How to start a home care agency in Oregon (the in-home care agency license, 2026)

"An agency that establishes, conducts, or represents itself to the public as providing in-home care services must be licensed by the Authority" (OAR 333-536-0010(1)). In-home care services are "personal care services ... that are necessary to assist an individual in meeting the individual’s daily needs, but does not include curative or rehabilitative services" (ORS 443.305(2)). The personal care tasks are bathing; personal grooming and hygiene; dressing; toileting and elimination; mobility and movement; nutrition, hydration and feeding; care of the client’s body, such as foot or nail care; and medication reminding (OAR 333-536-0045(1)). An agency may add housekeeping and other supportive services (0045(8)).

Only a licensed agency may provide these services or use the name: "No entity shall provide in-home care services or use the term "in-home care agency" in its advertising, publicity, or any other form of communication unless it holds a current valid license as an in-home care agency issued by the Authority." (OAR 333-536-0010(6)).

Who is outside it

• Housekeeping-only businesses. The licensing law does not apply to "Independent individuals, volunteers, family, neighbors, or to agencies offering only housekeeping or on-call staffing for facilities, or to support services provided and funded by the Oregon Department of Human Services (ODHS)" (OAR 333-536-0010(1)(b)). OHA’s FAQ: "You do not need to be licensed if your business is only providing housekeeping and supportive services such as laundry or shopping and errands." (OHA FAQ 2)
• Referral and matching services, unless they schedule caregivers, assign work, set pay rates, define working conditions, negotiate for a caregiver or client, or place a caregiver with a client (OAR 333-536-0010(1)(d)). A business that supplies a list of private contractor caregivers is a caregiver registry, a separate license (OHA determination tool).
• Home health agencies (a different, medical license). A licensed home health agency that provides personal care "is not required to be licensed as an in-home care agency under ORS 443.315" (ORS 443.090(1)). OHA asks it to attest to the in-home care rules: "The ORS requires that the HHA comply with all laws and rules concerning IHC services." (OHA 8953)

Companion-only businesses: our reading

Companionship is not one of the personal care tasks listed in OAR 333-536-0045(1), though the rule’s definition of personal care services says it is "not limited to" that list (OAR 333-536-0005(31)). Our reading: a business that only offers companionship, with no hands-on help and no medication reminders, may be outside the license, as housekeeping-only businesses are. OHA has not said so in writing; its FAQ names housekeeping and supportive services such as laundry, shopping and errands. Ask OHA’s In-Home Care program, or use its licensure determination tool, before relying on it.

Every agency is licensed in one classification, and "No agency licensed by the Authority shall provide services or use a classification title in its advertising, publicity, or any other form of communication other than what the agency is licensed to provide." (OAR 333-536-0007(2)).

• Limited: "An agency that provides personal care services that may include medication reminding but does not provide medication assistance, medication administration, or nursing services" (0007(1)(a)).
• Basic: "An agency that provides personal care services that may include medication reminding and medication assistance but does not provide medication administration or nursing services" (0007(1)(b)).
• Intermediate adds medication administration, and Comprehensive adds nursing services (0007(1)(c)-(d)). OHA’s FAQ says medication and nursing services "require additional conditions for approval. These conditions include additional policies and procedures and a nurse on staff." (OHA FAQ 3). OHA’s FAQ speaks loosely here: under the rule and Table 1, only medication administration (Intermediate) and nursing (Comprehensive) need an employed RN; Basic’s medication assistance does not (OHA Table 1).

Branches and subunits. The service area is "60 miles in any direction from the parent agency or subunit’s physical location" (OAR 333-536-0005(12)). A branch office within that area must be added to the license before it is used (0050(3)(c)), and OHA says "There is no fee charge for branch requests" (OHA). "If an agency provides services from an office that exceeds 60 miles from the location of the parent agency, that office will constitute a subunit of the agency." (0050(4)) A subunit is separately licensed and pays its own fee (0050(4)).

