The short answer Wisconsin licenses skilled home health agencies through DHS; non-medical personal care is regulated only via Medicaid personal care agency certification, leaving private-pay non-medical care unlicensed.
What Wisconsin requires
Wisconsin
Licensing agency. The Wisconsin Department of Health Services (DHS), Division of Quality Assurance, licenses home health agencies under Wis. Stat. § 50.49 and Wis. Admin. Code ch. DHS 133.
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Non-medical status. Private-pay non-medical home care (companion/homemaker/personal care) requires no state license; agencies serving Wisconsin Medicaid personal care must instead be certified as personal care agencies under DHS 105.17.
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Renewal and surveys. Home health licenses renew annually with fees under § 50.49; DQA conducts initial and periodic surveys plus complaint investigations with plan-of-correction enforcement, and serves as the CMS certification survey agency.
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Caregiver law. Wisconsin's Caregiver Law (Wis. Stat. §§ 50.065, 48.685) requires background checks and bars specified offenses for caregivers at DHS-regulated entities, including home health agencies and Medicaid personal care agencies.
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The federal baseline (applies in every state)
Federal
No federal home care license. There is no federal license for home care or home health agencies. Licensure is a state function: each state (and DC) decides whether and how to license home health agencies and non-medical personal care/companion agencies, so requirements vary dramatically by jurisdiction.
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Medicare certification (42 CFR Part 484). Agencies that bill Medicare for skilled home health must be certified as meeting the Medicare Conditions of Participation at 42 CFR Part 484 (patient rights, comprehensive assessment, QAPI, skilled professional services, home health aide standards, and more), on top of any state license.
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Accreditation with deemed status. Most new Medicare home health agencies obtain certification through a CMS-approved accrediting organization with deeming authority — ACHC, CHAP, or The Joint Commission — whose surveys substitute for the state agency's Medicare certification survey.
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State survey agencies enforce both. State survey agencies (usually the state health department) operate under agreements with CMS to survey Medicare-certified agencies, and most also run the state licensure survey program — initial surveys, renewal/recertification surveys, complaint investigations, and plan-of-correction enforcement per the CMS State Operations Manual.
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