This June marks 27 years since the United States Supreme Court handed down its decision in Olmstead v. L.C. — one of the most consequential disability rights rulings in American history. If you're a family member of someone with an intellectual or developmental disability, or a person with I/DD yourself, you may not have heard the name Olmstead. But you have very likely lived inside the world it created. Every time someone with I/DD lives in their own apartment instead of an institution, attends a community-based day program instead of a sheltered workshop, joins a public school class instead of being segregated, or gets to choose where, how, and with whom they live — Olmstead is part of the reason that's possible. As we approach the anniversary of this landmark ruling, we want to take a moment to share what Olmstead is, what it has changed, what it has not yet changed, and why it remains the legal and moral foundation of community-based services like the ones we provide at North Star Oregon. A Brief History: Two Women in Georgia The story of Olmstead begins not with policy but with two women — Lois Curtis and Elaine Wilson — who were living at Georgia Regional Hospital, a state-run psychiatric institution, in the mid-1990s. Both women had intellectual disabilities and mental health diagnoses. Both had been institutionalized for years. And both had been told by their treatment teams that they no longer needed to be in the hospital — that they could live successfully in the community with appropriate supports. But the community supports they needed weren't available, or weren't being offered. So they remained in the hospital, year after year, even though everyone agreed they didn't need to be there. With the help of the Atlanta Legal Aid Society, they sued the state of Georgia, arguing that the unjustified institutionalization of people who could live in the community violated Title II of the Americans with Disabilities Act (ADA). Their case made its way to the U.S. Supreme Court. In June 1999, the Court ruled in their favor. What the Court Actually Said The Olmstead decision is technically narrow but philosophically vast. In a 6-3 ruling, the Court held that under the ADA, states are required to provide community-based services to people with disabilities when: Such services are appropriate. The individuals affected do not oppose community-based treatment. The placement can be reasonably accommodated, taking into account the resources available to the state and the needs of others receiving disability services. In plain language: if a person with a disability can live and receive services in the community rather than in an institution, and they want to, the state must make that possible — except in narrow circumstances. Unjustified segregation, the Court ruled, is itself a form of discrimination prohibited by the ADA. That last sentence is the heart of it. Unjustified segregation is a form of discrimination. For decades before Olmstead, the default response to disability — particularly intellectual and developmental disability — was to separate people from the rest of society. Large state institutions warehoused tens of thousands of people with I/DD across the country. Children were taken from their families and placed in these settings, sometimes for life, often based on doctors' recommendations to parents that they should "let go" and "move on." Olmstead didn't end that history overnight. But it did establish, in the highest court in the country, that the practice was wrong — and that doing the opposite (supporting people in their communities) wasn't just kind or progressive but legally required. What Olmstead Has Changed In the 27 years since the decision, the landscape of disability services has shifted dramatically. Institutional populations have continued to decline. In 1967, there were nearly 200,000 people with I/DD living in state institutions in the United States. Today, that number is under 16,000 nationally and continues to drop. Oregon closed its last state institution for people with I/DD, Fairview Training Center, in 2000 — the year after Olmstead. The state has not built another one. People who previously would have lived in institutions now live in their own homes, with family, in foster care, or in small group homes — supported by community-based services. Community-based service systems have grown. Medicaid Home and Community-Based Services (HCBS) waivers — like the ones Oregon uses to fund North Star's services — were expanded and strengthened in the years following Olmstead. The 1915(c) waivers and Oregon's K Plan are direct descendants of the Olmstead mandate. Without them, the kind of in-home attendant care and community-based DSA programs we provide simply wouldn't exist at this scale. Person-centered planning has become the standard. The Individual Support Plan (ISP) process — where a person's preferences, goals, and choices drive the services they receive — owes its prominence to Olmstead's emphasis on integration and individual choice. Sub-minimum wage and sheltered workshops have come under scrutiny. Oregon, in particular, has been a national leader in transitioning away from segregated employment settings toward integrated, community-based work. The state's Employment First initiative, formalized through executive orders and legal settlements in the 2010s, was driven in significant part by Olmstead obligations. Day services have moved into the community. The North Star Oregon DSA model — community outings, volunteering, real workplaces, public libraries, museums, parks, neighborhoods — is itself an Olmstead-era model. Day services that take place primarily in segregated buildings, with the same group of people every day, doing activities that wouldn't be available to non-disabled adults in the same age range, are increasingly being phased out as inconsistent with the integration mandate. What Olmstead Has Not Yet Changed It would be inaccurate to say Olmstead has fully delivered on its promise. Twenty-seven years on, gaps remain. Waiting lists for community-based services remain long. In many states, including Oregon at times, the demand for HCBS waivers has exceeded the supply. Oregon does not currently maintain a waiting list for I/DD waiver services, which is something the state should be commended for. But the workforce shortage in direct support — caused largely by stagnant wages — has created a different kind of access problem: services are authorized but providers can't be found to deliver them. People in nursing homes are still under-served by Olmstead. A significant share of the Olmstead litigation in recent years has focused on people with disabilities living in nursing facilities who could be supported in the community but aren't, because the state's system is structured around institutional rather than community placements. People with the most complex needs sometimes still struggle. The integration mandate is for everyone, but the rhetoric of community-based services can sometimes leave behind people whose support needs are intensive, especially when funding doesn't keep pace with the cost of high-quality community supports for those individuals. Segregation can take subtler forms. A person can technically live "in the community" while still being functionally segregated — going from a group home to a sheltered workshop and back, with little real participation in community life. Olmstead requires not just physical placement in the community but meaningful integration. Living in a community is not the same as being part of one. The work is not done. Why Olmstead Matters at North Star Oregon We think about Olmstead often, even when we're not naming it. When a parent-caregiver chooses to be hired as a W-2 employee to care for their own adult son in a shared-home setting — that's Olmstead. The person isn't being moved into an institution; they're being supported at home with their family. When a young woman in our Eugene DSA program decides she wants to spend her Tuesdays volunteering at the humane society and her Thursdays taking a community college painting class — that's Olmstead. Her day looks like the day of any other young adult in Eugene with similar interests, not a clinical setting. When a man in our Salem program rides the bus to work, eats lunch at a downtown café where the staff know his name, and goes home to an apartment he shares with a friend — that's Olmstead. He is not in an institution. He is a member of a community. When we reject the term "clients" in favor of "the individuals we support," that's a small linguistic choice rooted in a much larger philosophical one: the people we work with are people first, with their own preferences, dreams, and rights, not subjects of a service. What This Means for Families If you are a parent, sibling, spouse, or family member of someone with I/DD, the Olmstead decision gives you legal grounding for some of the things you instinctively want for the person you love: They have a right to live in the most integrated setting appropriate to their needs. They have a right to participate in planning their own services and lives. They have a right to refuse institutional placement when community-based services would meet their needs. They have a right to providers who treat them as members of the community, not as patients to be managed. If you ever feel like you are being pushed toward a more segregated, more institutional, more restrictive setting than your loved one needs — you have legal and moral standing to push back. Olmstead is part of the bedrock you can stand on. If a service system is not working for your family, you can advocate for change. You can contact your CDDP services coordinator. You can reach out to advocacy organizations like Disability Rights Oregon, which is Oregon's federally designated Protection and Advocacy agency. You can talk to your state legislator. You can connect with other families who have walked similar paths. Looking Forward A generation ago, the future for many people with I/DD was institutional. That future is no longer the default — and that is largely because of the women and men, like Lois Curtis and Elaine Wilson, who refused to accept it as inevitable, and the courts and legislatures that listened. The next chapter of disability rights is being written now, by today's self-advocates, today's families, today's direct support professionals, and today's policymakers. The work is incomplete, but the direction is clear: more inclusion, more choice, more community. At North Star Oregon, we consider it a privilege to be part of that work. The people we support are not "served" by us; they are walking through their own lives with us walking beside them, and we are better for the company. To learn more about our community-based services — In-Home Attendant Care across Oregon and Day Support Activities in Albany, Corvallis, Eugene, Springfield, Salem, and Tangent — visit northstaroregon.com or reach out to our team. We'd be honored to be a part of your community.

