Last verified: October 2026. Rules and fees change, so confirm every figure with the Washington State Department of Health before you file.
Washington licenses non-medical home care as an In-Home Services Agency in the Home Care category, and its fees went up in June 2026. It also has some of the strictest caregiver rules in the country: most aides must complete 75 hours of training and pass a state exam. This guide covers the steps, costs and timelines.
Quick facts: Washington home care licensing
| License name | In-Home Services Agency, Home Care service category |
| Issued by | Washington State Department of Health (DOH) |
| Governing law | RCW 70.127; WAC 246-335 |
| Initial fee | $5,000 per service category (12-month license), effective June 1, 2026 |
| Renewal | Every 24 months, $2,400 to $3,700 depending on staff size |
| Required before applying | DOH in-home services orientation class |
| Caregivers | Home Care Aide certification (75 hours + exam) |
Do you need a license for home care in Washington?
Yes, for paid non-medical help to people who are ill, disabled or vulnerable, including companion care delivered through an agency. Family caregivers, unpaid care, meal-only services, and individuals working under a direct agreement or a DSHS contract are exempt.
Step-by-step: how to open a home care agency in Washington
- Get a Washington business license.
- Attend DOH’s in-home services orientation class; you need the certificate to apply.
- Write your home care policies. Do not copy Medicare home health policies.
- Submit the application with proof of $1M per occurrence general liability insurance, an FTE worksheet, State Patrol background checks for key staff, an org chart, your orientation certificate and the fee.
- Pass the announced initial survey.
- Finish within 9 months of submitting, or the application closes with no refund.
How much does it cost?
- Initial license: $5,000 per service category.
- Renewal every 24 months: $2,400 (5 or fewer FTEs) up to $3,700 (101+ FTEs); lower rates apply to agencies with DSHS or Area Agency on Aging contracts.
- Change of ownership $500; late renewal $50 a day up to $1,000.
- General liability insurance of at least $1M per occurrence.
Budget separately for insurance, payroll for your first caregivers before clients pay, software, and marketing. Licensing is rarely the biggest line. See what it really costs to start a home care agency.
Caregiver requirements in Washington
- Home Care Aide certification: apply within 14 days of hire.
- 5 hours of orientation and safety training before working, then 75 hours of DSHS-approved training within 120 days, and a passed Prometric exam.
- A temporarily extended certification deadline of 365 days from hire (provisional to day 425) runs through December 31, 2027; the normal 200-day deadline returns after that.
- 12 hours of continuing education a year, plus agency background checks every 2 years and a TB risk assessment.
- You must employ a Supervisor of Direct Care Services and an alternate, each with 10+ hours of training a year.
How long does it take?
Plan on roughly 4 to 9 months. The 9-month application limit is set in rule, and survey scheduling is usually the bottleneck.
Medicaid in Washington
Medicaid in-home personal care in Washington runs through DSHS Aging and Long-Term Support Administration and the local Area Agencies on Aging, which contract with licensed agencies. Individual providers are employed separately through Consumer Direct of Washington, so that track does not involve agencies.
Comparing states? See the home care license requirements for every state.
Want the full playbook?
I built and run a licensed home care agency in California. The licensing steps differ state to state, but getting clients, hiring good caregivers and managing cash flow work the same way in Washington. The Home Care Agency Blueprint covers that side in 49 lessons. You can see the syllabus, start with the $29.99 Startup Workbook, or book a free call to map out your Washington launch.
FAQ
Is the $5,000 fee per county?
No. It is per service category, and home care is one category.
Can a CNA skip the Home Care Aide credential?
Some credentialed workers are exempt under RCW 18.88B.041, but the agency must still verify their skills.
Can I take clients before my survey?
No. You need a license to advertise or operate.
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