Board approves $785,726 FY26 budget modification for Medicaid 1115 housing waiver rent assistance

The Multnomah County Board of Commissioners approved a budget modification to appropriate $785,726 in fiscal year 2026 from Health Share of Oregon funds tied to the Medicaid 1115 demonstration waiver for housing. County staff said Health Share awarded Multnomah County $1.3 million over 18 months; $785,726 will be spent in the current fiscal year and the remainder will be added to the FY27 budget.

Department of County Human Services (DCHS) staff explained the funds will be used to provide rent and utility assistance for up to six months per eligible household and will support three new positions while extending six previously funded positions. Miles (quality manager for the Medicaid waiver rent assistance program) described DCHS’s role as a provider working with coordinated care organizations (CCOs) that authorize households under the 1115 waiver. Once authorized by a CCO, the county (acting as a provider) will collect documentation from landlords and issue payments.

Commissioners asked about eligibility, payment timeliness and how the benefit interacts with other housing supports. Staff said the waiver includes a broad set of qualifying conditions (over 300 medical, behavioral health and social indicators, plus age and young‑child criteria) and that approximately 2,000 households in Multnomah County have received authorizations but still need a payer/provider to complete assistance. Staff acknowledged complexities with utilities payments under Medicaid rules and are working to automate processes to speed assistance.

Public testimony supported the funding and urged stronger connections between eviction court and this housing assistance. The board approved the budget modification by roll call vote.