Alabama · personal care aide (PCA)
Alabama has no statewide training law for personal care aides. The rules that do exist come from Alabama Medicaid’s home care programs, which require agency workers to be trained before they start and to take 12 hours of training each year. Here is how it works and how family caregivers can get paid.
At a glance
What the state asks of PCAs who work for licensed agencies or Medicaid programs.
| Job titles | Personal care worker, personal care attendant, self-directed personal care employee, homemaker, home attendant |
| Training | No set number of starting hours. Medicaid agency workers must finish an orientation before serving clients. Self-directed workers are trained by the client or family. |
| Exam | No statewide exam. Medicaid workers must be able to read, write, and understand instructions. |
| Certification | None. Alabama has no state certificate or registry for personal care aides. |
| Background check | National background check by the agency for Medicaid waiver workers. No state rule found for private-pay caregivers. |
| Yearly training | 12 hours a year for Medicaid agency personal care workers (6 hours for companion workers) |
| Minimum age | 18 for Medicaid waiver workers |
| Agency licensing | No state license. Agencies serving Medicaid clients need a business license and approval from Alabama Medicaid. |
Training
If you work for an agency that serves clients on the Elderly and Disabled (E&D) Waiver, a Medicaid program for care at home, you must finish an orientation before you see clients. State rules do not say how many hours it must be. After that, you need at least 12 hours of training every year, and a licensed nurse supervises the care you give.
In Personal Choices, Alabama’s self-directed option, the client or family trains you before you start. Training covers the care plan, the client’s condition, help with daily tasks like bathing and dressing, medication help if needed, record keeping, and how to report problems. No training rule was found for private-pay caregivers who do not work through Medicaid.
The steps
The usual path for a new aide.
Family caregivers
Yes, in some cases. Through Personal Choices, Alabama Medicaid’s self-directed option for several waiver programs, relatives and legal guardians can be hired and paid if they qualify. A spouse can also be paid through Personal Choices if they meet the program’s rules.
Two limits: a relative cannot be paid through a regular agency for E&D Waiver personal care, and the person chosen as the client’s Personal Choices representative cannot also be the paid worker.
Read our full guide: how to get paid to care for a family member.
Compare
All three help people with daily care. Training, tasks, and pay differ.
| Personal care aide | Home health aide | CNA | |
|---|---|---|---|
| Training | No set hours; 12 hours a year for Medicaid agency aides | 75 hours federal minimum, including 16 hands-on | State-approved program, 75 hours or more |
| Medical tasks | Mostly not. Help with daily living, like bathing, dressing, meals, and housework | Some, like vital signs, under nurse supervision | Yes, under nurse supervision |
| Where you work | Clients' homes, group homes, assisted living | Clients' homes, through home health agencies | Nursing homes and hospitals |
| Median pay (AL) | $13.39 an hour* | $13.39 an hour* | $16.41 an hour |
*Federal pay data groups personal care aides with home health aides. Many PCAs later become CNAs, which opens more jobs and higher pay.
FAQ
Short answers to what people ask most.
No. Alabama has no state certificate or registry for personal care aides. If you work for a Medicaid home care agency, you need the agency's orientation, a background check, and 12 hours of training each year.
There is no set number of starting hours. Medicaid agency workers must finish an orientation before seeing clients, but state rules do not say how long it is. Ask your agency.
Yes, if your parent is on an Alabama Medicaid waiver and uses the Personal Choices option. Relatives can be hired and paid if they qualify. A relative cannot be paid through a regular agency for E&D Waiver personal care.
Medicaid agency personal care workers need at least 12 hours of training each calendar year. Companion workers need at least 6 hours.
Home health and personal care aides in Alabama earn a median of $13.39 an hour, based on the May 2025 federal wage survey.