Public notice and request for comment on waiver renewal applications

The Oregon Department of Human Services (ODHS) Office of Aging and People with Disabilities (APD) seeks public comment on two Medicaid waivers it plans to renew through the Centers for Medicare and Medicaid Services (CMS). The waivers, which are set to expire Dec. 31, 2026, allow Oregon to modify standard Medicaid rules so people can receive the help they need at home or in the community.

Public comments are due by May 31, 2026, on the following waivers:

• 1915(c) Aged and Physically Disabled Waiver: Uses Medicaid funds for case management services, which help people connect to needed medical, long-term services and supports, and other services. It covers housing support services for those who need help with housing. Lastly, it covers community transition services that help people move from a hospital or care facility to a home where they can receive in-home care. For people whose income is too high for standard Medicaid, the 1915(c) waiver allows the state to provide Medicaid, including long-term services and supports, if they meet eligibility requirements.
• 1915(b)(4) Case Management and Agency with Choice Freedom of Choice Waiver: Allows APD to use Medicaid funds to contract with a limited set of approved providers for delivering the case management and housing support services that are part of the 1915(c) waiver. These approved providers are Area Agency on Aging (AAA) offices, APD offices and willing Tribes. The waiver also allows APD to contract with up to two Agency with Choice providers.

Summary of updates

Proposed changes for the 1915(c) Aged and Physically Disabled Waiver:

• Case managers must document a person's choice of services, service setting and service providers using a specific choice form.
• When someone is moving from an acute care hospital to any home and community-based setting, known as a community transition, it must be to an arrangement that is more independent and less restrictive.

Both waiver renewal applications include small changes to make the information clearer. Both also include updated cost estimates. These estimates explain how much the services are expected to cost and show that they continue to meet federal requirements. The 1915(c) includes an increase in users for case management services due to rising caseloads.

The draft waiver applications with proposed changes are available on the APD website. Print versions are posted in local APD and Area Agency on Aging (AAA) offices. To ask for a printed version, contact APD Medicaid State Plan and Waiver Policy Analyst at 503-856-2768 or [email protected].

How to submit feedback on the proposed changes

1. Send an email to [email protected].
2. Send written comments to Beth Jackson, Oregon Department of Human Services, 500 Summer Street NE E-02, Salem, OR 97301.

Comments must be received by May 31, 2026.

APD will review and consider all public comments as part of the renewal process. The program will prepare and submit the renewal applications to CMS by July 4, 2026. Following CMS approval, the waivers will be in effect Jan. 1, 2027, through Dec. 31, 2031.