Welcome back to Care to CEO, the podcast that helps caregivers and underdogs take bold steps toward confident business ownership in the care industry! In this episode, host Crystal Smith cuts through the confusion around getting licensed —and getting paid — for a home care business. Crystal shares her personal journey, practical steps, and plenty of hard-won wisdom on how to navigate the paperwork, state requirements, and the all-important approval process to become a Medicaid or state-funded provider.
If you’ve ever felt overwhelmed by confusing government websites, unsure of what license you really need, or just stuck googling into the void, this episode is your go-to guide. Crystal walks us through the exact steps she took: choosing her business structure, opening the right doors at state agencies, leveraging mentorship, and building her network. She talked about common mistakes (so you don’t make them!), working with reviewers, setting up for renewal, and even how to diversify your funding streams. Plus, Crystal shares that sometimes “starting scared” is the best way to get going — no matter how daunting it all seems.
So whether you’re just dreaming or deep into your application, tune in for real-world tips and inspiring stories to help you launch and grow your care business. Let’s get you from uncertainty to approval, and from care to CEO — together!
Timestamps:
00:00 Overcoming Licensing Challenges
05:53 Licensing Challenges for New Businesses
08:16 Choosing a Path in Caregiving
11:23 Medicaid Payee Approval Process
15:48 Foster Care Challenges and Experiences
18:59 Medical Coding for Billing Payments
22:47 "Effective Communication and Responsiveness"
23:51 Application Process Challenges and Review
27:10 Helpful Feedback from Reviewer
33:08 Power of Mentorship
36:28 "Embracing Help and Delegation"
39:15 Affordable Help and Rachel's Book
40:59 Mentorship: Driven to Elevate Others
43:35 Embrace Action Despite Fear
How to Get Licensed and Paid as a Care Business Owner: Real-World Lessons from the Care to CEO Podcast
Starting your own care-based business can feel overwhelming — especially when navigating the maze of licensing, compliance, and finding your first source of income. In Episode 3 of the Care to CEO podcast, Crystal Smith — veteran care business owner and mentor — demystifies the process for new founders and shares her hard-earned tips for getting started, licensed, and paid.
Why Licensing is the Hardest (and Most Important) First Step
A major hurdle for new entrepreneurs in the care industry is understanding the licensing process. As Crystal shares, staring at endless paperwork and outdated state websites can be daunting. Early on, she felt overwhelmed, but breaking the process into small, daily tasks helped her keep moving. Instead of trying to figure it out all at once, she recommends focusing on just one piece at a time and not hesitating to reach out for advice.
Key Steps to Getting Licensed:
Decide Who You’ll Serve
Your target population—whether elders, individuals with developmental disabilities, or youth—will determine which state departments and requirements apply. For example, working with people with developmental disabilities often involves the Department of Developmental Disabilities, while elder care may require licensing from the Department of Aging.Choose a Business Structure
Selecting the right LLC or corporation type is crucial. Crystal learned this the hard way after initially choosing the wrong structure but corrected it by consulting her state’s Secretary of State website and the IRS for her EIN (Employer Identification Number).Prepare and Organize Documents
From diplomas to ID, insurance, and your operating policies, most state portals require extensive document uploads. Creating clear, state-compliant policies and procedures can be tedious but is the foundation of your application’s success.Set Up Finances and Insurance
Many states require proof of a certain amount of business capital (Crystal’s state asked for $10,000 for three months) and business liability insurance. These are often stumbling blocks, but finding payment plans and free resources can help reduce costs.
Crystal’s Pro Tip:
Treat your licensing application like a full-time job, and don’t be afraid to call state departments regularly for clarifications. Persistence shows professionalism and keeps your application moving.
Demystifying Getting Paid: Medicaid, State Programs, and More
Many aspiring care owners are confused about where the money comes from. Crystal clarifies: licensing bodies and payers are different. Typically, state departments issue licenses, while payers like Medicaid, specific waiver programs, foster care boards, or private families will pay you for services rendered.
Main Funding Streams:
Medicaid Waivers for those eligible, especially in elder and disability care.
State-Funded Programs (like “Passport” for elders).
County Foster Agencies for youth or foster care situations.
Private Pay families, especially for in-home or specialized care.
Setting up contracts with multiple streams brings business stability. Every program comes with its own billing system, so it’s vital to pay close attention to detail to avoid costly errors and delays in payment.
Overcoming Perfection Paralysis—Start Scared, Start Now
Feeling overwhelmed, underfunded, or unqualified is normal for new entrepreneurs. Crystal encourages would-be business owners to “start scared”—don’t wait for the perfect moment or perfect credentials. Action, not perfection, is what leads to results.
Mentorship Matters:
Crystal accelerated her journey (and those of her mentees) by seeking mentorship and leveraging others’ expertise. Connecting with experienced industry professionals can save weeks, if not months, in the application process.
Final Takeaway
The path to owning a successful care business is challenging but possible. By choosing your target population, organizing documents, persistently following up with state departments, and seeking mentorship, you can navigate licensing and set up reliable payment streams. Start before you feel ready — progress comes through imperfect action.
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Care to CEO - Podcast Show Website - https://caretoceo.com/
Crystal Smith - https://www.crystalsmithandco.com/
TopHealth - https://tophealth.care/