Oregon caregiver programs include a Spousal Pay Program that can pay a spouse to provide Medicaid in-home care when strict conditions are met. Add the K Plan, Consumer-Employed Provider (CEP) self-direction, respite through the Family Caregiver Support Program, and VA benefits, and the state's support for family caregivers runs deeper than most families realize.

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

Program What It Offers Who Qualifies Who Pays
Spousal Pay Program Pays a spouse to provide care Medicaid in-home recipient needing full help in 4+ of 6 ADLs, with a debilitating medical condition, who would otherwise need nursing facility care; ODHS approves Medicaid; recipients with excess income contribute to the cost
K Plan / CEP self-direction Home and community-based services; the recipient employs the homecare worker Medicaid in-home services recipients Medicaid
Homecare worker (adult child or other relative) Pays a relative the recipient hires as their homecare worker Medicaid in-home services recipient; the relative meets provider enrollment standards and the case manager approves; not the spouse or the recipient's representative Medicaid
Independent Choices Program (ICP) Monthly cash benefit to hire and pay your own workers, who may include family members or a spouse Medicaid in-home services recipient who also meets ICP's own tests, including three months of stable living and timely bill payments Medicaid
Family Caregiver Support Program (NFCSP) Respite, counseling, support groups, training Caregivers of adults 60+ who need in-home care, or of anyone with Alzheimer's or a related disorder; for a family caregiver of an older person, NFCSP respite requires that person to be frail Federal Title III-E provides limited funding; ask your Area Agency on Aging
VA PCAFC Monthly stipend that can pay a spouse Veteran with a 70%+ rating, a discharge, 6+ months of in-person care needs and VA health care enrollment; VA decides on a joint application VA
VA Aid and Attendance Pension paid to the veteran or surviving spouse Pension claimant VA finds qualifies for Aid and Attendance; net worth under $163,699 VA

Oregon Caregiver Programs That Pay Family Members

Oregon's publicly funded in-home care workforce is made up of homecare workers, personal support workers, and personal care attendants, and the Oregon Department of Human Services (ODHS) Home Care Workforce (OHCC) pages are where those workers get their provider resources. State law requires a criminal records check when a homecare worker registers with the Home Care Commission or renews, and ODHS lists the OHCC-SEIU collective bargaining agreements, most recently the 2025-2027 SEIU OHCC Contract.

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

Oregon's K Plan is a Medicaid state plan option authorized under the Affordable Care Act. It lets the state provide home and community-based services and supports to Oregonians who need help with regular activities and want to stay in their home or a community setting, with a six percent increase in federal funding for those services. The federal option CMS describes in the same terms is Community First Choice, under Section 1915(k).

Under the Consumer-Employed Provider (CEP) program, the person receiving care is the consumer-employer of their homecare worker. Within CEP, ODHS says the Spousal Pay Program described below and the Independent Choices Program (ICP) are the only in-home service options that allow payment to a spouse provider. If the person you care for does not meet Spousal Pay eligibility, ODHS guidance is that the spouse cannot continue as the paid homecare worker; the individual may hire a different homecare worker, or pursue having their spouse be their paid provider through ICP if they meet ICP eligibility criteria and are approved for ICP. One situation works differently: a homecare worker who marries their consumer-employer, where that consumer meets all Spousal Pay eligibility requirements, is not paid under the Spousal Pay Program; a standard in-home service plan is built on the consumer's needs, with full IADL hours. Ask your APD office about ICP by name, and about what its approval takes.

Can an adult child or other relative be the paid homecare worker in Oregon? Yes, subject to case manager approval. The person receiving care may employ anyone who meets the provider enrollment standards, and the Department or AAA office decides whether that worker may be enrolled and paid. ODHS's homecare worker FAQ answers "Yes!" to whether you can get paid to support a family member or friend who is an older adult or person with a disability. A representative may not be a paid caregiver for the person they represent, and a person with a guardian must have a representative (a guardian may designate themselves), so the relative who acts as representative cannot also be the paid homecare worker. ODHS may authorize paid hours only as needed to supplement help family and friends give voluntarily. On service plans created since Sept. 1, 2016, a homecare worker is limited to 40 hours a week unless the person has a Weekly Cap exception or the worker averaged 40 or more paid hours a week in March through May 2016 (capped at 50), with no more than 16 hours of awake care in a 24-hour period. Oregon homecare workers, including Spousal Pay providers, are paid on a statewide scale: $21.25 to $25.25 an hour by pay step for non-legacy providers under the 2025-2027 SEIU contract from Jan. 1, 2026, plus any earned differential.

