Updated September 4, 2026. Quick answer: yes, through Consumer-Employed Provider (CEP) Program, including the Spousal Pay (SP) and Independent Choices (ICP) Programs. Most adult family members can be hired and paid to provide the care. A spouse can also be the paid caregiver.
How Oregon pays a family caregiver
| Program | Consumer-Employed Provider (CEP) Program, including the Spousal Pay (SP) and Independent Choices (ICP) Programs |
|---|---|
| Can a family member be paid? | Yes. “unless that person is a paid provider, even if the provider is a family member (OAR 411–028–0000(13))” |
| Can a spouse be paid? | Yes. “The SP Program and the Independent Choices Program (ICP) are the only CEP in-home service options allowing payment to a spouse provider (OAR 411–027–0020(5)).” |
Why the spouse question is different
Federal Medicaid rule treats a spouse (and a parent paying for a minor child) as a “legally responsible relative”, someone already assumed to owe the care for free, so paying them is barred by default. A state has to build an explicit exception into its waiver or state-plan option to pay a spouse at all; the rule for any other relative (an adult child, a sibling, a grandchild) is looser and usually allowed. That is why the two rows above can carry different answers on the same page.
The going rate
$21.25 to $25.25/hour (Step 1 to Step 5), effective Jan. 1, 2026. “Providers will receive a $1.25 hourly rate increase for hours worked beginning with the first pay period after Jan. 1, 2026. Step 1 Jan. 1, 2026 Hourly rate $21.25. Step 5 Jan. 1, 2026 Hourly rate $25.25”
How it works
Oregon’s Aging and People with Disabilities division administers in-home Medicaid personal care through the Consumer-Employed Provider (CEP) program, under which the participant is the common-law employer of a directly hired Homecare Worker, including relatives generally. A spouse can be paid specifically through the Spousal Pay Program (or Independent Choices Program), which requires full assistance in at least four of six ADLs plus a documented debilitating medical condition; Central Office must review and approve the plan, spouse hours are capped at 60/week, and the spouse’s IADL hours are automatically halved because household duties are considered shared.
What this doesn’t answer
The comparison-of-roles document confirms family members generally can be paid Homecare Workers but does not itemize which relatives qualify, citing program rules rather than restating them. The wage rate cited is the general Homecare Worker/PCA/Spousal Pay collective-bargaining scale; the guide confirms Spousal Pay providers are paid as HCWs under this scale but a Spousal-Pay-specific rate line was not separately located.
Sources
- Oregon DHS, Aging and People with Disabilities: Spousal Pay Program Guide and FAQ (updated April 17, 2026)
- Oregon DHS APD: Comparison of In-Home Service Plan Assistance Types and Roles (updated April 18, 2026)
- Oregon Home Care Commission: 2025–2027 Collective Bargaining Agreement summary (SEIU Local 503)
Read September 4, 2026.
Same question, other states: Pennsylvania · Rhode Island.
Related: the private-pay caregiver-agreement rule · the household-employee tax rules once you’re being paid · what family caregiving actually costs unpaid.
General information drawn from each state’s own Medicaid agency and public program materials, not legal, tax or financial advice. Medicaid self-direction programs are administered state by state and change by budget cycle and waiver renewal; this page cannot see your own state’s current program status or your family’s eligibility. We are not a law firm, a benefits counselor, or a fiduciary, and this is not personalized advice. We sell nothing on this page and earn nothing from it.