PERSONAL CARE SERVICES PROVIDER IN OREGON

Fatumata Kaba
Oct 6
4 min read

DELIVERING COMPASSIONATE, CLIENT-CENTERED SUPPORT TO MAINTAIN INDEPENDENCE AND DIGNITY FOR OREGONIANS IN THEIR HOMES AND COMMUNITIES

Personal Care Services (PCS) in Oregon are Medicaid-funded supports that assist eligible individuals with daily living tasks such as bathing, dressing, mobility, eating, and medication reminders. These services are aimed at helping older adults, people with disabilities, and individuals with chronic conditions live safely in their homes and avoid institutional care. PCS are authorized under Oregon’s Medicaid program, Oregon Health Plan (OHP), and through Home and Community-Based Services (HCBS) waivers and the State Plan Personal Care Option.

1. GOVERNING AGENCIES

Agency: Oregon Department of Human Services (ODHS) – Aging and People with Disabilities (APD)

Role: Administers and authorizes PCS for eligible OHP recipients, including through local APD and Area Agency on Aging (AAA) offices.

Agency: Oregon Health Authority (OHA)

Role: Oversees the Medicaid program (OHP), contracts with coordinated care organizations (CCOs), and ensures federal compliance.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Ensures Oregon’s Medicaid State Plan and waiver services comply with federal regulations.

Agency: Oregon Secretary of State (SOS) – Corporation Division

Role: Registers new business entities and maintains business compliance.

2. PERSONAL CARE SERVICES OVERVIEW

PCS in Oregon are provided in the client’s home or community setting and support daily functioning, reduce hospitalization risks, and promote dignity.

Approved providers may deliver:

Assistance with Activities of Daily Living (ADLs): Bathing, dressing, eating, toileting, and ambulation.
Instrumental ADLs (IADLs): Light housekeeping, meal preparation, laundry, and shopping.
Medication Reminders: Non-skilled cueing and monitoring for medication compliance.
Protective Supervision: Ensuring safety for individuals with cognitive impairments.
Escort to Appointments: Support for accessing health and community resources.
Documentation and Progress Notes: Daily service logs, care plans, and billing records.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Oregon Secretary of State.
Obtain an Employer Identification Number (EIN) from the IRS and a National Provider Identifier (NPI).
Enroll with Oregon Medicaid through the Oregon Health Plan Provider Portal.
If employing skilled staff (e.g., RNs), ensure licensing through Oregon State Board of Nursing (OSBN).
Secure general liability and workers’ compensation insurance.
Develop a Personal Care Services Policy & Procedure Manual aligned with APD standards.

4. OREGON PROVIDER ENROLLMENT PROCESS

Step 1: Register your LLC or corporation and obtain EIN/NPI.

Step 2: Submit a Medicaid provider application via the Oregon Health Plan Provider Portal.

Step 3: Pass background checks and submit ownership and staffing details.

Step 4: Receive approval and begin coordinating with local APD/AAA offices.

Step 5: Accept referrals and begin delivering authorized PCS services.

5. REQUIRED DOCUMENTATION

Business registration and Articles of Incorporation
EIN and NPI documentation
Insurance certificates
Staff rosters and credentialing logs
PCS Policy & Procedure Manual including:
- Care planning and service protocols
- ADL/IADL service delivery procedures
- Documentation templates and standards
- Incident reporting and participant safety procedures
- Privacy, dignity, and HIPAA compliance policies
- Medicaid billing protocols

6. STAFFING REQUIREMENTS

Role: Personal Support Worker (PSW) / Personal Care Aide (PCA)

Requirements: DHS-approved, background-checked, and trained in ADL support.

Role: Program Coordinator / Supervisor

Requirements: Experience managing care services; oversees documentation and staff compliance.

Role: Registered Nurse (optional for oversight or skilled support)

Requirements: Licensed through OSBN; supports medication management or advanced care needs.

All staff must complete:

Orientation on rights, dignity, and autonomy
Documentation and electronic visit verification (EVV) training
Abuse reporting and elder protection education
Annual refresher and skills validation

7. MEDICAID WAIVER PROGRAMS

Personal Care Services in Oregon are available through:

Oregon K Plan (State Plan Personal Care Option) – provides services under the Community First Choice Option (1915(k)).
Aging & People with Disabilities (APD) HCBS Waivers – for seniors and adults with physical disabilities.
Developmental Disabilities Waivers – for individuals with intellectual/developmental disabilities (IDD).
Children's Waiver and Medically Fragile Waivers – for youth needing in-home support.
Oregon Health Plan (OHP) Standard PCS – for qualifying members needing short- or long-term support.