Nursing Home Outreach Services

The Department of 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 intellectual disability authority evaluate persons with intellectual disability 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:

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:

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:

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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This File Was Last Modified: Friday July 29 2016