Personal Care Aide Training Requirements: An Update

Personal care aides (PCAs) provide essential daily assistance to older adults and people with disabilities in private homes and community settings across the United States. This workforce is large and growing rapidly to meet escalating demand for home and community-based services (HCBS). Together, PCAs and home health aides (HHAs) comprise the second largest workforce in the country, and the U.S. Bureau of Labor Statistics projects that the U.S. will add 924,000 new HHA and PCA jobs between 2021 and 2031, which is more job growth than in any other occupation.

Robust entry-level and ongoing training opportunities are critical for recruiting and retaining a strong PCA workforce that is prepared to meet growing and evolving HCBS needs. Yet unlike other segments of the direct care workforce (nursing assistants and home health aides), no federal training requirements exist for PCAs. Instead, training is determined at the state or program level, resulting in a fragmented and inadequate training landscape—and inequitable access and quality for HCBS consumers.

A 2014 study found that only 4 states had implemented rigorous PCA training standards that were uniform across all Medicaid-funded programs, while 11 states had no training requirements at all. A more recent assessment found that 7 states still have no training requirements. However, thanks to increased attention on the PCA workforce shortage and the recent infusion of federal funds for HCBS through the American Rescue Plan Act, additional states are moving toward enhancing their PCA training standards and systems.


Key Objectives

This project aims to:

  • Examine training regulations in Medicaid state plans, HCBS waiver programs, and home care licensing standards for every state and the District of Columbia.
  • Assess training requirements in each state with regards to the consistency and rigor of those requirements and the portability of the required training.
  • Analyze training standards in a sub-set of “leader states” with the most consistent and rigorous requirements and portable credentials.


This study is a collaboration with PHI.

For more information, contact Susan Chapman.