New performance audit finds reduction in test sites, long delays are barriers for prospective home care aides

The Office of the Washington State Auditor's new performance audit – I-1163: Addressing testing barriers for home care aides – found that home care aides face several barriers to becoming certified, including access to fewer tests sites and long testing delays.

A two-page summary of the key findings can be found here and the full report can be found here.

Since our 2016 audit on home care aide certification requirements, the number of regional test sites has dropped by 20 percent. We found applicants in many communities – including Aberdeen, Longview, Moses Lake, Pullman, Vancouver and Walla Walla – live outside a one-hour drive of a test site. Additionally, many existing sites offered applicants fewer available testing dates because they require a minimum number of people to schedule a test date. The overall number of people applying to test dropped due to COVID-19 waivers during the pandemic.

The reduction in test sites and available testing dates poses challenges for prospective home care aides across the state, especially those in rural areas. The Seattle Times recently reported that caregivers are increasingly difficult to find in rural parts of Washington where many residents 65 and older live. The decline in available home care aides and testing sites is likely to concern local governments, in part because it means that Washington's aging population will have inequitable access to home care services based on where they live.

In addition to fewer testing sites and dates, home care aide applicants experience long wait times for testing. The longer applicants have to wait to test, the less likely they are to pass. Even before the COVID-19 pandemic disrupted testing, only one-third of applicants tested within the Department of Health's expected time frame – which totals almost 60 days between training and testing.

With the need for caregivers growing across Washington, the audit warns that the Department must do more to help applicants test promptly. The audit recommends legislators and state leaders with the authority to remove or lessen certification barriers do so, while continuing to ensure home care aides are properly trained. Concrete steps such as establishing more test sites and reducing delays between the completion of training and scheduling a certification test would result in a greater number of qualified home care aides available in communities across Washington.