Virginia · personal care aide (PCA)
Agency personal care aides in Virginia Medicaid waivers usually qualify with a 40-hour course, unless they are CNAs or qualify another way, and take 12 hours of training every year, while consumer-directed attendants are trained by the person who hires them. Since July 2025, parents of minor children can also be paid for some extra care. 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, home attendant, consumer-directed attendant, personal assistant |
| Training | Aides at agencies not licensed by the Virginia Department of Health (VDH): at least 40 hours in a nurse-taught course, unless they are CNAs or finished a Board of Nursing approved program. Aides at VDH-licensed agencies can also qualify through nursing training, a competency evaluation, or the state training curriculum. Consumer-directed attendants: no set hours. |
| Exam | Licensed home care organizations may qualify attendants through a competency evaluation limited to personal care tasks, or through the state training curriculum. |
| Certification | No state personal care aide certificate was found. Completing the training or qualifying another way, such as being a CNA, is what counts. |
| Background check | Virginia criminal history check with barrier crime screening, cleared within 30 days of hire for agency staff. Consumer-directed attendants also get a federal exclusion check, plus a child abuse registry check if serving a minor. |
| Yearly training | 12 documented hours of agency-provided training each year for agency personal care aides |
| Minimum age | 18 |
| Agency licensing | Virginia Department of Health (VDH), Office of Licensure and Certification |
Training
If you work for an agency serving Medicaid waiver members that is not licensed by VDH, you need at least 40 hours of training in a provider course taught by a registered nurse (RN), unless you are a CNA or finished a Board of Nursing approved program. All agency aides in the waiver then need 12 documented hours of agency training each year.
Aides at VDH-licensed home care organizations follow VDH rules instead, which allow nursing or nurse aide training, a competency evaluation limited to personal care tasks, or the Department of Medical Assistance Services (DMAS) Personal Care Aide Training Curriculum. Consumer-directed attendants have no set hours. The person or employer of record who hires them provides the training.
The steps
The usual path for a new aide.
Family caregivers
Yes. Through Cardinal Care Medicaid waivers, including Commonwealth Coordinated Care Plus (CCC Plus) and the Community Living (CL) and Family and Individual Supports (FIS) waivers, members can hire their own attendant with help from a fiscal employer agent. Relatives can be paid.
Since July 1, 2025, legally responsible individuals, such as parents or guardians of minor children, can be paid for extraordinary personal care, up to 40 hours a week per child, with documentation and monitoring every 90 days. Whether a spouse of an adult member can be paid is unclear, so confirm with DMAS.
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 | 40 hrs for agency waiver aides; 12 hrs a year | 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 (VA) | $14.57 an hour* | $14.57 an hour* | $20.77 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.
There is no separate state certificate. Agency aides in Medicaid waivers must complete approved training, often a 40-hour course, or qualify another way, such as being a CNA.
The standard course for agency aides in Medicaid waivers is at least 40 hours, though CNAs and aides at VDH-licensed agencies can qualify other ways. Agency aides then need 12 hours of training every year. Consumer-directed attendants have no set hours.
Yes, if she is in a Medicaid waiver with consumer-directed care, such as CCC Plus. She can hire relatives like you as her attendant.
Yes, since July 1, 2025. Parents and guardians of minors can be paid for extraordinary personal care, up to 40 hours a week per child, through Medicaid waivers.
Home health and personal care aides in Virginia earn a median of $14.57 an hour, based on the May 2025 federal wage survey.