Guidance Issued on In-Service Training for PCAs, HHAs and Hospice Aides

On July 23, the state Department of Health (DOH) released a Dear Administrator Letter (DAL) on in-service training requirements for Personal Care Aides (PCAs), Home Health Aides (HHAs) and hospice aides.

According to the DAL, DOH will continue to exercise “enforcement discretion” when surveying providers for compliance with in-service training requirements for PCAs (3 hours on a semiannual basis) until December 31, 2021, and for HHAs (12 hours annually) until the end of the first full quarter following the declaration of the end of the federal Public Health Emergency (PHE). Last week, the Biden Administration renewed the federal PHE for an additional 90 days.

HCA has persistently advocated that these and other regulatory relief measures be continued even after the state public health emergency was ended, and has communicated that message via numerous phone calls to DOH and written documents. In addition, HCA organized a joint letter with other provider Associations to DOH with a similar message.

Hospice Aide In-Service and Annual Training 

DOH advises that in April 2020, the U.S. Centers for Medicare and Medicaid Services (CMS) waived the requirement that hospice aides receive at least 12 hours of training on an annual basis. Additionally, CMS modified the requirement that hospices annually assess the skills and competence of all individuals furnishing care and provide in-service training and education when required. Specifically, CMS postponed this requirement until the end of the first full quarter following the declaration of the end of the federal PHE.

As a reminder, this federal modification does not alter minimum personnel requirements set forth by 42 CFR Part 418.114, and specific hospice staff must continue to complete training and have their competencies evaluated as indicated in 42 CFR Part 418, to the extent such federal regulations have not been waived by CMS.

It is HCA’s understanding that a pending future state DAL will further address and provide clarification on hospice aide in-service training and annual supervision.

Recommended Actions

Notwithstanding these allowances, DOH strongly encourages employers to complete the annual and semi-annual in-service requirements for HHAs and PCAs as soon as is practicable and to document such training in staff personnel files. Agencies that are not currently conducting annual or semi-annual in-service training should begin planning immediately for how the agency will execute forthcoming in-services to staff at the conclusion of the PHE.

DOH also reminds employers that in-services for PCAs and HHAs can be conducted remotely or through other off-site methods such as online education. All in-service education must be done under the supervision of an RN with an opportunity for questions to be answered and must be accompanied by validation that learning occurred. Regardless of the method selected for completion of the in-service, the agency must document that the in-service was completed in each aide’s personnel file.

Questions related to this DAL and other issues should be addressed to or to 

Close Menu