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CNA vs HHA: Which Should You Get First?

CNA and HHA certifications both launch healthcare careers — but they're not the same. Here's the honest breakdown of salary, work settings, and why the order matters.

8 min read•February 19, 2026•By LMCC Staff

CNA vs HHA: Which Should You Get First?

Both CNA and HHA are entry-level healthcare certifications. Both get you working with patients. CNA is WIOA-eligible — HHA is just $850 with 0% payment plans.

But they are not the same thing — and the order you get them in matters more than most people realize.

Here's the honest breakdown.

What Each Certification Actually Is

CNA (Certified Nursing Assistant) is the foundational healthcare certification in California. CNAs work in hospitals, skilled nursing facilities, clinics, and rehab centers. They provide direct patient care under the supervision of licensed nurses — bathing, dressing, vital signs, repositioning, reporting changes in patient condition.

The California CNA program is 162 hours total: 48 hours of theory and 114 hours of clinical training. At LMCC, that takes 31 business days. The program is approved by the California Department of Public Health (CDPH) and requires passing a state competency exam.

HHA (Home Health Aide) is a certification built *on top of* the CNA. In California, you must already be a certified CNA (or in a CDPH-approved NA program) before you can enroll in HHA training. HHAs work in home settings — one-on-one with elderly, disabled, or recovering patients — often with more independence than facility-based CNAs.

The HHA add-on at LMCC is just 5 additional days (40 hours) after CNA. There is no separate state exam for HHA.

The Math on Pricing

At LMCC:

- CNA alone: $2,995

- HHA alone (add-on): $850

- CNA + HHA together: $3,845

If you're doing the math: $2,995 + $850 = $3,845. The combined track costs the same as buying each separately. There is no discount for bundling — but there is a strategic reason to enroll in the combined track from the start.

WIOA covers one program at a time — your CNA tuition ($2,995) is covered, and you pay $0. The HHA add-on is just $850. LMCC offers 0% interest payment plans so you can split that into manageable installments during your training.

Salary: Where the Gap Actually Matters

This is the number that changes the conversation.

CNA starting salary in Los Angeles/Inland Empire: ~$22/hour (~$46,000/year)

HHA starting salary (home care): ~$32/hour (~$66,000/year)

Wait — HHA pays *more* than CNA? Yes, in many cases. Here's why:

Home health aides working through home care agencies in California — especially those caring for complex patients — often earn more per hour than entry-level facility CNAs. The higher rate reflects the independence of the work and the one-on-one responsibility.

The combined track advantage: If you do CNA+HHA together, you qualify for both facility-based and home-based positions. You can start in a SNF (skilled nursing facility) as a CNA while building your resume, then transition to home care as an HHA for higher hourly rates. Or do both simultaneously with two part-time positions.

For just 5 extra days of training ($850), that's an additional pathway worth $10–$20k more per year in earning potential.

Trade-Offs: Being Honest

### CNA (facility-based)

  • ✅ Higher stability — hospitals and SNFs always hiring
  • ✅ Team environment — you work alongside nurses, therapists, other CNAs
  • ✅ Better stepping stone to LVN → RN
  • ✅ Benefits (health insurance, retirement, PTO) more common in facilities
  • ❌ Fixed schedule, structured workplace — less flexibility
  • ❌ Higher physical demands in some settings (hospital patient turnover)

    • ### HHA (home-based)

  • ✅ More flexibility — some HHAs set their own hours through agencies
  • ✅ Deeper one-on-one relationships with patients
  • ✅ Less clinical paperwork than hospital CNAs
  • ✅ Higher hourly rate in many cases
  • ❌ Driving required — your car is your commute to every client
  • ❌ Less structured supervision (can be a pro or con depending on you)
  • ❌ Benefits less consistent — agency-by-agency
  • ❌ Requires CNA first — can't skip the foundation

    • ### HHA requires CNA. Always.

    This is the most common misconception: people think they can get HHA without CNA first. In California, you cannot. HHA training requires current CNA certification as a prerequisite.

    So the question isn't really "CNA or HHA?" — it's "CNA only, or CNA + HHA?"

    Who Should Get Both (The CNA+HHA Combined Track)?

    Get the combined track if:

  • You want maximum career flexibility
  • You want to work home care eventually (higher hourly)
  • You're WIOA-eligible (CNA is $0, HHA is just $850 — 0% payment plan available)
  • You want to be done with certification training in one stretch (36 days total)
  • You're thinking about eldercare, pediatric home care, or private-pay clients

    • Who Should Start with CNA Only?

    Start CNA-only if:

  • You want to get working as fast as possible (31 days vs 36)
  • You're certain you only want facility-based work
  • WIOA only approves CNA and you want to assess home care interest later
  • You need to reduce upfront cost and aren't sure about home care yet

    • The HHA add-on is always available later — if you're a licensed CNA, you can enroll in HHA at any point.

    LMCC's Recommendation

    If you're WIOA-eligible: Your CNA ($2,995) is covered. HHA is just $850 more — use our 0% payment plan to spread that cost. The extra 5 days of training opens significantly more earning potential.

    If you're self-paying: CNA first makes sense. Prove the career to yourself, get hired, then add HHA with a payment plan once you're earning.

    If you're pressed for time: CNA alone in 31 days. Get working. Add HHA when you're ready.

    Ready to Compare Programs?

    Our admissions team can walk you through both options, check your WIOA eligibility, and help you decide which path makes sense for your situation.

    [Explore the CNA+HHA Combined Track Program →](/programs/cna-hha)

    Or call us directly at (909) 625-8050 — Mon–Fri, 9AM–5:30PM.

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