D.C. roundtable spotlights long‑term care workforce shortfalls and push to implement single CNA credential

Councilmember Christina Henderson, chair of the Committee on Health, and Councilmember Anita Bonds, chair of the Committee on Executive Administration and Labor, hosted a joint roundtable March 26 to examine strategies for expanding Washington, D.C.'s long‑term care workforce, which witnesses said is shrinking even as the city ages.

The discussion focused on worker shortages, the upcoming transition to a single certified nurse aide credential, testing capacity, pipeline programs and the need for cross‑agency coordination to retain and recruit direct care workers.

Why this matters: Witnesses and agency officials said a weak pipeline, reduced training capacity and licensing bottlenecks are combining with low pay and burnout to hollow out a workforce that supports older adults and people with disabilities. Council staff cited projections that the District’s older population will grow substantially by 2030, raising demand for in‑home and facility‑based care.

Councilmember Henderson opened the roundtable with workforce figures she cited from DC Health and the council’s budget office, saying nearly 4,000 CNAs and HHAs did not renew credentials between 2020 and 2024 and that the number of certified home health aides and certified nurse aides has declined substantially. "Currently, there are about 11,466 CNAs and HHAs certified to work in the district," Henderson said. DC Health and coalition witnesses repeated that training capacity has contracted — several CNA/HHA training programs closed since 2021 — while demand rises.

Implementation of single CNA credential: DC Health and other witnesses discussed the Certified Nurse Aid Amendment Act of 2024, which creates a single CNA credential that will allow people to work in both clinical and home settings and seeks to streamline licensing between settings. "This legislation creates a single nurse aid credential, the CNA, which will allow professionals to work in both clinical and home settings," said Sam Hurley, Senior Deputy Director, Health Systems and Preparedness Administration, DC Health. Hurley said DC Health convened the five‑member advisory committee this week to develop recommendations on curriculum, certification requirements and transitional rules for current HHAs and CNAs.

Training seats, exams and testing capacity: Witnesses and agency staff said testing capacity for psychomotor (skills) exams is a bottleneck. DC Health provided data for Oct. 2024–March 2025 showing 34 scheduled exams and eight cancellations; the department said 107 testing seats went unfilled in that period. "Board of Nursing staff are now providing weekly open test seat reports to educational providers to ensure increased transparency around psychomotor or skills testing availability," Hurley said. He also said DC Health is working with the State Office of the State Superintendent of Education and the University of the District of Columbia to add testing site capacity.

Scholarships, apprenticeships and pipeline programs: Agencies and employers described several existing or planned pipeline efforts. DC Health said it secured roughly $3,700,000 (via DHCF) to expand a High Needs Healthcare Career Scholarship program and anticipated training an additional 126 CNAs by the end of FY2025. Justin Palmer of the District of Columbia Hospital Association described the DC Healthcare Employment and Apprenticeship Link (DC HEAL) and cited industry partnerships and career ladder work. Tina Sandry, CEO of Forest Hills of D.C., described an employer‑sponsored CNA apprenticeship that emphasizes dementia and end‑of‑life care; she urged on‑the‑job training to retain trainees.

Coordination and a designated coordinator: Multiple witnesses recommended a named, cross‑agency coordinator or office to break down silos. "DC must identify and fund a person within the government to facilitate continuous collaboration and convening of all stakeholders," Kristen Ewing, policy counsel at DC Appleseed, said. Sal Siveggio of the DC Coalition on Long Term Care likewise urged an entity with authority to coordinate agencies and stakeholders on recruiting, training, certification and deployment.

Other workforce supports and policy issues: Witnesses and provider representatives urged wage investments and described non‑wage supports such as transportation credits, mental‑health supports for staff and tort‑reform changes providers say would lower liability costs. PHI, a national direct care workforce group, recommended a universal training and credentialing system with core competencies and portable credentials to allow workers to move between settings and advance.

Agency commitments and next steps: DC Health said it has appointed the advisory committee required by the 2024 law and will issue regulations after the committee finalizes recommendations; it also said it would increase testing capacity and distribute open‑seat reports to education providers. Councilmembers signaled follow‑up oversight, particularly on implementation timetables for licensure changes, test availability and use of scholarship dollars.

Looking ahead: Witnesses asked the council to track implementation milestones and consider braided funding to support training, wages and retention. DC Health said its next operational steps include formalizing the blended CNA curriculum and expanding testing sites; the council said it will continue oversight on workforce, training and licensure implementation.