Skip to main content

Oregon State Flag An official website of the State of Oregon »

Oregon Department of Human Services Search Site

I/DD Provider Types

This page explains the different types of I/DD providers and endorsements to help you understand your options. 

Medicaid agencies Foster homes

 Already chosen a provider type and ready to apply? Visit Become a Provider. Please note: each provider type has a different application process.

Medicaid agencies

A Medicaid agency provider is a public or private organization that provides services to people with I/DD.

The Office of Developmental Disabilities Services (ODDS) certifies Medicaid agencies and approves endorsements for specific services under Oregon Administrative Rule (OAR) 411-323.

Agency responsibilities

  • Provide services to people with intellectual and developmental disabilities
  • Give support through its employees, contractors, or volunteers
  • Recruit, supervise, and pay support workers
  • Have an executive director who meets the requirements listed in (OAR) 411-323

Agency endorsements

  • When an agency first applies to become a certified Medicaid provider, they choose one or more endorsements as part of the same application.
  • An endorsement is the type of service the agency will provide after they are certified. 
  • An agency needs an endorsement for each service it will provide. Each endorsement has its own rules, policies, and qualifications.
  • ODDS reviews and approves endorsements during the initial certification. After certification, an agency may request to add or change endorsements at any time.

Here are the Medicaid agency endorsement options:

​​Adult and​​​ child 24-Hour Residential services provide person-centered supports to individuals with I/DD in community homes.

Services and responsibilities

  • ​Follow the standards and qualifications outlined in ​ OAR ​411-325.
  • Hold a license for each site that has a unique address. 
    • ​Note: A ​license application form is completed for each site, and is separate from the agency certification and edorsement application.​
  • Train and oversee all staff​​.
  • Provide services based on each person's needs and goals, including but not limited to:
    • Personal care
    • Medication management
    • Behavioral support
    • Skill development
    • Community integration
  • Serve adults (18 and older) or children (until their 18th birthday)​.
Medicaid agency application

Host Homes provide services in a family home setting to individuals with I/DD, ages 0–18. When an individual turns 18, they may continue living in the Host Home if they are on a modified diploma or enrolled in a transition program and may stay in the home until age 21. 

Host Home providers are resp​onsible for recruiting, training, and supporting caregivers who deliver care in their Host Home.

Services and responsibilities

  • Follow the standards and qualifications outlined in​ OA​R 411-348​.
  • Hold a license for each Host Home location. 
    • ​Note: A ​license application form is completed for each site, and is separate from the agency certification and edorsement application.​
  • Ensure access to nursing services and other professional supports based on individual needs.
  • Train and oversee all staff.
  • Provide services based on each child’s needs and goals, including but not limited to:
    • Personal care
    • Health and safety support
    • Behavioral and mental health supports
    • Help with school or work needs
    • Recreational and community integration
Medicaid agency application​​

​Employment providers deliver community‑based employment services and supports. Oregon’s Employment First policy makes community jobs in fully integrated settings the top priority for people with developmental disabilities. This priority comes before unemployment, segregated work, ​​day‑support activities, or other non‑work activities.

When a person reaches their goal of working in the community (competitive integrated employment), future planning focuses on how to keep their job or explore new career or growth options.

Services and responsibilities

Follow the standards and qualifications outlined in OAR 411-345.​

Job Development​ — Typically offered through Vocational Rehabilitation (VR)​

  • An employment professional in a job development role supports an individual to find competitive, integrated employment.
  • Support may include goal setting, job searches, and other strategies
  • As of June 14, 2025, Vocational ​Rehabilitation entered Order of Selection. ODDS now delivers Job Development services.

Job Coaching

  • ​An employment professional in a job coaching role supports an individual to learn new job tasks, adjust to a new workplace, and maintain or advance in competitive and integrated employment.
  • The individual’s job must pay at least minimum wage or better. 
  • ODDS may fund initial, ongoing and renewal, or maintenance job coaching after the individual stabilizes through VR or ODDS.
  • Job coaching may be available for self-employment in collaboration with Vocational Rehabilitation services.

