Oregon directly pays for assisted living services through its Community First Choice State Plan Option and indirectly through its Aged and Physically Disabled waiver for qualified seniors. Both programs are open to Medicaid beneficiaries who have disability and care needs consistent with an assisted living level of care.

The Community First Choice State Plan Option

Oregon’s Community First Choice State Plan Option, also known as the K Plan, is the default option for many seniors participating in Oregon’s Medicaid program who are looking for help with the cost of assisted living. Under this program, eligible seniors get a 6% increase in federal medical assistance funds, which may be used to pay for a number of assisted living and senior care services. Benefits of the K Plan include attendant care, respite care, behavior support therapy, community nursing services, nutritional support and home-delivered meals.

Transition services out of nursing care and into assisted or independent living are covered, as are assistive devices and emergency response systems. The program pays for limited home modifications for seniors aging in place at home and transportation for both independent and assisted living residents. Seniors in assisted living who need memory care can also get the help they need through the Community First Choice State Plan.

The Aged and Physically Disabled Waiver

Oregon’s Aged and Physically Disabled waiver is the state’s home- and community-based waiver program. It provides less direct support for seniors than the K Plan, but many beneficiaries choose it as an alternative because of the greater flexibility it offers in organizing assisted living services. This waiver does not pay for the nonmedical components of assisted living care, such as room accommodations and meals, but physical, mental health and medication support services do fall under the program’s umbrella.

In addition, the waiver pays for many transition services for seniors coming out of nursing home care, such as referrals and facility locator services, application assistance, case manager help and direct financial aid with security deposits, basic furnishings and utility deposits to get services connected.

Who Is Eligible for Both Programs?

In order to participate in either of Oregon’s assisted living waiver programs, seniors must be enrolled in Medicaid and have a medical or age-related need for assisted living or caregiver support. Beneficiaries enrolled in the Aged and Physically Disabled waiver program are allowed to have up to $2,523 a month in income and a maximum of $2,000 in assets. Since this income limit is higher than the Oregon Medicaid cap of $853 a month for eligibility, nearly all seniors who currently participate in Medicaid meet the income restrictions of the Aged and Physically Disabled and Community First waivers.