Children's Waiver Environmental/Vehicle Modification and Assistive/Adaptive Technology
Frequently Asked Questions
- FAQs is also avialable in Portable Document Format - (PDF)
Q: Why was the Pre-Project Evaluation Payment Request Form created?
A: The Pre-Project Evaluation Payment Request Form was created to expedite payment to pre-project evaluators. Evaluators should not have to wait for payment until the project is completed.
Q: Is an invoice needed for a Pre-Project Evaluation?
A: Yes, invoices for all fees associated with the project are required to be submitted with the
Final Cost Form.
Q: If I submit the Pre-Project Evaluation Payment Request Form, do I still need to submit a
Description and Cost Projection Form?
A: Yes, the Description and Cost Projection Form is always required for EMod/VMod/AAT requests. The Pre-Project Evaluation Payment Request Form can be submitted prior to or along with the Description and Cost Projection Form.
Q: How do I know if a pre-project evaluation is required for an EMod/VMod/AAT project?
A: A pre-project evaluation should be completed when the proposed project impacts the integrity of the environment's structure and/or its surroundings. A pre-project evaluation should also be completed when the proposed project is technical in nature, requiring the input from a specialist or expert in the content area (i.e. a VMod that requires alterations made to mechanical aspects of a vehicle).
Q: What happens if a pre-project evaluation is completed, but then the family decides that they are unable to follow through with the project? Is the FMS responsible for the cost of the pre-project evaluation?
A: The cost of a pre-project evaluation is covered under the HCBS Children's Waiver regardless of project outcome. If a project has been withdrawn, the HHCM/C-YES should notify the FMS and indicate the reason for withdrawal. A Description and Cost Projection Form and a Final Cost Form along with necessary documentation may be required if payment has been requested. If all required documentation is submitted, FMS will provide funding for pre-project evaluations.
Q: If a client is using C-YES, are they acting as the CM agency in this process?
A: Yes, C-YES is the care manager for any clients they are working with.
Q: If a family purchases a used and already modified vehicle, can the purchase be reimbursed?
A: The Children's Waiver can provide funding towards the current value of the modification in an already modified vehicle with pre-approval if the vehicle is sold by a NMEDA dealer and the modification meets the child's identified medical needs. The entire purchase would not be covered as depreciation is also considered. Seeking specific information and what would be covered prior to a purchase is recommended.
Q: Would it be safe to say that if an item has a DME CPT Code that it should fall under DME and not Assistive Technology?
A: If the item can be found on the DME CPT Code list than the item would be considered DME. If there are specific product questions that arise, please send detailed information about the product to fms@childrenshealthhome.org so that the FMS can confirm the item's classification with DME Bureau of Medical Review.
Q: Can you make environmental modifications on a rental home if it is the member's primary residence?
A: If the rental home is to be the permanent and primary residence of the child, the environmental modifications may be allowed. Signed permission from the property owner allowing for the modification will be required.
Q: What exactly is the requirement to exhaust looking for community resources to fund these projects? How many charities are we expected to contact? How many grants are we supposed to apply for?
A: The HHCM/C-YES must ensure that the EMod/VMod/AAT cannot be covered by Third Party Health Insurance. It is expected that the HHCM/C-YES make a reasonable effort to research alternate funding options (i.e. grants, community organizations, etc.). These efforts must be documented and submitted along with the Service Request Packet but there is not a specific number required.
Q: Does an evaluator need to add project cost to their evaluation report?
A: Evaluators are neutral parties responsible for evaluating projects based on the needs of the child. Evaluators are not responsible for determining the price of projects. Contractors/Vendors are responsible for submitting bids based on the evaluation and project description provided by the pre-project evaluator and HHCM/C-YES.
Q: Should I include the cost of any associated taxes on requested projects on the Description and Cost Projection Form?
A: Projects funded by Medicaid are exempt from taxes. Project costs on the Description and Cost Projection form should not include taxes.
Q: Where can I send questions about the EMod/VMod/AAT request process?
A: Please contact fms@childrenshealthhome.org or call 855-209-1142
Additional guidance can be found on the Children's Waiver webpage here and the FMS Waiver webpage here.
