10.7.8 Approval process for building alterations

A client’s place of residence, education or work, may require alteration to enable the client freedom of access and egress, and allow the safe use of facilities within the place of residence, education or work.

A ‘place of residence’ is defined as all the buildings or parts of buildings on a property which are occupied and used by the client as their main place of living, regardless of ownership of the property.  For example, a ‘place of residence’ could be owned (solely or jointly), rented or the person could be living in a house owned by a family member.

Some home modifications may be provided through the Rehabilitation Appliances Program (RAP) where the client holds a DVA Health Card. Where the client holds a Gold Card, there must be an assessed clinical need for the home alterations. Where the client holds a White Card, the assessed clinical need for the alterations must be linked to the client’s accepted condition(s).

For ease of administration, the following process should be used:

• If the client requires simple house modifications, such as non-slip surfacing, ramps, lever taps, grab rails and hand rails, step modifications, or minor hold modifications, then RAP should be considered in the first instance.
• If the client requires complex home modifications, such as bathroom and kitchen modifications, alterations to flooring, modification of doorways to accommodate a wheelchair etc., then DVA delegates should follow their internal escalation process for technical advice. 

Complex home alterations through RAP are subject to the RAP National Guidelines and prior approval process. 

The RAP Schedule and RAP National Guidelines stipulate that any home modifications must be completed in accordance with the regulations and requirements of any statutory bodies or authorities having jurisdiction over the works. The property owner must provide written approval for modification to be undertaken and provide DVA with an undertaking not to seek compensation for restoration of property when the modifications are no longer required by the entitled person. Installations should only be carried out in the entitled person’s principle place of residence. Confirmation is required that the entitled person intends to remain in the dwelling to be modified for the foreseeable future. Subsequent requests for modifications of the same area will only be considered where this further need could not have been reasonably foreseen by the entitled person in light of their illnesses and/or injuries and prognoses.

The following criteria must be met before complex home modifications can be considered through RAP:

• the entitled person’s inability to use certain necessary facilities within their home is permanent;
• non-structural alterations and RAP aids and appliances are inadequate to the purpose;
• assistance from carers and community services are inadequate to the purpose;
• the residence to be altered should be the entitled person’s primary residence;
• in the judgement of the delegate, the entitled person is likely to remain living in the residence for the foreseeable future;
• the property needs to be of sufficient structural soundness as to accommodate the alterations;
• having regard to the entitled person’s illnesses, injuries and disabilities, the need for the modifications could not have been reasonably foreseeable at the time of purchase;
• relocation to a more suitable residence is not viable;
• in respect of a fixed ramp, the entitled person should be unable to safely negotiate steps; and
• in respect of steps, new steps are not installed in cases where no steps currently exist. Step modifications also do not include maintenance of unsafe stairs or standardising uneven steps that do not meet relevant building costs.

Regardless of which provisions (RAP or the rehabilitation provisions) are being considered to supply the home alterations, the following guidelines are to be considered when reviewing requests for alterations:

• Professional advice is to be obtained from treating practitioners, Occupational Therapists, and other allied health providers to:

• assess and make recommendations for clients who are making decisions regarding their place of residence.  For example, if a person is being discharged from care, it would be reasonable to obtain a professional assessment of the client’s residential needs and requirements.  This will provide advice and guidance for the client when making choices regarding their place of residence.  This could better identify any need for, or type of alterations;
• assess and recommend the type of alterations required according to the client’s impairment.  For example, a client with a severe disability such as paraplegia or quadriplegia may require significant bathroom modifications, the installation of grab rails, the removal of shower hobs, the installation of wheelchair ramps;
• clearly define how the alterations will assist a client achieve their rehabilitation goals, ie improved mobility, safely improving or maintaining independence; and
• how the alterations will impact on the client’s general functioning.

• Health professionals with specialist skills/qualifications should be used where appropriate, for example, Occupational Therapists who have specialist skills in traumatic brain injury will be well placed to provide advice about what home alterations might be required for clients with these conditions. The DVA OT Advisers are also a useful resource for delegates, particularly where clients have complex needs;
• Whether the request is consistent with community standards. For example, it would be considered consistent with community standards that a person is able to have safe access to their property;
• When alterations have previously been provided any repeat claims for the same type or level of assistance may mean the client will be required to make a financial contribution to subsequent alterations (this only applies when the alterations are being provided through the rehabilitation provisions);
• Clients shall not be restricted in choosing their place of residence. However, where the client’s final choice of a place of residence creates a requirement for extensive and costly alterations, the client may be required to make a larger financial contribution towards the cost of such alterations.  This is where an assessment prior to final choice being made can be beneficial for both the client and the Department.
• The Rehabilitation Coordinator must be satisfied of ‘value for money’, by obtaining competitive quotes.  The number of quotes to be supplied should be commensurate with the cost of the project:

•  1 – 2 quotes for projects up to $2000; and
•  3 quotes for projects over $2000.

• Approval for payment for home or workplace alterations may only be given for work to be performed by builders or other tradesmen who are registered and who hold appropriate industry standard insurance to cover the owner/s against loss through defective workmanship or damage.
• Prior to any alteration work commencing on a home, education or workplace, the owner/s of the property must provide written consent for the alterations to be undertaken.  Such consent is especially important where the property is not owned outright by the client.  However, this consent is also required when the client is the sole owner of the property.
• If local council or other building/planning approvals are required for proposed building alterations, then these approvals must be obtained prior to the commencement of work.