Personal care aide is the fastest growing occupation in the United States, yet training standards for PCAs are lax and inconsistent, according to a new report from the Paraprofessional Healthcare Institute.

PCA training standards impact seniors who are increasingly looking for at-home care. Long-term care providers are also affected. Home health offerings have become increasingly important as operators look to forge partnerships with health systems, experts have recently noted. While training standards for certified nurse aides and home health aides are well-defined and federally regulated, PCA training programs are left to the states and, in some cases, to the PCAs’ employer.

Abby Marquand, a PHI policy research analyst, compiled the report by looking at training standards for PCAs participating in Medicaid programs.

Twenty-three states have at least one program with no specific training standards,* and 27 states task the agency-employer with setting standards, Marquand found. Training requirements are not uniform across states or even, in many cases, within states. This makes it hard for seniors to judge the qualifications of a PCA and makes it difficult for PCAs to switch jobs, Marquand noted.

Improving PCA training is likely to become even more pressing in the coming years. The number of PCAs is projected to grow 71% by 2020, according to the Bureau of Labor Statistics.

The PHI report summarizes PCA training requirements for each state and the District of Columbia. Click here to access the complete report.

*Editor’s Note: The article originally stated “twenty-three states have no specific training standards.” It has been updated to reflect that these states have at least one program with no training standards. There are 10 states with no training standards for all programs.