Spousal Pay

What is the Spousal Pay Program?

Spousal Pay is a Medicaid program that pays your spouse for providing your long-term care services in your home. You and your spouse must be legally married.

Who is eligible?

You must:
• Be eligible for Medicaid long-term care services in your home.
• Require 24 hour care.
• Have a medically diagnosed, progressive, debilitating condition or have a spinal
cord injury or similar   disability with permanent impairment.
• Require full assistance in four out of six of the activities of daily living (see list below);

The spousal pay provider provides the following activities of daily living, if needed:

• Bathing/personal hygiene;
• Dressing/grooming;
• Mobility, ambulation and transferring;
• Feeding and assistance with eating;
• Elimination assistance: toileting, bowel and bladder; and
• Cognition, including assistance with any confusion or behaviors.

In addition, your spouse must:
• Meet all DHS qualifications for enrollment as a Homecare Worker, and
• Pass a criminal history check.

What does a spousal pay provider do?

The spouse who provides in-home services is the spousal pay provider. The spousal pay provider must have the necessary health and ability to provide personal care, including lifting, carrying, bending, reaching, and manual dexterity (such as fastening clothing).

The spousal pay provider also provides other assistance for his or her spouse, including:
• Housekeeping
• Meal preparation
• Shopping
• Transportation
• Medication and oxygen management. 

What benefits does a spousal pay provider receive? 

Spousal pay providers are live-in Homecare Workers covered by a union contract with SEIU Local 503, OPEU. As a Homecare Worker, your spouse receives certain benefits. These benefits can change based on what is negotiated in the most recent union contract. All Homecare Workers are eligible for the following benefits, regardless of how many hours they work:
• Workers’ compensation;
• Income tax withholding;
• Unemployment insurance;
• FICA/Medicare tax withholding; and
• Direct deposit of paychecks – voluntary electronic deposit.

Depending on the number of authorized service hours your spouse provides you, your spouse may also be able to receive health insurance and paid leave. Your spouse must work enough hours to be eligible and must enroll through the Homecare Union Benefits Board (HUBB).

How do I apply for Spousal Pay or get more information on this program?

If you would like more information or would like to apply for Spousal Pay, please contact an Information and Assistance Specialists for Marion, Polk and Yamhill counties at (503) 304-3420, or toll-free at 1-866-206-4799. For Clatsop and Tillamook counties you can call (503) 815-2060 or toll-free at 1-800-584-9712.

You can also email us at information.nwsds@nwsds.org

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