How to Become a Home Health Aide in Pennsylvania: Steps and Pay

People searching for “home health aide Pennsylvania” or “certified home health aide Allentown” usually have the same question: which job do I need? The first thing to know is that the work comes in two legal forms. One is the certified home health aide at a Medicare-certified home health agency, who completes a 75-hour federal training program. The other is the direct care worker at a licensed home care agency, where the state requires a background check, tuberculosis screening and a competency exam or training, but no certification. Most caregiver jobs in Allentown are the second kind. Here is what each path requires, what the work pays, and how to apply.

Two jobs, two sets of rules

People use “home health aide,” “caregiver,” “personal care aide” and “direct care worker” as if they were the same. In Pennsylvania they are not, and the difference decides what you must do before your first shift.

	Home health aide (HHA)	Direct care worker (DCW)
Employer	Medicare-certified home health agency	Home care agency licensed by the PA Department of Health
What the work is	Personal care as part of a nurse-supervised plan of care after a doctor’s order	Non-medical personal care and companionship: bathing, dressing, meals, mobility, medication reminders
Rule that governs training	42 CFR 484.80 (federal)	28 Pa. Code Chapter 611 (state)
Minimum training	75 hours, at least 16 in a classroom before at least 16 of supervised practical work, plus a competency evaluation	Competency exam or a training program covering required topics; no set number of hours
Ongoing	12 hours of in-service training every 12 months	Competency review at least once a year; TB documentation updated every 12 months
Who pays for it	Usually the agency or a school program	Usually the agency

The details below apply to the direct care worker path, the job most people in the Lehigh Valley are applying for. The federal certification is covered at the end.

What Pennsylvania actually requires of a direct care worker

Home care agencies in Pennsylvania are licensed by the Department of Health under 28 Pa. Code Chapter 611. The regulation sets what an agency must verify before it sends you to a client.

Interview and references. The agency must interview you in person and obtain “at least two satisfactory references”: positive, verifiable references from a former employer or someone not related to you (§ 611.51).

Criminal history. If you have lived in Pennsylvania for the past two years, you need a Pennsylvania State Police criminal history record. If less than two years, you need a federal (FBI) record plus a letter of determination from the Department of Aging. The report must be dated within one year before you apply, and an agency may not hire you if it shows a conviction prohibited under the Older Adults Protective Services Act regulations (§ 611.52). A ChildLine clearance is required only if the agency serves clients under 18.

Provisional start. You can begin while the background check is pending: up to 30 days if you have lived in Pennsylvania two years or more, 90 days if not (§ 611.54). That is why many caregivers start within a week of applying.

Competency. Before your first assignment you must hold a Pennsylvania nursing license, pass a competency exam developed by the agency, or complete an approved training program. The exam or program must cover confidentiality, consumer control, instrumental activities of daily living, recognizing changes in the client, infection control, emergencies, documentation, reporting abuse or neglect, and difficult behaviors. For personal care it must also cover bathing, grooming and dressing, skin and mouth care, walking and transfers, meals and feeding, toileting, and help with self-administered medications (§ 611.55).

Annual review. The agency must review your competency at least once a year, through observation, testing, training or client feedback. Chapter 611 does not set a number of annual training hours; the 12-hour figure you may have seen belongs to the federal home health aide rule. Your competency documentation transfers to another Pennsylvania agency if your break in employment is under 12 months.

TB screening. You must provide documentation that you were screened for tuberculosis under CDC guidelines, dated no more than one year before your start date, and update it every 12 months (§ 611.56).

What you do not need

• A CNA license. Nurse aide certification is one of several ways to meet the competency rule, not the only one. Most direct care workers in Pennsylvania qualify through the agency’s own exam or training.
• A college degree. The Bureau of Labor Statistics lists a high school diploma or equivalent as the typical entry-level education for home health and personal care aides and notes that “some positions do not require it” (BLS Occupational Outlook Handbook).
• Prior paid experience. The same BLS profile lists work experience in a related occupation as “none” and on-the-job training as “short-term.” Caring for a parent or grandparent counts for a lot in an interview.
• A car, in every case. Many agencies require one because clients are spread across Lehigh and Northampton counties; some assign clients near bus routes. Ask.
• CPR and first aid. Not in Chapter 611, but some agencies require or provide it.

What the job pays in the Lehigh Valley

The Bureau of Labor Statistics publishes wages for home health and personal care aides (occupation 31-1120) by metro area. These are the May 2025 estimates for Allentown-Bethlehem-Easton, PA-NJ, the latest available (BLS OEWS, Allentown-Bethlehem-Easton):

Measure, May 2025	Allentown-Bethlehem-Easton	Pennsylvania	United States
Employment in the occupation	12,030
Median hourly wage	$14.61	$14.14	$17.21
Mean hourly wage	$15.71
10th percentile (entry)	$13.45
90th percentile	$19.88
Mean annual wage	$32,680	$31,460	$36,120

Two things to read into those numbers. The Allentown median is above Pennsylvania’s but below the national one, and the spread between the 10th and 90th percentiles is more than six dollars an hour: experience, weekend and overnight shifts, and the agency you choose move the number. And BLS puts nursing assistants in the same metro at a median of $21.33 an hour, the usual next step for caregivers who earn a CNA.

BLS projects employment of home health and personal care aides to grow 18 percent from 2025 to 2035, with about 760,500 openings a year nationally, most of them replacing workers who leave. That is why agencies in Allentown hire year-round and why a reliable caregiver with a year of experience is rarely out of work.

