The orientation class: free
Online, about four hours, free of charge, and required before a first application. It is not required to renew, add a category or change ownership.
Washington · License fees and time frames · WAC 246-335-990
Washington home care license: cost and timeline
DOH charges $5,000 for a first 12-month home care license, plus a surcharge for each county after the first, then a 24-month renewal fee set by your staff numbers. DOH publishes no processing time; the rule gives you nine months to finish every step. Here are DOH’s fees, the other costs the law sets and what is free, each step from the orientation class to the license, and why a new agency is private pay for its first three years.
- Rule-verified October 2, 2026
- Quoted from WAC 246-335-990 and DOH’s pages
- Every fee linked to its source
Quick answer
Cost: the Washington State Department of Health (DOH) charges $5,000 for a first home care license, which lasts 12 months, plus $500 for each additional urban county or $100 for each additional rural county. After that, renewal is a 24-month fee set by your full-time equivalents, from $2,400 to $3,700 (WAC 246-335-990). These are DOH’s fees, in force since June 1, 2026, not CareRulebook prices.
Time: DOH publishes no processing or survey scheduling time. The rule gives the applicant nine months from submitting the application to complete every step, or DOH may close the file with no refund (WAC 246-335-320(4)). Before that, you take DOH’s free orientation class, which runs about once a month.
What is free: the orientation class, and initial caregiver background checks run through DSHS’s Background Check Central Unit. What comes later: DSHS contracts and WA Cares both ask for three years as a licensed home care agency, so by our reading a new agency is private pay for at least its first three years.
What DOH charges
Every amount below is a state fee paid to DOH under WAC 246-335-990, in force since June 1, 2026. None of them is a CareRulebook price.
| What for | DOH fee | Term | Notes | Source |
|---|---|---|---|---|
| Initial license, home care category | $5,000 | 12 months | Per service category. Home health and hospice are separate categories with their own fee. Before June 1, 2026 it was $3,283. | WAC 246-335-990(1) |
| Each county after the first | $500 urban, $100 rural | With the application | One county is included. We did not find DOH’s list of which counties are urban or rural. | WAC 246-335-990(3) |
| Renewal, by full-time equivalents (Table 1) | $2,400 to $3,700 | 24 months | 5 FTEs or fewer: $2,400; 6 to 15 FTEs: $2,800; 16 to 50 FTEs: $3,000; 51 to 100 FTEs: $3,500; 101 FTEs or more: $3,700. DOH assumes at least 2 FTE for each approved county. | WAC 246-335-990(4) |
| Renewal for DSHS or AAA contracted agencies (Table 2) | $1,700 to $2,600 | 24 months | Only for an agency under contract with and monitored by DSHS or an Area Agency on Aging that meets the substantial equivalency rule. | WAC 246-335-990(4)(b) |
| Adding a service category later | $5,000 | 12 months | For example, adding home health to a home care license. | WAC 246-335-990(2) |
| Change of ownership | $500 | Rest of the license period | Per licensed service category; a new license is issued for the rest of the current period. | WAC 246-335-990(5) |
| Extra on-site survey | $5,000 | When DOH charges it | DOH may charge it for a follow-up survey needed to complete the survey process, after an inadequate response to deficiencies, after a substantiated complaint, or for renewal surveys longer than two days. | WAC 246-335-990(6) |
| Late renewal | $50 a day | Up to $1,000 | Counted from the renewal date, 30 days before the license expires. | WAC 246-335-990(8) |
- Why fees rose in 2026. The initial fee went from $3,283 to $5,000 (WSR 26-04-110) and the smallest home care renewal fee from $1,530 to $2,400 (WSR 26-04-110). DOH said "The program ended fiscal year 2024 with a revenue shortfall of $245,000." (WSR 25-24-044)
- Refunds. Two-thirds of the initial fees (less $50) back if no survey or technical assistance has happened; one-third (less $50) after; nothing after more than one on-site visit or once nine months pass without a license. (WAC 246-335-990(9)-(10))
- How to pay. DOH’s packet says to mail the application with your check or money order payable to the Department of Health (DOH 505-052).
Working out your DOH fees
Simple arithmetic, not a DOH figure
Three counties. One is included, so two carry the surcharge: $5,000 + 2 × $500 = $6,000 if both are urban, or $5,200 if both are rural (WAC 246-335-990(3)).
Simple arithmetic, not a DOH figure
The first three years, one county. The 12-month initial license and one 24-month renewal: $5,000 + $2,400 = $7,400, if you renew in the 5-FTE-or-fewer band. With one county, the 2 FTE minimum DOH assumes per approved county is also in that band (WAC 246-335-990(4)).
