Delaware personal assistance services agency license: opening a non-medical home care agency

What Delaware means by “personal assistance services”

Delaware does not use the terms “companion agency” or “non-medical home care license.” The license is for a personal assistance services agency: “any business entity or subdivision thereof, whether public or private, proprietary or not-for-profit, which refers direct care workers to provide personal assistance services to individuals primarily in their home or private residence” ⁠². The licensing requirement applies to everyone: “No person shall establish, conduct, or maintain in this State any personal assistance services agency without first obtaining a license from the Department” ⁠¹. There is no minimum number of clients or workers.

Regulation 3345 defines personal assistance services as paid services “that do not require the judgment and skills of a licensed nurse or other professional.” They are limited to:

• help with, or supervision of, activities of daily living
• companion, homemaker and transportation services
• reporting changes in the client’s condition
• medication reminders and completing reports ⁠¹

These services “do not require physician’s orders” ⁠¹. Activities of daily living include bathing, dressing, grooming, eating, toileting, walking and transfers ⁠¹. So unlike some states that split companion-only and personal-care agencies, Delaware puts hands-on personal care and homemaking under the same license, within the task limits described below.

The rule calls clients “consumers” and caregivers “direct care workers.” A direct care worker can be an employee or a contractor. You may use contractors, but they must meet the same requirements as employees, and you need a written contract with each one ⁠¹.

When you need a different license, or none

The statute excludes three kinds of business from the PASA license ⁠²:

• Skilled agencies. An agency “providing skilled professional health-care services” is not a PASA. If you plan to offer nursing, therapy or other work by licensed professionals, you need a home health agency license from DHCQ instead; this site has no Delaware guide for it yet. DHCQ also lists a separate “Home Health Agencies – Aides Only” category, and regulation 3345 excludes a home health agency that solely provides the services defined in 16 Del.C. § 122(3)o ⁠¹. Ask DHCQ which category fits your service list.
• Community Based Attendant Services Act agencies. An agency that provides only the services defined in 16 Del.C. Chapter 94 is excluded ⁠¹⁠².
• Staffing-only firms. An agency that provides staffing exclusively to other agencies, such as nursing facilities, home health agencies and hospitals, is not a PASA ⁠². The rule excludes temporary staffing agencies that supply staff to licensed PASAs. Such a firm “may not provide services under direct agreements with consumers,” and its staff must meet regulation 3345 when they work for a licensed agency ⁠¹.

The regulation also excludes:

• an individual who contracts directly with a client and is paid by the client, “where … neither the consumer nor the individual pays an agency on a periodic basis”
• suppliers that only provide durable medical equipment
• services run by and for people who rely on prayer alone for healing ⁠¹

The first exclusion is narrow. If you match caregivers with families and take an ongoing fee, you are acting as an agency.

Where you can operate: office, service area and name

Three rules affect your business plan before you apply.

• A Delaware office. The office is where you run the business and store personnel, contractor and client records, and it “shall be located in the State of Delaware” ⁠¹. Each office needs a separate license ⁠¹.
• A county-based service area. Your service area is the county where your office is located plus any Delaware county immediately next to it. You “shall only provide services in the service area,” except during short trips a client takes outside it ⁠¹. Delaware has three counties. An office in Kent County borders both New Castle and Sussex, while an office in New Castle or Sussex borders only Kent.
• No “healthcare” branding. You “must not use the word ‘healthcare’, or any other language which implies or indicates the provision of healthcare services,” in your name or advertising ⁠¹. Check this before you register a business name. You also may not market yourself as a personal assistance services agency until DHCQ issues the license ⁠¹.

If you move the office, you must notify DHCQ in writing at least 30 calendar days ahead ⁠¹.

The director you must have on staff

Every agency needs a full-time director with full authority to plan, staff and run the agency ⁠¹. The definitions section sets the minimum qualification: “at least an associates degree plus 2 years healthcare or home care supervisory experience.” Directors in place as of June 1, 2020 are exempt ⁠¹. Home care experience means help with or supervision of daily living activities that does not require a nurse’s judgment ⁠¹.

