HomeCareAtlas Team · Updated November 2026
Researched from primary state regulatory sources.
How to Start a Home Care Agency in Illinois
Starting a home care agency in Illinois costs roughly $35,000 - $90,000+ and takes Up to 90 Days to Provisional + 240-Day Provisional Period. Here's every step, fee, and deadline — sourced directly from Illinois Department of Public Health (IDPH).
Illinois requires a Home Services Agency (HSA) license for non-medical home care. That means help with daily tasks, housekeeping, laundry, and company in a client's home. IDPH runs the license. The law is the Home Health, Home Services, and Home Nursing Agency Licensing Act (210 ILCS 55). The rules are in 77 Ill. Adm. Code 245. The fee is $1,500 a year. Illinois has other license types too: placement agencies, home nursing, and home health. So pick the right one before you apply. IDPH's license steps do not include a Certificate of Need.
To start a non-medical home care agency in Illinois, you need a Home Services Agency License from the Illinois Department of Public Health (IDPH). The application fee is $1,500 (annual hsa license fee), the process takes approximately up to 90 days to provisional + 240-day provisional period, and total startup costs range from $35,000 - $90,000+. Illinois requires a Home Services Agency license from IDPH ($1,500 a year). You get a provisional license within 90 days of a complete application. It lasts 240 days, then IDPH surveys you. You must have Health Care Worker Registry access.
- License Required
- Yes — Home Services Agency License
- Regulatory Body
- Illinois Department of Public Health (IDPH)
- Application Fee
- $1,500 (annual hsa license fee)
- Timeline
- Up to 90 Days to Provisional + 240-Day Provisional Period (idph statutory / regulatory timeline)
- Total Startup Cost
- $35,000 - $90,000+
- Key Requirement
- Illinois requires a Home Services Agency license from IDPH ($1,500 a year). You get a provisional license within 90 days of a complete application. It lasts 240 days, then IDPH surveys you. You must have Health Care Worker Registry access.
- Last Verified
- November 2026 against Illinois Department of Public Health (IDPH) regulations
IDPH Statutory / Regulatory Timeline
Source: 77 Ill. Adm. Code 245.100(a)(1)-(2) · Checked Nov 2026
Residents Age 70+
Moderate Opportunity
How Illinois compares to neighboring states
| State | License Fee | Timeline | Startup Cost |
|---|---|---|---|
| Illinois ← | $1,500 | Up to 90 Days to Provisional + 240-Day Provisional Period | $35,000 - $90,000+ |
| Indiana | $250 | 60-90 Days | $30,000 - $60,000 |
| Wisconsin | $0 (no license) | 2-6 Weeks (Private Pay) | 6-12 Months (Medicaid PCA) | $40,000 - $75,000 |
| Missouri | $0 (no license) | 4-8 Weeks | $25,000 - $55,000 (our estimate) |
| Iowa | $0 (no license) | No timeline | $18,000 - $40,000 |
In This Article
Illinois Licensing Overview
The Illinois Department of Public Health (IDPH) oversees all non-medical agencies.Illinois requires a Home Services Agency (HSA) license for non-medical home care. That means help with daily tasks, housekeeping, laundry, and company in a client's home. IDPH runs the license. The law is the Home Health, Home Services, and Home Nursing Agency Licensing Act (210 ILCS 55). The rules are in 77 Ill. Adm. Code 245. The fee is $1,500 a year. Illinois has other license types too: placement agencies, home nursing, and home health. So pick the right one before you apply. IDPH's license steps do not include a Certificate of Need.
Home Services Agency License Required
If you hire and manage caregivers who give non-medical care in clients' homes, you need a Home Services Agency license. A placement agency is different. It only finds workers for clients.
Agency or Placement Agency?
A Home Services Agency employs its workers. It handles training, supervision, and the rules. A Home Services Placement Agency places workers who become the client's employees. IDPH says a placement agency also needs a Private Employment Agency license from the Illinois Department of Labor.
Provisional License Comes First
IDPH gives a new agency a provisional license within 90 days of a complete application. It lasts 240 days. IDPH inspects you in the last 30 days. If you are close but not there yet, IDPH may extend it once, for up to 90 days.
Background Check Rules
You must follow the Health Care Worker Background Check Act (77 Ill. Adm. Code 955). Each new hire needs a fingerprint check. You also check workers in the Health Care Worker Registry when you hire them and each year. You must show IDPH you have Registry access through the IDPH Web Portal.
