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This study aims to explore the financial status of Medicaid Home Care Aides (HCAs) working in Washington State (WA). This study importantly covers both economic and psychological components of financial insecurity, a comprehensive approach that may help advance policy development for HCAs' financial security. An online survey was conducted from April to May 2019 among employed WA HCAs. The descriptive analyses were conducted using Stata. About two-thirds earned less than $30,000 annually (62%) from all their jobs combined, including non-caregiving work. Over 1 in 4 reported having over $40 k in long-term debt (28%). More than 3 in 4 reported they could only cover housing and basic living expenses using savings for less than 2 months (76%), showing likely unreadiness for sudden financial shocks (financial vulnerability). Nearly 3 in 4 HCAs (73%) experienced at least one material hardship that include housing hardship, utilities hardship, medical hardship, and food insecurity. One in 4 expressed their financial stress was severe. More WA HCAs experienced material hardships (73%) than U.S. low-income families (64.2%). In 2021, the median annual wage for WA HCAs was about 20% higher than the national one; however, their wages still remain below the living wage. In conclusion, although WA HCAs' wages are comparable to national averages, they still experience financial vulnerability and material hardships. Therefore, achieving living wages is necessary for WA HCAs. [ABSTRACT FROM AUTHOR]

This study assessed the prevalence of Adverse Childhood Experiences (ACEs) among Home Care Aides (HCAs) and explored the relationship between ACEs and mental health. A 2017 survey of 424 HCAs assessed childhood trauma using the CDC-BRFSS ACE module. Approximately 27% of HCAs had a high ACE score (between 4 and 10). There were no associations found between ACE score and respondent demographic characteristics. HCAs with high ACE scores reported lower rates of social and emotional support and higher rates of past-month hopelessness compared with those with no or limited experience of adverse childhood events. This research suggests that HCAs have higher than average rates of ACEs, known to be linked to various negative physical and mental health outcomes. [ABSTRACT FROM AUTHOR]