From application to approval, we handle your NYSDOH licensing — then hand you the platform to run your agency from day one. Most consultancies disappear when your license arrives. We keep going.
Want to open a non-medical home care agency in New York? You need a Licensed Home Care Services Agency (LHCSA) from the New York State Department of Health. Our estimate: 270–540 days for provisional approval plus an on-site survey. State filing fees total $2,000 and are paid directly to NYSDOH.
Non-medical home care agencies do not require a CON in New York.
Medicaid Program
Consumer Directed Personal Assistance Program (CDPAP)
Plus the Managed Long Term Care (MLTC) and Medicaid Personal Care Services for qualifying providers.
Home Care License Type in New York
New York regulates home-based care under several license categories. Most new founders start with a LHCSA License for non-medical care, then add skilled services later if they choose.
NON-MEDICAL
Licensed Home Care Services Agency (LHCSA)
Starting a home care agency in New York is not like other states.
Personal care and daily living assistance
Companionship and homemaker services
Medication reminders (not administration)
Transportation and errand assistance
Respite care for family caregivers
State fee:
$2,000 LHCSA Application Fee (PHL §3605(13))
Timeline:
9-18 Months for provisional approval
Regulator:
New York State Department of Health
How to Get Licensed in New York
New York licensing follows a structured 7-step process through NYSDOH. Our specialists handle all 7 steps in the Launch and Signature packages; in the Licensing Kit, you handle the submission yourself with our expert guidance.
270–540 days from start to provisional approval
1
FOUNDATION
2
POLICIES
3
INSURANCE
4
APPLICATION
5
PROCESS
1
Public Need Research (NYSE-CON)
FOUNDATION
Every new LHCSA must prove public need. Check the DOH LHCSA Need Report. It lists the counties where the state presumes no need. You must rebut that with data for each such county. Examples: a group no one serves, a language gap, or a service no one offers. You can ask for up to 5 counties in one DOH region.
2
Business Formation
FOUNDATION
Form your business with the NYS Department of State. Get an EIN from the IRS. Register with the NYS Tax Department.
3
Secure Office Space
POLICIES
Plan an office. The rules say it must be big enough to run the agency well (10 NYCRR 766.9). They do not set a size. Ask DOH before you use a home office.
4
Insurance & Financial Documents
INSURANCE
Get liability insurance. Work with a CPA on your budget. Your working capital must cover at least your first two months of costs (DOH DAL 22-14).
5
Submit LHCSA CON Application in NYSE-CON
APPLICATION
File the LHCSA CON application online in NYSE-CON. Include your public need rebuttal, money documents, and character and competence forms. Mail the $2,000 fee (PHL Section 3605(13)). DOH must get it within 30 days. The fee is not refunded once DOH acknowledges your application (DOH LHCSA FAQ). Do not send your policy manual yet. DOH asks for it after PHHPC approval.
6
PHHPC Review, Policy Manual, and Pre-Opening Survey
POLICIES
DOH reviews your file, then puts it on a PHHPC agenda. PHHPC meets six times a year. If you get contingent approval, you send your Policy and Procedure Manual to your DOH Home Care regional office. Once the manual is accepted, the regional office schedules a pre-opening survey. DOH says it cannot give an exact timeframe.
7
License Issuance
PROCESS
After you pass the survey, the Bureau of Home Care Licensure and Certification issues your LHCSA license. Then you must register with DOH every year (PHL Section 3605-b).
Why New York Founders Choose HomeCareAtlas
The biggest difference between us and traditional consultancies isn't the license — it's what happens after the license arrives.
Traditional Consultant
HomeCareAtlas
Pricing
A mystery sales process and hard upsells
Clear packages built for your goals
Policies & Procedures
Generic templates
Built around your state and your service model
Application Filing
You assemble the packet
Done-for-you in Launch and Signature
Survey Day
You're on your own
On-call phone support during your state visit
After License Arrives
Relationship ends
Platform, dashboard, and directory listing go live
Caregiver Onboarding
Not included
Digital onboarding ready for hire #1
Compliance Tracking
You build a spreadsheet
Live compliance dashboard included
Directory Presence
None
Listed on Carezano the day you open
Three Ways to Get Your New York Agency Licensed
Pick the level of support that matches how hands-on you want to be. New York state fees ($2,000 to NYSDOH) are passed through at cost.
