Poor State Training for Personal Care Aides Leading to Home Care Crisis

State training standards for personal care aides (PCAs) are inadequate and inconsistent, say health workforce researchers.

Less than half of states, or 45%, have one or more programs with no PCA training requirements and 22% have no PCA training requirements at all, according to a recent report published by the UCSF Health Workforce Research Center on Long-Term Care (HWRC).

The report, “The National Landscape of Personal Care Aide Training Standards,” found that only four states have implemented thorough PCA training standards that are uniform across all Medicaid-funded programs.


Most state training programs for PCAs are “undeveloped” compared with standards for certified home health aides and nursing assistants, say report authors Abby Marquand, director of Policy Research at PHI, and Susan A. Chapman, co-director of the HWRC in a written statement.

“With projected demand for PCAs skyrocketing and states reporting difficulty attracting and retaining enough high-quality workers, we are fast approaching a crisis,” Marquand says. “We believe that improving training standards is a critical first step in meeting the coming demand.”

The number of people in the United States needing personal assistance services is expected to grow from 13 million in 2000 to 27 million by 2050, according to the report. And by 2020, it is estimated that 64 million Americans will be eligible for Medicare — one-third more than today.


“For the sake of these indispensible health care workers as well as the well-being of the people they care for, it is important that states bring PCA training standards up to some level of rigor and uniformity,” says HWRC Director Joanne Spetz. 

But some states do stand out as leaders in PCA training, according to a complementary research brief  “Leader States in Personal Care Aide Training Standards.” Alaska, Arizona, Arkansas, Idaho, Minnesota, Virginia and Washington have achieved rigor and consistency in their PCA training, research shows.

“The diverse routes taken by the seven leader states may prove useful starting points for those states that are developing or reforming their standards,” Marquand says.

Access both reports here.

Written by Cassandra Dowell

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