How to get paid for caregiving for a relative

No state requires you to obtain a license to be a family caregiver or personal care assistant. However, if you expect to be paid  through Medicare or Medicaid, federal regulations (see Title 42 CFR §484.36) require you to participate in at least 75 hours of training and either pass a proficiency assessment (test) or earn certification so you can get your medicaide payor number.

To earn certification through your state’s Department of Health Services, you might need to provide proof of training or competency through formal education and testing. You could find that your state offers or allows training and skills evaluations online.

(Keep reading to find out how to get the education hours you need and proof of certification.)

Federal legislation (42 CFR 484.36) requires that Medicare-certified home health agencies employ home health aides who are trained and evaluated through training programs approved by their state. Federal regulations require Personal Care Aides (or Personal Care Attendants, means the same thing) also have education through the state or organizations.  These training programs must consist of at least 75 hours of training.

Licensed Home Health Aides and Certified Nursing Aides (but not Personal Care Aides) must also receive at least 16 hours of supervised practical or clinical training and 12 hours of continuing education per 12 month period.

Federal regulations also list the subject areas and skills to be taught, outline the qualifications for approved trainers and define the competency evaluation process.

In its recent report on the adequacy of the healthcare workforce for older Americans (Retooling for an Aging America, 2008), the Institute of Medicine (IOM) recommends that “Federal requirements for the minimum training of certified nursing assistants (CNAs) and home health aides should be raised to at least 120 hours and should include demonstration of competence in the care of older adult as a criterion for certification” (Recommendation 5-1).  This is only a recommendation and is not yet law as of this date.

If you are a Family Caregiver or a professional Personal Care Aide and need to get educated and certified so you can get paid for the good, hard work you do, then consider getting your credentials from  Their programs meet or exceed most state and federal laws and can be taken online at your convenience.  Also, you can print out your certificate(s) for proof of education and testing as soon as you pass the required exam(s).  The Personal Care Aide Certification Program™ offered by give you the minimum 75 hours you for the non-clinical (ie., Registered Nurse supervised testing) portion of the federal requirements.

Personal Care Attendant requirements are less stringent than those for nurses or licensed  home health aides.  Find out here what the difference is between a Personal Care Aide (PCA) and a home health aide.

Insist caregivers get education. Education helps caregivers and helps the cared for.

Wouldn’t you rather have a caregiver who actually knows what to do?  Do not hire a caregiver who is not formally certified.

What are you doing to reduce elder abuse?


About Elder Care Advice blog

Get professional elder care giving advice, advocacy, education and tips for those who care for and about the frail elderly at the ElderCareAdvice blog. We are generously sponsored by Most posts are written by Cathleen V. Carr, unless attributed otherwise. We welcome relevant submissions. Submit your article and by-line for publishing consideration (no promises!) to Havi at, our own editor who will ensure submissions are given the best possible treatment and polish before publication, ensuring a professional level of publication. There is a nominal service fee involved ($45). Allow up to 30 days for publishing.
This entry was posted in Uncategorized. Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s