Personal and Home Care Aide State Training Program (PHCAST)

In 2010, six states won three-year federal grants as part of the PHCAST program. The six states—California, Iowa, Maine, Massachusetts, Michigan, and North Carolina—are developing and testing competency-based training, assessment, and certification for personal care aides, an entry-level caregiving position for which, currently, there are no federal training standards.

According to the federal agency in charge of administering the grant program—the Health Resources and Services Administration (HRSA) — “It is expected that the training standards established under these State grants would be utilized as a ‘Gold Standard’ for future training of personal and home care.”


California developed a 25-module standardized, competency-based curriculum for PCAs, along with competency-based testing. The curriculum is adapted from PHI’s model personal care services curriculum.

North Carolina used its PHCAST grant to develop, pilot, implement, and evaluate a four-phase comprehensive training and competency program for direct-care workers. The four-phase approach provides a progression of knowledge, skills, and competencies, beginning with an introduction to direct-care, and moving through basic skills, certified nurse aide (CNA) training, and a home care nurse aide specialty. Using PHI’s 77-hour personal care services curriculum as its starting point, the PHCAST grantees designed a highly interactive, adult-learner experience, grounded in the realities of direct-care work.

Massachusetts developed a core curriculum, called the ABCs (Acquiring Basic Core Competencies) for Direct Care Workers, which consists of 13 stackable core competency modules that provide the opportunity for direct care workers to advance along a career lattice.

Michigan’s Building Training… Building Quality (BTBQ) project trained 1700 personal care aides serving participants in the MI Choice Home and Community-Based waiver program. A group of regional experts and multi-disciplinary stakeholders identified core competencies and revised the PHI model personal services curriculum to create a 22-module curriculum aligned with the state’s person-centered philosophy.

Maine’s Direct Service Worker Training Program (MDSWTP) developed a 50-hour competency-based, coordinated training program that prepares participants for specialized instruction in any of three entry-level direct service positions. The goal of this approach was to improve worker mobility across job settings by creating a core training and certification that enables cross-training and career progression for multiple categories of direct service workers serving multiple populations.

The Iowa PHCAST project, led by the Iowa Department of Public Health (IDPH), identified competencies, developed curriculum, and piloted a new career pathway for its direct-care workforce. The state plans to establish a credentialing board that will oversee and implement regulation of the direct-care profession and issue credentials.


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