Supported Small Group Employment

  • This service provides work experience opportunities and supports individuals in building job skills so they can succeed in competitive, integrated employment alongside their peers.
  • The individual’s job must pay minimum wage or better and be provided in a manner that promotes integration in the workplace.
  • This service may be supporting a group of two to eight individuals with disabilities.

Discovery

  • This person centered employment planning service is for an individual seeking competitive, integrated employment.
  • Work or volunteer activities help individuals learn about their strengths, interests, skills, experience, and support needs.
  • Providers work with individuals to identify work conditions where they can succeed.

Employment Path

  • This time-limited service helps individuals explore employment, gain work experience, or build skills for competitive, integrated employment.
  • This service may be community-based or facility-based. Facility-based services are provided at a fixed site that is operated, owned, or controlled by the provider, and must include a community based component.
  • This service is used in combination with Small Group Employment Services.
  • It may also be used in combination with Job Development services when available.

Solo Employment Path

  • This service must take place in the general community business setting and must be provided one-on-one.

On-the-Job Attendant Care

  • This service supports an individual with activities of daily living, instrumental activities of daily living, and health related tasks. Support may include hands on assistance, supervision, cueing, and behavior supports. These supports help the individual maintain competitive, integrated employment when job coaching is not provided.
Medicaid agency application

​Supported Living programs provide support to individuals who live in the home of their choice. This could be an independent apartment or house, or provider-owned and operated housing. The level of support provided is based on each individual's needs and preferences listed in their Individual Support Plan (ISP).

Services and responsibilities

  • Follow the standards and qualifications outlined in OAR 411-328​.
  • Provide direct-support staff for up to 24 hours of training and support for individuals to help them live in their chosen home, and be a part of and participate in their communities.
  • May offer help with activities of daily living, appointment and transportation coordination, and meal planning.
  • ​​Assist with finding housing that meets individuals’ needs, in some cases.​​
Medicaid agency application

Community Living Supports (CLS) support people with intellectual and developmental disabilities to live safely and as independently as possible in their own homes or family homes. This can include support with activities of daily living, skill-building, community inclusion, meeting health and safety needs, and working toward an individual’s personal goals

Community Living Supports are offered in two ways, and providers can only hold one CLS endorsement at a time:

  • Employer Model, or
  • Standard Model
Note: Day Support Services can only be provided by agencies with a Standard Model endorsement.​

CLS – Employer Model

Employer Model agencies support people with I/DD to live as independently as possible in their own homes or family homes. These agencies provide training, coaching and support for individuals who choose to self direct their services. The agency helps them understand their responsibilities, navigate managing or training workers, and maintain the level of choice and control they want as they direct their own services.

Services and responsibilities

  • Follow the standards and qualifications outlined in OAR 411-450.
  • Assist with activities of daily living and instrumental activities of daily living.
    • ​Personal hygiene, mobility, meal preparation and community participation
  • Skills training, relief care, and emotional or cognitive support based on each person’s needs.
  • Handle all administrative tasks such as payroll, billing, compliance and documentation.

CLS – Standa​rd Model

Standard Model agencies provide traditional, agency-managed services and supports for people with I/DD. These services help people remain in their own home or their family’s home. Under this model, the agency employs, trains, manages, and supervises the staff who provide support. The agency also handles all administrative tasks such as payroll, billing, compliance, and documentation.

Services and responsibilities

  • Follow the standards and qualifications outlined in OAR ​411-450.
  • Assist with activities of daily living ​and instrumental activities of daily living.
    • Personal hygiene, mobility, meal preparation, and community participation
  • Skills training, relief care, and emotional or cognitive support based on each person’s needs.
  • Access to a supervisor while services are being provided.
  • Handle all administrative tasks such as payroll, billing, compliance, and documentation.
Medicaid agency applicationM​​ore about in-home supports

Direct nursing services (DNS) is a special endorsement used to provide nursing care to people with I/DD who have complex health needs. DNS requires a high level of nursing support based on the person’s medical needs. This level gives the individual between 140 and 554 hours of nursing services each month.

