Oregon licenses in-home care agencies through the Oregon Health Authority (OHA) under OAR 333-536, and licenses home health agencies separately. Medicaid in-home care for older adults and people with physical disabilities is authorized by the Oregon Department of Human Services (ODHS) and paid straight to enrolled agencies through the state's claims system, at $40.40 an hour since July 1, 2026. Agencies with a Medicaid census of at least 20% must report their caregivers' average hourly base pay by November 30, 2026.
Red means act now, amber means read it this month, grey is for the record.
In-home agencies enrolled in Medicaid whose Medicaid census is at least 20% must report the average hourly base pay of their direct caregivers as of August 30, 2026. The Legislature asked for this data. ODHS may limit an agency's ability to serve Medicaid clients if it does not respond.
The Legislature passed a cost-of-living increase for in-home care agencies and other community providers. The contracted in-home care agency rate went from $39.40 to $40.40 an hour for July 1, 2026 to June 30, 2027.
ODHS added Agency with Choice as a new Medicaid in-home option. The provider, GT Independence, co-employs caregivers the client picks and handles hiring paperwork, background checks, payroll and training. Case managers are asked to describe it to people who have no caregiver or who are not using all their authorized hours. It is open only to people on certain benefit plans (not Oregon Project Independence). In-home care agencies remain an option.
Senate Bill 537 led to new rules for home health agencies. From May 1, 2026, each agency needs a workforce violence prevention program: safety risk questions at intake, annual safety training, quarterly safety assessments, a way for staff to do safety checks, and a flagging system for potential threats.
The most-cited items in the first half of 2026 were client records, caregiver orientation, service plans, caregiver training and medication administration. OHA also warns that agencies cannot refuse or reschedule a survey, and that training logged in a single day must be backed by payroll showing the full hours.
Dates taken from the rules and notices as we read them.
Medicaid in-home agencies with a Medicaid census of at least 20% report caregivers' average hourly base pay as of Aug. 30, 2026.
The OHA application form marks renewal "Due 12/1" and says to file at least 30 days before the license expires.
The 1915(c) Aged and Physically Disabled Waiver and the 1915(b)(4) waiver would run Jan. 1, 2027 to Dec. 31, 2031.
Every state follows the same outline, so you always know where to look. Open a section for the detail.
Sometimes two official documents say different things. Here is what we went with, why, and what each document says, so you can judge for yourself.
The OHA fact sheet (July 2021) describes the rule as it was revised in 2021, when 6 of the 8 hours could be finished within 120 days of hire. The rules were revised again effective October 23, 2023 (OHA applicant FAQ). The newer OHA training memo (revised June 2024) quotes the current rule text: training must be finished before a caregiver works independently. OHA's 2026 survey citations also refer to the caregiver training rule as "rev. 10.2023".
Every answer was written and checked ahead of time, with the official document next to it. Nothing is made up on the spot.
Yes, if you provide personal care.
You need an in-home care agency license from OHA if you provide in-home care services and also schedule caregivers, assign work or pay rates, set working conditions, negotiate for a caregiver or client, or place a caregiver with a client. You do not need one if you only provide housekeeping and supportive services such as laundry, shopping and errands. Referral or matching services are exempt unless they do one of those things. A caregiver registry, which keeps a list of private contractor caregivers for clients, needs its own OHA license. OHA's determination form can help you decide.
About six to nine months.
OHA says initial applications take six to nine months, and 50 were waiting in July 2026. All initial applications go through the online portal (hflclicensing.oregon.gov) since May 12, 2025. After you pass the initial survey, the license is issued within ten business days, and you may not accept clients before that.
$2,000 to $3,000 to start; $1,000 to $1,500 a year.
The initial fee depends on the class: $2,000 Limited, $2,250 Basic, $2,500 Intermediate and $3,000 Comprehensive. Yearly renewal is $1,000 for Limited or Basic, $1,250 for Intermediate and $1,500 for Comprehensive. Subunits cost $1,250 to start and $1,000 a year, and an ownership change is $350.
4 hours of orientation plus 8 hours of training.
OAR 333-536-0070 requires at least 4 hours of agency orientation and 8 hours of caregiver training, with a documented competency evaluation, before a caregiver works independently. Caregivers who give medication services need at least 4 more hours of medication training and a return demonstration checked by a qualified individual. Caregivers with a current Oregon health care license or certificate can be exempt from the caregiver training, but not from medication training. Every year, caregivers need 6 hours of continuing education plus 1 hour on medication services.
Basic or higher for assistance.
Every class can provide medication reminding. Medication assistance needs a Basic, Intermediate or Comprehensive license. Medication administration, including moving medicine from its original container into a secondary container, needs Intermediate or Comprehensive and an RN review every 90 days. Injectable medications and nursing services need a Comprehensive license.
Yes, with a Comprehensive license and Medicaid enrollment.
To be paid by ODHS you need a Comprehensive-class OHA license, a Medicaid provider number, current business registration and a Medicaid Provider Enrollment Agreement. Local offices rotate referrals among enrolled agencies when a client has no preference. You must decline a client whose needs you cannot meet, but you may not turn someone away only because they are on Medicaid.
$40.40 an hour from July 1, 2026.
The contracted in-home care agency rate is $40.40 an hour for July 1, 2026 to June 30, 2027, up from $39.40. You can bill up to three hours at the care rate for the required initial assessment (code T2024), and mileage for community transportation tied to an assessed need.
Any system that meets the rule; you report monthly.
OAR 411-033-0030 requires in-home care agencies to use an EVV system that records the service, client, date, location, worker and start and end times. The rule does not name a state system. Each month you must send ODHS a report of those visits and an attestation that all claims met EVV rules. Home health agencies pick their own vendor and report monthly to OHA.
Before hire, for anyone with client contact.
Agencies must check anyone with direct client contact before hiring them or letting them volunteer. People convicted of the crimes listed under ORS 443.004 may not be hired. Agencies paid by Medicaid must use the ODHS Background Check Unit (BCU), and BCU checks are redone every three years. A new hire can start before the check is final only with no direct client contact and active supervision.
No.
OHA, ODHS and the Oregon Home Care Commission told in-home agencies in October 2023 that requiring caregivers to sign non-competition agreements violates ORS 653.295, and the agreements are void. Clients on Medicaid can choose their own providers, including former agency caregivers working as homecare workers.
The official link for each document. Our own dated copies will sit next to them, so a document is still here when a state moves its website.
69 documents — showing the newest 25