OlderAdultHomesModification_LHC-2600-DC-0069.pdf

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LHC-2600-DC-0069

Applications are due by 11:59 pm Eastern Time on 08/31/2026.

Lead Hazard Control and Healthy Homes

U.S. Department of Housing and Urban Development

Older Adults Home Modification Grant Program

Table Of Contents LHC-2600-DC-0069 Page 2 of 73

I. BASIC INFORMATION

A. Summary

B. Agency Contact(s)

II. ELIGIBILITY

A. Eligible Applicants

B. Eligible Applications

C. Cost Sharing or Matching

III. PROGRAM DESCRIPTION

A. Purpose

B. Goals and Objectives

C. Authority

D. Unallowable Costs

E. Indirect Costs

IV. APPLICATION CONTENTS AND FORMAT

A. Standard Forms, Assurances, and Certifications 27

B. Budget

C. Narratives and Other Attachments

D. Other Application Content

V. APPLICATION REVIEW INFORMATION

A. Threshold Review

B. Merit Review

C. Risk Review

D. Selection Process

E. Award Notices

VI. SUBMISSION REQUIREMENTS AND

DEADLINES

A. Deadlines

B. Submission Methods

C. Other Submission Information

D. False Statements

VII. POST-AWARD REQUIREMENTS AND

ADMINISTRATION

A. Administrative, National and Departmental Policy

Requirements, and General Terms and Conditions

B. Environmental Requirements

C. Remedies for Noncompliance

D. Reporting

VIII. CONTACT AND SUPPORT

A. Agency Contact

B. Grants.gov

C. SAM.gov

D. Debriefing

E. Applicant Experience Survey

F. Other Online Resources

APPENDIX

Appendix I. Definitions

TABLE OF CONTENTS

Before You Begin LHC-2600-DC-0069 Page 3 of 73

If you are a good candidate for this funding opportunity, register in the required systems and review the application materials. If you are already registered, confirm that your information is current and active.

SAM.gov Registration You must have an active and up-to-date account with SAM.gov, at the time of application and throughout the life of any award.

To register, go to SAM.gov Entity Registration and click Get Started. From the same page, you can also click the Entity Registration Checklist for the information you will need to register.

It can take several weeks to register in SAM.gov, so get started now if you are planning to apply. SAM.gov also provides each organization with a unique entity identifier (UEI). A valid UEI is required to apply for funding.

Grants.gov Registration You must have an active Grants.gov registration. This requires a Login.gov registration as well. See step-by-step instructions at the Grants.gov Quick Start Guide for Applicants. You must apply for funding using Grants.gov, unless HUD has approved your waiver request.

See Section VI.B. Submission Methods.

Find the Application Package Use the Grants Search at Grants.gov and search for opportunity number LHC-2600-DC-0069 . The application package has all the online forms you need to apply. You also need to access the Download Instructions link and review the content before you apply.

If you have other technical difficulties using Grants.gov, contact the Support Center on Grants.gov.

To get updates on changes to this notice of funding opportunity (NOFO), click Subscribe from the View Grant Opportunity page on Grants.gov.

Application Deadline Applications are due by 11:59 pm Eastern Time on 08/31/2026.

HUD Listserv To get email alerts about current and future funding opportunities, subscribe to HUD's Funding Opportunities listserv.

BEFORE YOU BEGIN

https://sam.gov/ https://sam.gov/content/entity-registration https://sam.gov/ https://sam.gov/ https://grants.gov/ https://login.gov https://www.grants.gov/quick-start-guide/applicants https://grants.gov/ https://grants.gov/ https://grants.gov/ https://grants.gov/ https://www.hud.gov/subscribe/signup?listname=HUD%20Funding%20Opportunities&list=HUD-FUNDING-OPPORTUNITIES-L https://www.hud.gov/subscribe/signup?listname=HUD%20Funding%20Opportunities&list=HUD-FUNDING-OPPORTUNITIES-L

I. Basic Information

II. Eligibility III. Program Description

IV. Application Contents and

Format

V. Application Review

Information

VI. Submission Requirements and

Deadlines

VII. Post-Award Requirements and

Administration

VIII. Contact and Support

Appendix

I. BASIC INFORMATION

I. Basic Information

A. Summary

B. Agency Contact(s)

II. Eligibility III. Program Description

IV. Application Contents and

Format

V. Application Review

Information

VI. Submission Requirements and

Deadlines

VII. Post-Award Requirements and

Administration

VIII. Contact and

I. Basic Information LHC-2600-DC-0069 Page 5 of 73

I. BASIC INFORMATION See Contact and Support section of this NOFO.

A. Summary Federal Agency Name:

United States Department of Housing and Urban Development (HUD) HUD Program Office:

Lead Hazard Control and Healthy Homes Announcement Type:

Initial Program Type:

Discretionary Paperwork Reduction Act Information:

2501-044 Due Date for Intergovernmental Review:

See Section VI.C.1.

