Personal Care Aide Training Requirements

A state-by-state analysis of training requirements for personal care aides.

BACKGROUND

Training for personal care aides (PCAs)—who constitute one of the largest and fastest growing occupations in the country—is not governed by any federal standards, unlike training for home health aides and nursing assistants. Instead, there is a patchwork of training requirements which vary widely across and within states—and in many cases, these requirements fall short of adequately preparing PCAs to provide high-quality care. Here, we present information on training standards for PCAs who support older adults and people with disabilities across all 50 states.

Key Findings

14 states have consistent training requirements for all agency-employed PCAs, while 7 states do not regulate training for PCAs at all. The other 29 states and the District of Columbia have varying requirements for agency-employed PCAs, depending whether they work in specific Medicaid programs or for private-pay home care agencies.
26 states require a minimum number of training hours for PCAs in at least one set of training requirements, including 15 states and the District of Columbia that require 40 or more hours of training.
34 states and the District of Columbia require PCAs to complete a competency assessment after training in at least one set of training regulations.
17 states regulate instruction methods in at least one set of regulations, including 11 states and the District of Columbia that require trainers to use a state-sponsored curriculum or curriculum outline.

Methodology

To generate this national catalogue of PCA training requirements, we reviewed Medicaid regulations, Medicaid waiver documents, Medicaid provider policy manuals, and state licensure regulations.

The focus of this research is PCAs who provide services to older adults and people with disabilities. We excluded direct support professionals, who assist people with intellectual and developmental disabilities, as they have different on-the-job responsibilities and therefore distinct training needs.

We define a “training requirement” as a set of regulations that specifies training content and/or duration. We excluded regulations that specify neither content nor duration, as well as training regulations that specify only first aid and CPR, as these skills are not specific to PCA roles.

As well as reviewing content and duration requirements, we also searched for requirements on instructor qualifications, competency assessment, portability of credentials, and continuing education. If the regulations specify these additional elements, we have included them in our findings.

For states that require PCAs to be trained as home health aides or nursing assistants, we included requirements for those occupations in our findings.

Alabama

There is one set of personal care aide training requirements in Alabama.

1. Personal Care Worker (Agency-Employed)

Description: Under state Medicaid programs, agency-employed personal care workers are required to undergo an orientation before providing services. Employers determine the content of this initial training.

Proof of Competency: No proof of competency required.

Required Duration: No training duration specified, but workers must complete 12 hours of continuing education annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. Because the state does not license home care agencies, workers employed by private-pay home care agencies are not subject to any statutory training requirements.

Alaska

There is one set of personal care aide training requirements in Alaska.

1. Personal Care Assistant (Agency-Employed)

Description: Agency-employed personal care assistants who provide Medicaid-funded services must complete training that follows a state-sponsored curriculum within their first four months of employment. Trainers may use their own curricula if they receive approval from the state. Training must be provided by a registered nurse.

Proof of Competency: Personal care assistants must pass a standardized competency exam administered by a home care agency or other training agency. After passing the test, they receive a portable certificate.

Required Duration: 40 hours.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. Because the state does not license home care agencies, workers employed by private-pay home care agencies are not subject to any statutory training requirements.

Arizona

There are two sets of personal care aide training requirements in Arizona.

1. Direct Care Worker (Agency-Employed)

Description: Under the state’s Medicaid managed long-term care system, direct care workers who are employed by home care agencies must complete a state-approved training program within 90 days of starting employment. The state provides a model curriculum, Principles of Caregiving. Although training entities may create their own curricula, they must cover the same topics as the Principles of Caregiving. At a minimum, trainers must pass the direct care worker competency test, and they are required to have one year of experience in caregiving and one year of experience teaching adults. Trainers may allow prospective direct care workers to take a challenge test.

Proof of Competency: Once direct care workers pass a standardized competency exam and skills demonstration, they are listed in a central registry. Employers may allow experienced direct care workers to skip training and take a challenge test instead.

Required Duration: Regulations do not prescribe training hours for pre-service training, but workers must complete 6 hours of continuing education annually.

2. Attendant Care Worker (Consumer-Directed)

Description: Consumer-directed attendant care workers must have valid certifications in CPR and first aid. Consumers must train their workers in universal infection-prevention precautions and the Health Insurance Portability and Accountability Act (HIPAA).

Proof of Competency: No proof of competency required.

Required Duration: No training duration specified.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers through private-pay arrangements. Because the state does not license home care agencies, workers employed by private-pay home care agencies are not subject to any statutory training requirements.

Arkansas

There are two sets of personal care aide training requirements in Arkansas.

1. Personal Care Aide (Agency-Employed)

Description: Personal care aides who are employed by any Medicaid-reimbursed home care agency must complete training in 13 detailed state-designated topics, but agencies have flexibility in crafting their curricula. Training must be provided by a registered nurse.

Proof of Competency: Home care agencies (or other training entities) must assess worker competency through a written or oral exam and a skills demonstration. Agencies have broad discretion over assessment tools. After passing the test, workers receive a portable certificate.

Required Duration: 40 hours, including 16 hours of hands-on practical training, plus 12 hours of continuing education annually.

2. In-Home Assistant (Agency-Employed)

Description: The state does not license private-pay home care agencies, but private-pay agencies that serve people age 50 and over must employ trained in-home assistants. These workers must complete training in 10 detailed competencies outlined by the state, which overlap somewhat with training requirements for aides employed by Medicaid-reimbursed agencies.

Proof of Competency: No proof of competency required. Employers are required to maintain training records and in-home assistants do not need to retrain when they start working for new employers.

Required Duration: 40 hours.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

California

There are two sets of personal care aide training requirements in California.

1. Home Care Aide (Agency-Employed)

Description: All home care agencies must by licensed by the state. They must provide new home care workers with an orientation on the role of the caregiver and basic safety precautions.

Proof of Competency: No proof of competency required.

Required Duration: 5 hours, plus 5 hours of continuing education annually.

2. Personal Care Services Worker (Agency-Employed)

Description: Individuals at high risk of admission into a skilled nursing home or who have recently transitioned out of a skilled nursing home may receive Waiver Personal Care Services (WPCS) through the Home and Community Based Alternatives Waiver or the In-Home Operations Waiver. Under these programs, home care agencies must provide personal services workers with training in seven broad topics. These requirements also apply to workers who are associated with employment agencies, which provide placement services but do not directly employ workers.

Proof of Competency: No proof of competency required.

Required Duration: 8 hours.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers through private-pay arrangements. Under the In-Home Services and Supports (IHSS) and the Multipurpose Senior Services (MPSS) Medicaid programs, county-based public authorities must provide workers with an orientation, which explains the rules and requirements for workers, but all other training must be provided by the consumer.

Colorado

There are two sets of personal care aide training requirements in Colorado.

1. Personal Care Worker (Agency-Employed)

Description: All home care agencies must be licensed by the state. All licensed home care agencies must provide an orientation in six broad topics within 45 days or hire.

Proof of Competency: No proof of competency required.

Required Duration: No training duration specified.

2. Personal Care Worker (Agency-Employed)

Description: Under Medicaid programs, agency-employed personal care workers must complete training in 19 broad topics before providing services.

Proof of Competency: No proof of competency required. However, personal care aides can forgo training by passing a skills validation test.

Required Duration: 20 hours.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

Connecticut

There are no training requirements for personal care aides in Connecticut.

Delaware

There is one set of personal care aide training requirements in Delaware.

1. Direct Care Worker (Agency-Employed)

Description: All home care agencies must be licensed by the state. Direct care workers employed by licensed home care agencies must complete training in 23 broad topics before assisting consumers. If the home care agency serves individuals with Alzheimer’s or other dementias, workers must receive specialized training in these cognitive diseases.

Proof of Competency: After completing pre-service training, workers must pass a written test developed by their employer. They must pass the exam once again every year to demonstrate their ongoing competency. Employers must maintain training records, but training is not portable among employers.

Required Duration: No training duration specified.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

District of Columbia

There is one set of personal care aide training requirements in District of Columbia.

1. Home Health Aide (Agency-Employed)

Description: Under Medicaid programs, all personal care services must be provided by licensed home health agencies and workers who provide personal care must be certified as home health aides. Trainers must use a District-sponsored curriculum, which covers 35 detailed training topics. Training must be overseen by registered nurses with two years of experience, including one year in home care. Additionally, under the District’s waiver program for older adults and people with disabilities, home care agencies are also required to cover training topics mandated by the Department of Healthcare Financing’s Long-Term Care Administration, which include person-centered care and community integration.

Proof of Competency: Workers must pass a standardized competency exam administered by a private testing company to receive certification. Certification records are maintained on a District-operated registry and are portable among employers.

Required Duration: 125 hours, including 20 hours of lab instruction and 16 hours in a clinical setting. Aides must also complete 12 hours of continuing education annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. The state only licenses home health agencies that provide nursing care, so workers employed by private-pay home care agencies that solely provide non-medical assistance are not subject to any statutory training requirements.

