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Emod pest cont bath safety application

Environmental Modification, Pest Control and Bath Safety

Disclosure of Ownership

Provider Enrollment form

Provider Enrollment Form #2

Pest Control Standards

Ramp Standards

General Ramp Specifications IV the minimum standards that providers must adhere to when building ramps for CLTC participants.

These specifications are to be used as a guide to our providers. They will not be used to diminish in any way local, state and national codes. These specifications are a summary of information gathered using the International Building Code (2003 Edition), ICC, ANSI A117.1 1998 and ADA Standards for Accessible Design.
  • General Notes:
    Permits are the responsibility of the provider.
    Ramps are to be firm, stable, slip resistant and safe.
    Ramps and landings with drop offs will have a minimum 4” curb and railings.
    Ramps will be built using pressure (weather) treated lumber.

  • General Materials:
    4x4 posts
    2x6 (min.) joists
    2x6 or 5/4x6 decking
    2x4 (min.) curbing, side, top, and top support rail
    Pressure treated handrails (2x2 are acceptable)
    2x4x4” handrail spacers
    Pressure treated decking nails
    2500 PSI cement

  • Foundations:
    Posts must be a minimum 4x4 CCA lumber
    Posts must be sunk a minimum 8” into the ground and set in concrete (min. 25lbs)
    Exception – if post is set on cement walkway or driveway, post may be anchored with a post base attached to the cement, or cross- braced for stability.
    Foundation posts are to be set no more than 8’ apart.

  • Floor Framing:
    Outside joists shall consist of 2x6 (min) lumber connected to the foundation posts.
    Inside joists shall be 2 x 6 (min) and shall be connected to the foundation posts using a header board and proper joist hangers.
    There shall be no more than 24” between joists.

  • Slopes:
    All landings must be level (slope no greater than 1:50)
    All cross slopes must not exceed 1:50
    Ramps will have a maximum slope of 1:12 with few exceptions.
    In the RARE case a steeper slope is needed, the following will apply:
    A 1:10 slope is permitted for no more than a 6” rise.
    A 1:8 slope is permitted for no more than a 3” rise.

  • Ramps:
    Shall not rise more than 30” between landings.
    Shall lead to a firm stable landing, provider is responsible for the area at the end of a ramp.
    Shall be level with a cross slope of no more than 1:50
    Shall have a clear width of 36”.
    With a drop off of more than 2” shall have a minimum 4” curb.
    Shall allow for water to run off and not collect.
    Must be slip resistant (floor areas painted with a non- slip paint).
    Must use 2’x6” or 5/4”x6” as decking.
    Ramps are not to be built attached to the house unless necessary (2’ spacing).
    Ramps for clients using stretchers should avoid turns and be angled if possible.
    The end of the ramp will be finished with a metal plate or concrete.

  • Landings (general):
    Must be level – slope less than 1:50, must be stable and slip resistant.
    Landings must have top rail, side rail, and curbing.
    Must be at least 60” x 60” clear space if the ramp changes direction.
    “Straight through” landings must be the width of the ramp and 5’ long.
    “Switchback landings” will be at least 60”x 96” clear space.

  • Landings at doorways:
    Shall have no more than a ½” beveled threshold between landing and interior floor.
    Must have a minimum 18” of clear space past the latch side of the door (24” preferred).
    Will minimum have 60” x 60” clear space.
    Railings are required for drop offs of more than 2”.
    Must not be positioned in such a way as to expose people to the danger of falling.

  • Handrails:
    Shall run parallel to the floor of the landing or ramp.
    Shall be continuous on both sides.
    Shall extend 12” past the end of the ramp.
    Shall have a 1 ½” clearance between handrail and top rail and any wall.
    Shall be between 34” and 38” high.
    Shall not rotate within its fittings.
    Must be grip-able with a width of no more than 1 ¼” – 1 ½” (a 2x4 cap does not comply).
    Must be able to withstand 250 Lbs. of pressure.

  • Top rails, side rails, and curbing:
    Top rail must have a side support rail on the inside of the ramp.
    Side rails will consist of a minimum 2x4 running parallel to the floor at a mid point between the curbing and the handrail.
    Side rails shall be attached on the inside of the ramp to the 4x4 posts (no toe- nailing between posts).
    Must have a 2x4 vertical support rail between the top rail and joist at a mid-point between foundation posts.
    Curbing shall be attached on the inside of the ramp to the 4x4 posts (no toe- nailing between posts) and be 1” off the ramp.
    Top rail will extend 12” past the end of the ramp with a return.

  • Heavy Duty Ramps and Landings:
    Ramps and landings for clients above 250 lbs. shall be built to accommodate the extra weight.
    These ramps shall use: 2 x 6 decking boards; 2 x 8 joists every 16”; and be a minimum of 44” wide clear space.

Bathroom Safety Product Standards

Bath Safety Standards 2010 , the minimum standards that providers must adhere to when providing bathroom safety products for CLTC participants.

