Home Health Aide Training Requirements by State
|State||Minimum Training Hours||Minimum Clinical Hours|
|District of Columbia||125||40|
Federal legislation (42 CFR 484.36) requires that Medicare-certified home health agencies employ home health aides who are trained and evaluated through training programs approved by their states. Federal regulations require that these training programs consist of at least 75 hours of training, including at least 16 hours of supervised practical or clinical training and 12 hours of continuing education per each 12-month period.
Federal regulations also list the subject areas and skills to be taught, outline the qualifications for approved trainers, and define the competency evaluation process.
In its recent report on the adequacy of the healthcare workforce for older Americans (Retooling for an Aging America, 2008), the National Academy of Medicine (formerly the Institute of Medicine) recommends that “federal requirements for the minimum training of certified nursing assistants (CNAs) and home health aides should be raised to at least 120 hours and should include demonstration of competence in the care of older adults as a criterion for certification” (Recommendation 5-1).
- 33 states do not require more than the minimum federal standard of 75 hours, a standard which has not been changed in nearly 30 years.
- Though 17 states and the District of Columbia exceed the federal minimum for training hours, only six states and the District of Columbia meet the standard suggested by the National Academy of Medicine of 120 hours.
- 15 states and the District of Columbia require more than the minimum 16 hours of clinical training, with required clinical hours ranging up to 80 hours.
- Of the 16 states exceeding the federal standard, 11 require home health aides to be certified nurse aides. An additional four states allow certified nurse aides to become certified home health aides with supplementary training.
- Federal standards for Certified Nurse Aide training have also remained at 75 hours for the past 30 years. However, 30 states and the District of Columbia have exceeded these minimum standards for certified nurse aide training hours. By comparison, relatively little progress has been made towards meeting the improved standards for Home Health Aide training recommended in the National Academy of Medicine report.
Alabama: Follows the Federal Code of Regulations: CFR Title 42, Vol. 3, 484.
Alaska: Alaska Administrative Code, Title 7, 12.519.
Arizona: Arizona Revised Statutes, Title 36, Article 2, 36.2939 (B.2.a).
Arkansas: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484.
California: California Code of Regulations, Title 22, Division 5, Chapter 6, §74747.
Colorado: Code of Colorado Regulations, 10 CCR 2505‐10 8.525.
Connecticut: Connecticut Department of Public Health Regulations, Public Health Code, Title 19‐13‐D69.
DC: District of Columbia Municipal Regulations, Title 17, Chapter 93, §9327.3.
Delaware: Delaware Administrative Code, Title 16, §4406.
Florida: Florida Administrative Code, Rule Chapter 59A‐8.0095.
Georgia: Follows Federal Code of Regulations: CFR Title 42, Vol.3, 484.
Hawaii: Hawaii Administrative Rules, Title 11, Chapter 97, Section 1.
Idaho: Idaho Administrative Code, IDAPA 16.03.07.
Illinois: Illinois Administrative Code, Title 77, §245.70; 77 IL Admin. Code §395.150.
Indiana: Indiana Code 16‐27‐1.5‐1
Iowa: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484.
Kansas: Kansas Administrative Regulations 28‐51‐100.
Kentucky: Follows Federal Code of Regulations: CFR Title 42, Vol.3, 48Louisiana: Follows Federal Code of Regulations: CFR Title 42, Vol.3, 484.
Maine: Code of Maine Rules, 10‐144, Chapter 119.
Maryland: Code of Maryland Regulations, Title 10.39.01.08.
Massachusetts: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484.
Michigan: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484.
Minnesota: Minnesota Administrative Rules, 4664.0260.
Mississippi: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484.
Missouri: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484.
Montana: Montana Department of Public Health and Human Services, Policies and Procedures, State Certification of Competency for Home Health Aides.
Nebraska: Nebraska Administrative Code, Title 175, 14‐006.04G5.
Nevada: Nevada Department of Health & Human Services, Medicaid Service Manuals, 1403.8.
New Hampshire: New Hampshire Code of Administrative Rules, Chapter He‐W 553.
New Jersey: New Jersey Administrative Code, Title 13:37‐14.4.
New Mexico: New Mexico Administrative Code, 184.108.40.206.C.
New York: New York Codes, Rules, and Regulations (NYCRR), Title 10, § 700.2., New York State Department of Health
North Carolina: Division of Medical Assistance, Medicaid Clinical Coverage Policies and Provider Manuals, Clinical Coverage Policy No.: 3A (6.2).
North Dakota: North Dakota Administrative Code, 33.03.10.1.18.
Ohio: Ohio Administrative Code, 5160-12-03.
Oklahoma: Oklahoma Administrative code, Title 310, 677-9-4.
Oregon: Oregon Administrative Rules, 410‐127‐0020.
Pennsylvania: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484.
Rhode Island: Rhode Island Rules and Regulations, R23‐17‐HNC/HC/PRO.South Carolina: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484.
South Dakota: South Dakota Administrative Code, 67‐16:05:01.
Tennessee: Rules of the Tennessee Department of Health, Board of Licensing Health Care Facilities, Chapter 1200.08.26.
Texas: Texas Administrative Code, Title 40, Part 1, Chapter 97, Sub-Chapter D, §97.701.
Utah: Utah Administrative Code, Rule R432-700-22.
Vermont: Regulations for the Designation and Operation of Home Health Agencies, Part X, 10.1.
Virginia: Virginia Administrative Code, Title 12, Agency 30, Chapter 50, Section 160.
Washington: Washington Administrative Code, 246- 335-015-23.
West Virginia: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484.
Wisconsin: Wisconsin Administrative Code, Chapter DHS 129, Certification of Programs for Training and Testing Nurse Aides, Medication Aides and Feeding Assistants, Subchapter II.
Wyoming: Wyoming Department of Health, Aging Division, Rules for Program Administration of Home Health Agencies, Chapter 9.