D.C. Moves Toward a Single Credential for Nurse Aides and Home Health Aides
On September 11, the District of Columbia Department of Health (DC Health) published a proposed rule to merge the training and credentialing requirements for Certified Nurse Aides (CNAs) and Home Health Aides (HHAs). The new, shared CNA credential—as mandated by the Certified Nurse Aide Amendment Act of 2024—will cover employment in both home care and nursing homes. Since HHAs and CNAs are currently required to complete similar but entirely separate training pathways, the shared credential will open up new opportunities for job seekers and create a more versatile direct care workforce without creating unnecessary barriers to entry into either role.
PHI advocated for the CNA Amendment Act of 2024 and supports this proposed rule. Consistent with PHI’s Universal Direct Care Workforce Model™, DC’s shared CNA credential will make it easier for qualified workers to carry their skills from one care setting to another. Aligning credentials can help create more employment options and provide a foundation for further career development. To realize these benefits, DC will still need to ensure that training is accessible and that workers have opportunities for advancement and wage growth, all of which are central goals of the Universal Direct Care Workforce Model.
The proposed rule also addresses interstate portability, which will increase workforce flexibility and mobility and help meet the growing demand for direct care services. According to the rule, CNAs in Maryland and Virginia will be considered to have met DC’s new CNA training and testing requirements, while CNAs in other states can qualify through equivalent training and testing, or work experience. In addition, the proposed rule will allow temporary certification for CNAs from Maryland and Virginia while their full certification is processing—potentially addressing unnecessary delays in recognizing interstate portability.
PHI is proud to work alongside the DC Coalition on Long-Term Care, which has long pushed for reforms to improve direct care jobs.
“This effort by DC Health to merge the DC HHA and CNA licenses via proposed rulemaking is a significant step in the right direction. This measure will help ease the District’s workforce shortage by removing unnecessary barriers to employment across care settings.” – Eric Behna, member of the coalition’s steering committee
As other states look to better align their direct care training and credentials, the District’s experience can help inform similar efforts across the country. Through our Universal Direct Care Workforce Initiative™, PHI will continue to support states in setting a new standard for how direct care careers are structured and supported and how employers and states sustain high-quality care.
