Strengthening in-home care through APD

elderly man's hands on a cane


Disability Rights Oregon along with our partners at the Oregon Law Center (OLC) and Legal Aid Services of Oregon (LASO) have reached an agreement with
the Oregon Department of Human Services, Aging and People with Disabilities (APD) to strengthen in-home services.

As a result of the agreement, people who receive hourly in-home care may see their hours of service increase modestly or remain the same. People who used to receive
live-in care will be reviewed individually to set an appropriate number of hours for their in-home care services. Everyone getting any kind of in-home care will receive clearer explanations of how their services are determined.

Thousands of Oregonians with physical disabilities or older Oregonians wish to live independently, but need help meeting their daily care needs. APD’s in-home services
make it possible for these individuals to safely stay in their homes, and APD’s long-term care residential services make it possible for many Oregonians to live in a home-like residential setting and get the care they need. Long-term care is generally not covered by traditional health insurance or Medicare.


APD provides long-term care to about 35,000 low income older adults and Oregonians with physical disabilities. This includes about 19,000 people who get services in their own homes.

In 2017, APD announced a number of changes to that would end a service option for live-in caregivers, reduce the number of care hours available to some individuals, and
make it more difficult for some individuals to qualify for services. DRO, LASO, and OLC worked with APD to address concerns with how these changes impacted the individuals who use these vital services and supports.

On February 7, 2018, DRO, OLC, and LASO reached a temporary agreement with APD to restore some services while the groups worked on a final agreement.

The Latest Agreement

On May 7, 2018, the advocacy organizations reached a final agreement with APD. Under the agreement, APD has committed to:

1. Improving the notices that consumers receive when their services are reduced,terminated, or denied.

2. Enacting new administrative rules that will improve the transparency and fairness of the process for getting exceptional in-home hours that exceed regular maximums.

3. Restoring the maximum hours available for each Activity of Daily Living (ADL). ADLs are those personal functional activities required by all of us for continued well-being, health, and safety. The affected ADLs include bathing, eating,mobility, and dressing.

4. Make changes in eligibility rules that will help guide case managers in assessing individuals’ abilities to accomplish tasks with safety and dignity.

5. Removing a rule that would consider whether an individual’s decision not to take medication was impacting their cognitive function.

6. Conducting surveys of individuals’ satisfaction with their services and any unmet needs.

7. Review service plans for individuals who were formerly in the live-in service option to ensure their new hourly plans meet their needs.

DRO, LASO, and OLC look forward to continuing to work together with APD to advance our shared goal of ensuring effective and sustainable services that will allow Oregon’s older adults and people with disabilities to continue to lead safe and healthy lives in their homes and communities.

Additional Resources:

Settlement Term Sheet (February 7, 2018)

Memorandum of Understanding May 7, 2018)

Provisions for Individuals who used to receive live-in services:

The live-in service option has ended. However, APD has committed to reviewing the services plans for individuals who used to receive live-in services. Prior to July 31,
2018, APD will conduct a review of service plans for all individuals who were enrolled in the live-in service option as of July 27, 2017. APD has committed to have the central office review all service plans for this group of former live-in consumers to ensure that they receive all services for which they are eligible, which may increase shift services.

APD intends to provide these individuals with notice of their new service plans and the opportunity to challenge any denial or partial denial of exceptional service hours and/or shift services.

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