The rule asks for written policies and procedures that "include, but are not limited to" ten topics (OAR 333-536-0051):

OHA adds: "Other requirements can be found throughout the rules, including sections 0050, 0052, 0055, 0070, 0075, 0080, and 0093." (OHA policy and procedure memo). Its IHC Initial Checklist turns most of this into one list. "Prospective licensees must develop agency specific policies and procedures (including associated forms or documentation, such as the initial assessment form, disclosure form, etc.) to address and ensure compliance with the In-Home Care (IHC) Oregon Administrative Rules (OARs), Chapter 333, Division 536." It asks you to "fill out the page numbers of this form and include the completed form with the policies and procedures" (IHC Initial Checklist). The checklist has no separate line for medical and non-medical emergency response (OAR 333-536-0051(7)), but the rule still requires that policy, and OHA’s own criteria ask you to "Ensure all requirements contained in the applicable OARs are addressed."

By our count, the checklist has 101 items under 17 rule headings, nearly all listed as a separate policy, procedure, and form or documentation (our count of OHA’s checklist):

Items outside your class

Some headings name the classes they apply to, such as "Medication Services – Medication Administration (Intermediate and Comprehensive)" (IHC Initial Checklist). The checklist does not say how a Limited or Basic applicant should mark the medication administration and nursing items. Ask OHA; a short note that your agency does not provide the service, with the page where your policy says so, is one approach (our suggestion, not OHA’s). Some documents also appear under two headings, such as infection control, QAPI, client records and the fitness determination form.

What OHA will accept

Under the checklist, OHA prints what makes submitted policies and procedures acceptable. In OHA’s words, "In order for submitted policies and procedures to be acceptable, you must:"

• "Ensure policies and procedures do not only restate OAR language."
• "Ensure policy statements are clear."
• "Ensure you include clear procedures, which describe the steps necessary to carry out policies."
• "Ensure all requirements contained in the applicable OARs are addressed."
• "Ensure the language contained in the documents submitted do not contradict applicable OAR requirements."
• "Ensure the language contained in the documents submitted do not contradict language in other documents submitted."
• "Ensure applicable or referenced forms/documentation were submitted for review."

(IHC Initial Checklist, acceptability criteria)

OHA’s policy and procedure memo adds (OHA memo, May 5, 2025):

• "Your policies and procedures should match the actual practice of the agency."
• "Policies and procedures must be updated when Oregon Administrative Rules are revised or the agency’s practice has changed."
• "If policies or procedures reference a form, the form should be kept with the policy or procedure (as an attachment)."
• "In order to keep changes to a minimum, use “titles” of positions not names."

The memo’s own example numbers a policy by its rule section, "0065(1-2)" (OHA memo, appendix a), which makes the checklist easier to fill in. It also asks for a definitions page: "Include all IHC Rule definitions in a “definitions page” available for reference" (IHC Initial Checklist).

Before the survey: completeness and sufficiency

"Incomplete applications cannot be submitted and will not be processed until complete." (OHA FAQ 5) OHA’s July 2026 update describes two reviews: "All applicants get a completion review from the admin staff and a sufficiency review from a surveyor." "Surveys are scheduled once the applicant’s submitted materials have been reviewed and determined to be complete and sufficient." "Insufficiency includes unqualified administrators, missing information (RN or address), or policies and procedures that do not comply with OARs." (OHA, July 2026)

This two-stage process is OHA’s guidance. The rule itself says that in reviewing an application, OHA confirms the fee and a complete application, conducts a survey, and assesses compliance (OAR 333-536-0015).

How long it takes

• "It is currently taking an average of 6-9 months to get through the entire initial application process", and "Our office is only able to devote ½ FTE Surveyor for 45-60 initial applicants" (OHA, July 2026). OHA’s FAQ said the same in August 2025: "application processing times are currently taking six to nine months." (OHA FAQ)
• "Applicants who turn in complete and sufficient documentation, return the attestation quickly, and have flexible availability for scheduling the survey may see a shorter processing time." (OHA, July 2026). OHA does not say which attestation it means; ask when you apply.
• Applicants are generally reviewed first come, first served, but "applicants located in a rural area may be given priority review and survey scheduling" (OHA, July 2026).

The initial on-site survey

The statute says "the authority shall conduct an on-site inspection of each in-home care agency prior to services being rendered and once every two years thereafter as a requirement for licensing." (ORS 443.315(7)). "The survey will be scheduled for a date and time agreed upon by the agency and the surveyor who will conduct the survey." (OHA FAQ 6) OHA’s FAQ lists what to have ready (OHA FAQ 6):

• all your policies and procedures, well organized and easy to find;
• forms that document each caregiver’s training;
• "Quality Improvement Program Plan which demonstrates an assurance of compliance with the OARs";
• "A mock client record, which contains all documents and forms to be used by the agency";
• "At least one caregiver record for staff who has been hired, trained and determined to be competent and ready to provide IHC services".

