Oregon submits 1115 waiver application to expand services for older adults


Emily Boerger


Earlier this month, the Oregon Health Authority (OHA) submitted the state’s 1115 waiver demonstration application to the Centers for Medicare and Medicaid Services (CMS) to expand services for older adults and adults with disabilities. The waiver specifically asks for the authority to expand Oregon Project Independence (OPI) and to create a new Family Caregiver Assistance Program (FCAP).


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“These programs provide limited services and supports to individuals at risk of entering the Medicaid long-term services and supports system, with the intent to assist individuals to either avoid or delay entering the Medicaid system,” reads the application.

OHA submitted the waiver in partnership with the Department of Human Services and the Office of Aging and People with Disabilities. CMS opened the public comment period for the application on Tuesday.

Oregon Project Independence (OPI) is funded entirely by state funds and provides in-home supportssuch as personal care services, home-delivered meals, and case managementto older adults and individuals with Alzheimer’s and other dementia diagnoses. The program currently serves about 2,350 individuals but the state is asking to create a federally matched program to allow OPI to serve a projected 4,500 individuals. The application states:

“The level of state funding for OPI has fluctuated over the last three decades making long term stability difficult and making it difficult to meet the demand for these services. There is a high demand for the program.”

The FCAP, reads the application, would utilize federal and state funds to support individuals who receive care from family members. The program would offer a list of services including adult day services, transportation, caregiver respite, and assistive technology. The state estimates the program would serve up to 1,800 individuals and their caregivers.  

Consumers would be eligible to receive services totaling a maximum of $500 per month, with an annual increase to meet inflation.

“With both programs, consumers will receive limited services tailored to their needs and life choices that are culturally and linguistically responsive to each consumer’s needs. These programs can help avoid unnecessary hospitalizations or acute emergency medical care and out-of-home placement in an institutional or community long-term care setting.”

The waiver says these expanded programs are particularly important as Oregon’s population continues to age. Oregon’s population in the 65-74 years old age bracket is expected to increase by 60% in the next 10 years. During this same time, the population aged 85 and older is expected to increase by 33%.  

The new FCAP program and the expansion of OPI would become operational on July 1, 2022. The state is requesting that the demonstration cover a 5-year period with possible renewal.