How to start a home care agency in Oklahoma

Oklahoma requires a Home Care Agency license (for hands-on personal care); Companion or Sitter Service license (companion/sitter only) from Oklahoma State Department of Health to operate a home care agency. Fee: $1,000. Processing time: Apply at least 30 days before starting operations; incomplete applications are dismissed 30 days after the applicant is notified.

License required

Yes

License

Home Care Agency license (for hands-on personal care); Companion or Sitter Service license (companion/sitter only)

Issuing agency

Oklahoma State Department of Health

Fee

$1,000

Fee details

$1,000 non-refundable initial application fee for either a home care agency (or subunit) or a companion/sitter service; home care branch offices $25.

Renewal

Every year · $500 annual renewal for either license type ($25 per home care branch). Home care agency licenses expire July 31 each year, with the first renewal prorated at $125 per quarter; companion/sitter licenses expire one year after issue.

Processing time

Apply at least 30 days before starting operations; incomplete applications are dismissed 30 days after the applicant is notified.

Insurance and bonds

Liability insurance of at least $100,000 per occurrence and $300,000 aggregate for both license types; companion/sitter services must also show workers' compensation coverage.

Regulation

63 O.S. 1-1960 et seq. (Home Care Act); Okla. Admin. Code 310:662 (subchapter 2 licenses; subchapter 8 sitter or companion services)

1. Decide the license type: personal care (dressing, bathing, ambulation, etc.) requires a home care agency license; companion or sitter services only need the companion/sitter license
2. Set up a publicly accessible place of business physically located in Oklahoma
3. Obtain liability insurance of at least $100,000 per occurrence / $300,000 aggregate (and workers' compensation for a companion/sitter service)
4. For a home care agency, have an administrator certified by OSDH as a home care agency administrator
5. File the application with disclosure statements and affidavit at least 30 days before opening, with the $1,000 fee
6. Renew annually at least 30 days before expiration

Staffing

• Home care agency administrator must be certified by OSDH
• Companion/sitter service must name an individual responsible for supervising services
• Staff must be supervised by personnel at the licensed Oklahoma location
• Companion/sitter services keep a copy of each employee background check

Program

SoonerCare (Oklahoma Health Care Authority, OHCA), including SoonerSelect managed care

Enrollment portal

OHCA Provider Portal (ohcaprovider.com) — online provider contracting

Application fee

OAC 317:30-3-19.4 sets the fee at the CMS amount, adjusted for inflation, for provider types listed in OHCA's appendix. Individual physicians and non-physician practitioners are exempt, as are providers who already paid the fee to Medicare or another state's Medicaid/CHIP program. The fee is not refunded if screening leads to denial. Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts.

Fingerprinting

Under OAC 317:30-3-19.4, high-risk screening adds a fingerprint-based criminal background check of the provider and of anyone owning 5% or more. OHCA's enrollment sheet lists DME and home health as high-risk provider types and says providers enrolled with Medicare may be exempt. Limited- or moderate-risk providers move to high risk after a fraud-based payment suspension, an overpayment, or an exclusion.

Site visit

Moderate-risk screening includes pre- and post-enrollment site visits by OHCA Provider Enrollment staff. OHCA lists these moderate-risk types: ambulance services, behavioral health agencies and groups, individual behavioral health providers, hospice, independent diagnostic testing facilities, laboratories, and physical therapy groups and physical therapists. High-risk types also get site visits.

Revalidation

OHCA screens and enrolls providers and revalidates them periodically, as federal rules require. Existing providers handle this through 'renewal contracts' in the OHCA provider portal. Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years.

Full Oklahoma Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need (Long-term Care CON Act; Psychiatric and Chemical Dependency Facility CON Act)

Agency

Oklahoma State Department of Health, Health Facility Systems

Services covered

• long-term care facilities as defined in 63 O.S. §1-851.1 (licensed nursing facility beds)
• ICF/IID beds
• psychiatric or chemical dependency facilities, services or units in hospitals or related institutions
• acquisitions of covered health care facilities

Oklahoma certificate of need details →

Model

hybrid

State vendor

Fiserv AuthentiCare (moving to Acumen DCI, expected fall 2026); HHAeXchange for SoonerSelect plans

Services in scope

• personal care
• nursing
• home health
• DDS waiver services
• ADvantage waiver services

Alternate EVV allowed

Yes

Program

https://oklahoma.gov/ohca/individuals/programs/electronic-visit-verification/evv-faqs.html

Oklahoma EVV requirements →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

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)

174 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

992,735 (as of Jun 1, 2026)

All Oklahoma Home care Medicaid rates, ranked →

• OK Advantage Waiver (1915(c))
• OK Community Waiver (1915(c))
• OK Homeward Bound Waiver (1915(c))
• OK In-Home Supports Waiver for Adults (1915(c))
• OK In-Home Supports Waiver for Children (1915(c))
• OK Medically Fragile Waiver (1915(c))

Oklahoma waivers and waiting lists →