So you hire, screen, orient and train at least one caregiver before you are licensed, without any clients.

Accreditation instead. OHA may accept a federal certification or an accreditation from a body OHA approves in place of the on-site inspection, if the agency lets OHA join any exit interview and gives OHA the documents it asks for (ORS 443.315(8); (8)(a)-(b)).

After the survey

• Pass: "A license will be issued for your agency or subunit within ten business days." "You are not allowed to accept clients until you have received your license." (OHA FAQ 7)
• Corrections needed: OHA sends a list of corrections, which must be completed before licensing. "If the request for a new survey is not received within 15 days, or if compliance is not achieved during the second initial survey, the agency will be required to submit a new application, including fee, and repeat all steps of the initial licensure process." (OHA FAQ 8) "If your agency is substantially out of compliance with Chapter 333, Division 536 of the OARs, your application may be denied." (OHA FAQ 8)

• Nonrefundable. "The completed application to license an agency must be accompanied by a nonrefundable licensing fee specified in ORS 443.315." (OAR 333-536-0010(3))
• Changing class. "The fee for change of classification request requires the difference between the initial fee for the current classification and the initial fee for the new classification requested." (OHA change of classification instructions)
• Caregiver background checks. The agency pays its own screening vendor; the rule sets the vendor standards but no price (OAR 333-536-0093(8)).
• Owner fingerprints. Owners or administrators with direct client contact who have lived in another state, had an out-of-state address, or been outside Oregon for more than 60 consecutive days in the last five years submit electronic fingerprints through Fieldprint (OHA Fieldprint instructions): "Fingerprint appointments cost $60.50 (which include OSP & FBI processing fees)."
• Bond and insurance. We found no surety bond and no insurance amount in ORS 443.305 to 443.350 or OAR 333-536 (our reading of the saved text; OAR 333-536). Ask your insurer what cover suits your services.

Penalties (not fees)

• "An individual who operates an agency without a license is subject to the imposition of a civil penalty not to exceed $500 a day per violation." (OAR 333-536-0125(2))
• An agency that violates the in-home care laws or rules can face a civil penalty "not to exceed $1,000 per violation and may not total more than $2,000" (OAR 333-536-0125(1)). Each day a violation continues counts as an additional violation (0125(5)).

Medication reminding is a personal care task in every class. It means "providing a client with an audio, visual or oral reminder to take his or her medication when a client is able to self-direct" (OAR 333-536-0005(24)). OHA adds: "This is a personal care service and must not include touching medication or medication containers." (OHA medication guidance)

"Medication reminding or medication assistance services may only be provided by an agency that is licensed and classified to provide those services for a client who can self-direct." (OAR 333-536-0045(3)) Before reminding or assisting, the agency must:

• "document the client’s knowledge of the following information using a standardized form required by the Authority": the reason for each medication, the dose, the route and the time of day (0045(4)(a));
• keep a copy of that form, signed by the client, in the client’s record (0045(4)(b), (6)); and
• re-evaluate: "An agency must evaluate whether a client can continue to self-direct at a minimum of every 90 days." If the client can no longer self-direct, arrange the right services without delay or transfer the client to an agency in a higher class within 30 days (0045(5)).

The standardized form is OHA’s Medication Self-Direct Evaluation Tool. It says: "Any time you are asked to provide medication reminding or medication assistance to a client, the following questions must be asked and answered affirmatively by the client." (OHA form) Self-direct evaluation, medication reminding and reminding documentation were all among OHA’s ten most cited survey tags from January to July 2026; self-direct evaluation was cited 14 times (OHA, July 2026).

Assistance and administration

• Medication assistance (Basic and above). "Medication assistance does not include putting medication in the client’s mouth, eyes, ears, nose, applying medicated lotions/cremes/salves, or crushing or modifying the medication." (OHA medication guidance) A family member or client representative may fill secondary containers under a signed agreement with the agency (OAR 333-536-0075(2)).
• Pill organizers. "Medication Set-up, moving medication from the original container into a secondary container, is medication administration" (OHA medication guidance), which needs the Intermediate or Comprehensive class.
• Injectables. "Medication administration to provide injectable medication to clients must include a delegation from an Oregon licensed Registered Nurse (RN) prior to administration and can only be provided by Comprehensive IHCs." (OHA medication guidance)
• Naloxone. OHA’s January 2026 update answered a question about Narcan: "Narcan = medication administration", which must meet the medication administration rule (0075(3)). OHA said agencies may request a waiver, with a training plan and clear service plan documentation, if they expect to need it (OHA, January 2026).

