Oregon IHSS: K Plan Eligibility, Caregiver Pay, and How to Apply

Oregon does not run a program called IHSS, but it has a direct equivalent: the K Plan, Oregon’s version of California’s In-Home Supportive Services. Funded through Medicaid under the Oregon Health Plan, the K Plan pays a caregiver, which can be a family member, to help you with daily tasks at home instead of moving into a nursing facility. To qualify, you have to meet both financial limits and a functional test showing you need nursing-facility-level help.

The formal name is the Community First Choice Option. The Oregon Department of Human Services administers it through its Aging and People with Disabilities (APD) offices for seniors and adults with physical disabilities. A parallel K Plan track exists for people with intellectual and developmental disabilities, run through local Community Developmental Disability Programs with its own intake; if that applies to you or your family member, start there rather than at an APD office.

Who Qualifies for the K Plan

Income and Assets

You must be on the Oregon Health Plan. For long-term care programs like the K Plan, Oregon sets the income ceiling at 300% of the SSI federal benefit rate.¹ With the 2025 SSI rate at $967 a month, that puts the monthly income cap at $2,901.² The figure adjusts every January with the cost-of-living increase.

A single applicant can hold no more than $2,000 in countable assets. If you’re married and only one spouse is applying, the applicant is still capped at $2,000, but the other spouse can keep up to $162,660 in 2026. Your home and one vehicle are generally not counted. Bank accounts, investments, and some retirement funds are.

Nursing-Facility Level of Care

Money is only half of it. You also have to need what Oregon calls a nursing facility level of care. In practice, that means a case manager scores your ability to handle Activities of Daily Living: eating, bathing and personal hygiene, dressing and grooming, mobility, toileting, and cognitive function.³

Each activity gets a rating. An “assist” means you need hands-on help, verbal cues, or someone standing by at least four days per month. A “full assist” means you can’t complete the task at all without someone doing it for you, every time.⁴ Your combined scores determine whether you clear the nursing-facility threshold.

Instrumental activities such as meal preparation, housekeeping, and medication management factor into your service plan once you qualify, but needing help only with those won’t get you in. The gate is persistent need with core personal care.

How to Apply

Start by contacting your local Aging and People with Disabilities office or the Area Agency on Aging in your county. The main application is form SDS 0539A.⁵

Pull these together before you file:

Medical records from the past year, with contact information for your primary care doctor and any specialists, and current diagnoses.
Financial documents: bank statements, retirement account balances, property records, and proof of income such as Social Security or pension payments.
Identification: birth certificate, passport, or other government-issued ID.

When you describe your daily difficulties on the application, be concrete. “Needs help around the house” gives the assessor almost nothing. “Cannot get in or out of the bathtub without someone physically lifting her legs,” or “forgets medications and has been hospitalized twice because of missed doses,” gives them something to work with before anyone comes to the house.

What Happens at the In-Home Assessment

After you apply, a case manager or personal agent schedules a visit. This is where your actual service hours are decided, so it matters more than the paperwork.

The assessor walks through your home and watches how you move, how you manage balance, how aware you are of your surroundings, and how safely you handle daily routines. They score each ADL using a standardized tool, then build a person-centered service plan that reflects both the scores and your own goals.⁶ Those scores convert through state formulas into a specific monthly hour allotment. Someone who needs help only with bathing and dressing may get a few hours a week. Someone who needs full help with mobility, eating, and toileting can approach full-time care.

You’ll get a written notice listing your approved hours, the tasks your caregiver is authorized to perform, and your appeal rights. If the hours look too low for what you actually live with, don’t just accept the number. The assessment is a single snapshot, and assessors sometimes underestimate how long real tasks take or miss needs that weren’t visible during the visit.

What the K Plan Pays For

The core of the program is personal care tied to your ADL needs: bathing, dressing, grooming, help with eating, toileting, mobility, and supervision for cognitive impairments. Your caregiver can also handle authorized instrumental tasks like cooking, cleaning, laundry, grocery shopping, and medication reminders.

The K Plan also covers ancillary services under OAR Chapter 411, Division 035:⁷

Assistive technology such as medical alert systems and adaptive devices.
Environmental modifications like grab bars, wheelchair ramps, or widened doorways.
Chore services for heavy cleaning or maintenance, handled separately from your home care worker’s duties.
Transition services for people moving out of a nursing facility or the Oregon State Hospital back into the community.

Hiring a Caregiver, Including a Family Member

Once your plan is approved, you pick how to receive the care.

Hiring Your Own Worker

Most K Plan participants use the Consumer-Employed Provider model, which gives you the most control. You hire the home care worker directly, and that worker is often a family member, friend, or someone you find through the state’s registry. On paper the worker is your employee, but the state handles payroll, taxes, and workers’ compensation, so you aren’t running a business.⁸ You set the schedule, direct the work, and make sure the service plan is followed.