Summer in Oregon is a season worth celebrating. After a long gray winter and a rainy spring, the sun returns with real conviction — and with it comes the chance to spend time outdoors, visit the coast, work in the garden, or simply sit on the porch and listen to the neighborhood come alive. For the individuals we support — children, adults, and seniors with intellectual and developmental disabilities (I/DD) — summer opens up possibilities that matter. It also opens up a handful of safety considerations that caregivers do well to think through in advance. Heat, sun, hydration, sensory overload, water safety, medication interactions, and changes in routine can all affect individuals with I/DD in distinct ways. A little preparation goes a long way toward making summer a season of joy rather than one of crisis management. This guide is for Oregon parents, parent-caregivers, Direct Support Professionals (DSPs), and family members who want to help the people they love have the best summer possible. It draws on what we've learned over years of supporting families across the Willamette Valley, and it's written to be practical — not to lecture you or add to the mental load you're already carrying. Why Summer Requires Extra Thought Many individuals with I/DD experience the body and the environment differently than their neurotypical peers. Some of the factors that can make summer trickier include: Difficulty recognizing or communicating discomfort. A person who can't easily say "I'm hot" or "I'm thirsty" may not realize — or may not be able to tell a caregiver — that something is wrong until symptoms are more advanced. Medication effects. A number of medications commonly prescribed to individuals with I/DD (certain antipsychotics, anticholinergics, some seizure medications, ADHD stimulants, and others) can reduce the body's ability to regulate temperature or increase sensitivity to sun. Sensory processing differences. Heat, humidity, bright light, sunscreen textures, swimsuit fabrics, bugs, and sudden loud sounds (fireworks, lawnmowers, crowds at festivals) can push a sensitive nervous system past its comfort zone quickly. Routine disruptions. Summer often means schedule changes — no school, different staff, travel, vacations, or different daily rhythms. Predictability is soothing. Unpredictability can be stressful. Hydration challenges. Individuals who have trouble swallowing, who forget to drink, or who are dependent on others for fluids need more active support in hot weather. None of these challenges are reasons to stay inside. They are reasons to plan well and to pay close attention. Heat Safety: The Basics Oregon summers have been running warmer in recent years, and multi-day heat waves are no longer unusual in the valley. That's a meaningful shift. A few foundations: Know the early signs of heat illness. Heat exhaustion and heat stroke don't usually arrive all at once. Earlier signs include flushed skin, unusual tiredness, irritability, headache, nausea, dizziness, and a pulse that feels faster than usual. Heavy sweating may slow or stop as things get worse. In a person who struggles to report symptoms, you are looking for changes — a quieter mood, a reluctance to keep playing, a sudden request to sit down, a change in skin color. Move quickly when you see them. Get the person into shade or air conditioning. Offer cool (not ice-cold) fluids if they can drink safely. Use cool, damp cloths on the neck, wrists, and forehead. Remove excess clothing. If symptoms don't clear up within 15 to 20 minutes — or if they seem to be worsening, especially with confusion, loss of consciousness, or very high body temperature — call 911. Heat stroke is a medical emergency. Plan around the heat, not through it. Schedule outdoor time for mornings and evenings during hot stretches. Save the middle of the day for the library, the mall, an indoor pool, a movie, or time at home with the AC on. This isn't giving up on summer — it's working with it. Check medications. A five-minute conversation with your pharmacist about heat sensitivity can change the way you approach the season. Some medications need to be stored in cool places; some amplify sun sensitivity; some affect thermoregulation. Knowing which apply to your loved one is worth your time. Cool surfaces aren't always cool. Playground equipment, car seats, metal buckles, sand, and dark asphalt can all reach temperatures that cause burns. Test surfaces with the back of your hand before your loved one touches them. Cars are not safe. This is true for all of us, but especially true for individuals who may not be able to get out on their own or communicate distress. Never leave someone in a parked car in summer, even for a moment, and even with windows cracked. Temperatures rise dramatically within minutes. Hydration That Actually Works "Drink water" is easy advice to give. Making it happen for an individual who doesn't feel thirst, who can't pour their own drink, who has specific preferences, or who has swallowing challenges is another matter. A few strategies that work in real households: Put fluids everywhere. A water bottle in every bag, every room, every vehicle. Out of sight is out of mind — including for caregivers on a hot day. Offer variety. Water is ideal, but it's not the only option. Low-sugar electrolyte drinks, flavored waters, herbal iced teas, milk, smoothies, popsicles, watermelon, cucumbers, and broths all count toward hydration. For someone with a strong preference, meeting them where they are works better than a power struggle. Build hydration into routine. Linking drinks to daily events ("we always have a cup of water when we come inside") creates a habit that doesn't depend on remembering. Watch output. Fewer bathroom trips, darker urine, and dry mouth are early warning signs. In a nonverbal individual, this kind of practical tracking can catch dehydration before it becomes dangerous. Respect swallowing needs. Individuals with dysphagia may need thickened fluids or specific positioning. If you're unsure, check in with a speech-language pathologist or healthcare provider. Don't just push fluids without considering safety. Sun Protection That Respects Sensory Needs Sunscreen, hats, and UV-protective clothing are great — in theory. In practice, they can run into sensory barriers that caregivers know all too well. A few things that help: Try different formulations. Mineral sunscreens, lotions, sticks, sprays, and creams all feel different on skin. A brand that one person hates, another might tolerate. Test small patches at home before a big outing. Apply before other things. Sunscreen on clean, cool, dry skin sinks in better. Applying it in a rushed way right before leaving the house — when everyone is already overstimulated — rarely goes well. Use clothing where possible. UV-protective swim shirts, wide-brimmed hats, and lightweight long sleeves can reduce the amount of sunscreen needed on skin, which is often easier for people with sensory sensitivity. Sunglasses matter. Bright light can be genuinely painful for sensitive individuals. Good sunglasses, especially paired with a brimmed hat, can turn an overwhelming outdoor experience into a comfortable one. Water Safety Drowning is a leading cause of accidental death for children with autism, and water risks apply to adults too — especially those who are drawn to water but may not understand depth, currents, or their own swimming limits. If your loved one will be around water this summer — pools, rivers, lakes, the coast, even bathtubs — make a plan: Use a well-fitted, Coast Guard-approved life jacket for any open water activity, regardless of the individual's swimming ability. Always have a designated water watcher whose only job is watching. Not grilling, not chatting, not scrolling. Watching. Be honest about your loved one's skills. "Can swim" and "is safe swimming alone" are two very different things. Consider adaptive swim lessons. Organizations across Oregon offer instruction designed for people with disabilities. Even basic water safety skills can save lives. Treat rivers with respect. The Willamette and other Oregon rivers can be swift and cold even when they look calm. Current hazards aren't always visible. Sensory-Friendly Summer Summer brings a lot of sensory input: heat, bright sun, new smells, insects, crowds, fireworks, changing clothes, different foods. For some individuals, those changes are exciting. For others, they're exhausting. A few principles for sensory-friendly summer planning: Map the day before you live it. Preview outings with pictures, video, or social stories when possible. Knowing what's coming reduces anxiety. Build in recovery time. If you're planning a big outing, plan a quiet day on either side. Stamina for sensory input is a finite resource. Pack a comfort kit. Noise-reducing headphones, a favorite fidget, a weighted lap pad, sunglasses, extra water, a change of clothes, and any essential food or snacks can turn a possibly-hard day into a manageable one. Pay attention to fireworks. Fourth of July and other summer celebrations can be deeply distressing for individuals with sensory sensitivities.  Planning ahead — staying home with a calm activity, using headphones, or traveling somewhere quieter — is not "missing out." It's respecting a real need. Have an exit plan. For every outing, know how you will leave early if needed. Knowing the exit exists can be what allows someone to stay. The pressure to tough it out is what causes meltdowns; permission to leave is what allows enjoyment. Maintaining Routine in an Unstructured Season For children who thrive on school schedules and for adults whose day programs take a summer break, the unstructured parts of summer can be harder than the heat. Loss of structure, staff, transportation, and social contact can lead to increased anxiety, behavior changes, and regression on skills. A few supports that help: Keep some anchors. Wake-up and bedtime routines, meal times, and a few predictable weekly activities create structure even when the calendar is otherwise loose. Use visual schedules. A simple morning-to-evening picture schedule, updated daily, does more than you'd think. Maintain some connection with day programming when possible. Our DSA programs run through the summer in most locations, with schedules built to respect summer rhythms while still offering meaningful community engagement. Plan for transitions back to school. A few weeks before September, start easing back into school-year routines — bedtime, morning prep, lunchboxes, the works. Emergency Preparedness for Summer Hazards Oregon summers bring some specific environmental risks worth preparing for: Wildfire smoke. During smoke events, keep indoor air as clean as possible, use air purifiers if you have them, stay inside, and reschedule outdoor plans. For individuals with asthma or other respiratory conditions, a plan with your healthcare provider is essential. Power outages. Heat waves can strain the grid. If your loved one depends on powered medical equipment, refrigerated