California home care rules

California licenses non-medical home care organizations through the Department of Social Services (CDSS) and home health agencies through the Department of Public Health (CDPH). Medi-Cal pays for home care through county-run In-Home Supportive Services (IHSS), waivers such as HCBA and MSSP, and Medi-Cal health plans (most of the 25 in a June 2026 DHCS table), which choose, county by county, whether to offer Personal Care and Homemaker Services. From January 1, 2027, home care aides' annual training must cover dementia care.

145 official documents·collected September 22, 2026·checked against them September 22, 2026

License for non-medical home care?YesHome Care Organization license from CDSS · renew every two years. Aides must be on the Home Care Aide Registry.

License for home health?YesHome health agencies are licensed by CDPH Licensing and Certification. Home health aides need a CDPH certificate.

EVVIn placeMedi-Cal personal care since Jan. 1, 2022 and home health since Jan. 1, 2023, through CalEVV or an approved alternate system

Medicaid health plansMost of 25 plans, by countyPersonal Care and Homemaker Services is an optional Community Support each plan chooses county by county

Compare states Federal rules →

What changed, and what to do about it

Red means act now, amber means read it this month, grey is for the record.

Act nowPIN 26-02-HCS, March 27, 2026

Home care aides’ annual training must cover dementia care from January 1, 2027

SB 412 changed Health and Safety Code 1796.44. From January 1, 2027, every HCO must make sure affiliated home care aides’ annual training includes the special care needs of clients with dementia. CDSS will not set a curriculum, but will check training materials at application, renewal and inspections.

What to do: Add dementia care to your annual training plan now and keep the curriculum on file so you can show it at your next inspection.

CA CDSS PIN 26-02-HCS 2025 Laws Affecting Home Care Organizations ↗our copy

Read this monthPIN 26-05-CCLD, April 15, 2026 · PIN 26-08-CCLD, April 29, 2026 · PIN 26-09-CCLD, May 4, 2026

New Live Scan and transfer forms for background checks

The Live Scan form LIC 9163 (11/25) now has a required applicant signature line confirming the applicant read the privacy notices. The clearance and exemption transfer forms (LIC 9182, LIC 9188) were reworded, with one form per facility number. CDSS recommends starting each background check in Guardian before the applicant goes to a Live Scan vendor.

What to do: Replace old copies of LIC 9163, LIC 9182 and LIC 9188, and start new hires’ checks in Guardian so the Live Scan form is filled in for you.

CDSS PIN 26-08-CCLD Live Scan Form Updates ↗our copyCDSS PIN 26-05-CCLD Clearance and Exemption Transfer Forms Updates ↗our copyCDSS PIN 26-09-CCLD Updated Guardian and Background Check Best Practices ↗our copy

Read this monthAPL 26-007, April 24, 2026

Health plans must update network provider agreements

DHCS told Medi-Cal health plans that network providers must be enrolled in Medi-Cal and hold a written agreement that meets new requirements. Plans must bring agreements into line at the next renewal or by December 31, 2027, whichever is earlier.

What to do: Check that your Medi-Cal enrollment is current, and read any new agreement your health plans send before you sign it.

APL 26-007 Network Provider Agreements ↗our copy

For the recordDHCS fact sheet (undated; posted May 2026)

DHCS proposes tighter rules for Personal Care and Homemaker Services

DHCS has proposed that health plans tighten rules on the concurrent referral to IHSS and on authorizing hours beyond those IHSS approves, and set minimum enrollment requirements for all Community Supports providers. It is a proposal, with savings estimated from the 2026-27 budget year.

What to do: Nothing yet. Keep records of each member’s IHSS referral and approved hours.

DHCS Proposed Refinements for Community Supports and ECM Fact Sheet 2026 ↗our copy

For the recordMSSP Site Manual revision, June 2026

MSSP vendor contracts must now address EVV

The California Department of Aging revised the MSSP Site Manual. Vendor contracts must include EVV self-registration and ongoing compliance, and the minimum age for MSSP services moved from 65 to 60.

What to do: If you are an MSSP vendor, expect a contract update and make sure your CalEVV registration is current.

CA CDA MSSP Site Manual Summary of Changes June 2026 ↗our copy

Deadlines coming up

Dates taken from the rules and notices as we read them.

100days

January 1, 2027

Dementia care must be part of home care aides’ annual training

New HCO applicants from this date must include it in the training plan they submit.