1. NOFO Summary The Older Adults Home Modification Program (OAHMP) provides competitive awards to eligible applicants to support comprehensive programs that make safety and functional home modifications, repairs and renovations to enable low-income seniors to age in place. The goal of the home modification program is to enable low-income elderly persons to remain in their

Key Facts Opportunity Name:

Older Adults Home Modification Grant Program Opportunity Number:

LHC-2600-DC-0069

Federal Assistance Listing(s):

14.921

Key Dates Application Due Date:

11:59:59 PM Eastern Time on:

08/31/2026 Anticipated Award Date:

09/21/2026 Estimated Performance Period Start Date:

11/02/2026 Estimated Performance Period End Date:

11/01/2029

II. Eligibility III. Program Description

IV. Application Contents and

Format

V. Application Review

Information

VI. Submission Requirements and

Deadlines

VII. Post-Award Requirements and

Administration

VIII. Contact and

I. Basic Information LHC-2600-DC-0069 Page 6 of 73 homes through low-cost, low barrier, high-impact home modifications to reduce older seniors' risk of falling, improve general safety, increase accessibility, and to improve their functional abilities in their home.

2. Funding Details Type of Funding Instrument CA (Cooperative Agreement) Awards will be made as cooperative agreements. Anticipated substantial involvement by HUD staff for cooperative agreements may include but will not be limited to:

1. Review and suggestion of amendments to the program design, including: selection of, and guidance in the use of, partners to encourage awareness of the program and enrollment in it by eligible families and contractors; techniques for addressing needs of older adults in urbanized areas and in rural communities; planning for and implementing collection and analysis of data on the benefits, if any, of the program for the older adults served by the program; collaboration with HUD's Office of Policy Development and Research (PD&R) and any HUD research on the program.

2. Review and provision of recommendations in response to quarterly progress reports and other information provided by the grantee or otherwise obtained by HUD, such as recommending amendments to the grantee's program design and/or implementation based on preliminary results.

3. Review and provision of technical recommendations on the interim and final reports on the benefits, if any, of the program for the older adults served by the program.

Available Funds Funding of approximately $64,000,000 is available through this NOFO.

Additional funds may become available for award. Use of these funds is subject to statutory constraints. All awards are subject to the selection process contained in this NOFO.

Estimated Number of Awards 32 awards from available funding Minimum award amount: $2,000,000 Maximum award amount:$3,000,000 Length of Performance Period:

36-month project period and budget period Length of Periods Explanation:

N/A

B. Agency Contact(s) See Contact and Support section of this NOFO.

Dr. Taneka Blue

II. Eligibility III. Program Description

IV. Application Contents and

Format

V. Application Review

Information

VI. Submission Requirements and

Deadlines

VII. Post-Award Requirements and

Administration

VIII. Contact and

I. Basic Information LHC-2600-DC-0069 Page 7 of 73

Phone: 202-402-6846 Email: olhchh.nofa@hud.gov mailto:olhchh.nofa@hud.gov

II. ELIGIBILITY

II. Eligibility

A. Eligible Applicants

B. Eligible Applications

C. Cost Sharing or Matching

II. Eligibility III. Program Description

IV. Application Contents and

Format

V. Application Review

Information

VI. Submission Requirements and

Deadlines

VII. Post-Award Requirements and

Administration

VIII. Contact and

II. Eligibility III. Program Description

IV. Application Contents and

Format

V. Application Review

Information

VI. Submission Requirements and

Deadlines

VII. Post-Award Requirements and

Administration

VIII. Contact and

II. Eligibility LHC-2600-DC-0069 Page 9 of 73

II. ELIGIBILITY

A. Eligible Applicants If your organization is not an eligible applicant, your application won't be reviewed or scored, and you won't receive funding from HUD.

1. Eligible Entity Types:

00 (State governments) 01 (County governments) 02 (City or township governments) 04 (Special district governments) 08 (Public housing authorities/Indian housing authorities) 12 (Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education) Additional Information on Eligibility You cannot apply as an individual.

Faith-based organizations may apply just like any other organization. HUD does not have any policies or practices that unfairly target these institutions.

For-profit organizations, institutions of higher education, and tribes, including Indian housing authorities, are not eligible to apply. Federal agencies, foreign entities, and sole proprietorship organizations are not eligible to apply.

Eligible applicants include experienced nonprofit organizations, states and local governments, and public housing authorities that have at least 3 years of experience in providing services to elderly adults. Nonprofit organizations are Internal Revenue Service recognized 501(c)(3) organizations. Applicants must satisfy the threshold requirements contained in Section III for their application to be considered.

2. Restrictions

a. Statutory and Regulatory Requirements You must meet the current General Statutory and Regulatory Eligibility Requirements. If you do not meet these requirements, your application won't be scored, and you won't receive funding from HUD. This is a threshold requirement for all HUD funding.

b. Resolution of Civil Rights Matters If you have any outstanding or unresolved judgments for violating civil rights laws, you must settle them before you apply. If you don't, settle the civil rights law violations before you apply, your application won't be scored, and you won't receive funding from HUD. This is a threshold requirement for all HUD funding.

