What are the Independent Choices Program and K Plan?
Oregon offers Medicaid-funded, self-directed home care through two connected paths. The K Plan, formally the Community First Choice State Plan Option (a 1915(k) state plan benefit), is Oregon's entitlement for in-home personal care. Under the K Plan, an Oregon Health Plan member who needs a nursing-facility level of care can hire their own homecare worker through the Consumer-Employed Provider (CEP) program, and that worker can be an adult child, sibling, grandchild, other relative, or friend. Because it is a state plan entitlement, there is no waitlist for people who meet the eligibility rules.
The Independent Choices Program (ICP), governed by Oregon Administrative Rule 411-030-0100, is the cash-and-counseling option that sits alongside these services. Instead of the state paying a homecare worker directly, ICP gives the participant a monthly cash allowance, deposited into a dedicated ICP checking account, that they use to hire, train, schedule, and pay their own employee provider. The participant sets the pay (at least Oregon minimum wage), and up to a small portion of the budget can go toward approved goods and services that support independence.
A key reason Oregon stands out is spousal pay. Most states will not pay a husband or wife to be a caregiver, but Oregon has two ways it can happen: a spouse can be a paid employee provider under ICP (as long as they are not also serving as the participant's designated representative), and Oregon runs a separate Spousal Pay Program (OAR 411-030-0080) that pays a spouse directly as a homecare worker when the care recipient needs heavy daily care.
All three routes are administered by the Oregon Department of Human Services (ODHS), Aging and People with Disabilities (APD), working through local APD offices and Area Agencies on Aging (AAA). A case manager assesses the person's needs using the Client Assessment and Planning System (CAPS), authorizes hours or a budget, and the Oregon Home Care Commission sets the homecare worker wage scale through its union contract.
Oregon ICP and K Plan eligibility requirements
To use ICP or the K Plan, the person receiving care must qualify for Oregon Health Plan long-term care (OSIPM) and be assessed as needing a nursing-facility level of care. The caregiver does not have to meet income or asset limits; only the care recipient does. Figures below reflect 2026 limits and can change each year.
Who can - and cannot - be paid in Oregon
Oregon is more flexible than most states, and the spouse answer depends on which program you use. Under the K Plan (Consumer-Employed Provider) a spouse cannot be paid, but adult children and relatives can. Under ICP and the Spousal Pay Program, a spouse can be paid.
- Adult children (18 or older) of the care recipient
- Siblings, grandchildren, nieces, nephews, aunts, uncles, and in-laws
- Other relatives and close friends or neighbors, if 18 or older
- A spouse - through the Independent Choices Program (if not the designated representative)
- A spouse - through Oregon's separate Spousal Pay Program, when the care recipient needs full help with at least 4 of 6 ADLs
- A parent of an adult child (the person receiving care is 18 or older)
- A spouse paid through the K Plan / Consumer-Employed Provider program (use ICP or Spousal Pay instead)
- The care recipient's legal guardian, as a paid provider
- A designated representative who is also acting as the paid provider under ICP (one person cannot fill both roles)
- Anyone under 18, or anyone who does not pass the required background check
Oregon caregiver pay, hours, and overtime
Oregon has one of the higher homecare worker wage scales in the country, set by the Oregon Home Care Commission through its SEIU Local 503 contract. The number of hours (or the size of an ICP cash budget) depends on the CAPS assessment of the person's needs.
Hourly pay
Under the 2025-2027 Oregon Home Care Commission contract, homecare and personal support workers earn on a step scale that, effective the first pay period of January 2026, runs from about $21.25 per hour at the base step to about $25.25 per hour at the top step. A further raise on January 1, 2027 brings a majority of workers to at least $25 per hour. Homecare workers are W-2 employees with taxes withheld, and eligible providers can receive mileage reimbursement, paid time off, and health coverage. Under ICP the participant sets the wage from their monthly cash allowance and must pay at least Oregon minimum wage; the allowance is calculated from assessed task hours at department rates and includes the employer share of payroll taxes.