The director must appoint, in writing, a similarly qualified person to act in their absence. The director or that designee must be available to clients during all operating hours ⁠¹. If the director or other management staff change, you must notify DHCQ in writing within 15 calendar days ⁠¹.

Applying: the statement of intent and application package

The rule starts the process with a letter, not a form.

1. Send a written statement of intent. Describe the services you plan to offer and ask DHCQ for a licensure application ⁠¹. Receiving a form “is in no way a guarantee” that your application will be accepted ⁠¹. DHCQ’s main number is (302) 421-7400 ⁠⁴. DHCQ’s PASA page, which lists licensed agencies, does not give an address for statements of intent, and the rule does not name one ⁠¹⁠⁵. Call DHCQ to ask where to send it and which application form it will issue.
2. Complete the application and attach the required documents. Section 2.2.2 lists them ⁠¹:
   • Names, addresses and types of any facilities you already own or manage.
   • Your full policies and procedures manual (see the next section).
   • The identity of each corporate officer and director, general partner or managing member, and governing body member, and anyone in those roles with a financial interest of 5% or more. Include proof of nonprofit status if you claim it.
   • Disclosure of any officer, director, partner, employee, direct care worker, managing member or governing body member who has a felony record.
   • The name of the director and a list of management staff with their credentials.
   • A copy of the competency test you will give direct care workers.
   • Proof of insurance and bonding.
3. Include the statutory evidence and fee. DHCQ cannot issue or renew a license unless you include the fee and evidence that you ⁠²:
   • comply with the § 1145 background check law and the § 1146 drug-testing law
   • disclose to clients whether the agency and its workers carry attendant tax, workers’ compensation and liability insurance.
4. Receive the 90-day initial license. An agency that completes the application process receives an initial license for 90 calendar days. With it, you can hire or contract workers and build a caseload ⁠¹.
5. Pass the on-site survey while operating. DHCQ surveys every new agency on site during its first 90 days. At the survey, the agency “must be in operation and caring for consumers” ⁠¹. The initial license cannot be renewed ⁠¹. If you are in substantial compliance, you move to a 12-month annual license. Otherwise DHCQ may issue a provisional license for less than one year, with conditions, and you will need an approved plan of correction ⁠¹.

Because the survey has to happen while you are serving clients, line up your first clients and trained workers before the 90-day clock starts.

As of 2026-10-12, DHCQ’s online list of licensed agencies showed 91 entries, each with a PASA license number and expiration date ⁠⁵. The list is a useful way to check a competitor’s or partner’s license status.

The policies DHCQ reads before licensing you

The policies manual goes in with the application, so it has to be finished before you apply. Regulation 3345 requires written policies on:

• Each job classification: qualifications, responsibilities and employment requirements, with pre-employment requirements, position descriptions, orientation, annual performance review and competency testing, and evaluation of your program ⁠¹
• Client rights and grievances: a written rights notice delivered at the first home visit or before services start, plus a process for resolving grievances ⁠¹
• Complaints to DHCQ: a procedure that lets clients and families report concerns to the Department “without fear of reprisal” ⁠¹
• Incidents and emergencies: handling and documenting incidents, accidents and medical emergencies, with reports kept for 6 years ⁠¹
• Communicable disease control and an infection prevention and control program based on CDC guidelines. It must cover protective equipment and have a designated lead ⁠¹
• COVID-19: testing of new staff, vendors and volunteers before their start date under Division of Public Health guidance. Policies must also cover work exclusion, testing refusals and outbreak staffing ⁠¹
• Intake, worker referral and case closure ⁠¹
• Coverage: a “sufficient pool” of qualified workers and a backup system for substitutes when a regular worker is unavailable ⁠¹
• Emergencies and disasters: a plan consistent with FEMA and ASPR TRACIE standards and with local and state plans. It must cover continuing services when care is interrupted, staff notification, communication with emergency agencies, backups and prioritizing clients ⁠¹

You must review and date your policies every year ⁠¹.