Every home care worker has to pass a criminal background check and an abuse check under OAR Chapter 407, Division 007 before starting, and complete orientation and safety training.⁹ If a background check turns up a potentially disqualifying offense, you as the employer can still choose to hire that person; the state doesn’t automatically bar them in this model.

Using an Agency

If you’d rather not manage a worker, go through a private home care agency. The agency hires, trains, schedules, and screens its own staff. You lose some say in who shows up, but you also drop the employer role. This often fits people who don’t have a family member available or who simply don’t want to supervise anyone.

The State Registry

The Oregon Home Care Commission runs a Registry and Referral System that matches you with qualified workers based on language, schedule, location, and the kind of tasks you need. Workers have to update their availability every 60 days to stay on the referral list.¹⁰ You can reach it online through the OHCC website.

What Home Care Workers Earn in 2026

Oregon’s home care worker wages are set through a collective bargaining agreement between the state and the workers’ union. Pay runs on a step system tied to total hours worked since January 1, 2023. As of January 2026:¹¹

Step 1, under 2,000 hours: $21.25 per hour
Step 2, 2,000 to 3,999 hours: $22.25 per hour
Step 3, 4,000 to 5,999 hours: $23.25 per hour
Step 4, 6,000 to 7,999 hours: $24.25 per hour
Step 5, 8,000 or more hours: $25.25 per hour

These rates reflect a $1.25 per hour increase that took effect in the first pay period after January 1, 2026. Workers may earn additional differentials on top. Private-pay home health aides in Oregon typically run $30 or more per hour, so a qualifying family is paying nothing for a service that would otherwise be out of reach.

Tax Break for Caregivers Who Live With the Person They Care For

If you’re the caregiver and you live in the same home as the person you care for, your K Plan wages may be fully excluded from federal income tax. Under IRS Notice 2014-7, Medicaid waiver payments for home and community-based services qualify as “difficulty of care” payments that are not taxable as gross income, but only when the caregiver and care recipient share the same home.¹²

The home has to genuinely be yours too. If you keep a separate residence and travel to the care recipient’s home to work, the exclusion doesn’t apply. If you share meals, holidays, and daily life in one household, it does, even if more than one caregiver in that home is receiving Medicaid waiver payments.¹²

On a W-2, the nontaxable amount should show in Box 12 with Code II, and you subtract it on Schedule 1, line 8s of your Form 1040. On a 1099, report the full amount and back out the excludable portion on Schedule 1. Caregivers miss this all the time and overpay for years. Flag it with your tax preparer.

Annual Reviews and Mid-Year Changes

The state reassesses your level of care at least once a year to confirm you still meet nursing-facility criteria and to adjust your plan.⁶ Your case manager conducts a new functional assessment, talks through any changes in your condition and goals, and updates your hours.

Oregon waives the annual reassessment for some people, including those with profound intellectual disabilities, advanced progressive cognitive conditions like late-stage dementia, and permanent physical disabilities with no possibility of improvement. In those cases your case manager can set a different review schedule.⁶

If your condition gets worse between annual reviews, call your case manager and ask for a reassessment. There’s no reason to wait and go without hours you need now.

Appealing a Decision You Disagree With

You can request an administrative hearing if your services are denied, reduced, suspended, or terminated. You can also request one if more than 90 days have passed since you applied and you still don’t have a decision.¹³

A hearings representative is assigned as your contact and schedules an informal phone call first, which sometimes resolves the issue. If it doesn’t, a formal hearing goes through the Office of Administrative Hearings and is held by phone unless you ask to appear in person. An Administrative Law Judge issues a Final Order by mail. If you still disagree, you can appeal to Marion County Circuit Court, and the Final Order itself explains how.

If your services are being cut while you appeal, ask for continuing benefits as early as you can. In many cases you can keep your current hours in place while the appeal is pending, though you may have to repay the difference if you ultimately lose.

1
Federal Register. Medicaid Program; Community First Choice Option
2
Social Security Administration. Understanding Supplemental Security Income SSI Benefits
3
Oregon Department of Human Services. Oregon Administrative Rules Chapter 411 Division 035 – K-State Plan Ancillary Services
4
Legal Information Institute. Oregon Admin Code 411-015-0006 – Activities of Daily Living (ADL)
5
Oregon Department of Human Services. Oregon Department of Human Services Application for Benefits
6
Medicaid.gov. Oregon Community First Choice Option State Plan Amendment Summary
7
Oregon Department of Human Services. K Plan Ancillary Services Guidance
8
Oregon Secretary of State. Oregon Administrative Rules Chapter 411 Division 030 – In-Home Services
9
Oregon Department of Human Services. Oregon Administrative Rules 411-030 – In-Home Services
10
Oregon Department of Human Services. Registry and Referral System
11
Oregon Department of Human Services. 2025-2027 Collective Bargaining Agreement
12
Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income
13
Oregon Department of Human Services. Administrative Hearings for I/DD Services