Our reading, for planning
Several counties, small team. At 2 FTE per county, three approved counties count as at least 6 FTE, the $2,800 band, even with fewer staff. DOH’s FTE worksheet and instructions still say a minimum of 1 FTE (DOH 505-137), so ask DOH how it will count you.
The surcharge rule speaks of an "applicant or licensee" (WAC 246-335-990(3)) but does not say whether the surcharge is paid once or again at each renewal, so the three-year figure leaves it out. Ask DOH before you budget for several counties.
Other costs of getting and keeping the license, and what is free
Each card says where the duty comes from. We give a price only where an official source sets one; none of the sources we checked publishes typical prices for insurance, training or tests.
Caregiver background checks: initial checks free through BCCU
DOH says BCCU provides initial checks for long-term care workers and certified home care aides at no charge to the agency, and the statute bars DSHS from passing the fingerprint cost to workers or employers. DSHS says fingerprints taken by law enforcement instead of its contractor may cost something.
DOH, Updated RulesRCW 74.39A.056(1)(b)(i)How the checks work →
State Patrol checks: WSP’s fees
The administrator and supervisor checks for your application, and everyone’s two-year rechecks, go through the Washington State Patrol. WSP sets its record check fees by rule and may not charge a nonprofit. We do not quote WSP’s current fee here; check it with WSP.
Liability insurance
The rule asks for commercial general liability cover of $1 million per occurrence or $2 million combined. The statute asks for professional liability, public liability and property damage insurance in an amount DOH sets, and the rule does not mention professional liability, so ask your insurer and DOH.
Caregiver training: 75 hours
Unless a worker is exempt: 75 hours of DSHS-approved entry-level training within 120 days of hire, 5 hours of it before any care, then 12 hours of continuing education a year. Only DSHS-approved curricula count. None of the sources we checked gives a price.
Home care aide certification: DOH’s fees
DOH charges $100 to apply for home care aide certification and $100 to renew it, every year on the aide’s birthday. Workers apply within 14 days of hire unless exempt. The rule does not say whether the worker or the agency pays.
TB screening and testing
A TB risk assessment on DOH’s form for every new employee and every year, with testing when the form calls for it. DOH acknowledges the TB rules add costs, and its form has an option to focus testing for agencies with limited resources. No rule we found says who pays for a test.
Hepatitis B vaccine and bloodborne training
If your risk assessment finds a reasonably anticipated exposure to blood, you offer workers the Hepatitis B vaccine series at the agency’s expense. Employees with exposure get bloodborne pathogens training at no cost to them, during paid working hours.
An office in Washington, and business licenses
At least one in-state office where records are kept, secured and accessible, with the license displayed. DOH asks for copies of every current government business license for each office.
Your written policies
DOH says the policies make up a manual it must review and approve before the license is issued. You can write them, buy a manual or hire a consultant.
Fees and penalties are set by the state, not by CareRulebook.
CareRulebook
The manual DOH reviews, written for your agency
Answer a few questions and CareRulebook writes your Washington policies and forms, answering every tag on DOH’s home care policy checklist, with your agency’s details. You also get a DOH review copy with the rules cited but not quoted. Read every policy before you adopt it.
- 42 policies, 154 requirements mapped
- All 60 tags on DOH’s policy checklist answered
- Editable Word and PDF when you pay; download again free for 12 months
Preview your manual
$199CareRulebook founding price for the first 50 Washington agencies, then $249. Not a DOH fee; DOH’s $5,000 initial license fee is separate.
How long it takes, step by step
The order comes from the rule and DOH’s pages; only the steps with a fixed time show one. Tick steps off as you go; progress is saved in this browser only.
Take DOH’s orientation class
Before applyingThe class is online, about four hours (8:30 a.m. to about 12:30 p.m.), free, and limited to 80 participants. Remaining 2026 dates on DOH’s schedule: October 7, November 4 and December 9. The certificate arrives by email within two business days and is valid for one year, and DOH will not process an initial application without it.
Get the two key background checks
Within 3 months before mailingWashington State Patrol checks and DOH disclosure statements for your administrator and supervisor of direct care services, obtained within three months of the application date. Time these so they are not older than that when you mail.
Insurance, counties and the rest of the packet
Before applyingCommercial general liability cover, your counties, the FTE worksheet, business licenses for each office, your organizational structure and how you will manage services across your counties.
Have your policy manual ready
Before applyingDOH says it must review and approve the manual before it issues the license, and its survey office asks for it after you apply. Our suggestion: finish it before you mail, because the nine months start when you submit. What DOH reviews.
