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Home care programs · Oregon

Oregon home care programs

Oregon pays for care at home through 10 programs. Consumer-directed care is available through Consumer-Employed Provider Program (Medicaid in-home services) (HCW), Developmental Disabilities in-home supports (independent providers / Personal Support Workers) (PSW), Independent Choices Program (ICP), and Spousal Pay Program (SPP). Family members can be paid caregivers in 5 of them.

Verified Oct 9, 2026Sources: official state and federal agencies

Every state
Programs
10
Consumer-directed
Yes
Family can be paid
Yes
Structured family caregiving
No
On this page
Programs

Every way Oregon pays for care at home

Oregon pays for care at home through 10 programs. Consumer-directed care is available through Consumer-Employed Provider Program (Medicaid in-home services) (HCW), Developmental Disabilities in-home supports (independent providers / Personal Support Workers) (PSW), Independent Choices Program (ICP), and Spousal Pay Program (SPP). Family members can be paid caregivers in 5 of them.

ProgramTypeCan family be paidHow it differs
Home Health Services (Oregon Health Plan) (HHA)State Plan home health (1905(a)(7))Home healthNot statedSkilled home health: nursing, therapy and aide visits under a plan of care from a licensed home health agency; run as a Medicaid State Plan benefit, available through fee-for-service and managed care.
Contracted In-Home Care Agency servicesMedicaid in-home services (K Plan / OR.0185)Agency personal careNot statedAgency personal care: non-medical daily help from aides a licensed agency employs; paid fee-for-service.
Consumer-Employed Provider Program (Medicaid in-home services) (HCW)1915(k) Community First Choice (K Plan) and 1915(c) Aged and Physically Disabled waiver OR.0185Consumer-directedYesConsumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a Community First Choice (1915(k)) state plan option, paid fee-for-service.
Developmental Disabilities in-home supports (independent providers / Personal Support Workers) (PSW)1915(k) K Plan and 1915(c) waivers incl. OR.0375 (Adults' HCBS) and OR.0117 (Children's HCBS)Consumer-directedYesConsumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a Community First Choice (1915(k)) state plan option, paid fee-for-service.
Independent Choices Program (ICP)Medicaid in-home services (self-directed cash option)Consumer-directedYesConsumer-directed care: the participant hires and directs their own aide, with payroll handled for them; paid fee-for-service.
Spousal Pay Program (SPP)Part of Medicaid in-home services (K Plan / OR.0185)Consumer-directedYesConsumer-directed care: the participant hires and directs their own aide, with payroll handled for them; paid fee-for-service.
Children's Extraordinary Needs Program (CEN)1915(c) waiver OR.2386 (SB 91, 2023)Waiver in-homeYesWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
Oregon Project Independence-Medicaid (OPI-M)Section 1115 demonstration (approved 2024-02-13)Waiver in-homeNot statedWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as an 1115 demonstration, paid fee-for-service.
Program of All-Inclusive Care for the Elderly (PACE)1934 PACEPACENot statedPACE: one organization covers medical care, a day center and home care for people 55 and over; run as the PACE benefit, delivered through managed-care plans.
Oregon Project Independence (OPI)state-funded (ORS 410.410-410.480)State-fundedNot statedState-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.
Guide

Home health vs home care vs consumer-directed care in Oregon

What each kind of program is, who employs the caregiver and when a family member can be paid.

Home health: the medical benefit

In Oregon, skilled home health is Home Health Services (Oregon Health Plan) (HHA). It is a medical benefit: a doctor or other practitioner orders nursing, therapy or home health aide visits under a written plan of care, and the visits stop when the skilled need ends.

Only a licensed home health agency enrolled with Oregon Medicaid can bill it, and the agency's own nurses, therapists and aides make the visits.

Home care: non-medical personal care through an agency

Help with bathing, dressing, eating, toileting and household tasks is "home care" or personal care. In Oregon the agency route is Contracted In-Home Care Agency services. No skilled need is required; the person qualifies on functional need, usually measured by an assessment of daily activities.

The agency recruits, trains, schedules and pays the aides, and it is the employer. The aide is agency staff rather than a relative.

Consumer-directed care: the person hires their own aide

Oregon's consumer-directed option is Consumer-Employed Provider Program (Medicaid in-home services) (HCW), Developmental Disabilities in-home supports (independent providers / Personal Support Workers) (PSW), Independent Choices Program (ICP), and Spousal Pay Program (SPP). The person receiving care, or a representative, recruits, hires, trains, schedules and supervises the aide, and can let go of one. A fiscal intermediary runs payroll, taxes and background checks, so the person never handles wages directly.

This is the route most families use to be paid: Consumer-Employed Provider Program (Medicaid in-home services) (HCW), Developmental Disabilities in-home supports (independent providers / Personal Support Workers) (PSW), Independent Choices Program (ICP), and Spousal Pay Program (SPP) allow a relative to be hired as the paid aide. Which relatives qualify (adult children, parents of adults, spouses, legal guardians) and how a live-in caregiver is treated are set program by program.

