Missouri · personal care aide (PCA)
Missouri requires 12 hours of orientation for in-home aides working for Medicaid providers, with 6 hours done before you meet your first client. Aides must also register with the state Family Care Safety Registry. In the Consumer Directed Services program, the person you care for trains you instead.
At a glance
What the state asks of PCAs who work for licensed agencies or Medicaid programs.
| Job titles | In-home aide, personal care aide, Consumer Directed Services (CDS) attendant |
| Training | 12 hours of orientation within 30 days of hire, with at least 6 hours before your first client. Covers agency rules, emergencies, and dementia basics. |
| Exam | No state exam. In-home aides get yearly written evaluations. Advanced personal care aides need a nursing credential or documented aide training. |
| Certification | Register with the Family Care Safety Registry (FCSR) and stay off the Department of Health and Senior Services (DHSS) Employee Disqualification List |
| Background check | FCSR screening with criminal and registry checks, plus an Employee Disqualification List check, before you provide services |
| Yearly training | 5 hours a year after your first year, which your provider may lower to a 2-hour refresher after 3 years and 15 in-service hours |
| Minimum age | 18 |
| Agency licensing | No state license for non-medical in-home providers was found; they contract with MO HealthNet, Missouri’s Medicaid program. DHSS licenses skilled home health agencies. |
Training
Aides who work for Medicaid in-home service providers complete 12 hours of orientation within 30 days of hire. At least 6 of those hours must be done before you meet your first client. Orientation covers the agency’s rules, handling emergencies, and the basics of dementia.
After your first year, you need 5 hours of in-service training each year. Once you have 3 years and 15 in-service hours, your provider may lower it to a 2-hour refresher. If you work in Consumer Directed Services, the consumer orients and trains you, with help from the CDS vendor.
The steps
The usual path for a new aide.
Family caregivers
Yes. In Consumer Directed Services, the consumer hires, trains, and supervises their own attendant through a CDS vendor, and family members can be paid.
The CDS attendant cannot be the consumer’s spouse or guardian. If you work for a regular in-home services agency instead, you cannot be assigned to an immediate family member: a spouse, parent, sibling, child, stepchild, grandparent, or grandchild.
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 | 12 hours of orientation | 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 (MO) | $15.90 an hour* | $15.90 an hour* | $18.11 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. You must register with the Family Care Safety Registry, pass its screening, and not be on the Employee Disqualification List. Agency aides also complete 12 hours of orientation.
It is a state registry that caregivers must join. Registering lets you be screened through criminal and registry checks before you start work.
12 hours of orientation within 30 days of hire, with 6 before your first client, then 5 hours a year after your first year.
Yes, if she uses Consumer Directed Services. She can hire you as her attendant through a CDS vendor. Spouses and guardians cannot be paid, and agency aides cannot be assigned to care for a parent or other immediate family member.
Home health and personal care aides in Missouri earn a median of $15.90 an hour, based on the May 2025 federal wage survey.