CA CDSS PIN 26-02-HCS 2025 Laws Affecting Home Care Organizations ↗our copy

464days

December 31, 2027

Latest date for health plans’ network provider agreements to meet APL 26-007

Or at the next renewal of the agreement, whichever is earlier.

APL 26-007 Network Provider Agreements ↗our copy

The brief

Every state follows the same outline, so you always know where to look. Open a section for the detail.

Who regulates you

Non-medical home care: CDSS Community Care Licensing Division, Home Care Services Branch (HCSB): (877) 424-5778, HCSB@dss.ca.gov
Home health: CDPH Licensing and Certification. Its Healthcare Workforce Branch certifies home health aides.
Medi-Cal: Department of Health Care Services (DHCS): Medi-Cal, the HCBA Waiver, health plans and EVV. The California Department of Aging (CDA) runs the Multipurpose Senior Services Program (MSSP) waiver.
IHSS: In-Home Supportive Services is run by the counties under CDSS. Some counties contract with private agencies to deliver it.
Complaints: CDSS's Centralized Complaint and Information Bureau has taken home care complaints since January 2, 2024: (844) 538-8766, letusno@dss.ca.gov

Sources:CA CDSS Home Care Services Consumer Protection Act Fact Sheet ↗our copyCDPH HHA Initial Sample Application ↗our copyCDPH 283D Home Health Aide Initial Application ↗our copyEVV Compliance Letter 22-01 ↗our copyCDSS ACL 25-81 Updated Maximum Allowable Contract Rates for IHSS Counties ↗our copyCDSS PIN 24-01-HCS Home Care Complaint Intake Moves to Centralized Bureau ↗our copyCA Medi-Cal Manual - MSSP ↗our copy

Licensing

The law: Home Care Services Consumer Protection Act (Health and Safety Code, Division 2, Chapter 13), in effect since January 1, 2016. A Home Care Organization (HCO) arranges non-medical home care by registered home care aides.
Not HCOs: Home health agencies, licensed hospice agencies, licensed health facilities, IHSS, employment agencies, community care facilities and clinics, among others
No medical care: HCOs may not arrange medical services, such as insulin shots, tube feeding, post-surgery wound care or giving medication. Aides may remind clients and open bottles for medication the client takes on their own. CDSS cannot waive this.
How to apply: Mail the HCS 200 and the packet listed in HCS 281 with the non-refundable fee to HCSB, 744 P Street, M.S. 9-14-90, Sacramento. Attend a virtual orientation ($50). Owners of 10% or more need a background clearance. You need $1,000,000 per occurrence / $3,000,000 aggregate general and professional liability insurance, workers’ compensation and a $10,000 employee dishonesty bond.
Renewal: Every two years. Postmark the renewal and fee by the expiration date; operating on an expired license brings a $900-a-day civil penalty. Since July 10, 2023 you no longer send the HCS 200 or proof of insurance and bond at renewal. A 2022 CDSS notice gave the fee as $5,603; we don’t hold the current fee schedule.
Home health: Home health agencies apply to CDPH Licensing and Certification on form HS 200 (Licensure and Certification Application).

Your workers

Home care aides: Must be listed on the CDSS Home Care Aide Registry, be 18 or older, be free of active tuberculosis and have a CDSS background clearance before client contact. Registration form HCS 100, $35. Renew by the expiration date or the registration is forfeited.
Aide training: 5 hours before client contact (2 hours orientation, 3 hours safety: basic safety, infection control, emergency procedures), then at least 5 hours every year. From January 1, 2027 the annual training must cover dementia care (SB 412).
Background checks: Through CDSS Guardian and Live Scan (form LIC 9163). No one may work until CDSS sends a clearance or exemption letter; the Department of Justice letter is not enough. Clean checks are clearing in about 14 days.
Home health aides: Certified by CDPH. Renew every two years with 24 hours of in-service training (12 in each year; no online CEUs).
Reporting abuse: Care custodians are mandated reporters of elder and dependent adult abuse (Welfare and Institutions Code 15630). For abuse outside a long-term care facility, report to Adult Protective Services or law enforcement right away, then in writing within two working days (SOC 341). Keep a signed SOC 341A in each employee file.
Minimum wage: $16.90 an hour from January 1, 2026. Covered health care facility employers pay a higher minimum under Labor Code 1182.14 ($23 an hour from July 1, 2026 for the ‘other covered’ group); the notice we hold does not list which facility types are covered.