Mail the application with the $5,000 fee
Day 0A paper application by mail, with your check or money order payable to the Department of Health, to P.O. Box 1099, Olympia, WA 98507-1099.
DOH reviews the application
No published timeDOH tells you in writing about any missing documents or fees. DOH publishes no time for this step.
DOH schedules the announced initial survey
No published timeAfter it accepts the application, DOH’s Office of Investigation and Inspection contacts you to schedule the survey. You must pass it for the license to be issued.
License issued, for 12 months
Within 9 monthsEvery step, survey included, must be done within nine months of submitting the application, or DOH may close the file with no refund. The first license lasts 12 months.
First renewal, then every two years
Month 11, then every 2 yearsSend the renewal papers and the 24-month fee at least 30 days before the license expires.
Why we give no date
We did not find a DOH processing time for this license:
- DOH’s pages say that after review and acceptance of the application, its Office of Investigation and Inspection contacts you to schedule the survey, without a time frame (DOH, License Requirements).
- The rule sets a limit on the applicant, not on DOH: "an applicant has nine months from the application submission date to complete all steps required for initial licensure" (WAC 246-335-320(4)). DOH’s license requirements page repeats it as an important notice (DOH, License Requirements).
- DOH’s open license data gives issue and expiry dates but no application dates, so it cannot show how long applications take (data.wa.gov; our check).
What is fixed: the orientation class comes first and runs about monthly; the two key background checks must be no more than three months old when you apply; and the nine months run from submission. Our planning arithmetic, not a DOH estimate: an application submitted on December 1, 2026 would reach nine months on September 1, 2027. The rule counts from the "application submission date", while the refund rule counts nine months from when DOH receives the application (WAC 246-335-990(10)), so keep proof of the date you mailed it.
Our suggestions: have the policy manual finished before you mail, so the survey office’s request does not start the writing; answer every DOH letter quickly; and do not sign client contracts, advertise or set a start date until the license is issued, since a license is required to advertise or operate an agency, operating without one is a misdemeanor (RCW 70.127.020), and DOH may fine up to $5,000 for each day (RCW 70.127.213(5)). DOH’s home care page links a page where you can check the status of a new or renewal application.
Renewal and changes after you are licensed
- Term. "A license, unless suspended or revoked, is effective for a period of two years, however an initial license is only effective for twelve months." (RCW 70.127.100)
- What renewal needs. Renewal paperwork (application, proof of insurance, FTE worksheet, current background checks and disclosure statements, organizational structure, fee) is due at least 30 days before the license expires. (WAC 246-335-325) Background checks and disclosure statements are renewed within two years of the previous ones.
- Late renewal. $50 a day, up to $1,000, counted from the renewal date (30 days before expiry). (WAC 246-335-990(8))
- New counties. To serve new counties the licensee files an amended application and must have DOH approval before serving there. (WAC 246-335-335(6)(b))
- Other changes. Written notice to DOH within 30 days of a change of administrator or supervisor of direct care services, opening or closing an office, ceasing home care, or reducing service areas. (WAC 246-335-335(5))
- Selling. "A license issued under this chapter shall not be transferred or assigned without thirty days prior notice to the department and the department’s approval." (RCW 70.127.100) Both the current licensee and the new owner file at least 30 days before the change, and DOH’s change of ownership fee is $500 per category (WAC 246-335-330(6)-(7); WAC 246-335-990(5)).
- Surveys after licensing. DOH surveys unannounced at least once in each licensure period (WAC 246-335-340(1)), and may charge $5,000 for a renewal survey that needs more than two days on site (WAC 246-335-990(6)).
Payers
Plan on three years of private-pay clients
Medicaid. DOH’s application instructions say "Contracts are not available to newly licensed home care agencies." (DOH 505-053). DSHS’s home care agency application, posted April 2026, asks providers to "have at least three years’ experience in Washington State as a licensed in-home service provider in the home care agency category", with an independent financial audit or review without findings for the two years before contracting (DSHS, Home Care Agencies application). Even then, DSHS says "A Medicaid contract allows a provider to offer services, but it does not guarantee referrals." (DSHS)
WA Cares asks for a DOH in-home services license held "for a minimum of three consecutive years", with no significant deficiencies, and electronic visit verification (WA Cares, home care agency provider details).
What that means for your budget, by our reading: your first three years of revenue come from private-pay clients and families, and you pay the standard renewal fees in Table 1, because the lower Table 2 rates are for agencies under contract with and monitored by DSHS or an Area Agency on Aging (WAC 246-335-990(4)(b)).