medications, or cooling, have a backup plan — generator access, identifying a cool place to go, knowing where chargers are. Ticks and other pests. Oregon has ticks in much of the valley and coast range. Light-colored clothing, repellents you tolerate, and checking skin after outdoor time are all worth building in. Travel kits. If you're heading to the coast or on a longer trip, a kit with medications, essential documents, comfort items, sensory supports, backup clothing, and snacks will save you. A Note on Caregivers You cannot take care of someone else well if you are running on empty. Summer, with its unstructured days and altered routines, can be particularly tough on parent-caregivers. Make sure you have: Someone to call. A trusted person who will pick up the phone on a hard day. Some physical relief. Relief care hours, a short break, time alone to drink a cup of coffee that doesn't get cold. Permission to scale back. Not every week needs to be packed with adventure. A quiet summer is also a good summer. If you could use more support with relief care, attendant care hours, or day programming for your loved one this summer, we're here for that. You don't have to be in crisis to ask. In fact, the best time to build support is before you need it. Bringing It All Together The goal isn't a perfect summer. No family has one. The goal is a summer full of small good moments — moments made possible because you thought ahead about the water bottles, the shaded bench, the backup plan, the favorite snack, the quieter route home. That kind of thoughtful planning isn't hovering or overprotective. It's what caregiving looks like when it's done well. The individuals we support deserve to experience Oregon summers fully. They deserve lake days, ice cream cones, trail walks, and long evenings on the porch. And they deserve caregivers — family and professional alike — who have the support and knowledge to make those experiences possible. If you'd like to talk through how North Star Oregon can help your family this summer, whether through in-home attendant care, relief care, or Day Support Activities in Albany, Corvallis, Eugene, Springfield, Salem, or Tangent, please reach out. Visit northstaroregon.com to learn more or contact our team directly. Summer is here — let's make it a good one. --- North Star Oregon provides In-Home Attendant Care and Day Support Activities for individuals with intellectual and developmental disabilities across Oregon, funded through the K Plan and 1915(c) Medicaid waivers. This article is general information and not a substitute for medical advice. Always consult your loved one's healthcare team about specific medical, medication, and safety questions.

Most parents of an adult child with an intellectual or developmental disability share a quiet, persistent worry. It does not always have a name, but if you sit with it long enough, the question is the same: what happens when I am no longer here? Or, almost as pressing: what happens when I am too tired, too aged, or too unwell to keep coordinating everything I have been coordinating for the last twenty or thirty or fifty years? This worry is not a flaw. It is one of the clearest signs of love. And while it cannot be made to disappear entirely, it can be substantially eased by something families often put off because it sounds intimidating: a real long-term plan. At North Star Oregon, we walk with families through many practical decisions, and while we are not financial planners or attorneys, we have seen which planning pieces actually help families feel grounded. Three of them stand out: a Special Needs Trust, a Letter of Intent, and an Oregon ABLE Savings Plan account. This is an educational guide. Every family's situation is different, and decisions about trusts, estates, and benefits planning should always be made with a qualified attorney and financial advisor who specialize in disability law. Why "Just Leaving Money to My Child" Does Not Work It is the most natural impulse in the world. Parents save, scrimp, build a small estate, and assume they will leave it to their child with disabilities so that child has a financial cushion for the rest of their life. Unfortunately, in the way most estates are written, this can do active harm. Many of the supports an adult with I/DD relies on — Supplemental Security Income, Oregon Health Plan, Medicaid-funded In-Home Attendant Care, Day Support Activities — are means-tested. They are available to people whose countable assets stay below a fixed limit, currently $2,000 for an individual on SSI. An inheritance, a life insurance payout, or a well-meaning grandparent's bequest can push an individual over that limit overnight, suspending or terminating the very benefits that fund their daily life. The intended gift becomes the cause of the crisis. We have seen it happen. The good news is that this is exactly the situation special needs planning is designed to prevent. Special Needs Trusts: The Foundation of the Plan A Special Needs Trust, sometimes called a Supplemental Needs Trust, is a legal arrangement that allows assets to be held for the benefit of a person with a disability without being counted as that person's resources for means-tested benefits purposes. Funds in a properly drafted SNT can pay for a wide range of supplemental needs — therapies, recreation, education, adaptive equipment, accessible vehicles, vacations, and many other things — without disqualifying the beneficiary from SSI, Medicaid, or other public benefits. Three main types come up in family planning: Third-Party Special Needs Trusts are funded with assets that have never belonged to the person with a disability. These are the trusts parents and grandparents typically set up. They can be created during the parent's lifetime or as part of their will or revocable trust. Crucially, when the beneficiary dies, the remaining funds can pass to other family members or chosen heirs — they do not have to repay Medicaid. First-Party Special Needs Trusts, sometimes called (d)(4)(A) trusts, are funded with assets that already belong to the individual with the disability — for example, a personal injury settlement or an unexpected inheritance. They serve the same protective purpose, but federal law requires that any funds remaining at the beneficiary's death first be used to repay Medicaid for services provided during the beneficiary's lifetime. Pooled Special Needs Trusts, run by nonprofit organizations, combine funds from many beneficiaries for investment purposes while maintaining individual sub-accounts. They can be a good fit when the assets to be protected are smaller, when no family member is a strong fit to serve as trustee, or when professional administration is preferred. Oregon families have access to several pooled trust options. Choosing among these — and drafting a trust that actually does what you intend — is not a do-it-yourself project. The attorney's specialty matters. Generic estate planners sometimes produce documents that technically exist but do not interact correctly with SSI, Medicaid, and Oregon's specific I/DD service rules. Look for an Oregon attorney who specifically practices special needs planning or elder law with a disability focus. Funding the Trust: Where the Assets Come From A trust without funding is just a piece of paper. Families typically fund a Special Needs Trust through a combination of sources: Life insurance is one of the most common. A whole or term policy on one or both parents, with the SNT as the beneficiary, can ensure that meaningful funds become available exactly when they are most needed. Retirement account designations — IRAs, 401(k)s, and similar accounts — can name the SNT as a beneficiary, though the post-SECURE Act distribution rules around inherited retirement accounts add complexity that requires careful planning. Direct contributions during the parent's lifetime are possible, and sometimes desirable for tax or estate-equalization reasons. Wills and revocable trusts can pour assets into the SNT at the parent's death. Family contributions from grandparents, aunts, uncles, and others should always be directed to the SNT rather than to the individual directly. This is one of the most important conversations to have with extended family well in advance of any estate event. The goal is not necessarily to fund the trust to a high dollar amount. The goal is to make sure that whatever resources do exist are protected and usable for the person's benefit. The Letter of Intent: The Document Nobody Talks About Enough A Special Needs Trust handles money. A Letter of Intent handles everything else. A Letter of Intent is a non-legal document that captures everything a future caregiver, trustee, guardian, or care team would need to know about the person with a disability if you were no longer there to tell them. It is not legally binding, but it is one of the most practical and powerful documents a family can produce. It is also, for many families, the hardest to start, because it is the document that most directly forces the question we usually keep at arm's length. A strong Letter of Intent typically includes: The person's full identity story — preferred name, pronouns, family relationships, important people in their life, and how they identify themselves. Daily routines, preferences, comforts, and dislikes — including foods, clothing, sensory preferences, sleep patterns, and communication style. Medical history and current providers, medications, allergies, and any specific protocols that have proven important. This section should be updated whenever it changes. Communication considerations — how the person communicates, what supports they use, what helps them when they are dysregulated, and what does not. Educational and vocational history, current activities, friendships, and community involvement. Religious or spiritual practices and what role they play in the person's life. Hopes, dreams, and goals — both the person's own goals where they can articulate them, and what the family understands about what brings the person joy. Financial and benefits information — what programs the person is enrolled in, who manages what, and how to reach the right people. Names and contact information for the person's circle of support, including extended family, friends, providers, doctors, attorneys, and trustees. The Letter of Intent is meant to be revised. Many families set a calendar reminder to update theirs once a year, often around a birthday or annual ISP meeting. The document grows with the person's life, and that is the point. Oregon ABLE Savings Plan: The Tool for Today While a Special Needs Trust handles long-term planning, the Oregon ABLE Savings Plan addresses something different: the ability for the individual themselves (or family members and friends on their behalf) to save and spend without jeopardizing benefits, in a way that the person can have direct control over. Authorized by the federal Achieving a Better Life Experience Act of 2014, ABLE accounts are tax-advantaged savings