10/28/2026
Presented by Oregon Department of Human Services
Give feedback on proposed changes to Children’s Extraordinary Needs waiver
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:
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.
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, they're linked at the top of this message here: https://content.govdelivery.com/accounts/ORDHS/bulletins/4301dd0
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 here: https://www.oregon.gov/odhs/idd/Pages/waivers.aspx
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 [email protected]
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.
Email questions to [email protected]
