North Carolina · personal care aide (PCA)
North Carolina has no minimum training hours on record for in-home aides. Instead, aides must show each care task to a health care practitioner before doing it on the job. Family caregivers may be paid in some Medicaid waiver cases.
At a glance
What the state asks of PCAs who work for licensed agencies or Medicaid programs.
| Job titles | In-home aide, in-home caregiver, home care aide, personal care aide |
| Training | No hour minimum found. Agencies train on client rights, privacy, personal care skills, incident and abuse reporting, and infection control, with dementia training in some cases. |
| Exam | Task-by-task skills demonstration to a registered nurse or other health care practitioner at the agency |
| Certification | None for basic in-home aides. Nurse Aide I tasks need Nurse Aide I training. An optional Home Care Aide listing exists for Nurse Aide I listees. |
| Background check | Criminal history check before hire, and no substantiated finding on the NC Health Care Personnel Registry |
| Yearly training | Not confirmed in state sources; ask your agency |
| Minimum age | 18, or a high school graduate or equivalent |
| Agency licensing | NC Department of Health and Human Services (DHHS), Division of Health Service Regulation (home care agency license) |
Training
North Carolina focuses on proven skills rather than class hours. A licensed home care agency must document that each aide has shown every assigned task to a health care practitioner, and aides may do only the tasks they have proven they can do.
For Medicaid Personal Care Services (PCS), agencies must train aides in client rights, confidentiality, personal care skills, incident reporting, abuse and neglect reporting, and infection control, plus dementia care for some clients. Aides doing Nurse Aide I tasks must meet the state’s Nurse Aide I training and testing rules. Nurse Aide I listees can also earn an optional Home Care Aide listing by finishing a state-approved home care program.
The steps
The usual path for a new aide.
Family caregivers
Sometimes. Medicaid’s Community Alternatives Program for Disabled Adults (CAP/DA) and for Children (CAP/C) offer consumer direction. Under guidance from November 2025, a legally responsible person such as a parent or guardian may be paid up to 40 hours a week for extraordinary care if criteria are met.
Regular Medicaid PCS does not pay spouses, close relatives, or anyone living with the client. Whether spouses count as legally responsible persons under CAP was not stated, so ask NC Medicaid.
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 set hours; skills shown task by task | 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 (NC) | $15.02 an hour* | $15.02 an hour* | $18.49 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.
Not for basic in-home aide work. There is no state certificate, but your agency must confirm you can do each task, and you must pass a background check. Nurse Aide I tasks require Nurse Aide I training.
No hour minimum was found in state rules. Aides must show each assigned task to a health care practitioner, and Medicaid agencies must cover set topics.
Not through regular Medicaid PCS, which bars close relatives and anyone living with the client. Some family caregivers can be paid through the CAP/DA or CAP/C waivers.
Possibly. Under CAP consumer direction, a parent or guardian may be paid up to 40 hours a week for extraordinary care if criteria are met.
Home health and personal care aides in North Carolina earn a median of $15.02 an hour, based on the May 2025 federal wage survey.