Florida

There is one set of personal care aide training requirements in Florida.

1. Home Health Aide (Agency-Employed)

Description: All home care agencies must be licensed as home health agencies by the state. Agency licensure regulations prescribe training on 15 broad topics for all home health aides, which include federally required topics for home health aides who provide Medicare-reimbursable services. Home health aides who are listed with nurse registries, which provide placement services but do not directly employ workers, are also subject to these training requirements. All training must be provided by a registered nurse with two years of experience, including one year in home care. Aides must also complete continuing education annually.

Proof of Competency: Home health aides must pass a standardized competency exam and skills demonstration. Testing records are maintained by home health aides and their trainers. Aides may also take a “challenge test” to be exempted from the training requirements.

Required Duration: Home health aides who provide Medicaid funded services must complete 40 hours of training. If they provide Medicare-funded services, they must complete 75 hours of training, including 16 hours in a clinical setting (in line with federal requirements).

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

Georgia

There is one set of personal care aide training requirements in Georgia.

1. Personal Care Assistant (Agency-Employed)

Description: All home care agencies must be licensed by the state. Aides employed by licensed agencies are required to complete training in nine broad topics. This training must be overseen a registered nurse. Workers must also complete annual continuing education on first aid, infection control, body mechanics, nutrition, and CPR.

Proof of Competency: No proof of competency required.

Required Duration: Personal care aides must complete 40 hours of training, including 20 hours prior to working with consumers and 20 hours within the first six months of employment. Additionally, workers must complete at least 8 hours of continuing education annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

Hawaii

There is one set of personal care aide training requirements in Hawaii.

1. Personal Care Aides (Agency-Employed)

Description: All agency-employed personal care aides must be certified as nurse aides. The state requires nurse aide training programs to cover 14 detailed topics. Instructors must be registered nurses with experience teaching adults. Training agencies may develop their own training curricula, which must be approved by the state.

Proof of Competency: Personal care aides must pass a standardized nurse aide exam, which includes a written portion and skills demonstration. Once they are listed on the state’s nurse aide registry, they are eligible for hire.

Required Duration: 100 hours, including 70 clinical hours. The first sixteen hours of training must be completed before providing services. Workers must also complete 12 hours of continuing education annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. Under the state’s Med-QUEST managed care program, homemakers primarily assist consumers with household chores, but they may also aid with activities of daily living. These workers are not subject to any training requirements.

Idaho

There are two sets of personal care aide training requirements in Idaho.

1. Personal Care Aide (Agency-Employed)

Description: All aides providing personal care services under Medicaid waiver programs must be successfully trained in 11 detailed competencies, which are delineated in the Idaho Skills Matrix. Home care agencies have flexibility in determining training methods, but training content must be approved by a registered nurse.

Proof of Competency: Personal care aides must demonstrate competency through a written test, oral exam, skills demonstration, or trainer attestation. The Idaho Skills Matrix delineates which method must be used for each skill. Some assessment tools require verification by a registered nurse. Employers must develop their own assessment tools and maintain training and testing records. Workers must retrain when they start with new employers.

Required Duration: No training duration specified.

2. Personal Care Aide (Consumer-Directed)

Description: Under Medicaid waiver programs, the Idaho Skills Matrix requires fiscal intermediaries (FIs) must train consumer-directed personal care aides in communication, documentation, confidentiality, and patient rights.

Proof of Competency: Under the guidance of an FI-employed registered nurse, consumer-directed personal care aides are required to pass a written examination or skills demonstration or provide verification of experience. Workers must retrain when they start working under a new fiscal intermediary.

Required Duration: No training duration specified.

Illinois

There are four sets of personal care aide training requirements in Illinois.

1. Home Services Worker (Agency-Employed)

Description: All private-pay home care agencies must be licensed by the state. Workers employed by these agencies are required to complete agency-provided training and an examination in 11 broad topics outlined by the state. These requirements do not extend to agencies that solely provide Medicaid-funded services.

Proof of Competency: Workers must pass an agency-developed competency exam on the first half of training before providing services to consumers. After they complete the remainder of their training, they are required to pass a second agency-developed competency exam. Training credentials are portable among employers.

Required Duration: 8 hours, with half completed prior to working with consumers and the other half occurring within the first 30 days of employment. After the first year of employment, home services workers must complete a minimum of 8 hours of continuing education, which can consist of self-study courses.

2. Homecare Aide (Agency-Employed)

Description: Under the Medicaid-funded Community Care Program, people age 60 and older can receive personal care at home from agency-employed homecare aides. Before they provide services, these workers must receive training in 21 detailed topics. Following pre-service training, aides must complete annual continuing education, which must draw from a list of 23 state-mandated topics.

Proof of Competency: Each home care agency must develop and administer a competency evaluation and maintain training records. Workers do not need to retrain if they can prove to their employers that they have received appropriate training within the past two years.

Required Duration: 24 hours. Workers must also fulfill 12 hours of annual continuing education, 9 of which must cover state-mandated topics.

3. Homemaker (Agency-Employed)

Description: Under the Medicaid-funded Home Services program, people under 60 with disabilities (and older adults who enrolled in the program before they turned 60) can receive personal care from homemaker service agencies. Agency-employed homemakers must complete pre-service training that covers their on-the-job responsibilities and the philosophy and purpose of homemaker services, as well as annual continuing education that covers disability and AIDS awareness.

Proof of Competency: No proof of competency required.

Required Duration: Regulations do not prescribe training hours for pre-service training, but workers must complete 12 hours of continuing education annually.

4. Personal Assistant (Consumer-Directed)

Description: Under the Medicaid-funded Home Services program, people with disabilities under age 60 can directly employ personal assistants. Under this program, personal assistants who work with consumers with infectious diseases are required to have knowledge of infection prevention.

Proof of Competency: Workers who need to have knowledge of infection prevention must have their competency verified by a Center for Independent Living or health care provider.

Required Duration: No required duration.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers through private-pay arrangements. Under Medicaid programs, aside from consumer-directed workers who must be trained in infection prevention, consumer-directed workers are exempt from training requirements.

Indiana

There are no training requirements for personal care aides in Indiana.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. All home care agencies must be licensed in Indiana. Under the licensure requirements, agencies must train workers, assess their competency, and document training, but they have total autonomy in meeting these general requirements. Medicaid regulations do not delineate training requirements for participating agencies.

Iowa

There is one set of personal care aide training requirements in Iowa.

1. Home Care Aide (Agency-Employed)

Description: Under Medicaid programs, all agency-employed home care aides must complete an orientation on six broad topics before they provide services.

Proof of Competency: Workers must pass a written test and skills demonstration as determined by their employer. Training is not portable among employers.

Required Duration: 13 hours, plus 12 hours of continuing education each year.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. Because the state does not license home care agencies, workers employed by private-pay home care agencies are not subject to any statutory training requirements.

Kansas

There are no training requirements for personal care aides in Kansas.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. All agencies that provide solely provide non-medical, home-based assistance with daily tasks must maintain a Class B Home Health Agency license. These agencies must include training policies and procedures with their license applications, but the state does not specify training content, assessment, or duration requirements. Medicaid regulations do not delineate training requirements for participating agencies.

Kentucky

There is one set of personal care aide training requirements in Kentucky.

1. Personal Services Attendant (Agency-Employed and Consumer-Directed)

Description: Under Medicaid programs, all personal services attendants are required to complete training using the Kentucky Department of Aging and Independent Living (DAIL) Attendant Care Training, which is a slide presentation that covers 14 detailed topics.

Proof of Competency: Attendants must pass the DAIL-developed standardized written test in their first year and annually thereafter.

Required Duration: No training duration specified.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers through private-pay arrangements. Although private-pay home care agencies must be certified by the state, their workers are not subject to any statutory training requirements.

Louisiana

There is one set of personal care aide training requirements in Louisiana.

1. Direct Service Worker (Agency-Employed)

Description: All home care agencies must be licensed in Louisiana. According to the licensure rules, direct service workers must complete training in 14 broad topics within 45 days of employment.

Proof of Competency: Providers are responsible for creating oral or written competency evaluations on the training topics required for direct care staff and must maintain training records. Workers who can prove that they completed training with a previous employer are not required to retrain.

Required Duration: 16 hours, plus 8 hours of continuing education annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers through private-pay arrangements.

Maine

There are two sets of personal care aide training requirements in Maine.

1. Personal Support Specialist (Agency-Employed)

Description: Under Medicaid programs, agency-employed personal support specialists must complete training using a state-sponsored curriculum, Introduction to Health Care and Human Services, which covers 113 detailed topics. Workers without a personal support specialist certification must enroll in training within 60 days of hire.

Proof of Competency: Within six months of hire, personal support specialists must pass a standardized examination, which includes written questions and a skills demonstration. Trained personal support specialists receive a portable certificate. Additionally, agencies must verify that personal support specialists are competent in all tasks required to assist specific consumers. Agencies must document assessment methods and results in personnel records.