• Orientation. "Caregivers shall complete an agency-specific orientation, conducted by the agency administrator, administrator's designee, or administrator's delegate before independently providing services to clients." "The orientation shall be a minimum of four hours, obtained online or in person", and covers ten subject areas, from the caregiver’s job description and clients’ rights to what counts as medication reminding and its limits (OAR 333-536-0070(5)).
• Initial training and competency. "Caregivers shall complete appropriate caregiver training from a qualified individual, qualified entity, or qualified trainer and must have their competency evaluated and documented by the administrator or administrator's designee before independently providing services to clients." "The competency evaluation shall include a combination of both direct observation and written or oral testing." (0070(6)) The eight hours cover 14 listed topics, as applicable to your services, from medical emergencies and adverse behaviors to cultural competence and first aid (0070(7)).
• Medication training (Basic and above). "Caregivers assigned to provide medication services must obtain a minimum of four hours of basic non-injectable medication training before providing the services." The caregiver’s techniques "must be evaluated by a qualified individual through a successful return demonstration." (0070(8)) A qualified individual is someone who has completed an OHA-approved program, "is currently an LIP, registered nurse, licensed practical nurse, physician associate, or pharmacist", or another health professional OHA approves (0005(37)). OHA says "at this time there are no Authority approved training programs to become a qualified individual to provide caregiver or medication training" (OHA memo), and its training memo says the return demonstration "must be conducted by a Qualified Individual (see 333-5360005(37)(b) for a list of acceptable qualified individuals)": an LIP, RN, LPN, physician associate or pharmacist (OHA training memo). Limited agencies give no medication services, so their caregivers need none of this.
• Licensed caregivers. "A caregiver with proof of a current Oregon health-care related license or certificate is exempt from in-home caregiver training." (0070(13)) OHA’s training memo says medication training is still required for caregivers who give medication services (OHA training memo).
• Records. "Orientation, Caregiver Training, and Medication Training all need to be separately documented in order to ensure topic, length, and instructor requirements have been met." (OHA training memo) When an agency records all its training on one day, OHA’s April 2026 update says: "Payroll records must show the full 16 hours of training time required, plus any additional competency evaluation time, completed on that same day." (OHA, April 2026). OHA’s 16 hours is orientation, caregiver training and medication training together (4 + 8 + 4); a Limited agency’s caregivers need no medication training.

Training your own caregivers

An agency can designate its own qualified trainer, who "has two or more years of experience working with an agency, a long-term care facility as defined under ORS 442.015, a residential care facility as defined under ORS 443.400, or other health care setting" and, if the trainer is a caregiver, is current with the caregiver training rules (OAR 333-536-0005(38)(b)). OHA says "at this time there are no Authority approved training programs to become a qualified trainer to provide caregiver training", and "a qualified trainer can conduct agency specific orientation" (OHA qualified trainer memo, updated September 16, 2026). OHA also says a qualified trainer cannot teach the medication training; that needs a qualified individual or entity (OHA memo). Keep proof that each trainer or entity qualifies (0070(10)).

OHA also lists approved online qualified entities by name and what each is approved for (OHA memo). "QE courses cannot be mixed between entities, the entire program must be completed for each QE." (OHA memo) Check the current list before you choose, as OHA updates the memo.

The administrator

"An agency owner shall be qualified or employ a qualified administrator." In the rule, qualified means "possessing a high school diploma and having at least two years of professional or management experience in a health-related field or program" (OAR 333-536-0052(1)-(2)). Professional experience means a nursing, CNA, medication aide, medical or therapeutic license, certificate or degree used in a health-related field, or an OHA-approved training program; management experience means supervising people in a health-related field, including hiring, assigning, evaluating and discipline (0005(35); 0005(20)).

The administrator or designee is accessible during all hours services are provided and "shall be on-site at the agency multiple days per week" (0052(5)-(6)). A designee named in writing covers temporary absences and meets every administrator qualification (0052(3)); OHA’s January 2026 update says "Designee must be temporary only" (OHA).

