<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".18" citation="COMAR 10.09.56.18" title_num="10" subtitle_num="09" chapter_num="56" heading="Covered Services — Environmental Accessibility Adaptations.">
  <paragraph num="A.">
    <text>Environmental accessibility adaptations are those physical adaptations to the participant's home, which are reasonable and medically necessary to:</text>
    <paragraph num="(1)">
      <text>Prevent the participant's institutionalization;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Assure:</text>
      <paragraph num="(a)">
        <text>The participant's health, welfare, and safety; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A safe, therapeutic environment;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Prevent the participant's self-injurious behavior; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Enable the participant to function with greater independence in the home.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Environmental accessibility adaptations include:</text>
    <paragraph num="(1)">
      <text>Alarms or locks on doors, windows, or fences;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Protective padding on walls or floors;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Plexiglass on windows;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Outside gates and fences;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Brackets for appliances;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Raised electrical switches and sockets;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Safety screen doors; and</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Individual tracking devices.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The environmental accessibility adaptations shall be preauthorized in the participant's plan of care and by the State Department of Education.</text>
  </paragraph>
  <paragraph num="D.">
    <text>All construction shall:</text>
    <paragraph num="(1)">
      <text>Be provided in accordance with applicable State or local building codes; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Pass the required inspections.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Window locks may only be used if there is no other way to prevent a participant's rapid movement into a potentially dangerous situation.</text>
  </paragraph>
  <paragraph num="F.">
    <text>With the added safety precautions, it shall be assured that the house has enough exits, so there are not fire or safety concerns.</text>
  </paragraph>
  <paragraph num="G.">
    <text>Several rooms may be secured, but not the whole house.</text>
  </paragraph>
  <paragraph num="H.">
    <text>As appropriate, the adaptations shall be approved by the fire department or fire marshal as meeting the fire safety requirements.</text>
  </paragraph>
  <paragraph num="I.">
    <text>This service is not covered for facilities where residential habilitation services are delivered.</text>
  </paragraph>
  <paragraph num="J.">
    <text>Excluded are those adaptations or improvements to the home, such as carpeting, roof repair, and central air conditioning, which:</text>
    <paragraph num="(1)">
      <text>Are of general utility;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Are not of direct medical or remedial benefit to the participant; or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Add to the home's total square footage.</text>
    </paragraph>
  </paragraph>
</regulation>