Hours and scheduling
Authorized hours come from the CAPS assessment and vary widely with the person's ADL and IADL needs, from a handful of hours a week up to substantial monthly hours for those with high needs. A person can split hours across more than one worker (for example, two adult children sharing the week). Under the Spousal Pay Program specifically, the paid spouse receives all of the assessed hours for certain ADLs plus one-half of the assessed IADL hours.
Overtime rules
Federal Fair Labor Standards Act overtime applies to Oregon homecare workers: hours over 40 in a workweek are generally paid at 1.5x. ODHS also sets weekly hour limits and requires prior authorization for any overtime, and there are caps on the total hours a single homecare worker can be paid across all the people they serve. Many families schedule more than one worker to stay within limits and avoid unpaid overtime.
How to apply for ICP or the K Plan in Oregon
- Contact your local Aging and People with Disabilities (APD) office or Area Agency on Aging (AAA). You can find your local office and start the process through the Aging and Disability Resource Connection (ADRC) of Oregon at 1-855-673-2372 or adrcoforegon.org.
- Apply for Oregon Health Plan long-term care (OSIPM). If the person is not already enrolled, apply through benefits.oregon.gov or by calling 1-800-699-9075. Gather proof of Oregon residency, identification, Social Security number, and income and asset documentation.
- Complete a CAPS needs assessment with an APD or AAA case manager.
- The case manager evaluates help needed with ADLs (bathing, dressing, toileting, eating, mobility) and IADLs
- They confirm a nursing-facility level of care and assign a service priority level
- They authorize monthly care hours (K Plan) or calculate a monthly cash allowance (ICP)
- Choose your path with the case manager: hire a homecare worker through the Consumer-Employed Provider program (K Plan), enroll in the Independent Choices Program for a self-directed cash budget, or, for a qualifying husband or wife, apply for the Spousal Pay Program.
- Enroll and onboard your caregiver.
- The caregiver completes an ODHS background check (OAR 407-007)
- K Plan and Spousal Pay workers enroll as homecare workers with the Oregon Home Care Commission and complete required orientation
- ICP participants set up the ICP checking account and, if needed, arrange a fiscal intermediary to handle payroll and taxes
- Track hours and get paid. Homecare workers record time through Electronic Visit Verification (EVV) and are paid on the state homecare payroll schedule; ICP participants pay their provider from the cash allowance and keep records for the case manager's budget review, which happens about every six months.
Oregon Independent Choices and K Plan frequently asked questions
Can my spouse be paid to care for me in Oregon?
Yes, and this is what makes Oregon unusual. Most states will not pay a husband or wife, but Oregon offers two ways. First, a spouse can be a paid employee provider under the Independent Choices Program (ICP), which gives you a monthly cash budget to hire and pay your own caregiver; the one restriction is that the spouse cannot also be your designated representative. Second, Oregon runs a separate Spousal Pay Program (OAR 411-030-0080) that pays a spouse directly as a homecare worker, but only when you need heavy daily care, specifically full assistance with at least four of the six activities of daily living and a nursing-facility level of care while living together at home. One route that does NOT pay spouses is the standard K Plan Consumer-Employed Provider program, so if you want a spouse paid, use ICP or the Spousal Pay Program instead.
How much do Oregon caregivers get paid in 2026?
Oregon has one of the higher homecare wage scales in the country. Under the 2025-2027 Oregon Home Care Commission contract, homecare and personal support workers are on a step scale that, as of the first pay period in January 2026, runs from roughly $21.25 per hour at the base step to about $25.25 per hour at the top step, with experience-based steps in between. A further raise on January 1, 2027 pushes a majority of workers to at least $25 per hour. Workers are W-2 employees with taxes withheld, and eligible providers can receive mileage reimbursement and paid time off. Under the Independent Choices Program the model is different: you receive a monthly cash allowance and you set your caregiver's wage, which must be at least Oregon minimum wage, from that budget.
How long does it take to get approved in Oregon?
Plan for up to about three months from start to finish, though it can be faster or slower depending on your situation. The main steps are confirming Oregon Health Plan (OSIPM) eligibility, completing the CAPS needs assessment with an APD or AAA case manager, and enrolling your caregiver. If the person is not yet on Oregon Health Plan long-term care, the Medicaid application itself can add time, so start it early. Because the K Plan (Community First Choice) is a state plan entitlement, there is no waitlist once you qualify. You can speed things up by gathering documents in advance: proof of Oregon residency, identification, Social Security number, and detailed income and asset records. The caregiver should also start their background check paperwork as soon as possible, since provider enrollment can run in parallel.
