ANALYSIS: States Require Little or No Training for PCAs

Twenty-three states (45 percent) have no training requirements of any kind for at least one publicly funded personal assistance program, a new PHI analysis on state training standards for personal care aides (PCAs) found.

Findings from the PHI analysis, along with three states’ experiences with establishing model statewide competency-based curricula and credentialing standards for PCAs through the Personal and Home Care Aide State Training (PHCAST) Program, were the subject of a Capitol Hill briefing on September 24.

The briefing was co-sponsored by the U.S. Senate Special Committee on Aging, the U.S. Senate Health, Education, and Labor and Pension (HELP) Committee, and PHI.

Of the states with training standards for PCAs, the standards vary widely from state to state and even lack uniformity between the publicly funded programs within each state, reported PHI Policy Research Director Dorie Seavey, who conducted the analysis with PHI Policy Research Analyst Abby Marquand.

“Our findings show that states need strong federal guidance to encourage them to adopt a ‘Gold Standard’ for PCA training,” said Seavey.

PHI Analysis

The PHI researchers found that of the states with training requirements, standards ranged widely:

• 35 percent of states have a requirement for training hours
• just 22 percent of states have state-sponsored PCA curriculum
• only 35 percent of states require an exam
• only 18 percent of states require PCA certification

Dorie Seavey, PHI Director of Policy Research

Of states that have a requirement for training hours, 68 percent require 40 hours or less of training.

The researchers also analyzed the training uniformity within the states’ programs and whether required credentials are portable across different programs or populations being served.

They found that 19 states have established uniform requirements across their different PCA programs.

However, only five specify detailed skills and a curriculum. Another four states require PCAs to complete home health aide training and competency evaluation.

Of the states with uniform requirements across their publicly funded programs, most training requirements are woefully inadequate, Seavey said.

PHCAST Program

At the briefing, representatives from North Carolina, Iowa, and California‘s PHCAST Programs — three of the six states that were awarded a three-year, federally funded PHCAST demonstration grant — reported on their progress in establishing statewide competency-based curricula and credentialing standards for PCAs.

They discussed the significant progress made in developing and testing entry-level training curricula and in-service modules. Some states have focused on articulating career pathways among direct-care occupations, while others have developed flexible modules that can supplement existing training programs. Several are also experimenting with online delivery.

Representatives of PHCAST Programs and Seavey

The PHI Workforce and Curriculum Development team has worked with several of the states to identify core competencies, adapt the PHI model personal services curriculum to meet the specific needs of the state, and develop appropriate competency testing and credentialing systems.

“Requiring that PCAs are adequately trained in every state — and uniformly trained from program to program within states — allows PCAs to work in multiple long-term care programs and settings, which helps to prepare our nation to build the workforce it needs to ensure quality care for consumers,” Seavey said.

More Information

PHI recommends that federal and state governments make several investments to address the training needs of personal care aides.

The PHI recommendations; more information on the PHI analysis on state training requirements for personal care aides, including which states require training; and the PHCAST Grantee Project Updates are available on the PHI website.

State-by-state details on the PCA training standards will also be posted on the PHI website soon.

— by Deane Beebe