Understanding Oregon Project Independence and Other State-Funded In-Home Care Options

For many older adults, remaining at home is an important part of maintaining independence, comfort, and familiarity. Yet there may come a point when everyday activities become difficult to manage without assistance.

For families in Beaverton, Portland, Hillsboro, Tigard, and surrounding Oregon communities, the cost of in-home care can also become a significant concern.

Fortunately, Oregon has several programs designed to help eligible adults receive support in their homes. One of the best-known options is Oregon Project Independence, commonly called OPI. Other possibilities include Oregon Project Independence-Medicaid, Medicaid long-term services and supports, and different models for arranging in-home workers.

Understanding how these programs differ can help families identify potential resources and have more productive conversations with local aging and disability service professionals.

Program rules and availability can change, so families should confirm current eligibility and services with Oregon's Aging and Disability Resource Connection or their local aging and disability services office.

What Is Oregon Project Independence?

Oregon Project Independence is a state-funded program that provides limited in-home services to adults who need some assistance to continue living independently in their own homes.

According to the Oregon Department of Human Services, services can include:

• Personal care

• Housekeeping

• Home-delivered meals

• Case management

• Assistive technology

• Other approved supports

OPI is specifically intended for people who need help remaining at home and do not have Medicaid long-term care benefits.

This makes OPI an important option for some older adults who may need assistance but do not qualify for Medicaid long-term care.

Who May Benefit From OPI?

OPI can be particularly useful for an adult who remains capable of living at home but needs help with certain daily activities.

For example, a senior may still manage many personal decisions independently while having difficulty with:

• Bathing

• Dressing

• Meal preparation

• Housekeeping

• Transportation

• Certain household responsibilities

• Other activities necessary for maintaining independence

The purpose is to provide support where it is needed without automatically requiring a move to a residential care setting.

However, receiving OPI is not automatic. Families should contact the appropriate local agency for an assessment and current eligibility information.

Does OPI Have Income or Asset Limits?

One important feature of traditional OPI is that it does not have income or asset limits.

However, participants generally contribute toward the cost of their services using a sliding-scale arrangement. Oregon also notes that some areas have waiting lists, with priority given to people with the highest needs who are at risk of leaving their homes because they lack adequate support.

This means a senior who does not qualify for Medicaid should not automatically assume that government-supported in-home assistance is unavailable.

OPI may provide another pathway.

What Is OPI-M?

Oregon Project Independence-Medicaid, commonly called OPI-M, is a Medicaid-funded expansion of Oregon Project Independence.

The program is designed for people who meet its financial and functional eligibility requirements.

Unlike traditional OPI:

• OPI-M has income and asset limits

• The limits are higher than those used for some standard Medicaid long-term care programs

• Eligible participants receive services at no cost under current Oregon guidance

• Services are intended to support eligible individuals in remaining at home

Oregon describes OPI-M as an expansion that allows more people to access in-home services through Medicaid funding.

Because eligibility rules can be complicated, families should obtain an official determination rather than relying on a general income estimate.

OPI vs. OPI-M: What Is the Difference?

Although the names are similar, the programs have important differences.

OPI:

• State-funded

• Designed for adults without Medicaid long-term care benefits

• No income or asset limits

• Participants pay part of the cost on a sliding scale

• Waiting lists may exist in some areas

OPI-M:

• Medicaid-funded

• Has income and asset requirements

• Financial limits are higher than some Medicaid long-term care programs

• Eligible participants have no service cost under current guidance

Oregon's current home care guidance provides these distinctions for families exploring government-funded services.

What About Medicaid Long-Term Services and Supports?

Oregon's Medicaid program is called the Oregon Health Plan, or OHP.

Medicaid can pay for long-term care services for people who meet applicable eligibility requirements. Services may be available in the person's home or in other care settings and can include assistance with daily activities and health-related tasks.

Eligibility can involve factors such as:

• Income

• Financial resources

• Functional needs

• The level of assistance required

• The specific Medicaid program involved

This is different from Medicare, which generally does not function as a long-term custodial home care benefit.

Families should therefore avoid assuming that having Medicare automatically means ongoing in-home personal care will be covered.

What Is the Consumer Employer Model?

Qualifying individuals may have choices in how their government-funded in-home care is arranged.

Under Oregon's Consumer Employer or Homecare Worker option, the individual can hire and manage their in-home workers.

The individual takes on employer responsibilities while the program provides administrative assistance and pays workers according to program procedures. Oregon lists this as an option for people receiving Medicaid long-term services and supports, OPI, or OPI-M.

This model may appeal to someone who wants substantial control over who provides their care.

It can also require more involvement from the individual or their representative.

What Is the Independent Choices Program?

Independent Choices is another self-directed option available to certain Medicaid recipients.

Under this model:

• The participant receives a monthly cash benefit

• The participant chooses and manages workers

• The participant pays workers directly

• The participant has greater control over how services are arranged

Oregon's current guidance states that eligible participants can hire workers of their choice, including certain family members or a spouse, subject to program requirements.

This can provide flexibility, but it also means the individual takes on significant responsibility for managing their care arrangement.

What Is an In-Home Care Agency?

An in-home care agency provides another way to arrange care.

Instead of the older adult becoming the direct employer, the agency handles employment-related responsibilities for its caregivers.