Spousal Pay Program

Oregon's Spousal Pay Program (OAR 411-030-0080) is one of the hourly service options under Medicaid in-home services, and it pays a spouse to provide that care. The person receiving care may be eligible only when all of these are true:

  • They have met all eligibility requirements for Medicaid in-home services;
  • They require full assistance in at least four of the six activities of daily living, as determined by the state's assessment;
  • They have a debilitating medical condition, which ODHS defines as a severe and persistent medical condition that significantly impairs the ability to function and participate in most activities of daily living. A medical diagnosis is not required to establish one;
  • They would otherwise require nursing facility services without Medicaid in-home services; and
  • Their service needs exceed, in both extent and duration, the usual and customary services one spouse renders to another.

The spouse has conditions to meet too. The spouse must demonstrate the capability and health to provide the services and actually provide the principal services, including the majority of service-plan hours; must meet all requirements for enrollment as a homecare worker in the Consumer-Employed Provider Program; and must not be designated as the individual's representative. ODHS Central Office reviews and approves Spousal Pay eligibility at initial enrollment and at every annual reassessment. Authorized hours are one-half of the assessed IADL hours plus all of the hours for specific ADLs, paid at hourly homecare worker rates. Recipients with excess income must contribute to the cost of services. A spouse paid this way also may not act as the consumer-employer.

For every Spousal Pay condition, what it pays and how to apply, see How to Get Paid to Care for Your Spouse in Oregon.

Independent Choices Program (ICP)

Oregon's Independent Choices Program is a self-directed Medicaid in-home services option. The participant receives a cash benefit at the start of each month, calculated from the ADL and IADL task hours in their assessment, and uses it to hire and pay their own workers. Participants may hire family members, their spouse, neighbors and other applicants, including homecare workers. A representative, the person who makes ICP decisions for a participant who cannot direct their own services, may not be a paid worker regardless of relationship. ICP has entry tests of its own on top of in-home services eligibility, including evidence of a stable living situation for the past three months and timely, current utility and housing payments over that time (or a payment history from before a hospital or facility stay).

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

Respite Care Programs

Oregon Family Caregiver Support Program (NFCSP)

Oregon's Family Caregiver Support Program (FCSP) helps caregivers support their loved ones and themselves. ODHS's caregivers page describes Oregon's program for family caregivers and lists its services: connecting you to local services like home-delivered meals, transportation or legal assistance; counseling and support groups for caregivers; and respite care to give caregivers a break from providing care. The person you care for must be an adult who is at least 60 years old and who needs in-home care, or someone of any age who has Alzheimer's disease and other related disorders. Call 1-855-673-2372 (OR-ADRC).

Its regulatory authority is Title III-E of the Older Americans Act, the National Family Caregiver Support Program (NFCSP), which ODHS says provides limited funding. Under that federal law, services are delivered by an Area Agency on Aging or an entity it contracts with, and respite and supplemental services are available to a family caregiver only where the older person cared for is frail: unable to perform at least two activities of daily living without substantial human assistance, or needing substantial supervision because a cognitive or other mental impairment makes their behavior a serious health or safety hazard. Information, help gaining access to services, and counseling, support groups, and training carry no such condition.

Medicaid In-Home Services (K Plan)

If the person you care for receives Medicaid in-home services, the K Plan is the state plan option that lets Oregon serve people in their own homes or a community setting. Ask the APD case manager what the service plan can cover.

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 Family Caregiver Support Program respite, caregiver counseling, benefits screening, and local resources.