Whatever the class, the disclosure statement each client signs states the agency’s classification and services, including the extent of RN involvement, and "a clear statement indicating that it is not within the scope of the agency’s license to manage the medical and health conditions of clients who are no longer stable and predictable" (OAR 333-536-0055(3)). "A client who is no longer stable and predictable may only receive housekeeping or other support services from the agency." (0055(4)(a))

The statute: "An in-home care agency shall conduct a criminal background check before hiring or contracting with an individual and before allowing an individual to volunteer to provide services on behalf of the in-home care agency, if the individual will have direct contact with a client of the in-home care agency." (ORS 443.004). If the check shows a conviction for a crime listed in ORS 443.004, "the home health agency or in-home care agency may not employ the individual" (ORS 443.004(6), formerly (4); renumbered by HB 4115); OHA publishes the crime list.

• Before hire. "An agency shall conduct a criminal records check and make a fitness determination before hiring an SI" who will have direct contact with a client (OAR 333-536-0093(2)). Your written policy covers the barred crimes, preliminary fitness and a documented weighing test for other convictions (0093(5)-(7)).
• The vendor. A screening company accredited by the National Association of Professional Background Screeners (NAPBS), or one in business at least two years with the licenses its home state requires and at least $1 million of errors and omissions insurance (0093(8)).
• What the check covers. A name and address trace, identity verification, local records for the last seven years, a nationwide criminal database search, a nationwide sex offender registry search, and arrest, warrant and conviction data with sources (0093(10)). "An agency shall perform and document a query of the List of Excluded Individuals and Entities (LEIE)." (0093(11))
• While results are pending. "an agency may employ an individual pending the outcome of a criminal records check if the agency ensures that there is no direct contact with any client prior to making a final fitness determination." Document a preliminary fitness determination, keep the person actively supervised at all times, and keep a written employee disclosure in their file saying they may have no client contact until the check is complete (0093(4)). For staff serving ODHS Medicaid clients, preliminary hire follows the BCU’s rule (OAR 407-007-0315) instead (0093(9)(b)).
• Every three years. "An agency shall ensure that a criminal records check is performed on an SI every three years from the date of the SI’s last criminal records check in accordance with these rules." (0093(13))
• Medicaid (ODHS) clients. "The agency shall submit a criminal records check request on any SI working with an ODHS client to the ODHS, Background Check Unit (BCU)." (0093(9)) "The BCU shall make the final fitness determination for an SI working with an ODHS client." A BCU check replaces the vendor check for that person (0093(9)(c), (f)).
• Owners and administrators. OHA, not the agency, checks an owner or administrator who has direct contact with clients, at application and every three years (0010(4); 0093(14)). "If you have criminal history, the Health Care Regulation & Quality Improvement (HCRQI) program will weigh several factors to decide if you are fit for the license/position for which you are applying." (OHA background check request form)
• After hire. Staff with client contact report "any new arrests, charges, or convictions after hire to determine if any personnel action is necessary" (0052(7)(a)).

HB 4115 (2026)

Oregon Laws 2026, chapter 59 (HB 4115), in force since June 5, 2026, amended ORS 443.004. The amendments apply to checks completed on or after that date (Oregon Laws 2026, ch. 59, section 3):

• Three years. For checks completed on or after June 5, 2026, the statute says: "Except as provided by the authority by rule, a criminal background check under this subsection shall last for three years." (ORS 443.004(3)(c) as amended). That matches the three-year re-check the rule already sets.
• Portable BCU checks. A valid check means a current, approved check completed by the ODHS Background Check Unit (ORS 443.004(1)(i) as amended). ODHS and OHA may not require a new check on a worker who holds one solely because the worker changes employer or care setting (ORS 443.004(4)(a) as amended), and both must publish how portability works ((4)(b)). OHA has not said how this fits with the agency’s own pre-hire check under OAR 333-536-0093(2); ask OHA. Under the rule, "to maintain portability, the SI must be rechecked through the BCU every three years." (OAR 333-536-0093(9)(d))

The official ORS page still shows the 2025 edition, so we cite the session law for these changes.