accounts for eligible individuals with disabilities. Eligibility generally requires that the disability began before age 26 (rising to age 46 starting in 2026 under the ABLE Age Adjustment Act) and meets the SSI definition of disability. Key features of an Oregon ABLE account: Contributions can come from the account owner, family, friends, or employers, up to an annual limit (currently aligned with the federal gift tax annual exclusion). Account balances up to $100,000 are not counted as resources for SSI purposes. Higher balances can affect SSI but generally do not affect Medicaid eligibility. Earnings in the account grow tax-free. Withdrawals are tax-free when used for "qualified disability expenses," a category that is interpreted broadly and includes housing, transportation, education, employment supports, health, assistive technology, financial management, and basic living expenses. The account is owned by the individual with the disability. This is meaningful. ABLE accounts are one of the few tools that explicitly position the person with a disability as the account holder, with all the dignity that implies. For many Oregon families, the practical sequence is straightforward: open an Oregon ABLE account for routine savings and family contributions, and establish a Special Needs Trust for larger inheritances and long-term planning. The two tools complement each other rather than competing. Coordinating With Public Benefits The whole point of these planning tools is to protect the person's eligibility for the public benefits that fund their daily life. That makes coordination essential. Before establishing or funding any of these tools, families should understand which benefits the individual currently receives or will be eligible for: SSI, Social Security Disability Insurance (SSDI) if applicable, Oregon Health Plan, Medicare if applicable, Oregon's K Plan and 1915(c) waiver-funded I/DD services, SNAP, and housing assistance, among others. Each program has its own rules about what counts as a resource and what counts as income, and the rules occasionally interact in surprising ways. A planning attorney or benefits counselor can map this out clearly. Disability Rights Oregon and the Oregon Council on Developmental Disabilities are also valuable resources for families trying to understand the landscape. Common Mistakes Families Make Across the families we have walked alongside, certain planning mistakes show up repeatedly: Naming the individual with a disability as a direct beneficiary on life insurance policies, retirement accounts, or wills, rather than directing those assets to a Special Needs Trust. Setting up a generic trust through a non-specialized estate planner that does not actually qualify as an SNT under federal rules. Failing to communicate the plan to extended family, leading to grandparents or aunts and uncles leaving direct gifts that disrupt benefits. Funding a trust but never updating the Letter of Intent, leaving future caregivers with money but no map. Waiting too long. Estate planning becomes more difficult, more expensive, and more emotionally fraught when it is done in crisis or under time pressure. Assuming that a sibling will simply take over without ever talking to the sibling about whether they are willing, what role they would actually want, and how they would handle competing demands of their own family and career. None of these mistakes are signs of bad parenting. They are signs of how complex this system is and how rarely families are walked through it intentionally. Where to Start If you have not done special needs planning yet, the most useful first step is usually a consultation with a qualified Oregon special needs attorney. Many offer free or reduced-cost initial consultations, and the conversation alone often clarifies what your family actually needs. In parallel, families can begin a draft Letter of Intent at any time. There are templates available through several disability advocacy organizations that can be customized to your family. Even a rough draft is more useful than a blank page. For the ABLE Savings Plan, families can learn more and open accounts directly through the Oregon ABLE Savings Plan website. Setup is straightforward and does not require an attorney. Caring for the Caregiver, Too This kind of planning is hard partly because it asks parents to think clearly about a future they would prefer not to imagine. But the families who do this work tell us, almost universally, that they sleep better afterward. The worry does not vanish, but it becomes manageable. It moves from a vague, looming dread to a set of decisions that have actually been made. At North Star Oregon, we support individuals with I/DD and their families across Oregon. While long-term financial and estate planning is outside our direct services, we believe deeply that whole-family support means caring about whole-family stability — which includes the long arc of life, not just the next month. If you have questions about how our In-Home Attendant Care or Day Support Activities programs fit into your family's overall plan, or if you would like to talk through where you are in your planning journey, we would welcome the conversation. Visit northstaroregon.com to learn more about our services and to get in touch with our team.

April in Oregon means the world is waking up — and there's no better time to get outside, get your hands in the soil, and experience the therapeutic power of nature. --- Why Nature Matters There's a reason people feel better after spending time outside. Research on the benefits of nature exposure is extensive and compelling: reduced anxiety, improved mood, better sleep, increased focus, and a stronger sense of well-being. These benefits apply to everyone — and for individuals with intellectual and developmental disabilities (I/DD), time in nature can be especially meaningful. Nature doesn't require social scripts. It doesn't judge. It moves at its own pace and invites you to do the same. For individuals who experience sensory sensitivities, social anxiety, or difficulty with the fast-paced demands of indoor environments, outdoor spaces offer a different kind of engagement — one that's often calmer, more flexible, and deeply grounding. Here in Oregon's Willamette Valley, we're fortunate to live in one of the most naturally beautiful and accessible regions in the state. From community gardens to river trails to botanical parks, the opportunities for meaningful outdoor experiences are everywhere. And spring is the ideal season to take advantage of them. The Therapeutic Power of Gardening Gardening has long been recognized as a form of therapeutic activity, and its benefits for individuals with I/DD are well documented. Horticultural therapy — the practice of using gardening and plant-based activities to achieve specific therapeutic goals — has been used in rehabilitation, mental health, and disability services for decades. But you don't need a formal therapy program to experience the benefits. Simple gardening activities offer a rich combination of sensory input, physical movement, cognitive engagement, and social interaction that supports growth in multiple areas of life. Sensory Engagement Gardening is a full-body sensory experience. The texture of soil between your fingers. The smell of herbs like basil and lavender. The bright colors of marigolds and zinnias. The sound of birds and water. For individuals who benefit from sensory-rich environments — or who are working on sensory tolerance — gardening provides natural, graded exposure to a wide range of sensory inputs. For those with sensory sensitivities, gardening can be adapted easily. Gloves for individuals who don't enjoy the feeling of dirt. Raised beds or container gardens for those who have difficulty bending or kneeling. Fragrant plants can be chosen intentionally to match individual preferences. Motor Skills and Physical Activity Digging, planting, watering, weeding, and harvesting all involve fine and gross motor movements. For individuals working on hand strength, coordination, or endurance, gardening provides purposeful physical activity that doesn't feel like exercise. Adaptive tools — ergonomic grips, lightweight watering cans, long-handled tools — make gardening accessible to people with a wide range of physical abilities. Cognitive Skills Gardening involves sequencing (first we dig, then we plant, then we water), following instructions, making choices (which seeds to plant, where to place them), problem-solving (why isn't this plant growing?), and patience. It's a natural context for practicing executive functioning skills in a low-pressure, highly motivating environment. Responsibility and Pride There is something profoundly empowering about growing something from seed. Watching a plant grow because of your care and effort reinforces a sense of competence and agency. For individuals with I/DD who may have limited opportunities to take ownership of a project from start to finish, a garden plot can be a powerful source of pride and accomplishment. Spring Gardening Ideas for Oregon April is the sweet spot for gardening in the Willamette Valley. The soil is warming up, the rain is (mostly) tapering off, and there's a long growing season ahead. Here are some accessible gardening projects that work well for individuals with varying abilities and experience levels. Container Herb Gardens You don't need a yard. A few pots on a patio or windowsill can become a thriving herb garden. Basil, mint, chives, and parsley are all easy to grow, fast to produce visible results, and useful in the kitchen — which creates a natural bridge to cooking and meal preparation skills. Start with transplants from a local nursery rather than seeds if you want quicker gratification. Let the individual choose which herbs to plant based on what they like to smell or eat. Sunflower Growing Challenge Sunflowers are almost impossible to kill, they grow fast enough to maintain interest, and they produce dramatic, rewarding results. Plant seeds directly in the ground or in large containers in mid-April. Measure growth weekly to incorporate math and observation skills. By midsummer, you'll have towering flowers that attract bees and birds — a whole ecosystem to observe. Community Garden Plots Several cities in the Willamette Valley maintain community garden programs where individuals or organizations can rent a plot for the growing season. The city of Corvallis, the city of Eugene, and various neighborhoods in Salem all have community garden options. These spaces offer the added benefit of being around other gardeners — creating natural opportunities for social interaction and community belonging. Sensory Garden Design A sensory garden is planted specifically to engage all five senses. Think lamb's ear for soft texture, lavender and rosemary for fragrance, cherry tomatoes for taste, ornamental grasses that rustle in the wind for sound, and vibrant flowers for visual stimulation. Designing and planting a sensory garden can be a