From Oregon Housing and Community Services

It’s increasingly clear that there are strong intersections between health and housing. That’s why Oregon Housing and Community Services (OHCS) is excited to partner with the Oregon Health Authority (OHA) to support the 2022-2027 1115 Medicaid Demonstration Waiver, which includes broadly expanding provisions to serve people experiencing houselessness.

As you are likely aware, Medicaid provides healthcare services for children, pregnant women and other populations including older adults or people with disabilities. Each state operates its own Medicaid program (In Oregon, we have the Oregon Health Plan (OHP), which delivers care to people who have low incomes.) Every five years, states can propose additions or changes with a waiver application which must be approved by the federal agency called the Center for Medicare and Medicaid Services (CMS).

Oregon submitted an application in February, which includes new innovative proposals that would allow Oregon for the first time to spend Medicaid funds on housing services if approved. OHCS is excited to support this equity-centered system of health while continuing to use Oregon’s Coordinated Care Organization (CCO) model to deliver services to OHP members and advancing the state’s commitment to ensure access to coverage for all people in Oregon.

CMS has accepted the waiver application and is currently accepting public comments on it. After public comment closes, the state will negotiate with CMS around the application’s proposals until final approval, which is likely to come in the fall.

If your organization is interested in submitting submit feedback or a letter of support, please do so before April 13, 2022, at:

A draft letter can be found here as a sample. Please adjust the language to your organization’s voice.

OHA has shared that they greatly appreciated the input, feedback, support, and partnership in developing the Oregon Health Plan’s vision for the next five years.

I sincerely hope that a broad showing of Oregon housing partners will help elevate the waiver renewal’s innovative focus on housing policy.

Please feel free to reach out with any questions or concerns. Thank you.


Andrea Bell

Executive Director, OHCS


Additional background information:

A summary of the policy concepts addressing housing services is available at:

The sections of the waiver application that are most applicable to people experiencing or at risk of houselessness are found in:

  • Section I. Program Description, 3. Proposed Changes, 3.2 Improving Health Outcomes by Streamlining Life and Coverage Transitions
  • Strategy 3: Provide a defined set of SDoH services based on transition related criteria to support vulnerable populations in need during transitions (pg. 19). Especially,
    • Proposed transition services related to housing (pg. 20)
    • Proposed transition services related to exposure to climate events (pg. 21)
  • Section IV. Benefits and Cost Sharing Requirements
    • Changes to Benefit Packages- Social Determinants of Health Support Services (pg. 61)
    • Changes to Benefit by Population (pg. 64)

The Oregon Health Authority has posted their materials related to the 2022-2027 1115 Medicaid Demonstration Waiver at