National question: Can a family caregiver get paid? Official programs decide eligibility.

Oregon Medicaid In-Home Services (Consumer Employer/Homecare Worker and Independent Choices)

Oregon Medicaid long-term services and supports include consumer-directed in-home options for older adults and people with disabilities, including the Consumer Employer/Homecare Worker model and the Independent Choices Program. After a person qualifies for state-paid in-home services, they may be able to hire, schedule, and direct approved providers or receive a cash benefit to arrange services under option-specific rules.

Oregon offers several in-home service options for people who qualify for state-paid long-term services and supports. In the Consumer Employer/Homecare Worker option, the person receiving services or their representative hires, schedules, trains, and supervises a homecare worker while Oregon handles provider enrollment, background checks, and payment through the public homecare workforce system. The Independent Choices Program pays a monthly cash benefit so the participant can arrange and pay for approved services, including hiring qualified family members or friends; Oregon's ICP materials say a spouse or parent may be a service provider if program qualifications are met. Oregon also has a Spousal Pay Program for approved people whose spouse provides in-home care. For children with very high medical or behavioral needs, the Children's Extraordinary Needs Program lets eligible parents or guardians be paid for up to 20 hours per week, but the program is capped and uses a waitlist. The 2025-2027 Oregon Home Care Commission contract lists 2026 regular homecare-worker wages from $21.25/hr at Step 1 to $25.25/hr at Step 5, with possible differentials such as CPR/First Aid and enhanced or exceptional qualifications. Actual hours, cash benefit amounts, and provider eligibility depend on assessment, service plan, Medicaid or other state-paid service eligibility, and the selected option.

Eligibility

• Household income at or below 150% of the Federal Poverty Level
• Care recipient must have a qualifying disability
• Relationship: parent, child, other relative

Questions to ask the program

These are questions to ask the program, not a verdict on your eligibility. Confirm the current rules directly with the program.

• Does the person receiving care live in Oregon? — Residency is usually the first thing a program checks.
• Does your relationship to the person — parent, child, or other relative — count for this program?
• What are the current income and asset limits, and whose income counts? — Our record lists 150% of the federal poverty level — limits change, so confirm the current figures.
• What counts as a qualifying disability or level of care need, and what documentation shows it?
• Is there a caregiver-specific department, coordinator, or support line? Ask for it by name. — Many agencies have one that isn’t advertised on the website.
• What documents do you need from us to start an application?
• Is there a waitlist right now, and how long is it?

Services

Oregon offers several in-home service options for people who qualify for state-paid long-term services and supports. In the Consumer Employer/Homecare Worker option, the person receiving services or their representative hires, schedules, trains, and supervises a homecare worker while Oregon handles provider enrollment, background checks, and payment through the public homecare workforce system. The Independent Choices Program pays a monthly cash benefit so the participant can arrange and pay for approved services, including hiring qualified family members or friends; Oregon's ICP materials say a spouse or parent may be a service provider if program qualifications are met. Oregon also has a Spousal Pay Program for approved people whose spouse provides in-home care. For children with very high medical or behavioral needs, the Children's Extraordinary Needs Program lets eligible parents or guardians be paid for up to 20 hours per week, but the program is capped and uses a waitlist. The 2025-2027 Oregon Home Care Commission contract lists 2026 regular homecare-worker wages from $21.25/hr at Step 1 to $25.25/hr at Step 5, with possible differentials such as CPR/First Aid and enhanced or exceptional qualifications. Actual hours, cash benefit amounts, and provider eligibility depend on assessment, service plan, Medicaid or other state-paid service eligibility, and the selected option.

How to apply

• apply or update benefits at benefits.oregon.gov or 800-699-9075; the Aging and Disability Resource Connection (ADRC) at adrcoforegon.org or 855-673-2372 is also an entry point

Use the official program page for application details: official program page.