Sources:CDSS HCS 281 Application Instructions for Home Care Organization License (12-21) ↗our copyCA CDSS Home Care Organization Inspection Checklist HCS 9201 ↗our copyCDSS HCS 100 Home Care Aide Registration or Renewal Application (7-23) ↗our copyCDSS PIN 22-08-HCS Home Care Aide Registration Forfeiture Letters ↗our copyCA CDSS PIN 26-02-HCS 2025 Laws Affecting Home Care Organizations ↗our copyCDSS PIN 26-09-CCLD Updated Guardian and Background Check Best Practices ↗our copyCDSS PIN 25-12-CCLD Background Check Approval and Eligibility ↗our copyCDPH 283C Home Health Aide Renewal Application ↗our copyCDSS SOC 341A Statement Acknowledging Requirement to Report Abuse (2-24) ↗our copyCDSS SOC 341 Report of Suspected Dependent Adult-Elder Abuse (2-24) ↗our copyDIR California Minimum Wage 2026 Order ↗our copyDIR Health Care Worker Minimum Wage Supplement 2026 ↗our copy

Getting paid

Enrollment: Enroll in Medi-Cal through the DHCS Provider Application and Validation for Enrollment (PAVE) portal. Health plans’ network providers must also enroll in Medi-Cal where a state enrollment pathway exists for their provider type.
IHSS: Some counties contract with private agencies to deliver IHSS. CDSS’s Maximum Allowable Contract Rates (updated effective July 1, 2025, ACL 25-81) are the most the state will help pay per hour; a county may agree to a higher rate but pays the difference itself.
HCBA Waiver: Waiver Personal Care Services (WPCS) can be given by individual providers, employment agencies, personal care agencies, home health agencies or non-profit agencies. A WPCS provider will not be paid for more than 12 combined hours a day.
MSSP: Supplemental personal care may come from a home health agency or an agency with a local business license (Appendix 40, June 2026). Vendor contracts must now cover EVV self-registration and compliance.
Health plans: Personal Care and Homemaker Services (T1019 or S5130 with modifier U6) is a Community Support. IHSS comes first; PCHS can add hours beyond what IHSS authorizes. It cannot be used with WPCS. Plans may contract with, for example, home health agencies, personal care agencies, county agencies and Area Agencies on Aging.
Home health: Medi-Cal covers home health under a written treatment plan reviewed by the physician or other practitioner every 60 days. See the HHA billing codes chart for which services need a Treatment Authorization Request (TAR).

Sources:Medi-Cal Manual Provider Guidelines (Sep 2026) ↗our copyAPL 22-013 Provider Credentialing and Screening-Enrollment ↗our copyAPL 26-007 Network Provider Agreements ↗our copyCDSS ACL 25-81 Updated Maximum Allowable Contract Rates for IHSS Counties ↗our copyHCBA Waiver 2023-2027 approved document ↗our copyCA CDA MSSP Appendix 40 Provider Licensure and Certification ↗our copyCA CDA MSSP Site Manual Summary of Changes June 2026 ↗our copyDHCS Community Supports Policy Guide Vol 1 (Apr 2025) ↗our copyCA Medi-Cal Manual - Home Health Agencies ↗our copy

EVV

Who: Medi-Cal personal care services and home health care services given during in-home visits, including health plan Community Supports (personal care and homemaker, respite), the HCBA Waiver and MSSP
From: Personal care since January 1, 2022; home health since January 1, 2023
System: The state’s CalEVV system from Sandata is free. You may use an alternate EVV system, but you must still self-register in CalEVV and take Sandata’s training. Sandata support: (855) 943-6070.
Live-ins: A caregiver who regularly stays more than 24 hours at a time is exempt for that member only and must file the Live-In Caregiver exemption form (Notice 23-01)
Your data: Link your agency only to the plans and other paying entities you contract with. Sending EVV data to one you don’t is a HIPAA violation (Notice 24-01).
IHSS and WPCS: Individual providers use CDSS’s system instead. Since July 1, 2023, providers who don’t live with the recipient check in and out at the start and end of each workday.

