Federal sources Most assistance will come at the private or county level; however, the federal government does provide some resources. The Home and Community Based Medicaid Waiver program exists to help people on Medicaid make modifications to their existing homes. Rules differ between state programs. The USDA Rural Housing Home Repair Loan and Grant Program provides loans and grants to very low-income homeowners to modify, repair, and modernize their homes. There are strict requirements as to who is eligible for this program. Finally, the local Veterans’ Affairs (VA) may pay for home modifications on behalf of their beneficiaries. They have specific rules about who may complete the work and how big spaces must be. One example is the requirement that all bathrooms, regardless of the actual needs and abilities of the person, be 5 ′ by 5 ′ large. This may require the loss of a bedroom, but in order for the VA to pay for the modification, it must be that big. AVAILABLE ADVANCED CERTIFICATIONS AND CONTINUING EDUCATION OPPORTUNITIES
professionals are not allowed to utilize this resource; part of the CLIPP training involves the proper use of the assessment in order to accurately assess a home for safety and make the appropriate recommendations. Recently, the Living in Place Institute has begun hosting free 1-hour webinars on various topics, all of which are advertised on their website. Executive certification in home modifications The University of Southern California runs online courses related to home modifications through their Fall Prevention Center of Excellence (Fall Prevention Center of Excellence, 2017). It consists of a series of five courses, all provided online. It is encouraged to take the courses in the proper order, though not required. Additionally, clinicians may choose to take individual courses if they do not wish to obtain the full certification. Courses run approximately 3 to 4 weeks and are offered at various times during the year; interested students must wait until the course is offered in the appropriate time frame before enrollment. Topics include home assessments, communication skills, contractor identification, project and product identification and evaluation, funding sources, raising community awareness, and the ethics of home modifications. These courses are also designed for occupational or physical therapists, remodelers, interior designers, architects, contractors, builders, policymakers, and people who represent older-adult-related community organizations. Students must pass a final exam at the completion of the five courses before obtaining the certification. OTHER RESOURCES While physical therapists have many discipline-specific resources at their disposal, other organizations have information, courses, and networking opportunities to enhance the physical therapist’s practice. American Association of Retired Persons (AARP) The American Association of Retired Persons is dedicated to the creation of livable communities for all people, but especially older adults. One specific community program provided by AARP is the HomeFit program (AARP, 2017). Volunteers often provide a community presentation on how to utilize a HomeFit guide, after which participants can go home and assess their own living environment for safety. AARP’s HomeFit website provides helpful modification hints to increase safety and also presents information on utilizing CAPS certified professionals to complete required official safety assessments and modifications. They provide information for specific needs and conditions and suggestions to modify the home for little money. The program and website are geared toward consumers, homeowners, and older adults, but can serve as a great resource for clinicians and for patient education materials. American Institute of Architects (AIA) The American Institute of Architects has their own version of a special interest section, known as the Design for Aging Knowledge Community (AIA, 2017). Most resources are for AIA members; however, they have small articles, pictures, blueprints, and advertisements for conferences, design competitions, and shows that would be of interest to someone wishing to learn more about design for aging in place. There are also Design for Aging publications that showcase various designs for independent living, assisted living, long-term care, and continuing care communities. While not specifically therapy related, for someone wishing to consult with design
This course is meant to be an introduction to the world of aging in place and home modifications. This field is evolving constantly; interventions are truly only limited by our imaginations. Accordingly, there are many resources and opportunities available for further education, certifications, and support from experts in the field inside and outside physical therapy. Clinicians interested in home modifications, and especially those with the intent of making a business from this practice area, should consider pursuing the options listed below. HOME MODIFICATION CERTIFICATIONS There are certifications that are recognized in the building and design industries. These designations require completion of The National Association of Home Builders (NAHB) offers a 3-day certification course to become a Certified Aging in Place Specialist (CAPS; NAHB, 2017b). Each day presents one of the three required classes to become CAPS certified. CAPS is widely recognized in the home building industry as a specialization. It is available for occupational/physical therapists, contractors, builders, architects, and interior designers; classes are interprofessional in attendance. Often, builders or contractors teach these courses. There is a heavy emphasis on the creation of a business model and marketing; in fact, one entire day is devoted just to the running of a home modifications business. The other two days will discuss marketing and communication strategies, an overview of interprofessional teamwork, and design standards and ideas for an accessible home. It is possible to have the business class waived if an appropriate substitute has been taken and approved by the NAHB. Clinicians become CAPS certified after passing the exam at the end of each day and paying a fee. To remain CAPS certified, continuing education is required every three years according to their requirements listed on their website. Certified Living in Place Specialist (CLIPP) The Certified Living in Place Professional Program is a 2-day training from the Living in Place Institute that focuses on training medical, construction, architectural, design, and home inspection professionals on how to assess homes for accessibility and make appropriate recommendations to increase the certification courses and provide credentials. Certified Aging-in-Place Specialist (CAPS) accessibility (Living in Place Institute, 2017). They focus on the living-in-place market. It differs from CAPS in that it focuses on the ability of all people, regardless of age or condition, to be able to reside in the home, rather than just an aging-in-place market. They provide access to an electronic home safety checklist upon certification developed by the Living in Place Institute and require background and liability checks of all those holding the certification (Chabot, 2017). There is a greater focus on products and design as opposed to the CAPS certification. They also address some pediatric concerns and special considerations for congenital conditions in addition to the typical age-related concerns. Clinicians become CLIPP certified after passing an exam at the end of the course. There is a requirement to complete continuing education units or perform other professional development activities every two years to maintain the designation. CLIPP clinicians have the choice to utilize the electronic assessment after payment of an additional annual fee and completion of background checks. Non-CLIPP
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