Insurance and the client disclosure form

Section 7 requires insurance that covers clients’ injuries and losses caused by your services. These minimums must be in force at all times ⁠¹:

• general liability covering property damage, bodily injury, libel and slander, at $1 million per occurrence
• $500,000 single limit coverage

The application also asks for proof of bonding. However, section 7.0 (titled “Insurance and Bonding”) lists only the liability coverage above, and the rule as published on 2026-10-12 sets no bond amount ⁠¹. Ask DHCQ what proof of bonding it expects with the application.

Separately, you must tell every client whether the agency and its workers are covered for attendant tax, workers’ compensation and liability insurance. You must use a form developed by the Department ⁠¹⁠². If you place workers inside a hospital, nursing home or other licensed facility, you must give that facility the same disclosure and get its written permission first ⁠¹.

Hiring: background checks, drug screens and health tests

Delaware’s background check and drug-testing laws apply to all “home-care agencies,” which include agencies licensed under § 122(3)x ⁠³. In practice:

• Criminal history through the Background Check Center (BCC). “All employers must now use the DHCQ Background Check Center” ⁠⁴. An employer “may not employ an applicant for work in a private residence before obtaining a criminal history” ⁠³. The BCC pulls together several sources ⁠⁴:

  • state and FBI fingerprint checks
  • the Adult Abuse Registry, Child Protection Registry and Nurse Aide Registry
  • the state and national sex offender registries
  • the HHS Office of Inspector General exclusion list
  • Department of Labor service letters

  The BCC helpline is (302) 421-7405 ⁠⁴.

• Fingerprinting. As published on 2026-10-12, fingerprinting is done walk-in only at the State Bureau of Identification, 600 S. Bay Road, Suite 1, Dover. It costs $85 ⁠⁴. You may hire someone conditionally for up to 60 days, but only after you have proof they were fingerprinted ⁠³. A BCC criminal history stays valid for other employers for one year ⁠³.

• Drug screening. Applicants must be screened for marijuana, cocaine, opiates, PCP and amphetamines before employment ⁠³. Penalties for skipping either check run from $1,000 to $5,000 per violation ⁠³.

• Health. Each worker needs a physical exam completed within 12 months before hire and TB testing that follows current CDC recommendations, both on file ⁠¹.

Training: orientation, a competency test and dementia content

Every direct care worker must complete your agency’s orientation before serving a client ⁠¹. Section 4.5.2 lists 24 required topics ⁠¹. They include:

• client rights and confidentiality
• infection control and body mechanics
• nutrition and meal preparation for special diets
• aging and disability
• assistive technology
• observing and reporting changes
• Delaware’s personal assistance regulations
• dementia-specific content: communication, the person’s psychological, social and physical needs, and safety measures

Workers must then pass a competency test before giving care and every year after that. The test must cover the orientation topics ⁠¹. You submit this test with your application ⁠¹.

If you serve anyone with Alzheimer’s disease or another dementia, all direct care workers also need annual dementia training ⁠¹. Personnel files must include annual written evaluations and a letter of appointment ⁠¹.

What your workers may and may not do

Delaware allows a competent client who does not live in a medical facility or a Chapter 11 licensed facility to delegate personal care to unlicensed workers ⁠¹⁠⁶. Regulation 3345 then limits that care task by task ⁠¹.

Medication. Workers may give verbal medication reminders. Actual administration is allowed only if a worker has completed a Department-approved medication administration training program and all of the following are true ⁠¹:

• A responsible caregiver authorizes it and signs an agreement with the agency.
• The caregiver supplies prepackaged doses, each labeled with the client’s name, the drug, the dose and the date and time, along with written instructions.
• No dose is given by injection, IV, rectum, vagina, catheter or feeding tube.
• No Schedule II or Schedule IV drugs are involved.