B. Eligible Applications https://www.ecfr.gov/current/title-24/part-5/appendix-Appendix%20A%20to%20Subpart%20A%20of%20Part%205 https://www.federalregister.gov/documents/2025/02/12/2025-02611/eradicating-anti-christian-bias https://www.federalregister.gov/documents/2025/02/12/2025-02611/eradicating-anti-christian-bias https://www.hud.gov/sites/dfiles/OCHCO/documents/Eligibility-Requirements-Addendum-FY2025.pdf

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1. An application from an eligible entity is considered for funding if it meets basic threshold requirements and passes merit review.

2. Your application must support the goals of this NOFO.

3. Awards made under this NOFO will not be used to conduct activities that subsidize or facilitate illegal racial preferences or other forms of illegal discrimination, including activities where race or intentional proxies for race will be used as a selection criterion for employment or program participation.

Program-Specific Requirements In addition to the Threshold Eligibility Requirements under V.A, the OAHMP has the following requirements:

1. Urbanized Area or Substantially Rural Designation. Applicants must designate in their applications the target area for performing home modifications as being an urbanized area and/or substantially rural based on the definitions provided in Appendix I, Section 2. In determining this designation, applicants must use the Urbanized / Substantially Rural Designation of Areas Tool developed by HUD (see Appendix II). An application that does not include an urban or rural designation or includes an incorrect one shall be treated as having a curable deficiency (see Appendix I, Section 2).

2. Program Performance. Grantees shall take all reasonable steps to complete all activities within the approved period of performance. HUD reserves the right to terminate the cooperative agreement prior to the expiration of the period of performance if the grantee fails to make reasonable progress in implementing the approved program of activities or fails to comply with the terms of the cooperative agreement. If requested, determined to be appropriate, and subsequently approved by HUD, grantees will be eligible to receive a single extension of up to 12 months in length. To facilitate completing all activities within the approved period of performance, if awarded a grant, the applicant is committing to working in the described area and developing a work plan for which the recruitment, assessment, home modification, and evaluation elements are described. These awards are being made as cooperative agreements as they require substantial involvement post-award, federal programmatic participation in the project.

3. OSHA Compliance. The requirements of the Occupational Safety and Health Administration (OSHA) (e.g., 29 CFR parts 1910 and/or 1926, as applicable) or the state or local occupational safety and health regulations, whichever are most stringent, shall be met.

4. Civil Rights. Grantees must comply with all fair housing and civil rights laws. (see Section III.G.2 of this NOFO).

5. Privacy. Submission of any information to databases (whether website, computer, paper, or other format) of addresses of housing units identified and treated under this project is subject to the protections of the Privacy Act of 1974, and shall not include any personal information that could identify any person affected. Grantees should also check to ensure it meets state and local privacy regulations.

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6. Economic Opportunities for Low- and Very Low-Income Persons (Section 3).

Section 3 of the Housing and Urban Development Act of 1968 (12 U.S.C. § 1701u) is applicable to grants funded under this program NOFO (see 24 CFR 75.3(a)(2)(i)). For projects for which you are required to comply with Section 3, any contractor, subcontractor or sub-grantee must also comply with the Section 3 requirements for any new training, hiring or sub-contracting opportunities provided under those contracts. Applicants for this grant program must plan to recruit and collect the level of detailed information to report out to the federal government the success of their efforts to meet these goals annually. For more information about Section 3, see HUD's Section 3 website, https://www.hudexchange.info/programs/section-3/, particularly its Frequently Asked Questions document, which discusses lead hazard control and healthy homes grants, and HUD's Section 3 regulations (24 CFR Part 75), https://www.ecfr.gov/current/title-24/subtitle-A/part-75.

7. Limited English Proficiency (LEP). The Grantees shall take reasonable steps to ensure meaningful access to their program and activities for LEP individuals pursuant to Title VI of the Civil Rights Act of 1964.

8. Section 504. Section 504 of the Rehabilitation Act of 1973 (Section 504) prohibits discrimination on the basis of disability in federally assisted housing programs, services, or activities. HUD's Section 504 regulation includes nondiscrimination and equal opportunity requirements. Among other obligations, recipients must provide reasonable accommodations for individuals with disabilities. Reasonable accommodation is a change, modification, exception, alteration, or adaptation rule, policy, procedure, practice, program, service, or activity, including a structural modification, that may be necessary to provide a person with a disability an equal opportunity to use and enjoy a dwelling, including public and common use areas, to participate in, or benefit from, a program, service or activity, or to otherwise avoid discrimination against an individual or class of individuals on the basis of disability. For example, a grantee may need to permit an individual with a disability to complete the application or participate in follow-up meetings at a different location or in one's home as a reasonable accommodation, or may need to otherwise modify an existing rule in order to accommodate an individual with a disability.