season-long project with built-in goal-setting, decision-making, and creative expression. Beyond the Garden: Nature Activities in the Willamette Valley Gardening is just one way to connect with nature this spring. Oregon's Willamette Valley offers a wealth of outdoor experiences that are accessible and meaningful for individuals with I/DD. Accessible Trail Walks Many of the valley's parks and natural areas include paved or well-maintained paths suitable for wheelchairs, walkers, and individuals with mobility differences. A few favorites include Avery Park in Corvallis, which has wide paved paths through gardens and along a creek; Alton Baker Park in Eugene, with its flat, paved bike path along the Willamette River; and Minto-Brown Island Park in Salem, which has miles of paved and gravel trails through natural areas. These walks offer opportunities for exercise, nature observation, and simply being outside without the need for strenuous hiking. Farmer's Market Outings Oregon's farmer's markets start ramping up in April and May. The Corvallis Saturday Farmer's Market, the Eugene Saturday Market, and the Salem Saturday Market are all vibrant community gathering spaces where individuals can practice social skills, make purchasing decisions, explore new foods, and engage with their local community. These outings combine community participation with sensory experience and practical life skills. Bird Watching and Nature Journaling Spring migration brings a flurry of bird activity to the Willamette Valley. You don't need expensive equipment — a simple pair of binoculars and a field guide (or a free app like Merlin Bird ID) are enough to get started. Bird watching encourages focus, patience, and observation. Pairing it with a nature journal — drawing what you see, noting the date and location — adds a creative and literacy-building component. Visits to Botanical Gardens and Nature Centers The Owen Rose Garden in Eugene, the Peavy Arboretum near Corvallis, and the Oregon Garden in Silverton (a short drive from Salem) are all beautiful spring destinations. These managed landscapes offer the sensory richness of nature in a structured, predictable environment — which can be a good fit for individuals who benefit from clear paths and defined spaces. Incorporating Nature into Day Support Activities At North Star Oregon, outdoor experiences are a regular part of our Day Support Activities programming. Our DSA programs in Albany, Corvallis, Eugene, Springfield, Salem, and Tangent incorporate nature-based activities throughout the spring season — from group gardening projects to trail walks to farmer's market outings. These activities aren't just recreational. They're designed to support individual goals identified in each person's Individual Support Plan (ISP). A trip to the farmer's market might be building toward independent purchasing skills. A gardening project might be developing responsibility and follow-through. A nature walk might be working on physical endurance or social engagement with peers. The beauty of nature-based programming is its flexibility. Activities can be scaled to any ability level, adapted for sensory needs, and modified based on the weather — which, in Oregon, is always a factor. Getting Started You don't need a program or a plan to start connecting with nature this spring. Here are a few simple ways to begin. Pick one plant. Go to a local nursery with the individual you support and let them choose a plant that appeals to them. Bring it home, find a spot for it, and make watering and caring for it part of the daily routine. Go outside for ten minutes. That's it. Sit on a porch, walk around the block, visit a park. Make it low-pressure. The goal isn't a wilderness expedition — it's simply being present in the natural world. Follow the seasons. Oregon's landscape changes dramatically through the year, and each season brings new things to notice, explore, and enjoy. Spring is just the beginning. --- North Star Oregon's Day Support Activities programs include nature-based and outdoor experiences throughout the Willamette Valley. If you're interested in learning more about our community-based programming for individuals with I/DD — or if you'd like to explore attendant care services — visit northstaroregon.com or contact our team today. Spring is a great time to get started.

From outdoor adventures to creative workshops, here's how Day Support Activities programs help individuals with disabilities build skills, friendships, and confidence this spring. --- Why Spring Is Our Favorite Season for DSA There's something about an Oregon spring that makes everything feel possible. The rain starts to ease, the Willamette Valley turns impossibly green, and suddenly there are a hundred reasons to get outside and do something together. For the individuals we support through Day Support Activities — and for the staff who work alongside them — spring opens up a world of programming options that just aren't available during the darker, wetter months. Day Support Activities (DSA) is a Medicaid-waiver-funded service that provides structured, community-based programming for individuals with intellectual and developmental disabilities (I/DD). The goal isn't to fill time — it's to build real skills, foster meaningful relationships, and support each person's path toward greater independence and community belonging. At North Star Oregon, our DSA programs operate across the Willamette Valley in Albany, Corvallis, Eugene, Springfield, Salem, and Tangent. Each location develops programming that reflects the interests of the individuals we support and the unique resources of the local community. Here's a look at what spring brings. Outdoor Adventures: Getting Into Oregon's Backyard Oregon's spring weather — mild temperatures, longer daylight hours, and the occasional spectacular sunny day — is perfect for outdoor programming. Our DSA groups take full advantage of this season with activities designed to get people moving, exploring, and connecting with the natural beauty around them. Park Visits and Nature Walks. The Willamette Valley is home to dozens of accessible parks and trail systems. Groups visit spots like Avery Park in Corvallis, Alton Baker Park in Eugene, and Minto-Brown Island Park in Salem for guided nature walks, birdwatching, and outdoor picnics. These outings aren't just fun — they support physical fitness, sensory engagement, and an understanding of the natural world. Gardening Projects. Spring is planting season, and several of our DSA programs incorporate gardening into their weekly activities. Working with soil, seeds, and plants teaches patience, responsibility, and cause-and-effect thinking. It's also deeply satisfying to watch something you planted grow over the weeks and months. Some groups maintain raised garden beds; others partner with community gardens in their area. Fishing and Waterside Activities. As the weather warms, some groups take trips to local fishing spots or spend time along rivers and creeks. These outings combine outdoor skills with social interaction and provide sensory experiences — the sound of running water, the feel of a breeze — that many of the individuals we support find calming and grounding. Creative Expression: Art, Music, and More Community-based programming isn't all about the outdoors. Creativity is a core part of what makes DSA meaningful, and spring brings fresh energy to our art and creative workshops. Art Workshops. Our programs regularly incorporate visual arts — painting, drawing, collage, ceramics, and mixed media. These sessions are adapted to meet each person where they are, whether someone is working on fine motor skills through brush control or expressing complex ideas through abstract art. Some of our groups display their work at local community centers or participate in art shows, which is a powerful experience for the artists and a meaningful way to increase visibility and inclusion for people with disabilities. Music and Movement. Music is a universal connector. DSA groups engage with music through drumming circles, sing-alongs, movement-based activities, and even songwriting. For individuals who communicate in nontraditional ways, music provides an alternative channel for expression and connection. Cooking and Baking. Spring means fresh produce starts appearing at local farmers markets, and our cooking activities reflect the season. Groups learn to prepare simple, healthy meals using seasonal ingredients — strawberries, asparagus, snap peas, herbs. Cooking builds practical life skills (measuring, following sequences, kitchen safety) while also creating opportunities for social interaction and shared meals. Community Connection: Volunteering and Social Skills One of the most important aspects of DSA programming is its focus on community integration. The individuals we support aren't just going on outings — they're becoming active, visible, valued members of their communities. Volunteering. Several of our DSA groups participate in regular volunteer activities. This might mean helping at a local food bank, picking up litter at a park, assisting at an animal shelter, or sorting donations for a thrift store. Volunteering builds a sense of purpose and contribution. It also challenges the narrative that people with disabilities are only recipients of support — in fact, they have a great deal to give. Community Outings. Spring programming includes visits to local museums, libraries, bowling alleys, movie theaters, and community events. These outings provide real-world practice in social skills like ordering food, paying for activities, navigating public spaces, and interacting with community members. For some individuals, these experiences are steps toward greater independence. For all of them, they're opportunities to be part of the fabric of their community. Social Skills Groups. Many of the individuals we support are actively working on social and communication skills. DSA provides a natural setting for this work — not in a clinical office, but in the flow of real activities and real relationships. Staff support individuals in practicing conversation, managing emotions, resolving conflicts, and building friendships within the group. Skill Building: Working Toward Independence Every DSA activity, whether it's a hike or an art project, is an opportunity for skill development. Our programming is designed around person-centered goals, meaning the activities are chosen and adapted to support what each individual is working toward in their Individual Support Plan (ISP). Daily Living Skills. Activities like cooking, gardening, and community outings naturally incorporate daily living skills — things like following a schedule, managing money, using transportation, and practicing hygiene and self-care routines. Communication and Self-Advocacy. DSA groups create space for individuals to practice making choices, expressing preferences, and advocating for their own needs. This might look like choosing which activity to do, asking for help, or telling a peer what