Oregon's Independent Choices Program gives eligible people on Medicaid in-home services a cash benefit to hire and pay their own caregiver, who can be an adult child, a spouse or another relative. The Independent Choices Program (ICP) pays that benefit at the start of each month, in place of the usual service provider plan.

Who You Can Hire Through Independent Choices

The Oregon Department of Human Services (ODHS) says Independent Choices participants "may hire family members, their spouse, neighbors and other interested applicants (including homecare workers) to help," and the program's rule, OAR 411-030-0100, says "a participant's relative may be employed as an employee provider."

Your relationship Can you be the paid caregiver?
Adult child or other relative Yes
Spouse Yes, if your spouse is approved for ICP
Neighbor, friend or homecare worker Yes
The person's representative No, whatever the relationship

If your parent can't direct their own services, the Independent Choices rule says they must have a representative to act for them, and "a representative may not be an employee provider regardless of relationship to the participant."

The Spousal Pay Program and Independent Choices are the only two Consumer-Employed Provider (CEP) in-home options that allow paying a spouse, per the ODHS Spousal Pay program guide. If your spouse doesn't meet the Spousal Pay requirements, ODHS guidance says they can pursue having you as their paid provider through Independent Choices if they meet its eligibility criteria and are approved.

Does Your Family Member Qualify for Oregon's Independent Choices Program?

ODHS says people eligible for Oregon's Medicaid-paid in-home services for adults over 65 and people with physical disabilities may be eligible for Independent Choices. For those in-home services, a person must be 18 or older, eligible for the Oregon Health Plan Plus benefit package, and assessed at one of service priority levels 1 through 13.

The Independent Choices rule adds tests of its own, including these two. A participant must:

  • Provide evidence of a stable living situation for the past three months.
  • Show they can manage money through timely and current utility and housing payments for the past three months.

A hospital stay can throw a parent's bills off track, and the rule allows for that. If the past three months included a hospital, community-based care or nursing facility stay, the Independent Choices rule also accepts a history of timely payments from before that stay.

How the Oregon ICP Cash Benefit Works

The Independent Choices cash benefit is built from your family member's assessment: the rule adds up the daily-living (ADL) and household (IADL) task hours that the Client Assessment and Planning System (CA/PS) assessment finds they're eligible for, "at the rates according to the Department's rate schedule.",

What the caregiver earns. The Independent Choices participant sets the caregiver's hourly pay, and OAR 411-030-0100 says it must be "no less than the federal or state minimum wage, whichever is greater." The ODHS consumer overview says "whichever is less," but the rule sets the floor.

Typical pay: about $21.35 an hour (estimate based on home care aide wages in Oregon, BLS, May 2025). That is the occupation's Oregon median, not a rate ICP pays a family caregiver.

A small fund for other needs. An Independent Choices participant may set aside up to 10 percent of the cash benefit, not counting employee taxes, as a monthly discretionary fund, which buys items that relate directly to the participant's health, safety and independence and aren't otherwise covered by Medicaid home and community-based services; the participant's case manager must approve it.

The ICP cash benefit can't be used to buy services from an Adult Day Service provider or a licensed care setting.

What It Means to Be the Employer

Under ICP, the participant or their representative "carries full responsibility for locating, screening, interviewing, hiring, training, paying, and terminating employee providers." That includes payroll and taxes; see W-2 or 1099 for a household employer.

An Independent Choices participant may use a fiscal intermediary, such as an accountant or bookkeeper, and must arrange one if they can't manage the accounting, tax or payroll duties and don't have a representative, and pays its fees from the discretionary fund or other non-ICP money.

What Can Stop the Payments

The ICP cash benefit stops when the participant is away from home for longer than 30 calendar days because of illness or medical treatment. It may resume when they return, as long as they still meet the Independent Choices eligibility criteria. Because your wages come out of that benefit, a long hospital or rehab stay can stop your pay too, so plan with the case manager for a gap in income.

Independent Choices participants who are disenrolled, voluntarily or involuntarily, "may not reapply for six months."

How to Start With the Independent Choices Program in Oregon

1
Step 1

Call the Aging and Disability Resource Connection (ADRC) at 855-ORE-ADRC (855-673-2372)

Ask about Medicaid in-home services and the Independent Choices Program by name.

2
Step 2

Apply for Medicaid if needed

Use how to apply for Oregon Medicaid.

3
Step 3

Complete the CA/PS assessment

, which sets the task hours behind the ICP cash benefit.,

4
Step 4

Gather proof for the Independent Choices tests

three months of timely housing and utility payments, or records from before a facility stay.

5
Step 5

Decide who is the employer and who is paid

Any representative must be someone other than the paid caregiver; set an hourly rate at or above the Independent Choices pay floor.

Frequently Asked Questions

Is Independent Choices the only way to get paid to care for my mom in Oregon?

No. In Oregon, an adult child can also be hired as a Medicaid homecare worker through the Consumer-Employed Provider program, with case manager approval. Our guide to getting paid as a family caregiver in Oregon compares the routes.

I'm my dad's guardian. Can I be his paid caregiver through Independent Choices?

Not while you're also his representative. Oregon's in-home services rules say a person with a guardian must have a representative, and a guardian may name themselves. Because an Independent Choices representative can't be a paid employee provider, ask the case manager who else can fill that role.

Learn More

CaregiverHow to Get Paid as a Family Caregiver in OregonOregon paid family caregiver options for 2026: Medicaid in-home services and homecare workers, the Spousal Pay Program, Independent Choices, and VA programs. CaregiverHow to Get Paid to Care for Your Spouse in OregonCan you get paid to care for your spouse in Oregon? Yes, through Oregon's Spousal Pay or Independent Choices programs and, for veterans, VA's PCAFC stipend. CaregiverCaregiver Programs in OregonA directory of every caregiver program in Oregon for 2026: the Spousal Pay Program, K Plan, CEP self-direction, respite, NFCSP grants, VA benefits, and taxes. MedicaidHow to Apply for Oregon MedicaidApply for Oregon Medicaid (OHP) in 2026: the ONE portal, the Income Cap Trust gate over $2,982/month, documents, the 45-day clock, and how to appeal. CaregiverW-2 or 1099 for a Household EmployerCaregiver W-2 or 1099? Usually a W-2: a family paying a private caregiver has no 1099 to issue. The 2026 thresholds, every step in order, and family exemptions. CaregiverCaregiver Payroll ServicesNo. Your family can run a caregiver's payroll itself. A payroll service can file and pay the taxes, but you stay the employer and stay liable if it fails.

Get personalized help with Oregon's Independent Choices Program at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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