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Home and Community-Based Services (HCBS)

Individuals, Families, Caregivers and Guardians

Welcome to the resource page for individuals, families, caregivers, and guardians. Here, you will find support and information to help ensure quality care. If you are seeking home and community-based services for yourself, a family member, or someone you are responsible for or caring for, this page is designed to guide you to the resources and assistance you need.

Process to Get Services

To be eligible for the services, a person must:

  • Be enrolled in Medicaid,
  • Be 21 years of age or older,
  • Have a mental illness diagnosis,
  • Have a need for one or more services at least monthly, and
  • Need daily help with at least two activities because of mental health needs.

Comagine Health will assess if the person is eligible for HCBS during the eligibility determination process listed below. Comagine Health is the Independent Qualified Agent (IQA) for Oregon. An IQA is the contractor who is responsible for reviewing and reporting to OHA for designated programs and services. The IQA is responsible for reviewing, assessing, and developing service plans for qualified individuals in a program. 

Step 1: Start Referral Process Here 

In this step, you will start the process of getting the services you need.

If you do not have Medicaid, you can use the ONE System to apply for Medicaid benefits before submitting the required forms.

If you already have Medicaid, work with your provider or by yourself to complete the referral form and submit to Comagine Health.

Step 2: Get Initial Eligibility Check 

In this step, a case manager from Comagine Health contacts you to complete the required paperwork to determine if you are eligible for HCBS. This part of the process is called the functional eligibility determination.

Step 3: Get Services Approved 

In this step, your case manager from Comagine Health submits the required paperwork to Oregon Health Authority for authorization and approval.

Once Comagine Health completes the 1915i eligibility process and determines the service level, Comagine Health sends a referral to the community mental health program (CMHP).

Step 4: Coordinate Services 

In this step, you will work with your CMHP to coordinate services and supports based on your needs.

Your CMHP will and offer you choices of available placements and/or of services.

Frequently Asked Questions

​Personal Care Attendants (PCA) provide in-home care for individuals experiencing behavioral health conditions.​

​Peer Support Specialists (PSS) are people who have shared life experiences, such as addiction or mental health conditions, with the individuals they support. They are self-identified individuals in recovery or currently/formerly receiving mental health or addiction services.

There are four types of Peer Support Specialists: Family Support, who help parents of children with mental health or addiction issues; Youth Support, who assist individuals under 30 facing mental health or addiction challenges; Adult Addictions, who support those recovering from addiction; and Adult Mental Health, who aid others with similar mental health experiences.

​Peer Wellness Specialists (PWS) are people who meet the qualifications set by the authority under ORS 414.665 and work through community outreach to assess and support the mental health and substance use disorder needs of members of a coordinated care organization. A Peer Wellness Specialist helps members access services, address barriers, provide education to reduce stigma, and assist in maintaining recovery, health, and wellness.​

​Personal Support Workers (PSW) support children and adults with intellectual and developmental disabilities in their own homes and communities.​

​Homecare workers provide in-home care for older adults and people with disabilities.​

​If you think your services were wrongly denied or your eligibility assessment was incorrect, please read about the hearing process here​.

​A case manager from Comagine helps organize and manage health care services for people, making sure they get the right care and support. They work with different healthcare providers to create and follow care plans that fit each person's needs.

A care coordinator from a CCO also manages healthcare services but focuses on working within the CCO network. They aim to make care more efficient and improve health outcomes by coordinating services across various providers in the network.

​An IQA is the contractor who is responsible for reviewing and reporting to OHA for designated programs and services. The IQA is responsible for reviewing, assessing, and developing service plans for qualified individuals in a program. Comagine Health is the IQA for Oregon and has been since July of 2020.​

​Yes, the consumer will have their Medicaid eligibility redetermined on a cycle. The Independent Qualified Agent will assess their functional eligibility on a different cycle. Both types work together to provide Home and Community-Based Services (HCBS).​

​ If you have questions about your care status, please email 1915i.MedicaidPolicy@odhsoha.oregon.gov​.

​If you have questions about your ONE System Application, please call 1-800-699-9075.

If you need technical assistance with your account, please call 1-833-978-1073.

You can also apply for any programs or get assistance at the Oregon Department of Human Services (ODHS) office nearest to you.

​ To contact Comagine:

Relevant Resources

  1. What do I do if I am denied services? Read about the Hearings process
  2. Learn about Oregon's Medicaid State Plan
  3. Visit the Comagine Health (Independent Qualified Agent) page to begin the referral process or ask questions

Related Pages

Oregon Health Authority – Home and Community-Based Services

Oregon Department of Human Services – Home and Community Based Services website

Apply for Oregon Health Plan (OHP)

Find coordinated care organizations (CCOs)

Learn about Oregon's State Medicaid Plan

Understand “Activities of Daily Living" (ADLs) and “Instrumental Activities of Daily Living" (IADLs)

Contact Us

Do you have questions about Home and Community-Based Services? Email us at 1915i.MedicaidPolicy@odhsoha.oregon.gov.

Thank you for visiting the Home and Community-Based Services pages. The HCBS pages are work in progress, with updates coming soon! If you have any feedback, please email us at 1915i.MedicaidPolicy@odhsoha.oregon.gov. We look forward to hearing from you!

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