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. Plan on 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 8-step process through NYSDOH. Our specialists handle all 8 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
APPLICATION
4
INSURANCE
5
SURVEY
6
PROCESS
1
Public Need Research (NYSE-CON)
FOUNDATION
Since August 2022, all new LHCSA applications must go through the NYSE-CON system and demonstrate public need. Research your target county — counties with 5 or more active LHCSAs face a Presumption of No Need. To get approved in these counties, you must present evidence of unmet demand: underserved populations, language access gaps, specialized services not currently available, or geographic coverage gaps. This review applies statewide, not just to certain counties.
2
Business Formation
FOUNDATION
Register business entity with NYS Dept of State, obtain EIN, and register with NYS Tax Department.
3
Administrator Training
POLICIES
Complete DOH-approved 16-hour home care administrator training program.
4
Secure Office Space
APPLICATION
Lease office space that meets DOH requirements (accessible, adequate space for records, separate from residence).
5
Insurance & Bonding
INSURANCE
Obtain liability insurance ($1M/$3M minimum) and surety bond ($100k minimum).
6
Submit LHCSA Application
APPLICATION
Complete comprehensive application packet including policies, procedures, organizational documents, public need documentation, and pay the $2,000 application fee (per PHL §3605(13)).
7
PHHPC Review + DOH On-Site Survey
SURVEY
The Public Health and Health Planning Council (PHHPC) reviews your application for public need, character/competence, and financial feasibility. DOH schedules an on-site survey to verify compliance with regulations. PHHPC review cycles and survey scheduling backlogs can significantly extend this phase.
8
License Issuance
PROCESS
Upon PHHPC approval and successful survey, receive LHCSA operating certificate and begin operations.
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
Gated, sales-call only
Published online, no surprises
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.
Atlas Licensing Kit
Get licensed without mistakes
$2,495+ state fees
For self-directed founders who want expert guidance and will file the application themselves.
Licensing
New York licensing roadmap
Annotated application guide
Custom P&P manual (state-ready)
Prep tools
Office setup checklist
Bond & insurance sourcing
Admin interview prep
Survey prep guide
Expert support
2 × 60-min strategy calls
Application red-line review
60 days email support
Platform
3 months free Atlas SaaS
Free Carezano directory listing
Upgrade to Launch for
Done-for-you filing
Medicaid enrollment
Website & launch kit
Live survey prep
Most Popular
Atlas Launch
Licensed & ready for first client
$5,495+ state fees
For founders ready to be fully licensed, operational, and taking their first client on day one.
Everything in Licensing Kit, plus:
Application prepared & filed
P&P custom-built for your model
Background check coordination
Surety bond assistance
Site review prep
Live admin interview prep
Survey & enrollment
Live survey prep session
Survey-day on-call support
Medicaid enrollment guidance
Waiver enrollment guidance
50% off plan-of-correction support
Launch setup
Atlas Edge
Branded website landing page
Google Business Profile setup
Caregiver recruitment kit
HR / employee handbook
Intake + care plan templates
Scheduling templates
Support & platform
90 days Slack/email support
6 months free Atlas SaaS
Priority Carezano placement
Licensing approval guarantee
Upgrade to Signature for
Business formation (LLC, EIN)
Full brand + multi-page site
Go-to-market system
Founder-level attention
Atlas Signature
White-glove launch & full setup
$9,995+ state fees
For founders who want direct access, white-glove execution, and long-term support with minimal lift.
Everything in Launch, plus:
LLC formation + EIN
Registered agent (1st year)
Operating agreement
Full brand + web
Logo + branding kit
Business cards + marketing materials
Multi-page website
Domain + professional email
Go-to-market system
First-month marketing plan
Curated referral source list for your area
Discharge planner scripts
Private pay contracts
LTC insurance setup
Premium support
Signature Only
Weekly calls (first 60 days)
Direct phone/text access
Founder-level attention
Extended support
6 months compliance support
12 months free Atlas SaaS
Premium directory placement
First-year renewal included
1 free plan of correction
What are state fees?Hide state fee details
New York charges a state application fee, paid directly to the state licensing body. We don't mark it up.
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 August 2022, all new LHCSA applications must go through the NYSE-CON system and demonstrate public need. Counties with 5 or more active LHCSAs face a Presumption of No Need — you must rebut with evidence of unmet demand such as underserved populations, language access gaps, or specialized services not currently available. The PHHPC reviews applications for public need, character/competence, and financial feasibility. This is the single biggest barrier to new LHCSA approval.
Can I operate from home in New York?
No. New York requires a commercial office space separate from any residential dwelling. The office must be accessible to the public, have adequate space for secure record storage, and meet DOH inspection standards.
What is CDPAP and should I participate?
