Massachusetts · personal care aide (PCA)
In the MassHealth Personal Care Attendant (PCA) program, the person receiving care hires and trains their own attendant, and new PCAs take a paid 4-hour orientation. Home care agency rules are changing: a 2026 state law creates licensing for home care agencies, and the rules are still being written.
At a glance
What the state asks of PCAs who work for licensed agencies or Medicaid programs.
| Job titles | Personal Care Attendant (PCA), home care worker, personal care homemaker, homemaker |
| Training | MassHealth PCAs take a one-time, paid 4-hour New Hire Orientation within nine months of hire. The consumer trains you on daily tasks. |
| Exam | No exam for MassHealth PCAs was found in state sources |
| Certification | No state certification for PCAs was found in state sources |
| Background check | For MassHealth PCAs, a criminal record check, sex offender registry check, or drug test is up to the consumer. The 2026 law adds checks for agency workers once rules take effect. |
| Yearly training | None for MassHealth PCAs. The 2026 law requires yearly training for agency home care workers once the rules are written. |
| Minimum age | 16 with working papers for MassHealth PCAs, per a state page that may be out of date |
| Agency licensing | Executive Office of Health and Human Services (EOHHS) under a 2026 law; rules are still being written. Before this, non-medical home care agencies had no state license. |
Training
In the MassHealth PCA program, the consumer is your employer and trains you on their daily tasks. You also complete a one-time, paid, 4-hour New Hire Orientation within nine months of hire.
If you work for a home care agency, things are changing. A 2026 state law creates licensing for home care agencies and requires yearly training and competency for agency workers on topics like infection control, abuse reporting, and dementia. EOHHS is still writing the rules, so the hours are not set yet.
Homemakers and personal care homemakers in the state aging services Home Care Program may have their own training rules, but their hours could not be confirmed in official sources. Ask the agency.
The steps
The usual path for a new aide.
Family caregivers
Yes, in many cases. The MassHealth PCA program is consumer directed, so the member is the employer and can hire family members.
The member’s spouse, surrogate, or other legally responsible relative cannot be paid as their PCA, and a parent or foster parent cannot be paid when the member is a minor. MassHealth rules also bar the member’s foster parent at any age.
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 | 4-hour paid orientation for MassHealth PCAs | 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 (MA) | $19.67 an hour* | $19.67 an hour* | $22.44 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 individual license was found for PCAs. MassHealth PCAs take a 4-hour orientation. A 2026 state law creates licensing for home care agencies, and agency workers will face new training and background check rules once those rules are written.
MassHealth PCAs complete a paid 4-hour New Hire Orientation within nine months of hire. The consumer who hires you trains you on their daily care.
Yes, if she is a MassHealth member in the PCA program. She can hire you as her PCA as long as you are not her surrogate. Spouses cannot be paid.
A state page says 16 with working papers for MassHealth PCAs. That page may be out of date, so confirm with the program.
Home health and personal care aides in Massachusetts earn a median of $19.67 an hour, based on the May 2025 federal wage survey.