Required Duration: 50 hours. New hires who have not yet obtained certification must complete 8 hours of orientation training prior to providing services.

2. Attendant (Consumer-Directed)

Description: Under Medicaid consumer-directed programs, consumers must verify workers are competent in five broad topics within 21 days of hire.

Proof of Competency: Consumers must assess worker competency through on-the-job observation, then submit a statement of competency to the state. Workers must retrain when they start working with new employers.

Required Duration: No training duration specified.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers through private-pay arrangements. Also, the state offers a non-Medicaid, state-funded personal care aide program called the Independent Support Services Program, and workers under this program are not subject to training requirements. Although all home care agencies must be licensed by the state, private-pay agencies are not subject to any training requirements under the licensure regulations.

Maryland

There is one set of personal care aide training requirements in Maryland.

1. Caregiver (Agency-Employed)

Description: Home care agencies must be licensed if they provide services to consumers who require medication management. Licensed agencies must train caregivers in seven broad topics. With approval from the state, this training can be provided by external training agencies on behalf of home care agencies.

Proof of Competency: No proof of competency required.

Required Duration: No training duration specified.

Exempted Workers: Under state Medicaid programs, personal care aides may be employed directly by consumers or by unlicensed agencies (which do not provide medication management). These workers must be trained by a registered nurse in the skills necessary to assist each consumer, but there are no requirements for training content or duration. Also, the state does not regulate training for personal care aides who are employed directly by consumers through private-pay arrangements.

Massachusetts

There are two sets of personal care aide training requirements in Massachusetts.

1. Personal Care Homemaker (Agency-Employed)

Description: Under Medicaid programs, agency-employed personal care homemakers must complete an orientation as well as training in personal care and homemaker services before providing services. This training must cover universal precautions and working with consumers who have HIV or AIDS. The state recommends trainers use the ABCs for Direct Care Workers, a state-sponsored curriculum developed under the federal Personal and Home Care Aide State Training (PHCAST) grant program.

Proof of Competency: Workers must demonstrate competency in each personal care task in a skills checklist developed by the Massachusetts Home Care Aide Council. The ABCs of Direct Care also offers guidance for instructors on assessing workers’ knowledge, skills, and attitudes through observation and testing. Trained workers will soon be listed on the state’s home care worker registry.

Required Duration: 60 hours, including the 40 hours for homemakers and the additional 20 hours on personal care. Personal care homemaker must also complete 6 hours of continuing education annually.

2. Personal Care Attendant (Consumer-Directed)

Description: Under state-funded consumer-direct programs, personal care attendants must complete an orientation within six months of employment. The content is determined by the Massachusetts Personal Care Attendant Workforce Council. Training may be provided online or in person by consumers or the local union.

Proof of Competency: No proof of competency required.

Required Duration: 3 hours.

Michigan

There is one set of personal care aide training requirements in Michigan.

1. Community Living Supports Worker (Agency-Employed and Consumer-Directed)

Description: Under the Michigan Choices Medicaid waiver, agency-employed and consumer-directed workers must have training in four broad topics prior to providing services. Most training is conducted by home care agencies or waiver agencies (the local organizations that are contracted to administer the waiver program).

Proof of Competency: No proof of competency required.

Required Duration: No training duration specified.

Exempted Workers: Aside from workers who provide services under the Medicaid Choices waiver, the state does not regulate training for personal care aides under Medicaid programs. Also, the state does not require training for workers who are paid by consumers in private-pay arrangements. Because the state does not license home care agencies, workers employed by private-pay home care agencies are not subject to any statutory training requirements.

Minnesota

There is one set of personal care aide training requirements in Minnesota.

1. Personal Care Aide (Consumer-Directed and Agency-Employed)

Description: Under state Medicaid programs, personal care aides must complete a state-sponsored online training, which covers nine broad topics. This training must be completed prior to providing services.

Proof of Competency: Personal care aides must pass an online, standardized test. Testing records are maintained by the state.

Required Duration: No training duration specified.

Mississippi

There are two sets of personal care aide training requirements in Mississippi.

1. Personal Care Attendant (Agency-Employed)

Description: Under the state’s Elderly and Disabled Medicaid waiver program, home care agencies must train personal care attendants in 12 detailed topics. In addition, agencies must provide annual continuing education on infection control, the Vulnerable Persons Act, and emergency preparedness.

Proof of Competency: Prior to working with consumers, personal care attendants must demonstrate competency in each task required to assist consumers with activities of daily living. Employers must maintain training records, but attendants must retrain when they start with new employers.

Required Duration: 40 hours.

2. Personal Care Attendant (Consumer-Directed)

Description: People with orthopedic or neurological disabilities may receive services through the state’s Independent Living Medicaid waiver program. Prior to providing care, all personal care attendants must complete training in 14 broad training topics, which overlap with requirements under the Elderly and Disabled Waiver but emphasize principles of consumer direction. The state provides a model curriculum, but training agencies may deviate from the curriculum with state approval. Training may be provided by the Mississippi Department of Rehabilitation Services (MDRS) or an agency that is qualified to train nursing assistants. Training through MDRS must be provided by the consumer and a case manager or a nurse. Agencies that provide training to nursing assistants must Personal care attendants must also complete annual continuing education on the Vulnerable Person’s Act, caregiver boundaries, and managing challenging situations.

Proof of Competency: Prior to providing personal care services, attendants must demonstrate competency in assisting with activities of daily living to consumers and an MDRS registered nurse or case manager. Training records are maintained by MDRS, but workers must retrain if they start working for a new consumer.

Required Duration: No training duration specified.

Missouri

There are two sets of personal care aide training requirements in Missouri.

1. Personal Care Aide (Agency-Employed)

Description: Under Medicaid programs, home care agencies must train personal care aides in 13 broad topics.

Proof of Competency: Within the first 30 days of employment, an aide must demonstrate competency in six tasks as described in state regulations. This assessment can take place in a consumer’s home or in a classroom setting. The assessment must be performed by a nurse, supervisor, or experienced aide (who has been employed by the agency for at least six months). Agencies must maintain documentation of all training and competency assessments.

Required Duration: 20 hours, plus 10 hours of annual continuing education. Workers must complete 8 hours of training before providing services. Agencies may waive the remaining 12 hours of training for workers who can demonstrate prior training or experience in paid caregiving.

2. Advanced Personal Care Aide (Agency-Employed)

Description: Under Medicaid programs, consumers whose services involve specialized equipment or procedures must receive assistance from advanced personal care aides. Home care agencies must provide advanced personal care aides with training on the 13 broad topics required for personal care aides plus an additional 13 advanced topics.

Proof of Competency: As well as meeting the competency requirements for basic personal care aides, advanced personal care aides must be assessed by a registered nurse on five advanced tasks in a consumer’s home. This skills assessment cannot be waived.

Required Duration: 28 hours, including 20 hours of basic personal care aide training and 8 hours of advanced training. Agencies may waive the additional hours for workers who can demonstrate prior advanced training. Workers must also complete 10 hours of annual continuing education.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. Because the state does not license home care agencies, workers employed by private-pay home care agencies are not subject to any statutory training requirements.

Montana

There is one set of personal care aide training requirements in Montana.

1. Personal Care Attendants (Agency-Employed)

Description: Under Medicaid programs, personal care attendants must complete training in 10 broad topics before they provide services. The training must be provided by a registered nurse. Regulations mandate the use of interactive instructional methods; training cannot solely comprise videos and self-study. Workers may also be required to complete continuing education on specific topics at the request of consumers.

Proof of Competency: Home care agencies must verify worker competency through written or oral testing, skills demonstrations, and/or on-the-job observations. Agencies must maintain training records and provide personal care attendants with a transferable certificate of completion.

Required Duration: 16 hours, plus 8 hours of continuing education annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. Because the state does not license home care agencies, workers employed by private-pay home care agencies are not subject to any statutory training requirements.

Nebraska

There are no training requirements for personal care aides in Nebraska.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. Home care agencies must be licensed by the state and licensed agencies must include training policies and procedures with their license applications, but the state does not specify training content, assessment, or duration requirements. Medicaid regulations do not delineate training requirements for participating agencies.

Nevada

There are two sets of personal care aide training requirements in Nevada.

1. Personal Care Attendant (Agency-Employed)

Description: All home care agencies must be licensed by the state. Licensing regulations require home care agencies to provide personal care attendants with training in six detailed topics within 12 months of providing care to consumers.

Proof of Competency: Agencies are required to evaluate personal care attendants, but they have broad discretion in how they assess worker competency. Agencies must also maintain training records, but workers must retrain when they start working with new employers.

Required Duration: Regulations do not specify initial training hours, but workers must complete 8 hours of continuing education annually.

