One respondent stated that in the absence of a budget crisis Oregon would probably want to expand and improve the current HCBS system, noting that the state is pretty close to a balanced system. Another said that the state's program has changed since its inception and it will continue to change, noting that it is important for the state to continually assess the strengths and weaknesses of its program and make changes accordingly. For example, the State is currently updating its RCF rules and is examining the role of community nurses in all residential care setting. They are also working on initiatives related to person-centered planning.
Another noted that the state's 18 categories of level-of-care criteria has been helpful in times of budget cuts in that it provides a mechanism for the state to reduce the number of people being served based on level of need. However, the respondent said that it's not perfect and that the state wants to revise the criteria to incorporate more risk factors, such as chronic care needs and acuity.