Starting a Hawaii Home Health or Personal Care Agency?

The three paths shown above serve different business models:

• Medicare-certified Home Health Agency: skilled home health services with separate federal certification and enrollment to bill Medicare.
• State-licensed Home Health Agency: skilled medical care and personal care, with Insurance, VA, Private Pay, and Workers Compensation reimbursement arrangements. This startup path cannot bill Medicare.
• Home Care Agency: non-medical personal care, homemaker, and respite services under Hawaii's home care agency rules.

Select the path that matches your services and intended payers before preparing your application.

The Hawaii Department of Health's Office of Health Care Assurance (OHCA) oversees both. Non-medical Home Care Agencies follow HAR Chapter 11-700. Home Health Agencies follow HAR Chapter 11-97.1.

These are different licensing categories. Registering a company or obtaining a business tax license does not replace the required agency license.

The fee schedules in HAR Chapter 11-103.1 list:

• Home Care Agency: $1,500 for initial licensure and $1,000 for renewal.
• Home Health Agency: $2,750 for initial licensure and $2,000 for renewal.

These government fees are separate from our startup-package price. Follow OHCA's current payment instructions and confirm the amount due before submitting payment. Business registration, background checks, insurance, and other third-party costs are additional.

OHCA's Home Care Agency application and checklist call for company and ownership information, an administrator and qualified supervisor, and documents showing how the agency will operate. Prepare:

• Business registration and supporting tax-clearance and good-standing documents.
• A description of services and the geographic areas to be served.
• Administrator and supervisor qualifications.
• Agency policies, a client service agreement, service-plan forms, and client-record procedures.
• Personnel qualifications, orientation and training procedures, background-check procedures, and tuberculosis-screening documentation.

Use OHCA's application checklist to assemble the submission; a policy manual alone is not the complete application.

Prepare the agency's legal and ownership information, office address and operating hours, administrator and clinical leadership information, service descriptions, personnel credentials, policies, and any agreements for services provided under contract.

OHCA's published opening process includes review of the submitted materials and an initial onsite survey. Address the SHPDA determination described below and prepare the agency to carry out its clinical, recordkeeping, quality, and emergency procedures.

Contact the State Health Planning and Development Agency (SHPDA) for a written determination for your proposed project. OHCA's published opening guidance calls for an approved Certificate of Need for a federally certified proposal, or a SHPDA letter stating that a CON is unnecessary for a non-federally-certified proposal.

The determination should match your actual services and certification plans. A full CON application, hearing work, Medicare certification, and accreditation are separate from the advertised state-licensure startup package unless included in writing.

Both agency types need an administrator responsible for management. Ownership and the required management or clinical positions are separate roles; owning the business does not itself establish the qualifications needed to supervise care.

A Home Care Agency must provide appropriate supervision through a qualified supervisor. A Home Health Agency's governing body appoints its administrator, and the administrator must ensure that a qualified clinical manager is available during operating hours. Identify who will fill each role and document that person's qualifications.

Not necessarily. Hawaii's Home Care Agency requirements allow a supervisor with at least two years of relevant experience and training in personal care or homemaker services, or an appropriate professional license, such as an RN, LPN, social worker, physical therapist, or occupational therapist.

The supervisor may also be the administrator, but cannot be the client's case manager. This home care supervision rule is different from the clinical staffing requirements for a skilled Home Health Agency.

OHCA's Home Care Agency application instructions require personal care aides to complete the basic state-approved nurse aide course or an equivalent course, or qualifying coursework as a health professional.

The agency also needs written job descriptions, orientation, ongoing training, and records establishing each worker's qualifications. Assign duties that fall within the worker's training and the agency's permitted service scope.

Plan for an identifiable agency office where management functions and required records can be reviewed. OHCA asks for the business location and service area, and home health rules require agency records to be kept in the agency office.

Describe the islands and areas you can actually staff and supervise. A home health license is issued for a single contiguous geographic location. Discuss additional locations or island coverage with OHCA before expanding, and confirm that a proposed office meets applicable local use requirements.

Timing depends on application completeness, staffing and office readiness, document review, inspection scheduling, and correction of any deficiencies. A CON review or Medicare certification can add separate steps; there is no fixed opening date promised by this package.

A new agency must obtain its required license before operating and providing agency services. Submitting the application or purchasing startup documents does not authorize client care.

A Home Care Agency may provide personal care, homemaker services, and respite care within its approved scope. Examples include help with dressing, feeding, personal hygiene, household tasks, shopping, meal preparation, and relief for family caregivers.

This license does not authorize skilled nursing or therapy. Homemaker services also exclude managing a client's money or finances or balancing the client's checkbook. The service agreement, care plan, and employee duties should reflect these limits.

