South Dakota · personal care aide (PCA)
South Dakota has no state training rule for private-pay personal care aides, and it does not license non-medical home care agencies. Aides who work for Medicaid in-home providers get an orientation before working alone and at least 6 hours of training a 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 aide, in-home aide, personal attendant, homemaker, caregiver |
| Training | No state rule for private-pay aides. Medicaid in-home providers give a new employee orientation before you work in a client’s home alone. No hour count is set. |
| Exam | No statewide exam. Personal attendants in the ADLS program must show competency. |
| Certification | None. South Dakota has no state certificate or registry for personal care aides. |
| Background check | State fingerprint check, or an approved alternative, for Medicaid in-home aides. Some violent, sex, and serious felony convictions disqualify you. |
| Yearly training | At least 6 hours a year for aides of Medicaid in-home providers |
| Minimum age | 16 for Medicaid in-home aides; 18 for Structured Family Caregiving |
| Agency licensing | No state license for non-medical agencies. Medicaid agencies pass a state Department of Human Services (DHS) review and sign an agreement. |
Training
If you work for a Medicaid in-home provider, the agency must give you a new employee orientation before you go into a client’s home without supervision. After that, you need at least 6 hours of training each year, and your supervisor makes unannounced visits. The state does not set a number of hours for the orientation.
Personal attendants in the Assistive Daily Living Services (ADLS) program, for people with quadriplegia, need nurse aide or home health aide training, a nurse-supervised attendant course, or a signed skills check. Private-pay aides have no state training rule.
In 2026, lawmakers passed a bill to license in-home care agencies and require 8 hours of training for their aides. The governor vetoed it, and the attempt to override the veto failed, so it did not become law.
The steps
The usual path for a new aide.
Family caregivers
It depends on the program. Medicaid State Plan personal care cannot be provided by a family member. HOPE Waiver providers may hire a qualified relative or legal guardian, and relatives who live with the client are referred to Structured Family Caregiving.
Structured Family Caregiving, part of the HOPE Waiver, pays a main caregiver age 18 or older who lives with the client. In the ADLS program, a spouse, parent, or adult child can be paid as a personal attendant.
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 state rule for private pay; 6 hours a year for Medicaid 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 (SD) | $18.15 an hour* | $18.15 an hour* | $18.65 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. South Dakota has no state certificate or registry for personal care aides. Medicaid in-home aides need an orientation, a background check, and 6 hours of training a year.
Not non-medical ones. A 2026 bill to license in-home care agencies and require 8 hours of aide training was vetoed, and the override failed.
Possibly. HOPE Waiver providers can hire qualified relatives, and Structured Family Caregiving pays a live-in caregiver age 18 or older. Medicaid State Plan personal care cannot be given by a family member.
Medicaid in-home aides can be 16. Structured Family Caregiving caregivers must be at least 18.
Home health and personal care aides in South Dakota earn a median of $18.15 an hour, based on the May 2025 federal wage survey.