Caregiver training requirements by state

Requirements at a glance

We’re adding states as we verify them against the rule text. Don’t see yours? Your state health department or licensing agency publishes the rule for home care or personal care agencies.

Arizona

Arizona licenses home health agencies that primarily provide skilled nursing and therapy, and we found no separate state license, or training rule, for non-medical home care agencies. Agencies serving Arizona’s Medicaid long-term care program have their own direct care worker training requirements through AHCCCS.

California

Home care aides affiliated with a licensed Home Care Organization need at least 5 hours of entry-level training before they’re with a client: 2 hours of orientation to the aide’s role and terms of employment, and 3 hours of safety, covering basic safety precautions, emergency procedures and infection control.

Every year after that they need 5 hours on core competencies specific to the clients they serve, including client rights and safety, daily living needs, preventing and reporting abuse and neglect, personal hygiene and home care services, and safe transport if they drive clients. From January 1, 2027, the special care needs of clients with dementia is added to the annual topics. Both trainings may be done online.

Florida

Providers of only companion or homemaker services register with AHCA rather than being licensed, and companions and homemakers may not provide hands-on personal care. Hands-on care is a home health aide service, which requires a licensed home health agency and at least 40 hours of aide training or a competency test.

Florida’s dementia training law does cover companion and homemaker providers: staff with regular client contact get basic written information at hire and a free one-hour online course within 30 days, and staff who give personal care complete two more hours within seven months.

Georgia

A personal care assistant at a licensed private home care provider qualifies through a nurse aide program, a recognized competency exam or credential, or a 40-hour agency training program run by a registered nurse: 20 hours before serving clients and the other 20 within six months. No task may be assigned until the aide has been trained and shown competency in it.

Companions and sitters have no set hours but must be trained or show competency in topics such as meals, housekeeping, home safety, medical emergencies and infection control. All staff get orientation before working with clients and at least 8 hours of training a year after the first year.

Illinois

Home services workers at a licensed home services agency need at least 10 hours of initial training: 5 before their first assignment, after which they must pass the agency’s competency evaluation, and 5 more within their first 30 days, with a second evaluation. The initial topics include understanding dementia and handling challenging behaviors.

After that, workers need 10 hours every year on topics including client rights, disaster procedures, hygiene and infection control, abuse and neglect, and activities of daily living. Training has to be documented with dates, time per topic, the instructor and a signature. Illinois also has a separate dementia training rule for staff who work with clients with dementia (77 Ill. Adm. Code 973.140).

New Jersey

Aides who provide personal care through a health care service firm or a licensed agency must be certified homemaker-home health aides, which takes at least 76 hours of training (60 classroom, 16 clinical) and a competency exam. Certification renews every two years. We didn’t find a state rule setting annual in-service hours for CHHAs; the 12-hour figure often quoted comes from the federal Medicare rule below.

New York

Personal care aides employed by a licensed home care services agency complete at least 40 hours of training on the Department of Health’s standard curriculum (testing and breaks don’t count), within 90 days of starting, or pass an alternate competency demonstration. Aides must be listed on the state’s Home Care Registry. After that, personal care aides need 6 hours of in-service training a year; home health aides need 12. Orientation before care doesn’t count toward the 6.

North Carolina

North Carolina doesn’t set training hours for in-home caregivers at a licensed home care agency. A caregiver may only be assigned tasks they have demonstrated to a health care practitioner, and the agency keeps that documentation. Supervisory visits happen every 90 days, plus an annual visit with the caregiver present.

Ohio

Since October 2022, Ohio has required a nonmedical home health services license from the Department of Health for agencies providing personal care, whoever pays. The licensing rules don’t set training hours for aides. Providers certified for the Department of Aging’s programs, such as PASSPORT, have their own training and annual in-service requirements.

Pennsylvania

Direct care workers at a licensed home care agency show competency through a Pennsylvania nurse license, a competency exam, or an approved training program such as a home health aide or nurse aide program. There’s no hour count, but competency is reviewed at least once a year. Required areas include confidentiality, consumer control, recognizing changes in condition, infection control, emergencies, documentation and abuse and neglect, plus personal care skills for workers who provide it.

Tennessee

Tennessee licenses personal support services agencies. There’s no hour minimum, but before starting work each worker must demonstrate basic competency in abuse and neglect reporting, recipient rights, health precautions, personal hygiene assistance, safety and emergency procedures, and be trained on each client’s needs. Helping with medication requires training by or under a registered nurse. After that, workers get job-related training at least once a year, with no hours set.

Texas

Texas doesn’t set training hours for personal assistance services under an HCSSA license. The aide must be at least 18 (with limited exceptions) and have demonstrated competency in the tasks the supervisor assigns. Every HCSSA must provide orientation, job-specific training and a continuing, systematic training program for all staff. Certain tasks, such as tube feeding or help with medications, need a structured training and competency program and a yearly check.

Virginia

Home attendants at a licensed home care organization qualify through a nurse aide program or certification, a federal competency evaluation, or the state’s personal care aide training curriculum; the rule sets no separate hour count. Home attendants who provide personal care need 12 hours of training a year.

Washington

Long-term care workers, including home care aides, complete 75 hours of training within 120 days of hire: 5 hours before giving care (2 orientation, 3 safety) and 70 hours of basic training. Every year after that they need 12 hours of continuing education, due by the worker’s birthday.

For comparison: home health aides (Medicare)

Aides at Medicare-certified home health agencies follow a federal rule: at least 75 hours of training, including 16 hours of supervised practical training, or a competency evaluation, plus at least 12 hours of in-service training every 12 months (42 CFR 484.80). It doesn’t apply to private-pay, non-medical agencies, but it’s where many “75 hours” and “12 hours” figures come from.

Keeping training records

• Record each session’s date, topic, format, hours, instructor and result, and have the caregiver sign or initial it.
• Keep initial and annual training separate, since states count them differently.
• Keep certificates from other agencies when your state lets you accept prior training.

The free in-service training log is set up this way.

Sources

1. Arizona: A.R.S. §36-151
2. California: Cal. Health & Safety Code §1796.44
3. Florida: Fla. Stat. §400.509 and §430.5025
4. Georgia: Ga. Comp. R. & Regs. 111-8-65-.09
5. Illinois: 77 Ill. Adm. Code 245.71
6. New Jersey: N.J.A.C. 13:37-14.4
7. New York: NYS DOH PCA training program guide (18 NYCRR 505.14)
8. North Carolina: 10A NCAC 13J .1110
9. Ohio: Ohio Admin. Code 3701-60
10. Pennsylvania: 28 Pa. Code §611.55
11. Tennessee: Tenn. Comp. R. & Regs. 0940-05-38-.08
12. Texas: 26 TAC §558.404 and §558.245
13. Virginia: 12VAC5-381-290 and -360
14. Washington: RCW 74.39A.074 and 74.39A.341
15. Illinois: 77 Ill. Adm. Code 973.140 (dementia training)
16. Texas: 26 TAC §558.245 (staffing policies)
17. Florida: Fla. Stat. §400.462 (definitions)
18. Florida: Fla. Admin. Code 59A-8.0095
19. New Jersey: N.J.A.C. 13:37-14.13 (renewal)
20. New York: 10 NYCRR 766.11 (in-service hours)
21. Federal: 42 CFR 484.80 (home health aides)