Relating to in-home care for minor children with disabilities; declaring an emergency.
Senate Bill 538 requires the Oregon Department of Human Services (ODHS) to operate a program that pays parents to provide attendant care services for their minor children with developmental disabilities who have very high medical needs or very high behavioral needs. The bill defines key terms such as parent provider, client child, very high medical needs, and very high behavioral needs, and it sets eligibility and employment rules for participating families and agencies. It also allows parent providers to be paid for up to 40 hours per week and requires overtime pay under the same circumstances as other direct support professionals.
The bill also directs ODHS to seek federal financial participation for the program by January 1, 2026, using any available federal authority, including Medicaid waivers or amendments. It amends a 2023 law to reinforce that the program may not be run with state General Fund dollars unless those dollars are matched by federal Medicaid funds, and it declares an emergency so the act takes effect immediately upon passage. In addition to payment authority, the bill imposes training, reporting, and oversight requirements intended to preserve nonparent caregiving options, manage conflicts of interest, and ensure statewide consistency.
SB 538 amends ORS 427.191 and section 2, chapter 367, Oregon Laws 2023, to expand and formalize ODHS authority to compensate parents for providing in-home attendant care to eligible minor children with disabilities. It affects the state’s developmental disability services system, Medicaid waiver administration, agency-provider relationships, and the rules governing who may be paid, how care is supervised, and what services are excluded during school hours. The bill also requires annual reporting to the Legislature and limits use of appropriated funds to this program, while directing ODHS to pursue federal matching funds and other federal financing mechanisms.
The overall sentiment reflected in the bill text and committee action is supportive. The measure passed the Senate committee unanimously, 5-0, with a do-pass recommendation and amendments, suggesting broad agreement on the need to support families caring for children with significant disabilities. The findings in the bill emphasize cost savings, workforce shortages, and improved outcomes for children and families, which frame the proposal as both a family-support and system-efficiency measure.
The main points of contention are not reflected in recorded committee testimony, but the bill itself signals likely policy concerns. These include whether paying parents could displace nonparent caregivers, create conflicts of interest, or reduce opportunities to build the direct care workforce. The bill addresses those concerns by requiring recruitment efforts for nonparent caregivers, training, oversight, and limits on parent-provider roles. Another likely issue is fiscal and federal compliance: ODHS is required to seek federal matching funds, and the bill restricts use of General Fund money without Medicaid match, indicating sensitivity to program cost and federal approval requirements.