CDPAP (Consumer Directed Personal Assistance Program) allows Medicaid recipients to hire their own caregivers, including family members. Agencies can serve as fiscal intermediaries. It's a large program but has been undergoing restructuring and faced a temporary restraining order in April 2025. The program's operational framework remains in flux — don't build your entire business model around CDPAP without monitoring developments closely. When stable, it can be lucrative once payroll/HR systems are in place.
How long does the LHCSA application really take?
Realistically 9-18 months from start to license, and approval is not guaranteed. The main delays are PHHPC review cycles and DOH survey scheduling backlogs. Complete, thorough applications with strong public need documentation move faster, but the old 6-month estimate is no longer realistic given the NYSE-CON review requirements added in August 2022.
What's the difference between LHCSA and Home Health Agency?
LHCSA (Licensed Home Care Services Agency) provides non-medical care such as personal care, companionship, and homemaking. Home Health Agency provides skilled nursing and therapy services. The licensing, staffing, and regulatory requirements are completely different. Most new non-medical agencies start by evaluating the LHCSA path.
Can I operate a home care agency in New York without a license?
No. New York requires licensure for all agencies providing home care services, including non-medical personal care and companion services. Operating without a valid LHCSA license is a violation of state law and can result in significant penalties.
Will getting my LHCSA license guarantee I can take Medicaid patients?
No. Many MLTC plans maintain closed provider networks. Getting your LHCSA license is a prerequisite for Medicaid contracting, but it does not guarantee acceptance into any MLTC plan's network. Research which plans have open networks in your service area before building your Medicaid revenue plan.
Should I apply for a new license, buy an agency, or partner with one?
That depends on your budget, timeline, and risk tolerance. Applying for a new LHCSA can be slower, cheaper upfront, and much less certain. Buying an existing licensed agency is often faster but far more expensive. Partnering under an existing operator can be the quickest path to market, but you give up some control. In New York, many founders seriously evaluate all three options before choosing a path.
What are the biggest challenges of starting a home care agency in New York?
The top challenges include: (1) demonstrating public need through the NYSE-CON process, especially in counties with 5+ existing LHCSAs; (2) the 9-18 month licensing timeline with no guarantee of approval; (3) meeting high wage parity requirements ($19.65/hr minimum in NYC/LI/Westchester plus benefit supplements); (4) competing for talent in a tight labor market; and (5) securing MLTC contracts with closed networks. Despite these challenges, New York's massive demand and high reimbursement rates make it one of the most rewarding markets for well-run agencies.
New York Home Care Licensing: What You Need to Know
Starting a home care agency in New York is not like other states. While a typical setup may cost $100,000-$200,000 and take 9-18 months, many applicants never receive approval at all. Since August 2022, all new Licensed Home Care Services Agency (LHCSA) applications must pass through New York's Certificate of Need process in the NYSE-CON system — a highly competitive, need-based review where many counties are already considered saturated. In practice, founders usually pursue one of three paths: apply for a new license, buy an existing licensed agency, or partner with an existing operator. If you do apply, the LHCSA license is governed by 10 NYCRR Part 766 and covers agencies providing home health aide, personal care, homemaker, and companion services on a per-visit or per-hour basis. New applicants must demonstrate public need, financial feasibility, and character and competence. Counties with 5 or more active LHCSAs are subject to a Presumption of No Need, which means applicants must rebut that presumption with evidence such as underserved populations, language access gaps, or specialized service offerings. The process also includes an on-site survey and PHHPC review, making New York one of the most rigorous and least predictable states for new home care agency entry.
The Licensed Home Care Services Agency (LHCSA)
Because new approvals are difficult and uncertain, many operators enter New York by buying an existing licensed agency or partnering under an existing license rather than starting with a fresh LHCSA application. Your application must show character, competence, and financial viability. You need detailed policies, an organizational chart, a staffing plan, and proof of clinical oversight by a registered nurse. All owners, operators, and key personnel must clear criminal background checks through the Justice Center for the Protection of People with Special Needs. New York also requires 16-hour administrator certification (typical cost $200 - $500).
Certificate of Need (CON) in New York
Public Need Review (NYSE-CON) — Biggest Barrier. Since August 2022, all new LHCSA applications must demonstrate public need via the NYSE-CON system. Counties with 5+ active LHCSAs face a Presumption of No Need — you must prove an unmet demand such as underserved populations, language gaps, specialized services, or geographic coverage gaps to get approved. This is the single biggest barrier to entry.
Medicaid Participation — Consumer Directed Personal Assistance Program (CDPAP)
NY's program allowing Medicaid recipients to hire, train, and supervise their own caregivers (including family members). Fiscal intermediaries manage payroll.
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
30 minutes with a home care specialist. We'll map out New York licensing for your specific situation, your timeline, and your best path forward — 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
Common New York-specific mistakes to avoid
If you'd like, which Atlas package is right for you
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.
