Services for People with Developmental Disabilities under the OBRA Law
The Omnibus Budget Reconciliation Act (OBRA) is a law that was passed by Congress and signed by the President of the United States in 1987. Congress was concerned that people with mental retardation were being inappropriately place in nursing homes because they did not have medical nursing needs. The law required each state to develop a pre-admission screening and an annual resident review (PASARR) process for nursing home residents suspected of having a developmental disability.
After January 1989, every person, regardless of payment source, must have a Level I identification screen prior to admittance to a nursing home. If through the screening process a person has, or is suspected of having, a history of a developmental disability, a Level II pre-admission screening is completed. The purpose of the Level II is to confirm or discount a diagnosis of mental retardation (MR) or other related conditions (ORC) that necessitate services similar to a person with mental retardation. If a diagnosis of MR/ORC is identified, that person can only be admitted to a nursing home if they are on a convalescent stay, are seriously medically ill, or are elderly.
Since 1994, a Level I, and when indicated a Level II, must also be completed for people making application to Montana’s Home and Community-Based Service (HCBS) Medicaid Waiver. This process was intended to separate eligibility between the HCBS Medicaid Waiver and the Developmental Disabilities Waiver, referring applicants to the appropriate Medicaid Waiver service as indicated.
In 1995, Specialized Services was an additional option for people with a diagnosis of MR/ORC who were residing in nursing homes. Specialized Services is a separate limited case management service funded through the Developmental Disabilities Program. It allows residents access to 4 visits throughout the year from their case manager and provides limited funding to purchase services or goods not otherwise funded. The case manager is then responsible for the annual resident review as mandated through the OBRA law.
CDC provides pre-admission screening for people suspected or diagnosed with a developmental disability who are making application to a nursing home and/or the HCBS Medicaid Waiver across all of western Montana. CDC also provides annual resident reviews and limited case management services to people with MR/ORC currently residing in nursing homes across all of western Montana.
For more information regarding this program, please call CDC @ 549-6413 and ask for the OBRA Coordinator.
OBRA Services are offered to adults of all ages.