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¶
- Care recipient must have a qualifying disability
- Relationship: spouse, parent, child, sibling, grandparent, other relative, non relative
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¶
- For older adults and people with physical disabilities, start by contacting a local Aging and Disability Resource Connection (ADRC), Area Agency on Aging (AAA), or ODHS Aging and People with Disabilities office to ask for long-term services and supports screening.
- The local office determines eligibility for state-paid in-home services based on financial eligibility, functional need, and the program pathway.
- After approval, the person and case manager choose the appropriate in-home option, such as Consumer Employer/Homecare Worker, Independent Choices, In-Home Care Agency, or Agency with Choice when available.
- For children with extraordinary medical or behavioral needs, families can contact Oregon's Children's Extraordinary Needs Program, but the program is capacity-limited and uses a waitlist.
Use the official program page for application details: official program page.