How to Become a Home Health Aide in Maryland: Your 2026 Guide

By Athena KanUpdated May 24, 2026

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If you are seeking a direct path to a meaningful healthcare career in Maryland, understanding the state's specific requirements is the first step. The path to becoming a Home Health Aide (HHA) in Maryland is unique: it begins with becoming a Certified Nursing Assistant (CNA). HHA status is an official endorsement added to your CNA certificate, not a separate license.

This guide provides the definitive, updated process for 2026. You will learn how to navigate Maryland's two-part certification process to launch your career providing vital care. Professionals in this field in Maryland earn a median annual salary of $38,670, and the state projects a 19% growth in jobs by 2032, showing strong and sustained demand for these essential caregivers.

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What Is a Home Health Aide in Maryland?

In Maryland, a Home Health Aide is a Certified Nursing Assistant who has also completed a specific competency evaluation to work in a home care setting. They provide hands-on personal care and basic health services to clients in their homes, always under the supervision of a Registered Nurse.

It is important to understand the distinctions between roles:

Caregiver/Personal Care Aide: This is often an entry-level role that may not require formal certification. Duties focus on companionship, light housekeeping, and non-medical assistance with daily living.
Certified Nursing Assistant (CNA): A CNA has completed a 100-hour, state-approved training program and passed a competency exam.
Home Health Aide (HHA): An HHA is a CNA who has gained an additional endorsement to specialize in home-based care. This requires passing a federally standardized HHA competency evaluation.

An HHA's duties blend personal support with health-related tasks. Common responsibilities include:

Assisting clients with personal hygiene, such as bathing, dressing, and grooming.
Helping with mobility, including transfers from a bed to a chair.
Preparing meals according to dietary needs and performing light housekeeping.
Taking and recording vital signs like blood pressure and temperature.
Reminding clients to take medications and assisting with prescribed exercises.
Observing and reporting any changes in a client's condition to the supervising nurse.

The First Step: Becoming a Certified Nursing Assistant (CNA)

Because HHA is an add-on certification in Maryland, your journey must begin with earning your CNA certificate. This is a non-negotiable prerequisite set by the Maryland Board of Nursing (MBON).

Here is what the CNA certification process involves:

Find an Approved Program: You must enroll in a nursing assistant training program that is officially approved by the Maryland Board of Nursing. Students who complete non-approved programs are not eligible for certification.
Complete 100 Hours of Training: Maryland's requirements exceed the federal minimum. Your program will consist of at least 100 hours of instruction, broken down into 60 hours of classroom and lab work and 40 hours of supervised clinical practice.
Pass the Competency Exam: After completing your training, you must pass a Board-approved competency evaluation. This exam typically has a written or oral component and a practical skills demonstration. The NNAAP Nurse Aide Examination administered by Credentia is a common exam used in the state.

Once you successfully complete these steps, you will be issued a CNA certificate from the Maryland Board of Nursing and can proceed to the HHA endorsement.

How to Become a Home Health Aide in Maryland: A Step-by-Step Guide

With a clear understanding that CNA certification is the foundation, here is the correct, actionable path to earning your HHA endorsement in Maryland.

Step 1: Meet the Foundational Requirements

Before you can enroll in any training, you must meet the basic eligibility criteria. You must be at least 18 years old, have a high school diploma or GED, and be able to pass a criminal history records check, which is mandatory for working with vulnerable populations.

Step 2: Complete a Maryland-Approved CNA Program

Enroll in and successfully complete a 100-hour CNA training program approved by the Maryland Board of Nursing. These programs are offered by community colleges, vocational schools, and private training providers across the state.

Step 3: Earn Your CNA Certification

Pass the state competency evaluation to earn your CNA certificate. Your training provider will give you information on how to register for the exam. Upon passing, your name will be added to the Maryland Nursing Assistant Registry, and you will be a certified CNA.

Step 4: Complete the HHA Competency Evaluation

To get the HHA endorsement, you must pass a home health aide competency evaluation that meets federal standards outlined in 42 CFR §484.36. This evaluation is separate from your CNA exam. It specifically tests your skills for the home care environment. The agency or program that administers this evaluation will submit proof of your successful completion to the MBON. The "HHA" designation will then be added to your CNA certificate.

