1. GOVERNING AGENCIES

Agency: California Department of Public Health (CDPH) – Licensing & Certification Division
Role: Licenses and monitors Home Health Agencies (HHAs) under Title 22 and federal Medicare Conditions of Participation

Agency: California Department of Health Care Services (DHCS)
Role: Administers Medi-Cal reimbursement and enrollment for certified HHAs

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight and issues Medicare certification

Agency: California Managed Care Plans (e.g., LA Care, Anthem Blue Cross)
Role: Contract with HHAs for covered home health services under Medi-Cal managed care

2. HOME HEALTH SERVICE OVERVIEW

Home Health Services are ordered by a physician and delivered by licensed professionals to individuals who are homebound or need assistance recovering from illness or injury.

Approved providers may deliver:

• Skilled nursing (e.g., wound care, injections, chronic condition monitoring)
• Physical, occupational, and speech therapy
• Home Health Aide (HHA) assistance (bathing, mobility, hygiene)
• Medical social work and patient education
• Medication management, coordination with physicians
• Comprehensive care planning and progress documentation

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3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the California Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Apply for a Home Health Agency License through CDPH
• Pass pre-licensure survey and meet building, staffing, and documentation standards
• Obtain Medicare Certification from CMS (optional but often required for Medi-Cal billing)
• Enroll with DHCS and Medi-Cal managed care plans (if applicable)
• Hire clinical staff including RNs, therapists, and HHAs
• Maintain general and professional liability insurance

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4. PROVIDER ENROLLMENT PROCESS

Step 1: CDPH Home Health Agency Licensing

• Submit application with program plan, staffing structure, infection control policy, and proof of ownership
• Undergo facility survey and comply with Title 22 regulations
• Receive State License Number upon approval

Step 2: CMS Medicare Certification (optional)

• Apply for CMS certification (Form CMS-855A)
• Undergo federal survey and obtain CMS provider number

Step 3: Medi-Cal Enrollment

• Apply through the California DHCS PAVE portal
• Submit licensure, Medicare number (if applicable), NPI, and ownership info
• Enroll with managed care plans for additional client referrals

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5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Fictitious Business Name (FBN)
• IRS EIN Letter
• NPI confirmation
• CDPH Home Health Agency License
• Medicare certification (if applicable)
• Medi-Cal provider enrollment documentation

Policy & procedure manual including:

• Physician order intake and care coordination protocols
• Skilled nursing, aide, and therapy care plans
• HIPAA compliance and patient rights documentation
• Infection control, quality assurance, and adverse event protocols
• Visit logs, treatment plans, and progress notes
• Emergency preparedness and staff safety protocols
• Staff hiring, credentialing, and supervision plans

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6. STAFFING REQUIREMENTS

Role: Administrator / Director of Patient Care Services (DPCS)
Requirements: RN with 1+ year supervisory experience in home health care

Role: Registered Nurse (RN)
Requirements: California RN license, CPR certification, home health experience preferred

Role: Licensed Vocational Nurse (LVN)
Requirements: Works under RN supervision, licensed in California

Role: Certified Home Health Aide (HHA)
Requirements: CDPH-certified HHA with background clearance and TB test

Optional Staff:

• Physical Therapist (PT)
• Occupational Therapist (OT)
• Speech-Language Pathologist (SLP)
• Medical Social Worker (MSW)

Training Requirements for All Staff:

• Client confidentiality, ethics, and HIPAA
• Infection control and emergency procedures
• Annual skills competency checks and CEUs

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7. MEDICAID WAIVER SERVICES

Home Health Services are reimbursed under:

• California Medi-Cal State Plan
• Medi-Cal Managed Care Plans
• HCBS Waivers (for dual eligibility and medically fragile populations)
• California Children's Services (CCS) & EPSDT Supplemental Benefits

Approved providers may deliver:

• In-home skilled nursing and therapy as ordered
• Personal care and assistance via HHAs
• Coordination with physicians, waiver case managers, and discharge planners
• Thorough documentation of services for audit compliance

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8. TIMELINE TO LAUNCH

Phase: Business Formation
Timeline: 1–2 weeks

Phase: CDPH Home Health Licensing
Timeline: 90–150 days

Phase: CMS Certification (if applicable)
Timeline: 60–90 days

Phase: DHCS Medi-Cal Enrollment & MCO Contracting
Timeline: 45–90 days

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9. CONTACT INFORMATION

California Department of Public Health (CDPH) – Licensing & Certification
Phone: (916) 558-1784
Website: https://www.cdph.ca.gov

California Department of Health Care Services (DHCS)
Email: providerEnrollment@dhcs.ca.gov
Website: https://www.dhcs.ca.gov/services/medi-cal/Pages/PEB.aspx

California PAVE Provider Portal
Website: https://pave.dhcs.ca.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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10.SCOPE OF WORK

• Business registration (LLC, EIN, NPI)
• CDPH Home Health license application and survey preparation
• Medicare and Medi-Cal enrollment support
• Policy & procedure manual for clinical and compliance operations
• Templates for care plans, nurse notes, therapy logs, and visit schedules
• Website, domain, and email setup
• Staff credentialing trackers and supervision logs
• Client intake packet, consent forms, and rights documents
• Incident reporting systems and audit preparation tools
• Referral networking with hospitals, MCOs, and discharge planners

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — CALIFORNIA HOME HEALTH SERVICES PROVIDER

We help home health agencies launch fully licensed and Medicaid-compliant Home Health Services in California, from licensing to Medicare/Medi-Cal enrollment and documentation readiness.

​​​​​​​​​​​​​To get started, click the link to request portal access.