Public notice and request for comment on ODDS Medicaid waiver updates

The Oregon Department of Human Services Office of Developmental Disabilities Services (ODDS) seeks public comment on the following Medicaid waivers:

• 1915 (c) Children's Extraordinary Needs (CEN) Waiver
• 1915 (b) (4) Fee-for-Service Selective Contracting Program

Summary of substantial updates

Increase the number of children served in the CEN waiver

Originally, the 1915 (c) CEN Waiver could serve 155 children at one time. We're increasing the number of children that can be in the CEN program to 230 children at a time. This helps us plan for children entering and leaving the program during the year.

We're also increasing the total number of children who can be in the CEN program during a one-year period from 171 to 280.

We're asking the Centers for Medicare and Medicaid Services (CMS) to approve this change retroactively to July 1, 2026.

Context for the proposed change: The CEN program started July 1, 2024. The Oregon Legislature gave the program a limited budget. At that time, we estimated that the program's budget could support 155 children at a time.

About 15 months after the program began, we had enough data to begin analyzing the program's service usage. The average cost per child was lower than expected. Since then, the data continues to affirm this finding. That's why we can expand the program to serve more children within its budget. The federal government doesn't consider this a big change, so we can ask for a retroactive start date to July 1, 2026, which is when we expanded enrollment for the program.

Updated cost projections for CEN case management services

The 1915 (b) (4) Fee-for-Service Selective Contracting Program allows ODDS to specify the number and type of case management entities that are allowed to provide waiver case management services. Cost projections for CEN case management are included in this waiver. We are updating these projections to account for the increase in the number of children served in the CEN waiver. ODDS is asking CMS for a retroactive approval date of July 1, 2026.

How to submit feedback on the proposed changes

1. Send an email to [email protected].
2. Send written comments to ODDS Medicaid waiver/State Plan analyst, 500 Summer Street NE E-09, Salem, OR 97301.

The deadline for comments is Nov. 25, 2026. We must receive comments by this date.

More information

Read the drafted waivers and the community notice announcing these updates on the ODHS website.

Print versions of the updates are posted in local community developmental disabilities programs and support services brokerages.

To ask for a printed version, contact ODDS Medicaid Waiver/State Plan Analyst at 503-507-2083 or [email protected].

You can get this document for free in other languages, large print, braille or a format you need. Email [email protected] or call 503-945-5811. We accept all relay calls.