Starting a care business in Idaho

Child care licensing depends on head count. Caring for 7 or more children, with pay for at least one, requires a Basic Daycare License: one license with fees of $100 for 7 to 12 children, $250 for 13 to 25 and $325 for 26 or more, valid for two years. IdahoSTARS collects the application for DHW and your public health district collects the fee. A family daycare home with 6 or fewer children needs no license, but a provider caring for 4 or more children must still pass a DHW criminal history check, and the home may opt in to the license. Two 2025 laws, House Bills 243 and 312, rewrote the ratio and training sections and repealed the local-option section of the daycare law. Even so, DHW still tells applicants that cities and counties can adopt their own ordinances, so check with your planning and zoning office first.

For adults, the dividing line is whose home it is. Paid care for an elderly or disabled adult who lives in the caregiver's own home requires certified family home certification, and the provider must live there. The limit is two residents, or three or four if DHW grants a variance for each additional resident. Fees are a $150 application fee and $25 a month. Operating without certification is a misdemeanor.

A building where staff give supervision, personal assistance, meals and lodging to three or more unrelated adults needs a residential assisted living facility (RALF) license. There is one license for every size, and each facility needs an administrator licensed through the Division of Occupational and Professional Licenses. The Legislature rewrote the assisted living law in 2025, and DHW reissued most of IDAPA 16.03.22 effective July 1, 2026. Neither the statute, the 2026 rule nor DHW's licensing page states a facility license fee, so ask the RALF Program in writing before you budget.

Idaho Code and DHW's programs list no state license for adult day care or for non-medical home care agencies. The state requirements that do exist apply to Medicaid payment: adult day health and personal assistance are Medicaid services, and personal assistance agencies sign a provider agreement with DHW (Idaho Code 39-5603). A certified family home may also offer hourly adult day care under a written policy that meets the Medicaid adult day terms. Idaho repealed its home health agency license law, Title 39 chapter 24, effective July 1, 2025. An agency that will bill Medicare or Medicaid still needs federal certification under 42 CFR 484, and DHW's Bureau of Facility Standards acts as the state survey agency for CMS. Nurses and therapists still need their own professional licenses.