If you or a loved one lives with a disability or chronic condition requiring ongoing personal assistance and medical care, having control over your support services is crucial for maintaining comfort, dignity, and independence.
Oregon’s Consumer-Directed Personal Assistance Program (CDPAP) lets recipients take the lead in shaping care around their unique needs and preferences, rather than fitting into restrictive agency schedules and one-size-fits-all assistance.
This in-depth guide will equip you to access and optimize self-directed support services through Portland-area CDPAP providers. Read on to learn how directing your own care can greatly enhance quality of life for those managing chronic illness or disability.
What is CDPAP?
The Consumer-Directed Personal Assistance Program (CDPAP) gives chronically ill and disabled individuals the freedom to customize and manage their own homecare services.
Rather than receiving pre-determined agency care, CDPAP recipients can hand-pick caregivers, set personalized schedules, determine assistance duties, and oversee payroll/budgets. This empowers each person to build a tailored care plan matching their needs.
New York first pioneered the model in the 1990s before programs spread nationwide. Currently 12 states administer CDPAP plans, with more exploring self-directed support options.
Under Oregon’s CDPAP program:
- Recipients qualify based on functioning needs documented by a medical professional
- Services may include aide with dressing, bathing, meals, errands, household tasks, and medical/nursing functions
- Family can serve as caregivers while managing outside payroll and accounting
- Strict supervision and audits safeguard against financial exploitation
CDPAP utilizes Medicaid funding, allowing low-income individuals with disabilities/chronic conditions to receive assisted living level of care at home regardless of age or diagnosis.
The model aligns with decades of policy efforts and litigation affording people with disabilities more choices to live independently rather than in institutional settings. It also draws inspiration from global self-directed care movements.
Why Choose CDPAP Over Standard Home Care?
Consumer-directed programs like CDPAP offer important advantages over traditional home healthcare.
Benefits include:
-
Greater flexibility in scheduling care to match recipients‘ personal needs and last-minute changes rather than rigid agency worker shifts. No more struggling to reschedule an appointment because homecare is only available at set times.
-
Wider service range as recipients can authorize any medical or daily living assistance required rather than pre-determined care tasks alone. Have an important event on a weekend most agencies don’t staff for? With CDPAP you direct the care plan.
-
More tailored care via one-on-one relationships with caregivers responsive to recipients‘ unique needs and preferences rather than impersonal agency rotations. This fosters dignity and comfort.
-
Higher transparency and accountability with recipients responsible for interviewing, hiring, training, and directing caregivers themselves rather than an agency assigning rotating workers. This allows better oversight of care quality.
-
Increased independence and choice empowerment with recipients fully at the helm of care decisions based on their personal needs and capabilities. This supports self-confidence and control.
-
Cost savings, as paying caregivers an hourly wage instead of contracting through a private agency carrying large overhead can reduce overall expenses 20-30%. These savings get redirected into recipient living expenses or additional care hours.
Of course self-directed care also involves more administration and hands-on management from the recipient or a designated representative. But for many, the benefits make that increased work worthwhile.
A Snapshot of Oregon CDPAP Utilization
Since pioneering the model in the early 2000s, Oregon remains a national leader in expanding access to self-directed homecare services via Medicaid policy and regulation.
As of 2021 statewide CDPAP utilization metrics show:
- 8,228 Oregonians currently directing their own in-home care
- 94% of recipients satisfied with their control over services
- 30%+ cost savings over equivalent agency care hours
CDPAP participation continues rising yearly, though shortages of care workers and lack of program awareness among those who qualify hamper growth. Approximately 58,000 additional disabled and elderly Oregonians would likely enroll if more caregivers got involved.
The Oregon CDPAP Waiver recently increased self-directed care eligibility to include more diagnoses like Alzheimer‘s disease, enabling better customized memory care. Officials also expanded the family member pool who can provide paid assistance to recipients.
However health equity challenges remain with minority groups accessing services at lower rates. And not all disabilities automatically qualify recipients for publicly funded care.
Still, Oregon demonstrates how CDPAP empowers chronically ill individuals to take ownership over support services, reduce taxpayer costs, and delay more expensive facility-based care.
Am I Eligible for Oregon‘s CDPAP?
Oregon utilizes Medicaid funding to cover qualifying recipients’ CDPAP services based on level of assistance required with “activities of daily living” (bathing, dressing, eating, mobility, etc.) and associated hands-on medical/nursing tasks.
To receive coverage, you must demonstrate functional impairment requiring help with these daily personal care and skilled nursing services by:
- Having a disability determination from the Social Security Administration
Or
- Getting a doctor or nurse practitioner‘s signed certification of assistance needed based on a qualifying condition.
