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Obra Waiver

The Omnibus Budget Reconciliation Act (OBRA) Waiver is a Home and Community-Based Waiver program Consumer Directed Services | Department of Human Services | Commonwealth of Pennsylvania that may help if you are between the ages of 18-59, have a developmental physical disability which allows participants to remain in the community and maintain independence 

 

Eligibility requirements:

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  • A resident of Pennsylvania.

  • Age 18-59. Individuals who turn age 60 while in the waiver are able to continue to receive services through the OBRA Waiver until services are no longer needed. New applicants age 60 and older will be referred to other programs.

  • Have a severe developmental physical disability requiring an Intermediate Care Facility/Other Related Conditions (ICF/ORC) level of care.

  • The disability must result in substantial functional limitations in three or more of the following major life activities:

  • Self-care, communication, learning, mobility, self-direction and capacity for independent living.

  • Meet the financial requirements as determined by your local County Assistance Office.

 

Other related conditions (ORCs) include physical, sensory, or neurological disabilities which manifested before age 22 and are likely to continue indefinitely.

 

Application Process

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  1. Determine eligibility: 

    1. apply for Home and Community-Based Services (HCBS) eligibility through county assistance office COMPASS Intake  this website has link to see if you qualify and application completion -

  2. Initiate application: 

    1. Contact the PA Independent Enrollment Broker (IEB) telephonically 1-877-550-4227, online https://paieb.com/en/waiver-application, mail application PA Independent Enrollment Broker - Web Referral Form 

  3. Functional Assessment: 

    1. An assessment agency will schedule face to face visit to determine functionality, completed by local Area Agency on Aging (AAA)

  4. Complete physician certification form: 

    1. verify need for nursing level facility level of care MA 570 Physician Certification Form

  5. Submit documentation: 

    1. proof of income, assets, and medical needs PA 1968 - Long-Term Services and Supports Pending Documentation Form

  6. Service Planning: 

    1. Service plan is developed based on individual assessed needs

    2. Services may include personal assistance, job coaching, therapy, adaptive equipment, transportation and more

 

Services available to you may include:

  • Adult Daily Living

  • Employment Skills Development

  • Job Coaching (Intensive and Extended Follow-along)

  • Personal Assistance Services

  • Residential Habilitation Services

  • Respite

  • Service Coordination

  • Structured Day Habilitation Services

  • Behavior Therapy Services

  • Nursing Services

  • Occupational Therapy Services

  • Physical Therapy Services

  • Specialized Medical Equipment and Supplies

  • Speech and Language Therapy Services

  • Community Integration

  • Community Transition Services

  • Counseling Services

  • Home Adaptations

  • Job Finding

  • Non-Medical Transportation

  • Nutritional Consultation

  • Personal Emergency Response System

  • Prevocational Services

  • Supported Employment

  • Vehicle Modifications

 

How to Apply by Phone

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Call the Statewide Customer Service Center at 1-866-550-4355 to get started. Here's what happens when you call:

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  1. The Customer Service Center staff will help you complete your financial application (form 600L) over the phone

  2. They'll send your completed application to your local County Assistance Office (CAO) for review

  3. You'll still need to meet both clinical and financial requirements to qualify for services
     

Importantly, this phone option only covers the financial application portion. Clinical assessments and eligibility determinations still follow existing processes through the appropriate channels (CAO for nursing facility services; Independent Enrollment Broker for certain waivers).

 

Special Process for CHC and OBRA Waiver Applicants

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If you're applying for Community HealthChoices (CHC) or OBRA waivers, you have two pathways:

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Option 1: Start with the Independent Enrollment Broker (IEB)

  • Contact the IEB directly to schedule your at-home clinical assessment

  • The IEB also continues to guide applicants on how to complete the financial application for long term care services.

  • This has been the traditional pathway and remains available
     

Option 2: Start with the Customer Service Center

  • Call the Center at 1-866-550-4355 to begin with the financial application

  • They will connect you with the IEB, who will conduct the required clinical assessment

  • The IEB also continues to advise applicants on how to complete the financial application for long term care services.
     

Importantly, the clinical assessment component remains unchanged regardless of which application option you choose. The IEB still serves as the point of contact for clinical assessments and continues to provide guidance on the overall waiver application process. Since this process is so now, we don't yet have data on whether processing times or efficiency differs between these two starting points. We will continue to monitor this process and provide updates.

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Individuals who experience problems with the new phone application process or whose application for waiver or nursing facility services is denied can contact PHLP’s Helpline for assistance: 1-800-274-3258 or staff@phlp.org.

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