Health workers face varying types of regulation in D.C., Va., Md.

The rules in D.C., Va., Md.

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Among Washington jurisdictions, regulation of direct-care workers varies considerably.

IN MARYLAND, the Board of Nursing licenses all certified nursing assistants and home health aides. The state requires them to complete 100 hours of training. Those working in homes must receive an additional 12 hours of training annually and pass a competency evaluation. They must also undergo a criminal background check. Maryland does not set standards for personal care aides.

VIRGINIA requires that certified nurse assistants have 120 hours of training and that home health aides have the 75 hours specified by federal law. Personal care aides must have 40 hours of training if they work for a Medicaid agency. The state requires all employees of home health agencies to have a Virginia State Police check, which does not include fingerprinting.

THE DISTRICT mandates that certified nursing assistants have 120 hours of training and that home health aides and personal care aides have 75 hours. People in all three professions also must receive 12 hours of annual training and undergo a criminal background check.

— Jessica Marcy