General eligibility guidelines include:
-
Oregon resident
-
U.S. citizen or qualified non-citizen
-
Financial criteria like income thresholds and asset limits depending on age and Medicaid rules
-
Requires minimum hands-on assistance in 3+ daily activity areas
Note if you have employer-sponsored long term care insurance, your policy likely covers CDPAP services. Self-pay options also exist in the Portland region.
Reaching out to a local CDPAP agency facilitates getting qualified and enrolled if you meet functional criteria. They guide clients through documentation and application requirements, Medicaid determinations, and Oregon waiver processes.
Some covered diagnoses and disabilities include:
- Spinal cord injuries
- Cerebral palsy
- MS, ALS, Muscular dystrophy
- Spina bifida
- Alzheimer’s disease
- Brain/head injuries
- Stroke
- Amputations
- Severe arthritis
- Cancer recovery
And age-related frailty requiring extensive personal assistance.
The exact conditions and functioning thresholds to receive Medicaid funded CDPAP support depends on Oregon Health Plan guidelines. But consumer-directed care seeks to cover more diagnoses going forward so people can live independently rather than needing facility placement.
How Does CDPAP Work?
Once approved for Oregon‘s CDPAP program based on detailed medical eligibility documentation, recipients take the lead directing nearly all aspects of their care.
Key elements of self-directed assistance include:
-
Choosing your own caregivers – Hire family, friends or professionals you trust rather than unknown rotating agency staff
-
Training caregivers – Teach them to expertly assist with your specific needs from transfers, to bowel programs, medication administration, and more
-
Setting schedules – Design personalized daily/weekly care calendars tailored to your changing routine
-
Determining care duties – Outline exact daily living and skilled nursing tasks needed hands-on help with rather than pre-set assistance
-
Managing payroll/taxes – Work with a designated fiscal agent on payment, taxes, compliance rather than handle finances
-
Overseeing quality – Supervise caregivers based on your care standards rather than agency metrics
-
Changing plans as needed – Modify your care hours, tasks, or caregivers as health evolves rather than fixed services
This facilitates truly customized, consumer-driven care centered around each recipient’s preferences, dignity, and autonomy.
Behind the scenes, CDPAP agencies provide crucial support navigating program rules, training for success, caregiver connections, and fiscal management.
Spotlight: Portland-Area CDPAP Providers
Specialized home care agencies facilitate Oregon’s Consumer-Directed Personal Assistance Program. They handle admin like documentation, payroll, compliance and counseling so recipients can focus entirely on managing their personalized care.
Selecting the right CDPAP provider ensures access to quality caregivers, responsive support addressing your concerns, and smooth fiscal management.
Here are three top-rated Portland-region agencies enabling CDPAP recipients to thrive through customized, self-directed care:
1. Assisted Living At Home
With a mission to promote independence and choices, Assisted Living at Home serves CDPAP clients in Portland and surrounding cities. Highly-rated by recipients and caregivers alike, they simplify admin so recipients can succeed directing their care plans.
Services include:
- Assistance finding and onboarding caregivers
- Training for clients new to managing their care
- Criminal background checks of all workers
- Processing payroll and taxes
- Care planning and coordination
- 24/7 on-call assistance
Assisted Living at Home prioritizes open communication so recipients always feel supported, whether answering program questions or helping resolve care quality issues. Many clients consider their advisors an invaluable partner for the challenges and rewards of self-direction.
Reviews: "We don’t know what we would have done without the expertise and encouragement of our care coordinator guiding us through setting up mom’s CDPAP.”
2. At Your Side Home Care
Employing over 750 caregivers, At Your Side serves CDPAP clients in Portland, Vancouver, and surrounding regions. Their person-centered philosophy makes them a top choice facilitating Oregon consumer-directed care.
All administrative aspects from hiring to payroll get handled by At Your Side’s experienced team, including:
- Assistance locating and vetting caregivers
- New hire orientations and training
- Verifying credentials and references
- W-2 tax paperwork
- Processing payroll
- Insurance for care workers
- Care planning assistance
At Your Side also hosts free monthly seminars on succeeding with self-direction, as well as support groups allowing recipients to share advice. Clients give high marks for responsive coordination guiding their journey to customized care.
Reviews: “We never feel alone trying to figure everything out thanks to our wonderful care team.”
3. EmpRes Healthcare
Supporting Oregonians managing disability and chronic illness since 2009, EmpRes Healthcare offers personalized CDPAP guidance so clients gain greater independence directing their care.
Their dedicated advisors provide ongoing support including:
- Helping clients articulate preferences and care needs
- Onboarding suitable caregivers matched to recipient goals
- Training for successful self-direction
- Processing payroll, taxes and compliance
- Answering program questions
EmpRes aims to shift healthcare power back to the individual. Reviews praise theiremphasis on recipient needs and preferences, flexible scheduling, and skill guiding clients new to managing their care needs.
