Thanks for posting to the Community, @scottrichins.

Right now, changing the items' status to active/inactive via import is unavailable in QBO. You can include additional details to the items before importing, but updating the status in the importing process isn't possible.

I'll take this as feedback and submit it to our product engineers. Please note the feature implementation varies on the number of customers requesting for it.

You can look for an app that can help you import status ready items in QuickBooks Apps. There you can look/enter the service available in an app in the search box like export and import.

You can refer to the article given by my colleague, @Angelyn_T above this thread. It includes there how to import products and services with sub-categories and sub-items.

Please feel free to leave a message if you have something else to add for assistance. I'm always here to help. Have a good one!