State Training Standards for Personal Care Aides Inadequate and Inconsistent, Say Health Workforce Researchers Reports issued by UCSF Health Workforce Research Center on Long-Term Care encourage states to improve training requirements, cite seven “leader states” as examples
The vast majority of states have extremely weak or non-existent standards for training personal care aides (PCAs), while a few states do better, according to the authors of two complementary research reports issued by the UCSF Health Workforce Research Center on Long-Term Care (HWRC).
Personal care aides provide the majority of care at home for older Americans and persons with disabilities, according to the US Bureau of Labor Statistics.
A report titled “The National Landscape of Personal Care Aide Training Standards” concluded that less than half of states (45 percent) have one or more programs with no PCA training requirements and 22 percent have no PCA training requirements at all. Only four states have implemented rigorous PCA training standards that are uniform across all Medicaid-funded programs.
Authors Abby Marquand, MPH, director of Policy Research at PHI (formerly the Paraprofessional Healthcare Institute) and Susan A. Chapman, PhD, RN, FAAN, co-director of the HWRC, said that most state training programs for PCAs are “undeveloped” compared with standards for certified home health aides and nursing assistants.
“With projected demand for PCAs skyrocketing and states reporting difficulty attracting and retaining enough high-quality workers, we are fast approaching a crisis,” said Marquand. “We believe that improving training standards is a critical first step in meeting the coming demand.”
According to the report, 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. Demographers estimate that by 2020, 64 million Americans will be eligible for Medicare ― one third more than today.
As defined in the reports, PCAs provide essential supports and services that enable older adults and people with disabilities to remain living safely at home and engaged with their communities. These include paramedical services such as oral medication administration and dressing changes; assistance with activities of daily living, including bathing, dressing, preparing meals and shopping; and support for community participation.
HWRC Director Joanne Spetz, PhD, FAAN, observed, “The need for PCAs is predicted to increase almost 50 percent between now and 2022. For the sake of these indispensable 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.”
A companion research brief, “Leader States in Personal Care Aide Training Standards,” describes the approaches of seven “leader states” Alaska, Arizona, Arkansas, Idaho, Minnesota, Virginia and Washington that Marquand and Chapman credit as having achieved rigor and consistency in their PCA training programs.
“There is no ‘one size fits all’ approach to improving standards,” said Chapman. “All of these states provide different examples for how to begin to go about this process.”
“The diverse routes taken by the seven leader states may prove useful starting points for those states that are developing or reforming their standards,” concluded Marquand.
The reports are available at
http://healthworkforce.ucsf.edu/news/read-our-first-reports and were funded by the U.S. National Center for Health Workforce Analysis.
They are the inaugural reports issued by the HWRC, which was created to examine the supply, demand, distribution and capacity of the health care workforce to meet the needs of older adults and persons with disabilities.
PHI works to transform eldercare and disability services, fostering dignity, respect, and independence―for all who receive care, and all who provide it. The nation's leading authority on the direct-care workforce, PHI promotes quality direct-care jobs as the foundation for quality care.
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