they need in a social interaction. Physical Health and Fitness. Active programming — walking, bowling, swimming, dancing — supports physical health in ways that are enjoyable and sustainable. For individuals with certain conditions like Down Syndrome or Cerebral Palsy, adaptive approaches ensure that physical activities are safe, accessible, and beneficial. What Makes North Star Oregon's DSA Different There are several DSA providers in the Willamette Valley, and families have the right to choose the one that's the best fit. Here's what we think sets North Star Oregon apart: Direct Employment. All of our DSA staff are W-2 employees of North Star Oregon. They receive training, supervision, and support from our team. This means consistent quality, accountability, and stability for the individuals and families we serve. Person-Centered Programming. We don't run a one-size-fits-all program. Activities are planned around the interests, goals, and needs of the people in each group. If someone loves being outdoors, we make sure they have plenty of outdoor time. If someone is working on social skills, we build in opportunities for supported social practice. Community Presence. We're embedded in the communities where we operate. Our staff know the local parks, businesses, and organizations. We build relationships with community partners so that the individuals we support are welcomed and included wherever they go. Family Communication. We know that families want to know what their loved one is doing during the day. We maintain open communication with families about programming, progress, and any concerns that arise. How to Access DSA Services DSA is funded through Oregon's Medicaid waiver system and accessed through referrals from ODDS (Oregon Disability and Developmental Services). Here's the basic path: 1. Eligibility. The individual must be eligible for developmental disability services through ODDS. This typically involves a determination of intellectual or developmental disability and functional eligibility. 2. Service Planning. DSA hours are authorized through the Individual Support Plan (ISP), developed with the individual, their family, and their services coordinator. 3. Provider Selection. Families choose their DSA provider. You're welcome to contact North Star Oregon at any point in this process to learn more about our programs and availability. 4. Getting Started. Once services are authorized and a provider is selected, programming begins based on the individual's schedule and goals. If you're already receiving services through another provider but are curious about what North Star Oregon offers, you have the right to change providers at any time. Spring Is Calling The Willamette Valley is one of the most beautiful places in Oregon, and spring is when it really shows off. For the individuals we support, this season is a chance to try new things, build new skills, and deepen their connection to the communities they call home. If you'd like to learn more about Day Support Activities through North Star Oregon — or if you're interested in enrolling a family member in our spring and summer programming — we'd love to connect. Visit northstaroregon.com or contact us directly. Let's make this a spring to remember.

If you are new to Oregon's disability service system, you may have heard the word "brokerage" thrown around in a way that sounds almost transactional — like a stock brokerage, or a real estate broker. It's not that. A brokerage in Oregon's I/DD system is a local nonprofit organization that helps adults with intellectual and developmental disabilities plan, coordinate, and manage the supports they need to live the life they want. Brokerages are one of the most distinctive features of Oregon's disability service landscape. They are also one of the most misunderstood. This guide walks through what brokerages are, who they serve, what personal agents do, and how brokerage services fit alongside the care North Star Oregon and other providers deliver. A Little History (The Short Version) In the early 2000s, Oregon became one of the first states in the country to build a system for adults with developmental disabilities that emphasized self-direction. The idea was simple but radical: instead of routing every adult with I/DD into the same county case management system, give adults the option to direct their own supports through a local nonprofit that worked for them, not the state. Brokerages were the result. Oregon currently has a network of fourteen regional brokerages covering every county in the state. They are independent nonprofit organizations, but they are funded through ODDS and operate under state oversight. Some serve a single county; some serve many. The brokerage system is specifically for adults age 18 and older who live on their own, with family, or in other non-24-hour settings — people who want help planning and coordinating supports but who are not in a residential or foster-care arrangement. Who Does a Brokerage Serve? You may be a good fit for brokerage services if: · You are an adult with I/DD eligible through ODDS · You live in your own home, with family, or in a non-licensed setting (not a residential care facility or adult foster home) · You want an active voice in how your supports are chosen and used · You have a level of support need that does not require 24-hour supervision Brokerages are an alternative to county case management through a Community Developmental Disabilities Program (CDDP). Most adults in Oregon can choose either path. Children and adults who need 24-hour residential supports are typically served through their CDDP or through a comprehensive residential provider rather than a brokerage. Meet Your Personal Agent The single most important person in the brokerage system is the personal agent (often called a PA). A personal agent is your primary point of contact at the brokerage. Their job is to help you figure out what you want your life to look like, plan supports that move you toward it, manage the budget and paperwork, and adjust the plan as things change. A good personal agent does many things: · Leads your person-centered planning process · Writes and updates your Individual Support Plan (ISP) with you · Explains what services you are eligible for and what your budget allows · Helps you identify and hire providers like North Star Oregon · Reviews timesheets, service agreements, and documentation · Connects you with community resources · Advocates for you when something isn't working Personal agents typically carry a caseload of around 40–60 individuals, which is lower than most county case managers. That lower caseload is a deliberate design choice — it is part of what allows PAs to know their clients well and respond to their actual lives, not just to compliance requirements. Person-Centered Planning: The Heart of Brokerage Work The planning process at a brokerage is designed to start with the person, not the system. A good person-centered plan starts with questions like: · What does a good day look like for you? · What do you want to learn or get better at? · Who are the important people in your life, and how do you stay connected to them? · What do you want your home, work, and community life to look like in one year? Five years? · What is making life harder right now, and where do you want support? These questions may feel obvious, but historically the disability services system has worked the other way around — starting with what the system has and fitting people into it. Oregon's brokerages helped lead a national shift back toward putting the person first. The ISP that comes out of that conversation is meant to be your plan, not the brokerage's plan for you. What Services Can a Brokerage Fund? A brokerage itself does not provide direct care. What it does is help you use your Medicaid waiver dollars — your "support services" budget — to purchase services from providers. Common services funded through brokerage plans include: · Attendant Care — One-on-one help with activities of daily living, delivered in your home or community by an agency like North Star Oregon. · Community Inclusion — Support to participate in community life: volunteering, hobbies, classes, events, faith communities, and relationships. · Employment Support — Help finding, learning, and keeping a job in the community. · Environmental Modifications — Physical changes to your home (ramps, grab bars, accessible bathrooms) that support independence. · Transportation — Help getting to work, medical appointments, and community activities. · Specialized Medical Supplies and Equipment — Items not covered by standard health insurance. · Relief Care — Support that gives family caregivers a break. · Family Training — Education for family members on specific topics relevant to the individual's support needs. Your personal agent helps you decide which services make sense, how many hours you need, and which providers are a good fit. You are the decision-maker — the PA is the guide. How a Brokerage Works With a Provider Like North Star Oregon Here is where the two worlds meet. The brokerage plans and coordinates. Providers like North Star Oregon deliver. In practice, that means: 1. You and your personal agent identify that you need, say, 20 hours per week of In-Home Attendant Care and a DSA program three days per week. 2. Your PA shares a service agreement template with us, outlining hours, goals, and funding. 3. We meet with you and your family, talk through what support should look like day to day, and introduce you to caregivers we think will be a good match. 4. Our caregivers (W-2 employees of North Star Oregon) deliver services in your home and community. 5. We document services, invoice the brokerage, and communicate with your PA about progress, concerns, and any adjustments needed. 