How to Get Paid to Care for Your Adult Child in Oregon

Oregon parents can be paid to support an adult son or daughter with an intellectual or developmental disability through state developmental disabilities services and attendant care hours outlined in an Individual Support Plan.

Caring for an adult child with intellectual or developmental disabilities requires countless hours of labor, organization, and advocacy. In Oregon, families navigating this reality have a pathway to receive financial compensation for that work.

Parents can step into a paid caregiving role by registering as a Personal Support Worker or by joining the payroll of an approved provider agency like North Star Oregon. The option provides a direct way to monetize in-home support, but the process demands strict adherence to state administrative rules.

Eligibility and Assessment Rules

Before any compensation begins, the adult child must qualify for state developmental disabilities services through the local Community Developmental Disabilities Program. Enrollment in Oregon Medicaid, such as the Oregon Health Plan, serves as a mandatory baseline requirement under OAR 411-450-0030.

Once eligibility is secured, families must work with a Services Coordinator at the CDDP or a Personal Agent at a support services brokerage to embed in-home attendant care into the Individual Support Plan. The total number of monthly care hours is determined by the Oregon Needs Assessment, which caps the combined hours allowed for attendant care, Day Support Activities and some other services.

Families can request an approved exception to raise this monthly limit if the care recipient’s specific needs demand it, as outlined in OAR 411-450-0060 and 411-450-0065. North Star Oregon notes that hours used for day support activities draw directly from the exact same monthly total.

Choosing Between a PSW and an Agency Employee

Parents must choose between two distinct employment routes to get paid. Both paths cover the attendant care hours specified in the ISP, but they differ significantly regarding tax structures, supervision, and paperwork.

Compare	Personal Support Worker (PSW)	Agency employee
Who employs you	A common law employer: your son or daughter, their legal or designated representative, or someone they choose. The PSW cannot also be the common law employer.	The agency. You are its W-2 employee.
How you are paid	The state pays you. You record hours with electronic visit verification (EVV) and submit claims in the state’s eXPRS system.	Through the agency’s payroll.
Wages and benefits	Set by the union contract between the Oregon Home Care Commission and SEIU Local 503.	Compensation at North Star Oregon begins at $25–26/hr, accompanied by medical, dental, and vision benefits for full-time employees after 30 days, alongside a 401(k) match of up to 3.5%.
Training	State-required training and a competency evaluation.	Training the agency provides under state rules. At North Star Oregon, training hours are paid.

Operating as a PSW requires passing a background check administered by the Oregon Department of Human Services, completing state-required training, and finishing a competency evaluation under OAR 411-375-0020. Parents who act as legal guardians for their adult children face an additional requirement. They must appoint a designated representative to plan supports, and a person other than the guardian must act as the common law employer.

The agency route bypasses the common law employer requirement entirely because the agency acts as the employer of record. North Star Oregon is a standard model agency. Oregon also endorses employer model agencies, which require the agency to train and coach the care recipient on self-direction and on their role in hiring, scheduling and training staff pursuant to OAR 411-450-0095.

Tax Exemptions and Living Arrangements

Living arrangements dictate specific exemptions regarding federal income tax. Under IRS Notice 2014-7, qualified Medicaid waiver payments received for care provided inside a shared home can be excluded from federal taxable income. The IRS maintains a dedicated question-and-answer page explaining these excludable payments.

The tax exclusion applies whether the caregiver is related to the recipient and whether the payment originates from the state or a certified Medicaid provider agency. However, payments for care delivered outside the shared residence do not qualify for the exemption.

State rules prohibit combining both payment routes for the same care recipient. A parent cannot serve as a PSW for their son or daughter while simultaneously being employed by an agency to provide attendant care or skills training for that same individual.