1.1 This Part applies in relation to services referred to in section 4(1) of the Act.
1.2 The LSA recognises that because of their motor vehicle injury, home modifications will be the preferred option for some participants. In determining funding for home modifications, the LSA will consider the participant’s short and long term living arrangements, and all reasonable alternatives. This may include the provision and installation of equipment or relocation to a more appropriate residence, as well as home modifications.
1.3 The LSA will pay for the necessary and reasonable cost of home modifications for a participant.
1.4 All home modifications require prior approval by the LSA.
1.5 The LSA’s funding of modifications does not negate the responsibilities of another agency or department to provide them.
2.1 The participant should be involved in the decision-making processes relating to their home modifications and agree to any proposed modifications.
2.2 Agreement and permission from the home owner and, if necessary, any body corporate, must be obtained in writing before the home modification process can proceed.
3.1 The LSA will first ensure that the participant’s home is, in the opinion of the LSA, reasonably able to be modified. This will be assessed on several factors including, but not limited to:
3.1.1 access to and egress from the home;
3.1.2 accessibility to all areas of the home;
3.1.3 the safety of the participant, family members and attendant care workers;
3.1.4 the ownership of the home;
3.1.5 the cost and extent of the home modifications; and
3.1.6 the participant’s expected length of tenancy, if the home is rented/owned by another party.
3.2 Any necessary council or planning approvals must be obtained before any work can begin.
3.3 The LSA will not pay for home modifications for any residence or property that constitutes, is likely to constitute, or will result in, an illegal structure.
4.1 The LSA will conduct a home assessment using both an appropriately qualified occupational therapist and where required a builder, chosen by the LSA.
4.2 The assessment will include the participant’s current functional status, projected long-term needs and their proposed home environment.
4.3 The assessment should identify environmental barriers relating to the motor vehicle injury, including all options to overcome these barriers.
For example, non-structural home modifications should be considered as an option, if they enable an appropriate level of autonomy or safety for the participant and family and safety of support or attendant workers.
4.4 Recommendations for home modifications must include clear clinical and practical justification as to why home modifications are necessary and reasonable, the outcomes to be achieved and the feasibility of the proposed home modifications compared with other alternatives such as relocation. The clinical justification must make reference to the relevant codes and Australian Standards where appropriate.
5.1 Factors that the LSA will take into account when deciding if a home modification is necessary and reasonable include:
5.1.1 the anticipated length of time that the participant will need home modifications and whether this need is likely to change;
5.1.2 structural constraints;
For example, size, surrounding terrain and condition of the home.
5.1.3 ownership of the property;
5.1.4 permission of the owner or body corporate to temporarily or permanently undertake modification to the home;
5.1.5 local planning regulations and building permits;
5.1.6 length of lease of a rental property;
5.1.7 anticipated period of occupancy of the home to be modified;
5.1.8 the scale and cost of the proposed modifications when considered in conjunction with alternative residential options; and
5.1.9 the LSA’s ability to negotiate any necessary agreement or consent required on modifications with any external parties.
5.2 The LSA will assess whether home modifications are necessary and reasonable based on information contained in building modification project plans, reports from the home assessment completed by the occupational therapist and where utilised, the builder, final modification costs, and any other relevant information or reports.
5.3 The LSA may delay permanent or major modifications, where the motor vehicle injury is likely to change or improve. In these circumstances the LSA may approve temporary equipment or staged modifications to ensure the safety of the participant in the short term.
5.4 At times, the owner of the property, the participant and/or their legal representative or family member may desire additional building works, or higher cost finishes because of aesthetic, architectural or other reasons, which are more than is necessary and reasonable for the purposes of the Scheme. These works need to be quoted separately, agreed upon and the cost borne by the participant and/or property owner and must take place only after the completion of the funded works (unless the LSA agrees in writing or they relate to higher cost finishes paid for by the participant). Any such additional work should not affect participant access to or within the area being modified, or in any way adversely compromise the impact of any modifications that have been approved.
6.1 The LSA will pay for necessary and reasonable home modifications irrespective of the type of residence or accommodation being modified, if the owner of the premises agrees to the proposed modifications and the home is able to be modified.
7.1 The LSA will pay for necessary and reasonable home modifications for participants in a rental property if the owner of the premises agrees to the proposed modifications.
7.2 If the participant moves out of a rental property, the LSA will pay for the necessary and reasonable costs of returning a rental property to its former state, when the costs:
7.2.1 are related to the services or modifications that were previously approved or installed by the LSA; and
7.2.2 are related to the participant’s motor vehicle injury.
