What is an Environment Modification (as defined by Virginia DMAS)?

Environmental modifications” or “EM” means physical adaptations to an individual’s primary residence or primary vehicle that are necessary to ensure the individual’s health, safety, or welfare or that enable the individual to function with greater independence and without which the individual would require institutionalization.

These can include:

  • Modification to the layout (remove a door to make the opening wider)
  • Provide adaptive equipment (install a tub bench)
  • Architectural Modification (install a ramp, bathroom modification)
  • Vehicle Modification (installing controls, modifying for wheelchair)

What Exclusions does an Environmental Modification have (as defined by Virginia DMAS)?

  • does not include adaptations or improvements to the primary home that are of general utility and are not of direct medical or remedial benefit to the waiver individual shall be excluded, including but not limited to, carpeting, flooring, roof repairs, central air conditioning or heating, general maintenance and repairs to a home, additions or maintenance of decks, maintenance/replacement or addition of sidewalks, driveways, carports, or adaptations that only increase the total square footage of the home.
  • does not include items for general leisure, or diversion items, or those items that are recreational in nature or those items that may be used as an outlet for behavioral supports. Such non-covered items include, but shall not be limited to, swing sets, playhouses, climbing walls, trampolines, protective matting or ground cover, sporting equipment or exercise equipment, such as special bicycles or tricycles.
  • does not include costs to remove or dispose or any other costs, of previously installed modifications, whether paid for by DMAS or any other source.
  • Providers of (EM) shall not be the individual's spouse, parent (natural, adoptive, foster, legal guardians), or other legal guardians, or conservator. Providers who supply EM to waiver individuals shall not perform consultations or write EM specifications for such individuals.
  • The contractor providing the modification MUST complete an assessment and quote to perform any approved work.


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