Adult care homes are licensed, single family residences that offer 24-hour care for up to five adult residents in a homelike setting. The Adult Care Home Program (ACHP) provides licenses to operators in Multnomah County for two populations:
- Older adults and people with physical disabilities (APD)
- Behavioral health (formerly MHA)
Pay rates depend on:
- The population served.
- The classification level of care provided. For example, APD 2 pays more than APD 1 because APD 2 residents need a greater amount of skilled care.
- Whether residents pay privately or through Medicaid.
Adult care home operators are small business owners. They must budget for monthly expenses, such as food, supplies, utilities and staffing expenses. They also are required to have enough money available to cover unexpected costs. Becoming an operator is a major financial commitment!
Private Pay
With private pay, the resident has a contract to pay the adult care home operator each month for specific care and services. Private pay rates are negotiable and based on the services provided. What other operators charge also influences the rates of a new adult care home. Rates for private pay residents commonly range from $3,500 to $8,000 per month.
Medicaid Rates as of January 1, 2025
Older Adults and People With Physical Disabilities
Monthly rates for APD residents range from $2,120 to $3,278, plus $752 room and board payment. The resident’s Medicaid case manager calculates the total payment based on an assessment of care needs.
A new model for calculating rates paid to adult care home operators will go into effect on January 1, 2026. Learn more at Adult Foster Home Provider Rate Change.
Behavioral Health
The average monthly rate for behavioral health residents is $2,862, plus $752 room and board payment.