Document Type


Publication Date



This site visit looked at the continuum of care for its elderly and disabled citizens in the first state ever to secure Section 1915(c) and (d) waivers under Medicaid to support home- and community-based services. More than three-quarters of Oregon's Medicaid clients now receive care in these settings. Site visitors were briefed on the history and development of long-term care in the state as well as the various care settings available. Panels discussed strategies and partnerships focused on alleviating workforce shortages and highlighted Oregon nurses' authority to delegate certain caregiving tasks to laypeople. Multnomah County staff described county-level activities, especially the role of Area Agencies on Aging, and then escorted site visitors on small-group visits to various care facilities in the county. Other topics explored were consumer protection, consumer-directed care, and Medicare and Medicaid integration. Site visitors traveled to a health plan clinic facility to participate in a discussion of Medicare managed care in Oregon and to hear about the plan's social HMO program. The integration of medical and custodial needs was pursued during tours of two PACE (Program of All-Inclusive Care for the Elderly) sites.

Open Access




To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.