Call 1-855-673-2372 (OR-ADRC) or dial 211 for the broader social-services network. Oregon also runs Oregon Project Independence (OPI), which provides limited in-home services to people who need a little help to continue living independently. Ask the ADRC at 1-855-673-2372 about OPI where you live before assuming anything about age, income, or Medicaid.

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. The caregiver must be at least 18 and either a family member, including the veteran's spouse, or someone who lives full time with the veteran (or is willing to). VA lists four things that must all be true for the veteran: a VA disability rating (individual or combined) of 70% or higher; a discharge or a date of medical discharge; a need for at least 6 months of continuous, in-person personal care services; and enrollment in VA health care. A 70% rating alone is not enough, and even those four are a first screen: you and the veteran apply together, and VA decides through its application process. Primary Family Caregivers can also receive at least 30 days of respite care per year, and the stipend is paid only by direct deposit.

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:

  • 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.
  • Legacy participant or legacy applicant (a status defined in 38 CFR 71.20(b) and (c); ask VA whether it applies to you): the factor is set instead by the sum of the veteran's 2019 clinical ratings. 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.

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.

Veteran-Directed Care (VDC) gives veterans who need personal care and help with activities of daily living a budget they manage, with a counselor's help, to hire their own workers, who VA says might include their own family member or neighbor. Eligibility is conditional: enrolled veterans qualify if they are eligible for community care, meet the clinical criteria, and the service is available, and services vary by location. In Oregon, ACL's directory lists VDC sites at the Portland VA Medical Center, the Southern Oregon Rehabilitation Center & Clinics, the VA Roseburg Health Care System, and the White City VA Medical Center. Ask the site serving you whether a spouse can be one of the hired workers.

VA Aid and Attendance Pension

Aid and Attendance is a higher maximum pension rate within VA's Veterans Pension and Survivors Pension, for claimants VA finds qualify for Aid and Attendance benefits. To be eligible for either pension at all, net worth, which includes the claimant's and dependents' assets and income for VA purposes, must be under the limit: $163,699 from December 1, 2025, to November 30, 2026. VA sets these as maximum annual pension rates, not flat payments: VA pays the difference between a claimant's income for VA purposes and the applicable maximum. Unreimbursed medical expenses above 5% of the household's basic pension rate (not the higher Aid and Attendance rate) may reduce that income. For that period, a veteran with no dependents has an Aid and Attendance maximum of $29,093 a year, and a veteran with one dependent $34,488 a year. Pension is paid monthly: VA reduces the annual maximum by countable income, divides by 12, and rounds down to the whole dollar. The pension is paid to the veteran or surviving spouse.

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

Under IRS Notice 2014-7, qualified Medicaid Home and Community-Based Services waiver payments to an individual care provider, for personal care of a recipient who lives in the same home as the provider, are treated as difficulty-of-care payments and may be excluded from the provider's federal gross income. Where the care is given decides it: the exclusion applies only to care in the provider's home where the recipient lives, so a caregiver who keeps a separate home of their own may not exclude the payments. Payments the recipient makes from their own private funds are not excludable, and whether Social Security and Medicare taxes apply is a separate question that depends on who employs you. Ask a tax preparer familiar with the notice whether your Oregon payments qualify before you file.

Oregon State Income Tax

Notice 2014-7 is IRS guidance about gross income under the federal Internal Revenue Code. Confirm with a tax preparer how these payments are treated on your Oregon return before you file.

Medicaid Look-Back

Oregon applies a 60-month look-back to asset transfers for Department-paid nursing facility or home and community-based care. A transfer made even partly to gain or keep eligibility can bar those services for months, based on its uncompensated value.

Transfers to a spouse or blind or disabled child can be exempt if only they benefit. A caregiving child can get the home penalty-free only if they lived there continuously for at least two years before the parent's long-term care admission (absences of 30 days or less aside), give convincing evidence their care kept the parent home, and gave at least 20 hours a week of daily help with both personal care and household tasks without pay from the Department. Ask ODHS or an elder law attorney first.

Frequently Asked Questions

Can I get paid to care for my spouse in Oregon?

