The federal government has approved Oregon’s request to allow more people with disabilities and older people to receive long-term care services at home, allowing them to lead more independent lives.

The approval expands an existing program called Oregon Project Independence (OPI), which has been around since 1975 and is managed by Oregon Department of Human Services (ODHS). Because most health insurance, including Medicare, rarely offers long-term care benefits, OPI has filled that gap for tens of thousands of people over the years. It is among only a few programs of its kind in the United States.

The expansion of OPI is called OPI-M, which stands for Oregon Project Independence – Medicaid, because it uses federal Medicaid dollars to pay for more people to receive these services. People who earn incomes too high to qualify for Oregon Health Plan (OHP/Medicaid) may qualify for OPI-M because its income limit is 400% of the federal poverty level (FPL), which is much higher than traditional OHP income limits. (FPL changes every year. In 2024, 400% of the FPL for a single individual is about $60,000, and just over $80,000 for a couple.)

Additionally, individuals who don’t necessarily need all the benefits Medicaid offers may still qualify. For example, someone who needs help only with managing their medication may qualify for OPI-M.

While Oregon’s original OPI sometimes requires a fee to participate, OPI-M services are fully covered and participants will not have to pay a fee. Additionally, OPI-M benefits will not be subject to estate recovery, which is when the assets an individual leaves behind after their death are used to pay back the government for certain services. Eliminating estate recovery strengthens the financial stability of families by making it possible for generations to pass down life savings.

Other things to know about OPI-M:

• OPI-M will be available to insured and underinsured adults statewide with physical disabilities ages 18 and older, as well as people ages 60 and older, who meet certain criteria.
• OPI-M will first be offered to eligible people on the original OPI wait list (currently about 1,200 people). Next, it will be offered to people already enrolled in original OPI, should they like to switch over.
• After eligible people on the OPI waitlist and current OPI participants have been offered the opportunity to apply for OHP-M, the program will be opened up to Oregon’s general population in 2025.
• For now, people enrolled in original OPI who choose to remain in that program will continue to receive approved services. Those who choose to move to OPI-M will be able to do so.
• An individual may qualify for OPI-M even if their health care and some of their long-term services and supports needs are already covered.
• Some Oregon Health Plan (OHP/Medicaid) members may be eligible to receive OPI-M benefits under certain conditions.
• People without health insurance may be eligible for OPI-M if they meet the criteria. However, individuals without insurance may want to apply for Medicaid or explore the Marketplace options to see if they are eligible for health coverage.

How can I apply?

ODHS will begin contacting potentially eligible people on the OPI wait list later this year, but if others are interested in OPI-M and wonder if they will qualify, they can begin the process now and contact their local Aging and People with Disabilities (APD) or Area Agency on Aging (AAA) office. Use this search tool to find a local APD or AAA office near you. New applications for OPI-M services could be accepted as early as spring 2025.

Learn more about Oregon Project Independence-Medicaid (OPI-M) here.