- Bureau of Health Professions Licensure
The Executive Office of Health and Human Services (EOHHS) and the Department of Public Health (DPH) are releasing a new curriculum framework to support enhanced training and certification of Certified Nurse Aides (CNAs) across the Commonwealth.
Please click here to access the State-Approved CNA Curriculum Framework and Associated Learning Objectives.
Overview:
The Commonwealth is advancing the Direct Care Worker Career Pathway Initiative, which aims to modernize training standards, strengthen career pathways, and support a more sustainable direct care workforce.
The Direct Care Worker Career Pathway Initiative is a multi-discipline, multi-year effort, which will be rolled out in phases. Initial efforts are focused on preparing Certified Nursing Aide training providers with updated curriculum and exam requirements while laying the groundwork for future phases that will support the existing workforce.
The revised curriculum and exam requirements represent the first time the Department of Public Health has established a unified set of training expectations for the state’s CNAs that formally build upon federal standards. This framework was developed in partnership with industry, education, and workforce experts across the state to elevate the essential caregiving role direct care workers provide across home and community-based settings. It builds upon the state’s successful PHCAST training program, which provides accessible, web-enhanced training for homemakers and personal care homemakers.
This memo provides a high-level overview of anticipated changes for training providers. Additional detailed guidance will be issued throughout 2026.
Training Provider Requirements & Timeline:
DPH-approved training providers and education partners will be required to update curricula to align with the revised State-Approved CNA Curriculum Framework and Associated Learning Objectives, linked above. These curriculum updates are intended to align with planned revisions to the state Nurse Aide credentialing exam. Revised exams are expected to roll out in early 2027.
Training providers are also expected to align programs to new minimum training hours. DPH will be increasing the required minimum training hours from the federal standard of 75 hours to 87 hours, including 21 hours of supervised practical training. Many approved programs already exceed this minimum training hour threshold and will continue to have discretion to do exceed the minimum hours.
Curriculum Framework Highlights:
The new CNA curriculum framework adopts a holistic approach to training the next generation of Massachusetts Nurse Aides and provides a foundational skill set that supports care delivery across:
- Home-based care
- Long-term care
- Assisted living
- Community-based settings
The framework directs CNA training programs to expand content in key skill areas, including:
- Behavioral and mental health
- Community inclusion
- Care of LGBTQ+ older adults
- Person-centered care
- Cross-setting caregiving skills
These enhancements will equip newly trained professionals to provide high-quality care and meet the diverse needs of the Commonwealth’s aging population. A consistent statewide curriculum framework will also support career advancement into more advanced direct care and nursing roles.
CNAs who are currently in good standing on the Massachusetts Nurse Aide Registry will not be required to complete additional training. Additionally, Massachusetts Home Health Aides will not be required to take action.
Transition Support & Resources:
To support implementation, the Commonwealth is developing online learning modules to be delivered through a dynamic Learning Management System (LMS) to be deployed in 2026.
Key features:
- More than 40 hours of knowledge-based content
- Available in English, Spanish, and Haitian Creole
- Designed to supplement in-person skills training
- Offered at no cost to DPH-approved CNA training programs that opt in
The LMS will serve as a free, complementary tool to existing training programs, enhancing provider resources, expanding accessibility, and increasing training capacity across geographic and language barriers.
Future Phases:
Future phases will include expedited bridge training pathways for Home Health Aides and Personal Care Homemakers. These bridge training programs aim to create clear, attainable career pathways for direct care workers seeking to advance their skills and pursue expanded opportunities. These changes are for CNAs and will not impact current Home Health Aide training or position attainment.
Ongoing Communication and Stakeholder Engagement Sessions:
Additional guidance — including implementation details, timelines, and future training pathways — will be released in phases. We will be facilitating a series of stakeholder engagement sessions with training organizations, providers, workforce partners, and Home Health Agencies to drive deployment awareness, understanding and gather feedback.
This next phase of engagement will ensure all impacted parties are fully aware of upcoming changes, understand available deployment resources and have the opportunity engage with project leadership.
To support ongoing communication:
- A dedicated initiative webpage will launch this spring
- The page will serve as a central hub for updates, resources, and announcements
- Stakeholders will be able to submit questions, provide feedback, and sign up for updates
- Will post Stakeholder Engagement Session opportunities
Sign Up to Receive Ongoing Updates or Provide Feedback:
Please complete the feedback form here if you would like to receive future updates or share feedback on the initiative.
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