In addition, a recipient must ensure effective communication with applicants and beneficiaries with visual, hearing, speech, intellectual or other developmental disabilities, and other communication-related disabilities. Recipients must provide appropriate auxiliary aids and services necessary to ensure effective communication, which includes ensuring that information is provided in appropriate accessible formats as needed, e.g., Braille, audio, large type, assistive listening devices, sign language interpreters, and accessible electronic communications.

Additionally, under Section 504, no qualified individual with disabilities shall be denied the benefits of, excluded from participation in, or otherwise subjected to discrimination under any program or activity of a recipient receiving HUD funding because a recipient's facilities are inaccessible to or unusable by individuals with disabilities. 24 C.F.R. § 8.20. Recipients and subrecipients are also required to ensure that new construction, alterations, and existing facilities are readily https://www.hudexchange.info/programs/section-3/ https://www.ecfr.gov/current/title-24/subtitle-A/part-75

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II. Eligibility LHC-2600-DC-0069 Page 12 of 73 accessible to and useable by individuals with disabilities (see "Physical Accessibility" section). For more information, HUD has issued Section 504 of the Rehabilitation Act of 1973 and The Fair Housing Act to provide guidance to HUD recipients.

9. Beneficiary Eligibility Determination. Grantees will establish a process for determining beneficiary/client eligibility. See Beneficiary Eligibility Criteria in Section

III.G.

10. Client Referral Network. Grantees must have relationships with organizations in the community that will refer low-income older adults to ensure that the grantee meets its target number of beneficiaries.

11. Scope of Home Modifications. The allowable modifications are defined as low-cost changes to the home environment that are directly related to reducing the risk of falling and improving general safety, accessibility, and functional abilities of the client. The resulting home environment is expected to make tasks easier, reduce accidents, and lengthen the amount of time the client can continue to live in their primary residence. In addition:

The cost of home modifications per housing unit, which is inclusive of labor, contractor services, materials and supplies associated with structural modifications and adaptive equipment, is averaged at $5,400 per home based on the congressionally mandated program evaluation published in 2025 for cohort 1 by PD&R and Healthy Housing Solutions. This $5,400 average per unit amount excludes the salary for the Occupational Therapist (OT), licensed OT Assistant, Certified Aging-in-Place Specialist, or other trained professionals with relevant experience in home assessments, accessibility, and aging-in-place modifications. When the aggregate unit cost is expected to be above $15,000, HUD approval is required prior to contracting for any services for that unit.

Grantees must publish a list of in-scope and out-of-scope modifications as part of their program documentation marketing as well as in the program policy and procedures.

Grantees must ensure these policies determining the types of home modifications covered under their program do not result in discrimination against persons with different types of disabilities.

12. Occupant protection and possible temporary relocation

a. Occupants shall not be permitted to enter the worksite during home modification activities (unless they are employed in conducting these activities) until after the work has been completed.

b. Occupants shall be temporarily relocated during home modification activities to a suitable, decent, safe, and similarly accessible dwelling unit (as noted in HUD's Lead Safe Housing Rule (24 CFR 35.1345(a)(2)), except if the activities are exterior activities only and occupants have safe access to bathroom and kitchen facilities, and, after each day's work, sleeping areas; or the activities include interior activities and:

(a) Will be completed within one period of 8 daytime hours, and the worksite is contained if hazardous dust or debris could be released into other areas (with https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.hud.gov%2Fsites%2Fdocuments%2F05-09cpdn.doc%23%3A~%3Atext%3DHUD%2520regulations%2520implementing%2520Section%2520504%2520at%252024%2520CFR%25208.22(a%2C24%2520CFR%25208.22(c).&wdOrigin=BROWSELINK https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.hud.gov%2Fsites%2Fdocuments%2F05-09cpdn.doc%23%3A~%3Atext%3DHUD%2520regulations%2520implementing%2520Section%2520504%2520at%252024%2520CFR%25208.22(a%2C24%2520CFR%25208.22(c).&wdOrigin=BROWSELINK https://www.huduser.gov/portal/publications/Evaluation-of-the-HUD-Older-Adult-Home-Modification-Grant-Program-Final-Report-Cohort-1-Grants.html

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II. Eligibility LHC-2600-DC-0069 Page 13 of 73 occupants' belongings in the contained area moved to a safe and secure area outside of it, or covered with an impermeable covering with seams and edges sealed), and no safety, health or environmental hazards (e.g., exposed live electrical wiring, release of toxic fumes, or on-site disposal of hazardous waste) will be created; or

(b) Will be completed within 5 calendar days and the worksite is protected as above, and after each day's work, occupants have safe access to sleeping areas and bathroom and kitchen facilities.

(c) The OAHMP targets low-income senior homeowners and renters interested in home modification repairs to enable them to remain in their primary residence. While the relocation of owner/tenant occupants for a project receiving funds pursuant to this NOFO generally do not trigger the applicability of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, as amended (URA), 42 U.S.C. 6301 et seq., tenant-occupants who must be temporarily relocated may be entitled to URA benefits and assistance.

