Oregon Personal Support Worker Shortage: How to Find and Hire PSWs

The Gap Between Authorized Hours and Actual Services

Oregon has maintained a no-waitlist policy for adult developmental disability services since 2000. Under the K Plan — the Community First Choice Option authorized by Section 1915(k) of the Social Security Act — every eligible individual has a legal right to the attendant care hours their Individual Support Plan authorizes. No enrollment caps, no statewide queue.

But having authorized hours and actually receiving services are two different things. A young adult might be approved for 80 hours of monthly attendant care and go weeks or months without a provider who can deliver those hours. The bottleneck isn't bureaucratic — it's a severe, chronic shortage of Personal Support Workers and Direct Support Professionals across the state.

Rural and non-metropolitan counties experience the worst of it. While Portland Metro families can sometimes draw from multiple agencies and independent providers, Eastern Oregon and coastal communities face near-total provider deserts.

Why the Shortage Exists

PSW and DSP positions are among the lowest-paid caregiving roles in the state, with high physical and emotional demands. Turnover rates run well above the average for healthcare occupations. The K Plan's uncapped entitlement structure means demand for workers is functionally unlimited — every eligible person gets authorized hours — but the supply of workers willing to provide services at current reimbursement rates hasn't kept pace.

Agency providers face the same staffing constraints. A home care agency might have contracts with dozens of families but only enough staff to serve a fraction of them at any given time.

Practical Strategies for Finding Providers

Use your CDDP or Brokerage's provider list. Both case management models are required to provide Choice Advising — a standardized, unbiased list of qualified local providers. Start here, but don't stop here. The list may include agencies that are nominally accepting new clients but have internal waitlists of their own.

Post independently. Oregon allows families to hire independent PSWs directly through the state's fiscal intermediary system. Ask the CDDP or Brokerage how the arrangement handles employer-of-record responsibilities, then recruit from your own networks — community boards, church groups, disability advocacy organizations, college programs in social work or special education.

Expand the candidate pool. Ask your CDDP or Brokerage which people in your network are eligible to become independent PSWs and what training, background-check, payroll, and tax requirements apply. Requirements depend on the program and provider arrangement.

Contact multiple agencies simultaneously. Don't wait for one agency to respond before reaching out to others. In a tight market, the first agency with an opening wins.

Ask about shift flexibility. Providers with full caseloads sometimes have capacity for non-standard hours — early mornings, weekends, or split shifts. Flexibility on timing can unlock providers who are fully booked during traditional daytime windows.

What to Do When Hours Go Unfilled

Document everything. Track authorized hours vs. delivered hours month by month. If your CDDP or Brokerage isn't actively helping locate providers, escalate to ODDS directly. The authorization on the ISP creates a legal obligation — the state may not have the staff to fulfill it, but your documentation establishes the service gap and strengthens any future complaint or legislative advocacy.

The Oregon IEP Transition to Adulthood Guide includes a provider recruitment tracker and an agency communication log to help families manage the search process and build a paper trail.

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