2. Personal Assistant (Consumer-Directed)

Description: Consumers who direct their services under state Medicaid programs are supported by state-certified intermediary service organizations. According to the certification requirements, intermediary service organizations must provide training to personal assistants in nine detailed topics within 120 days of hire, or otherwise verify that consumers have provided this training.

Proof of Competency: No proof of competency required.

Required Duration: 16 hours, plus 8 hours of annual continuing education.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers through private-pay arrangements.

New Hampshire

There is one set of personal care aide training requirements in New Hampshire.

1. Personal Care Services Provider (Agency-Employed)

Description: Home care agencies must be licensed in New Hampshire. Licensure regulations require agencies to train all personal care service providers in seven broad topics prior to providing services. Workers must complete training in seven additional topics if they provide services under the Personal Care Attendant Services (PCAS) program, which serves people with disabilities who use wheelchairs.

Proof of Competency: No proof of competency required.

Required Duration: No training duration specified.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

New Jersey

There is one set of personal care aide training requirements in New Jersey.

1. Certified Homemaker-Home Health Aide (Agency-Employed)

Description: Under Medicaid programs, personal care services must be provided by certified homemaker-home health aides. To become certified, aides must complete training in 15 detailed topics. Training must be provided by a registered nurse with two years of experience, including one year in home care.

Proof of Competency: Training providers must develop and administer competency evaluations after training. Worker training credentials are portable among employers.

Required Duration: 76 hours, including 60 hours of classroom instruction and 16 hours of clinical instruction in a skills laboratory or patient care setting, plus 12 hours of continuing education annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. Because the state does not license home care agencies, workers employed by private-pay home care agencies are not subject to any statutory training requirements.

New Mexico

There are two sets of personal care aide training requirements in New Mexico.

1. Personal Care Attendant (Agency-Employed)

Description: Under the state’s managed care plan, home care agencies must train personal care attendants in 13 broad topics within three months of hire.

Proof of Competency: Workers must pass an agency-developed competency exam. The state requires agencies to maintain records of each worker’s training, but training is not portable between employers.

Required Duration: 12 hours, plus 12 hours of annual continuing education.

2. Independent Providers (Consumer-Directed)

Description: Under the Mi Via consumer-directed program, consumers must train workers in safety and prevention of abuse and neglect, or arrange for their workers to receive this training from other parties. Training records are maintained by fiscal management service providers, but workers must retrain when they start working with new employers.

Proof of Competency: No proof of competency required.

Required Duration: No training duration specified.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. Because the state does not license home care agencies, workers employed by private-pay home care agencies are not subject to any statutory training requirements.

New York

There is one set of personal care aide training requirements in New York.

1. Personal Care Aide (Agency-Employed)

Description: All home care agencies must be licensed by the state, and licensed agencies must hire certified personal care aides who are listed on the state’s Home Care Registry. To obtain certification, personal care aides must complete a training course that follows the state-sponsored Home Care Curriculum. All curricula must be approved by the state. Training must be provided by a registered nurse, a social worker, or a health economist with bachelor’s degree in a field related to human services or education.

Proof of Competency: Training agencies must assess worker competency using a state-sponsored written exam and skills demonstration. Once deemed competent, workers are listed on the state’s Home Care Registry.

Required Duration: 40 hours, with 3 hours of continuing education every six months.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

North Carolina

There are three sets of personal care aide training requirements in North Carolina.

1. In-Home Aide (Agency-Employed)

Description: All home care agencies must be licensed by the state. Licensed agencies must train in-home aides in six skills before they provide services to consumers.

Proof of Competency: No proof of competency required.

Required Duration: No training duration specified.

2. In-Home Aide, Personal Care Level II (Agency-Employed)

Description: Consumers who require assistance with one or two activities of daily living must receive level-two personal care. In-home aides who provide these services must be trained in 25 detailed training topics, including the 12 topics required for aides who provide level-one services (not described here because level-one services comprise household maintenance only, not direct hands-on assistance).

Proof of Competency: Within one year of starting employment, worker competency in all required tasks must be assessed by a registered nurse through a skills demonstration. Agencies must document worker training and competency, or may accept training verification from a previous employer or an external training agency.

Required Duration: No training duration specified, but the state recommends 59 hours of training, including 21 hours of training in level-one services.

3. In-Home Aide, Personal Care Level III (Agency-Employed)

Description: Consumers who require assistance with three or more activities of daily living must receive level-three personal care. In-home aides who provide these services must be trained in 38 detailed training topics, including the 25 topics required for aides who provide level-two services.

Proof of Competency: Within four months of starting employment, level-three in-home aides must pass a written or oral test and skills demonstration and become certified as nursing assistants. Aides who fulfill these requirements are listed on a registry.

Required Duration: 101 hours, plus 12 hours of annual continuing education.

Exempted Workers: Home care agencies may waive training for workers who solely care for their family members, although these workers must still demonstrate competency in the tasks required to assist their loved ones. The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

North Dakota

There is one set of personal care aide training requirements in North Dakota.

1. Qualified Service Provider (Consumer-Directed and Agency-Employed)

Description: All personal care assistants (whether consumer-directed or agency-employed) who provide state-funded home care must be trained in 21 skills related to assistance with activities of daily living and instrumental activities of daily living.

Proof of Competency: Personal care aides can demonstrate competence in each skill through verbal or written explanations or through skills demonstrations. The state maintains a central registry of qualified service providers who have completed these training requirements.

Required Duration: No training duration specified.

Ohio

There is one set of personal care aide training requirements in Ohio.

1. Personal Care Aide (Agency-Employed and Consumer-Directed)

Description: Under Medicaid programs, all personal care aides must complete the training required for home health aides, which must cover 13 detailed topics. Training must be administered by a registered nurse with two years of experience, including one year in home health. All training curricula must be approved by the state.

Proof of Competency: Under most Medicaid programs, personal care aides must be certified as home health aides. Under requirements for home health aides, training agencies must evaluate trainees through a written or oral exam and a skills demonstration. Under the PASSPORT Medicaid waiver for older adults, personal care aides must demonstrate their competency, but they do not need to be certified as home health aides and evaluation methods are not specified. Employers must document worker competency and training is portable among employers.

Required Duration: 75 hours, including 16 clinical hours. Aides must also complete 12 hours of continuing education annually. Under the PASSPORT Medicaid waiver for older adults, aides may forego the 16 hours of clinical instruction and continuing education.

Oklahoma

There is one set of personal care aide training requirements in Oklahoma.

1. Supportive Home Assistant (Agency-Employed)

Description: All home care agencies must be licensed by the state. Supportive home assistants employed by licensed agencies must complete training in seven broad topics before they work with consumers. Training must be provided by a registered nurse.

Proof of Competency: Supportive home assistants must pass a standardized competency exam, which must include a written or oral portion, as well as skills demonstrations. The exam must be administered by a state-approved independent testing agency. This entity must maintain a central registry of training records, which allows supportive home assistants then to forgo retraining when they change employers.

Required Duration: No training duration specified.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

Oregon

There is one set of personal care aide training requirements in Oregon.

1. Caregiver (Agency-Employed)

Description: All home care agencies must be licensed by the state. Licensure regulations require all agency-employed caregivers must complete training on 11 broad topics before they assist consumers.

Proof of Competency: Employers must determine how to evaluate caregivers and must document evaluation results. Caregivers must demonstrate their competency to each new employer, but they do not need to retrain.

Required Duration: Although home care agencies determine initial training duration, caregivers are required to complete 6 hours of continuing education annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

Pennsylvania

There are three sets of personal care aide training requirements in Pennsylvania.

1. Direct Care Worker (Agency-Employed)

Description: All home care agencies must be licensed by the state. Under licensure regulations, agency-employed direct care workers must complete training in 16 broad topics prior to assisting consumers. Under separate regulations, Medicaid-reimbursed agencies must also provide initial and annual training in six broad topics, which overlap somewhat with the 16 topics required for initial training. Medicaid-reimbursed agencies must also train workers in each skill required to assist each consumer.

Proof of Competency: All licensed home care agencies must assess worker competency and maintain competency records. However, they have broad discretion in determining competency. Training is transferable among employers.

Required Duration: No training duration specified.

2. Personal Assistance Worker (Agency-Employed)

Description: As well as the training required for all licensed home care agencies, Medicaid-reimbursed agencies must provide annual continuing education in six broad topics.

Proof of Competency: All licensed home care agencies must assess worker competency, but they have broad discretion over assessment methods. Employers must maintain competency records, and training is transferable between employers.

Required Duration: No training duration specified.

3. Individual Support Service Worker (Consumer-Directed)

Description: Consumer-directed individual support service workers must complete training in the six broad topics required for all Medicaid providers. They must complete this training initially and annually.

Proof of Competency: No proof of competency required. However, training must be verified by consumers and their fiscal management service agencies.

Required Duration: No training duration specified.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers through private-pay arrangements.

Rhode Island

There is one set of personal care aide training requirements in Rhode Island.