These benefits and assistance include moving costs and increased housing costs during the relocation. For further guidance, see HUD Handbook 1378, available at:

https://www.hud.gov/sites/dfiles/OCHCO/documents/1378CPDH.pdf.

Temporary relocation of residents must also be carried out in compliance with all applicable fair housing and nondiscrimination requirements at 24 CFR 5.105.

(d) OAHMP funds may be used to cover relocation expenses related to OAHMP activities for both owner-occupants and tenant-occupants, regardless of the applicability of the URA. Relocation expenses should include moving costs and increased housing costs during the relocation.

13. Physical Accessibility Requirements. All new construction and alterations of existing buildings and facilities must be done in compliance with Section 504 of the Rehabilitation Act of 1973 and its implementing regulations at 24 CFR part 8, or the 2010 ADA Standards for Accessible Design with exceptions as noted at FR-5784-N-01 Nondiscrimination on the Basis of Disability in Federally Assisted Programs and Activities:

https://www.federalregister.gov/documents/2014/05/23/2014-11844/nondiscrimination-on-the-basis-of-disability-in-federally-assisted-programs-and-activities, design and construction requirements under the Fair Housing Act and its implementing regulations at 24 CFR part 100, Title II of the Americans with Disabilities Act and its implementing regulations at 28 CFR part 35, and the Architectural Barriers Act of 1968 and its implementing regulations at 24 CFR part 40 as applicable. HUD applies the Uniform Federal Accessibility Standards (UFAS) through its regulations under part 8. All applicable laws must be read together and followed.

Note that all meetings open to the public must be held in facilities that are physically accessible to persons with disabilities. Where physical accessibility is not achievable, Recipients must give priority to alternative methods of product or information delivery that are accessible to and usable by individuals with disabilities and offer programs and activities to qualified individuals with disabilities in the most integrated setting appropriate in accordance with Section 504 of the Rehabilitation Act of 1973 (29 U.S.C.§ 794) and HUD's implementing regulations at 24 CFR part 8, Title II of the https://www.hud.gov/sites/dfiles/OCHCO/documents/1378CPDH.pdf https://www.federalregister.gov/documents/2014/05/23/2014-11844/nondiscrimination-on-the-basis-of-disability-in-federally-assisted-programs-and-activities https://www.federalregister.gov/documents/2014/05/23/2014-11844/nondiscrimination-on-the-basis-of-disability-in-federally-assisted-programs-and-activities

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Americans with Disabilities Act (42 U.S.C. §§ 12131-12134) (ADA) and the implementing regulations at 28 CFR part 35, and all other applicable laws and regulations. The Fair Housing Act's reasonable accommodations, reasonable modifications, and physical accessibility requirements apply. Under the Fair Housing Act, it is unlawful for any person to refuse to permit, at the expense of the person with disabilities, reasonable modifications of existing premises occupied or to be occupied by such person if such modifications may be necessary to afford such person full enjoyment of the premises. See 24 C.F.R. § 100.203 for more information, including relevant information in the case of a rental unit.

In addition, Title II of the ADA prohibits discrimination on the basis of disability in programs, activities, and services provided by public entities (state and local governments and their instrumentalists and special purpose districts). For more information, please visit the Department of Justice's (DOJ) ADA page, https://www.ada.gov/, and DOJ's Title II implementing regulation at 28 C.F.R. part 35 (Title II). For more information on federal accessibility requirements, please visit HUD's website, https://www.hud.gov/stat/fheo/rights-obligations

14. Program Services Model. The minimum requirements of the services to be provided by the Grantee are as follows:

All services are voluntary for the beneficiary. Written consent of the client, and/or legal guardian is required before delivery of services. Grantees are strongly encouraged to work with the client to complete all phases of the program model; however, the client or legal guardian may opt out at any time.

The home modifications and other services must be designed to improve general safety, improve accessibility, and improve functional abilities of the client to make tasks easier, reduce housing-related accidents and the risk of falls, and lengthen the amount of time the client can continue to safely live in their primary residence.

The Program Services Model shall include but is not limited to the following components:

a. Initial Interview and In-Home Assessment conducted by a Licensed Occupational Therapist (OT), or a licensed OT Assistant, or Certified Aging-in-Place Specialists, or other trained professionals with relevant experience in home assessments, accessibility, and aging-in-place modifications. The assessor will conduct the initial interview with the client and care takers (if available) in their home and assess the home for safety and hazards, including the client's fall risk, general mobility, existing adaptive equipment, and/or the client's functional abilities with daily self-care (ADLs) and household tasks (IADLs). During this in-home visit, the assessor will conduct a "baseline" health interview and evaluation with clients and a home hazard visual assessment of the home using standardized evaluation forms.

b. Work Order by the OT, or a licensed OT Assistant or a Certified Aging-in- Place Specialist, or other trained professionals with relevant experience in home assessments, accessibility, and aging-in-place modifications. With the client's input and consent, the assessor will prioritize the necessary home https://www.ada.gov/, https://www.hud.gov/stat/fheo/rights-obligations

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II. Eligibility LHC-2600-DC-0069 Page 15 of 73 modifications and complete a work order and any additional specifications (e.g., placing tape on walls to indicate the position of grab bars).

c. Home Modification Work. The work must be performed by a licensed contractor, or in accordance with local and state regulations, a contractor qualified to perform the required work.

d. Follow-up Assessment and Inspection. The assessor will conduct an in-home follow-up assessment within one month following services, accompanied by appropriate education and training for the client in the safe and proper use of adaptive equipment. The assessor will also inspect the work of the licensed contractor to ensure that it meets the requirements and complete a work order for any required adjustments before services are paid in full.

