When people hear "government contracting" in home care, they often think of large, complex RFP responses and certifications and proposal writing teams. That is the advanced version. And it is real, and worth building toward. But it is not where most agencies start. Here is where you actually start: MEDICAID WAIVER PROVIDER ENROLLMENT In Virginia, the DD Waiver, CCC Plus Waiver, and EDCD Waiver programs all fund home care services for eligible individuals. To serve Medicaid waiver clients, you need to be enrolled as a Medicaid provider with DMAS — and in many cases, also credentialed with the managed care organizations that administer these programs. This is not the same as a competitive government contract. It is a provider enrollment — an application process that, once approved, makes you eligible to serve Medicaid-funded clients in your service area. If you are not yet enrolled with DMAS and your state's waiver programs, this is step one. Everything else comes after. IN MARYLAND, THE DDA PROCESS For agencies serving individuals with developmental disabilities in Maryland, DDA provider approval is the pathway to serving the community. Understanding the distinction between community development services, residential habilitation, and community supported living — and which your agency is licensed and staffed to provide — is essential before you pursue this route. DC DEPARTMENT ON DISABILITY SERVICES AND DEPARTMENT OF HEALTH CARE FINANCE In DC, the pathways for home care funding include DHCF's Medicaid programs and DDS for disability services. Each has its own provider enrollment process and requirements. The point: government-funded clients are available to licensed agencies. The pathway is provider enrollment, not competitive bidding — at least at first. Start with the enrollment that matches your license. Build your census there. Then consider government contracting through RFPs once you have operational history to demonstrate. One step at a time. The pathway is clear if you know where you are starting.

The intake call is not administrative. It is a sales conversation. And most home care agency owners are not treating it that way. Let me be clear: I am not suggesting you pressure anyone or use manipulative sales tactics. The families calling you are in a vulnerable moment. What I am saying is that your intake call either earns their trust and their business, or it does not — and the difference is in how you run the conversation. Here is what an effective intake call does: IT STARTS WITH LISTENING, NOT PITCHING The caller has a situation. Let them tell it. Fully. Do not interrupt to explain your services. Ask open questions: "Tell me about your mom's current situation." "What has been the most challenging part for your family?" People trust the person who listens, not the person who talks. IT DEMONSTRATES UNDERSTANDING OF THEIR SPECIFIC SITUATION After they share, reflect it back. "So it sounds like your father is recovering from a hip replacement, he lives alone, and your biggest concern is making sure he is safe at home during the day when you cannot be there. Is that right?" That reflection tells them you actually heard them — and it confirms you have the clarity to care for their loved one. IT ANSWERS THE REAL QUESTIONS BEHIND THE ASKED QUESTIONS When a family asks "How much do you charge?" they are also asking "Is this worth it?" When they ask "What happens if the caregiver does not show up?" they are asking "Can I trust you?" Answer the real question, not just the surface one. IT MAKES A CLEAR NEXT STEP Every intake call should end with a specific next action: scheduling the in-home assessment, sending the family a packet to review, or confirming a follow-up call. Never end a call with "feel free to reach out if you have questions." That is how interested families become lost leads. IT DOCUMENTS EVERYTHING The intake call is the first entry in the client file. Who called, when, what they shared, what was discussed, and what the next step is. If the call goes somewhere, you need that documentation. If it does not, you need to know why.

