New York State categorizes four types of home health care agencies. As of 2010, the state has an imposed moratorium on new Certified Home Health Agencies (CHHA) and Long Term Health Care Programs (LTHCPs), which provide temporary in-home care to people on Medicaid and Medicare. New Licensed Home Care Service Agencies (LHCSAs), which offer full-service home health care with professional nurses and therapists to people with private health insurance, and Activities of Daily Living (ADLs) professionals, who assist patients with everyday tasks in their homes, are still accepted. All employees must obtain licensure in their field, and a New York State business license is required.

Contact the New York State Department of Health to apply for a business license if you are a qualified registered nurse or licensed practical nurse or plan to hire qualified staff and want to start an LHCSA. Licensed therapists, social workers, physicians, and personal care aides can also work in an LHCSA. You can specialize in one type of service or provide a full range of services to patients with private insurance, including skilled nursing and therapy. Licensed agencies can subcontract with state or local organizations.

Apply to your local social services office in New York State to find out requirements for ADL licensure. ADLs help the elderly, disabled, convalescing and mentally and terminally ill with personal hygiene, dressing, light housekeeping, meal preparation and laundry, and provide physiological support. They might also be required to change dressings, check temperatures, administer medications and transport patients to doctor's appointments.

Obtain your certification--or if you plan to be the administrator--advertise for employees in the local newspaper or contact the local health department and ask if they know of any licensed people looking for jobs. Anyone working in the home health care field who is not a professional nurse or therapist must obtain home health care aide certification. The education to obtain a diploma or certificate is offered online at several colleges and can take from a few days to several months to complete depending on the courses chosen. Classes include introductions to the professional fields, including body systems, nutrition, physical therapy, recording vital signs and more.

Perform the necessary background checks on anyone you plan to hire. Contact previous employers or use online employment screening companies, some of whom specialize in the health care business.

Reach out to national and local health insurance providers. Give them your details and familiarize yourself with their claim procedures.

Create your employee handbook. This will help establish your business policies and will prevent misunderstandings between you and your staff. Include payroll type and frequency--employees can be paid on a part-time 1099 basis or they can be full-time employees paid hourly or on salary. Address benefits and holiday pay policies. Locate a uniform provider and possibly a laundering service if you are going to provide uniforms. There are several choices in the state of New York. Know if you are going to provide transport to the patients' homes, or if employees will use their own vehicles and will be reimbursed for mileage or gas.

Advertise your services once you have a business license and health care certification. You can do this online, in local newspapers and medical journals or contact a medical employment agency if you are willing to pay their fees.