Home Modification and Repairs for Older Adults: Challenges and Opportunities for State Units on Aging: This report by the USC Fall Prevention Center of Excellence and ADvancing States reports on a national survey

ALABAMA DEPARTMENT OF SENIOR SERVICES (State Unit on Aging)

State Units on Aging (SUAs) are designated state-level agencies that develop and administer state plans that advocate for and provide assistance, including home modifications or repairs, to older residents, their families, and adults with physical disabilities. SUAs administer funds, including Older Americans Act funds, which may be used to support home modification or repair services through local Area Agencies on Aging and other state and local entities.

1. Alabama Cares Program 
Program Description: Under the Alabama Cares Program, Caregivers Supplemental Services, caregivers may qualify on a limited basis for incontinent supplies, minor home modifications, assistive technology, and emergency response alarms to family caregivers.
Population Served: Caregivers in Alabama who provide daily care to someone who has a disability, Alzheimer’s Disease or some form of dementia, or is frail.

2. Home and Community-Based Services for the Alabama Community Transition (ACT) Waiver 
Program Description: This Medicaid Waiver, operated by the Alabama Department of Senior Services, provides services to individuals with disabilities or long term illnesses who currently live in a nursing facility and desire to transition to the home and community setting. The code provides home modifications for physical adaptations of the home required by the individual’s Plan of Care. The limit on home modification is $5,000 per waiver participant and the state coordinator must approve any expenditure in excess of the maximum allowed amount and the Medicaid designated personnel.
Population Served: Medicaid-eligible individuals with disabilities or long term illnesses who currently live in a nursing facility and desire to transition to the home and community setting.

ALABAMA MEDICAID AGENCY

1. Home and Community-Based Waiver for Persons with Intellectual Disabilities
Program Description: This Medicaid Waiver, operated by the Alabama Department of Mental Health, provides services including home modifications to intellectually disabled adults and children who would otherwise qualify for care in an intermediate care facility for the intellectually disabled. Environmental accessibility adaptation services may include those to accommodate medical equipment and supplies necessary for the welfare of the waiver recipient (e.g., installation of ramps and grab bars, widening of doorways, modifications of bathroom facilities, or installation of specialized electric and plumbing systems).
Population Served: Medicaid-eligible adults and children with intellectual disabilities who would otherwise qualify for care in an intermediate care facility.

2. State of Alabama Independent Living Waiver Program
Program Description: This Medicaid Waiver, operated by the Alabama Department of Rehabilitation Services, provides support to adults 18 years or older with a disability who have specific medical diagnoses and would otherwise qualify for care in a nursing care facility. Supportive Services include environmental accessibility adaptations.
Population Served: Adults 18 years or older with a disability who have a specific medical diagnosis.

ALABAMA STATE ASSISTIVE TECHNOLOGY PROGRAM

STAR, Alabama’s Assistive Technology Act program
The State Assistive Technology Grant Program, funded under the Assistive Technology Act of 2004, supports comprehensive, statewide programs in each state that improve the provision of assistive technology (often home modification-related) to individuals with disabilities of all ages.

1. To locate the Area Agency on Aging in your state, please contact Eldercare Locator at https://eldercare.acl.gov/Public/Index.aspx

2. Data Brief: Building Community Capacity to Serve Older Adults: The Role of Area Agencies on Aging in Home Modifications and Repairs
This Data Brief highlights key findings from the 2019 National Survey of Area Agencies on Aging on how Area Agencies on Aging are providing and funding home modification and repair activities. It was developed by the USC Fall Prevention Center of Excellence in partnership with the National Association of Area Agencies on Aging as part of the Administration for Community Living project, “Promoting Aging in Place by Enhancing Access to Home Modifications.”

3. Featured Efforts:

A Matter of Balance
Central Alabama Aging Consortium
Montgomery, Alabama
A Matter of Balance, offered by the Central Alabama Aging Consortium, is an evidence-based program designed for older adults living in the community. It provides education for reducing one’s fear of falling and improves activity levels of older adults in their communities, including how to safely navigate their home environment.

Neighbors for Seniors Program
Southern Alabama Regional Council on Aging
Dothan, Alabama
The Neighbors for Seniors Program assists older adults and individuals with disabilities who are on a fixed income with home safety improvements and home repairs critical to their health. Southern Alabama Regional Council on Aging (SARCOA) connects clients with groups and individuals who donate time, skills and money to complete the needed home projects. Since the program started in 2015, more than 300 individuals have been assisted. This includes persons that not only were assisted with home repairs and yard work, but were recipients of air conditioners, heaters and fans. Due to the skillset of most volunteers, projects are limited to minor home repairs, such as ramps, grab bars, and handrails. The program has a dedicated volunteer to oversee ramp construction, which allows volunteers with lower skill levels to assist in the builds. Donations from the community cover the cost of the projects.