1. Program Definition and Services

Adult Health Services in Oregon provide short-term support to children and adults with intellectual/developmental disabilities and chronic conditions. The program aims to help maintain individuals with disabilities in the community, averting the need for long-term services and supports. Services include:

• In-Home Personal Care: Individual support in the individual/family home or community (Personal Care Services, Medication Management, Routine Health Monitoring, Care Plan Implementation, and Nutrition Assistance)
• Residential Personal Care: Supervision and care in a licensed residential, community-based setting (Skilled Nursing Services, Therapeutic Exercise Delivery, Adult Day Health Supervision, Wellness Checks, and Service Coordination)

2. Regulations

The program is governed by the following regulations:

• Oregon Administrative Rules (OAR) Chapter 411, Division 033 (In-Home Care Agencies Providing Medicaid In-Home Services)
• Oregon Administrative Rules (OAR) Chapter 411, Division 034 (State Plan Personal Care Services)
• Oregon Administrative Rules (OAR) Chapter 333, Division 536 (Oregon Health Authority In-Home Care Agencies Licensure)
• Federal 1915(c) and 1915(k) Community First Choice (Oregon K Plan) Medicaid Authorities

3. Licensing or Certification

Providers must be certified by the Oregon Department of Human Services (ODHS) and follow all Home and Community-Based Services (HCBS) requirements.

4. Responsible State Agency

The Oregon Department of Human Services (ODHS) Aging and People with Disabilities (APD) division and the Oregon Health Authority (OHA) are responsible for reviewing applications and certifying adult health services providers.

5. Application Process

The application process is conducted through the electronic Oregon Health Authority (OHA) Provider Portal. Providers must submit forms online to initiate the application process.

6. Required Documentation

While specific documentation requirements vary based on the target waiver, providers typically need to submit:

• Proof of compliance with state safety and operational rules
• Agency policies and procedures
• Staff qualifications and training records
• Proof of general and professional liability insurance

7. Timeline for Approval

The exact timeline for approval fluctuates based on agency capacity. Providers should contact their regional office for detailed information on current processing timeframes.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must establish their business entity and secure necessary federal identification numbers.

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Access details are sent to qualified applicants once preliminary paperwork is reviewed.

10. Additional Notes

• Providers must ensure that intensive care settings meet all state accessibility and environmental safety guidelines
• In-Home Personal Care must be provided directly by the certified agency's employed personnel
• All direct care staff must conduct mandatory background clearances and fingerprinting screenings
• Providers must maintain detailed records of face-to-face services for Medicaid documentation and billing

Why Choose Waiver Consulting Group?

Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state.

With proven expertise, a structured process, and ongoing support, we take the guesswork out of launching your healthcare business. Whether you're a first-time entrepreneur or an established provider looking to expand, our team ensures you stay compliant, competitive, and fully operational.

To get started, click the link to request portal access