How Oregon pays for disability services

Waiver inventory

Effective dates: adult, children's, CEN, and medically involved waivers effective Jan. 1, 2025; behavioral and medically fragile waivers effective Jan. 13, 2026; selective contracting waiver effective July 1, 2024. Waiver index: oregon.gov

Total ODDS enrollment: 38,261 people (January 2025), 25,497 adults and 12,764 children.

State-only funded programs

• Family Support Services (SE150), OAR 411-305. The ODDS Expenditure Guidelines state that Family Support services "are 100% General Fund" and are not available to children enrolled in the K Plan or a waiver. Annual limit $1,418.12 per child. Covered purchases include assistive devices and technology, attendant care, professional behavior services, community inclusion, community transportation, and environmental and environmental safety modifications. Administered by Community Developmental Disabilities Programs under ODDS rules. oregon.gov and secure.sos.state.or.us
• The 2025-27 Governor's Budget shows the ODDS total at $6.37 billion split $2.341 billion General Fund, $3.996 billion federal (all Medicaid), and $33.8 million Other Fund. A separate appropriation figure for the Family Support program alone was not published in that presentation. oregon.gov
• Oregon Council on Developmental Disabilities: $2.2 million in the 2025-27 Governor's Budget. Same source.

County / regional / local funding

• Community Developmental Disabilities Programs (CDDPs). Local agencies, in most counties operated by county government, that determine eligibility, provide case management and adult protective services, and administer Family Support. They operate under contract with ODHS pursuant to ORS 430.610 through 430.695 and OAR chapter 411, division 320. CDDP enrollment: 17,777 adults and 12,186 children (January 2025). secure.sos.state.or.us and oregon.gov
• Support Services Brokerages. Nonprofit case management entities serving adults, governed by OAR chapter 411, division 340. Brokerage enrollment: 7,720 adults (January 2025). secure.sos.state.or.us
• Scale. The CDDP and brokerage line in the 2025-27 Governor's Budget is $499.2 million, 8 percent of the ODDS total, covering 37,683 people at an average operational cost per case of $7,615 (2024 average). Case Management Entities employ 1,948 staff. oregon.gov
• Mechanism. These are state and federal dollars passed through by contract. No county levy, county mill levy, or dedicated local tax for IDD services was identified in the ODDS budget presentation, the CDDP rules, or the ODDS Expenditure Guidelines.

Funding scale

• Total ODDS budget, 2025-27 Governor's Budget: $6.37 billion, 28 percent of the $22.49 billion ODHS total. oregon.gov
• Fund split: General Fund $2.341 billion (37 percent), federal Medicaid $3.996 billion (63 percent), Other Fund $33.8 million.
• By program area: I/DD Program $5.614 billion (88 percent), CDDPs and Brokerages $499.2 million, SACU $122.0 million, I/DD Program Design $119.1 million, Children's Residential and CIIS $13.7 million, DD Council $2.2 million.
• Main drivers, 2025-27: Adult Residential Services $2,234,475,337; Adult In-Home Services $2,036,179,816; Children In-Home Services $713,479,922; Children Residential Services $163,450,919; SACU $122,017,069; Nursing $43,229,035.
• Oregon FY2026 FMAP: 57.75 percent. macpac.gov ODDS reports a 58 percent match on waivers and 58 percent plus the 6 percentage point Community First Choice enhancement, equal to 64 percent, on the K Plan. oregon.gov
• Spending per participant (Fall 2024 cost per case, monthly): Adult 24-Hour Group Homes $16,784; Children's 24-Hour Group Homes $25,786; Adult Foster Care $7,463; Adult Supported Living $9,289; Children's Foster Care $5,908; Children's Host Homes $7,105; Adult In-Home Supports $6,716; Children's In-Home Supports $4,329; Day Support Activities $1,241; Employment Services $1,669; SACU $105,787.
• People served by setting (January 2025): 24-hour residential group homes 4,048 adults and 217 children; adult foster care 2,461; children's foster care 264; supported living 814; host homes 3 children; in-home 12,812 adults and 6,853 children; employment services 3,541; day support activities 4,656 adults; SACU 80.
• Waiting list: there is no general waiting list. The K Plan is a state plan entitlement and ODDS states it "is obliged to make available to individuals the number of hours they are assessed as needing." The adult and children's 1915(c) waivers have unlimited enrollment. Waiting lists exist only for capped programs: the Children's Extraordinary Needs program had a waitlist of 2,127 with roughly 1,600 eligible children against 155 slots, and the three model waivers had referral queues of 68 (medically involved), 14 (medically fragile), and 6 (behavioral) as of January 2025. oregon.gov

Residential funding detail

Oregon prices residential support through the Oregon Needs Assessment, which places each person in a Service Group that maps to Payment Category 1 through 4. Rates are per day and assume a 344-day billing year.