What the agency must do

• The administrator ensures "the timely reporting of any allegation of abuse or neglect to the appropriate authority that includes but is not limited to the ODHS, Authority, or local law enforcement agency" (OAR 333-536-0052(6)(i)). Among the rule’s listed violations: "Fail to report suspected abuse of elderly persons as defined in ORS 124.050" (0110(6)).
• Investigate every complaint, adverse event, error and abuse or neglect allegation, and keep the documentation in a separate file from client and caregiver records (0051(2)(d); 0052(6)(h)).
• "An agency shall cooperate with investigations of allegations of client abuse and neglect conducted by the ODHS- Adult Protective Services, ODHS-Child Protective Services, Authority, or other agencies such as law enforcement." (0043(4))
• OHA’s checklist asks for an abuse policy, an abuse procedure and an abuse reporting form (IHC Initial Checklist).

What caregivers report themselves (our reading)

Oregon’s three reporting laws each list "home health aide or employee of an in-home health service" among mandatory reporters: for people 65 or older (ORS 124.050(9)(b)), for children (ORS 419B.005(6)(d)), and for certain adults with developmental disabilities, mental illness or substance use disorders who receive services from a community program, facility or state hospital, as ORS 430.735 defines them (ORS 430.735(11)(b)). The statutes do not say "in-home care agency", but ODHS’s Medicaid rule says "All employees of an in-home health service, which does include IHCA are required by statute (ORS 124.050-124.095) to report suspected abuse or neglect" (OAR 411-033-0020(5)(b), an ODHS program rule). Our reading: treat every caregiver as a mandatory reporter.

• How. For elder abuse, "an oral report shall be made immediately by telephone or otherwise to the local office of the Department of Human Services or to a law enforcement agency" (ORS 124.065(1)). OHA’s FAQ: "All abuse reporting can be made to the main hotline at 1-855-503-SAFE (7233)." (OHA FAQ 12)
• OHA’s guidance. If you have reasonable cause to believe a client is being or has been abused, "you are required to report this information to the appropriate Department of Human Services (DHS) office immediately." (OHA abuse reporting guidelines)

A gap. We found no deadline in the rules or OHA’s guidance for the agency to tell OHA itself about an abuse report, beyond the duty to ensure timely reporting to ODHS, OHA or police. Ask OHA what it expects.

• Surveys every two years. The rule has OHA "conduct at least one survey of each agency prior to services being rendered and once every two years thereafter" (OAR 333-536-0041(1)). "The Authority shall notify the agency owner and administrator no less than 72 hours prior to the date of an initial or biennial licensing survey." (0041(2)) OHA’s January 2026 update adds: "No rescheduling of surveys" (OHA). "An unannounced complaint investigation shall be carried out as soon as practicable" (0043(1)).
• What the notice asks for. OHA’s relicensure memo asks for lists of clients, caregivers and nurses, and "a list of complaints, which include allegations of abuse or neglect, adverse events, and medication or treatment errors" (OHA relicensure memo).
• Deficiencies. "A signed plan of correction must be mailed to the Authority within 10 business days from the date the statement of deficiencies was received by the agency." (0117(3)) "An agency shall correct all deficiencies within 60 days from the date of the exit conference" (0117(4)). OHA’s tip: "Ensure you are addressing all five of the required POC elements." (OHA plan of correction guidance)
• What OHA cites most. In 2025, service plan elements (tag 0530) was cited 46 times, the most of any tag (OHA, January 2026). From January 1 to July 1, 2026, client records (tag 0675) led with 20 citations, followed by caregiver orientation (OHA, July 2026).
• Changes. "An agency shall submit a revised application to the Authority within 30 days of the change." (0010(5)) A new administrator, a change of classification, and a branch or subunit need OHA’s approval before they take effect (0010(5)(a)). To change class, OHA asks you to "attach all agency Policies and Procedures, revised as required for updated classification requested" (OHA change of classification instructions).
• Keep policies current. "Policies and procedures must be updated when Oregon Administrative Rules are revised or the agency’s practice has changed." (OHA memo)
• Non-competes. ODHS, OHA and the Oregon Home Care Commission say "it is not a legal practice to require in-home agency caregivers to sign these agreements" (provider alert, October 26, 2023).
• Medicaid (a program, not the license). "In-home care agency (IHCA) services are one of the in-home service options available for individuals eligible for Medicaid in-home services." Under that ODHS program rule, "the IHCA shall begin services within five business days from the date of acceptance" of a referral (OAR 411-033-0020, an ODHS program rule).

