Oregon K Plan Services: Community First Choice with No Waitlist

What the K Plan Is

The K Plan — officially the Community First Choice Option — is Oregon's primary vehicle for delivering home-and-community-based services to people with intellectual and developmental disabilities. It is authorized under Section 1915(k) of the Social Security Act, which makes it a state plan service rather than a waiver program.

That legal distinction drives the most important practical fact about the K Plan: because it is a state plan entitlement, Oregon cannot impose enrollment caps or maintain a waitlist. Every individual who meets the eligibility criteria is entitled to services. This makes Oregon one of a small number of states where families do not face years-long waits for community supports.

What the K Plan Covers

K Plan services are designed to keep individuals living in the community rather than in institutional settings. The service menu includes:

• Attendant care and personal support: assistance with activities of daily living — bathing, dressing, toileting, eating, mobility, and medication management
• Skills training: teaching independent living skills, community navigation, cooking, budgeting, and social interaction
• Relief care (respite): temporary support for primary caregivers, available on a planned or emergency basis
• Assistive technology and devices: communication devices (AAC systems), adaptive utensils, mobility aids, and other equipment that supports independence
• Environmental modifications: physical changes to the home — ramps, grab bars, widened doorways, accessible bathrooms — that allow the individual to live safely in a community setting
• Related waiver services: non-medical transportation and other supports outside the K Plan may be funded through the Support Services Waiver

The specific services and hours authorized depend on the Oregon Needs Assessment (ONA), a standardized tool that measures the individual's support requirements across multiple domains.

Eligibility Requirements

To access K Plan services, an individual must meet two thresholds:

Clinical eligibility: the individual must require an institutional level of care. In practical terms, this means they need regular assistance with daily living activities that, without community-based supports, would make institutional placement (a nursing facility or intermediate care facility) the alternative. Oregon's CDDP intake process determines whether this standard is met.

Financial eligibility: the individual must be enrolled in Medicaid through Oregon Health Plan. The most common pathway for young adults with disabilities is OSIPM (Oregon Supplemental Income Program Medical), which requires a disability determination, a $2,000 resource limit, and income at or below $2,982/month. SSI recipients may meet the financial eligibility rules for OSIPM, but Oregon still requires a separate OHP application.

The Waitlist That Does Not Exist (and the Bottleneck That Does)

Oregon eliminated its developmental disability services waitlist in 2000. Since then, every eligible adult has been enrolled in the system upon determination. There is no statewide enrollment queue for K Plan services.

But enrollment is not the same as receiving services. Oregon faces a severe and ongoing shortage of direct support professionals — the personal support workers, agency staff, and residential caregivers who actually deliver K Plan services. This shortage is the real bottleneck.

The economics tell the story: low reimbursement rates compete against retail and food service jobs that often pay comparable wages without the physical and emotional demands of disability support. The result is high turnover, chronic understaffing, and authorized service hours that go unfilled.

The impact is worst in rural Oregon. Urban areas like the Portland metro, the Salem-Keizer corridor, and the Eugene-Springfield area have larger provider networks and more agency options. In rural and coastal counties — Curry, Harney, Wallowa, Wheeler — families may have a single CDDP office, no Support Services Brokerage presence, and a vanishingly small pool of available workers.

How the ISP Connects to the K Plan

Once the ONA determines the individual's support level, the case manager (either a CDDP service coordinator or a Brokerage personal agent) develops the Individual Support Plan. The ISP specifies:

• Which services are authorized (attendant care, skills training, respite, etc.)
• The number of hours per week or month for each service
• The goals the services support (employment, community participation, health, independent living)
• The providers who will deliver the services

The ISP is reviewed annually and can be amended between reviews when needs change. If the individual's health declines, their behavioral support needs increase, or their living situation changes, the case manager can request a new ONA and adjust the plan.

K Plan vs. the 1915(c) Waivers

Oregon's DD services system uses the K Plan as the foundation, supplemented by two Section 1915(c) waivers:

• Support Services Waiver: covers services beyond the K Plan menu — primarily case management, non-medical transportation, and supported employment — for adults living independently or with family
• Comprehensive Waiver: covers 24-hour licensed residential care for adults with the highest support needs

All three programs share the no-waitlist commitment. The practical difference is that K Plan services are available wherever the individual lives in the community, while the Comprehensive Waiver requires placement in a licensed residential setting — and those beds are limited by the physical capacity of existing group homes.

For most young adults transitioning from school to adult services, the K Plan plus the Support Services Waiver covers what they need. The Comprehensive Waiver is reserved for individuals whose safety cannot be maintained in a home setting even with intensive in-home supports.

Starting the K Plan Before School Ends

The strongest transition strategy is to begin the ODDS eligibility process during the final two years of school, while the IEP team is still coordinating services. The IEP transition plan should include a referral to the county CDDP as a documented transition goal.

Starting early gives the family time to navigate the intake process, complete the ONA, secure a case manager, and begin recruiting personal support workers before the school-based supports end. Families who wait until after graduation often face a gap of several months where no structured supports are in place.

The Oregon SSI at 18 & Adult Disability Benefits Guide includes the ODDS enrollment timeline alongside SSI, OHP, and VR applications — so every agency connection happens in the right sequence.

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