  • Specs for Raised Toilet Seats:
    Reimbursement - $46.00
    Maximum weight capacity - 250 lbs.
    Seat width - 15"
    Seat depth - 15"
    Seat height - 5"
    Installation

  • Specs for Transfer Benches:
    Reimbursement - $150.00
    Adjustable height from 17” to 23”
    Backrest
    Arm rail
    Seat depth – 18”
    Seat width – 33” minimum
    Minimum Weight capacity – 350 lbs.
    Installation, assembly and adjustment

  • Specs for Shower Chair with Back:
    Reimbursement - $60.00
    Back rest
    Minimum 300 lbs weight capacity
    Adjustable
    Seat height- 17” to 21”
    Seat width – 20”
    Seat depth – 18”
    Installation

  • Specs for Hand-Held Showers:
    Reimbursement - $50.00
    Minimum 5’ hose
    Pause/ shut off function
    Intallation with Teflon tape

CLTC Environmental Modification Sanctioning Process


Sanction Process for Environmental Modification Providers that will apply when providers do not adhere to the minimum standards set forth by CLTC.

Community Long Term Care (CLTC) will review provider compliance with environmental modification program requirements on an ongoing basis. Reviews will be completed by the department’s environmental modification specialist. Failure to comply with the environmental modification requirements will result in the application of sanctions, either suspension and/or termination.

Suspension
:
The environmental modification provider is removed from the provider choice list. The provider will not be allowed to bid or be listed on the participant’s choice list for the duration of the sanction. The minimum period of suspension is 1 month. Providers who are suspended must complete all outstanding jobs to the specifications indicated by the environmental modification specialist before being allowed to perform new work with CLTC.

Termination
:
The cancellation of your enrollment in the Medicaid (CLTC) program resulting in denial of Medicaid participation for a period of three (3) years. After two suspensions for any reason, a third suspension in a two (2) year period from July-June will lead to termination from Medicaid participation.


Compliance Issues Resulting in Suspension and/or Termination

Refusing to complete jobs that the provider has bid on and won: Providers are expected to complete any job where they are the winning bidder. If the winning bidder accepts the job, then refuses to complete the project the provider will be subject to the following sanctioning process.

    First offense - Suspend one (1) month
    Second offense- Suspend two (2) months (within 1 year of first offense)
    Third offense Termination (within 1 year of first offense)
Example:

The provider bids and accepts jobs in several different areas, gets to the jobsite and decides he has underbid the project and/or doesn’t have the time or manpower to complete the job and refuses to honor his bid. This action will result in sanctioning of the provider.

Failure to complete jobs timely as defined by the date on the environmental modification specialists bid notification in Phoenix: Providers are expected to complete work in a timely manner. If it is identified that there are three (3) occurrences of this type within a six (6) Month time period of january thru june and/or july thru december the following sanctions will apply.

    A) Suspension for two (2) months
    B) Each subsequent occurrence- Suspension for two (2) months
Example:

The provider accepts a project through Phoenix which has an expected date of completion on it; if the provider accepts the job he is accepting the completion time frame. If the environmental modification specialist discovers that the provider is not completing this project in the allotted time frame indicated on the bid in Phoenix this action will result in sanctioning of the provider indicated above.


SCDHHS environmental modification Inspector returning to jobsite due to poor workmanship:

Providers are expected to comply with the standards set forth by the environmental modification inspector. If the SCDHHS inspector must return to the jobsite due to poor workmanship the following sanctioning process will occur.

    A) Three (3) substantiated returns in any quarter - Suspend two (2) months
    B) Six (6) substantiated returns in any quarter - Terminate
Example:

The provider accepts a project through Phoenix and completes the job. The environmental modification specialist will then review the work that was done. If the environmental modification specialist determines that the project was not done to general contracting standards a letter will be sent to the provider indicating the corrections that need to be completed on the job. If this occurs sanctioning of the provider will occur on the schedule mentioned above.


Documenting in Phoenix that a job is complete and/or billing for services through Care Call prior to completion of job:

Providers cannot bill Medicaid prior to the completion of an environmental modification project. If providers are found to have billed Medicaid or documented in Phoenix that the job was completed prior to job completion the following sanctioning process will apply:

Recoupment of inappropriate payment, if found job is not completed plus
    A) First offense – Suspend for one (1) month
    B) Second offense – Suspend two (2) months
    C) Third offense- Termination
Example:

The provider accepts a project through Phoenix and goes to work on the job. The provider is told by his crew that they have completed the job and the provider indicates this in the Phoenix system and/or bills for the job through Care Call. The environmental modification specialist and/or participant determine that project was not complete prior to indicating it in phoenix and/or billing through Care Call will result in the sanctioning of the provider on the schedule mentioned above.


Refusal or inability to complete job to the specifications set forth by the Environmental Modification inspector:

Providers are expected to complete jobs within the standards set forth by the environmental modification specialist. Any job not completed to general contracting specifications will receive a corrective action letter that must be followed. If the provider does not follow the corrective action letter and the deficiencies are not corrected within two (2) weeks all funds will be recouped and the provider will be automatically suspended from providing services to Medicaid participants until the job has been completed. The provider will be reinstated one month after the date of completion of the job.

A second offense of the type described above will result in being suspended for two months after the correction of the deficiencies and a third offense will result in automatic termination as a Medicaid provider.

Example:

The provider accepts a project through Phoenix and completes the job. The environmental modification specialist will then review the work that was done. If the environmental modification specialist determines that the project was not done to general contracting standards a letter will be sent to the provider indicating the corrections that need to be completed on the job. If the provider does not correct the deficiencies within two weeks this will lead to the sanctioning process mentioned above.