Estimated Startup Costs (2026)
Budget for $35,000 - $90,000+ to ensure 3-6 months of runway.
| Category | Low Est. | High Est. |
|---|---|---|
| Annual HSA License Fee | $1,500 | $1,500 |
| Business Formation / Legal Setup | $400 | $2,000 |
| Liability Insurance (min $1M per occurrence / $3M total) | $2,500 | $7,500 |
| Workers' Compensation | $1,000 | $4,500+ |
| Background Check / Registry / Onboarding Setup | $800 | $2,500 |
| Policies, Forms, Compliance Buildout | $1,500 | $6,000 |
| Office / Tech / Phone / Records Setup | $1,500 | $6,000 |
| Recruiting & Initial Marketing | $2,000 | $8,000 |
| Payroll Float / Working Capital | $20,000 | $50,000+ |
We map every cost and file your Illinois license for you.
How to Get an Illinois Home Services Agency License
1-3 Days
Choose the Right License Type
Decide if you need a Home Services Agency, Home Services Placement Agency, Home Nursing, or Home Health license. You can hold more than one, but each needs its own application and fee. If you will hire and manage caregivers, pick Home Services Agency.
1-2 Weeks
Form the Business and Set Up an Office
Form your LLC or corporation. Get an EIN. Open a business bank account. Pick your name. Set up an office where you can answer the phone during business hours and keep client records private.
2-5 Days
Pick the Counties You Will Serve
Your application needs a map or list of the area you will serve. Later, you must get IDPH approval before you take clients in a new county.
1-2 Weeks
Choose an Agency Manager and Fill Out Attachment E
IDPH reviews your agency manager closely. Fill out Attachment E. Show work history that proves they can run staff, records, and the rules. Weak proof can slow you down. You also name a backup for the manager.
2-6 Weeks
Write Your Policies, Job Descriptions, and Client Contract
Write policies for complaints, staff health, infection control, background checks, supervisory visits, records, and training. Write a job description for every role. Make a sample service plan and your client contract. The contract must say who is the employer and who pays wages and taxes.
1-2 Weeks
Get Health Care Worker Registry Access
Register with the IDPH Web Portal and get access to the Health Care Worker Registry. Your application must include proof of this access. Set up how you will run fingerprint checks for new hires.
2-4 Weeks
Build Your Training Program
Each worker needs at least 10 hours of training. Five hours come before the first assignment. The other five come within 30 days. Workers pass a skills test before their first assignment and again after the rest of the training. If you serve clients with dementia, add the dementia training too.
Up to 90 Days
Mail the Application and Answer Fast
Mail the Home Services application, a Certificate of Insurance, Attachment E, your policies, and the other items. Include a $1,500 check or money order. IDPH does not take online applications or payments yet. IDPH says it reviews within 30 days. The application must be complete and approved within 90 days, or it may be denied.
240 Days
Get Your Provisional License and Start Serving
If approved, you get a provisional license good for 240 days. Use this time to run a real agency. Serve clients. Keep training records, contracts, and background checks up to date.
Last 30 Days of Provisional Period
Pass the IDPH Survey
IDPH inspects you in the last 30 days of the provisional license. If you meet the rules, you get a regular license. It ends one year from the end of the month your provisional license began. If you are close but not there yet, IDPH may extend the provisional license once for up to 90 days.
We can do all of them for you in Illinois.
New 2026 Legal Mandates
No Home Services Agency Without a License
No one may open, manage, run, or keep up a home services agency in Illinois without an IDPH license (210 ILCS 55). The rule's definition (77 Ill. Adm. Code 245.20, Home Services Agency) leaves out agencies that only clean houses. It also leaves out programs that serve only clients of the Community Care Program, DHS Rehabilitation Services, or the VA.
A Complete Application Matters
IDPH gives the provisional license within 90 days only if the application meets Section 245.90. Incomplete applications may be denied. Check every page before you mail it.
Liability Insurance
Your application must include a Certificate of Insurance (Section 245.90(a)(2)). It must show at least $1 million per occurrence and $3 million total. No bond is required, and a bond does not replace the insurance. Keep your coverage active.
Written Policies and Job Descriptions
You must have written policies and a job description for every role. They go in with your application. Surveyors also review them.
Client Contract
You need a signed contract with each client, printed in at least 12-point type. It must list services, rates, contacts, complaints, billing, and how long it lasts. It must also say who is the employer and who pays wages, taxes, and workers' comp.
