How to start a home care agency in Maine

Maine requires a Personal Care Agency license from Maine Department of Health and Human Services, Division of Licensing and Certification (DLC) to operate a home care agency. Fee: $500. Processing time: The rule says DLC decides on an initial application within 90 working days after receiving all required documents, but DLC currently reports running 6–9 months behind normal processing and inspection timelines because of rapid growth in applications.

License required

Yes

License

Personal Care Agency license

Issuing agency

Maine Department of Health and Human Services, Division of Licensing and Certification (DLC)

Fee

$500

Fee details

$500 initial application fee; non-refundable. A $10 processing fee applies when a name, site or location change requires the license to be reissued.

Renewal

Every 2 years · A full license runs up to two years. Renewal fee depends on staff count at renewal: 1–5 employees $200; 6–10 $500; 11–20 $1,000; 21–50 $1,500; 51+ $2,000.

Processing time

The rule says DLC decides on an initial application within 90 working days after receiving all required documents, but DLC currently reports running 6–9 months behind normal processing and inspection timelines because of rapid growth in applications.

Insurance and bonds

General and professional liability insurance adequate to protect clients from personal injury; the rule sets no dollar amount.

Survey and inspection

DLC may inspect before initial licensure, before renewal, after a complaint, and after a change of administrator, physical plant or sites.

Regulation

10-144 CMR Chapter 129, Personal Care Agency Licensing Rule (adopted 2024-08-20)

1. Read 10-144 CMR Ch. 129 and DLC's PCA physical site guidance
2. Get general and professional liability insurance
3. Obtain a State Bureau of Identification criminal background check for every owner, dated within 30 days of applying
4. Submit the online Personal Care Agency License Application with required documents, administrator contact, payment sources served, and the $500 fee
5. Expect a possible pre-licensure inspection; DLC issues a provisional license (3–12 months) and later a full license of up to 2 years
6. Renew with the staff-count-based fee

Staffing

• Administrator and owner(s) must show capacity to run the agency safely
• Direct care supervisor must be an LPN or RN, a registered CNA, or someone who completed the department-approved personal care course and has at least 1 year of personal care experience
• Supervisor makes on-site visits at least every 30 days for each new direct care worker's first 3 months, and does annual performance reviews
• All employees, owners and administrators must clear a Maine Background Check Center check, plus APS/CPS substantiation checks

Training

• Workers giving hands-on help (bathing, toileting, transfers, dressing, eating, hygiene) must have completed Personal Support Specialist (PSS) or another department-approved course, or enroll within 60 days of hire and finish within 9 months; not required if duties are limited to meals, money management, shopping, light housework and communication
• Annual training for every employee: mandated reporting, abuse/neglect/misappropriation policy, grievances, infection control, emergency/disaster policies, confidentiality

Program

MaineCare (Office of MaineCare Services, Maine DHHS)

Enrollment portal

MIHMS Health PAS Online Portal — Provider Enrollment Application (PEA) via Trading Partner Account (moving to the new 'MaineCare Partner Portal' in late September 2026)

Fiscal agent

Gainwell Technologies (MaineCare provider enrollment vendor/MIHMS)

Application fee

MaineCare charges the fee to providers that are newly enrolling, revalidating or adding a practice location, unless exempt, paid by debit or credit card in the Trading Partner Account; its fee spreadsheet lists the provider types that pay. Home health agencies and DME suppliers must also post a surety bond at enrollment, revalidation and new locations. 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

MaineCare runs automated criminal history checks on all providers and on 5%+ owners, board members, managing employees and rendering providers. 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

MaineCare does site visits on revalidating provider locations assigned moderate or high risk; risk is set by provider type and service-location specialty (Risk Category Assignments, May 2024). 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

MaineCare revalidates at least every five years (every three years for DME providers) or whenever it asks; it has a federally required 2026-2028 off-cycle revalidation plan. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Maine Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need (Maine Certificate of Need Act of 2002)

Agency

Maine Department of Health and Human Services (CON Unit, Division of Licensing and Certification)

Services covered

• hospitals and psychiatric hospitals
• nursing facilities
• kidney disease treatment centers / freestanding hemodialysis
• rehabilitation facilities
• ambulatory surgical facilities
• independent radiological service centers
• independent cardiac catheterization centers
• cancer treatment centers
• transfers of ownership or control of a health care facility
• major medical equipment acquisitions

Maine certificate of need details →

Model

hybrid

State vendor

Sandata (through fiscal agent Gainwell Technologies)

Services in scope

• personal care
• home health

Alternate EVV allowed

Yes

Program

https://www.maine.gov/dhhs/oms/providers/electronic-visit-verification

Maine EVV requirements →

State minimum wage

$15.10 an hour

Effective

2026-01-01

Scheduled increases

Rises to $15.70 on 2027-01-01 (CPI-W Northeast indexing).

Direct-care wage floor

MaineCare and state-funded reimbursement for essential support workers must build in at least 125% of the state minimum wage for the labor portion of the rate, plus related taxes and benefits, updated whenever the minimum wage rises (in effect since 2022-01-01). This is a rate floor, not a direct wage mandate on employers.

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)

634 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

327,698 (as of Jun 1, 2026)

All Maine Home care Medicaid rates, ranked →

• Home and Community Based Services for Members with Brain Injury Waiver (1915(c))
• Home and Community Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder Waiver (1915(c))
• Elderly and Adults with Disabilities Waiver (1915(c))
• Home and Community Based Services for Adults with Other Related Conditions Waiver (1915(c))
• Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder Waiver (1915(c))

Maine waivers and waiting lists →