Caregiver Programs in Oregon: Paid, Respite, Support (2026)

Oregon caregiver programs include something most states do not: a Spousal Pay Program that pays a spouse to provide care. Add the K Plan, Consumer-Employed Provider (CEP) self-direction, free respite, and VA benefits, and the state's support for family caregivers runs deeper than most families realize.1

If you are caring for an aging parent, a spouse, or an adult child with a disability in Oregon, the hard part is rarely whether help exists. It is knowing what is there and where to start. This directory maps the major caregiver programs across the state for 2026 and points you to the right one for your situation.

You don't have to figure this out alone, and you don't have to fund all of it from your savings.

In This Guide

• Oregon Caregiver Programs at a Glance
• Oregon Caregiver Programs That Pay Family Members
• Respite Care Programs
• Support, Training, and the OR-ADRC
• VA Caregiver Benefits in Oregon
• Taxes for Oregon Caregivers
• Frequently Asked Questions
• Resources
• Learn More

Oregon Caregiver Programs at a Glance

Oregon Caregiver Programs That Pay Family Members

Oregon delivers paid in-home care through the Oregon Department of Human Services (ODHS) Aging and People with Disabilities, with payroll handled by the Oregon Home Care Commission (OHCC), which oversees the state's publicly funded home care workforce.9

The K Plan and Consumer-Employed Provider (CEP) Program

Oregon's K Plan is the state's Community First Choice (CFC) option, a Medicaid state plan benefit under Section 1915(k). As a state plan entitlement, there is no waitlist for eligible participants.2

Under the Consumer-Employed Provider (CEP) program, the care recipient is the employer of their homecare worker. Friends and family members aged 18 or older, including adult children, siblings, other relatives, and friends, can be hired and paid to provide care. The OHCC handles payroll and taxes. A spouse cannot be an ordinary CEP homecare worker in Oregon, which is exactly why the state built the separate Spousal Pay Program below.1

Spousal Pay Program

Oregon's Spousal Pay Program (OAR 411-030-0080) is a Medicaid in-home services pathway that pays a spouse to provide care, a benefit most states do not allow.1 To qualify, the care recipient must:

• Be married to the caregiver, both residing together in their own home (not a nursing facility or assisted living);
• Require full assistance in at least four of the six activities of daily living (mobility, eating, elimination/toileting, dressing/grooming, bathing, and cognition/behavior);
• Have a medically diagnosed debilitating condition; and
• Require care that would otherwise necessitate nursing facility services.

The service need must exceed, in both extent and duration, the usual and customary services one spouse renders to another. The spouse enrolls as a homecare worker through the OHCC and the Consumer-Employed Provider Program, passes a background check, and provides the majority of the service-plan hours. Authorized hours equal all assessed ADL hours plus one-half of the assessed IADL hours, paid at the standard homecare worker rate.1

For the full guide to paid pathways, see How to Get Paid as a Family Caregiver in Oregon.

Respite Care Programs

Medicaid Respite (K Plan)

The K Plan authorizes in-home respite as part of the care plan, delivered by a hired homecare worker through the OHCC. Ask your APD case manager to include respite hours.4

Oregon Family Caregiver Support Program (NFCSP)

The Oregon Family Caregiver Support Program (OFCSP) is the state's implementation of the National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act and administered through Area Agencies on Aging. Services include in-home respite, adult day vouchers, caregiver training, and counseling, with no income test for respite services. Call 1-855-673-2372 (OR-ADRC).3,4

For the full respite guide, see Respite Care in Oregon.

Support, Training, and the OR-ADRC

Oregon's Aging and Disability Resource Connection (OR-ADRC) is the statewide front door for caregiver support that is not tied to a Medicaid waiver. It connects you to your regional Area Agency on Aging for NFCSP/OFCSP respite, caregiver counseling, benefits screening, and local resources.

Call 1-855-673-2372 (OR-ADRC) or dial 211 for the broader social-services network. These calls are free. Oregon also runs Oregon Project Independence, a non-Medicaid in-home support program for older adults who do not qualify for Medicaid; ask the OR-ADRC about eligibility.10

VA Caregiver Benefits in Oregon

Veterans enrolled in VA health care in Oregon have access to caregiver support programs that are separate from Medicaid and often more generous.

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran, and that caregiver can be a family member, including the veteran's spouse. To qualify, the veteran needs a service-connected disability rating of 70 percent or higher, a need for in-person personal care, and enrollment in VA health care. PCAFC also provides at least 30 days of respite care per year.5

The dollar amount starts from the federal General Schedule (GS) grade-4, step-1 annual rate for the veteran's locality, divided by 12, then multiplied by a stipend factor. Under 38 CFR 71.40(c)(4)(i) there are two factor schedules, and which one applies to your household depends on how the veteran qualifies:5

• Current program (the veteran was approved under the eligibility criteria now in force): the factor is 0.625, or 1.00 if VA determines the veteran is unable to self-sustain in the community.5
• Legacy participant or legacy applicant (the household was already in PCAFC, or had applied, before the program's October 1, 2020 expansion): the factor is set by the sum of the veteran's 2019 clinical ratings, and no self-sustain determination is required. The factor is 1.00 if that sum is 21 or higher, 0.625 if it is 13 to 20, and 0.25 if it is 1 to 12.5

A veteran who meets both sets of criteria is paid at whichever factor is higher. That matters most for legacy households: if the 2019 ratings summed to 21 or more, the stipend reaches 1.00 on the rating schedule alone, with no self-sustain finding needed. A legacy participant is also protected by a floor, meaning the stipend cannot drop below what the caregiver was eligible for on September 30, 2020, for as long as the veteran remains at the address VA has on record. The legacy rules end on October 1, 2028. Ask your VA Caregiver Support Coordinator which schedule your household is on before you accept a figure.5

Veteran-Directed Care (VDC) is also available in Oregon through the VA Portland Health Care System, letting the veteran direct a flexible monthly budget toward caregiver pay, including pay to a family member or spouse.6

VA Aid and Attendance Pension

Wartime veterans and surviving spouses who meet the functional criteria and have countable assets and income under the net-worth limit ($163,699 in 2026) may receive the Aid and Attendance pension. The VA sets these as maximum annual rates, not flat payments: VA pays the difference between a claimant's countable income and the applicable maximum, so someone with income receives less than the ceiling. In 2026, a single veteran has a maximum of up to $29,093 a year (roughly $2,424 a month for someone with no countable income); a veteran with one dependent up to $34,488 a year (roughly $2,874 a month). The pension goes to the veteran, who typically pays a family caregiver from it.11

The Oregon Department of Veterans' Affairs and county Veterans Service Officers help file at no cost. The VA Caregiver Support Line is in the Resources below.

Taxes for Oregon Caregivers

IRS Notice 2014-7

If you live in the same home as the person you care for and are paid through a Medicaid program, your wages may be excluded from federal gross income under IRS Notice 2014-7 as difficulty-of-care payments. This applies to many Oregon CEP and Spousal Pay arrangements where the caregiver and recipient share a home. Talk to a tax preparer familiar with the rule before filing.8

Oregon State Income Tax

Because Oregon calculates state income tax starting from your federal taxable income, confirm with a tax preparer how the IRS Notice 2014-7 exclusion carries over to your Oregon return before you file.

Medicaid Look-Back

Oregon applies a 60-month look-back to asset transfers for long-term care eligibility. Informal payments to a family caregiver without a written agreement can create a transfer-penalty period. A properly drafted personal services contract at fair-market rates protects future eligibility.7

Resources

Learn More

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.