OHCA's application instructions exclude an individual providing services, including an incorporated individual, and organizations providing only housecleaning. The rules also contain a specific exemption for a nonprofit providing only homemaker services when at least 90% of its staff are volunteers.

These are limited exclusions. A business that supplies a team of caregivers or combines cleaning with personal care should have OHCA review its actual operating model before relying on an exemption.

Yes. A Home Care Agency supervisor develops the service plan with the client or the client's representative. The supervisor and client or representative sign it, and it becomes part of the client record.

Staff and the supervisor review the plan at least annually and whenever the client's condition changes. The supervisor must also make a supervisory visit of employees providing services at each client's residence at least annually. These are Hawaii requirements; another state's supervision schedule should not be substituted.

Hawaii's home health rules require skilled nursing and at least one additional qualifying service, such as physical therapy, occupational therapy, speech-language pathology, medical social services, or home health aide services.

The rules allow specified services through appropriate written arrangements or contracts, subject to personnel and service requirements. Your staffing plan and agreements must support the services listed in the application.

Under HAR Chapter 11-97.1, the plan of treatment is ordered and signed by the responsible physician, advanced practice registered nurse, or physician assistant and kept in the patient's clinical record.

The attending practitioner reviews the total plan with agency professionals as often as the patient's condition requires, and at least once every two months. Staff must report changes that may require changes to the plan or services.

No. State licensure and Medicare participation are separate. A Home Health Agency must complete the applicable federal certification and enrollment requirements before it can bill Medicare.

The state-licensed Home Health Agency startup package on this page is for the agency type that cannot bill Medicare. Choose the Medicare startup option if Medicare reimbursement is part of your business plan.

These are payment avenues for the state-licensed skilled agency model shown above. Hawaii's home health rules expressly recognize care for VA beneficiaries under authorized VA practitioners.

Private-pay services require an appropriate client payment agreement. Insurance, VA, and Workers Compensation reimbursement depends on the applicable payer's provider participation, covered-service, authorization, and billing requirements. The agency license itself does not enroll the business with those payers.

A Home Care Agency needs written policies covering its services, service area, client plans and records, staffing, supervision, and related operating responsibilities.

A Home Health Agency also needs clinical policies, patient-rights and complaint procedures, infection prevention, a documented quality assessment and performance improvement program, and an emergency preparedness plan. Hawaii's home health emergency plan must be reviewed and updated at least every two years. Plan for continuity of care when local emergencies interrupt normal services.

Home Care Agency rules require background checks for employees and volunteers who provide client care or supervise staff, including the administrator, under Hawaii's applicable background-check law. They also require personnel health-screening and training procedures.

Home Health Agency rules require a personnel medical-examination and tuberculosis-screening plan, orientation, and continuing in-service education. Keep the required evidence in personnel records and follow OHCA's current screening and submission instructions for your agency type.

Both home care and home health agency rules provide for a two-year license cycle and require a renewal application at least 30 days before expiration. Track the actual expiration date on the issued license and submit the renewal and fee using OHCA's instructions.

Licenses are not transferable to another agency or owner as a simple business asset. Ask OHCA about the required process before changing ownership or reorganizing the licensed operation.

Each complete personal care or state-licensed home health startup package is $4,995, or three payments of $1,665. The listed package includes logo creation, a custom WordPress website, one year of hosting and domain registration, design and printing of 500 brochures and 500 business cards, customized agency documents, state application preparation, member resources, and guidance.

Document contents depend on the agency type; the skilled package includes clinical materials. Government fees and other third-party or operating expenses are separate unless expressly included. Contact us to adjust the package if you already have some components, or use the document-only links above.

Complete the company questionnaire linked on the post-payment thank-you page and send the requested information to Home Health Forms. Customized policy manuals, forms, and related digital documents are generally emailed within five business days after all company information needed for customization is received.

Website development, printing, and other components may have separate production timelines. Before ordering, you can request an email summary on either the personal care startup page or the home health startup page.

Home Health Forms provides startup guidance, customized documents, and application-preparation assistance. OHCA makes state licensing decisions, SHPDA determines applicable CON matters, and the appropriate federal authorities determine Medicare participation.

The applicant supplies complete and accurate information, qualified personnel, an appropriate office, required fees and operating resources, and responses to regulator requests. Approval and processing times cannot be guaranteed.

Cancellation and refund eligibility depends on the work already completed, customized materials produced, digital products delivered, third-party expenses paid, printing ordered, and other services already performed.

Call 1-877-967-5493 to discuss the services you want to provide, whether you plan to bill Medicare, your intended payment sources, and the island or areas you plan to serve. These choices determine which agency startup and document package fits your business.

You can also review the detailed FAQs and request the email summary on the appropriate startup page before ordering.