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Oregon selects vendor to run Agency with Choice program; lawmakers press agencies on private-equity concerns and rate-setting
Summary
APD, OHA and ODDS told the subcommittee that CMS approved state plan amendments and a waiver for Agency with Choice, that Guardian Track Independence (GTI) scored highest in the procurement and is in contract negotiations, and that agencies will execute separate identical contracts and begin enrollment in 2026; lawmakers asked for follow-up on vetting, rates and workforce impacts.
Oregon agencies updated a legislative subcommittee Feb. 9 on implementation of Agency with Choice, an in-home care co-employment model established in the 2024 session. Officials said federal approvals are in hand, a vendor was selected through a competitive process, and agencies are negotiating contracts that they expect to finalize in 2026 before phased enrollment.
APD and the Oregon Health Authority (OHA) said House Bill 4,129 directed the agencies to create an Agency with Choice option, limit licensing of providers under the model, set rates so direct support worker pay is comparable to existing home-care and personal-care attendant pay, and develop rules that ensure financial transparency and caps on administrative overhead. Shawna McDermott, deputy director for Medicaid services and engagement, reported that CMS approved the state plan amendments and waivers (including 1915(k) and 1915(i) components) in December 2025 and that a…
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