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Oregon - Integrated Employment — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

In Oregon, Competitive Integrated Employment (CIE) services for individuals with intellectual and developmental disabilities are funded through the Medicaid Home and Community-Based Services (HCBS) program and overseen by the Office of Developmental Disabilities Services (ODDS). Providers can operate as an Employment Provider Agency, a Personal Support Worker (PSW) Job Coach, or an independent contractor for discovery and job development, and must be certified and endorsed under OAR chapter 411, division 345.

To become an approved provider, agencies must navigate certification through ODDS or Vocational Rehabilitation (VR) and enroll as an Oregon Health Plan (OHP) Medicaid provider. The most significant structural precondition is that all job coaching and development must occur in Competitive Integrated Employment settings; sheltered workshops or settings designed specifically to hire people with disabilities (such as Qualified Rehabilitation Facilities or AbilityOne contracts) do not meet the definition and cannot be approved for this service.

1. Service Definition and Scope

Competitive Integrated Employment services in Oregon include job development, placement, and on-site coaching designed to help individuals with I/DD secure and maintain competitive work in a community setting. The work must be compensated at or above minimum wage, or the customary rate paid by the employer for similar work, with equivalent benefits.

The service must take place in an integrated setting typically found in the competitive labor market where the individual interacts with co-workers without disabilities. Work at a provider site to complete contracts requiring a set ratio of people with disabilities is explicitly excluded from this service definition.

2. Regulatory and Oversight Agencies

The primary oversight agency for I/DD employment services in Oregon is the Department of Human Services (ODHS), specifically the Office of Developmental Disabilities Services (ODDS). ODDS manages the HCBS waivers and sets the policies for Employment First initiatives.

The Oregon Health Authority (OHA) manages the Medicaid program (Oregon Health Plan) and handles the provider enrollment process and the MMIS Provider Portal.

3. Gatekeeping Prerequisites: Who Can Even Apply

Before applying to become an employment provider in Oregon, applicants must meet specific structural preconditions. The state requires that all employment services be delivered in settings that meet the federal HCBS settings rule for Competitive Integrated Employment.

There is no Certificate of Need required, but providers must be certified and endorsed by ODDS or VR. Independent contractors are limited to providing Discovery or Job Development services and must be approved by ODDS.

4. Licensure and Certification Requirements

Oregon does not issue a traditional "license" for this specific service; instead, providers must be certified and endorsed as an Employment Provider Agency under OAR chapter 411, division 345. This certification is managed by ODDS.

Agencies are encouraged to seek approval through both ODDS and Vocational Rehabilitation (VR) to ensure smooth transitions for individuals receiving services.

5. Medicaid Provider Enrollment

Once certified by ODDS, providers must enroll with the Oregon Health Authority (OHA) as an Oregon Health Plan (OHP) provider. Enrollment is processed through the MMIS Provider Portal or by submitting specific OHA forms.

Providers must determine their provider type and specialty code and submit the appropriate forms, such as the OHP 3113 and OHA 3975 for organizations, along with an EDMS coversheet if faxing.

6. Staffing, Training and Background Checks

Staff providing job coaching and development must meet qualifications outlined in OAR chapter 411, division 345. This includes passing comprehensive background checks required for all Medicaid HCBS providers in Oregon.

Personal Support Workers (PSWs) acting as job coaches must meet specific training and enrollment requirements through the Oregon Home Care Commission.

7. Documentation, Policies and Records

Providers must maintain documentation proving that the employment setting meets the Competitive Integrated Employment criteria. This includes verifying that the individual earns at least minimum wage and interacts with non-disabled coworkers.

Case managers must document the setting options explored in the person-centered service plan, ensuring non-disability specific settings were offered.

8. Billing, Rates and Claims

Services are billed through the OHA MMIS system for Medicaid fee-for-service or through Coordinated Care Organizations (CCOs) if the individual is enrolled in managed care. Rates are established by ODDS for HCBS waiver services.

Providers must use their 10-digit NPI for billing. Group affiliation information is required for enrollment but does not affect claim processing for fee-for-service.

9. Approval Sequence and Timeline

The approval process begins with obtaining certification and endorsement from ODDS under OAR 411-345. Once certified, the provider applies for OHP Medicaid enrollment through OHA.

Providers can check their fee-for-service application status online using the Application Tracking Number (ATN) provided during submission.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied if the proposed employment setting does not meet the strict definition of Competitive Integrated Employment. Settings that congregate workers with disabilities or operate as sheltered workshops will be rejected.

Medicaid enrollment applications submitted via fax without the required EDMS coversheet with the "Provider Enrollment" box checked will not be received or processed by OHA.

11. Key Contacts and Resources

Providers should utilize the official state resources for policy updates, forms, and enrollment tracking. The ODDS and OHA websites provide the necessary worker guides and transmittals.

For specific questions regarding independent contractor approval for discovery and job development, providers must contact the ODDS employment training review team.

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