Structured family caregiving: a paid live-in family caregiver

Oregon has no structured family caregiving program. A family caregiver is paid instead through consumer-directed care (Consumer-Employed Provider Program (Medicaid in-home services) (HCW), Developmental Disabilities in-home supports (independent providers / Personal Support Workers) (PSW), Independent Choices Program (ICP), and Spousal Pay Program (SPP)), by the hour, as the participant's chosen aide.

Other ways Oregon pays for care at home

Waiver in-home services: Children's Extraordinary Needs Program (CEN) and Oregon Project Independence-Medicaid (OPI-M). These pay for in-home supports for people who meet a nursing-home or similar level of care, often with more services than state plan personal care and, in some programs, a waiting list or enrollment cap.

PACE: Program of All-Inclusive Care for the Elderly (PACE). One PACE organization covers medical care, a day center and home care for people 55 and over who need nursing-home level care.

State-funded: Oregon Project Independence (OPI). Paid from state funds outside Medicaid, for people who do not qualify for Medicaid or are waiting for it.

Which one fits

  • Needs nursing, wound care, injections or therapy at home: home health (Home Health Services (Oregon Health Plan) (HHA)).
  • Needs daily help and wants an agency to supply and manage the aide: Contracted In-Home Care Agency services.
  • Wants to choose the aide, including a relative where allowed: Consumer-Employed Provider Program (Medicaid in-home services) (HCW), Developmental Disabilities in-home supports (independent providers / Personal Support Workers) (PSW), Independent Choices Program (ICP), and Spousal Pay Program (SPP).
  • Meets nursing-home level of care and needs more than personal care: Children's Extraordinary Needs Program (CEN) and Oregon Project Independence-Medicaid (OPI-M).
In the workspace

Oregon program rules, side by side

Eligibility, the family caregiver rules (spouses, parents, live-in caregivers), employer of record, fiscal intermediary, caregiver training, provider requirements, how to enroll, published pay, EVV and waiting lists: 93 details across 10 programs.

ProgramFamily rulesEmployerEligibilityPay
See Oregon's program rules — start free

Who can be paid, who employs the caregiver, what each program requires of agencies and caregivers, how to become a provider and what it pays, for all 10 programs.

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  • Provider requirements
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Program by program

Oregon's programs

What each program is and how it differs from the others. Locked details open in the workspace.

Home Health Services (Oregon Health Plan) (HHA)

Home health

State Plan home health (1905(a)(7)) · Oregon Health Authority (OHA)

Skilled home health: nursing, therapy and aide visits under a plan of care from a licensed home health agency; run as a Medicaid State Plan benefit, available through fee-for-service and managed care.

Can family be paid?Not stated
How to get set up
Provider track · 6 steps
  1. Get an OHA home health agency license
  2. 5 more steps: forms, fees, timelines and links
Family / participant track · 5 steps
  1. Have OHP coverage
  2. 4 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredEmployer of recordProvider requirementsHow to become a providerManaged-care plansRecent changesHow it differs, in detailSetup checklistUnlock the details →

Contracted In-Home Care Agency services

Agency personal care

Medicaid in-home services (K Plan / OR.0185) · ODHS APD

Agency personal care: non-medical daily help from aides a licensed agency employs; paid fee-for-service.

Can family be paid?Not stated
How to get set up
Provider track · 9 steps
  1. Register the business
  2. 8 more steps: forms, fees, timelines and links
Family / participant track · 7 steps
  1. Contact the local APD/AAA office or ADRC
  2. 6 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerPay rateEVVRecent changesHow it differs, in detailSetup checklistUnlock the details →

Consumer-Employed Provider Program (Medicaid in-home services) (HCW)

Consumer-directed

1915(k) Community First Choice (K Plan) and 1915(c) Aged and Physically Disabled waiver OR.0185 · Oregon Department of Human Services (ODHS), Aging and People with Disabilities (APD), with local APD/AAA offices

Consumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a Community First Choice (1915(k)) state plan option, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 10 steps
  1. Submit the homecare worker enrollment application
  2. 9 more steps: forms, fees, timelines and links
Family / participant track · 9 steps
  1. Contact the local APD/AAA office or ADRC
  2. 8 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordFiscal intermediaryCaregiver requirementsProvider requirementsHow to become a providerPay rateEVVWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

Developmental Disabilities in-home supports (independent providers / Personal Support Workers) (PSW)

Consumer-directed

1915(k) K Plan and 1915(c) waivers incl. OR.0375 (Adults' HCBS) and OR.0117 (Children's HCBS) · ODHS Office of Developmental Disabilities Services (ODDS) through CDDPs and brokerages

Consumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a Community First Choice (1915(k)) state plan option, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 10 steps
  1. Submit the PSW enrollment agreement
  2. 9 more steps: forms, fees, timelines and links
Family / participant track · 9 steps
  1. Contact the county CDDP
  2. 8 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordCaregiver requirementsHow to become a providerEVVRecent changesHow it differs, in detailSetup checklistUnlock the details →

Independent Choices Program (ICP)

Consumer-directed

Medicaid in-home services (self-directed cash option) · ODHS APD

Consumer-directed care: the participant hires and directs their own aide, with payroll handled for them; paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 2 steps
  1. No provider enrollment track
  2. 1 more step: forms, fees, timelines and links
Family / participant track · 9 steps
  1. Contact the local APD/AAA office or ADRC
  2. 8 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordHow it differs, in detailSetup checklistUnlock the details →

Spousal Pay Program (SPP)

Consumer-directed

Part of Medicaid in-home services (K Plan / OR.0185) · ODHS APD; Central Office approves eligibility at enrollment and each annual reassessment

Consumer-directed care: the participant hires and directs their own aide, with payroll handled for them; paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 11 steps
  1. Confirm the program route
  2. 10 more steps: forms, fees, timelines and links
Family / participant track · 9 steps
  1. Contact the local APD/AAA office or ADRC
  2. 8 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordFiscal intermediaryCaregiver requirementsHow to become a providerPay rateEVVHow it differs, in detailSetup checklistUnlock the details →

Children's Extraordinary Needs Program (CEN)

Waiver in-home

1915(c) waiver OR.2386 (SB 91, 2023) · ODHS ODDS

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 6 steps
  1. Become an ODDS-certified Medicaid agency
  2. 5 more steps: forms, fees, timelines and links
Family / participant track · 8 steps
  1. Have the child in ODDS services
  2. 7 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerEVVWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

Oregon Project Independence-Medicaid (OPI-M)

Waiver in-home

Section 1115 demonstration (approved 2024-02-13) · ODHS APD and Area Agencies on Aging

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as an 1115 demonstration, paid fee-for-service.

Can family be paid?Not stated
How to get set up
Provider track · 4 steps
  1. Enroll as a homecare worker or in-home care agency
  2. 3 more steps: forms, fees, timelines and links
Family / participant track · 6 steps
  1. Contact the local APD/AAA office
  2. 5 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredWaiting list or capRecent changesHow it differs, in detailSetup checklistUnlock the details →

Program of All-Inclusive Care for the Elderly (PACE)

PACE

1934 PACE · ODHS APD with CMS

PACE: one organization covers medical care, a day center and home care for people 55 and over; run as the PACE benefit, delivered through managed-care plans.

Can family be paid?Not stated
How to get set up
Provider track · 7 steps
  1. Form an eligible entity
  2. 6 more steps: forms, fees, timelines and links
Family / participant track · 5 steps
  1. Check the service area and contact PACE
  2. 4 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredEmployer of recordRecent changesHow it differs, in detailSetup checklistUnlock the details →

Oregon Project Independence (OPI)

State-funded

state-funded (ORS 410.410-410.480) · ODHS APD through Area Agencies on Aging

State-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.

Can family be paid?Not stated
How to get set up
Provider track · 4 steps
  1. Contract with the local Area Agency on Aging
  2. 3 more steps: forms, fees, timelines and links
Family / participant track · 5 steps
  1. Contact the local APD/AAA office
  2. 4 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredWaiting list or capHow it differs, in detailSetup checklistUnlock the details →
FAQ

Frequently asked questions

Can family members get paid to be caregivers in Oregon?

Yes. Consumer-Employed Provider Program (Medicaid in-home services) (HCW), Developmental Disabilities in-home supports (independent providers / Personal Support Workers) (PSW), Independent Choices Program (ICP), Spousal Pay Program (SPP), and Children's Extraordinary Needs Program (CEN) let a family member be the paid caregiver. Which relatives qualify, including spouses and parents of minor children, is set program by program.

Does Oregon have consumer-directed care?

Yes: Consumer-Employed Provider Program (Medicaid in-home services) (HCW), Developmental Disabilities in-home supports (independent providers / Personal Support Workers) (PSW), Independent Choices Program (ICP), and Spousal Pay Program (SPP). The person receiving care hires and directs their own aide, and a fiscal intermediary handles payroll.

Does Oregon have structured family caregiving?

No. Oregon does not run a structured family caregiving program. Family caregivers are paid through consumer-directed care instead.

What is the difference between home health and home care in Oregon?

Home health (Home Health Services (Oregon Health Plan) (HHA)) is medical: nursing, therapy and aide visits ordered by a practitioner and delivered by a licensed home health agency. Home care (Contracted In-Home Care Agency services) is non-medical help with daily activities, based on functional need.

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