1. California — $41,200 Median
California tops the list with a $19.80 median hourly rate. Bay Area and LA metro push local averages well past $22 an hour, and there is no ceiling for private-pay aides in wealthy areas.
The state's In-Home Supportive Services (IHSS) program is the biggest home care employer in the country. IHSS wages vary by county but have risen every year since 2019.
The main issue is affordability. Housing costs erase most of the wage advantage in coastal cities. Aides who work in Central Valley or Inland Empire keep more of what they earn even though gross pay is 15 to 20 percent lower.
