Personal Care Services Agency Licensing Program
Program Overview
The Indiana State Department of Health licenses agencies that provide (1) attendant care services; (2) homemaker services that assist with or perform household tasks, including housekeeping, shopping, laundry, meal planning and preparation, and cleaning; and;
(3) companion services that provide fellowship, care, and protection for a client, including transportation, letter writing, mail reading, and escort services;that are provided to a client at the client's residence.
Contact the Program
Indiana State Department of Health
Division of Acute Care
2 North Meridian Street, 4A
Indianapolis, IN 46204
(317) 233-7474 (Acute Care Receptionist)
(317) 233-1325 (ISDH Main Switchboard)
Map
Program Manager
Darlene Earls
dearls@isdh.in.gov
(317) 233-7492
(317) 233-7742 [Secretary]
Report a Complaint or Incident to the ISDH
Report a complaint regarding a health care facility
Individuals can call or email to make complaints about care provided at any licensed or certified Indiana health care providers or suppliers.
Report an incident regarding a health care facility
The Incident Report Form is for health care facilities to notify the Indiana State Department of Health of a reportable incident pursuant to the ISDH Reportable Unusual Occurrence Policy. The Incident Report Form is also for health care facility staff (nursing homes, intermediate care facilities, and hospice agencies) to report a reasonable suspicion of a crime against a resident pursuant to Federal regulations. This form is not to be used to file a complaint.
Agency Changes
Select a topic below for instructions on how to submit the change to the department. Please notify the department of changes as they occur at the agency.- Agency address, phone and fax changes
- physical address
- mailing address
- phone number
- fax number
- e-mail address
- Agency closure
- Agency name change
- add "doing business as" (dba) name
- Agency name change
- legal entity name
- Branch Changes
- add
- relocate
- close
- Criminal History Check Information
- expanded
- limited
- national
- Licensure Renewal
- Office hours
- Staff Changes
- manager
- alternate manager
- officers
- Stock Transfer
Applications: Applying for Initial Licensure or Change of Ownership
Initial Application
To apply for an initial license to operate a personal services agency complete the “Application For License To Operate A Personal Services Agency” (SF 53391) and submit with policies and procedures, $250.00 licensure fee and other required information to the Indiana State Department of Health.
Change of Ownership Application
To apply for a change of ownership for an existing agency complete the “Application For License To Operate A Personal Services Agency” (SF 53391) and submit with the policies and procedures, $250.00 licensure fee, applicable purchase agreement, and other required information to the Indiana State Department of Health.
Topics
Click on the applicable topic below for the instruction letter, forms, information, laws and rules for initial licensure or change of ownership application process. Review all applicable information prior to submission of application to the Department.
Instruction Letters
Select the “Initial Licensure Application Instruction Letter” for an initial licensure application and the “Change of Ownership Application Instruction Letter” for a change of ownership application.
Initial or Change of Ownership Application Form
Laws/Rules
- Personal Services Agency State Statute (Law) IC 16-27-4
- Criminal History State Statute (Law) IC 16-27-2
- Tuberculosis State Rules/Administrative Code 410 IAC 17-12-1 Sec.1(h)
Information
- Contact Information
- Criminal History Check Information
- Legal and Doing Business As (DBA) Names
- Policy and Procedure Example
Links
- Indiana Association For Home Health and Hospice (PSA 101 Training)
- Indiana Secretary of State (SOS)
- Indiana State Police
- U.S. Small Business Administration
Licensure Renewals
To renew the agency’s license to operate a personal services agency complete the renewal application and submit with the $250.00 licensure fee to the Indiana State Department of Health. Click on the applicable topic below for the instruction letter and application form to complete the licensure renewal process.Directories
Directory of Personal Services Agencies
Employment Opportunities
Learn more about Employment Opportunities with the Indiana State Department of Health
Laws and Regulations
State Laws and Rules
Personal Services Agency Statute
Indiana Law and Rules Homepage
Limited Criminal History Search
Links
Professional Organizations
Indiana Association for Home and Hospice Care
State Government
Indiana Public Access Counselor
Office of Medicaid Policy and Planning (FSSA)
Federal Government
Agency for Healthcare Research and Quality (AHRQ)
Americans with Disabilities Act (ADA)
Centers for Disease Control and Prevention (CDC)
National Patient Safety Foundation
Stay Connected