For example, the LSA may pay for making good the removal of grab rails, wedge ramps or replacement of a shower screen or hob at the end of a long-term tenancy.
7.3 The LSA will only consider other costs relating to returning a rental property to its former state if they are necessary and reasonable, related to the motor vehicle injury and specifically requested by the owner.
For example, wear and tear to carpets as a result of wheelchair use.
7.4 The LSA will not generally pay for other costs associated with the end of a tenancy that are a condition of the lease, such as advertising costs associated with breaking a lease, steam cleaning of carpets or cleaning a property at the end of a tenancy.
7.5 The LSA will consider funding the cost of relocating to a more suitable premises such as removalist fees.
8.1 The LSA will pay for home modifications where:
8.1.1 the home to be modified is the principal place of residence of the participant or their family;
8.1.2 the participant intends to remain living at that residence for the foreseeable future; and
8.1.3 relocation to another residence, or a more suitable residence, is not an appropriate option for the participant or their family.
8.2 The LSA may seek an agreement with the participant or home owner for home modifications regarding the potential for home modifications to increase the value of the home. The agreement may require the cost of the home modifications to be depreciated at 10 per cent per year over ten years. If the home modifications have led to a material increase in the value of the home, the agreement may require that any increase in value to the home as a direct consequence of the home modifications to be depreciated at 10 per cent per year over ten years. In the case of a major modification where the home is sold within ten years of installation, the owner may be required to reimburse the LSA for any pro rata costs. Reimbursement will occur on settlement. Any home valuation reports required to enforce this rule will be the responsibility of the LSA.
8.3 Taking into account the scale and cost of the proposed modifications, and the value of the property, the LSA may consider rebuilding or contributing to the cost of rebuilding, either on the existing land or elsewhere.
9.1 If the home is unable to be cost-effectively modified and relocation is the most appropriate option, the LSA may pay for the necessary and reasonable costs of:
9.1.1 assistance to locate an appropriate home where the participant is unable to look for alternative properties, or does not have family or friends to assist them to locate a suitable property;
9.1.2 professional assistance in order to identify suitable residential options for the participant and family;
For example, assessment of a property by an occupational therapist or an appropriately qualified person approved by the LSA.
9.1.3 real estate agent fees;
9.1.4 advertising costs;
9.1.5 legal and conveyancing fees at both ends of the transaction;
9.1.6 stamp duty;
9.1.7 Land Titles Office transfer fee;
9.1.8 cleaning costs associated with preparing a home for sale or rental; and
9.1.9 furniture removal.
10.1 When considering relocation to a new home, the LSA expects that the participant will locate a property that does not require substantial modification. The LSA does not consider it reasonable that a participant with significant functional limitations chooses to move to a home where substantial modifications need to be undertaken to allow them to reasonably access the home or parts of the home.
10.2 The LSA will only pay for modifications to a new home to enable the participant to access the following areas of the home:
10.2.1 necessary and reasonable access/egress;
10.2.2 a bathroom and toilet;
10.2.3 a bedroom;
10.2.4 a living/dining area; and
10.2.5 a kitchen (for participants who can fully or partially prepare their own food or beverages).
10.3 If the participant or their family is seeking to purchase or rent a new home which would require modifications, the LSA requires an assessment by a suitably qualified occupational therapist, a current building report, pest report and any other relevant documentation be provided before the home is purchased or rented, to ensure that the home is reasonably able to be modified. If such reports are not provided, the LSA will not pay for home modifications after purchase or renting. The LSA will meet the cost of the relevant reports.
11.1 Modifications will be approved by the LSA following the receipt of an agreed scope of works and a quotation for works to deliver the proposed modifications.
11.2 All home modifications the LSA pays for must be provided by an appropriately qualified licensed builder or tradesperson who holds current registration as a company or as a business/sole trader and appropriate insurance.
11.3 The home modification must be in accordance with the scope of works and quotation approved by the LSA and in accordance with the Discharge Plan or MyPlan. Any variations to the job specifications must be approved by the LSA, in writing, prior to the work being completed.
12.1 The LSA will pay for the necessary and reasonable cost of basic access, such as ramps, rails, doorway widening, and minor bathroom modifications for a secondary residence which is lived in concurrently by a participant.
For example, a participant who is a child may require a second home modification to stay at the residence of the parent/guardian/family member who is not the primary carer but has joint custody, or has agreed regular overnight access visits in an agreement ratified by the Family Court or agreed to by both parents.
