Oregon Home Modifications (HM) Policy Manual

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The Oregon Home Modifications (HM) Policy Manual provides a comprehensive and regulatory-aligned framework for the planning, approval, installation, and monitoring of physical modifications made to residences under the state’s Medicaid and Home and Community-Based Services (HCBS) programs. This manual is designed to support individuals with disabilities and aging adults in maintaining independence, safety, and full participation in community life by ensuring their home environments are accessible, adaptive, and person-centered.
Rooted in the Oregon Administrative Rules (OAR 411-035 and 410-173) and aligned with the HCBS Settings Rule (42 CFR §441.301), this manual outlines policies for environmental modification approvals, universal design implementation, lead safety, tribal coordination, and compliance with building codes such as the Oregon Residential Specialty Code, OSSC, and Portland Metro RRP Rules.
The manual includes clearly defined protocols for functional assessments, anticipatory needs evaluations, design approvals, construction standards, and post-installation inspections. It also covers emergency preparedness, hazard prevention, quality assurance, and staff qualifications—ensuring that modifications meet clinical, cultural, and safety standards. Special emphasis is placed on collaboration with licensed contractors, occupational and physical therapists, and tribal housing authorities.
This policy manual serves as a critical guide for case managers, Medicaid providers, contractors, and agency staff involved in home modifications funded through Oregon’s Medicaid programs. It ensures consistency, regulatory compliance, cost-effectiveness, and a commitment to improving the quality of life for individuals receiving long-term services and supports in the most integrated setting possible.