Mistakes that cost money or time
Letting the nine months run out
DOH may close the application with no refund of the licensing fees, and you would apply again with new fees.
WAC 246-335-320(4)Background checks that are too old
The administrator and supervisor checks and disclosure statements must be obtained within three months of the application date.
WAC 246-335-320(2)(d)(iv)A follow-up survey
DOH may charge $5,000 for an on-site follow-up survey it needs to complete the survey process, or after an inadequate response to a statement of deficiencies.
WAC 246-335-990(6)Mailing without the orientation certificate
DOH will not process an initial application without it.
DOH orientation pageServing a county before DOH approves it
Each county must be approved before you provide services there, at the start and when you expand.
WAC 246-335-335(6)(b)Renewing late
$50 a day, up to $1,000, counted from 30 days before the license expires.
WAC 246-335-990(8)Operating before the license
A misdemeanor, with each day a separate violation, and DOH may fine up to $5,000 for each day.
RCW 70.127.020(3), .213(5)Fees, fines and penalties are set by the state, not by CareRulebook.
Myths about cost and timing
Is the renewal fee another $5,000?
No. The $5,000 is DOH’s initial fee for a 12-month license. Renewal is a 24-month DOH fee set by your full-time equivalents: $2,400 for 5 or fewer up to $3,700 for 101 or more, or $1,700 to $2,600 for an agency under contract with and monitored by DSHS or an Area Agency on Aging that meets the substantial equivalency rule.
"A licensee shall submit to the department a 24 month renewal fee for home care, home health and hospice agencies, based on the number of full-time equivalents (FTEs)"
Do I pay for my caregivers’ fingerprint checks?
It depends. Not for the initial checks run through DSHS’s Background Check Central Unit: DOH says BCCU provides them at no charge for long-term care workers and certified home care aides. DSHS says fingerprints taken by law enforcement instead of its contractor may cost something, and the Washington State Patrol, which runs the two-year rechecks and the checks for your application, sets its own record check fees by rule and may not charge nonprofits.
"BCCU is required to provide only initial background checks for long-term care workers and certified home care aides at no charge to the home care agency."
Does DOH have to license me within nine months?
No. The nine months is a limit on the applicant: you have nine months from submitting the application to finish every step, or DOH may close the file without a refund. DOH publishes no processing time of its own.
"an applicant has nine months from the application submission date to complete all steps required for initial licensure"
If I stop partway, do I get DOH’s fee back?
It depends. Partly, depending on how far DOH got. Before any on-site survey or technical assistance, DOH refunds two-thirds of the fees less a $50 processing fee; after one, one-third less $50. Nothing comes back after more than one on-site visit, or once nine months pass without a license because the applicant did not finish.
"If an application has been received but no on-site survey or technical assistance has been performed or provided by the department, two-thirds of the fees paid, less a $50 processing fee"
Can a new agency get a Medicaid (DSHS or AAA) contract straight away?
No. DOH’s application instructions say contracts are not available to newly licensed home care agencies, and DSHS’s current application asks for three years as a licensed Washington home care agency. Plan to start with private-pay clients.
"Contracts are not available to newly licensed home care agencies."
Frequently asked questions
How much does a home care license cost in Washington?
DOH’s initial fee is $5,000 for each service category, for a first license that lasts 12 months, plus $500 for each additional urban county or $100 for each additional rural county (one county is included). Renewal is a 24-month fee set by your full-time equivalents, from $2,400 (5 or fewer) to $3,700 (101 or more). These are DOH’s fees under WAC 246-335-990, in force since June 1, 2026, not CareRulebook prices.
How long does it take to get a home care license in Washington?
DOH does not publish a processing or survey scheduling time, and the rules set none. What the rule does set is a limit on you: nine months from submitting the application to complete every step, survey included, or DOH may close the application without refunding the fee. The orientation class comes first and DOH runs it about once a month. We cannot give you a date.
Are caregiver background checks free in Washington?
The initial checks are, if you run them through DSHS’s Background Check Central Unit: DOH says BCCU provides initial checks for long-term care workers and certified home care aides at no charge to the agency, and the statute bars DSHS from passing the fingerprint check cost to workers or employers. DSHS says fingerprints taken by law enforcement instead of its contractor may cost something. The two-year rechecks, and the administrator and supervisor checks for your application, go through the Washington State Patrol, which sets its own fees by rule.
What insurance do I need for a Washington home care license?
DOH’s rule and application ask for commercial general liability insurance: $1 million per occurrence (bodily injury, property damage and contractual liability) or a $2 million combined single limit. The statute is wider, asking for professional liability, public liability and property damage insurance in an amount DOH sets. Ask your insurer and DOH whether you need professional liability cover as well. We do not quote premiums.
