Category guide
Caregiver Training Requirements for Home Care, by State
Last reviewed: July 24, 2026
Medicare-certified home health aides need 75 federal training hours everywhere. For non-medical personal care aides, states range from zero required hours to full state certification programs with exams and registries.
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Reviewed quarterly by Vitable Health.
Federal baseline (applies in every state)
Federal
75-hour HHA training standard. Under 42 CFR 484.80(b), home health aides at Medicare-certified home health agencies must complete a training program of at least 75 hours, including at least 16 hours of classroom training completed before beginning at least 16 hours of supervised practical (hands-on) training.
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Competency evaluation / CNA pathway. 42 CFR 484.80(a) allows aides to qualify by completing the 75-hour training and competency evaluation program, by passing a competency evaluation alone, or by completing a state nurse aide training and competency evaluation program (CNA) and being in good standing on the state nurse aide registry.
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12-hour annual in-service. 42 CFR 484.80(d) requires home health aides to receive at least 12 hours of in-service training during each 12-month period, which may occur while the aide is furnishing care and must be supervised by a registered nurse.
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RN trainer requirements. Under 42 CFR 484.80(b)(3) and (c)(2), classroom and supervised practical training must be performed by or under the general supervision of a registered nurse with at least 2 years of nursing experience, at least 1 year of which must be in home health care; competency evaluations must likewise be performed by an RN in consultation with other professionals.
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Every state at a glance
| State | HHA hours | PCA hours | Annual in-service |
|---|---|---|---|
| Alabama | 75 (federal) | None (no state licensure) | 12 hrs/yr (federal, HHA) |
| Alaska | 75 (federal) | None (private-pay unlicensed; Medicaid PCA rules separate) | 12 hrs/yr (HHA) |
| Arizona | 75 (federal) | None (agencies unlicensed) | 12 hrs/yr (federal, HHA) |
| Arkansas | 75 (federal) | 40 (24 class + 16 practical) | 12 hrs/yr |
| California | 120 (state cert) | 5 (2 orientation + 3 safety) | 5 hrs/yr (HCA); 12 hrs/yr (HHA) |
| Colorado | 75 (federal) + CNA cert (Class A) | No hour min (topic-based + competency) | 6+ topics/yr; 12 hrs/yr (HHA) |
| Connecticut | 75 (16 clinical) | None now; 8 hrs from 1/1/2027 | 12 hrs/yr (HHA); annual CE (HCA, 2027) |
| Delaware | 75 (state + federal) | Orientation + competency test (no hour min) | 12 hrs/yr (HHA); annual competency retest (PASA) |
| District of Columbia | 75 (16 practical) | 75 (same as HHA) | 12 hrs/yr |
| Florida | 75 (Medicare/Medicaid); 40 or test (licensed-only) | None (homemakers/companions) | 12 hrs/yr HHA; ADRD 1+2 hrs; HIV/AIDS |
| Georgia | 75 (federal) | 40 hrs (20 pre-service) | 8 hrs/yr |
| Hawaii | 75 (federal) | None specified (agency-set) | Annual, no set hours |
| Idaho | 75 (federal) | None (no licensure) | 12 hrs/yr (federal HHA) |
| Illinois | 120 (CNA-based) | 8 hrs initial (HSW) | 8 hrs/yr HSW; 12 hrs/yr HHA |
| Indiana | 75 + state exam | None (agency-determined) | 12 hrs/yr (HHA) |
| Iowa | 75 (federal) | None (no licensure) | 12 hrs/yr (federal) |