Service Area Approval
You must get IDPH approval before you care for clients in a new county. You must also tell IDPH within 10 days of a change to your address, phone, or name.
Our Illinois licensing team tracks the law so you do not have to.
Caregiver Mandates
Important Warning
Illinois checks how you run day to day, not just your paperwork. Training logs, skills tests, Registry checks, contracts, and complaint records must all be real and up to date.
- First Training: 10 Hours: Each worker needs at least 10 hours of training (77 Ill. Adm. Code 245.71). Five hours come before the first assignment. The other five come within the first 30 days. A worker trained at another licensed agency in the past year, or a CNA on the Registry, can skip this. They still take your skills test.
- Skills Test Before Work: A worker may not take an assignment until they pass your skills test on the first five hours of training. They take another test after the last five hours.
- Yearly Training: Every worker needs 10 hours of training each year. The first 10 hours count for year one. Write down the date, time spent, trainer, topic, and the worker's signature.
- Dementia Training: Staff who work with clients with dementia need 6 hours of dementia training in their first 60 days (77 Ill. Adm. Code 973.140(c)). Then they need 3 hours each year (973.140(f)). You also name an Alzheimer's services supervisor (973.130(b)). That person needs 8 hours of dementia training each year (973.140(b)).
- Background Checks and the Registry: Each worker needs a fingerprint check under the Health Care Worker Background Check Act. A worker with a disqualifying record cannot work without a waiver. Check the Health Care Worker Registry at hire and each year.
- Train for the Real Tasks: Train and test workers on the tasks they will do. That can include bathing, transfers, feeding, medication reminders, lifts, dementia care, emergencies, and infection control.
Regional Billing Snapshots
*Regional rates vary by specialized care needs (Dementia, Parkinson's) and local competition.*
We launch Illinois home care agencies start to finish.
Regional Market Opportunities
Illinois has about 2.4 million adults 65 and older (Census 2025 estimate). The Chicago area has the most clients and referral sources. Smaller cities cost less to run in. The rates below are our estimates of private-pay prices, not official numbers.
Chicago Metro (Cook, DuPage, Lake, Will)
The most seniors, hospitals, rehab centers, and families who pay on their own. Rates tend to be near the top of the range. But hiring is harder and there is more competition.
Key: Best if you can hire fast and build referral ties quickly.
Collar Counties / Suburbs
Suburbs can be a good middle path. Many families have good incomes, and there can be fewer agencies than in the city.
Key: Often a better first area than central Chicago.
Central Illinois
Lower costs and fewer competitors. But there may be fewer referrals and fewer workers to hire.
Key: A good fit if you want lower costs and steady local ties.
Rockford / Metro East / Other Smaller Markets
Smaller markets can reward agencies that build a local name and keep their area tight.
Key: Good if you want to grow locally before you expand.
Cost of care in Illinois
What agencies charge clients vs. what caregivers earn in Illinois. The difference is the agency's gross margin per billable hour — before overhead like insurance, admin, marketing, and compliance costs.
$35
Avg. hourly rate charged to clients
$21.24
Avg. caregiver hourly wage
$13.76
Gross margin per hour
39%
Gross margin %
What this means for agency owners
In Illinois, agencies keep roughly $13.76 per billable hour after paying the caregiver. That's a 39% gross margin.
This is a typical margin for the industry. You will need to manage overhead carefully, but profitability is achievable with good operations.
Sources: Avg. hourly rate from CareYaya and CareScout 2025 surveys (averaged). Caregiver wage from Care.com. Gross margin is before overhead costs like insurance, admin, marketing, and compliance.
Illinois Medicaid Programs
Community Care Program (CCP)
IDPH says Medicaid clients come through the Illinois Department on Aging's Community Care Program. Contact the Department on Aging to get approved. That is a separate step from your IDPH license.
DHS Division of Rehabilitation Services
IDPH also lists the Department of Human Services, Division of Rehabilitation Services, as a path for Medicaid clients. Contact DHS directly to ask how to become a provider.
Private-Pay First Is Still Common
A Home Services license lets you take private pay and private insurance. Many new agencies start there. They add public programs once staffing and cash flow are steady.
Becoming a Provider
Essential 2026 Tech Stack for Owners
Tiles outlined in teal are areas HomeCareAtlas covers in our platform.
Illinois Licensing FAQ
What is the correct Illinois license for a non-medical home care agency?
If you hire or manage caregivers who give non-medical care, you need a Home Services Agency license from IDPH.
What is the difference between a Home Services Agency and a Home Services Placement Agency in Illinois?
