In our pursuit of providing you with the most relevant and comprehensive information, we present to you a detailed guide on the OBRA and ACT 150 Pennsylvania Disability programs. These programs play a pivotal role in supporting adults with disabilities in the state of Pennsylvania. Our goal is to provide you with an in-depth understanding of these programs, their eligibility criteria, benefits, and how they can significantly impact the lives of those in need.
Understanding OBRA and ACT 150
What is OBRA?
OBRA a program operated by Pennsylvania’s Office of Long-Term Living (OLTL), particularly for individuals with developmental physical disabilities in Pennsylvania. As a Home and Community-Based Medicaid program, it enables eligible recipients to live independently within their community.
ACT 150 - Community-Based Services
ACT 150 is a state-level program in Pennsylvania that focuses on providing community-based services to adults with disabilities who require assistance to live independently. This program aims to enhance the quality of life for individuals with disabilities by offering various services and supports while allowing them to remain in their homes and communities.
Eligibility for OBRA and ACT 150
OBRA Eligibility
To be eligible for services under OBRA, an individual must:
- 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 wil 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.
ACT 150 Eligibility
ACT 150 is designed for individuals who wish to receive services in their communities rather than in institutional settings. Eligibility criteria for ACT 150 include:
- Be a resident of Pennsylvania.
- Meet the level of care needs for a Skilled Nursing Facility.
- Be between eighteen (18) and fifty-nine (59) years of age.
- Be capable of a) hiring, firing, and supervising attendant care worker(s); b) managing your own financial affairs; and c) managing your own legal affairs.
- Be capable of directing your own care.
- Have a medically determinable physical impairment that is expected to last of a continuous period of not less than twelve (12) calendar months or that may result in death.
- Proceed through the eligibility process for the Medicaid (MA) program and be determined financially ineligible.
- To take advantage of the Act 150 Program, you may be assessed a minimal co-payment. This co-payment is based on your income and will not be more than the total costs of services.
Benefits of OBRA and ACT 150
OBRA Benefits
- 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
ACT 150 Benefits
ACT 150 offers a wide range of benefits for eligible individuals seeking community-based services:
- Personal care assistance to support daily living activities.
- Support with transportation and meal preparation.
- Access to home modifications to improve accessibility.
- Respite care for family caregivers.
- Assistance in accessing community resources and services.
The Application Process
Applying for OBRA Services
For individuals seeking OBRA services please follow below steps. Click here for more details. Click here to fill community referral form.
Here’s a step-by-step process on how to apply for the OBRA waiver:
Initial Contact: Start by calling the Independent Enrollment Broker at 1-877-550-4227. Inform them that you wish to apply for OBRA waiver services.
First Home Visit: The broker will schedule your first home visit. During this visit, a representative will come to your house to initiate the application process. They will provide information about the waiver program and its services. They will also assist you in completing the necessary application forms.
Second Home Visit: A follow-up home visit is scheduled. During this visit, applicants undergo a “Functional Eligibility Determination.” This assessment evaluates if the applicant meets the required level of care for OBRA waiver enrollment. The assessor assesses the applicant’s needs for daily activities such as eating, bathing, dressing, toileting, and more.
Physician Certification: Your doctor must complete and submit a Physician Certification form. This form should confirm that you meet the level of care criteria necessary for the OBRA waiver. It should also specify the major life activities for which you require assistance. You can access physician certification form by clicking here and going to Provider Resources.
- Financial Review and Approval:
- The County Assistance Office (CAO) reviews your waiver application to determine if you qualify financially.
- If the CAO requires additional information, they will send you a letter requesting it.
- Once your application is complete, the CAO will either approve or deny it.
- The CAO sends a notice to you, the Pennsylvania Independent Enrollment Broker (PA IEB), and your selected Managed Care Organization or Service Coordination Agency.
Applying for ACT 150 Services
Rule Of Thumb
Always contact PA IEB (Independent Enrollment Broker) if you have an questions or concers.
Website of PA IEB (Apply, Check Status and Get Answers): https://paieb.com/en
Phone Number to reach PA IEB: 1-877-550-4227.
Conclusion
In conclusion, OBRA and ACT 150 are essential programs that cater to the needs of adults with disabilities in Pennsylvania.
By understanding the eligibility criteria and benefits of these programs, you can make informed decisions to support yourself or your loved ones in achieving a higher quality of life.
A Good Friend In Home Care is licensed to provide Personal Assistance Care services, approved by the Office of Long-Term Living and the Pennsylvania Department of Health. We are proud to offer the highest wages in Allegheny County to Family Caregivers who are dedicated to caring for their loved ones through this program. If you have any questions or require further information, please do not hesitate to contact us by clicking here.