Oregon identifies in-home care agencies as an option for people receiving:

• Medicaid long-term services and supports

• OPI

• OPI-M

• Private-pay home care

Agencies can manage caregiver hiring and other employment responsibilities, allowing families to focus more directly on the older adult's care needs.

For families who do not want to manage recruiting, hiring, payroll, and scheduling themselves, an agency-based model may be easier to navigate.

What Is Agency with Choice?

Oregon introduced Agency with Choice as a new in-home support option in 2026.

The model is designed to combine elements of self-direction with agency assistance.

Under the current Oregon model:

• The individual helps choose and train their worker

• The individual helps direct the worker's schedule and responsibilities

• The agency handles employment-related duties

• The agency manages tasks such as hiring, payroll, background checks, and worker benefits

• The individual receives support when a planned worker absence or interruption occurs

For older adults and people with physical disabilities receiving Medicaid services through the Office of Aging and People with Disabilities, Agency with Choice launched in July 2026.

This gives eligible individuals another option between fully managing their workers and using a traditional agency model.

Which Program Is Right for Your Loved One?

There is no single program that works for every older adult.

The appropriate option depends on factors such as:

• Current health and functional needs

• Income

• Financial resources

• Medicaid status

• Existing family support

• Desired level of control

• Availability of workers

• Local program capacity

• Whether the senior needs occasional or more consistent assistance

A professional assessment is important because eligibility is based on more than age alone.

Families in Washington County, Multnomah County, and Clackamas County can begin by contacting the appropriate local aging and disability services organization.

How Can Families Apply?

Oregon recommends contacting an Area Agency on Aging or Aging and People with Disabilities office for information about programs such as OPI and OPI-M.

The state's Aging and Disability Resource Connection can also help families understand available options.

Oregon currently lists the ADRC phone number as:

• 855-673-2372

Families can also use Oregon's online resources to learn about long-term care options and application pathways.

When contacting an agency, it can help to have basic information available about the older adult's:

• Current living arrangement

• Daily care needs

• Medical conditions

• Mobility limitations

• Existing caregiver support

• Income and resources

• Current insurance or Medicaid status

What If There Is a Waiting List?

A waiting list does not necessarily mean the family has no options.

Oregon notes that some areas may have waiting lists for OPI, with priority given to people with the highest needs and those at risk of leaving their homes without adequate support.

While waiting, families can investigate:

• OPI-M eligibility

• Medicaid long-term services and supports

• Local aging services

• Family caregiver programs

• Community meal programs

• Transportation assistance

• Private-pay home care

• Other community resources

A combination of resources may sometimes provide more practical support than relying on one program alone.

Government-Funded Care May Not Cover Every Need

Even when an older adult qualifies for a state or Medicaid-funded program, the approved services may not address every household need.

A care plan may specify particular services or a certain amount of assistance.

Families may still need to coordinate:

• Medical appointments

• Transportation

• Family visits

• Additional household responsibilities

• Care outside authorized hours

• Backup support

• Other services not covered by the program

Private-pay care can sometimes supplement publicly funded services when additional assistance is needed.

The specific arrangement should be discussed with the relevant case manager and care provider.

How Serenity Home Care Can Support Oregon Families

Families in Beaverton and the greater Portland Metro area may be exploring publicly funded programs while also considering professional home care.

Serenity Home Care provides compassionate in-home support designed around each client's established needs and preferences.

Depending on the funding arrangement and program requirements, an agency may be able to participate in authorized services. Families should confirm program-specific requirements with their case manager.

For private-pay clients, professional home care can also provide additional support when public programs are unavailable or do not cover all of the family's needs.

Care may include:

• Personal care assistance

• Meal preparation

• Light housekeeping

• Companionship

• Assistance with daily routines

• Grocery and household support

• Other appropriate non-medical services

The goal is to help older adults maintain dignity and independence while giving families greater confidence that daily needs are being addressed.

Start Exploring Options Before a Crisis

Many families begin researching home care only after a hospitalization, fall, or sudden change in functioning.

Starting earlier can provide more time to understand eligibility and compare care arrangements.

Families can begin by asking:

• What activities are becoming difficult?

• What help is already available?

• Does the senior have Medicaid or another qualifying benefit?

• Could OPI or OPI-M be appropriate?

• Would self-directed care be manageable?

• Would an agency provide a better fit?

• Is additional private-pay support needed?

• Who will coordinate the overall care plan?

These questions can make the process more manageable and help families make decisions based on actual needs rather than reacting to an emergency.

A More Informed Approach to Aging at Home

Oregon offers several pathways for eligible adults who need assistance remaining at home. OPI, OPI-M, Medicaid long-term services and supports, Consumer Employer services, Independent Choices, Agency with Choice, and traditional in-home care agencies each have different requirements and responsibilities.

For seniors and families in Beaverton, Portland, Hillsboro, Tigard, and throughout the Portland Metro area, understanding these choices can make long-term care planning feel less overwhelming.

The first step is often simply learning what may be available.

Families should confirm current eligibility, service availability, and program requirements directly with Oregon's Aging and Disability Resource Connection or the appropriate local office because programs and policies can change.

Serenity Home Care understands that arranging care for an aging loved one involves more than finding someone to help around the house. It is about protecting dignity, preserving familiar routines, and providing the right level of support at the right time.

If your loved one is beginning to need help with daily activities, contact Serenity Home Care for a warm, personalized consultation. We would be honored to learn about your family's situation and discuss how compassionate in-home support can help your loved one remain safe, comfortable, and independent at home.

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