Oregon Medicaid Waiver Programs: HCBS, APD Waiver, and Home Care Options
Oregon Medicaid Waiver Programs: Home and Community-Based Care Options
Your parent doesn't want to go to a nursing home, and you've heard Oregon has programs that pay for home care. That's true — but Oregon's system is structured differently from most states, and the terminology trips up families who research other states' programs first.
Why Oregon's System Doesn't Have Traditional Waivers
In most states, home and community-based services (HCBS) run through 1915(c) waivers with capped enrollment and waitlists that stretch for years. Oregon replaced that model with the K Plan under Section 1915(k) of the Social Security Act — the Community First Choice option.
The K Plan is an entitlement, not a capped waiver. If your parent meets the financial criteria ($2,982/month income, $2,000 assets) and the functional threshold (CAPS Service Priority Level 1-13), they are guaranteed services. No waitlist. No enrollment cap. No annual slot renewals.
This is why searching for "Oregon HCBS waiver" or "APD waiver" often leads to confusing results — the terminology from other states doesn't map cleanly onto Oregon's system.
The K Plan: Oregon's Primary Home Care Pathway
The K Plan covers services in three community settings:
In your parent's home: Through the Consumer-Employed Provider program, your parent chooses their own caregiver — including family members (adult children, siblings, other relatives). Spouses and legal guardians cannot be hired. The caseworker authorizes a specific number of monthly hours based on the CAPS assessment.
Assisted living and residential care facilities: The K Plan covers the care component. Room and board ($773/month in 2026) is paid by the resident from their personal income.
Adult foster homes: Similar to assisted living — Medicaid covers care, the resident covers room and board.
OPI-Medicaid: The Broader Safety Net
For parents who don't score SPL 1-13 on the CAPS assessment — meaning they need help but not at nursing home level — Oregon Project Independence - Medicaid (OPI-M) fills the gap.
OPI-M operates under a federal 1115 demonstration waiver with dramatically more generous eligibility:
- Income limit: $5,320/month (400% FPL)
- Asset limit: $103,645
- Covers all Service Priority Levels (1-18)
- No enrollment cap
- Completely exempt from estate recovery
The estate recovery exemption alone makes OPI-M worth exploring for families concerned about protecting the home. If your parent qualifies for OPI-M instead of the K Plan, the state cannot pursue the home after death.
Free Download
Get the Oregon — Medicaid Long-Term Care Eligibility Checklist
Everything in this article as a printable checklist — plus action plans and reference guides you can start using today.
State Plan Personal Care (SPPC)
For seniors who need hands-on help with at least one Activity of Daily Living but don't meet the nursing facility level of care, SPPC provides in-home personal care assistance. The eligibility bar is lower than the K Plan — your parent doesn't need to score SPL 1-13. However, spouses cannot serve as paid caregivers under SPPC.
Which Program Fits Your Parent
The right pathway depends on your parent's functional level and financial situation:
| Program | Income Limit | Asset Limit | Functional Requirement | Estate Recovery |
|---|---|---|---|---|
| K Plan | $2,982/mo | $2,000 | SPL 1-13 (NF level of care) | Yes |
| OPI-M | $5,320/mo | $103,645 | SPL 1-18 (any level) | No |
| SPPC | $2,982/mo | $2,000 | At least 1 ADL need | Yes |
Start with a call to the ADRC at 1-855-673-2372. They'll screen your parent and determine which program pathway makes sense based on their care needs and financial profile.
The Oregon Medicaid Long-Term Care & Asset Protection Guide maps each program's eligibility criteria, coverage limits, and application requirements side by side, so you can evaluate all options before committing to a pathway.
Get Your Free Oregon — Medicaid Long-Term Care Eligibility Checklist
Download the Oregon — Medicaid Long-Term Care Eligibility Checklist — a printable guide with checklists, scripts, and action plans you can start using today.