title: Home care workers: interstate differences in training requirements and their implications for quality.
abstract: Home care workers, the fastest growing segment of the U.S. direct care workforce, provide nonmedical services that are not reimbursed by Medicare; consequently, requirements for training and supervision are left to the states. The purposes of this study are to compare these state requirements and to identify core competencies for home care workers. Our content analysis of relevant state laws determined that 29 states require a license for home care providers. Of these 29 states, 26 require orientation and 15 require in-service training for home care workers; the duration and content of these programs vary widely across the states. Fifteen states require on-site supervision of home care workers. We believe that in addition to current state training requirements (e.g., activities of daily living (ADLs) and instrumental activities of daily living (IADL) assistance; infection control), other core competencies (e.g., basic medication information; behavioral management) should also be mandatory. More frequent on-site supervision is also necessary to improve home care quality.
authors.affiliation: University of Nebraska at Omaha, Lincoln, NE, USA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Kelly
authors.forename: Jennifer Craft
authors.initials: JC
authors.lastname: Morgan
authors.forename: Kendra Jeanel
authors.initials: KJ
authors.lastname: Jason
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D033161:Government Regulation; D006699:Home Care Services / Q000331:legislation & jurisprudence*; D018576:Home Health Aides / Q000193:education* / Q000331:legislation & jurisprudence; D006701:Home Nursing / Q000193:education* / Q000331:legislation & jurisprudence; D006801:Humans; D008004:Licensure; D008297:Male; D008875:Middle Aged; D011361:Professional Competence; D011785:Quality Assurance, Health Care; D013219:State Government; D014481:United States; D055815:Young Adult
keywords: direct care workers; home care; home- and community-based services; state policy; workforce development