• HB 4115 (in force). Oregon Laws 2026, chapter 59 (HB 4115), in force since June 5, 2026, amended ORS 443.004. For checks completed on or after that date, an in-home care agency’s background check lasts three years unless OHA’s rules say otherwise, and ODHS and OHA may not require a new check on a worker who holds a valid ODHS Background Check Unit check solely because the worker changes employer or care setting. We found no amendment to OAR 333-536 that follows it. See background checks (Oregon Laws 2026, ch. 59).
• OAR 333-536. The rules were rewritten in 2021 and last amended in 2023 (OHA says the revised rules took effect on October 23, 2023: OHA FAQ 5), with a minor correction to the definitions in 2024. On our check of October 8, 2026, OHA’s rulemaking page listed no in-home care proposal, filing or advisory committee (OHA rulemaking page). We could not search the Oregon Bulletin, so we cannot rule out a notice there.
• OHA’s guidance moves faster than the rules. The qualified trainer memo was updated on September 16, 2026 (OHA memo), and OHA publishes an update each quarter with its most cited tags (July 2026 update). Check OHA’s forms page before you submit.

We will email rule-change alerts when OHA proposes a change (sign up below), and all states’ open changes are on our rule changes page.

• Who may teach the six annual hours. The rule says annual education comes "from a qualified trainer, qualified individual or qualified entity" (OAR 333-536-0070(14)), and its definition lets an agency designate a qualified trainer for "agency specific orientation, initial caregiver training and annual caregiver training required by these rules" (0005(38)(b)). OHA’s quick reference guide lists "QE or QI as defined by Rule" for continued education (OHA training memo, rev. 06/2024). Our reading: the rule allows your own qualified trainer; until OHA confirms, using a qualified individual or entity for the annual hours satisfies both.
• A new administrator. The rule says a change of administrator needs OHA’s approval before it takes effect (OAR 333-536-0010(5)(a)). OHA’s FAQ says: "If the ownership, address, or administrator of your agency or subunit changes at any time, you must notify this office, in writing, within 30 days of the change." (OHA FAQ 9) Our reading: get approval first, as the rule says.
• The review before the survey. The completeness and sufficiency reviews, the checklist with page numbers and the acceptability criteria are OHA’s guidance. The rule says OHA confirms a complete application, surveys and assesses compliance (OAR 333-536-0015). In practice, follow OHA’s process: it decides when your survey is scheduled.
• Companion-only businesses. Covered above: on our reading possibly outside the license, not confirmed by OHA.
• Caregivers as mandatory reporters. The statutes say "employee of an in-home health service", and ODHS’s Medicaid rule says that includes in-home care agencies (above). Our reading: every caregiver reports.
• Home offices. We found no office type or zoning standard in the rules, but the license is posted "in an office that is viewable by the public" (0021(3)), client records are kept in the agency’s office (0085(1)), and the administrator is on site at the agency multiple days per week (0052(6)(a)). Ask OHA before relying on a home office.
• The rule text we quote. We quote OAR 333-536 from the Cornell Legal Information Institute’s copy (LII), because the Secretary of State’s rule database blocks our tools. We compared that copy’s history notes for all 35 rules with the official division 536 list on October 8, 2026, and they match. The statutes are quoted from the Legislature’s official 2025 edition.

OHA’s own counts: "Total IHC Agencies Licensed: 235 as of 7/1/2026" (OHA, July 2026), up from 217 on January 1 and 223 on April 1, 2026 (January; April). "Licensed IHC agencies have increased 88% since 2012 (125 in 2012 vs. 235 in 2026)." (OHA)

• New licenses (initial surveys that led to a license, OHA’s count): 20 in 2024, 17 in 2025 (OHA, January 2026) and 24 from January 1 to July 1, 2026 (OHA, July 2026).
• Applications. "Initial applications have increased 241% since 2020 (17 in 2020 vs 58 in 2025)." OHA had 50 submitted applications in the queue in July 2026 and says its queue has stayed between 45 and 60 since 2023 (OHA, July 2026).
• Who applies. Since 2023, OHA says, "nearly half of all applicants have held another ODHS license, most commonly adult foster home licensure", and a quarter of applicants do not live in Oregon (OHA, July 2026). OHA issued 9 subunit licenses from 2020 to 2025 and 6 in 2026 by July (OHA).

OHA’s public list of licensed agencies is blocked to our tools, so we cannot say how many hold each class.