• Adult 24-hour residential (group homes), OAR 411-325. Per day by home size and payment category: 3 or fewer residents $292.05 / $434.32 / $594.73 / $727.98; 4 to 5 residents $228.40 / $370.43 / $460.18 / $594.21; 6 or more residents $156.30 / $200.98 / $300.48 / $340.30.
• Children's 24-hour residential. 3 or fewer residents $547.67 to $904.30; 4 residents $503.86 to $858.78; 5 residents $410.92 to $696.11.
• Host homes (children), OAR 411-348. $137.86 / $193.55 / $272.04 / $345.96 per day by category.
• Foster homes, adult (OAR 411-360) and children's (OAR 411-346). The base foster care rate is set by the current SNAP schedule (ORAFC / ORCFC). Attendant care inside foster care is $16.69 per hour; 2:1 attendant care in foster care is billed under OR526ZE.
• Supported living (adults), OAR 411-328. A hybrid: a fixed monthly administrative and overhead payment plus either a monthly rate when more than 75 percent of authorized hours are delivered or an hourly rate when less. Service Group 1 $1,674.02 monthly admin plus $2,603.90 monthly; Service Group 4 $3,399.19 plus $13,697.35; Service Group 5 Plus $5,159.55 plus $28,198.63. Hourly 1:1 is $37.55 for groups 1 to 4 and $39.08 for groups 5 and 5 Plus.
• In-home and family settings. K Plan attendant care, hourly, by ratio and provider model. Standard model agency 1:1 $42.24; employer model agency 1:1 $35.44; agency group 1:2 $23.23 and 1:3 $16.90 per person; 2:1 $76.69; 3:1 $106.27; 4:1 $135.84.
• Stabilization and Crisis Unit (SACU). State-operated homes for 80 people, budgeted at $122,017,069 for 2025-27, cost per case $105,787 per year, described in the ODDS presentation as "state-run homes in neighborhoods" with limited capacity.
• ICF/IID. Oregon closed Fairview Training Center in 2000 and Eastern Oregon Training Center in 2009. No operating ICF/IID rate schedule appears in the ODDS Expenditure Guidelines or the ODDS budget presentation.

Room and board. The 24-hour residential, host home, supported living, and foster care rates in Appendix E of the Expenditure Guidelines are service rates. OAR 411-325 treats room and board as a separate obligation of the resident, listing failure "to pay for services or room and board" as a ground for involuntary exit. I did not locate a published Oregon room-and-board standard amount or a state room-and-board supplement, so room and board appears to fall to the individual's own income, principally SSI. secure.sos.state.or.us

Comparable service rates

All rates below are from the ODDS Expenditure Guidelines, Version 20, effective Jan. 1, 2026, updated July 1, 2026, Appendix E, unless noted.

Other useful rates from the same appendix: Professional Behavior Services $82.56 per hour under 70 miles and $103.20 at 70+ miles; Direct Nursing agency RN $94.52 per hour and agency LPN $58.88; Community Transportation $0.70 per mile PSW, $0.577 per mile agency, $2.09 per mile transport agency.

Official rate schedule links

• ODDS Expenditure Guidelines, Version 20, effective Jan. 1, 2026, updated July 1, 2026, Appendix E carries the operative rate tables: oregon.gov
• Burns and Associates final rate models dated Jan. 1, 2026, "Review of Provider Rates for Residential, Day, Employment, and Other HCBS": oregon.gov
• ODDS provider rate models page: oregon.gov
• Rate model average daily staffing assumptions, adult 24-hour residential: oregon.gov
• Rate model staffing assumptions, children's 24-hour residential: oregon.gov
• Children's residential setting rate exceptions presentation: oregon.gov
• 2024 APD-ODDS Rate and Wage Study: healthmanagement.com

Notable features and flags

• July 1, 2023: ODDS implemented new Burns and Associates rate models across seven service categories. A further set of final rate models was issued dated Jan. 1, 2026. Note that the Jan. 1, 2026 Burns model values and the Expenditure Guidelines Appendix E values differ service by service, so the Expenditure Guidelines should be treated as the operative paid rates. oregon.gov
• 2023 budget note, reported to Ways and Means April 2025: The rate and wage study's recommended rate models "would increase overall provider payments by an estimated $1.3 billion annually," of which $400 million would be General Fund. This is the single largest pending fiscal item in the Oregon IDD system. oregon.gov
• 2024 to 2026: Oregon Needs Assessment in-home hours implementation, following ONA delays from 2017 to 2025. Authorized in-home hours rose from 3.78 million (February 2024) to 4.33 million (January 2025) while utilized hours rose from 2.59 million to 3.05 million, a persistent gap ODDS attributes to workforce capacity. Same source.
• Senate Bill 91, Children's Extraordinary Needs program: allows parents and guardians to be paid attendant care providers for children with very high needs, but is limited to 155 enrollees and up to 20 hours per week against a waitlist of 2,127 and roughly 1,600 eligible children. Same source.
• Jan. 1, 2026 and Jan. 1, 2027: Personal Support Worker wage steps are scheduled to rise from $21.25 to $25.25 to $23.00 to $27.00, a collectively bargained schedule already published in the Expenditure Guidelines.
• Senate Bill 1548 implementation: new provider agency fiscal transparency reporting began in 2024, plus new rules on provider application requirements and criteria for denying, revoking, or suspending certificates and endorsements. ODDS also flagged inconsistent CDDP foster home licensing and a plan to bring all licensing duties back into ODDS. Same source.
• System modernization: PEMS provider enrollment Phase 1 late 2025 and Phase 2 early 2026; Case Management System Phase 1 early 2026, Phase 2 late 2026, Phase 3 mid-2027. Same source.

Confidence

Solid: the rate tables, which come directly from the ODDS Expenditure Guidelines PDF; the waiver inventory and effective dates from the ODDS waivers page; and the budget, caseload, cost-per-case, and enrollment figures from the two ODDS Ways and Means presentations of March 31 and April 1, 2025. The absence of a general waiting list is well documented and follows from the K Plan being a state plan entitlement. Estimated or uncertain: the discrepancy between the Burns Jan. 1, 2026 modeled rates and the Expenditure Guidelines Appendix E rates is unexplained in the source documents; I have used Appendix E and flagged the difference rather than reconciling it. Could not find: a published Oregon room-and-board standard for 24-hour residential and foster settings, a per-unit case management rate, the specific General Fund appropriation for the Family Support program, and any evidence of county levy or local tax funding for IDD.

---