Step 5: Maintain Your Certifications

Your HHA status is tied to your CNA certificate. You must renew your CNA certificate every two years by paying a $40 fee and proving you have worked at least 16 paid hours as a nursing assistant during that period. To maintain the HHA endorsement specifically, you must also complete 12 hours of in-service training every year.

HHA Salary and Job Outlook in Maryland

The career outlook for Home Health and Personal Care Aides in Maryland is strong. The demand for skilled in-home care professionals continues to grow as the population ages.

Maryland Salary: The median annual salary for Home Health and Personal Care Aides in Maryland is $38,670, or about $18.59 per hour, according to the most recent state data from BLS as of May 2024. Wages can range from $31,200 (10th percentile) to $46,570 (90th percentile) depending on experience, location, and employer.
Job Growth: Employment for HHAs in Maryland is projected to grow by 19.2% between 2022 and 2032. This translates to approximately 6,220 new jobs, offering excellent long-term career stability.
Employment Numbers: As of May 2025, there were 38,520 Home Health and Personal Care Aides employed in Maryland.

Key 2026 Updates Affecting Maryland HHAs

The home care landscape in Maryland is evolving. A significant legislative change, the Homecare Worker Rights Act of 2024, took effect on January 1, 2026.

This law mandates that Maryland Medicaid will only reimburse Residential Service Agencies (RSAs) for personal assistance services if the caregiver is classified as an employee, not an independent contractor. For HHAs, this means more job opportunities are likely to be traditional W-2 employment positions with benefits, rather than 1099 contract work. This change provides greater job security and protections for home care workers across the state.

Advancing Your Career Beyond a Home Health Aide

Earning your HHA endorsement is an excellent entry point into the healthcare field, but it doesn't have to be the final destination. The experience you gain provides a strong foundation for numerous career advancement opportunities.

Geriatric Nursing Assistant (GNA): As a CNA, you are already on the path to becoming a GNA, which is a specialization for working with the elderly in long-term care facilities.
Specialized Care: You can pursue additional training to specialize in high-demand areas like pediatric home care, hospice and palliative care, or working with clients who have dementia or Alzheimer's disease.
Agency Supervisor: With experience and leadership skills, you can advance to a supervisory role within a home health agency, where you would manage and schedule other HHAs.
Licensed Nurse (LPN/RN): Many HHAs use their experience as a springboard to pursue a nursing degree. Your hands-on patient care experience is invaluable in LPN or RN programs and can make you a more competitive applicant.

Frequently Asked Questions About Becoming an HHA in Maryland

How long does it take to become a Home Health Aide in Maryland?

The total time varies, but you can expect the process to take a few months. The required CNA training program is 100 hours, which can often be completed in 4 to 8 weeks, depending on whether you attend full-time or part-time. After that, you will need to schedule and pass your CNA exam and the HHA competency evaluation.

What is the difference between a caregiver and an HHA in Maryland?

A "caregiver" is a general term for someone who provides non-medical support and may not have formal training or certification. A certified Home Health Aide in Maryland is a CNA who has completed a 100-hour state-approved program, passed two separate competency exams, and is certified by the Maryland Board of Nursing to perform specific health-related tasks.

Are HHA and CNA the same thing in Maryland?

No. In Maryland, you must first become a CNA. HHA is an additional endorsement on your CNA certificate that qualifies you to work for Medicare-certified home health agencies.All HHAs in Maryland are CNAs, but not all CNAs have the HHA endorsement.

How much does an HHA make in Maryland?

The median salary for Home Health and Personal Care Aides in Maryland is $38,670 per year, which is approximately $18.59 per hour.

Start Your Maryland Healthcare Career Today

Becoming a Home Health Aide in Maryland is a structured process that begins with a solid educational foundation as a Certified Nursing Assistant. This rewarding career offers stability, growth, and the chance to make a profound difference in the lives of your clients every day. By following the steps to obtain your CNA certification and HHA endorsement, you can build a successful and fulfilling career in the thriving healthcare industry.

If you are ready to take the first step, Dreambound offers a comprehensive platform to explore and compare state-approved CNA training programs throughout Maryland such as the Home Health Aide classes in Baltimore. Find the program that fits your needs and begin your journey into healthcare today.