Grantees shall use standardized assessment forms and protocols to collect information before (i.e., baseline) and after the home modification intervention (i.e.

one-month follow-up). At a minimum, the assessment tool(s) shall cover the functional performance/ abilities of the client (i.e., dressing/ bathing, toileting, transfers, household mobility, housekeeping), the safety, and hazards in the home and an analysis/ summary of the assessment findings.

The program services shall not be a replacement of home care visits ordered by a provider for a person with specific rehabilitative or skilled nursing needs, such as follow-up from a hospitalization, inpatient rehabilitation, or other acute or skilled post-discharge need.

The program services (i.e., baseline assessment, home modifications, follow-up assessment) must take place within the primary residence of the eligible program participant. Assessment within a rehabilitative, assisted, or skilled nursing facility is not allowable under this program.

Existing evidence scientifically demonstrate occupational therapists as highly effective in comprehensive aging in place assessment and intervention due to their evidence-based, client-driven, approach to addressing functional impairments and barriers to safe and independent living. (See: Szanton SL, Leff B, Li Q, et al. CAPABLE program improves disability in multiple randomized trials; Anna Miller, Kathy Subasic, Carolyn Sithong. Occupational Therapy and the U.S. Department of Housing and Urban Development's Older Adult Home Modification Program: A Mixed-Methods Study;

Selena E. Washington, Emma Edwards, Abby Fink, Lucy Radocha; Inclusive Practices for Aging in Place: Environmental and Home Modifications for Older Adults. Although not required, HUD recommends the supervision/ oversight of an OT for guidance in establishing the scope of work, work plan, and approval of modifications to the established plan in each unit to manage cost, efficacy, and ensure client-centered service for optimal safety and occupational client outcomes.

If an applicant wishes not to use the Program Services Model or discipline described above, the applicant must provide a justification to deviate from the Model described above. The applicant must clearly provide a detailed overview of the model they intend to use and document the validation of their proposed model as a better option for its https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.17383 https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.17383 https://pubmed.ncbi.nlm.nih.gov/41636580/ https://pubmed.ncbi.nlm.nih.gov/41636580/ https://pubmed.ncbi.nlm.nih.gov/40101102/ https://pubmed.ncbi.nlm.nih.gov/40101102/

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II. Eligibility LHC-2600-DC-0069 Page 16 of 73 program than the OAHMP Program Services Model, along with the step-by-step process for accomplishment of the performance goals of all components described in paragraphs C.14 above. If a grant is awarded, acceptance of the deviations will be at the discretion of HUD.

15. Duplication of Benefits. The grantee shall avoid duplication of Medicare or Medicaid benefits received such as adaptive equipment already ordered by a medical provider.

16. Structural Modification and Case Support Direct-Hire/Contractor Requirements. The following requirements apply to all Grantee personnel (staff, contractors, practitioners) who provide direct services or make structural modifications in a client's residence. The personnel:

• Must participate in an onboarding process designed by the grantee before performing work that reflects the program's desired approach to interacting with older adults and their caregivers and families;

• Must be licensed, bonded, and insured in accordance with state and local requirements;

• For mobile homes and manufactured homes, must follow state licensing requirements for repair/modification of mobile homes and manufactured homes, as applicable; and

• Must provide a warranty period acceptable to the grantee for all home modifications (e.g., one year).

17. Addressing the Needs of a Vulnerable Population. Grantees must put policies and plans in place that address how to respond when they encounter clients who are highly vulnerable or whose homes are in need of major repairs. See Section V.A. Review Factors.

18. Program Consistency. Grantees shall participate in mandatory training provided by HUD:

a. Initial training. This is a one-time training session for two program representatives, including the program manager, about the goals and principles of the grant program, the guidelines, grant requirements, procedures that all the grantees must follow, and the elements that are common across all the grantee programs. The orientation shall be in-person unless HUD makes it virtual out of necessity.

b. Annual Program Manager School - Specialized Staff Training. This is training specific to staff roles. Program managers will receive training in grants management, hiring, contracting, procurement, reporting, and other program administration topics. Occupational therapists, their licensed assistants, Certified Aging-in-Place Specialists, or other trained professionals and maintenance/repair staff may receive training on such topics as how to work with older clients, motivational interviewing techniques, client and home assessments, and creating the home modification work order. The initial training shall be in-person or virtual at HUD's discretion.

