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Date: Oct. 23, 2026
To: Intellectual and developmental disabilities (I/DD) community members
From: Office of Developmental Disabilities Services (ODDS)
Hello,
This update is for the whole community. It’s most important for:
- Parents of children with extraordinary needs
- Staff at community developmental disability programs (CDDPs) and Children’s Intensive In-Home Services
What’s the news?
The Oregon Office of Developmental Disabilities Services (ODDS) is updating two Medicaid waivers. We seek your feedback on our proposed changes.
The waivers and changes include:
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1915 (c) Children’s Extraordinary Needs (CEN) Waiver: The update increases the number of children the waiver serves from 155 to 230. The CEN program is for children under 18 who have very high medical or behavior needs. Parents and guardians are paid to provide care for their child.
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1915 (b) (4) Fee-for-Service Selective Contracting Waiver: This update increases the cost projections for CEN case management.
Below is a more detailed summary of the changes. Please read it. If you need translations, we linked to them at the top of this message.
You don’t need to read the full waivers to provide feedback. Reading the summaries should be enough. If you prefer, you can read the full waivers with the proposed changes online in English.
Summary of proposed changes
1915 (c) Children’s Extraordinary Needs (CEN) Waiver
Originally, this waiver could serve 155 children at one time. We’re increasing the number of children that can be in the CEN program to 230 children at a time. This helps us plan for children entering and leaving the program during the year.
We’re also increasing the total number of children who can be in the CEN program during a one-year period from 171 to 280.
We’re asking the Centers for Medicare and Medicaid Services (CMS) to approve this change retroactively to July 1, 2026.
Why is this change happening?
The CEN program started July 1, 2024. The Oregon Legislature gave the program a limited budget. At that time, we estimated that the program’s budget could support 155 children at a time.
About 15 months after the program began, we had enough data to begin analyzing the program’s service usage. The average cost per child was lower than expected. Since then, the data continues to affirm this finding. That’s why we can expand the program to serve more children within its budget. The federal government doesn’t consider this a big change, so we can ask for a retroactive start date to July 1, 2026, which is when we expanded enrollment for the program.
1915 (b) (4) Fee-for-Service Selective Contracting Waiver
In this waiver, we’re updating the cost projections for case management for the CEN program. This waiver also allows us to specify the number and type of case management entities that are allowed to provide waiver case management services.
Why is this change happening?
We need to update the cost projections for case management to match the increase in the number of children that the CEN waiver serves. We’re asking for a retroactive approval date of July 1, 2026.
How do I submit my comments?
- Email waivers@odhsoha.oregon.gov.
- Mail written comments to ODDS Medicaid waiver/State Plan analyst, 500 Summer Street NE E-09, Salem, OR 97301.
What is the deadline?
Please submit your feedback by Nov. 25, 2026. We must receive your mailed comments by this date.
What will ODDS do with the community’s feedback?
We’ll read through your feedback and consider whether we need to update our drafted changes. We will submit the proposed changes to CMS for approval.
We’ll post a summary of your feedback to our website by Jan. 1, 2027. This summary will include our response to your feedback and whether we adapted your feedback. We’ll also post the final drafted waivers.
How do I ask questions or learn more?
Thank you,
Office of Developmental Disabilities Services
Oregon Department of Human Services
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