How to start a home care agency in Connecticut

Connecticut requires a Homemaker-Companion Agency certificate of registration from Connecticut Department of Consumer Protection (DCP), License Services Division to operate a home care agency. Fee: $375.

License required

Yes

License

Homemaker-Companion Agency certificate of registration

Issuing agency

Connecticut Department of Consumer Protection (DCP), License Services Division

Fee

$375

Fee details

$375 non-refundable application fee, payable to Treasurer, State of Connecticut.

Renewal

Every year · Registrations expire every October 31; the renewal fee equals the original application fee ($375). An application approved within 90 days of the expiration date is moved to the next renewal cycle.

Insurance and bonds

Surety bond or insurance policy of at least $10,000 that covers theft by an employee from a client.

Survey and inspection

DCP may inspect, copy or audit agency records at any reasonable hour and may investigate complaints.

Regulation

Conn. Gen. Stat. Chapter 400o, secs. 20-670 to 20-681

1. If a corporation, LLC or LLP, obtain an active Certificate of Good Standing from the Connecticut Secretary of the State
2. Obtain a surety bond or insurance policy of at least $10,000 that covers employee theft from clients
3. Apply to DCP online or on the paper form, listing all owners, officers or members
4. Owners, officers and members undergo state and national criminal history record checks
5. Certify under oath that the agency does comprehensive background checks, gives each client a written individualized contract or service plan, carries the bond/insurance, and keeps records open to DCP
6. Pay the $375 fee; renew annually by October 31

Staffing

• Before hiring, each prospective caregiver must pass a comprehensive background check: interview, SSN verification, registry check, national criminal records search through a PBSA-accredited screener, sex offender search, and out-of-state checks if the person has lived in CT under 3 years
• May not hire anyone excluded on the federal OIG list, or convicted within 5 years of certain health care, abuse, fraud or controlled-substance offenses

Program

Connecticut Medical Assistance Program (HUSKY Health)

Enrollment portal

CMAP Provider Enrollment/Re-enrollment Wizard (www.ctdssmap.com)

Fiscal agent

Gainwell Technologies (Provider Enrollment Unit, Hartford)

Application fee

Connecticut's application asks institutional providers to pay or attest to prior payment of the federal fee at enrollment, re-enrollment and when adding a service location; DSS sends a letter after submission if a fee is due. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

The enrollment wizard states that fingerprint-based checks apply to providers placed in the high-risk level at enrollment or re-enrollment. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

Connecticut calls revalidation 're-enrollment': most provider types re-enroll every five years, with a notice letter six months before their contract ends. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Connecticut Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need

Agency

Connecticut Office of Health Strategy, Health Systems Planning Unit (hospitals, surgery centers, behavioral health, imaging, ownership transfers); Department of Social Services for nursing homes and residential facilities for persons with intellectual disability

Services covered

• new health care facilities (hospitals, specialty hospitals)
• freestanding emergency departments
• outpatient surgical facilities
• mental health facilities
• substance abuse treatment facilities
• cardiac services
• termination of hospital services
• transfers of ownership of health care facilities and large group practices
• nursing homes (DSS)
• residential facilities for persons with intellectual disability / ICF (DSS)

Moratoria

CGS §17b-354 bars the Department of Social Services from accepting or approving requests for additional nursing home beds, with limited exceptions (e.g., beds restricted to AIDS or neurological rehabilitation patients, certain continuing care facility beds not used for Medicaid, and Medicaid bed relocations that meet a priority need in the state strategic plan).

Connecticut certificate of need details →

Model

hybrid

State vendor

Sandata

Services in scope

• personal care
• home health

Alternate EVV allowed

Yes

Program

https://portal.ct.gov/dss/health-and-home-care/electronic-visit-verification/electronic-visit-verification

Connecticut EVV requirements →

State minimum wage

$16.94 an hour

Effective

2026-01-01

Scheduled increases

Rises to $17.48 on 2027-01-01 (indexed to the employment cost index).

Rate pass-through

PA 25-168 raises nursing home Medicaid rates to fund wage increases for nursing, aide, dietary, housekeeping, laundry and maintenance staff: 3% on 2025-07-01, 3% on 2026-07-01 and 4% on 2027-01-01. A home that takes the add-on but does not raise wages may have its rate cut by the same amount. A further pool in FY2028 is aimed first at a $26/hour CNA minimum from 2028-01-01, to the extent funds allow.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Personal care / in-home supportive care organizations — active organization NPIs (NPPES)

572 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

895,290 (as of Jun 1, 2026)

All Connecticut Home care Medicaid rates, ranked →

• Acquired Brain Injury (ABI) Waiver (1915(c))
• ABI II Waiver (1915(c))
• Home and Community Supports Waiver for Persons with Autism (1915(c))
• Connecticut Home Care Program for Elders — 1915(i) portion (1915(i))
• Comprehensive Supports Waiver (1915(c))
• Employment and Day Supports Waiver (1915(c))
• Home and Community Based Services Waiver for Elders (1915(c))
• Individual and Family Support Waiver (1915(c))
• Katie Beckett Waiver (1915(c))
• Mental Health Waiver (1915(c))
• Personal Care Assistance Waiver (1915(c))

Connecticut waivers and waiting lists →