1. Nursing Assistant (Agency-Employed)

Description: All home care agencies must be licensed. Staff who provide personal care must be certified as nursing assistants. Training content must cover eight detailed topics, and curricula must be approved by the state. Nursing assistants must complete this training within 90 days of employment. Instructors must be registered nurses with at least two years of experience, including one year in long-term care. They must also have experience in teaching or supervision. Certain other health professionals may assist in non-clinical instruction, but these professionals must complete a course in teaching adults.

Proof of Competency: All nursing assistants must pass a competency exam and a skills demonstration within four weeks of starting employment. Training records are maintained in a central registry.

Required Duration: 120 hours, including 40 hours of clinical training. Aides must also complete 12 hours of continuing education annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

South Carolina

There are two sets of personal care aide training requirements in South Carolina.

1. Caregivers (Agency-Employed)

Description: All home care agencies must be licensed by the state. Caregivers employed by licensed agencies must complete training in eight broad topics before they work with consumers.

Proof of Competency: No proof of competency required. However, caregivers must maintain documentation of their training, which is portable among employers.

Required Duration: No training duration specified.

2. Personal Care Aide II (Agency-Employed)

Description: Under Medicaid programs, agency-employed personal care aides must complete training in seven broad topics, which overlap somewhat with training requirements under licensure regulations. Training must be provided by a registered nurse or licensed practical nurse.

Proof of Competency: All personal care aides must pass a competency evaluation before they provide services to consumers, but training agencies have broad discretion over assessment methods. Employers must document this training, and training credentials are portable among employers.

Required Duration: Training duration is not specified for initial training, but aides must complete 10 hours of continuing education annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers through private-pay arrangements, although Medicaid-reimbursed, consumer-directed workers must complete a brief training in billing practices.

South Dakota

There is one set of personal care aide training requirements in South Dakota.

1. In-Home Aide (Agency-Employed)

Description: Under Medicaid programs, agencies must document a staff training policy, including a pre-service orientation training. However, the state does not delineate training topics to be covered in this training.

Proof of Competency: No proof of competency required. Home care agencies must maintain training records for in-home aides.

Required Duration: Training duration is not specified for initial training, but aides must complete 10 hours of continuing education training annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. Because the state does not license home care agencies, workers employed by private-pay home care agencies are not subject to any statutory training requirements.

Tennessee

There are no training requirements for personal care aides in Tennessee.

Texas

There are no training requirements for personal care aides in Texas.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements. Home care agencies must be licensed by the state and licensed agencies must include training policies and procedures with their license applications, but the state does not specify training content, assessment, or duration requirements. Medicaid regulations do not delineate training requirements for participating agencies.

Utah

There is one set of personal care aide training requirements in Utah.

1. Personal Care Aide (Agency-Employed)

Description: All home care agencies must be licensed by the state. Before they work with consumers, agency-employed personal care aides must complete an orientation on three broad topics: their job duties, ethics and client rights, and prevention of abuse and neglect.

Proof of Competency: Regulations specify that home care agencies must document that personal care aides have demonstrated competency on all training topics, but they have broad discretion over how and when to assess competency. Aides must retrain when they change employers.

Required Duration: No training duration specified, but personal care aides must complete 6 hours of in-service training annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

Vermont

There are no training requirements for personal care aides in Vermont.

Exempted Workers: Medicaid-funded personal care services must be provided by home health agencies, which must be licensed by the state. However, these agencies may employ unlicensed staff to provide non-medical personal care. Agencies must train and determine competency for unlicensed staff, but specific training requirements are not specified. The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

Virginia

There is one set of personal care aide training requirements in Virginia.

1. Home Attendant (Agency-Employed)

Description: All home care agencies must be licensed by the state. All licensed agencies must train home attendants using the state-sponsored Personal Care Aide Training Curriculum. Training must be provided by a registered nurse with two years of experience.

Proof of Competency: Aides must pass a standardized written test and skills demonstration before providing services to consumers. Agencies must maintain training records, and training is transferable among employers.

Required Duration: 40 hours. Home attendants employed by Medicaid-reimbursed agencies must also complete 12 hours of continuing education annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

Washington

There are two sets of personal care aide training requirements in Washington.

1. Home Care Aide (Agency-Employed and Consumer-Directed)

Description: All home care agencies must be licensed by the state. Home care aides employed by licensed agencies and most aides who provide Medicaid consumer-directed services must complete an orientation, safety training, and basic training, which must be comprised of a core module and population-specific module. Trainers may use the state-sponsored Revised Fundamentals of Caregiving or develop their own curricula that cover the same 222 detailed topics. All curricula must be approved by the state and all training must be competency-based and adult learner-centered. State regulations prescribe detailed instructor qualifications related to experience, education, and competency in adult learner-centered teaching methods.

Proof of Competency: Home care aides must pass a standardized competency exam and skills demonstration within 200 days of hire, or within 260 days for trainees with limited English proficiency. Exam records are maintained centrally by the state.

Required Duration: 75 hours, plus 12 hours of continuing education annually.

2. Exempt Provider (Consumer-Directed)

Description: Exemptions from the basic training apply to parents who care for their adult children, adult children who care for their parents, and respite workers who work 20 hours or fewer per month. This abbreviated training must cover a consumer-specific subset of the core and population-specific topics required for the full basic training. Exempt providers must complete training within 120 days of starting to provide paid care.

Proof of Competency: No proof of competency required.

Required Duration: 30 hours. Adult children who care for their parents are also required to complete 12 hours of continuing education annually.

Exempted Workers: The state does not regulate training for personal care aides who are employed directly by consumers through private-pay arrangements.

West Virginia

There is one set of personal care aide training requirements in West Virginia.

1. Direct Care Worker (Consumer-Directed and Agency-Employed)

Description: Under Medicaid programs, all direct care workers, or personal care attendants as they are known under waiver programs, must complete training in eight broad topics prior to providing services. Under waiver programs, personal care attendants must also complete training in person-centered planning. Home care agencies must submit a curriculum on these topics to the state for approval. For agency-employed workers, training on certain topics must be covered in person by a registered nurse, whereas training on other topics may be provided online with state approval. Consumers are responsible for training workers whom they directly hire.

Proof of Competency: No proof of competency required.

Required Duration: Training duration is not specified for initial training, but aides must complete four hours of in-service training annually.

Wisconsin

There are two sets of personal care aide training requirements in Wisconsin.

1. Personal Assistance Worker (Agency-Employed)

Description: Under the Family Care Medicaid managed long-term care program for older adults and people with disabilities, workers who provide personal assistance must be trained in seven broad topics before they provide services. Agencies may waive these requirements for workers with paid caregiving experience.

Proof of Competency: No proof of competency required.

Required Duration: No training duration specified.

2. Personal Care Aide (Agency-Employed)

Description: Under the BadgerCare Plus Medicaid managed care program, which focuses on medical assistance, consumers may receive up to 250 hours of personal care annually. Under this program, agency-employed personal care aides must complete training in seven broad topics before they provide services. These topics differ from the topics required for personal assistance workers under the state’s Family Care program.

Proof of Competency: Under the observation of registered nurses, workers must demonstrate competency in performing each skill required for every consumer whom they work with.

Required Duration: No training duration specified.

Exempted Workers: Consumer-directed workers and workers employed by private-pay agencies.

Wyoming

There is one set of personal care aide training requirements in Wyoming.

1. Home Health Aide (Agency-Employed)

Description: Under Medicaid programs, personal care must be provided by agency-employed home health aides. Home health aides must first meet federal training requirements for nursing assistants, which prescribe training in seven detailed areas. Training must be provided by a registered nurse with at least two years of experience, including one year in a long-term care facility. Aides must then receive in home health-related tasks training from a registered nurse, but training topics for this supplementary training are not regulated by the state.

Proof of Competency: Home health aides must first pass a nursing assistant exam that includes a written portion and skills demonstration. For the supplementary home health training, a registered nurse must complete and submit to the state a competency attestation form. This information is stored on a state registry.

Required Duration: Home health aides must complete 91 hours of training, including 16 hours in a clinical setting and 16 hours of training specific to home health. Aides must complete 16 hours of training before any direct contact with consumers.

Exempted Workers: Because the state does not license home care agencies, workers employed by private-pay home care agencies are not subject to any statutory training requirements. The state does not regulate training for personal care aides who are employed directly by consumers under Medicaid programs or through private-pay arrangements.

Alabama

Centers for Medicaid and Medicare Services (CMS). 2018. AL SAIL Waiver. 0241.R05.00. Washington, D.C.: CMS. https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/?entry=8134.

Centers for Medicaid and Medicare Services. 2018. AL Home and Community -Based Waiver for the Elderly and Disabled. 0068.R07.00. Washington, D.C.: CMS. https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/?entry=8715.

