Medicaid self-directed care
Consumer Employer Program
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- Who qualifies
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People who have Medicaid long-term services and supports, Oregon Project Independence (OPI) or OPI-M. Whether you qualify for Medicaid depends on your income, financial resources and how much help you need at home. You hire and manage your in-home workers, and the program pays them directly.
You must be able to hire, train, schedule and supervise a homecare worker yourself, or name a representative to do it (OAR 411-030-0040).
Source: Home Care Services (Oregon Department of Human Services)Checked
- Can a family member be paid
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Yes. Yes. You can be paid as a homecare worker to support a family member or friend who is an older adult or a person with a disability.
A spouse is paid only through the Spousal Pay Program: see the next answer. A representative who acts as the employer for the person cannot also be their paid caregiver (OAR 411-030-0040).
Source: Homecare Workers: Frequently Asked Questions (Oregon Department of Human Services, August 16, 2024)Checked
- Can a spouse be paid
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Depends. Only through the Spousal Pay Program, when all its conditions are met: the person qualifies for in-home services, needs full assistance in at least four of six activities of daily living, has a debilitating medical condition (such as late stage cancer, coma, severe neuropathy, frequent and unpredictable seizures, or a spinal cord injury with permanent impairment), and would otherwise need nursing facility services; the care needed exceeds what one spouse usually gives another; and the spouse is able to give, and actually gives, most of the authorized hours, enrolls as a homecare worker, and is not the person's representative. The Department must approve it at enrollment and every year.
The spouse's paid hours are half of the assessed hours for instrumental activities of daily living and all of the hours for specific activities of daily living, paid at hourly homecare worker rates (OAR 411-030-0080). A homecare worker who later marries their consumer-employer is not paid under the Spousal Pay Program and does not need to meet its criteria; their hours follow the person's assessed needs.