If your grant agreement is not signed prior to the New Grantee Orientation, you will be reimbursed for any reasonable costs you incur to attend the New Grantee Orientation that

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II. Eligibility LHC-2600-DC-0069 Page 17 of 73 are allowable in accordance with 2 CFR part 200, especially 2 CFR 200.458 and 2 CFR

200.474. HUD reserves the right to disallow costs that are not reasonable, allowable and allocable in accordance with OMB Cost Principles, 2 CFR part 200, subpart E.

In addition, grantees are encouraged to participate in any additional training or technical assistance provided through HUD's technical assistance providers. Prior approval by HUD is required before any expenditure occurs.

19. Cooperation with Related Research and Evaluation. Grantees must cooperate fully with any research or evaluation sponsored by HUD or another government agency associated with this grant program. This cooperation includes but is not limited to preservation of project data and records and compiling requested information in formats provided by the researchers, evaluators, or HUD. This may include the compiling of certain relevant local demographic, dwelling unit, and participant data not contemplated in the original proposal. Participant data must be subject to the Privacy rules of the Health Insurance Portability and Accountability Act of 1996 HIPAA. For any Evaluation of the program in this NOFO, HUD does not expect research to be conducted that could affect human subjects.

20. Data Collection. You must collect, maintain, and provide to HUD the data necessary to document and evaluate grant program outputs and outcomes upon request.

21. Sustainability. Grantees must implement a strategy to build community capacity for home modification programs and services that will continue after the grant performance period ends. See Section V.A, Review Factors.

22. Procurement Requirements. All goods and services must be procured through a competitive process. Recipients must follow federal procurement requirements as defined in 2 CFR §§ 200.317 - 200.326, and PGI as applicable. The designation of an entity as a subrecipient or contractor must follow program policies and 2 CFR 200.331.

C. Cost Sharing or Matching This Program does not require cost sharing or matching.

https://www.ecfr.gov/current/title-2/part-200/section-200.1#p-200.1(Cost%20sharing%20or%20matching)

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III. PROGRAM DESCRIPTION

A. Purpose The overall purpose of the Older Adults Home Modification Program (OAHMP) is to assist experienced nonprofit organizations, state and local governments, and public housing authorities in undertaking comprehensive programs that make safety and functional home modifications, repairs and renovations to meet the needs of low-income seniors. The goal of the home modification program is to enable low-income elderly persons to remain in their homes through low-cost, low barrier, high-impact home modifications to reduce older seniors' risk of falling, improve general safety, increase accessibility, and to improve their functional abilities in their home. This will enable seniors to remain in their homes, that is, to "age in place," rather than move to nursing homes or other assisted care facilities.

HUD's Office of Lead Hazard Control and Healthy Homes is making available grant funds and training resources to non-federal entities. Under this NOFO, experienced nonprofit organizations, state and local governments, and public housing authorities will deliver home modification services to qualified beneficiaries. As required by the appropriation laws that fund the grants under this NOFO, at least one third of funding under this NOFO will be made available to grantees that serve communities with substantial rural populations, as defined below.

The NOFO establishes a program model that incorporates two core concepts: first, as people age, their needs change, and they may need adaptations to their physical environment to live safely at home; second, for any intervention to have the highest impact, the individual's personal goals and needs must be a driver in determining the actual intervention.

The OAHMP model focuses on low-cost, high-impact home modifications. Examples of these home modifications include installation of grab bars, railings, and lever-handled doorknobs and faucets, as well as the installation of assistive technology, adaptive equipment, such as temporary ramp, tub/shower transfer bench, handheld shower head, raised toilet seat, risers for chairs and sofas, and non-slip strips for tub/shower or stairs. The OAHMP model also encourages a person-centered approach that motivates and supports older adults as they identify their goals and learn to function safely in their home. The OAHMP model also relies on the relevant expertise of highly skilled professionals with relevant experience in home assessments, accessibility, and aging-in-place modifications to ensure home interventions address specific client goals and personal needs to enable full participation in daily life activities and roles. To help maximize the breadth of the program, the OAHMP supports using experienced Occupational Therapists (OT), their licensed assistants, Certified Aging-in-Place Specialists, or other trained professionals with relevant experience in home assessments, accessibility, and aging-in-place modifications with recommended oversight and consultation by licensed OTs, though not required. OT practitioners are highly skilled, trained in evidence-based measures to evaluate clients' functional abilities and the home environment, with knowledge of the range of low-cost, high-impact environmental modifications and adaptive equipment used to optimize the home environment and increase functional independence.