Serving clients: home visits, plans and incident reports

• Agreement. Each client signs a written agreement. It lists the services, hours and days, any transportation, emergency procedures and how services end. It also includes costs, payment method and billing procedures ⁠¹.
• Initial home visit. The director or designee visits the client’s home before services begin. The visit records the client’s physical condition, social situation and mental status, and a service plan is built from it ⁠¹.
• Every 90 days. Follow-up visits happen at least every 90 calendar days, and every other one must be in person. The rest may use an encrypted, real-time telehealth connection with the client’s consent. The service plan is also reviewed at least every 90 days ⁠¹.
• Incidents. You must report major adverse incidents to DHCQ within 48 hours. These include suspected abuse, neglect or exploitation, a serious injury, an unexpected death, and medication diversion or errors. A full investigation report is due within 30 calendar days ⁠¹.
• Records and closures. Keep adult clients’ records for at least 6 years after the last service ⁠¹. If you end services against a client’s wishes, give at least 2 weeks’ notice, apart from the exceptions listed in the rule ⁠¹.

Renewal, ownership changes and enforcement

An annual license lasts 12 months. You must apply to renew at least 30 calendar days before it expires ⁠¹ and pay the $100 annual fee ⁠². Missing the deadline can leave you on a provisional license ⁠¹. DHCQ may inspect “at any time,” scheduled or unannounced ⁠¹.

A license cannot be transferred. A change of ownership means reapplying as a new agency ⁠¹. You must report any modification of ownership or control at least 30 days ahead, and doing so voids the existing license ⁠¹. This covers:

• a sale or transfer of the majority interest
• a shift that turns the majority owner into a minority owner
• any transfer with a measurable effect on operational control ⁠¹

Violations can bring civil or administrative penalties of up to $5,000 each, and every day a violation continues counts separately ⁠¹⁠². Other sanctions include reprimand, provisional status with a freeze on new admissions, suspension and revocation ⁠¹. Revocation also bars the owners, officers and 5%-or-more interest holders ⁠¹. If you give up a license, you must notify clients and third-party payers at least 30 days in advance ⁠¹.

Medicaid: where personal care is paid for

Medicaid pays for personal care in Delaware through Diamond State Health Plan Plus (DSHP Plus), “a mandatory managed care Medicaid program” for elderly and physically disabled residents. Its home and community-based benefits include personal care services, respite and consumer-directed attendant care ⁠⁷. The program page does not say what a licensed PASA must do to be paid for these services ⁠⁷. Before you plan on Medicaid revenue, ask DHCQ and the DSHP Plus managed care organizations what credentialing and Medicaid provider enrollment they require.

If a family needs more care than an in-home agency can provide, the related Delaware settings are adult day care, family care homes for 2 or 3 residents, and assisted living.

Sources

1. 1
   Delaware Department of Health and Social Services, Division of Health Care Quality (Delaware Administrative Code), 16 DE Admin. Code 3345, Personal Assistance Services Agencies Checked 12 Oct 2026 · Back to text ↑
2. 2
   Delaware General Assembly, Delaware Code Online, 16 Del.C. § 122(3)x, personal assistance services agencies (Title 16, Chapter 1, Subchapter II) Checked 12 Oct 2026 · Back to text ↑
3. 3
   Delaware General Assembly, Delaware Code Online, 16 Del.C. §§ 1145-1146, criminal background checks and drug testing for home-care agencies Checked 12 Oct 2026 · Back to text ↑
4. 4
   Delaware Health and Social Services, Division of Health Care Quality, Criminal Background Checks, Fingerprinting and Mandatory Drug Testing Checked 12 Oct 2026 · Back to text ↑
5. 5
   Delaware Health and Social Services, Division of Health Care Quality, Personal Assistance Services Agencies (licensed agency list) Checked 12 Oct 2026 · Back to text ↑
6. 6
   Delaware General Assembly, Delaware Code Online, 24 Del.C. § 1921, applicability of the Nurse Practice Act Checked 12 Oct 2026 · Back to text ↑
7. 7
   Delaware Health and Social Services, Division of Medicaid and Medical Assistance, Diamond State Health Plan Plus Checked 12 Oct 2026 · Back to text ↑

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