How to Choose a Home Care Agency in Portland

Published September 27, 2026 by EQC Home Care

What “home care” can mean

People use “home care” loosely, and Oregon actually regulates several different kinds of in-home help under different rules. This guide focuses on the everyday kind most families are looking for: help with daily living, such as bathing, dressing, meals, mobility, medication reminders and companionship, delivered by a caregiver who comes to the home. That is generally what an Oregon in-home care agency is licensed to provide.

It is not the same thing as short-term recovery care ordered by a doctor after a hospital stay, or care focused on comfort near the end of life — those are separate, differently regulated categories with their own licensing rules, and this guide doesn’t cover how to evaluate them. If you’re not sure which category fits your situation, ask any agency you’re considering directly what it is licensed to provide, and confirm it with the state resources linked below.

Families also arrange in-home help through more than one channel. The rest of this guide walks through the three most common routes in the Portland area, how Oregon licenses agencies, what things tend to cost, and what to ask and watch for along the way.

Three ways to arrange help at home

Each of the three common routes shifts different responsibilities onto you, so it helps to know which one you’re choosing before you commit to it.

A licensed home care agency

An agency hires, trains, schedules and supervises caregivers, and carries its own liability and workers’ compensation insurance. It’s typically responsible for running background checks, arranging backup coverage if a caregiver is unavailable, and handling payroll and employment taxes. In Oregon, agencies that provide certain kinds of in-home personal care and support must be licensed by the Oregon Health Authority — the next section covers how to check that.

An independent worker through Oregon’s homecare registry

Oregon’s Home Care Commission maintains a registry — currently offered through a matching service called Carina — that helps connect consumers, mainly those using Medicaid programs such as Aging and People with Disabilities (APD) or Oregon Project Independence, with independent homecare workers. In this consumer-directed model, you or your representative are typically the worker’s employer: you interview, hire, schedule and supervise them directly, rather than an agency doing it for you. Availability and eligibility rules can change, so confirm current details with the Commission or your caseworker.

Hiring someone privately, on your own

You can also find and hire a caregiver on your own — through a referral, a classified ad or a general caregiving website — with no agency and no state registry involved. That gives you the most control over who you hire and what you pay, but it also means you take on every responsibility an agency or the registry would otherwise help manage: background screening, training, scheduling, backup coverage, and often payroll taxes and workers’ compensation if you become the worker’s legal employer. Talk with a tax or employment professional if you’re unsure what hiring someone directly requires of you.

None of these three routes is automatically the right choice — it depends on how much time you have to manage the details yourself, whether you’re paying privately or through a program such as APD or DD, and how much backup and oversight matters to you.

Verify the agency’s Oregon license

Oregon regulates in-home care agencies through the Oregon Health Authority. Before you sign anything, ask the agency for its license number and license class, and then verify that information yourself rather than taking it on faith — a license can lapse, change class, or belong to a different legal entity than the one that’s in front of you.

OHA: licensed in-home care agencies ↗ — The Health Facility Licensing & Certification program keeps a public list of licensed in-home care agencies. Search by the agency’s legal business name to confirm its license number, class and current status yourself.

License classes can differ in the scope of service an agency is approved to provide, so it’s worth asking what its specific class covers and whether that matches what you’re being offered — not just whether a license exists. A current license is also a baseline, not a guarantee of quality: it confirms the agency has met the state’s minimum requirements to operate, not that it’s the right fit for your family. If an agency can’t or won’t give you a straight answer about its license, treat that on its own as a serious red flag.

Understanding cost and payment

How care is paid for varies by household and by program, and it’s worth understanding before you compare quotes. Ask every agency for its current rate sheet in writing, including its hourly rate, any minimum-hours-per-visit requirement, holiday or overnight rate differences, and any separate assessment, start-up or cancellation fees.

If you’re exploring coverage through a Medicaid program such as APD or Developmental Disabilities (DD) services, eligibility, covered supports and authorized hours are determined by the program and your individual assessment, not by any single agency — ask the agency directly whether it participates in the program you’re considering, and confirm your own eligibility and authorized hours with your case manager or services coordinator. If you’re paying privately, get the full rate structure in writing before your first shift, not after.

Questions to ask before you sign a service agreement

Bring a list. A good agency will expect these questions and answer them plainly, and a written service agreement should reflect what you’re told out loud.

• What is your Oregon Health Authority license number and class, and can I see a copy of your license?
• Who actually employs the caregiver: your agency, or am I the employer of record?
• How do you screen and train caregivers, and what happens if a caregiver isn’t a good fit?
• What happens if my regular caregiver is sick or unavailable — who provides backup coverage, and how quickly?
• How are hours scheduled, tracked and billed, and what is your cancellation or minimum-hours policy?
• What insurance do you carry, and are your caregivers bonded?
• Who do I contact with a concern or complaint, and what is your process for handling it?
• Can I see a sample service agreement and your current rate sheet before I commit to anything?
• How do you handle a schedule or care-plan change, and how much notice do you need?
• What is your policy if I want to end services, and is there a notice period or fee?
• Do you accept Oregon APD or DD program payment, and how does billing work if my authorization or hours change?
• Will the same one or two caregivers usually come, or should I expect a rotating group?

Red flags worth pausing over

None of these automatically means an agency is dishonest, but any of them is a reason to slow down, ask more questions, or look elsewhere.

• Pressure to sign a service agreement on the spot, before you’ve had time to read it or compare options.
• Reluctance to provide a license number, or a license number that doesn’t match what you find in OHA’s lookup.
• No written service agreement at all, or one that doesn’t match what you were told out loud.
• Vague or shifting answers about rates, billing increments or extra fees.
• No clear plan for backup coverage when a caregiver is sick or unavailable.
• Asking for a large payment in cash, up front, before any services have been provided.
• An unwillingness to provide references, or references you can’t verify independently.
• No clear point of contact for concerns or complaints once services begin.
• A rate sheet that changes after you ask specific questions, or that the agency won’t put in writing.

A simple next step

Most families do better comparing more than one option — two or three agencies, or an agency against the registry and private-hire routes above — before deciding. Ask each one the same set of questions, in the same order, so the answers are actually comparable. Write the answers down rather than relying on memory a few days later.

• Confirm the license yourself in OHA’s lookup before your first conversation goes much further.
• Get the rate sheet and service agreement in writing, and read them closely before you sign.
• Ask what happens on a bad day: a caregiver calls in sick, your schedule changes, or you have a complaint.
• Talk with someone else who has been through this, if you can — a case manager, a discharge planner, or a friend who has hired care before.
• Give yourself time. A short delay to compare options is rarely the wrong call; a rushed decision is harder to undo.

If something about a conversation feels rushed, evasive or too good to be true, that feeling is worth listening to. You’re allowed to say you need more time, ask for something in writing, or walk away and call someone else.

This guide is general information for Portland-area families and isn’t legal advice. Oregon’s licensing rules and programs can change, so confirm current requirements directly with the Oregon Health Authority or with the agency, program or registry you’re considering.