Oregon Project Independence: Eligibility, Services, and How to Apply

Your parent makes too much money for traditional Medicaid but can't afford $7,627 a month for private in-home care in Oregon. You've been told there's nothing available — but that's wrong. Oregon Project Independence (OPI) and its Medicaid expansion, OPI-M, exist specifically for this gap.

OPI-M is one of the most significant programs most Oregon families have never heard of. Operating under a Section 1115 demonstration waiver through January 31, 2029, it provides state-funded home care services to the "forgotten middle" — people who are over-income for traditional Medicaid but lack the private resources to pay for long-term care out of pocket.

OPI vs. OPI-Medicaid: What's the Difference

Oregon Project Independence (OPI) is the original state-funded program providing in-home services to older adults and people with disabilities. It has limited capacity and often has waitlists because funding comes from state general revenue, not federal matching funds.

OPI-Medicaid (OPI-M) is the expanded version that draws federal Medicaid matching dollars. It has significantly higher income and asset limits than traditional Medicaid, making it accessible to middle-income families. OPI-M is the program most families should be targeting.

Both programs are strictly for in-home care settings — they do not cover residential facility costs. If your parent needs memory care facility placement, you'll need to look at the K Plan or traditional Medicaid instead.

2026 Eligibility Rules

Income Limits

OPI-M allows monthly income up to $5,320 per individual (400% of the Federal Poverty Level). Compare that to traditional Medicaid's limit of $2,982 per month — OPI-M nearly doubles the income ceiling.

This means a parent receiving $4,000 per month in Social Security and pension income would be disqualified from traditional Medicaid but would qualify for OPI-M.

Asset Limits

This is where OPI-M really stands out. The countable asset limit is $103,645 per individual (effective July 1, 2026). Traditional Medicaid's asset limit is $2,000. That's not a typo — OPI-M allows over 50 times more in countable assets.

For married couples where both spouses are applying, each spouse gets the $103,645 allowance. The primary home is exempt if equity is below $752,000 and the applicant or spouse resides in it.

Clinical Eligibility

Your parent must also meet the functional eligibility threshold through a CAPS (Client Assessment and Planning System) assessment conducted by your local APD or AAA office. The assessment evaluates assistance needs across Activities of Daily Living — mobility, eating, toileting, cognition, bathing, and dressing.

For OPI-M, Service Priority Levels 1 through 13 qualify for full program eligibility. SPLs 14 through 18 may qualify for preventive services but not the full benefit package.

For dementia families, the cognitive assessment component is especially relevant. Oregon administrative rules allow the case manager to extend the evaluation timeframe beyond the standard 30-day window when assessing cognitive decline and safety-related behaviors. Even if your parent hasn't wandered or had a behavioral incident in the past month due to a structured home environment, those documented behaviors still count toward the assessment.

What OPI-M Covers

Covered services include:

• Attendant care (help with bathing, dressing, meals, medication management)
• Home-delivered meals
• Chore services (heavy housework, yard maintenance)
• Respite care for family caregivers
• Assistive devices (grab bars, shower chairs, adaptive equipment)
• Environmental modifications (ramp installation, bathroom modifications, door alarms for wandering)

Under OPI-M, attendant care can be self-directed — meaning your parent can hire a family member or friend as a consumer-employed provider through the Oregon Home Care Commission Registry.

The Estate Recovery Advantage

Here's the strategic detail that makes OPI-M particularly valuable for dementia families with moderate assets: unlike traditional Medicaid, OPI-M has no estate recovery claim. After your parent passes, the state cannot seek reimbursement from their estate for OPI-M services received.

Under traditional Medicaid, Oregon is mandated to recover the cost of long-term care services from the estates of deceased recipients age 55 and older (ORS 414.105). That recovery can consume the family home and other assets. OPI-M sidesteps this entirely, allowing middle-income families to preserve home equity for heirs while still accessing state-funded in-home care.

How to Apply

1. Contact your local AAA or APD office. Call the ADRC of Oregon helpline at 1-855-673-2372 or visit adrcoforegon.org to find your local office.
2. Request a CAPS assessment. A case manager will schedule an in-person visit to evaluate your parent's functional needs.
3. Gather financial documentation. You'll need bank statements, income verification (Social Security, pensions, investment income), and documentation of assets.
4. Complete the application. The case manager will help determine which program — OPI, OPI-M, K Plan, or traditional Medicaid — best fits your parent's situation.

Processing times vary by office workload, but families typically wait 2 to 6 weeks for a CAPS assessment. If your parent has an urgent care need, make that clear when you call — some offices can expedite assessments for safety concerns.

When OPI-M Isn't Enough

OPI-M is an in-home care program. If your parent's dementia has progressed to the point where 24-hour supervised care is necessary — persistent wandering, elopement attempts, inability to be safely left alone — you'll likely need to transition to a residential setting. At that point, the K Plan (Community First Choice) or traditional Medicaid becomes the relevant funding pathway.

The Oregon Dementia and Memory Care Guide maps out the full care trajectory from early-stage planning through in-home care programs to residential facility selection, including side-by-side comparisons of OPI-M, K Plan, and traditional Medicaid eligibility.

See more Oregon guides →