Do you need a license to open a non-medical home care agency?

What each state entry covers

Every state page uses the same 16 items, so you can compare states and print a checklist. Where an official source could not confirm a fact, the entry says “Not confirmed in official sources” instead of guessing.

• License required?
• License type / name
• Licensing agency
• Agency website
• Initial application / license fee
• Renewal fee
• Renewal cycle
• Typical approval timeline
• Administrator qualifications
• Caregiver background checks
• Caregiver training hours
• Registry checks
• General liability insurance
• Workers' compensation
• Bonding (surety / dishonesty)
• Rule changes 2025–2026

See all 50 states in one table Open the licensing checklist

License, registration, certification or Medicaid enrollment

States use different tools, and the name matters because it tells you which office to call and what you are allowed to do. The 50-state table uses the labels below; open a state to read the details and sources.

How to read the labels

These definitions are the guide’s own.

Bracketed numbers [1]

Each fact links to the numbered source listed under that state. Official state government sources (.gov, state legislatures, state administrative codes) were used first.

Not confirmed in official sources — check with the state agency

We could not confirm this item on an official state source during our review, so we did not estimate it. In the guide’s data this is the UNVERIFIED grade: The fact could not be confirmed on an official source during this review. No estimate has been put in its place. Any note shown explains what was (or was not) found. Approval timelines show “No official timeline published — check with the agency”; fees with conflicting official figures show “Conflicting official figures — confirm current fee with the agency.”

Not required / N/A

An official source says the item does not apply (for example, a state with no license).

CHANGED SINCE MARCH 2026

An enacted law, adopted rule, fee schedule, or process change took effect, or was adopted, after March 1, 2026.

WATCH

A pending proposal, failed bill, or smaller program-level change that could affect agencies but is not a licensing change in force.

Changed or on watch since March 2026

17 state entries carry a flag. CHANGED items are in force or formally adopted; WATCH items are proposals, failed bills, or program-level changes.

• Colorado CHANGED New 2026/27 fee schedule effective July 1, 2026 (amounts Not confirmed in official sources — check with the state agency).
• Indiana CHANGED IDOH moved PSA licensing to its Gateway online process on May 1, 2026.
• Massachusetts CHANGED Chapter 180 of 2026 (approved Aug 6, 2026) creates a home care agency license that will become mandatory on a date EOHHS has not yet set; regulations pending. As of October 15, 2026, no license was being issued.
• Mississippi CHANGED MSDH Background Check Unit began final employment-eligibility determinations July 1, 2026; waiver letters discontinued.
• Oregon CHANGED ODHS caregiver certification and public caregiver registry rules effective July 1, 2026.
• Pennsylvania CHANGED Applications online only since Mar 31, 2026; mail/email no longer accepted.
• South Carolina CHANGED Amendments to Regulation 60-122 took legal effect May 22, 2026.
• Washington CHANGED New fee rule WAC 246-335-990 effective June 1, 2026.
• Georgia WATCH GCHEXS fingerprint policy added for Consumer Directed Care employers, effective July 1, 2026 (Medicaid program).
• Maryland WATCH OHCQ released draft COMAR 10.07.05 amendments (incl. training) for informal comment on Sept 9, 2026; not adopted.
• Missouri WATCH Family Care Safety Registry fee rose from $15 to $16 on Oct 1, 2026 (worker registry fee).
• New Jersey WATCH P.L. 2026, c. 45 (July 22, 2026) changed Medicaid Personal Care Assistance thresholds and reporting.
• Nevada WATCH Proposed fee regulation R071-26 (Apr 20, 2026) would set $1,374 initial / $687 renewal; adoption not confirmed.
• Ohio WATCH ODA rule 173-39-02.1 (Medicaid provider certification) effective Oct 1, 2026; substance Not confirmed in official sources — check with the state agency.
• South Dakota WATCH HB 1138 licensing bill vetoed; override failed Mar 30, 2026. Governor directed DOH to develop a new framework.
• Texas WATCH HHSC proposed HCSSA rule amendments published Sept 18, 2026 (Texas Register); not adopted.
• Wyoming WATCH Medicaid HCBS EVV minimum standard effective July 1, 2026.

Upcoming dates already set in law: California dementia-care annual training provision operative Jan 1, 2027 (SB 412, 2025); Connecticut 8 hours of paid employee training starting Jan 1, 2027 (P.A. 25-156). See those state entries for sources.

What this site covers

Scope: agencies that provide non-medical companion, homemaker, and personal care (hands-on help with daily activities) in the client's home. Skilled, Medicare-certified home health is covered only where it is the only state pathway. Where a state has no private-pay license, the Medicaid provider pathway is described and labeled as such.

Limits: fees and forms change often. Agencies sometimes post conflicting figures (a statute vs. an older form); those conflicts are shown, not resolved by guessing. Confirm the current fee with the agency before filing. This guide is a research reference, not legal advice.