Salem, Oregon – A program designed to help Oregon children with extraordinary care needs could serve significantly more families than originally planned. And the reason behind the proposed expansion is encouraging: providing services has cost less than state officials initially expected.
That finding is now opening the door for dozens of additional children to receive support without requiring an increase to the program’s existing budget.
The Oregon Department of Human Services (ODHS), through its Office of Developmental Disabilities Services (ODDS), is seeking public feedback on proposed updates to two Medicaid waivers. The changes would expand the number of children served through the Children’s Extraordinary Needs (CEN) program and revise related case management cost estimates.
Residents, families, advocates and other interested community members have until November 25, 2026, to submit their comments. The department must receive all feedback by that date.
One of the most significant proposed changes involves how many children can participate in the CEN program at the same time.
Under its original authorization, the program could serve 155 children simultaneously. ODDS is proposing to increase that number to 230, allowing 75 additional children to participate at one time. That represents an increase of approximately 48%.
The department also wants to raise the total number of children who can receive services during a single year from 171 to 280. That would allow 109 more children to participate annually, an increase of nearly 64%.
These two enrollment limits serve different purposes. The first determines how many children may receive services simultaneously, while the second accounts for children entering and leaving the program throughout the year.
The proposal follows an assessment of actual spending since the program launched on July 1, 2024.
When lawmakers originally funded CEN, the Oregon Legislature established a limited budget. State officials estimated that the available money would support approximately 155 children at a time.
However, after roughly 15 months of operations, ODDS had collected enough information to examine how services were being used and how much they cost.
The results showed that the average cost per child was lower than anticipated. According to the department, additional data has continued to support that conclusion, making it possible to serve more children within the existing budget.
ODDS is now asking the Centers for Medicare and Medicaid Services (CMS) to approve the expansion retroactively to July 1, 2026, when the state expanded enrollment.
The department explained that federal authorities do not consider the proposed enrollment adjustment a major change, allowing Oregon to request the earlier effective date.
The public comment process covers two separate Medicaid waivers.
The first is the 1915(c) Children’s Extraordinary Needs Waiver, which governs the proposed increase in program participation.
The second is the 1915(b)(4) Fee-for-Service Selective Contracting Program, which allows ODDS to determine the number and types of case management organizations authorized to provide waiver services.
Because the proposed CEN expansion would involve more children, Oregon must also update the cost projections for related case management services.
The department is requesting the same retroactive approval date of July 1, 2026, for those financial adjustments.
Members of the public can review the draft Medicaid waiver changes and the official community notice on the ODHS website.
Comments can be emailed to [email protected] or mailed to the ODDS Medicaid Waiver/State Plan Analyst at 500 Summer Street NE E-09, Salem, OR 97301.
Printed copies of the proposed updates are also available through local community developmental disabilities programs and support services brokerages.
Anyone needing a printed copy can contact the waiver analyst at 503-507-2083 or through the waiver email address.
ODHS also offers the documents free of charge in other languages, large print, braille and other accessible formats. Requests can be made by emailing [email protected] or calling 503-945-5811. All relay calls are accepted.
With the November 25 deadline approaching, the comment period gives families and community members an opportunity to review the changes before federal approval is finalized. If approved, the updated waivers would formally reflect Oregon’s expanded CEN enrollment and its revised projections for case management services.
, through its Office of Developmental Disabilities Services (ODDS), is seeking public feedback on proposed updates to two Medicaid waivers. The changes would expand the number of children served through the Children's Extraordinary Needs (CEN) program and revise related case management cost estimates.){kind=link}