The New York Times, February 25th, 2011

When the Direct Care Alliance first offered the test that would lead to
becoming a credentialed “personal care and support professional,” Maria
Frank, a 60-year-old home care aide in Nazareth, Pa., signed up.

She didn’t need the certificate to land a job; she’d been on the job
for more than two decades, and for the past 13 years had cared for the
elderly through Home Instead, the national home care franchise. It was
mostly for her own satisfaction that she wanted to pass the test.

“It was hard,” reported Ms. Frank. “It’s a pretty long test.” Two
hours, to be precise. But like 80 percent of the first 100 workers who
took the test in a pilot project, she passed. Her certificate — her
first professional credential — is in the mail.

The Direct Care Alliance,
which represents hands-on employees who care for the elderly and
disabled in facilities and in people’s homes, sees this credentialing
process as key to elevating the home care work force. “These workers
have a lot of knowledge and skills, but they don’t have a way to prove
it,” said Helen Hanson, professional development manager at the
alliance. “The credential is a way to show employers and prospective
employers their professionalism.”

For the elderly and their families, finding competent, caring home
care aides can be a daunting task. Do they go with someone advertising
on Craigslist, hoping her references are reliable? Or hire through an
agency, trusting that it has thoroughly vetted its employees? They’ll
pay more for agency people, but the workers themselves will take home
much less, and agency rules — many prohibit aides from driving their
clients, for instance — may not dovetail with an elder’s needs. Yet
hiring independently, unless an aide is already well known to the
community, can be a scary prospect.

Even the nomenclature is confusing: there are personal care
attendants and home care aides and home health aides. (And one wishes
that the alliance hadn’t selected such a mouthful — “personal care and
support professional” — for its new credential.)

But this is a field that resists standardization. Training and
certification requirements for home care aides remain a hodgepodge.
Thirty-five states regulate home care agencies and set varying
requirements for their workers, said Bill Dombi, vice president for law
at the National Association for Home Care and Hospice, which has also
operated a certification program (currently suspended) for Medicare home
health aides. But 15 have no regulations for agencies. And very few
states regulate individual caregivers at all.

So a national credential for home care workers makes sense. The
welter of state regulations may limit the usefulness of the Direct Care
Alliance’s new testing program, said Marla Lahat, executive director of
Home Care Partners, a nonprofit agency in Washington. Employers must
still hire only a certified nursing assistant to comply with state laws.

But she thought the alliance’s credential could be a big help to
independent aides who don’t work for agencies or to workers in states
without such regulations. “They can say, ‘I’m not just a baby sitter or a
housekeeper. I have skills. I passed a test,’ ” Ms. Lahat said.

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