Personal Care Aides (PCAs) play a vital role in the direct care workforce, providing essential support to older adults and individuals with disabilities or serious illnesses. PCAs, working alongside home health aides, make up the largest occupational group in the U.S. workforce, helping individuals maintain optimal health and independence in their homes and communities.

Despite their critical role, PCAs face systemic challenges, including inconsistent training standards across states, and the absence of a national training requirement. This results in fragmented job preparation, limited credential portability, job instability, and barriers to delivering consistent, high-quality care. Compounding these issues, many PCAs are underpaid, further undermining workforce stability and retention.

Based on the 2025 work of Jessica King, Kezia Scales, and Susan A. Chapman in their paper, Training Standards for Personal Care Aides Across States: An Assessment of Current Standards and Leading Examples—produced by ITUP in partnership with Policy at Healthforce— this fact sheet highlights the state of PCA training nationwide, showcases innovative state models, and presents policy solutions to strengthen and equitize the direct care workforce.