New York charges a state application fee, paid directly to the state licensing body. We don't mark it up.
Want to see pricing? We share it on your free 15-minute call. Pick a time →
The Platform That Comes With Your License
Every tier includes free time on Home Care Atlas — the operating system for your new agency. This is the part other New York consultancies don't offer.
New York Licensing Workspace
Track your application, documents, and deadlines in one dashboard. Your Atlas specialist works in the same view you do.
Custom New York P&P Manual
Written around your state's rules, your service model, and your agency — not a generic national template. Survey-ready before you file.
Business Formation
LLC, EIN, NPI, surety bond, and insurance — all tracked and handled in Launch and Signature packages.
Compliance Dashboard
From caregiver #1 onward, every certification, background check, and required document is tracked with automatic expiration alerts.
Caregiver Onboarding
I-9, W-4, direct deposit, and required background-check verifications — all collected digitally.
Carezano Directory Listing
Listed on our public directory the day you open. Local families find you, referral partners find you, you're visible from day one.
Common Questions Before You Book
Do I need to demonstrate public need to start in New York?
Yes. Since April 1, 2020, every new LHCSA must prove public need. You file through NYSE-CON. If a county has 5 or more LHCSAs actively serving patients, the state presumes no need (10 NYCRR 765-1.16). DOH counts an agency as actively serving at 25 or more patients (DOH LHCSA FAQ). You must rebut that with data. Examples: a group no one serves, a language gap, or a service no one offers. PHHPC reviews public need, character and competence, and money. This is the biggest barrier.
Can I operate from home in New York?
Maybe, but ask DOH first. The rules say your office must be big enough to run the agency well (10 NYCRR 766.9). They do not set a size. We did not find a rule that bans a home office. Records must be kept safe and private.
What is CDPAP and should I participate?
CDPAP (Consumer Directed Personal Assistance Program) lets Medicaid members hire their own caregivers, including family. One statewide fiscal intermediary, Public Partnerships LLC (PPL), now runs payroll for the whole program. Your LHCSA cannot be a CDPAP fiscal intermediary. Do not build your business plan on CDPAP FI revenue.
How long does the LHCSA application really take?
DOH says it cannot give an exact timeframe. Our estimate is 9 to 18 months, and approval is not sure. The steps are: DOH review, PHHPC agenda (PHHPC meets six times a year), policy manual review, then a pre-opening survey. DOH says a complete application and quick answers make it go faster.
What's the difference between LHCSA and Home Health Agency?
A LHCSA can give aide care, like personal care and homemaking. Some LHCSAs also give nursing. A Certified Home Health Agency (CHHA) is certified for Medicare and Medicaid home health care. The rules are very different. Most new non-medical agencies look at the LHCSA path.
Can I operate a home care agency in New York without a license?
No. Under Article 36 of the Public Health Law, an agency must be licensed or certified by DOH to give or arrange home care services. That includes home health aide, personal care, and homemaker services. Running one without a license breaks state law.
Will getting my LHCSA license guarantee I can take Medicaid patients?
No. Many MLTC plans have closed networks. You need a LHCSA license to contract with them. But the license does not promise a contract. Check which plans are open in your area first.
Should I apply for a new license, buy an agency, or partner with one?
It depends on your budget, time, and how much risk you can take. A new LHCSA costs less up front. But it is slower and less sure. Buying an agency is often faster but costs much more. Partnering can be the quickest way in, but you give up some control. Many New York founders look at all three first.
What are the biggest challenges of starting a home care agency in New York?