6. At your annual ISP meeting, the three of us — you, your PA, and our team — review what's working and update the plan. This three-way partnership (individual, brokerage, provider) is the core of how self-directed services work in Oregon. When it works well, it's one of the most person-centered disability service models in the country. CDDP vs. Brokerage: Which Is Right for You? This is one of the most common questions families ask, so let's be direct. Consider a CDDP if: · You need comprehensive 24-hour residential supports · You are a child (most children receive services through a CDDP) · You prefer a more traditional case management relationship with the county · Your support needs are complex and highly medical Consider a brokerage if: · You are an adult living on your own or with family · You want active involvement in directing your own supports · You value a lower caseload and more time with your case manager (personal agent) · You are looking for flexibility in choosing and changing providers Many adults are eligible for either path and can choose. You can also transfer from one to the other if your needs change. If you are unsure which is right for you, both your CDDP and your local brokerage will talk with you about the differences without pressure. Finding Your Brokerage Each region of Oregon has its own brokerage. In the Willamette Valley, depending on your county, you may work with brokerages serving Linn, Benton, Lane, Marion, Polk, and surrounding counties. ODDS maintains a directory, and your local CDDP can tell you which brokerages serve your area. When you contact a brokerage, you will typically have an introductory conversation with an intake coordinator who explains their services, walks you through enrollment, and connects you with a personal agent. Common Questions Do I have to give up my doctor, my providers, or my current services to enroll with a brokerage? No. Brokerages coordinate your ODDS-funded supports. Your medical care, therapies, and other non-ODDS services stay the same. Does the brokerage get a cut of my services budget? Brokerages are funded by ODDS to provide case management. Your services budget is used to pay providers for the direct services you receive. Can I change personal agents if we aren't a good fit? Yes. Brokerages are accustomed to reassignments. You can request a different PA, and in some cases you can change brokerages entirely. How often will I see my personal agent? This varies, but most PAs meet with the people they support at least quarterly, and more often during ISP development, transitions, or changes in circumstance. Why This Matters Oregon's brokerage system represents a deeply held belief: that adults with intellectual and developmental disabilities are not problems to be managed but people with their own lives to build. The structure of the system — small caseloads, self-direction, person-centered planning, and real choice in providers — is the infrastructure for that belief. Understanding how brokerages, personal agents, and providers fit together helps you use the system the way it was designed to be used: as a flexible set of tools that you and the person you love get to direct, not as a set of rules you are navigating around. Connect With Us North Star Oregon works closely with brokerages and personal agents across the state to deliver In-Home Attendant Care and Day Support Activities for adults with I/DD. If you are enrolled with a brokerage and looking for a provider, or if you are trying to decide whether a brokerage is the right path for you, we are happy to help you think it through. Visit northstaroregon.com or contact our team to learn more. There is no cost to have a conversation, and we are glad to share what we know — whether or not you ultimately choose to work with us.

We are excited to share a milestone for North Star Oregon: our Day Support Activities (DSA) program is now open in Josephine County, serving Grants Pass and the surrounding communities. This marks our first location outside the Willamette Valley and the next chapter in our commitment to bringing person-centered, community-based programming to adults with intellectual and developmental disabilities (I/DD) across Oregon. If you are a family, a services coordinator, a personal agent, or an individual looking for a DSA program in southern Oregon — welcome. We have been working toward this for a long time, and we are ready to meet you. What This Means Until now, our DSA programs have operated in Albany, Corvallis, Eugene, Springfield, Salem, and Tangent. Those sites have grown into communities in their own right — places where individuals come together most days of the week to create art, learn skills, volunteer, get outside, and spend time with people who know them well. Now Grants Pass joins that list. The Josephine County program brings the same model of care, the same commitment to individualized support, and the same belief that the adults we support deserve rich, meaningful days in their own community. We are enrolling participants now. Who We Serve in Josephine County Our Josephine County DSA program welcomes adults with I/DD — including Autism, Down Syndrome, Cerebral Palsy, and related conditions — who are eligible for services through Oregon's K Plan or 1915(c) Medicaid waivers. Referrals come through ODDS, typically via your Community Developmental Disability Program (CDDP) services coordinator or your brokerage personal agent. We support a wide range of participants: individuals who communicate in many different ways, individuals who use wheelchairs or other mobility equipment, individuals who thrive in busy social settings and individuals who prefer smaller group experiences. What unites our programming is a simple commitment: the day is built around the people in it, not the other way around. What a Day Looks Like Day Support Activities is not a place you drop someone off for eight hours of filler. At North Star, a DSA day is a calendar of real experiences — community outings, skill-building, creative expression, physical activity, volunteering, and social connection — guided by each participant's Individual Support Plan (ISP) and personal goals. In Josephine County, that means programming designed around the rhythms of southern Oregon life: · Trail walks and outdoor time in the parks and natural areas around the Rogue Valley, with accessibility and sensory needs built into every plan. · Art and creative expression — painting, music, crafts, and hands-on projects that give individuals room to try things, make mistakes, and create work they are proud of. · Community outings to local libraries, markets, museums, events, coffee shops, and gathering places in and around Grants Pass. · Volunteering — contributing to local organizations and causes, because everyone deserves the chance to give back. · Skill building — the practical work of independence, from using money to navigating public spaces to preparing simple meals. · Social connection — friendships, familiar faces, and the kind of belonging that comes from seeing the same people day after day. No two days will look exactly alike. That is the point. A good DSA schedule flexes around the interests, energy, and goals of the participants. A Regional Service Area While our Josephine County hub is based in Grants Pass, our program is designed to serve the broader county. We know that families in smaller Josephine County communities have historically had fewer options for community-based day programming close to home. That has been a real gap, and we want to help close it. If you live in a nearby area and you are not sure whether your location works for our program, please reach out. We would rather have a conversation than have a family assume the answer is no. Why Southern Oregon, and Why Now Expanding outside the Willamette Valley was not a casual decision. For years, families and professionals in southern Oregon have told us the same thing: there is real need for high-quality, person-centered DSA programming in the region, and not enough of it. Waitlists have been too long. Options have been too few. Individuals who want to be in their community have too often spent their days at home because nothing nearby fit. We cannot solve all of that at once. But we can show up, do the work well, and grow responsibly. Our Josephine County program will start with the capacity to support a focused group of participants and build out from there, the way we have done in every location we serve. Quality first, growth second. What Makes North Star Different If you are new to our organization, a few things are worth knowing as you consider whether we are the right fit for your loved one. We are a direct-employment model. Our Direct Support Professionals (DSPs) are W-2 employees, not independent contractors. That means they receive training, support, supervision, and benefits — and you get a stable, accountable workforce caring for your loved one. Person-centered is not a marketing term for us. Each participant's day is shaped by their preferences, goals, and ISP. We take the time to know people, and we adjust programming when something is not working. We explain the system. Medicaid waivers, ISPs, ODDS, tax rules for parent-caregivers, the difference between relief care and attendant care — these are the kinds of things we will walk you through in plain English, whether or not you end up working with us. We do both DSA and in-home attendant care. Many families use us for both. If your loved one attends our DSA program during the day and needs attendant care support at home, we can coordinate that care under one umbrella. We show up for the long haul. Services for adults with I/DD are not a short-term engagement. We build relationships with participants and families that last, and we behave accordingly. How to Get Started The path to enrollment is simpler than families sometimes expect. In most cases it looks like this: 1. Reach out to us. A short conversation tells us a lot. We will ask about your loved one, what you are looking for, and what has (and has not) worked in other settings. 2. Loop in your services coordinator or personal agent. If you are already receiving services through ODDS, your SC or PA will help with authorizations and ISP alignment. If you are not yet in services, we can help you figure out next steps. 3. Visit, if you'd like. Seeing a program in action answers questions that words on a page cannot. 4. Start slow and build up. We often begin with a small number of days per week and grow into a full schedule as the fit becomes clear. If you are not yet eligible for ODDS services and are just starting to explore the system, that is okay too. We can point you to the right first steps in Josephine County. For Services Coordinators, Personal Agents, and Community Partners If you work in the Josephine County disability services ecosystem and would like to learn more about our program, we would love to connect. We are actively building relationships with CDDPs, brokerages, and community partners in the region, and we believe strong coordination across providers is what makes services work for the people who depend on them. A Welcome Worth the Wait If you have been waiting for a DSA program in southern Oregon that takes the work seriously — the relationships, the planning, the dignity, the community connections, the quiet craft of a well-run day — we think you will recognize us when you see us. Our doors are open in Josephine County. We are enrolling now. And we would love to hear from your family. To learn more about our Day Support Activities program in Grants Pass and the surrounding Josephine County area, or to ask about in-home attendant care anywhere in Oregon, visit northstaroregon.com or contact our team. We are here to help you figure out the next right step — whatever that looks like for your family. --- North Star Oregon provides In-Home Attendant Care and Day Support Activities for individuals with intellectual and developmental disabilities across Oregon. Our programs operate in Albany, Corvallis, Eugene, Springfield, Salem, Tangent, and now Grants Pass / Josephine County. Services are funded through Oregon's K Plan and 1915(c) Medicaid waivers, with referrals coordinated through ODDS.

