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1115 Medicaid Demonstration Waiver

The Oregon Department of Human Services (ODHS), Office of Aging and People with Disabilities (APD) through the Oregon Health Authority (OHA) has section 1115 Waiver authority to serve more older adults and people with physical disabilities.

Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot or demonstration projects that promote the objectives of the Medicaid and Children's Health Insurance Program (CHIP) programs. Under this authority, the Secretary may waive certain provisions of the Medicaid law to give states additional flexibility to design and improve their programs. Under this authority, the Secretary may waive certain provisions of the Medicaid law to give states additional flexibility to design and improve their programs. To learn more, visit Medicaid.gov - Section 1115 Demonstrations.

Current Demonstration


The Demonstration's focus

Oregon Project Independence Medicaid (OPI-M) uses Medicaid to serve more older adults and people with physical disabilities who require some assistance with Activities of Daily Living (ADLs), but who are not accessing Medicaid long-term services and supports. This includes supports to unpaid family caregivers who care for these individuals. Oregon received 1115 Waiver approval in February 2024. APD is currently preparing to serve individuals through the Waiver.

Oregon added another option for individuals who need in-home services and supports in 2024. This new option is called Oregon Project Independence – Medicaid (OPI-M).

OPI-M is in addition to Oregon Project Independence (OPI), which is a state-funded program.

OPI-M is different than traditional Medicaid because it is easier to qualify for services. It is also different than regular OPI, because OPI-M receives federal funding to pay for services and may provide more supports for people who need help in their home. While Oregon’s original OPI sometimes requires a fee to participate, OPI-M services are fully covered by Medicaid and participants will not have to pay a fee to receive services. There is also no estate recovery with OPI-M. Your heirs can inherit your home and belongings.​

​The program offers services that may include:

  • In-home care services such as help with bathing, eating, and walking
  • Chore services such as deep cleaning a home or addressing bug infestations
  • Adult day services
  • Emergency response systems
  • Home delivered meals
  • Assistive technology
  • Home modifications to make it accessible
  • Supports for unpaid caregivers​​

​Oregon Project Independence – Medicaid is being introduced by first serving individuals who have been on waiting lists for support from OPI. New applications for services could be accepted as early as spring 2025. People enrolled in the original state funded OPI, who choose to remain in that program, will continue to receive approved services. Those who choose to move to OPI-M, the Medicaid funded program, will be able to do so.​

To qualify for OPI-M, a person must:

  • Be age 18 or older
  • Have income at or below 400% of the Federal Poverty Level
  • Have limited resources that do not exceed the cost of six months in a nursing facility
  • Need help from another person with personal care tasks

Post-Award Public Forum to Solicit Comments on the Oregon Project Independence – Medicaid (OPI-M) 1115 Demonstration Waiver

The Office of Aging and People with Disabilities in the Oregon Department of Human Services, along with the Oregon Health Authority, held on Aug. 5 its first Post-Award Public Forum to receive feedback on the Oregon Project Independence – Medicaid (OPI-M) 1115 Demonstration Waiver. The forum, which is required by federal regulations, was hosted on Zoom and was open to all members of the public to provide information on the implementation of OPI-M since the waiver was approved by the Centers for Medicare and Medicaid Services (CMS) on Feb. 13, 2024. OPI-M operates under the authority of section 1115(a) of the Social Security Act. It is in effect from Feb. 13, 2024, to Jan. 31, 2029.​

For more information on the OPI-M waiver, please read the Q1 Quarterly Monitoring Report.

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