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Indiana State Department of Health

ISDH Home > Health Care Quality & Regulatory > Acute Care/Hospitals > Personal Care Services Agency Licensing Program 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

Application for License to Operate a Personal Services Agency

Laws/Rules

Information

Links

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.