Services made available under this NOFO must be for the benefit of eligible low-income senior homeowners and renters who are at least 62 years old for work within their primary

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III. Program Description LHC-2600-DC-0069 Page 20 of 73 residence. Because of the vulnerable nature of the persons served, awardees of an OAHMP grant are highly encouraged to ensure that the intake process employed to qualify projects for home modifications avoids the potential for project implementation delays. One example of potential delay is enrolling a beneficiary whose home requires modifications beyond what HUD defines as maintenance. A proposed project involving repair or rehabilitation above the maintenance level requires an environmental review if it would alter the existing footprint of a structure or an improvement in a floodplain or a wetland (per the Consolidated Appropriations Act, 2026, Division D, Title II) either by the grant recipient (if a state or unit of general local government), a non-recipient Responsible Entity (state or unit of general local government), or by HUD. That environmental review includes consultation with the State Historic Preservation Officer and compliance with other federal environmental requirements listed at 24 CFR §58.5 or §50.4. Where the recipient is not a Responsible Entity, project implementation may be delayed 45+ days, pending completion of the environmental review, and approval by HUD, should no non-recipient Responsible Entity be willing/able to assume environmental review responsibilities (see Section VI.B for additional details). Proposed projects that meet the definition of maintenance will not require an environmental review or approval by HUD even if the home being treated is in a floodplain or a wetland, and the grantee may proceed with implementation; see Section VI.B. Additional guidance will be provided by HUD, post-award.

Background Research has demonstrated that, under certain conditions, home modification can significantly reduce the risk of falling among community-dwelling elderly persons (i.e., adults not living in institutional settings). Pighills, A., Ballinger, C., Pickering, R., Chari, S. British Journal of Occupational Therapy 79(3), November 2, 2015 (https://doi.org/10.1177/0308022615600181). This systematic literature review concluded that the research demonstrated that high intensity environmental assessment and home modification was clinically effective in preventing falls when conducted with high-risk elderly persons. The authors defined "high intensity" as an assessment that is delivered by an occupational therapist (OT) and "high risk" as adults aged 65 and older with one or more of the following risk factors: one or more falls in the previous year, a recent hospital admission, a chronic health condition, or visual impairment. The authors indicated that interventions implemented by OTs were likely effective because of the OT's focus on the impact of the environment on an individual's function and their consideration of personal, environmental, and activity-related fall risk factors. Though OTs are not required for this program, existing evidence indicates their efficacy and holistic approach to home modification improved client outcomes in safety and daily household functions long-term.

Research has also demonstrated that professional assessment and home modification can significantly decrease disability among community-dwelling elderly persons. The Johns Hopkins University School of Nursing developed a program called Community Aging in Place –Advancing Better Living in Elders (CAPABLE) that uses a team that includes an OT, a registered nurse, and a home modifier (i.e., handyman) to conduct an assessment and home modification to improve the functional ability of clients. Researchers conducted a randomized controlled trial with 300 adults aged 65 and older with no cognitive impairment who self-reported difficulty with physical functioning (i.e., activities of daily living (ADL) such as dressing, bathing, walking) or two or more instrumental activities of daily living (IADL) (e.g., https://doi.org/10.1177/0308022615600181

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III. Program Description LHC-2600-DC-0069 Page 21 of 73 shopping, managing medications). Up to 10 home visits were conducted over a 5-month period in the intervention group compared to the control group that received a similar number of social visits by research team members. The OT evaluated a client's functional disability, identified and addressed functional goals, assessed home safety risks, and oversaw communication with the primary practitioner. The registered nurse assessed a client's pain, depressive symptoms, medication use, strength, and balance. A goal of the intervention was to address functional goals (identified through client interview) by enhancing the client's capacity through use of adaptive equipment and home modification. The intervention group experienced a significant reduction in disability compared to the control group based on improvements in an ADL and/or IADL scoring tool. (See: Szanton, SL, et al. JAMA Internal Medicine 179(2):204-211. January 7, 2019 (https://pmc.ncbi.nlm.nih.gov/articles/PMC6439640/.)

HUD's Office of Policy Development and Research sponsored an evaluation of the first round of the OAHMP, in which enrollment was limited (by the Consolidated Appropriations Act, 2021, which funded the program) to low-income senior homeowners, thus, excluding low-income senior renters. The evaluation, conducted by Healthy Housing Solutions, Inc. and the National Center for Healthy Housing, found that:

• The enrollees experienced improvements in functional abilities–such as bathing and dressing–and reductions in emergency department visits, hospitalizations, and emergency response calls.

• Nearly all clients who were interviewed post-modification reported benefiting from the program.

• These positive associations had to be interpreted cautiously because the evaluation did not conduct research to establish causality.

(See: Reddy A.L., Beatley N., Williams A., Breysse J., Dixon S., Wilson J., Bloom C.

Evaluation of the HUD Older Adult Home Modification Grant Program – Final Report: Cohort 1 Grants (Fiscal Year 2021). March 29, 2024.

https://www.huduser.gov/portal//portal/sites/default/files/pdf/Evaluation-of-the-HUD-Older- Adult-Home-Modification-Grant-Program-Final-Report-Cohort-1-Grants.pdf.)

Recent research based on convenience sampling and volunteer self-selection of a small sample of clients of two OAHMP grants servicing rural communities, using structured interviews and home assessments under a validated inspection protocol, before and after home modification found:

• Improvements in clients' personal safety and accessibility.

•…