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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. To learn more, visit Medicaid.gov - Section 1115 Demonstrations.

Current Demonstration  Give feedback at Aug. 4 forum


Current Demonstration: OPI-M

Oregon Project Independence Medicaid (OPI-M) uses Medicaid to serve more older adults and people with physical disabilities who need help with Activities of Daily Living (ADLs), but who are not using Medicaid long-term services and supports. This includes supports to unpaid family caregivers. 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

Public notice announcement

Post-Award Public Forum asking for comments on the Medicaid 1115 Oregon Project Independence – Medicaid (OPI-M) Demonstration Waiver

Pursuant to 42 CFR 431.420(c), the Oregon Department of Human Services, Office of Aging and People with Disabilities, along with the Oregon Health Authority, will hold its second Post-Award Forum for the Oregon Project Independence – Medicaid (OPI-M) 1115 Medicaid Demonstration Waiver.

  • The forum will provide information on the implementation of OPI-M since the approval of the Waiver by the Centers on Medicare and Medicaid Services (CMS) on Feb. 13, 2024.
  • OPI-M operates under the authority of an 1115(a) waiver. This waiver is in effect from February 13, 2024, to January 31, 2029.

When: Aug. 4, 2025, 10-11:30 a.m. Pacific

Who should attend: We encourage interested parties and members of the public to attend. All are welcome to provide meaningful public comment and feedback on the progress of the waiver.

To join online:Join the August 4 forum by Zoom

To join by phone:

  • Dial in number: 669-254-5252
  • Meeting ID: 161 032 8361
  • Passcode: 447744

Accessibility: We will provide ASL interpretation and CART captioning. Please contact Max Brown at max.brown@odhs.oregon.gov or 971-707-1019 no later than 48 hours prior to the forum for other accommodations.

For more information on the OPI-M waiver, please read the Annual Report.