Oregon Medicaid Waivers & Home and Community Based Programs Overview
- Waiver Policy Analyst
- Jan 16
- 2 min read
Oregon, known as The Beaver State, has a well-developed Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for seniors, individuals with disabilities, and those with chronic health conditions.
Administered by the Oregon Health Authority (OHA) and the Oregon Department of Human Services (ODHS), Aging and People with Disabilities (APD) and the Office of Developmental Disabilities Services (ODDS), the state’s Medicaid waiver programs allow eligible individuals to receive services in their homes or community settings rather than institutional care.
Key waiver programs include the Aged and Physically Disabled (APD) Waiver, which provides personal care, home modifications, and assistive technology for seniors and adults with physical disabilities, and the Comprehensive (COMP) Waiver, which offers residential, employment, and behavioral health support for individuals with intellectual and developmental disabilities (IDD). Other significant programs include the Medically Fragile Children’s Waiver, the Behavioral Health Waiver, and the Independent Choices Program (ICP), which allows participants to self-direct their care and hire their own caregivers.
Regulatory oversight in Oregon is managed through OHA, ODHS, and ODDS, with additional provider licensing and compliance enforcement handled by the Oregon Department of Licensing and Regulatory Affairs (LARA). Oregon operates under a Managed Care model, with HCBS services integrated through Coordinated Care Organizations (CCOs) that manage physical, behavioral, and long-term care services under the state’s Medicaid system, known as Oregon Health Plan (OHP).
The state has also implemented Electronic Visit Verification (EVV) for personal care services, ensuring compliance and service integrity. Providers must navigate Medicaid enrollment, prior authorization requirements, and stringent regulatory standards to successfully participate in Oregon’s HCBS programs.
With a strong emphasis on community integration, self-directed care, and person-centered planning, Oregon’s Medicaid waiver system ensures that individuals receive high-quality, sustainable long-term care services while maintaining independence, dignity, and full inclusion in their communities.
Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.
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