When can a new Washington home care agency take Medicaid or WA Cares clients?
Not for at least three years, by our reading of the sources. DOH’s application instructions say DSHS contracts are not available to newly licensed home care agencies; DSHS’s current application asks for at least three years as a licensed Washington home care agency, with a clean audit or financial review for the two years before; and WA Cares asks for a DOH license held for at least three consecutive years.
Do I get the fee back if I withdraw my application?
Partly. Before any on-site survey or technical assistance, DOH refunds two-thirds of the fees less a $50 processing fee; after one, one-third less $50. Nothing is refunded after more than one on-site visit, or once nine months pass without a license because the applicant did not finish (WAC 246-335-990(9)-(10)).
Can I check where my application is?
DOH’s home care agencies page links a page to find out the status of a new or renewal application. For anything else, DOH’s home care program is on 360-236-2957.
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Keep reading
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The DOH in-home services license, the orientation class, the paper application and the initial survey.
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Texas
Texas license cost and timeline
How Texas compares: HHSC’s license fee and its published average processing time.
North Carolina
North Carolina license cost and timeline
DHSR fees and the steps to a license.
Georgia
Georgia license cost and timeline
DCH fees per service category and the steps to a license.
Virginia
Virginia license cost and timeline
OLC fees and the steps to a license.
Illinois
Illinois license cost and timeline
IDPH’s $1,500 fee and the 240-day provisional license.
Indiana
Indiana license cost and timeline
IDOH’s $250 yearly fee and the Gateway steps.
US
All US states
Which states we cover and how each licenses home care.
Sources
- Chapter 70.127 RCW, In-home services agencies · Washington State Legislature (app.leg.wa.gov) · retrieved October 1, 2026
- Chapter 246-335 WAC, In-home services agencies (Parts 1, 2 and 13; home health and hospice parts for comparison) · Washington State Legislature (app.leg.wa.gov) · retrieved October 1, 2026
- RCW 43.43.830 to 43.43.845, background checks (Washington State Patrol) · Washington State Legislature (app.leg.wa.gov) · retrieved October 2, 2026
- Chapter 74.39A RCW, Long-term care services options (sections .009, .056, .074, .076, .086, .341) · Washington State Legislature (app.leg.wa.gov) · retrieved October 2, 2026
- Chapter 246-980 WAC, Home care aide rules (as amended by WSR 26-12-065, effective July 3, 2026) · Washington State Legislature (app.leg.wa.gov) · retrieved October 2, 2026
- Chapter 296-823 WAC, Occupational exposure to bloodborne pathogens (Department of Labor and Industries) · Washington State Legislature (app.leg.wa.gov) · retrieved October 2, 2026
- WSR 26-04-110, In-home services agencies fee updates (permanent rule, filed February 3, 2026, effective June 1, 2026) · Washington State Register (Code Reviser) · retrieved October 1, 2026
- WSR 25-24-044, In-home services agencies fee updates (proposed rule, CR-102) · Washington State Register (Code Reviser) · retrieved October 1, 2026
- In-Home Services License Application Packet, DOH 505-052 (April 2026), with 505-053 instructions (February 2026), 505-109 license requirements (April 2026), 505-051 application, 505-055 disclosure statement and 505-137 FTE worksheet · Washington State Department of Health · retrieved October 1, 2026
- Home Care Agencies · Washington State Department of Health · retrieved October 1, 2026
- Home Care Agencies: License Requirements · Washington State Department of Health · retrieved October 1, 2026
- In-Home Services Orientation Class (information, registration and 2026 schedule) · Washington State Department of Health · retrieved October 1, 2026
- Home Care Agencies: Updated Rules (guidance on the 2018 rules: background checks, character, competence and suitability, TB risk assessment) · Washington State Department of Health · retrieved October 2, 2026
- Health Care Provider Credential Data (dataset qxh8-f4bd), credential type "In Home Services Agency License", queried October 2, 2026 · Washington State Department of Health (data.wa.gov) · retrieved October 2, 2026
- Background Checks: Private Home Care Agencies (HCA) · Washington State Department of Social and Health Services · retrieved October 2, 2026
- Information for Potential Medicaid Contractors · Washington State Department of Social and Health Services, Home and Community Living Administration · retrieved October 2, 2026
- Home Care Agencies: Medicaid provider application form (posted April 2026) · Washington State Department of Social and Health Services, Home and Community Services · retrieved October 2, 2026
- WA Cares: Home care agency provider application details (updated February 3, 2026) · WA Cares Fund (Washington State) · retrieved October 2, 2026