What training or certification does the caregiver need?
No nursing license or CNA certification is required to be an Oregon homecare worker or an ICP employee provider. The core requirements are that the caregiver be at least 18, be physically and mentally capable of doing the assigned tasks, and pass an ODHS background check under OAR 407-007. Homecare workers hired through the Consumer-Employed Provider program (including K Plan and Spousal Pay workers) enroll with the Oregon Home Care Commission and complete a basic orientation, and there is an optional Professional Development Certification that pays a wage differential for providers who complete extra training. Under the Independent Choices Program, you as the participant (or your designated representative) train your own provider on exactly the tasks you need, so there is no separate skills exam. This makes both programs accessible to family members who have already been providing care informally.
What is the difference between the Independent Choices Program and the K Plan?
They are two ways to get the same goal, paid in-home care, but the mechanics differ. The K Plan (Community First Choice) has the state pay your chosen homecare worker directly through the Consumer-Employed Provider program at the Home Care Commission wage scale; you choose and supervise the worker, and the state handles payroll. The Independent Choices Program (ICP) is a cash-and-counseling model: instead of the state paying a worker, you receive a monthly cash allowance in a dedicated ICP checking account and you hire, set the pay for, and pay your own provider, with more flexibility (including the ability to pay a spouse and to spend a small share on approved supports). ICP requires you to handle or arrange payroll and taxes, sometimes through a fiscal intermediary. Many families start on the K Plan and consider ICP if they want more control.
Can an adult child or other relative be paid?
Yes. Oregon allows adult children, siblings, grandchildren, nieces, nephews, aunts, uncles, in-laws, and other relatives to be hired and paid, as well as close friends and neighbors, as long as the person is at least 18 and passes the background check. Under the K Plan, the relative enrolls as a homecare worker through the Consumer-Employed Provider program and is paid by the state at the Home Care Commission wage scale. Under the Independent Choices Program, you hire the relative directly and pay them from your monthly cash allowance. A parent can also be paid to care for an adult child who is the Medicaid recipient. The only close relationship with restrictions is a spouse, who cannot be paid through the standard K Plan but can be paid through ICP or the separate Spousal Pay Program.
Who runs these programs and who is my case manager?
All of these programs are run by the Oregon Department of Human Services (ODHS), Aging and People with Disabilities (APD). Your day-to-day contact is a case manager at your local APD office or Area Agency on Aging (AAA). The case manager completes your CAPS assessment, decides your service priority level, authorizes your hours or calculates your ICP cash allowance, and reviews your plan periodically (about every six months for ICP budgets). The Oregon Home Care Commission sets the homecare worker wage scale and benefits through its union contract and maintains a registry of workers. For the Independent Choices Program, a contracted fiscal intermediary can help manage payroll, taxes, and Electronic Visit Verification. To get started or find your local office, contact the Aging and Disability Resource Connection (ADRC) of Oregon at 1-855-673-2372.
Does getting paid as a caregiver affect the care recipient's other benefits?
Enrolling in ICP or the K Plan does not reduce the care recipient's other Oregon Health Plan benefits, such as doctor visits, hospital care, prescriptions, and medical equipment; in-home personal care sits alongside the rest of the Medicaid package. What families should watch is the caregiver's own situation. Wages paid to a family caregiver are taxable income and could affect the caregiver's eligibility for income-tested benefits like SNAP. There is a narrow federal tax exception: payments to a caregiver who lives in the same home as the Medicaid recipient can sometimes be excluded from income under IRS difficulty-of-care rules, but the specifics depend on your circumstances. It is worth confirming details with your case manager and, if the amounts are significant, a tax professional, before you assume how a paycheck will interact with other benefits.
See also: Oregon caregiver guide
For all the ways to get paid to care for a family member in Oregon — including Independent Choices, VA programs, long-term care insurance, and more — read the full Oregon guide.