If you are trying to open a new home health agency in California, or already had a licensure application pending when the moratorium took effect, the application process has changed significantly.
Effective June 29, 2026, Senate Bill 164 changed California’s Home Health Agency licensing law and established a moratorium on new HHA licenses and new branch offices. CDPH later issued an All Facilities Letter (AFL-26-28) on August 27, 2026, explaining how the Department intends to handle both pending and new applications during the moratorium.
For enrolling agencies, this raises several immediate questions:
- What happens to an application that was already pending before the moratorium?
- Can an applicant still move forward with licensure?
- What does CDPH mean by an “unmet need” exception?
- What must a new applicant do before submitting a licensure application?
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The biggest thing to note is that having an application already in process does not automatically allow it to continue. New applicants in process generally cannot proceed through the traditional application process without first addressing the moratorium requirements.
*This article was written in consultation with Mariam Treystman.
At The Home Health Consultant, we help home health agencies navigate the licensing and Medicare enrollment process, from initial application through survey readiness and ongoing regulatory compliance.
In this article, we’ll focus specifically on what enrolling California home health agencies need to know, including…
- what happens to pending applications,
- how the exception process works,
- and what new applicants must do now
What Does the California Home Health Moratorium Stop for Enrolling Agencies?
For agencies trying to obtain a new California home health license, the first thing to understand is that this moratorium applies at the state licensure level. It is not a federal Medicare enrollment moratorium.
While the moratorium is in effect, CDPH generally cannot issue a new home health agency license. That means applicants who are still working through the California licensure process may not be able to move forward in the same way they could before June 29, 2026.
There is also no fixed end date for the moratorium. The law ties its duration to CDPH’s development of new home health regulations. Once those regulations take effect, the moratorium must end within 90 days.
Unlike California’s hospice moratorium, the home health law does not establish a five-year minimum period. As a result, applicants should be cautious about planning around an expected reopening date. At this point, the timing depends on when the new regulations are adopted and become effective.
Are There Exceptions to the California Home Health Moratorium?
Yes there are exceptions to the 2026 California home health moratorium, but the exception is based on ‘unmet need’.
In layman’s terms, ‘unmet need’ means showing CDPH that the proposed service area does not currently have enough home health services to meet the needs of patients in that area. So, CDPH will consider the concentration of existing home health services and may request additional evidence before granting an exception.
This is one of the most important nuances in the new law: neither SB 164 nor AFL 26-28 gives home health applicants a detailed mathematical formula for calculating unmet need.
The law says applicants must demonstrate it. CDPH may consider and request additional supporting evidence. But, at this time, there is no home-health-specific calculation in these sources telling an applicant exactly how many:
- agencies,
- patients,
- referrals,
- ZIP Codes,
- miles,
- or other factors
…will automatically establish that an area has an unmet need.
An agency should not assume that:
- simply calling an area "rural,"
- identifying a shortage of its preferred referral sources,
- or showing that it personally has patients to serve
will satisfy CDPH.
What Happens to Applications That Were Already Pending on June 29, 2026?
CDPH's All Facilities Letter (AFL) provides important detail on applications that were already pending on June 29th, 2026 (the date the home health moratorium went into effect).
CDPH stated that it must stop processing new HHA licensure applications that had not been issued a license as of June 29, 2026. In our recent webinar, we described June 29th as the operative dividing line: Having an application in process is not, by itself, enough to avoid the new requirements.
Important Note: However, the AFL gives pending applicants more specific options than simply withdrawing the application.
CDPH is sending letters to applicants whose applications were pending as of June 29th. Those applicants must indicate whether they intend to withdraw or provide a justification and supporting documentation for an exception.
The response deadline is October 9, 2026. CDPH says an application will be automatically withdrawn if the applicant does not respond before then.
Applicants who had previously paid an application fee and elect to withdraw may receive a refund. However, CDPH warns that the volume of applications may cause delays. An applicant that chooses to continue through the exception process remains subject to the applicable licensing fee.
This is an area where agencies should follow the specific instructions in the letter they receive from CDPH. Do not rely on general assumptions about what happens to an application that was "almost approved."
Can Someone Still Apply for a New Home Health Agency in California After the June 29, 2026 Moratorium?
CDPH may allow new home health agency applications during the moratorium, but the process has changed.
According to CDPH, a person or entity interested in applying for new HHA licensure after June 29 should first submit an exception request to CDPH's Centralized Applications Branch (CAB). That request must include written justification and supporting documentation demonstrating unmet need based on geographic concentration. This is the exception we brought up earlier.
If CAB determines there is an unmet need, it will notify the applicant that a licensure application may then be submitted.
Again, do not assume! An applicant should not assume that the old process of simply preparing and filing a new HHA application remains available during the moratorium.
Important Note: ‘Unmet need’ is not just a temporary concept that appears only in the moratorium exception. The new standards also add unmet-need requirements to HHA and branch licensure generally, including provisional licensure and licensure through accreditation.
So, unmet need may become a significant part of California home health licensing even after the moratorium itself ends.
What Should Enrolling California Home Health Agencies Do About the Moratorium?
Agencies that are still in the application process should not assume that having an application already pending means it can continue under the old process.
Applicants should:
- follow the specific instructions they receive from CDPH,
- determine whether they intend to withdraw or pursue an exception,
- and carefully review the unmet-need requirements before submitting additional documentation.
At The Home Health Consultant, we can help agencies evaluate how the home health moratorium affects a pending or proposed home health application.
Because many of these questions are fact-specific, and because some of the implementing guidance is still developing, we recommend reviewing your specific agency’s circumstances before taking action.
Questions about how the California HHA moratorium affects your pending or planned application?
Schedule a free consultation with us to discuss your situation and how your agency may be able to move forward under the new licensure requirements.
Source note: This article is based on The Home Health Consultant's September 2026 moratorium webinar, California Health and Safety Code Chapter 8 as amended by SB 164, and CDPH AFL 26-28. Where the webinar discussed possible future requirements using the recent hospice regulations as examples.
*Disclaimer: The content provided in this article is not intended to be, nor should it be construed as, legal, financial, or professional advice. No consultant-client relationship is established by engaging with this content. You should seek the advice of a qualified attorney, financial advisor, or other professional regarding any legal or business matters. The consultant assumes no liability for any actions taken based on the information provided.
