Iowa's direct-care workers are the state's "frontline" paid caregivers who provide daily living services and supports to persons with disabilities and chronic care needs, including the elderly and those with physical or intellectual and developmental disabilities (ID/DD). The majority of these staff work in the consumer's home, or in residential or community-based settings such as nursing homes, assisted living facilities, and group homes.

In standardized government surveys of employment and compensation, direct-care workers are officially counted as Personal and Home Care Aides; Home Health Aides; and Nursing Aides, Orderlies and Attendants. The  first occupational category also includes direct support professionals - workers who provide services and supports to individuals with ID/DD. A growing number of direct-care workers are independent providers working directly for consumers. These workers tend to be heavily undercounted by government
surveys.