If you are a parent caring for a child or adult with intellectual or developmental disabilities, you already know what most people don’t: caregiving is full-time, year-round, and unlike any other job in the world. There are no clock-out times. There are nights without sleep. There are mornings that begin again before the previous day has fully ended. And through it all, there is profound love — the kind that holds you up even when your body and mind are exhausted. You also know something else: you cannot pour from an empty cup. The well-being of the person you care for is tied directly to your own well-being. When you are rested, supported, and cared for, you can show up for them more fully. When you are running on fumes, everyone suffers. This is why relief care — sometimes called respite care — exists. And this is why every parent- caregiver in Oregon deserves to know it’s available, what it looks like, and how to access it. What Is Relief Care? Relief care, in the context of Oregon disability services, is short-term care provided by someone other than the primary caregiver. It allows the parent or family caregiver to step away — for an afternoon, a weekend, an evening out, an appointment, a workshop, a nap, a date night, or simply a few hours of quiet — while their loved one continues to receive safe, qualified support. Relief care can happen in many forms: • A trained Direct Support Professional (DSP) comes to your home for a few hours so you can run errands or rest • Your loved one attends a Day Support Activities (DSA) program during the day so you can work, recover, or do something for yourself • Overnight care is provided so you can sleep through the night, attend a wedding out of town, or take a much-needed vacation • A family member or friend is paid through the system to provide regular relief The goal of relief care is simple: to keep families strong, sustainable, and intact over the long haul. Caregiving is a marathon, not a sprint, and relief care is one of the most important ways the system supports families to keep going. Why Relief Care Is So Important The data on caregiver health is sobering. Studies consistently show that long-term family caregivers experience higher rates of: • Chronic stress and burnout • Depression and anxiety • Sleep deprivation • Physical health problems including back pain, immune dysfunction, and cardiovascular disease • Social isolation • Financial strain And these effects compound over years and decades. A parent caring for a child with significant disabilities for 20 or 30 years carries an enormous weight — physically, emotionally, and financially. Without breaks, the cost adds up. Relief care isn’t a luxury. It’s a necessity for sustainable caregiving. Families who use relief care regularly tend to report better mental health, stronger marriages, more present parenting for siblings, and a greater ability to keep their loved one at home rather than in a more restrictive setting. Said differently: relief care helps keep families together. How Relief Care Is Funded in Oregon In Oregon, relief care for individuals with intellectual and developmental disabilities is funded primarily through Medicaid — specifically through the K Plan (Community First Choice State Plan) and the 1915(c) waivers that support adults and children with I/DD. These programs pay for a range of in-home and community-based services, including: • In-Home Attendant Care (which can include relief care hours) • Day Support Activities • Employment supports • Skills training • And, in many cases, dedicated relief care hours within an Individual Support Plan The exact amount of relief care available depends on the individual’s annual budget, which is set through the Oregon Needs Assessment (ONA), and the priorities outlined in the Individual Support Plan (ISP). Some families have a specific allocation for relief; others fold relief into their broader attendant care hours. If you’re not sure how much relief care your loved one is approved for, your Services Coordinator (through your county CDDP) or Personal Agent (through a brokerage) is the right person to ask. They can walk you through your current ISP, help you advocate for additional hours if needed, and connect you with providers. Who Provides Relief Care? In Oregon, relief care is provided by qualified Direct Support Professionals — typically trained, background-checked, and employed by an agency that handles the complexities of payroll, workers’ compensation, training, and oversight. There are also models where families hire individuals directly, but increasingly, more families are choosing direct-employment agencies (where DSPs are W-2 employees of the agency, not contractors). The benefits of this model include: • The agency handles taxes, payroll, workers’ comp, and HR • DSPs receive training, supervision, and support • There is built-in backup if a regular caregiver is sick or unavailable • Liability and oversight are professionally managed • Continuity is more reliable, because the agency is invested in matching and retention At North Star Oregon, we use a direct-employment model precisely because we believe it produces better outcomes for both the individuals we support and the families who depend on us. What If a Family Member Wants to Be the Caregiver? Here’s a piece of news that surprises many families: in Oregon, parents and other family members can be paid to provide care for their own children or adult family members in many situations. This includes both regular attendant care hours and, in some cases, relief care hours when another qualified caregiver is unavailable. The ability to be paid for caregiving is significant for families where one parent has had to stop working or reduce hours to provide care. It transforms what was unpaid labor into a livable income, while also allowing the family to keep their loved one at home rather than in a more institutional setting. There are rules and structures to follow — caregivers must be hired through an agency or appropriate channel, must meet training and background check requirements, and must document hours worked. But for many families, this option has been life-changing. In a shared-home setting, North Star Oregon employs parent-caregivers as W-2 staff, which provides the legal, tax, and benefit protections of formal employment while honoring the unique role parents play in their children’s lives. Tips for Making the Most of Relief Care If you’re new to using relief care, here are a few things that experienced families have learned along the way: Start small. Your first time leaving your loved one with a new caregiver may feel impossible. Start with a one- or two-hour outing close to home before working up to longer breaks. Find the right match. A good DSP-to-individual fit makes all the difference. Don’t be afraid to give feedback to your provider if a match isn’t working — a quality agency will work to find someone who’s right. Build a routine. Consistency helps everyone. Same caregiver, same day, same time each week tends to work better than scattered, unpredictable coverage. Use the time intentionally. It’s tempting to use relief hours for chores and errands, and sometimes that’s exactly right. But also schedule time for things that fill you up — coffee with a friend, a walk in the park, a movie, a long bath, a nap. Whatever recharges you. Don’t feel guilty. This is a hard one. Many parent-caregivers carry deep guilt about taking time away. Remember: you are not abandoning your loved one. You are sustaining the very care they depend on. Rest is part of the work. Document and communicate. Keep a simple log of routines, preferences, and important details that help a new caregiver get up to speed quickly. The smoother the handoff, the more you can relax. Ask for what you need. If your current relief care hours aren’t enough, talk to your Services Coordinator. Needs change over time, and ISPs can be updated. A Word About Sustainability We meet many families who have been pushing through caregiving for years without ever taking a real break. Sometimes they didn’t know relief care was available. Sometimes they felt guilty asking. Sometimes they tried once, had a bad experience, and never tried again. If that’s you, please hear this: it’s not too late, and you are not alone. The system exists to support you. Good providers exist. Your loved one will be okay. And you — you matter. Your health matters. Your rest matters. Your joy matters. The most loving thing you can do for your family is take care of yourself well enough to stay in this for the long haul. How North Star Oregon Can Help At North Star Oregon, we provide In-Home Attendant Care and Day Support Activities across the Willamette Valley, including dedicated relief care hours that give parent-caregivers the breaks they need. Our W-2 employed Direct Support Professionals are trained, background- checked, and matched thoughtfully to each individual we support. Whether you need a few hours of relief each week, regular DSA programming so you can return to work, or overnight care so you can finally take a vacation, we’d love to help you build a plan that works for your family. Take the First Step If you’re a parent-caregiver in Oregon and you’ve been running on empty, let this be your sign. Reach out to North Star Oregon to learn more about relief care, in-home attendant care, and day support activities. We’re here to walk alongside your family. Visit northstaroregon.com or contact us today — and please, take the break you deserve.

A practical Guide for Oregon Families