Alaska

Alaska Administrative Code. 2018. Agency-Based Personal Care Services Program; Personal Care Assistant Education and Training Requirements. 7 AAC §125.160. http://www.akleg.gov/basis/aac.asp#7.125.160.

Alaska Department of Health and Social Services (DHSS). 2014. “Personal Care Assistance.” Anchorage, AK: DHSS.

Arizona

Arizona Health Care Cost Containment System (AHCCCS). 2014. AHCCCS Medical Policy Manual, Direct Care Worker Training and Testing Program. Phoenix, AZ: AHCCCS. https://www.azahcccs.gov/shared/Downloads/ACOM/PolicyFiles/400/429.pdf.

Arizona Health Care Cost Containment System (AHCCCS). 2014. AHCCCS Medical Policy Manual, Direct Care Services. Phoenix, AZ: AHCCCS. https://www.azahcccs.gov/shared/Downloads/MedicalPolicyManual/1200/1240-A.pdf.

Arkansas

Arkansas Division of Medical Services. 2008. Arkansas Medicaid Program Personal Care Provider Manual. Little Rock, AR: Division of Medical Services. https://cdm16039.contentdm.oclc.org/digital/collection/p16039coll3/id/265.

Arkansas Code. 2014. Training Requirements. 20 ACA §77-2303. https://advance.lexis.com/documentpage/?pdmfid=1000516&crid=fb651bf9-a474-462b-879b-8bfe73bdb76a&nodeid=AAUAAFAADAAYAAE&nodepath=%2fROOT%2fAAU%2fAAUAAF%2fAAUAAFAAD%2fAAUAAFAADAAY%2fAAUAAFAADAAYAAE&level=5&haschildren=&populated=false&title=20-77-2303.+Training+requirement.&config=00JAA2ZjZiM2VhNS0wNTVlLTQ3NzUtYjQzYy0yYWZmODJiODRmMDYKAFBvZENhdGFsb2fXiYCnsel0plIgqpYkw9PK&pddocfullpath=%2fshared%2fdocument%2fstatutes-legislation%2furn%3acontentItem%3a58VT-18M0-R03K-12MN-00008-00&ecomp=k5v8kkk&prid=cade2348-db35-4c37-af7a-2b5222d61270.

California

California Health and Safety Code. 2013. Affiliated Home Care Aides. 1796 HSC §44. https://leginfo.legislature.ca.gov/faces/codes_displayText.xhtml?lawCode=HSC&division=2.&title=&part=&chapter=13.&article=8.

Centers for Medicaid and Medicare Services. 2015. CA In-Home Operations. 0457.R02.00. Washington, D.C.: CMS. https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/?entry=8177.

Centers for Medicaid and Medicare Services. 2015. CA Nursing Facility/Acute Hospital Waiver. 0139.R05.00. Washington, D.C.: CMS. https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/?entry=8165.

Colorado

Code of Colorado Regulations. 2017. Home Care Agencies. 6 CCR §1011-11 Chapter 26. https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=7003&fileName=6%20CCR%201011-1%20Chapter%2026.

Code of Colorado Regulations. 2018. Medical Assistance. 10 CCR §2505-10. https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=6419&fileName=10%20CCR%202505-10%208.400.

Connecticut

Centers for Medicaid and Medicare Services. 2018. CT HCBS for Elders. 0140.R06.00. Washington, D.C.: CMS. https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/?entry=8681.

Delaware

Delaware Regulations. 2016. Personal Assistance Services Agencies. 4400 DR §4469. http://regulations.delaware.gov/AdminCode/title16/Department%20of%20Health%20and%20Social%20Services/Division%20of%20Public%20Health/Health%20Systems%20Protection%20(HSP)/4469.shtml.

District of Columbia

District of Columbia Municipal Regulations and District of Columbia Register. 2017. Home Health Aide Training Requirements. 17 DCMR 9327. https://www.dcregs.dc.gov/Common/DCMR/SectionList.aspx?SectionNumber=17-9327.

District of Columbia Municipal Regulations and District of Columbia Register. 2012. Home Health Aide Training Requirements. 17 DCMR §9327.

District of Columbia Municipal Regulations and District of Columbia Register. 2012. Definitions. 17 DCMR §9399. https://www.dcregs.dc.gov/Common/DCMR/SectionList.aspx?SectionNumber=17-9327.

District of Columbia Department of Health. Accessed March 25, 2019. “Search for a License.” https://doh.force.com/ver/s/.

Florida

Florida Administrative Code. 2013. Personnel. 59A FAC §8.0095. https://www.flrules.org/gateway/ruleno.asp?id=59A-8.0095.

Florida Statues. 2018. Licensure of Nurse Registries; Requirements; Penalties. 24 FS §400.506. http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0400/Sections/0400.506.html.

Florida Statues. 2018. Home Health Agencies. 24 FS §400.462. http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0400/0400.html.

Georgia

Rules and Regulations of the State of Georgia. 2017. Rules and Regulations for Private Home Care Providers. 111 GAC 8-65. http://rules.sos.state.ga.us/gac/111-8-65.

Hawaii

Centers for Medicaid and Medicare Services (CMS). 2018. QUEST Integration Medicaid Section 1115 Demonstration. Washington, D.C.: CMS. https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/hi/hi-quest-expanded-ca.pdf.

Hawaii Administrative Rules. 2018. Home Care Agencies. 11 HAR §700. https://health.hawaii.gov/opppd/files/2018/08/11-700-8-1-18.pdf.

Hawaii Department of Human Services (DHS). State Certified Nurse Aide Training Program. Honolulu, HI: DHS. https://health.hawaii.gov/opppd/files/2018/08/11-700-8-1-18.pdf.

Hawaii Administrative Rules. 2013. Requirements for Nurse Aide Certification. 16 HAR §89A-3. http://cca.hawaii.gov/pvl/files/2013/08/har_89a-c2.pdf.

Idaho

Idaho Department of Health and Welfare (DHW). 2014. Provider Training Matrix, Standards for Direct Care Staff and Allowable Tasks/Activities. Boise, ID: DHW. http://www.healthandwelfare.idaho.gov/Portals/0/Medical/MedicaidCHIP/Skills%20Matrix.pdf.

Idaho Statutes. 2000. Training of Personal Assistants. 39 IS §5605. https://legislature.idaho.gov/statutesrules/idstat/Title39/T39CH56/.

Idaho Administrative Rules. 2018. Provider Qualifications. 16 IAR §03.10.329. https://adminrules.idaho.gov/rules/current/16/160310.pdf.

Idaho Department of Health and Welfare. 2016. Idaho Health Plan Coverage. Boise, ID: Idaho Department of Health and Welfare. http://healthandwelfare.idaho.gov/Portals/0/Medical/MedicaidCHIP/Idaho%20Health%20Plan%20English.pdf.

Illinois

Illinois Administrative Code. 2015. Qualifications and Requirements for Home Services Workers. 77 IAC §245.71. http://www.ilga.gov/commission/jcar/admincode/077/077002450B00710R.html.

Illinois Administrative Code. 2015. Definitions. 77 IAC §245.20. http://www.ilga.gov/commission/jcar/admincode/077/077002450A00200R.html.

Illinois Administrative Code. 2014. Homemaker Service Provider Requirements. 77 IAC §686.200. http://www.ilga.gov/commission/jcar/admincode/089/089006860C02000R.html.

Illinois Administrative Code. 2014. Personal Assistant (PA) Requirements. 77 IAC §686.10. http://www.ilga.gov/commission/jcar/admincode/089/089006860A00100R.html.

Illinois Administrative Code. 2014. Homemaker Service Provider Requirements. 77 IAC §686.200. http://www.ilga.gov/commission/jcar/admincode/089/089002400O15350R.html.

Indiana

Indiana Code. 2018. Evaluation and Training. 16 IC §27-4-16. http://iga.in.gov/legislative/laws/2018/ic/titles/016#16-27-4.

Iowa

Iowa Administrative Code. 2018. Home Care Aide Services. 641 IAC §80.3(6). https://www.legis.iowa.gov/docs/aco/chapter/641.80.pdf.

Kansas

Kansas Statutes. 2017. Home Health Agencies Required to Be Licensed; Temporary License; Penalty for Violation. 65 KS §5102. https://www.ksrevisor.org/statutes/chapters/ch65/065_051_0002.html.

Kansas Department of Health and Environment (DHE). 2018. Kansas Licensure Home Health Agency Packet. Topeka, KS: DHE. http://www.kdheks.gov/bhfr/home_health_agencies/Kansas_HHA_Packet.pdf.

Kentucky

Kentucky Administrative Regulations. Provider Participation Requirements Excluding Participant-Directed Services. 907 KAR §7:010. https://apps.legislature.ky.gov/law/kar/907/007/010.pdf

Kentucky Cabinet for Health and Family Services, Department of Aging and Independent Living. “Attendant Care Education.” PowerPoint presentation.

