Waiver Consulting Group — Start any program. In any state.

Oregon - Adult Companion Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

In Oregon, Adult Companion Services are not licensed or enrolled as a standalone Medicaid provider type. Instead, non-medical supervision and socialization services are delivered as part of the broader Home and Community-Based Services (HCBS) system under the K Plan (Community First Choice) and the 1915(c) Aged and Physically Disabled (APD) Waiver, administered by the Oregon Department of Human Services (ODHS) Aging and People with Disabilities (APD) program.

Because Oregon does not issue a distinct "Adult Companion Services" license, providers offering these supports must enroll as an approved HCBS provider—such as an In-Home Care Agency or an Adult Day Services (ADS) program—or operate as an individual homecare worker. The most significant structural prerequisite is that agency providers must obtain the underlying state licensure or certification for their specific facility or agency type (e.g., Adult Day Services certification) before they can execute a Medicaid Provider Enrollment Application and Agreement (PEA) with ODHS.

1. Service Definition and Scope

Oregon delivers non-medical supervision, socialization, and assistance with activities of daily living through its K Plan (Community First Choice state plan option) and the 1915(c) Aged and Physically Disabled (APD) Waiver. These services allow individuals who meet a nursing-facility level of care to remain safely in their own homes or community settings.

Rather than a standalone "Adult Companion" service, these supports are integrated into in-home care, attendant care, and adult day services. The services must be delivered according to a Person-Centered Service Plan developed by a case manager, ensuring they support the individual's health, safety, and personal goals without duplicating other services.

2. Regulatory and Oversight Agencies

The primary oversight body for aging and physical disability HCBS in Oregon is the Department of Human Services (ODHS), specifically the Aging and People with Disabilities (APD) program. ODHS APD manages provider certification, Medicaid enrollment, and compliance with HCBS settings rules.

The Centers for Medicare and Medicaid Services (CMS) provides federal oversight of the K Plan and the 1915(c) APD Waiver. Background checks for all provider staff are processed through the ODHS Background Check Unit (BCU).

3. Gatekeeping Prerequisites: Who Can Even Apply

Oregon does not have a standalone "Adult Companion" provider enrollment category. To provide these services and bill Medicaid, an entity must first be legally established and certified or licensed in Oregon for the specific modality they intend to operate, such as an Adult Day Services (ADS) program or a licensed In-Home Care Agency.

There is no Certificate of Need required for HCBS in-home or adult day services in Oregon. However, an applicant cannot submit a Medicaid Provider Enrollment Application and Agreement (PEA) without first holding the underlying certification (e.g., ADS certification) and an active business registration with the Oregon Secretary of State.

4. Licensure and Certification Requirements

Because companion-type services are often delivered in Adult Day Services (ADS) settings or by In-Home Care Agencies, providers must meet the certification standards for those specific programs. For example, ADS programs are certified by ODHS APD to ensure they meet health, safety, and programmatic standards.

Certification involves submitting an application, passing an initial screening or survey, and demonstrating compliance with OAR chapter 411 rules. The certification measures the program's ability to meet DHS standards and must be kept current to maintain Medicaid enrollment.

5. Medicaid Provider Enrollment

Once certified or licensed, the provider must enroll with ODHS APD to receive a Medicaid Performing Provider Number. This number is required to receive service authorizations and submit claims for Medicaid-funded HCBS under the K Plan or 1915(c) waiver.

Enrollment requires completing the Adult Day Services (or applicable) Medicaid Provider Enrollment Application and Agreement (PEA). Providers must maintain required insurance and comply with all Medicaid rules to avoid termination of their provider number.

6. Staffing, Training and Background Checks

All staff and volunteers providing HCBS in Oregon must pass strict background checks and meet minimum qualifications. The ODHS Background Check Unit processes these checks to ensure participant safety.

Program directors for certified settings like ADS must meet specific age and educational or experience requirements. Additionally, staff involved in food service must hold appropriate food handler certifications, and all staff must be trained as mandatory reporters of abuse.

7. Documentation, Policies and Records

Providers must maintain comprehensive records for each participant, including medical information, service plans, and progress notes. Documentation must be kept current and available for review by ODHS or the Oregon Health Authority.

Agencies must have written policies covering everything from medication administration to emergency transportation. Failure to maintain these records or provide them to designated state entities can result in termination of Medicaid enrollment.

8. Billing, Rates and Claims

Medicaid reimbursement for HCBS under the K Plan and 1915(c) waiver is governed by the Medicaid reimbursement rate schedule maintained by ODHS. Providers bill using their assigned Medicaid Performing Provider Number.

Services must be prior-authorized by the participant's case manager and included in the Person-Centered Service Plan. Providers cannot bill for services that duplicate those provided by another agency or facility.

9. Approval Sequence and Timeline

Becoming an HCBS provider in Oregon is a multi-step process. An entity must first establish its business, obtain the necessary facility or agency certification from ODHS APD, and then apply for Medicaid enrollment.

While specific timelines for provider enrollment vary, the state is bound by federal rules regarding participant eligibility determinations (45 to 90 days). Providers should expect the certification and background check processes to take several weeks to months before they can execute the PEA.

10. Common Denials and Survey Findings

Medicaid provider enrollment can be denied or terminated if an agency fails to maintain its underlying certification or violates ODHS rules. Compliance with background check requirements and abuse reporting is strictly enforced.

During surveys or audits, common findings include incomplete participant records, failure to update medical information semi-annually, or lack of required progress notes. Providers may appeal terminations based on OAR 407-120-0360.

11. Key Contacts and Resources

Prospective providers should utilize ODHS resources to understand certification and enrollment requirements. The ODHS APD website provides access to rules, forms, and transition plan details.

For specific questions regarding HCBS compliance or the K Plan, providers can contact the state directly via designated email addresses or local APD offices.

See all Oregon services · Oregon Medicaid consulting · book a consultation.