Oregon K Plan Community First Choice: Eligibility, CAPS Assessment, and Services

Most states make you wait months or years on a waiver waitlist to get state-paid home care. Oregon doesn't. Under the K Plan (Community First Choice), anyone who meets the functional and financial eligibility criteria is guaranteed services — no waitlist, no enrollment cap.

This makes Oregon one of the strongest states in the country for keeping an aging parent at home instead of in a nursing facility. But qualifying requires passing a subjective functional assessment that most families walk into completely unprepared.

What the K Plan Covers

The K Plan is authorized under Section 1915(k) of the Social Security Act as a Medicaid state plan option. Because it's a state plan entitlement (not a waiver), Oregon cannot cap enrollment. Services include:

• Personal care assistance — help with bathing, dressing, eating, toileting, transferring, and mobility
• Chore services — heavy housekeeping, yard work, and home maintenance that the individual can't safely perform
• Assistive technology — devices that increase independence (grab bars, adaptive utensils, communication devices)
• Home modifications — ramps, doorway widening, bathroom remodels, and other structural changes
• Consumer-Employed Provider option — hire, train, and manage your own care workers, including trusted friends and some family members

The K Plan does not cover skilled medical care (that's Medicare home health) or room and board. It covers the daily living support that keeps your parent safely at home.

The CAPS Assessment: What Determines Everything

The Client Assessment and Planning System (CAPS) is the functional evaluation that determines whether your parent qualifies and how many care hours they receive. A trained assessor from the local APD or AAA office conducts it, typically in the home.

CAPS measures physical, cognitive, and social functioning across multiple domains. The output is a Service Priority Level (SPL) score on an 18-point scale, where SPL 1 represents the highest level of impairment.

The critical threshold: SPL 1 through 13 qualifies for K Plan services. SPL 14 through 18 does not.

This is where most families lose. The assessment is partially subjective — the assessor observes your parent during the visit and scores their functioning based on what they see. If your parent has a good day, minimizes their difficulties out of pride, or performs tasks during the assessment that they can't safely do consistently, they'll score lower (higher SPL number) and may fall outside the qualifying range.

How SPL Scoring Works

Eligibility is driven by significant assistance needs in these core categories:

• Mobility — ability to walk, transfer from bed to chair, use stairs
• Eating — ability to feed themselves, swallow safely, manage nutrition
• Elimination — ability to use the toilet, manage incontinence
• Cognition — orientation, decision-making, memory, safety awareness

Needing help with bathing, dressing, grooming, or personal hygiene alone — without impairments in the core categories above — will not qualify your parent for K Plan services.

The assessor scores each domain based on the level of assistance required: independent, supervision, limited assistance, substantial assistance, or full assistance. Higher assistance levels in core domains generate more points toward a qualifying SPL.

Preparing for the CAPS Assessment

The biggest mistake families make is treating the assessment like a doctor's visit where you want good results. This is the opposite — you need the assessor to see your parent's actual daily functioning, not their best performance.

Before the assessment:

• Document your parent's worst days, not their best. Write down specific incidents: falls, confusion episodes, times they couldn't get out of bed, meals they missed, times they wandered or got lost
• Keep a one-week care log showing exactly what assistance you provided and how long each task took
• Ask the physician for a diagnosis statement and any cognitive evaluations that document impairment

During the assessment:

• Do not help your parent perform tasks the assessor asks them to demonstrate
• Do not answer questions for your parent — let the assessor observe their actual cognitive processing
• Speak up when your parent minimizes their difficulties. Many elderly parents will say "I can do that" for tasks they haven't safely completed in months
• Mention nighttime needs — the assessor may not ask, but overnight wandering, incontinence, and fall risk significantly affect the SPL score

Financial Eligibility

K Plan services are administered through Medicaid, so your parent must meet Oregon's Medicaid financial eligibility:

• Asset limit: $2,000 in countable assets for a single individual
• Income limit: $2,982/month (300% of SSI). If income exceeds this, a Miller Trust must be established
• Spousal protections: The community spouse can retain up to $162,660 in assets and receive income diversion up to $4,066.50/month

How to Start

Contact the ADRC of Oregon at 855-673-2372 or your local APD/AAA office to request an intake assessment. If your parent is currently in the hospital or a SNF, request the CAPS assessment now — scheduling can take 2-4 weeks, and every week without services is a week your parent goes without authorized care.

The Hospital-to-Home Oregon toolkit includes a CAPS assessment preparation guide with a daily care log template and a domain-by-domain checklist of what the assessor looks for, so your parent's real needs are accurately captured.

See more Oregon guides →