Reviews: “The level of individualized attention stands out – I never feel like just a number.”
Making the Transition to Self-Directed Care
If you decided consumer-direction aligns with your values and care needs, take heart that many before you navigated the learning curve to start directing their own services successfully.
Here are some top tips to smooth the transition:
Apply early
Allow plenty of time for the eligibility process, as documentation and approvals can take months. Have your DPOA ready if needed.
Let go of perfection
Self-direction involves adjustment. Focus on progress over perfection in care details when starting out. Streamline by priorities.
Start conservatively
Better to realize you can handle more care hours than get overwhelmed doing too much independently at first. Build capacity.
Use agency support
Rely on your CDPAP provider to guide you through hurdles like hiring. Don’t shoulder the lift alone.
Focus on trust
Vet caregivers closely seeing if you click and align on care values. A relationship built on trust is key.
Train, train, train
Set detailed expectations and train caregivers on precisely assisting with your routines to avoid frustration.
Communicate needs
Speak up clearly about preferences and anything requiring adjustment, rather than let minor issues compound.
Plan ahead
Schedule out care calendars proactively to smoothly cover appointments etc. Stay organized.
Embrace flexibility
Learn to comfortably roll with changes in a way agencies can’t. Self-direction gets easier with confidence.
While each person’s capabilities differ, many new enrollees adapt quicker than expected to the initial challenges of directing their personalized care once skilled assistance is in place.
Voices of CDPAP Recipients
We spoke with three people currently utilizing Oregon‘s Consumer-Directed Personal Assistance Program through local providers about their experiences. Read firsthand how self-direction changed their lives for the better:
John P. – Quadriplegic CDPAP recipient
Managing round-the-clock care needs alone since a spinal cord injury left him quadriplegic, John grew overwhelmed trying to schedule reliably. Agency consistency suffered too.
Now with CDPAP John trains his own staff on his specialized assistance needs. “Directing my own care hours finally allows flexibility when I need extra help or have doctors appointments pop up. My health and peace of mind improved because I have consistent assistants who know me.”
What he values most is the ability to interview assistants and incorporate his personal preferences into care thanks to CDPAP self-direction privileges. “I can shape each day on my terms. My home life is so much less stressful and I get to just be me.”
Sheila R. – Mother and CDPAP caregiver
Unable to lift her adult son alone for transfers due to back problems, Sheila’s family struggled assisting with his cerebral palsy care once he aged out of children’s home health services.
Now as her son Jeffrey’s paid helper through CDPAP, Sheila handles his personal assistance needs while an agency supports them handling admin and payroll. “It took adjustment learning the responsibilities directing Jeffrey’s care, but the flexibility designing everything around his needs makes all the difference.”
Thanks to self-direction, Jeffrey enjoys more reliable and personalized daily living support tailored to his mobility limitations. Sheila values CDPAP giving them control over care choices rather than agency mandates. “I can have dinner with my family without worrying about a worker no-show. CDPAP reduced so much stress.”
Frank T. – Stroke survivor
Paralyzed on one side after a major stroke, Frank struggled waiting for agency assistants to transfer or shower him on their rigid schedule. “I felt like a task to rush through rather than a person. My dignity really suffered.”
Entering Oregon’s CDPAP program enabled Frank to customize care around his needs. Now with assistants he trained himself, Frank’s confidence and comfort improved dramatically thanks to respectful, self-directed support.
“Directing my own care was intimidating at first, but now I can’t imagine life any other way” Frank shared. “I have the flexibility to get family help some days or my favorite assistant on days I work from home. CDPAP brought back freedom and control.”
Take the Next Step Toward Independence
As John, Frank, Sheila, and over 8000 other Oregonians learned, consumer-directed services like CDPAP can profoundly improve care experiences for those managing disability or chronic illness.
No longer must you schedule life around rigid agency shifts or sacrifice dignity to rotating assistants. Enroll with a supportive Portland-region CDPAP provider to take charge of your personalized care.
This guide covered everything from program eligibility to real-life experiences directing your own services. Consider if self-direction could help you or a loved one live more freely based on your functional support needs and values.
Oregon‘s nationally-recognized CDPAP policies exist specifically to fund assisted living level of care at home for those who otherwise couldn‘t afford needed assistance. Qualify based on your hands-on care needs, not diagnosis.
Don‘t wait and risk declining health or wellbeing when self-directed support through CDPAP may empower you or your family member to stay at home safely, comfortably, and independently.
You deserve care on your own terms. Contact a top-rated local agency today to explore accessing life-changing consumer-directed assistance.