Iowa · personal care aide (PCA)
Iowa does not set statewide training hours for non-medical attendants. Training rules come from Iowa’s Medicaid home care programs, and clients who direct their own care can train their workers themselves. 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 | Attendant care provider, direct care worker, self-directed personal care worker |
| Training | No statewide hours. Medicaid waiver workers follow the state’s waiver provider manual. Brain injury waiver staff take state training modules within 60 days. |
| Exam | No statewide exam was found in state sources; ask your employer. |
| Certification | None. Iowa has no state certificate or registry for attendants. |
| Background check | Iowa criminal and abuse registry checks before you work with Medicaid waiver clients. A disqualifying record bars hiring. |
| Yearly training | Not confirmed in state sources; ask your employer. |
| Minimum age | 18 for attendant care in the brain injury waiver rule; other waivers set age in the provider manual. 16 and 17 year olds may do self-directed personal care. |
| Agency licensing | No state license found for non-medical agencies. Medicaid providers enroll with Iowa Health and Human Services (HHS). |
Training
Iowa does not have a statewide training requirement for non-medical attendants. If you work in one of Iowa’s Medicaid Home and Community Based Services (HCBS) waivers, you must meet the training standards in the state’s waiver provider manual. If you work with clients on the brain injury waiver, you must complete the state’s brain injury training modules within 60 days.
In the Consumer Choices Option (CCO), Iowa’s self-directed program, the client or their representative hires, trains, and supervises you. They decide what you need to learn and may set extra requirements.
The steps
The usual path for a new aide.
Family caregivers
Yes, in many cases. Through the Consumer Choices Option, available in six Iowa Medicaid waivers, family members can be hired and paid to provide care.
Two firm limits: Medicaid will not pay a spouse, or a parent or stepparent of a child under 18. A legal representative who is not a spouse or parent can be paid, but for no more than 40 hours a week.
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 statewide hours; set by Medicaid program or client | 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 (IA) | $17.34 an hour* | $17.34 an hour* | $18.92 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. Iowa has no state certificate or registry for non-medical attendants. If you work with Medicaid waiver clients, you need a background check and any training your employer or the waiver requires.
Iowa sets no statewide hours. Medicaid waiver programs and self-directing clients set the training. Brain injury waiver staff must finish state modules within 60 days.
Yes, if your parent is on an Iowa Medicaid waiver and uses the Consumer Choices Option. Adult children can be paid. Spouses and parents of minor children cannot.
Under Iowa's brain injury waiver rule, attendant care providers must be 18, and other waivers set the age in the state's waiver provider manual, so ask your employer. Workers who are 16 or 17 may be hired by clients who direct their own personal care through the Consumer Choices Option.
Home health and personal care aides in Iowa earn a median of $17.34 an hour, based on the May 2025 federal wage survey.