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    Medicaid Waivers

    2025 OBRA Waiver Amendment

    Effective January 1, 2025

    The Department of Human Services (DHS) Office of Long-Term Living (OLTL) will be submitting an amendment for the OBRA home and community-based services waiver with an effective date of January 1, 2025. The Department proposes the following substantive and technical changes to the OBRA waiver:

    • Amend the following service definitions: 
      • Benefits Counseling 
      • Employment Skills Development  
      • Home Adaptations  
      • Personal Emergency Response System (PERS) 
    • Add teleservices to the following services:  
      • Cognitive Rehabilitation  
      • Counseling Services 
    • Add the HCBS CAHPS survey as a patient experience of care/quality of life survey. 
    • Modify timeframe for filing for an appeal for waiver services to continue.  
    • Reduce the years of experience needed for Structured Day Habilitation Support Staff to two years. 
    • Update Appendix G: Participant Safeguards to current process. 
    • Modify language throughout for better readability. 
    • Clarify when child abuse clearances are needed for direct care workers. 

    Interested persons are invited to submit written comments regarding the proposed waiver amendment to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: OBRA 2025 Waiver Amendment, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments may also be submitted to the Department at RA-waiverstandard@pa.gov. Please use “OBRA 2025 Waiver Amendment” as the subject line. Comments received by close of business on July 14, 2024, will be reviewed and considered for revisions to the proposed waiver amendments. Please use the OBRA Waiver Comment Form at the bottom of this page.

    The OBRA waiver amendment public notice was published on Saturday, June 15, 2024, in the Pennsylvania Bulletin. View the public notice here. 

    (*) - This Appendix contains proposed changes

    OBRA Waiver Comment Form