Louisiana

Louisiana Administrative Code. Home and Community-Based Services Providers Licensing Standards. 48:1 LAC §5055. http://ldh.la.gov/assets/medicaid/hss/docs/HCBS/HCBS_LAC48_1_Chap50_51_Aug2018.pdf.

Maine

Code of Maine Regulations. In-Home and Community Support Services for Elderly and Other Adults. 10 CMR §149-5-63. https://www.maine.gov/sos/cec/rules/10/149/149c5-63.doc.

Maine Department of Health and Human Services (DHHS), The Division of Licensing & Regulatory Services. 2003. Introduction to Health Care and Human Services. Augusta, ME: DHHS.

Maine Department of Health and Human Services (DHHS). 2019. Consumer-Directed Attendant Services. Augusta, ME: DHHS. https://www.maine.gov/sos/cec/rules/10/144/ch101/c2s012.docx.

Maine Office of Elder Services. Section 69 Office of Elder Services Independent Support Services Program. Augusta, ME: Office of Elder Services. https://www.maine.gov/sos/cec/rules/10/149/149c5-69.doc.

Maryland

Code of Maryland Regulations. Residential Service Agencies. 10 COMAR §07.05. http://www.dsd.state.md.us/comar/SubtitleSearch.aspx?search=10.07.05*.

Massachusetts

Massachusetts Executive Office of Elder Affairs (EOEA). 2018. Homemaker Notification of Intent (NOI) Instructions for Current Providers and Prospective Bidders. Boston, MA: EOEA. https://noi.800ageinfo.com/Common/GetPubDocument?DocId=19.

Massachusetts Personal Care Attendant (PCA) Quality Home Care Workforce Council. 2016. Collective Bargaining Agreement Between the Personal Care Attendant (PCA) Quality Home Care Workforce Council and 1199SEIU United Healthcare Workers East. Boston, MA: Massachusetts PCA Quality Home Care Workforce Council. https://www.mass.gov/files/documents/2017/08/zj/pca-fully-executed-cba-2016.docx.

Michigan

Centers for Medicaid and Medicare Services (CMS). 2018. MI Choice Renewal. 0241.R05.00. Washington, D.C.: CMS. https://www.michigan.gov/documents/mdch/1915-c_HCBS_Waiver-6-2007_205659_7.pdf.

Minnesota

Minnesota Statues. 2018. Personal Care Assistance Program. 256B MS §0659. https://www.revisor.mn.gov/statutes/cite/256B.0659.

Minnesota Department of Human Services. “Individual Personal Care Assistance (PCA) Training.” Last modified September 20, 2018. https://mn.gov/dhs/partners-and-providers/training-conferences/minnesota-health-care-programs/provider-training/pca.jsp.

Mississippi

Centers for Medicaid and Medicare Services (CMS). 2017. MS Independent Living. 0255.R05.00. Washington, D.C.: CMS. https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/?entry=8604.

Centers for Medicaid and Medicare Services (CMS). 2017. MS Elderly and Disabled. 0272.R05.00. Washington, D.C.: CMS. https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/?entry=8603.

Mississippi Administrative Code. 2018. Provider Enrollment. 23 MAC §208-1.3. https://medicaid.ms.gov/wp-content/uploads/2014/01/Admin-Code-Part-208.pdf.

Mississippi Division of Medicaid. 2013. Mississippi Medicaid Provider Reference Guide for Part 208 Home and Community-Based Services. Jackson, MS: Mississippi Division of Medicaid. https://www.medicaid.ms.gov/wp-content/uploads/2014/01/Provider-Reference-Guide-208.pdf.

Missouri

MO HealthNet. 2019. Personal Care Manual. Jefferson City, MO: MO HealthNet. http://manuals.momed.com/collections/collection_per/print.pdf.

Montana

Montana Department of Public Health & Human Services (DPHHS). 2015. Community First Choice Policy Manual. Helena, MT: DPHHS. https://dphhs.mt.gov/Portals/85/sltc/documents/CommunityFirst/CFCAgencyBased/Section700/AB706.pdf.

Nebraska

Nebraska Department of Health and Human Services (HHS). 2004. Nebraska HHA Finance and Support Manual. Lincoln, NE: HHS. http://www.sos.ne.gov/rules-and-regs/regsearch/Rules/Health_and_Human_Services_System/Title-471/Chapter-15.pdf.

Nevada

Nevada Administrative Code. 2017. Attendants: Required Knowledge and Training. 449 NAC §3977. https://www.leg.state.nv.us/NAC/NAC-449.html#NAC449Sec3977.

Nevada Administrative Code. 2017. Attendants: Qualifications, Annual Training. 449 NAC §3975. https://www.leg.state.nv.us/NAC/NAC-449.html#NAC449Sec3975.

Nevada Administrative Code. 2017. Client to Serve as Managing Employer and Provide Training to Personal Assistant; Reporting of Training to Organization. 449 NAC §39519. https://www.leg.state.nv.us/NAC/NAC-449.html#NAC449Sec39519.

New Hampshire

New Hampshire Code of Administrative Rules. 2004. Personnel. He-P 822.17. https://www.dhhs.nh.gov/oos/bhfa/documents/he-p822.pdf.

New Hampshire Code of Administrative Rules. 1994. Training Requirements. He-W 552.07. http://gencourt.state.nh.us/rules/state_agencies/he-w500.html.

New Jersey

New Jersey Administrative Code. 2018. CHHA Training Program. 37 NJAC 13:37-14.4.https://www.njconsumeraffairs.gov/regulations/Chapter-37-New-Jersey-Board-of-Nursing.pdf

Code of Federal Regulations. 2001. Condition of Participation: Home Health Services. 42 CFR §484.36. https://www.law.cornell.edu/cfr/text/42/484.36.

New Jersey Statutes Annotated. 2016. Consideration as Health Care Service Firm; Terms Defined. NJSA 34:8-45.1. https://www.njconsumeraffairs.gov/Statutes/Employment-and-Personnel-Services-Law.pdf

New Jersey Division of Consumer Affairs. “Search for a Person License.” Last updated May 5, 2019. https://newjersey.mylicense.com/verification_4_6/Search.aspx?facility=N.

New Mexico

New Mexico Human Services Department (HSD) Medical Assistance Division. 2019. Managed Care Policy Manual. Santa Fe, NM: HSD. http://www.hsd.state.nm.us/uploads/files/Providers/Manuals%20and%20Guides/Managed%20Care%20Policy%20Manual/NM%20Managed%20Care%20Policy%20Manual_FINAL.pdf

New Mexico Administrative Code. 2018. Qualifications for Eligible Individual Employees, Independent Providers, Provider Agencies, And Vendors. 8 NMAC §314.6.11. http://164.64.110.134/parts/title08/08.314.0006.html.

New York

New York Consolidated Laws. Registration of Licensed Home Care Services Agencies. 36 NYCL §3605-B. https://www.nysenate.gov/legislation/laws/PBH/3605-B.

New York Consolidated Laws. Home Care Services Workers. 36 NYCL §3613. https://www.nysenate.gov/legislation/laws/PBH/3613.

New York State Department of Health (DOH). 2007. Home Care Curriculum. Delmar, NY: DOH. https://www.health.ny.gov/professionals/home_care/curriculum/docs/home_care_curriculum.pdf.

North Carolina

North Carolina General Statutes. 1991. Definitions. 131E NCGS §136. https://www.ncleg.net/EnactedLegislation/Statutes/HTML/ByChapter/Chapter_131E.html.

North Carolina Administrative Code. 2016. Personnel. 10A NCAC §13J.003. http://reports.oah.state.nc.us/ncac/title%2010a%20-%20health%20and%20human%20services/chapter%2013%20-%20nc%20medical%20care%20commission/subchapter%20j/subchapter%20j%20rules.html.

North Carolina Administrative Code. 2016. Competency Requirements. 10A NCAC §06A.0304. http://reports.oah.state.nc.us/ncac/title%2010a%20-%20health%20and%20human%20services/chapter%2006%20-%20aging%20-%20programs%20operations/subchapter%20a/subchapter%20a%20rules.pdf.

North Carolina Administrative Code. 2016. Time Frames for Completing Competency Requirements. 10A NCAC §06A.0306. http://reports.oah.state.nc.us/ncac/title%2010a%20-%20health%20and%20human%20services/chapter%2006%20-%20aging%20-%20programs%20operations/subchapter%20a/subchapter%20a%20rules.pdf.

North Carolina Division of Aging. 1992. In-Home Aide Services – Policies and Procedures. Raleigh, NC: Division of Aging. https://files.nc.gov/ncdhhs/DAAS_%20In-HomeAide_Policies_and_Procedures.pdf.

North Carolina Administrative Code. 2016. Nurse Aide I Training And Competency Evaluation. 10A NCAC §13O.0301. http://reports.oah.state.nc.us/ncac/title%2010a%20-%20health%20and%20human%20services/chapter%2013%20-%20nc%20medical%20care%20commission/subchapter%20o/subchapter%20o%20rules.html.