How to apply, step by step

1. Gather your documents. Government photo ID, Social Security card or work authorization, and the names and phone numbers of two references who are not relatives. A high school diploma or GED if you have one.
2. Order your criminal history record if you do not have one dated within the past year. The agency will tell you how, and many run it for you. If you moved here less than two years ago, you need the FBI record through the Department of Aging instead.
3. Get a TB screening from your doctor or a clinic, dated within one year before your start date.
4. Apply. Most agencies take applications online. Ours is at /careers/, and the employment application takes about ten minutes.
5. Interview in person. Expect questions about lifting, schedules, driving, and how you would handle a client who refuses a shower. Honesty about your availability matters more than polish.
6. Take the competency exam or training. Depending on the agency this is a written test, a skills check, or a short course with a test at the end. Ask whether it is paid.
7. Orientation and first client. You are matched to a client, shown the care plan, and often shadow another caregiver on the first visit.

To see the day-to-day before you apply, read the daily routines professional caregivers recommend and our note on what good caregiver training covers.

Questions to ask an agency before you accept

• Is the competency training paid, and how long is it?
• How many hours a week can you actually give me, and are they firm?
• How far apart are clients, and is travel time between them paid?
• What is the rate for overnight, weekend and holiday shifts?
• What happens to my hours when a client goes to the hospital or passes away?
• Who do I call at 9 pm if something goes wrong in the home?
• Do you assign the same caregiver to the same client, or rotate?

A good agency answers all seven without hesitating. The best answers to the last two are a supervisor you can actually reach and the same caregiver with the same client whenever the schedule allows. Our caregiver page shows the people doing the job today.

Why people with no experience start here

The direct care worker path exists because Pennsylvania decided in 2009 that non-medical home care should be regulated for safety without requiring a clinical credential. That opened the job to people who would never have taken a semester off for a CNA: parents who need daytime hours, people changing careers at 50, recent arrivals whose foreign nursing credentials are not yet recognized, and students who want healthcare experience before nursing school.

It is also the most direct way to find out whether you like the work. The core of the job is what our personal care service page describes: helping someone bathe, dress, eat and move safely, and noticing changes. Some caregivers stay for decades. Others use it as the first step to CNA, LPN or RN. Either way, the year of experience counts.

If you want the federal home health aide certification

Medicare-certified home health agencies must comply with 42 CFR 484.80. A home health aide there must complete at least 75 hours of classroom and supervised practical training, with at least 16 hours of classroom work before at least 16 hours of supervised practical training, and pass a competency evaluation in which certain skills are checked “by observing an aide’s performance of the task with a patient or pseudo-patient.” After that, the aide needs at least 12 hours of in-service training in each 12-month period.

Home health agencies and career schools offer the program, and it also satisfies Pennsylvania’s competency rule for home care work. If you already work as a direct care worker, that experience makes the 75 hours easier.

Five paperwork mistakes that delay a first shift

Most delays between “you’re hired” and the first client are not about qualifications. They are about a folder. Chapter 611 tells the agency what it must have on file before it sends you into a home, and every missing or expired document pushes your start date back. These are the five snags that come up most, what the rule actually says, and how to avoid each one.

Mistake	What the rule says	How to avoid it
A criminal history report more than a year old	The report must be dated within one year before you apply (§ 611.52)	Order a new one at epatch.pa.gov; the state fee is $22 (PA Access to Criminal History, PATCH)
Ordering only the state check after moving to Pennsylvania less than two years ago	Newer residents need the FBI record plus a letter of determination from the Department of Aging (§ 611.52)	Get fingerprinted through the Department of Aging’s vendor first; the FBI fee is $26.20
References who are relatives, or who cannot be reached	Two “satisfactory references,” from a former employer or someone not related to you (§ 611.51)	Line up two people before you apply and tell them to expect a call
A TB screening more than a year old, or none at all	Documentation dated no more than one year before your start date, renewed every 12 months (§ 611.56)	Book the screening the same week you apply
Assuming an old competency certificate still counts	Competency documentation transfers to another agency only if your break in employment is under 12 months (§ 611.55)	Keep a copy; after a longer gap, expect to retest

On timing. The Pennsylvania State Police returns a “No Record” certificate immediately about 85 percent of the time. A request marked “under review” can take two to four weeks (Pennsylvania State Police, overview of PATCH). That is the difference between starting next week and starting next month, and it is the reason § 611.54 lets an agency hire you provisionally while the report is pending. The FBI check has its own queue, so a newcomer to the state should start there.

On the FBI check. Since 2017 the Commonwealth’s fingerprint vendor has been IDEMIA, through its IdentoGO sites, and the FBI fee rose to $26.20 on June 15, 2024 (PA Department of Aging, criminal history background checks). You register online, get fingerprinted at a site, and the result goes to the Department of Aging, which issues the letter of determination the agency needs. Ask the agency which registration code to use before you go, so the result is routed to the right program.

If you have a record. The same Department of Aging page notes that the Peake court decision invalidated the lifetime employment bans that used to follow certain convictions, and it now recommends an individualized, case-by-case risk assessment; the check itself remains mandatory. Be upfront at the interview. The agency will see the report either way, and an explanation with dates does more for you than a surprise.

Keep your own file. Chapter 611 makes the agency responsible for the documents, but a copy in your own folder is what lets you change agencies without starting over. Keep the PATCH certificate, the TB result with its date, your competency documentation and your two references’ current phone numbers. When an agency has a client waiting, the applicant whose folder is complete is the one who starts first.

The five snags above belong to the direct care worker path this article describes. If you take the home health aide Pennsylvania route instead, the 75-hour federal program comes on top of them, so ask that agency for its own document list before your first class.

Frequently asked questions