Nursing Home Outreach Services

The Department for Aging and Rehabilitative Services provides specialized services to consumers with disabilities who live in nursing facilities across Virginia. Specialized services are those services consumers need to maximize self-determination and independence that they cannot access through a nursing facility (NF) or through the standard Medicaid state plan. DRS state OBRA funds through an agreement with the Department of Behavioral Health and Development Services (DBHDS) and the Department of Medical Assistance Services (DMAS).

This agreement covers specific consumers Department of Behavioral Health and Development Services (DBHDS) has identified as a result of Public Law 100-203, the Omnibus Budget Reconciliation Act of 1987. This act stipulates that the state mental retardation authority evaluate persons with mental retardation or related conditions who reside in Medicaid-funded facilities to determine specialized service needs. The state must then provide or arrange for delivery of those services. Related conditions include significant disabilities such as cerebral palsy, epilepsy, autism, spinal cord injury, brain injury, muscular dystrophy, multiple sclerosis, spina bifida, stroke or other conditions of neurological origin.


Eligibility for OBRA services is determined through the Department of Behavioral Health and Development Services (DBHDS). Eligible consumers are those who need and can benefit from specialized services and have a related condition, which manifests before 22 years of age. Identification of consumers takes place through the Nursing Home Pre-Admission screening prior to admission to a Medicaid-funded nursing facility. Further identification can occur when a consumer experiences significant change of condition and participates in a Resident Review.

Specialized Services

Specialized services include:

  • Assistive Technology
  • Education
  • Prevocational training
  • Supported employment
  • Community resource utilization
  • Communication training
  • Personal Assistance Services
  • Independent living skills training
  • Environmental modifications
  • Rehabilitation engineering
  • Individual and group counseling
  • Crisis intervention
  • Psychotherapy
  • Behavior management
  • Transportation to training or other services
  • Case management

State Plan Option (SPO) Day Health and Rehabilitation Services

The primary categories of specialized services for OBRA consumers who reside in NFs come under the heading of SPO Day Health and Rehabilitation. DRS may provide specialized services within or in support of the following categories:

  • Eating, self-care and hygiene
  • Task learning skills
  • Community resource utilization skills
  • Environmental behavior skills
  • Medication management
  • Travel and related training
  • Equipment use

Community and Other Services

The DRS OBRA staff also assists consumers to move from nursing facilities into the community. Consumers may access a variety of Community Waiver Services within the following categories:

  • Residential Support Services
  • Personal Assistance Services
  • Respite Care Services
  • Nursing Services
  • Environmental Modifications
  • Assistive Technology
  • Day Support Services
  • Supported Employment Services
  • Therapeutic Consultation Services

Contact Information

For further information regarding OBRA contact Carolyn Turner, Manager, Community Rehabilitation Case Management Services, 804-662-7107 or 1-800-552-5019 or email

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