Services and responsibilities

  • Follow the standards and qualifications outlined in OAR 411-380.
  • Check a person’s medical condition throughout each shift.
  • Complete skilled nursing tasks.
  • Give treatments and therapies.
  • Collect important health information such as medication or seizure logs.
  • Write shift notes and flow sheets.
  • Communicate with individuals, doctors, health professionals,​ and other groups.
Medicaid agency application

Positive Behavior Support Services include written tools that help staff, parents, and other supporters manage challenging behaviors that interfere with an individual’s ability to complete ADLs/IADLs, community integration, and living the life they want. Such behaviors may include verbal or physical aggression and property destruction. Behavior professionals provide these services.

Services and responsibilities

  • Follow the standards and qualifications outlined in OAR 411-304.
  • Temporary Emergency Safety Plan (TESP): An optional short-term plan written by a behavior professional to help supporters manage behavior safely until a full Positive Behavior Support Plan is finished.
  • Functional Behavior Assessment (FBA): A document created after interviews, observations, and reviewing records. It explains the person’s strengths, challenges and challenging behaviors.
  • Positive Behavior Support Plan (PBSP): Similar to a safety or medical protocol, this plan gives step-by-step strategies for preventing, responding to, and recovering from behavioral crises. It also explains how to help the person replace challenging behaviors with safer behaviors. It may include safeguarding interventions such as physical holds.
  • Training: A behavior professional can train supporters in how to follow the PBSP, including how to use approved safeguarding interventions.
  • Maintenance: A behavior professional reviews behavior data over time, updates the PBSP when needed, and provides retraining for new or current supporters.

Behavior professionals may work independently or through an agency. Every individual has the right to choose their behavior professional.

This Behavior Professional database​ lists all approved professionals in Oregon.

​​Before services can begin

  • ​​The service must be listed in the Individual Support Plan and Plan of Care.
  • The case management entity must verify the provider’s number in eXPRS.​​​
​ Medicaid agency application

Foster homes (adult and child)

Foster homes provide care and support in a home setting to individuals with I/DD who are not related to the provider. 

Adult foster homes are licensed, and child foster homes are certified.

Foster home provider types and responsibilities

Adult foster homes provide 24‑hour support to individuals with I/DD who are 18 and older. 

A provider or resident manager lives in the home with the individuals. A home can support up to five individuals who require care and are unrelated to the provider.

Each home is licensed with a special designation that shows the type or level of care it provides.

Adult foster home license types and care levels

  • Level 1: The provider must have the equivalent of one year of full-time experience providing direct care and services to support individuals with I/DD. This is the most common type of adult foster home.
  • Level 2B (behavioral): In additional to Level 1 requirements, these providers serve or intend to serve more than one individual who exhibits behavior that poses a significant danger to themself or others. The provider must have the equivalent of two years of full-time experience providing care and services to support individuals who exhibit behaviors that pose a significant danger to the themselves or others. 
  • Level 2M (medical): In additional to Level 1 requirements, these providers serve or intend to serve more than one individual who has a medical condition that is serious and may be life threatening. They are licensed health care providers such as a registered nurse or licensed practical nurse or have the equivalent of two years of full-time experience providing care and services to support individuals who have a medical condition described as serious or life threatening.
  • Limited: These providers intend to provide care and services to a specific individual who is not related to them, but with whom they have an established relationship of at least one year. The license is limited to caring for the individual named on the license. 
  • Provisional: A provisional license is valid for 60 days and is not renewable. ODDS grants provisional licenses in emergency situations where a current licensed provider is no longer overseeing the operation of the adult foster home.

Services and responsibilities

  • Follow the standards and qualifications outlined in OAR 411‑360.
  • Assist with activities of daily living, such as grooming, eating and leisure activities.
  • Provide access to services that help individuals maintain or increase their levels of independence.
Adult foster home application

​Child foster homes provide 24‑hour support for children with I/DD ages 0‒17.​​

The provider lives in the home with the children. A child foster home can be certified to support up to seve​n children, depending on how many providers live in the home. If a provider wants to care for children with significant medical needs, they must meet additional requirements.

If urgent situations arise where a certified provider is unable to run their home, they can apply for an emergency certification. This emergency certificate lasts for 30 days.

Services and responsibilities

  • Follow the standards and qualifications outlined in OAR 411‑346.
  • Assist with activities of daily living, such as grooming, eating and leisure activities.
  • Provide access to educational services that help children maintain or increase their levels of independence.
Child ​foster home application