| Kansas | CNA (90) + 20-hr HHA course | None (agency orientation) | 12 hrs/yr (federal) |
| Kentucky | 75 (federal) | None (orientation/competency) | 12 hrs/yr federal (+3 hrs dementia) |
| Louisiana | 75 (federal) | 16 hrs (DSW) | Annual competency eval |
| Maine | CNA required (130-hr course) | 50 hrs (PSS) | 12 hrs/yr (federal, HHAs) |
| Maryland | CNA 100 hrs (state) | CNA 100 hrs (RSA aides) | 12 hrs/yr (federal, if certified) |
| Massachusetts | 75 (federal) | None statewide (licensure bill pending) | 12 hrs/yr (federal, Medicare HHAs) |
| Michigan | 75 (federal) | None (no licensure) | 12 hrs/yr (federal, Medicare HHAs) |
| Minnesota | 75 (federal) | Orientation + competency (no set hours) | 8 hrs/yr (state) |
| Mississippi | 75 (federal) | None (not licensed) | 12 hrs/yr (federal) |
| Missouri | 75 (federal, incorporated) | 20 hrs (Medicaid); none private-pay | 12 hrs/yr (federal) |
| Montana | 75 (federal) | None (no license); Medicaid PAS agency-trained | 12 hrs/yr (federal) |
| Nebraska | 75 (federal) | None (agency-determined competency) | 12 hrs/yr (federal, HHAs) |
| Nevada | 75 (federal) | Pre-service program + CPR/first aid (no set hrs) | 8 hrs/yr (PCA); 12 hrs/yr (HHA, federal) |
| New Hampshire | LNA license (100 hrs); 75 federal | None fixed (orientation + competency) | Agency-determined; 12 hrs/yr federal (Medicare HHAs) |
| New Jersey | 76 (CHHA: 60 classroom + 16 clinical) | 76 (all aides must be CHHAs) | Ongoing in-service; 12 hrs/yr if Medicare-certified |
| New Mexico | 75 (16 practical) | No state hrs; Medicaid PCS 12 hrs/yr | 12 hrs/yr (HHA) |
| New York | 75 | 40 | 12 hrs/yr HHA; 6 hrs/yr PCA |
| North Carolina | 75 (federal) + NA registry listing | NA I listing or RN-verified competency | 12 hrs/yr (HHA, federal) |
| North Dakota | 75 (federal) | None (no state license) | 12 hrs/yr (federal HHA) |
| Ohio | 75 (federal/Medicare) | None fixed (ODH license; agency competency) | 12 hrs/yr (Medicare HHAs) |
| Oklahoma | 75 (16 practical), OSDH certification | Certified aide via OSDH registry (75) | 12 hrs/yr (federal) |
| Oregon | CNA required (155 hrs, OAR 851-061-0090) | Orientation + 8 hrs + competency eval | 6 hrs/yr (+1 hr if meds) |
| Pennsylvania | 75 (federal, Medicare-certified only) | None (competency exam or training per 611.55) | Annual competency review; no hour minimum |
| Rhode Island | CNA license (120 hrs) | CNA license (120 hrs) for hands-on care | Agency in-service; 12 hrs/yr federal |
| South Carolina | 75 (federal) | None (agency-determined) | 12 hrs/yr (HHA); topics only (IHC) |
| South Dakota | 75 (federal) | None (unlicensed) | 12 hrs/yr (federal only) |
| Tennessee | 75 incl. 16 practical | None (orientation/competency) | 12 hrs/yr (HHA only) |
| Texas | 75 (federal, L&C category) | None (agency competency, PAS) | 12 hrs/yr HHA (federal); agency-set for PAS |
| Utah | 75 (federal) | None (competency only) | 12 hrs/yr (federal) |
| Vermont | 75 (federal); LNA license | None (unlicensed) | 12 hrs/yr (federal) |
| Virginia | Nurse aide ed./CNA or competency eval | 40 hrs (Medicaid PCA) | 12 hrs/yr (certified only) |
| Washington | 75 + exam (HCA cert) | 75 + exam (HCA cert) | 12 hrs/yr CE |
| West Virginia | 75 (federal) | None (no licensure) | 12 hrs/yr (federal only) |
| Wisconsin | 75 (nurse aide + registry) | None private-pay; DHS training if Medicaid | 12 hrs/yr (federal) |
| Wyoming | CNA 75 + 16-hr HHA module | None (unlicensed) | 12 hrs/yr (federal) |
Click any state for the full requirements with citations.