There is a version of marketing that does not feel like marketing. It is showing up consistently in the places where your future referral sources and clients spend their time. This is what I call the community presence play. And it is one of the most underused strategies in home care. Here is what it looks like in practice: ATTEND AREA AGENCY ON AGING EVENTS AND PROVIDER MEETINGS Your local AAA holds meetings, workshops, and provider forums. These are not just education opportunities — they are the rooms where the people who influence home care decisions in your community gather. Being a consistent, engaged presence in those rooms makes you visible in a way that a cold outreach call never will. PARTNER WITH SENIOR CENTERS Senior centers are often looking for health and wellness programming. Offer to host a free workshop — falls prevention, medication management, understanding home care options. You are providing value to their members and introducing your agency to a room full of potential clients and their families. GET INVOLVED WITH DISEASE-SPECIFIC ORGANIZATIONS Alzheimer's Association, Parkinson's Foundation, Multiple Sclerosis Society — these organizations run support groups, caregiver education events, and family resource fairs. Families attending these events are often actively navigating care decisions. Being present and helpful — not salesy — positions your agency as a trusted resource. SHOW UP AT COMMUNITY HEALTH FAIRS Health fairs at churches, community centers, and libraries attract exactly the population you serve. A simple table with agency information, a few giveaways, and a genuinely helpful conversation with attendees is low-cost and high-relationship. LINKEDIN AND LOCAL BUSINESS NETWORKS FOR B2B RELATIONSHIPS If you are building relationships with discharge planners, physicians, and elder law attorneys, LinkedIn is where you maintain those relationships between in-person meetings. Post consistently. Share useful content. Comment on posts from people in your referral network. Stay visible.

There is a misconception in home care that private pay clients are only for agencies in affluent markets or that they require a completely different operation to serve. Neither is true. Private pay clients are families who are paying out of pocket for home care — typically because they are waiting for a Medicaid waiver, their loved one does not qualify for Medicaid, or they want more hours or services than a Medicaid program covers. They are in every market, including the DMV. Here is why building a private pay pipeline matters even if you are primarily a Medicaid-funded agency: Private pay rates are typically higher than Medicaid reimbursement rates. The margin on private pay hours is better for your business. And private pay clients are not subject to MCO authorization delays, prior approval requirements, or plan enrollment issues. When they say yes, you start. How to build the pipeline: YOUR DIGITAL PRESENCE MATTERS MORE FOR PRIVATE PAY Private pay families often start with Google. "Home care for elderly parent in [your city]" is a real search that real families do at 10pm when they are trying to figure out how to help a parent who can no longer live independently. If your agency does not appear in those results, you do not exist to that family. At a minimum, you need a Google Business Profile that is complete, up to date, and has reviews. If you do not have this set up, do it this week. It is free. ELDER LAW ATTORNEYS AND FINANCIAL ADVISORS ARE UNDERUSED Families planning for long-term care often work with an attorney or financial planner who helps them understand their options. These professionals become trusted advisors for what their clients need next. Get to know two or three elder law attorneys in your market. YOUR RATES AND YOUR VALUE PROPOSITION NEED TO BE CLEAR Private pay clients are comparing you to other agencies. They are making a financial decision and a trust decision simultaneously. Your intake call, your assessment, and your written service proposal need to communicate both your professionalism and your specific value — not just your hourly rate.

There is a version of marketing that does not feel like marketing. It is showing up consistently in the places where your future referral sources and clients spend their time. This is what I call the community presence play. And it is one of the most underused strategies in home care. Here is what it looks like in practice: ATTEND AREA AGENCY ON AGING EVENTS AND PROVIDER MEETINGS Your local AAA holds meetings, workshops, and provider forums. These are not just education opportunities — they are the rooms where the people who influence home care decisions in your community gather. Being a consistent, engaged presence in those rooms makes you visible in a way that a cold outreach call never will. PARTNER WITH SENIOR CENTERS Senior centers are often looking for health and wellness programming. Offer to host a free workshop — falls prevention, medication management, understanding home care options. You are providing value to their members and introducing your agency to a room full of potential clients and their families. GET INVOLVED WITH DISEASE-SPECIFIC ORGANIZATIONS Alzheimer's Association, Parkinson's Foundation, Multiple Sclerosis Society — these organizations run support groups, caregiver education events, and family resource fairs. Families attending these events are often actively navigating care decisions. Being present and helpful — not salesy — positions your agency as a trusted resource. SHOW UP AT COMMUNITY HEALTH FAIRS Health fairs at churches, community centers, and libraries attract exactly the population you serve. A simple table with agency information, a few giveaways, and a genuinely helpful conversation with attendees is low-cost and high-relationship. LINKEDIN AND LOCAL BUSINESS NETWORKS FOR B2B RELATIONSHIPS If you are building relationships with discharge planners, physicians, and elder law attorneys, LinkedIn is where you maintain those relationships between in-person meetings. Post consistently. Share useful content. Comment on posts from people in your referral network. Stay visible.