Oregon · state plan
Spousal Pay Program in Oregon
Oregon's Spousal Pay Program lets a spouse be paid as the homecare worker for a husband or wife who has very high care needs. The spouse enrolls as a homecare worker and is paid the state homecare worker hourly rate for authorized hours. Each case is reviewed and approved by ODHS Central Office.
Also called: Spousal Pay · SP program · Oregon spousal pay · pay spouse caregiver Oregon
Who do you care for?
Quick facts
- Pay
- $21.25–$25.25/hr
- Adult children & other relatives
- this option is only for spouses; other relatives use the Consumer-Employed Provider program or ICP.
- Spouse
- Yes
- Parent of a minor child
- Not right now
- Waitlist
- none
Who qualifies for Spousal Pay Program
- Eligible for Oregon Medicaid in-home services and would otherwise need nursing-facility care.
- Needs full assistance in at least four of the six activities of daily living.
- Has a debilitating medical condition such as late-stage cancer, coma, cachexia, frequent unpredictable seizures, stage 3–4 wounds, or a spinal cord injury.
- Needs care beyond what one spouse usually gives another, and ODHS Central Office approves enrollment (again at each annual review).
Who can be paid as the caregiver
- Adult children & other relatives
- this option is only for spouses; other relatives use the Consumer-Employed Provider program or ICP.
- Spouse Yes
- the spouse must meet homecare worker enrollment rules, provide most of the authorized hours, and cannot be the designated representative.
- Parent of a minor child Not right now
- the program is for married adults.
- Living together
- the program is built for spouses living together.
Who employs the caregiver: The spouse is a Consumer-Employed Provider (homecare worker) paid by the state; the spouse cannot also act as the consumer-employer.
Spouse rules differ by program — see spouse pay in Oregon.
How much Spousal Pay Program pays
$21.25–$25.25/hr. Spousal Pay providers are paid hourly homecare worker rates from the state rate schedule. Under the 2025–2027 OHCC/SEIU 503 contract, rates run $21.25 (step 1) to $25.25 (step 5) for 2026, rising to $23.00–$27.00 in January 2027. (Newer than states.json's $20–$24.10.)
Hours and budget: Authorized spousal hours equal one-half of assessed IADL hours plus all hours for qualifying ADLs. All hours must be prior-authorized; general in-home hour limits in OAR 411-030-0070 also apply.
Compare with other Oregon programs on the Oregon caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
Spousal Pay is an in-home services option with no published enrollment cap or waiting list; approval depends on meeting the strict medical criteria.
How to apply for Spousal Pay Program
- Call your local APD or AAA office (or ADRC at 1-855-673-2372) and request an in-home services assessment.
- Ask the case manager to screen for the Spousal Pay Program; they submit the request to ODHS Central Office.
- The spouse completes homecare worker enrollment (background check and orientation) with the Oregon Home Care Commission.
- After approval, the spouse records authorized hours and is paid through state homecare worker payroll.
- ODHS Aging and People with Disabilities · 503-945-5600 · official site
- ADRC of Oregon · 1-855-673-2372 · official site
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Spousal Pay Program questions
Who qualifies for Spousal Pay in Oregon?
The person receiving care must need full help with at least four of six daily activities, have a serious condition such as late-stage cancer or a spinal cord injury, and otherwise need a nursing home. ODHS Central Office must approve each case.
How much does a spouse get paid?
The same hourly rate as other homecare workers. For 2026 that is $21.25 to $25.25 an hour, depending on hours worked since 2023.
How many hours can a spouse be paid for?
Half of the assessed hours for household tasks, plus all hours for qualifying personal care tasks, as authorized by the case manager.
Is there a waiting list?
No waiting list is published. The main hurdle is meeting the medical criteria, not a slot limit.
What if I was already my partner's homecare worker before we married?
Oregon rules say a homecare worker who marries their consumer is not moved to Spousal Pay; their hours stay based on the consumer's needs.
Sources: oregon.public.law · sharedsystems.dhsoha.state.or.us · oregon.gov · medicaidplanningassistance.org · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Oregon caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Oregon — pick yours for the local picture.
Across the line
States that border Oregon
Each state writes its own rules, and they differ more than people expect — a spouse who can be paid on one side of the line often cannot be on the other.