A Home Services Agency employs its workers and keeps managing the client's care. A Home Services Placement Agency only places workers, who become the client's employees. IDPH says placement agencies also need a Private Employment Agency license from the Illinois Department of Labor. The placement license fee is up to $500 a year.
Do I need a Certificate of Need (CON) for an Illinois non-medical home care agency?
No. IDPH's steps for a Home Services license do not ask for a Certificate of Need. We could not open the state law site to double-check the Certificate of Need list.
How much is the Illinois Home Services Agency license fee?
The fee is $1,500 a year (77 Ill. Adm. Code 245.95). It is not refundable. Pay by check or money order to IDPH.
How long does it take to get licensed in Illinois?
IDPH says it reviews your application within 30 days. It should approve or deny the provisional license within 90 days. The provisional license lasts 240 days. IDPH surveys you near the end. So plan for up to 90 days to start, then about 8 months before your regular license.
What does Illinois require from the agency manager?
There is no required course. IDPH reviews the manager's work history and duties on Attachment E. A manager who looks weak on staffing, records, or the rules can cause delays.
What training is required for home services workers in Illinois?
At least 10 hours of training: 5 hours before the first assignment and 5 within the first 30 days (77 Ill. Adm. Code 245.71). Workers pass skills tests along the way. Then they need 10 hours of training each year.
Is there a dementia training requirement in Illinois?
Yes. Staff who work with clients with dementia need 6 hours of training in their first 60 days. Then they need 3 hours each year (77 Ill. Adm. Code 973.140).
What do Illinois surveyors actually look at?
IDPH's Surveillance Nurse Visit Checklist lists what to have ready. Surveyors may look at your policy manual, governing body records, client lists, and files. They may talk to staff and visit clients who agree. They check your insurance, complaint log, training files, and dementia training plan. You must show your Health Care Worker Registry access. Your manager or a stand-in must be there when the surveyor arrives.
Can I expand into another Illinois county after I get licensed?
Not on your own. You must get IDPH approval before you care for clients in a new county. Send IDPH the Geographic Service Area Request Form.
Why do Illinois applications get delayed or denied?
We often see the same problems. Missing pages. Business details that do not match. Weak proof for the agency manager. Thin policies. Missing job descriptions. No proof of Registry access.
Starting in a Nearby State?
Licensing requirements vary a lot between states. Compare your options:
Indiana
$250 fee · 60-90 Days
Wisconsin
No state license required · 2-6 Weeks (Private Pay) | 6-12 Months (Medicaid PCA)
Missouri
No state license required · 4-8 Weeks
Iowa
No state license required · N/A
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Home care agencies in Illinois
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- Home care agencies in Chicago
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Where our numbers come from
We check each fact against Illinois's own rules. Tap a source to read it yourself.
- License needed?Yes210 ILCS 55/3.3· Oct 2026
- Who oversees itIllinois Department of Public Health (IDPH)77 Ill. Adm. Code 245· Oct 2026
- License nameHome Services Agency License210 ILCS 55/3.3· Oct 2026
- The rules77 Ill. Admin. Code 245; 210 ILCS 5577 Ill. Adm. Code 245· Oct 2026
- First license fee$1,50077 Ill. Adm. Code 245.95(b)· Oct 2026
- License lasts1 year77 Ill. Adm. Code 245.95(b)· Oct 2026
- BondNone77 Ill. Adm. Code 245.90(a)(2)· Oct 2026
- Owner/manager trainingNo state minimum77 Ill. Adm. Code 245.40(a)· Oct 2026
- Caregiver training10 hours77 Ill. Adm. Code 245.71(c)· Oct 2026
- Background checksFingerprint-based check under the Health Care Worker Background Check Act, plus a Health Care Worker Registry check210 ILCS 55/6.3(a)(1); 225 ILCS 46; 77 Ill. Adm. Code 955· Oct 2026
- How long it takesUp to 90 Days to Provisional + 240-Day Provisional Period77 Ill. Adm. Code 245.100(a)(1)-(2)· Nov 2026
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This guide is for informational purposes only and does not constitute legal, regulatory, or business advice. Licensing requirements, fees, and regulations change frequently. Always verify current requirements with your state's licensing agency before making business decisions. HomeCareAtlas is not responsible for the accuracy or completeness of this information.
Researched and reviewed by
John Helmy, Founder of HomeCareAtlasBuilding tools and resources to help home care agency owners navigate licensing, compliance, and growth.