Here are the big ones: (1) proving public need in NYSE-CON, mainly in "no need" counties. (2) A long wait with no promise of approval. Our estimate is 9 to 18 months. (3) Paying the $19.65/hr downstate aide minimum wage, plus wage parity. (4) Finding enough aides. (5) Getting MLTC contracts when networks are closed. Still, New York has many seniors who need help at home.
New York Home Care Licensing: What You Need to Know
Starting a home care agency in New York is not like other states. Agencies that give home health aide, personal care, or homemaker services need a Licensed Home Care Services Agency (LHCSA) license. The rules are in 10 NYCRR Parts 765 and 766. Since April 1, 2020, every new LHCSA must prove public need. It must also show it can pay its bills. You file the LHCSA Certificate of Need (CON) application online in NYSE-CON (DOH LHCSA Application Requirements FAQ). The fee is $2,000 (PHL Section 3605(13)). Some counties already have 5 or more LHCSAs actively serving patients. There, the state presumes there is no need. DOH counts an agency as "actively serving" at 25 or more patients. You must rebut that with data. The Public Health and Health Planning Council (PHHPC) reviews public need, character and competence, and money. After PHHPC approval, you send your policy manual and pass a pre-opening survey. DOH does not give a set timeline. Our estimate is 9 to 18 months, and approval is not sure. That is why many people buy an agency or partner with one instead.
The Licensed Home Care Services Agency (LHCSA)
New approvals are hard and not sure. So many owners buy a licensed agency or partner with one. They skip a new LHCSA application. About 3.86 million New Yorkers are 65 or older. That is out of about 20 million people (U.S. Census 2025 estimate). Only California, Florida, and Texas have more seniors.
Certificate of Need (CON) in New York
Public Need Review (NYSE-CON) — Biggest Barrier. Since April 1, 2020, every new LHCSA must prove public need (10 NYCRR 765-1.16). You file through the NYSE-CON system. If a county has 5 or more LHCSAs actively serving patients, the state presumes no need (10 NYCRR 765-1.16). DOH counts an agency as actively serving at 25 or more patients (DOH LHCSA FAQ). You must rebut that with data. Examples: a group no one serves, a language gap, or a service no one offers. You can ask for up to 5 counties in one DOH region (DOH LHCSA FAQ). This is the biggest barrier to entry.
Medicaid Participation — Consumer Directed Personal Assistance Program (CDPAP)
NY's program that lets Medicaid members hire, train, and manage their own caregivers, including family. One statewide fiscal intermediary, Public Partnerships LLC (PPL), handles payroll for all members (DOH CDPAP page).
The NYSDOH On-Site Survey
Rigorous LHCSA Application. Your application must show character and competence, public need, and that you can pay your bills. Your working capital must cover at least your first two months of costs (DOH DAL 22-14). A CPA must check your money forms. After PHHPC approval, you send your policy manual and pass a pre-opening survey.
Common Reasons New York Applications Are Rejected or Delayed
Generic P&P manuals that don't reflect state-specific regulations
Incomplete administrator documentation
Insurance or surety bond policies that don't meet state minimums
Missing or inadequate quality assurance program documentation
Physical office that doesn't meet site-review standards
Caregiver background checks that miss required state databases
Every one of these is preventable with proper preparation. It's the biggest reason founders choose done-for-you packages over DIY — the cost of a rejection in lost time is almost always higher than the cost of doing it right the first time.
Book a Free New York Strategy Call
15 minutes with a home care specialist. We'll map out New York licensing for you, your timeline, and your best next step — even if you don't hire us.
Which New York license type fits your business model (Licensed Home Care Services Agency)
Your realistic timeline and budget
Whether Consumer Directed Personal Assistance Program (CDPAP) enrollment makes sense for your plan
No pressure. No obligation. New York-specific guidance either way.
Your Future New York Clients Are Already Looking for Care.
Every week you spend piecing this together alone is a week you're not serving your first New York client. Let's get your agency licensed, launched, and visible — with people on your side who know NYSDOH.
