Michigan One of Six States Developing Federal PCA Standards

It's the fastest-growing occupation in the United States, at a projected job increase of 70 percent from 2010 to 2020. Yet almost half of the states in the country – 23 – have no training requirements of any kind for Personal Care Aides (PCAs), the current 1.5 million workers who provide service and support to the elderly and those with disabilities.

Unlike home health aides and certified nurse aides (CNAs) employed by Medicare-certified agencies, there are no federal training standards for PCAs – many of whom utilize the same skills as those occupations. Of states with PCA training requirements, standards vary widely and have been described by the Paraprofessional Healthcare Institute (PHI) as "woefully inadequate."

A new initiative called the Personal and Home Care Aide State Training (PHCAST) Program, part of the Affordable Care Act, aims to address that problem. The program awarded a total of $4.2 million during fiscal years 2010-2012 to six states – California, Iowa, Maine, Massachusetts, Michigan and North Carolina – to develop competency-based training and credentialing systems for PCAs, with the intent that those systems will serve as models in creating federal training standards.

At a September 24 Capitol Hill briefing co-sponsored by the U.S. Senate Special Committee on Aging and U.S. Senate Health, Education, and Labor and Pension (HELP) Committee, PHI reported on the participating states' current progress in the program, including Michigan's project entitled Building Training…Building Quality (BTBQ). With the federal grant funding, Michigan is training 1,700 PCAs on 22 different modules addressing core skills and competencies. 1,300 of those PCAs will be trained in three specialized in-service topics: Prevention of Adult Abuse and Neglect, Dementia and Home Skills.

Traverse City is one of five areas in the state offering the training, with classes currently available through the Area Agency on Aging of Northwest Michigan.

"The first completed classes have graduates reporting they have been hired as PCAs," says Daniel Ochylski, RN, MSc, who is project director of of the Michigan program. "Many report they have never experienced the energy and excitement that takes place in the BTBQ classroom."

Ochylski says Michigan was a natural choice for the federal grant program, given that the state's aging and disability networks had a 10-year history already of developing training for those caring for the elderly and disabled. Because the state has minimal official training requirements, however, Ochylski says the grant gave them the opportunity to demonstrate "how a state with little formal infrastructure for training builds that infrastructure."

The goal, according to Ochlyski, is to seek ways to expand the program across the state, contribute to creating a "gold standard of training for PCAs throughout the nation," and train 47,050 PCAs here in Michigan by 2018.

At the Washington D.C. briefing, Senate Special Committee on Aging Chairman Herb Kohl noted that "we are facing severe shortages of health care workers who are adequately trained and prepared to care for older and disabled Americans." Developing a well-trained workforce, he added, by enacting uniform training standards for PCAs would help "meet this critical need" and allow Americans who require care to "live as independently as possible." BN