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.Public.Law. (n.d.). OAR 411-030-0080 – Spousal Pay Program. oregon.public.law. Retrieved Jun 3, 2026, from https://oregon.public.law/rules/oar_411-030-0080
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
| Program | What It Offers | Who Qualifies | Cost to You |
|---|---|---|---|
| Spousal Pay Program | Pays a spouse to provide care | Recipient needs full help in 4+ of 6 ADLs, lives at home with spouse | Free (paid by Medicaid) |
| K Plan / CEP self-direction | Family or friend hired as paid homecare worker | Medicaid in-home services recipients | Free (paid by Medicaid) |
| NFCSP respite grants (OFCSP) | Free in-home respite, adult day vouchers, training, counseling | Caregivers of adults 60+ or person with ADRD; no income test | Free |
| VA PCAFC | Monthly stipend that can pay a spouse | Veteran with 70%+ disability rating in VA health care | Free (VA benefit) |
| VA Aid and Attendance | Pension to the veteran; caregiver paid from it | Wartime veteran or surviving spouse under net-worth limit | Free to apply (VSO help) |
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.State of Oregon. (n.d.). PSW, HCW and PCA. oregon.gov. Retrieved Jun 3, 2026, from https://www.oregon.gov/odhs/providers-partners/homecare-workforce/pages/default.aspx
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.State of Oregon. (n.d.). APD Providers and Partners. oregon.gov. Retrieved Jun 3, 2026, from https://www.oregon.gov/odhs/providers-partners/seniors-disabilities/pages/waivers-kplan.aspx
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.secure.sos.state.or.us. (n.d.). OAR 411-030-0080 - Oregon Home Care Program / Spousal Pay. Retrieved Jul 13, 2026, from https://secure.sos.state.or.us/oard/view.action?ruleNumber=411-030-0080
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.Public.Law. (n.d.). OAR 411-030-0080 – Spousal Pay Program. oregon.public.law. Retrieved Jun 3, 2026, from https://oregon.public.law/rules/oar_411-030-0080 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.Public.Law. (n.d.). OAR 411-030-0080 – Spousal Pay Program. oregon.public.law. Retrieved Jun 3, 2026, from https://oregon.public.law/rules/oar_411-030-0080
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.Administration for Community Living. (n.d.). National Family Caregiver Support Program. acl.gov. Retrieved Jun 3, 2026, from https://acl.gov/programs/support-caregivers/national-family-caregiver-support-program
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).Administration for Community Living. (n.d.). National Family Caregiver Support Program. acl.gov. Retrieved Jun 23, 2026, from https://acl.gov/programs/support-caregivers/national-family-caregiver-support-program,State of Oregon. (n.d.). Community Services and Supports. oregon.gov. Retrieved Jun 3, 2026, from https://www.oregon.gov/odhs/providers-partners/community-services-supports/pages/family-caregiver-program.aspx
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.State of Oregon. (n.d.). Community Services and Supports. oregon.gov. Retrieved Jul 13, 2026, from https://www.oregon.gov/odhs/providers-partners/community-services-supports/pages/opi.aspx
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. The stipend is calculated from the federal General Schedule (GS) grade-4, step-1 annual rate for the veteran's locality, divided by 12, then multiplied by a level factor (0.625 or 1.00). 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.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
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.U.S. Department of Veterans Affairs. (n.d.). Veteran-Directed Care - Geriatrics and Extended Care. va.gov. Retrieved Jun 3, 2026, from https://www.va.gov/geriatrics/pages/Veteran-Directed_Care.asp
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. In 2026, a single veteran with Aid and Attendance receives up to $2,424 per month ($29,093 per year); a veteran with one dependent up to $2,874 per month. The pension goes to the veteran, who typically pays a family caregiver from it.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Jun 24, 2026, from https://www.va.gov/pension/veterans-pension-rates/
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.Internal Revenue Service. (n.d.). Certain Medicaid waiver payments may be excludable from income. irs.gov. Retrieved Jun 3, 2026, from https://www.irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
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.U.S. Government Publishing Office. (2023). 42 U.S.C. 1396p - U.S. Code (govinfo.gov, official). govinfo.gov. Retrieved Jul 13, 2026, from https://www.govinfo.gov/content/pkg/USCODE-2023-title42/html/USCODE-2023-title42-chap7-subchapXIX-sec1396p.htm
Frequently Asked Questions
Can I get paid to care for my spouse in Oregon?
Yes, through the Spousal Pay Program (OAR 411-030-0080), one of the few state Medicaid pathways that pays a spouse. The care recipient must need full assistance in at least four of six activities of daily living, have a medically diagnosed debilitating condition, and live at home with the spouse. The spouse enrolls as a homecare worker through the Oregon Home Care Commission.Public.Law. (n.d.). OAR 411-030-0080 – Spousal Pay Program. oregon.public.law. Retrieved Jun 3, 2026, from https://oregon.public.law/rules/oar_411-030-0080
Who else can be a paid caregiver in Oregon?
Under the Consumer-Employed Provider (CEP) program, friends and family members aged 18 or older, including adult children, siblings, other relatives, and friends, can be hired and paid as the homecare worker, with the care recipient as the employer. A spouse uses the separate Spousal Pay Program instead.secure.sos.state.or.us. (n.d.). OAR 411-030-0080 - Oregon Home Care Program / Spousal Pay. Retrieved Jul 13, 2026, from https://secure.sos.state.or.us/oard/view.action?ruleNumber=411-030-0080
What is the K Plan?
The K Plan is Oregon's Community First Choice option, a Medicaid state plan benefit under Section 1915(k) that funds in-home personal care. As a state plan entitlement, there is no waitlist for eligible participants.State of Oregon. (n.d.). APD Providers and Partners. oregon.gov. Retrieved Jun 3, 2026, from https://www.oregon.gov/odhs/providers-partners/seniors-disabilities/pages/waivers-kplan.aspx
Is there free respite in Oregon without Medicaid?
Yes. The Oregon Family Caregiver Support Program, the state's NFCSP implementation, provides free respite through Area Agencies on Aging with no income test. Call 1-855-673-2372 (OR-ADRC).Administration for Community Living. (n.d.). National Family Caregiver Support Program. acl.gov. Retrieved Jun 23, 2026, from https://acl.gov/programs/support-caregivers/national-family-caregiver-support-program
How do I reach my Area Agency on Aging in Oregon?
Call 1-855-673-2372 (OR-ADRC), Oregon's statewide connection to NFCSP/OFCSP respite, caregiver counseling, and local resources, or dial 211.State of Oregon. (n.d.). Community Services and Supports. oregon.gov. Retrieved Jun 3, 2026, from https://www.oregon.gov/odhs/providers-partners/community-services-supports/pages/family-caregiver-program.aspx
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.