Code of Federal Regulations. 1991. Nurse Aide Competency Evaluation. 42 CFR §483.154. https://gov.ecfr.io/cgi-bin/text-idx?SID=5de1a5b780da0cb33cd22cd4a576ad82&mc=true&node=sp42.5.483.d&rgn=div6#se42.5.483_1154.

North Dakota

North Dakota Department of Human Services (DHS). 2010. Medicaid State Plan Personal Care Services. Bismarck, ND: DHS. http://www.nd.gov/dhs/policymanuals/53505/Content/PD/SC%20535-05%20ML3444%20MSP%20Personal%20Care.pdf.

North Dakota Administrative Code. 2018. Qualified Service Provider Standards and Agreements. 75 NDAC §03-23-07. https://www.legis.nd.gov/information/acdata/pdf/75-03-23.pdf.

North Dakota Department of Human Services. “Search Qualified Service Provider.” Accessed March 25, 2019. https://secure.apps.nd.gov/dhs/qsp/qspsearch.aspx.

Ohio

Ohio Administrative Code. 2017. Ohio Home Care Waiver Program: Eligibility and Enrollment. 5160 OAC §46-02. http://codes.ohio.gov/oac/5160-46.

Ohio Revised Code. 2015. Coverage of Home Care Attendant Services. 51 ORC §5166.30. http://codes.ohio.gov/orc/5166.

Ohio Revised Code. 2009. Home Care Attendant Services Providers. 51 ORC §5166.301. http://codes.ohio.gov/orc/5166.301.

Ohio Department of Aging (ODA). 2014. ODA Direct Service Worker Training Approval Application. Columbus, OH: ODA. https://aging.ohio.gov/Portals/0/PDF/HHATrainingProgramApp.pdf.

Ohio Department of Aging (ODA). “Home and Community-Based Services and Supports.” Last March 25, 2019. https://aging.ohio.gov/HomeCommunityCare#716104-eligibility.

Ohio Administrative Code. 2018. ODA Provider Certification: Personal Care. 173 OAC §39-02.11. http://codes.ohio.gov/oac/173-39-02.11.

Oklahoma

Oklahoma Statues. 2013. Licenses Required – Exemptions. 63 OS §1-1962. https://www.ok.gov/health2/documents/MFS%20Title%2063-1-1960.HomeCareAct.eff.11.2013.pdf.

Oklahoma Administrative Code. 2019. Requirements for Administration of the Competency Examination. 310 OS §662-6-1. http://okrules.elaws.us/oac/310:662-6-1.

Oregon

Oregon Administrative Rules. 2012. Caregiver Qualifications and Requirements. 333 OAR §536-0070. https://secure.sos.state.or.us/oard/viewSingleRule.action?ruleVrsnRsn=64930.

Pennsylvania

Pennsylvania Code. 2010. Competency Requirements. 28 Pa. Code §611.55. https://www.health.pa.gov/topics/Documents/Facilities%20and%20Licensing/Chapter611.pdf.

Pennsylvania Code. 2010. Competency Requirements. 55 Pa. Code §52.21. https://www.pacode.com/secure/data/055/chapter52/subchapBtoc.html.

Rhode Island

Rhode Island Code of Regulations. 2018. Licensing Home Nursing Care Providers and Home Care Providers. 216 RICR §40-10-17. https://rules.sos.ri.gov/regulations/part/216-40-10-17.

Rhode Island Code of Regulations. 2018. Requirements Pertaining to Nursing Assistant Training Programs. 216 RICR §40-05-22.7.1. https://rules.sos.ri.gov/regulations/part/216-40-05-22.

South Carolina

South Carolina Department of Health and Environmental Control (DHEC). 2014. Regulation 61-122 Standards for Licensing In-Home Care Providers. Columbia, SC: DHEC. https://scdhec.gov/sites/default/files/media/document/R.61-122.pdf.

South Carolina Department of Health and Human Services (DHHS). 2018. CLTC Standards for Waiver Services. Columbia, SC: DHHS. https://www.scdhhs.gov/internet/pdf/manuals/cltc/Section%206.pdf.

South Dakota

South Dakota Department of Human Services (DHS). 2018. FY2019 In-Home Provider Supplemental Provision. Pierre, SD: DHS. https://dhs.sd.gov/docs/FY%202019%20IN-HOME%20SUPPLEMENTAL%20PROVISION%20final.pdf.

Tennessee

Rules of Tennessee Department of Finance and Administration Bureau of TennCare. 2018. TennCare Long-Term Care Programs. 1200-13-01. https://publications.tnsosfiles.com/rules_all/2018/1200-13-01.20180730.pdf.

Texas

Texas Administrative Code. 2009. Staffing Policies. 40 TAC §97.245. http://txrules.elaws.us/rule/title40_chapter97_sec.97.245

Utah

Utah Administrative Code. 2019. Orientation. R432 UAC §725-8. https://rules.utah.gov/publicat/code/r432/r432-725.htm#T8.

Utah Administrative Code. 2019. Personnel. R432 UAC §725-6. https://rules.utah.gov/publicat/code/r432/r432-725.htm#T6.

Vermont

Vermont Department of Disabilities, Aging and Independent Living (DAIL). 2013. Choices for Care, Long-Term Care Medicaid Program Manual. Montpelier, VT: DAIL. https://asd.vermont.gov/sites/asd/files/documents/Section%20IV.3.%20Personal%20Care%20Services%208.13.pdf.

Regulations for the Designation and Operation of Home Health Agencies. 2007. Unlicensed Caregiver Services. 13.3. https://dail.vermont.gov/sites/dail/files//documents/Regs_Operations_of_HHA_2007.pdf.

Virginia

Virginia Administrative Code. 2015. License. 12 VAC §5-381-20. https://law.lis.virginia.gov/admincode/title12/agency5/chapter381/section20/.

Virginia Administrative Code. 2006. Home Attendants. 12 VAC §5-381-290. https://law.lis.virginia.gov/admincode/title12/agency5/chapter381/section290/.

Virginia Department of Medical Assistance Services (DMAS). 2003. Personal Care Aide Training Curriculum. Richmond, VA: DMAS. http://leg5.state.va.us/reg_agent/frmView.aspx?Viewid=3a946000964%7E1&typ=40&actno=000964&mime=application/pdf.

Virginia Administrative Code. 2011. Personal Care Services. 12 VAC §5-381-360. https://law.lis.virginia.gov/admincode/title12/agency5/chapter381/section290/.

Virginia Administrative Code. 2010. Written Policies and Procedures. 12 VAC §5-381-180. https://law.lis.virginia.gov/admincode/title12/agency5/chapter381/section290/.

Washington

Washington Administrative Code. 2018. In-Home Services Agency. 246 WAC §335-310. https://apps.leg.wa.gov/WAC/default.aspx?cite=246-335-310

Washington Administrative Code. 2019. Home and Community Services and Programs. 388 WAC §71. https://app.leg.wa.gov/wac/default.aspx?cite=388-71.

Washington Aging and Long-Term Support Administration. “Individual Providers.” Last modified May 1, 2019. https://www.dshs.wa.gov/altsa/home-and-community-services/individual-providers.

West Virginia

West Virginia Department of Health and Human Resources Bureau for Medical Services (BMS). 2016. Personal Care Services. Charleston, WV: BMS. http://dhhr.wv.gov/bms/Public%20Notices/Documents/Chapter%20517%20-%20Personal%20Care%20Services.pdf.

West Virginia Department of Health and Human Resources Bureau for Medical Services (BMS). 2015. Aged and Disabled Waiver. Charleston, WV: BMS. http://dhhr.wv.gov/bms/Provider/Documents/Manuals/Chapter_501_Aged_and_Disabled_Waiver.pdf

Wisconsin

State of Wisconsin Department of Health Services (DHS) Division of Long Term Care. 2016. Managed Care Organization Training and Documentation Standards for Supportive Home Care. Madison, WI: DHS. https://www.dhs.wisconsin.gov/publications/p01602.pdf

Wisconsin Administrative Code. 2008. Personal Care Services. DHS 107.112. http://docs.legis.wisconsin.gov/document/administrativecode/DHS%20107.112.

Wisconsin Administrative Code. 2008. Personal Care Providers. DHS 105.17. https://docs.legis.wisconsin.gov/code/admin_code/dhs/101/105.pdf#page=6.

Wyoming

Centers for Medicaid and Medicare Services (CMS). 2018. WY Long Term Care. 0236.R04.00. Washington, D.C.: CMS. https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/?entry=8670.

Wyoming Administrative Rules. 2016. Program Administration of Home Health Agencies. Chapter 9. https://health.wyo.gov/wp-content/uploads/2016/11/HLS-Rule-Ch-9-Home-Health.pdf.

Wyoming Department of Health. “CNAs.” Last updated January 19, 2017. https://health.wyo.gov/aging/hls/certified-nurse-aides/.

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