTLY ASKED QUESTIONS
What counts as an EM under the waivers?
EM includes physical changes to the primary home or primary vehicle—such as ramps, widened doorways, roll-in showers, grab bars, or vehicle lifts—that directly improve safety, access, or independence. It does not include general home repairs, cosmetic upgrades, or items of general utility like carpeting, roof work, central air, or added square footage.
Who is eligible for waiver-funded EM?
Individuals enrolled in the CL, FIS, or BI waivers who are receiving at least one other waiver service and have a documented need for home or vehicle modifications that support health, safety, or greater independence may qualify. The need must be tied to the person’s ISP.
How is EM funded?
For waiver participants, approved EM (devices plus labor) can be funded up to 5,000 dollars per calendar year, with no carryover of unused funds. Private pay EM consultations and modifications are paid directly by the family or contracting entity.
Can EM be used to fix or improve my home generally?
No. EM cannot be used to bring a substandard dwelling up to basic habitability standards or to pay for general home improvements. It must directly relate to the person’s disability-related needs and provide clear medical or remedial benefit.
Can you modify any home or vehicle?
Modifications can be recommended for the person’s primary residence and primary vehicle (owned by the individual, a family member with whom they live or have ongoing contact, or a non-relative primary supporter). For rentals, owner permission is required. EM cannot be used to modify provider-owned or provider-leased residential settings that are already required to meet accessibility standards.
Do you also install the modifications?
No. VATN provides the assessment and recommendations. For waiver-funded work, an enrolled EM provider completes the modifications. For private pay work, families or agencies choose and contract with their own builder or vendor; we can consult with them if that is part of your chosen package.