Sources:APL 22-014 Electronic Visit Verification Implementation Requirements ↗our copyEVV Compliance Letter 22-01 ↗our copyHCBA PL 23-005 CalEVV Implementation ↗our copyCalEVV FAQ (Jan 2024) ↗our copyCalEVV Live-In Caregiver Information Notice 23-01 ↗our copyCalEVV Data Integrity Information Notice 24-01 ↗our copyCDSS ACIN I-34-23 EVV Implementation for IHSS and WPCS ↗our copyCA CDA MSSP Site Manual Summary of Changes June 2026 ↗our copy

What changed recently

Jul 2026: Health care facility minimum wage rose on July 1, 2026 ($23 an hour for the ‘other covered’ group, $25 for the largest systems). CDSS released a revised IHSS provider orientation video and told counties to keep IHSS forms electronically in CMIPS.
Jun 2026: MSSP site manual revised: vendor contracts must cover EVV, and the minimum age for MSSP moved from 65 to 60. DHCS updated its table of Community Supports by plan and county.
Apr–May 2026: CDSS updated the Live Scan form (LIC 9163 now has an applicant signature line), the clearance and exemption transfer forms (LIC 9182, LIC 9188) and its Guardian best practices (PIN 26-09-CCLD). DHCS issued APL 26-007 on health plan network provider agreements.
Mar 2026: PIN 26-02-HCS: dementia care in annual aide training from January 1, 2027; HCOs closed by an emergency or disaster may ask for inactive license status.

Where the official documents disagree

Sometimes two official documents say different things. Here is what we went with, why, and what each document says, so you can judge for yourself.

Documents disagree

What to send with your HCO license renewal

What this page uses: The renewal fee. The HCS 200 and proof of insurance, workers’ compensation and bond are no longer required at renewal.

The 2023 notice reports a change in the law (AB 120), and it is newer than the 2022 reminder. You must still keep the insurance and bond in force.

CDSS PIN 22-03-HCS HCO License Renewal Process Reminders ↗: "In order to apply for license renewal, a HCO licensee must provide: The current application fee of $5,603 ... Application for Home Care Organization License (HCS 200), and Verification of general and professional liability insurance, workers compensation policy, and proof of employee dishonesty bond."
CDSS PIN 23-04-HCS 2023 Chaptered Legislation Affecting Home Care Organizations ↗: "At renewal, an HCO licensee is no longer required to submit the following documentation: Form HCS 200 ... Proof of general and professional liability insurance; Proof of a valid workers’ compensation policy; Proof of an employee dishonesty bond."

Documents disagree

Does EVV affect payment?

What this page uses: You bill the same way, but health plans must withhold payment from providers who don’t comply with EVV.

The FAQ answers a question about the billing process. The All Plan Letter is DHCS’s direction to health plans and says plainly they must deny or withhold payment for non-compliance.

CalEVV FAQ (Jan 2024) ↗: "EVV does not impact billing. Providers will continue to bill the same way which should match what is entered in their EVV visit record."
APL 22-014 Electronic Visit Verification Implementation Requirements ↗: "Deny payment if the provider is not complying with EVV requirements" and "When a Network Provider is identified as non-compliant with these requirements, the MCP must not authorize the Network Provider to perform services and/or withhold the payment."

Documents disagree

What license does a waiver personal care agency need?

What this page uses: A CDSS Home Care Organization license if you arrange non-medical home care by aides, plus whatever the waiver asks.

The CDSS fact sheets say all HCOs must be licensed and list the kinds of organization that are not HCOs; waiver-paid agencies are not on that list. The waiver documents set a business license as the minimum to enroll, but they do not say an HCO license is unnecessary. Employment agencies are not HCOs under the act, so check with HCSB if your model is different.

CA CDSS Licensed vs Unlicensed Home Care Fact Sheet ↗: "Beginning January 2016, all Home Care Organizations (HCOs) must be licensed by the California Department of Social Services (CDSS) prior to providing home care services."
HCBA Waiver 2023-2027 approved document ↗: Provider Type: Personal Care Agency. "License (specify): California Business License" and "Have and maintain a current, unsuspended, un-revoked license to practice business in the State of California."
CA CDA MSSP Appendix 40 Provider Licensure and Certification ↗: 3.2 Supplemental Personal Care: "Home Health Agency ... State of CA" or "Private nonprofit or proprietary agency ... Local business license."

Questions agencies ask

Every answer was written and checked ahead of time, with the official document next to it. Nothing is made up on the spot.

Try:

Do I need a license to run a non-medical home care agency in California?

Yes, a Home Care Organization license.

Since January 1, 2016, a Home Care Organization (HCO) that arranges home care services by registered home care aides must be licensed by CDSS before it provides care. The act does not treat home health agencies, licensed hospice agencies, IHSS, employment agencies, community care facilities or clinics as HCOs. Every aide the HCO employs must be on the Home Care Aide Registry first.

CA CDSS Home Care Services Consumer Protection Act Fact Sheet ↗our copyCA CDSS Licensed vs Unlicensed Home Care Fact Sheet ↗our copy