Home Care Aide Training Standards Vary Vastly by State

Training standards for personal care aides employed through publicly-funded programs vary vastly from state to state—if any standards exist at all, finds a recent analysis from the Paraprofessional Healthcare Institute (PHI).

Despite being the fastest-growing occupation in the nation, there are no federal training requirements for personal care aides.

“Without federal training standards for PCAs, there is a scattered landscape of differing state-by-state training requirements, and where they exist, most are very minimal,” said Abby Marquand, PHI policy research analyst and author of the report, Personal Care Aide Training Requirements: Summary of State Findings.  “A well-trained workforce is important in ensuring that elders and individuals with disabilities receive the quality care they need and deserve.”


After analyzing all 50 states’ Medicaid Personal Care Option and home- and community-based waiver programs, Marquand found that 10 states (20%) have no training requirements for personal care aides in any of their programs.

Nearly half of all states (45%, or 23 states) with one or more home care programs have no training requirements of any kind, while 53% leave training standards to the discretion of the agency or employer.

Only 25 states with one or more home care programs specify required training hours for personal care aides, but of these, 14 states require no more than 40 hours of entry-level training.


Another 25 states with one or more such programs have a state-sponsored personal care aide curriculum and/or require certification.

Among states that do require training and have standards set in place, Marquand found those requirements were inconsistent across different states’ Medicaid programs and populations.

Twelve states had training programs in only some of their personal care aide programs, she found, while seven states that required training among all their programs had different training requirements across those programs.

Out of 22 states that did have uniform training requirements across all home care programs, only five specified detailed skills and included a curriculum for personal faire aides. Just four of those 22 states required personal care aides to complete home health aide training.

“Best case, if two PCAs are working in different programs but doing essentially the same work, they should encounter the same core training standards and be able to move from one program to another. That means the training should be portable across programs,” said Dorie Seavey, PHI director of policy research. “Disparate requirements across programs within a state for PCAs who perform the same work doesn’t make sense: it’s inefficient from a systems perspective, confusing for consumers and workers, and ultimately impedes the development of a stable, competent, and fluid personal assistance services workforce.”

Access the summary of PHI’s state training requirement findings.

Written by Alyssa Gerace

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