12.2 In determining if modifications to a secondary residence are necessary and reasonable, the LSA will consider the nature and extent of any previous home modifications approved by the LSA, along with the anticipated amount of time that the participant is expected to spend in the secondary residence, the reason for this, such as shared parenting arrangements versus a holiday home and the potential benefit of modifying the secondary residence.
13.1 The LSA recognises it may be necessary and reasonable to fund more than one home modification as the participant’s circumstances change. Such circumstances may include, but are not limited to:
13.1.1 a participant living with others who becomes able to live independently, such as a young adult leaving home;
13.1.2 deterioration in the participant's health as a direct result of the motor vehicle injury;
13.1.3 a participant who may need to relocate in order to access employment or services more readily; or
13.1.4 other significant changes in the participant’s personal circumstances such as marriage, separation or having children.
13.2 If subsequent home modifications are requested, the LSA expects that the participant will locate a property that does not require substantial modification. The LSA does not consider it reasonable that a participant with significant functional limitations chooses to move to a home where substantial modifications need to be undertaken to allow them to reasonably access the home or parts of the home.
13.3 If subsequent home modifications are requested, the LSA will consider in addition to factors set out in Part 10, Rule 5:
13.3.1 the extent of the requested modifications;
13.3.2 the age of the participant; and
13.3.3 the likely future circumstances of the participant.
14.1 The LSA will pay for the necessary and reasonable cost of repairs to and maintenance of home modifications funded by the LSA that are essential for participant access or safety and would not normally be required by the home owner. The LSA will consider funding the costs of repairs and maintenance for any additional wear and tear to a property that is a result of the motor vehicle injury.
For example, damage to floorboards from wheelchair use.
14.2 If costs for home modifications were not paid for in full by the LSA (for example, shared with the property owner), then the LSA will pay for the cost of repairs or maintenance proportional to the original costs paid.
14.3 The participant or property owner is responsible for any repairs and maintenance as a result of normal wear and tear (such as replacement of bathroom fittings/fixtures), for the upkeep of a residence (such as house painting) or maintenance of any additional works not funded by the LSA.
15.1 The LSA will not pay for:
15.1.1 any home modifications undertaken without approval from the LSA;
15.1.2 home modifications required as a result of a condition that existed before the motor vehicle accident or that are not a result of the motor vehicle accident;
15.1.3 home modifications where the owner, body corporate or other responsible authority has not given permission for the modifications;
15.1.4 the costs of modifications where the participant was advised that the home is unsuitable for modification and subsequently proceeded to purchase or rent the home;
15.1.5 the cost of more than one strata report, building report or pest inspection report, per property;
15.1.6 costs of any repairs or maintenance issues identified in strata, building or pest inspection reports;
15.1.7 body corporate/strata fees;
15.1.8 council or water rates;
15.1.9 building or construction of in-ground or above-ground pools, spas or other aqua-therapy facilities;
15.1.10 insurance of the home in which the modifications have been installed;
15.1.11 any loss of value of any home resulting from any modifications to, or removal of modifications from, the home; or
15.1.12 items that are normal household items (such as furniture or whitegoods, smoke alarms, surge protectors, towel rails, fans, lights, hot water services, security doors and windows) that are not related to the participant’s need arising from the motor vehicle injury, unless these items have required removal due to the home modifications and replacement of like for like items is agreed to and included in the scope of works.
16.1 The LSA will pay for the cost of room temperature control equipment if the participant is unable to self-regulate their body temperature as a result of the motor vehicle injury, or if the lack of room temperature control causes secondary complications.
16.2 For a participant with a complete spinal cord lesion at or above the level of T6, the LSA does not require the certification of a medical specialist for the provision of room temperature control equipment.
16.3 For participants, other than those who have sustained a complete spinal cord lesion at or above the level of T6, the LSA will require certification by an appropriately qualified medical specialist that the participant has an impaired or absent ability to regulate their body temperature which will not resolve, or causes significant secondary care complications.
16.4 Where an increase in the total consumption of energy can be shown to relate directly to the running of the room temperature control equipment, the LSA may contribute to the costs associated with its operation, if the participant is unable to self-regulate their body temperature as a result of the motor vehicle injury.
