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PCA Training Requirements Vary Significantly by State

April 10, 2013

A new PHI report offers the first-ever compilation of personal care aide (PCA) training standards for Medicaid programs from every state and Washington, DC.

The absence of PCA training standards at the federal level has created a scattered landscape of differing state-by-state training requirements, the report notes.

“Understanding what kind of training requirements exist for these workers is complicated by the fact that standards are very different from state to state,” said PHI Policy Research Analyst Abby Marquand, the author of the report. “Additionally, states usually have a variety of Medicaid programs offering personal care, with different PCA standards between programs.” 

The research was conducted by systematic searches of state regulations and statutes, Medicaid provider manuals, and Medicaid HCBS waiver documents. 

It also analyzes the training requirements through two “lenses”: 

  • Training elements: the level of training required for PCAs, ranging from full certification to no requirement at all; and
  • Training uniformity: the consistency of PCA requirements across all state Medicaid programs and populations.

Among the key findings of the report:

  • Approximately one quarter of states have a state-sponsored PCA curriculum and/or require certification in one or more personal assistance program. Meanwhile, 45 percent have no training requirements of any kind.
  • While 22 states have uniform training requirements for PCAs across all programs, only 5 of these specify detailed skills and a curriculum for PCAs.
  • Within participant-directed programs, the vast majority of states (75 percent) either leave training up to the program participant or do not address training at all.

— by Matthew Ozga

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