Possibly, through the Spousal Pay Program (OAR 411-030-0080). The care recipient must qualify for Medicaid in-home services, need full assistance in at least four of six activities of daily living, have a debilitating medical condition, and otherwise need nursing facility services, and their needs must exceed the usual care one spouse gives another. The spouse must have the capability and health to provide most of the care and must enroll as a homecare worker; ODHS Central Office approves eligibility, and recipients with excess income contribute to the cost. If those tests are not met, a spouse may still be paid through the Independent Choices Program if the person meets ICP eligibility criteria and is approved for ICP.

How does the CEP program work?

Under the Consumer-Employed Provider (CEP) program, the person receiving Medicaid in-home care is the consumer-employer of their homecare worker. For a spouse, ODHS names only two CEP options that allow payment: the Spousal Pay Program and the Independent Choices Program. Other relatives, such as an adult child, can be hired as the homecare worker if they meet the provider enrollment standards and the case manager approves.

What is the K Plan?

The K Plan is a Medicaid state plan option authorized under the Affordable Care Act that lets Oregon provide home and community-based services to people who need help with regular activities and want to stay at home or in a community setting. The federal option CMS describes in the same terms is Community First Choice, under Section 1915(k).

Is there respite in Oregon without Medicaid?

Yes. Oregon's Family Caregiver Support Program offers respite care to give caregivers a break when the person they care for is an adult at least 60 years old who needs in-home care, or someone of any age who has Alzheimer's disease and other related disorders. Call 1-855-673-2372 (OR-ADRC). Under the federal NFCSP that funds it, respite is available to a family caregiver only where the older person cared for is frail, meaning unable to perform at least two daily activities without substantial help, or needing substantial supervision for dangerous behavior from a cognitive or other mental impairment.

How do I reach my Area Agency on Aging in Oregon?

Call 1-855-673-2372 (OR-ADRC), the number ODHS gives for the Family Caregiver Support Program, or dial 211.

Resources

Aging and Disability Resource Connection (ADRC) of Oregon Help finding Family Caregiver Support Program respite, caregiver counseling, and your local Area Agency on Aging. 1-855-673-2372 adrcoforegon.org
ODHS Aging and People with Disabilities Runs Medicaid in-home care, the K Plan, and the Spousal Pay Program; ask for your local APD office. oregon.gov/odhs
Oregon Home Care Commission (OHCC) Provider resources, OHCC certifications, and the Provider Navigator Program for in-home care workers. oregon.gov/odhs
VA Caregiver Support Line Guidance on PCAFC, Veteran-Directed Care, and VA respite for Oregon veterans. 1-855-260-3274 caregiver.va.gov
Oregon Department of Veterans' Affairs County Veterans Service Officers file VA Aid and Attendance and pension claims at no cost. oregon.gov/odva
Eldercare Locator Connects you to your local Area Agency on Aging and aging services. 1-800-677-1116 eldercare.acl.gov

Learn More

CaregiverCaregiver Programs: The 50-State GuideA directory of caregiver programs in all 50 states: paid family caregiver pathways, respite, NFCSP grants, and VA benefits. Find your state's complete guide. CaregiverMedicaid Self-Direction and Consumer-Directed ServicesHow Medicaid self-direction lets a family member be your paid caregiver: employer authority, budget authority, the 1915(j) spouse rule, and how to get started. CaregiverThe National Family Caregiver Support Program (NFCSP): A Complete GuideWhat the National Family Caregiver Support Program funds, who is eligible, and how to reach respite and caregiver support through your Area Agency on Aging. 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. CaregiverRespite Care in OregonA 2026 guide to respite care in Oregon: NFCSP respite through local AAAs, VA respite, the Spousal Pay Program, and what to ask under the K Plan. CaregiverCaregiver Burnout: Signs, Stages, and How to Get SupportHow to recognize caregiver burnout, why it happens, and what actually helps, from respite care to evidence-based programs like REACH II and Powerful Tools. VA BenefitsVA Aid and Attendance in OregonVA Aid and Attendance in Oregon for 2026: who qualifies, pension ceilings up to $34,488 a year, how to apply, and free help from ODVA service officers. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house.
Your next step Find personalized help navigating Oregon caregiver programs 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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