16.5 The LSA will estimate the costs associated with the operation of room temperature control equipment by considering:
16.5.1 government or energy provider calculators of energy costs and usage to estimate average increased running costs and the amount that the LSA would pay;
16.5.2 the number and size of rooms to be heated/cooled;
16.5.3 whether the room temperature control equipment is used by the participant alone and whether there is a mutual benefit for other household members;
16.5.4 the proportion of the pre-accident utility accounts related to the participant’s usage; and the increase from pre-accident costs to current costs where the comparisons are able to be applied; and
16.5.5 eligibility for energy concessions such as the pensioner concession card.
16.6 Any change of domestic circumstances or prolonged absence from home will require a reassessment of the LSA’s contribution rate to the operating costs.
16.7 The LSA may contribute to the costs associated with maintenance and repair of room temperature control equipment if the participant is unable to self-regulate their body temperature as a result of a motor vehicle injury. The LSA may pay a contribution to the reasonable costs of servicing, preventative maintenance and repairs of room temperature control equipment. The LSA will negotiate this contribution having regard to the equipment to be operated, e.g. air conditioner or heater and the number and size of rooms to be heated or cooled.
16.8 Before the LSA will pay for any contribution to room temperature control equipment, maintenance or running costs, the participant must have fully claimed and/or utilised any entitlement to concessions, grants or rebates.
17.1 The LSA will not generally pay for:
17.1.1 any room temperature control equipment that another agency or department is responsible for providing;
17.1.2 energy services and supply charges;
17.1.3 the entire costs of energy; or
17.1.4 prospective payments for energy costs in advance.
18.1 The LSA will pay for the costs of short-term transitional accommodation in limited circumstances.
For example, when a home modification is in progress.
18.2 Transitional accommodation is defined by the LSA as accommodation required when:
18.2.1 the need for accommodation is related to the motor vehicle injury;
18.2.2 the participant’s usual place of residence is not accessible due to the motor vehicle injury or is outside the Adelaide metropolitan area; and
18.2.3 there is no other existing suitable accommodation option.
18.3 On a case by case basis the LSA will pay for necessary and reasonable transitional accommodation.
18.4 In determining whether transitional accommodation costs are necessary and reasonable the LSA may consider:
18.4.1 whether discharge from hospital or inpatient rehabilitation, or delivery of a participant’s treatment, care and support plan, is possible without the transitional accommodation;
18.4.2 the length of time for finding appropriate longer-term accommodation, or the completion of home modifications and whether home modifications are able to be staged to allow earlier access to the home;
18.4.3 whether the existing home is able to be occupied prior to finding appropriate longer-term accommodation, or during the home modification process;
18.4.4 factors impacting on finding appropriate longer-term accommodation, or the completion of the home modifications, and the length of time that transitional accommodation is required;
18.4.5 the nature of the motor vehicle injury and whether the participant requires treatment, care and support services that would be required in the transitional accommodation setting and the suitability of the setting in which these services would be delivered; and
18.4.6 whether transitional accommodation is the most cost effective option compared to any other accommodation option (such as when a home modification is in progress or when a participant is travelling regularly from a remote community for treatment care and support over a period of time).
19.1 The LSA will pay for the costs of ongoing accommodation in limited circumstances.
For example, a participant requiring integrated housing and supports.
19.2 Ongoing accommodation is defined by the LSA as accommodation required when the need for accommodation is related to the motor vehicle injury and:
19.2.1 the participant’s usual place of residence is not accessible due to the motor vehicle injury; or
19.2.2 when modification of an existing or new home, owned or rented by a participant, is not feasible.
19.3 The accessible home may be rented, owned or purchased by the LSA, or it may be an accessible home rented or purchased directly by a participant from a housing provider.
19.4 The LSA pays for costs to the extent the LSA considers it to be necessary and reasonable treatment, care and support, and related to the motor vehicle injury, above ordinary housing and living costs.
19.5 The LSA will require the participant to make a reasonable rent contribution, which is an ordinary cost of housing. For a participant in receipt of the Disability Support Pension (DSP), 25 per cent of the base rate plus any relevant Commonwealth Rent Assistance will be considered reasonable rent contribution.
19.6 The LSA will require the participant to fully meet all other ordinary costs of housing and living.
19.7 All ongoing accommodation arrangements require prior approval in writing by the LSA.
19.8 The participant should be involved in the decision-making processes relating to their ongoing accommodation and agree to any proposed options.
19.9 The LSA’s funding of ongoing accommodation does not negate the responsibilities of another agency or department to provide for it.
20.1 The LSA will not reimburse transitional or ongoing accommodation retrospectively unless in limited, exceptional circumstances.