Older adults, in particular, are vulnerable to injuries such as falls, and assistance that enables them to make even modest changes can have a substantial impact on their well-being. People with disabilities also benefit from modifications that make their home more accessible and safe. For example, users of mobility assistive devices such as canes or wheelchairs would benefit from wider doorways and installation of a chair lift if their home has stairs.

Many jurisdictions offer assistance that enables eligible households to make home safety modifications. This assistance is usually provided in the form of grants, loans, and/or in-kind assistance.

Approach

Many jurisdictions have programs to provide assistance for home safety modifications. Coverage can come in several forms. Some offer subsidized loans to pay for the modification, or guaranteed loans that allow banks to use less stringent lending requirements. One-time grants for a specific home modificationRetrofits and improvements done on homes to increase accessibility for older adults and people with disabilities. are another common option. Some have programs which offer a mix of loans and grants. Another form of assistance, often offered by not-for-profit organizations, is free or low cost labor to undertake the modifications, or long term loans of equipment or materials.

For funding, jurisdictions can make use of HUD Community Development Block GrantA federal program established as part of the Housing and Community Development Act of 1974. It funds various community development activities for neighborhood revitalization, economic development, affordable housing, and better community facilities and services. (CDBG) as well as locally generated revenue such as housing trust funds. HOME Investment Partnerships Program (HOMEFederal program established by Congress in 1990 that is designed to increasing decent affordable housing for low- and very low-income families and individuals. State and localities receive HOME fund from HUD each year, and spend it on things such as: rental assistance, assistance to homebuyers, new construction, rehabilitation, improvements, demlition, relocation, and administrative costs.) block grants can also be used to fund home modification projects for income-qualifying homeowners; these funds can be provided to owner-occupants through grants and subsidized loans.

In designing local programs to fund home modifications, localities should investigate what types of modifications can be paid for with state Medicaid Home and Community Based Services (HCBS) waivers and strive to supplement, rather than duplicate, this alternative funding source. Each state has different waivers and programs with different eligibility requirements and benefits, but many of them pay for home modifications (known as environmental accessibility adaptations) that will increase an individual’s ability to live independently.

Localities can also publicize other public and private sources of funding for safety modifications that individual households can apply for if they are eligible. For example, there are circumstances under which Medicare will pay for the hardware associated with home modifications when they are deemed medically required and prescribed by a doctor.

See the related discussion on homeowner rehabilitation assistance programs. Many of these rehabilitation programs can also be used to remove health and safety hazards or improve accessibility for persons with disabilities.

Coverage

Assistance programs are often open to both homeowners and renters. While the Americans with Disabilities Act (“ADA”) requires landlords to allow people with disabilities to make reasonable structural modifications (such as installing a ramp, lowering the entry threshold, or installing grab bars), these modifications must usually be made at the tenant’s expense.

Home safety modification programs offer many benefits but may be a challenge to administer in smaller localities.  Localities with limited administrative resources should consider developing a program in coordination with neighboring jurisdictions, working with the county, state, another regional authority, or partnering with non-profits or philanthropies to assist in management.

Eligibility

Most programs involve an age or disability requirement. Many also include income limits or Medicaid eligibility.

Examples

The District of Columbia’s Safe at Home Program provides safety adaptations for the homes of adults with disabilities and individuals aged 60 and over. Homeowners or renters with an annual household income at or below 80% of area median incomeRegion's median household income, calculated by the Department of Housing and Urban Development. Often abbreviated as AMI. (AMI) are eligible. The program is focused on preventative home adaptations that reduce the risk of falls, including handrails, grab bars, bathtub cuts and chair lifts.

Maine’s State Housing Authority oversees the Community Aging in Place Grant, which helps local organizations provide repairs to homes for older adults and those with disabilities across the state. Partners include eight public housing agencies and two community organizations. The program helps fund no-cost home safety checks, minor maintenance repairs, and accessibility modifications. Homeowners or those who live in a home owned by a family member are eligible if they’re over the age of 55 or have a disability, and have an annual household income at or below 80 percent of AMI.

Rebuilding Together NYC is a local affiliate of Rebuilding Together, a large national network of nonprofit organizations focused on safe and healthy housing. Rebuilding Together NYC provides critical home repairs and accessibility modifications for low-income residents (households with income below 80 percent of AMI) in New York City, at no cost to the resident. A large share of their funding comes from corporate donations and foundations.

At the state level, New York’s Homes and Community Renewal organization offers a program called Residential Emergency Services to Offer Repairs to the Elderly, or RESTORE. RESTORE funds may be used to pay for the cost of emergency repairs that eliminate hazardous conditions in homes owned by seniors when the homeowners cannot afford to make the repairs without assistance. Eligible participants must be 60 years of age or older, and their household income cannot exceed 100 percent of AMI.

Related resources

• The American Elder Care Research Organization’s website provides a repository of ways to cover the cost home modifications.
• The National Council of Aging’s website presents recommendations on how older adults can make home safety modifications to reduce their risk of falling and live independently and safely in their homes. The site also offers 18 specific steps to help fall-proof homes, including installing grab bars and bed rails.