Bollinger County, MO

Home care market report from Census, BLS and Missouri Medicaid data.

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Executive summary

A steady senior market with a thin home care workforce and a Medicaid rate of $32.68 an hour

Bollinger County has 2,428 people aged 65 and over, up 5.5% since 2020, and 10.3% of them need help bathing or dressing. 52 people worked in non-medical home care here in 2025.

2,428

People 65 and over, July 2025

Growing slower than the country

Up 5.5% since 2020, against 15.5% for the US. The 75 to 84 group grew 6.0%.

10.3%

Seniors, 2020–2024

Need help bathing or dressing

About 226 people. 6.4% in Missouri, 7.1% in the US.

Home care jobs, 2025

21.4 per 1,000 seniors

Against 58.7 across Missouri and 42.0 in the US. Includes caregivers families hire through Medicaid.

−24.6%

Home care jobs, 2019 to 2025

A shrinking workforce

From 69 to 52. 7 home care businesses with paid staff in 2023.

$16.32

Median aide wage, May 2025

What caregivers earn here

Above the Missouri median of $15.90. Nursing assistants earn $17.62.

$32.68

Medicaid fee schedule, MO

What Medicaid pays an agency

Fee schedule rate, not the average the federal rule asks for. 2 times the local aide wage.

Who needs care

Seniors who need help at home

20.7%

Living alone, Seniors, 2020–2024

Missouri 29.1% · US 26.6%

10.3%

Need help bathing or dressing, Seniors, 2020–2024

Missouri 6.4% · US 7.1%

12.3%

Need help with errands, Seniors, 2020–2024

Missouri 12.6% · US 13.2%

8.8%

Covered by Medicaid, Seniors, 2020–2024

Missouri 9.0% · US 14.1%

24.5%

Below the poverty line, Age 75 and over, 2020–2024

Missouri 11.3% · US 11.9%

$40,833

Median income, households headed by someone 65+, Seniors, 2020–2024

Missouri $52,285 · US $58,390

Census American Community Survey, 2020–2024 five-year estimates (tables B09020, B18106, B18107, C27007, B17020, B19049). Poverty is shown for 75 and over, the age band the table splits out. In small counties these are estimates from few responses.

Logicly’s reading

10.3% of seniors here need help bathing or dressing, against 6.4% in Missouri: about 226 people. 270 cannot run errands or get to appointments alone. 20.7% of seniors live alone.

Population ahead

Seniors by year

People 65 and over, 2020 to 2025

2,428 people 65 and over, 2025 +1.7% vs prior year

+6.0%

Age 75 to 84, 2020 to 2025

728 to 772

+9.8%

Age 85 and over, 2020 to 2025

234 to 257

+0.9%

Whole county, 2020 to 2025

10,556 to 10,646

93rd

of 115 Missouri counties on senior growth

Missouri county median +10.3%

Census population estimates, vintage 2025, July of each year. No federal source forecasts county populations; these are trends, not a forecast.

Logicly’s reading

Seniors grew about 6 times faster than the county as a whole. The 75 to 84 group, 772 people, reaches 85 over the next decade, the age when daily help is most common.

The market

Home care jobs and businesses

Home care jobs, 2019 to 2025

52 home care jobs, 2025 +18.2% vs prior year

21.4

Home care jobs per 1,000 seniors, 2025

Missouri 58.7 · US 42.0 · 41st of 57 Missouri counties

$268

Average weekly pay in home care, 2025

$136 in 2019

Home care businesses with paid staff, 2023

23 employees · $15,435 payroll each

Home care businesses by number of employees, 2023

Under 10 staff 6 · 100%
10 to 49 staff 0 · 0%
50 to 249 staff 0 · 0%
250 staff and over 0 · 0%

BLS Quarterly Census of Employment and Wages, private ownership, industry 624120 (non-medical home care, homemaker and companion services, adult day). Census County Business Patterns 2023 for businesses. The BLS job count is higher than the Census employee count because it also counts household employers, such as families who hire a caregiver through a Medicaid self-directed program. BLS withholds counts where a county has too few employers to publish without identifying them.

Logicly’s reading

Home care jobs went from 69 in 2019 to 52 in 2025, down 24.6%. Per senior, Bollinger County has less than the Missouri rate. More jobs per senior can mean a well-served market or heavy Medicaid and self-directed care; on its own it does not mean there is no room.

Can you hire here

Caregiver pay against other jobs

Median hourly wage, Cape Girardeau, MO-IL, May 2025

Nursing assistants $17.62
Janitors and cleaners $16.89
Stockers and order fillers $16.84
Home health and personal care aides $16.32
Retail salespersons $14.54
Fast food and counter workers $14.33
Cashiers $14.11

$16.32

Median aide wage, Cape Girardeau, MO-IL

Missouri $15.90 · US $17.21

$13.77

Aide wage at the 25th percentile, a typical starting rate

Missouri $13.75 · US $15.35

1,540

Home health and personal care aides, Cape Girardeau, MO-IL

May 2025

$13.77–17.23

Middle half of aide wages

25th to 75th percentile

BLS Occupational Employment and Wage Statistics, May 2025, all industries. Aides are occupation 31-1120; BLS no longer splits home health from personal care aides.

Logicly’s reading

Caregivers here can earn more as nursing assistants, stockers and order fillers and janitors and cleaners. Those jobs, more than other agencies, are who you compete with for staff.

What Medicaid pays here

Missouri Medicaid rates

$32.68

Agency personal care, fee schedule per hour

Fee schedule rate, not the average the federal rule asks for

$20.92

Individual providers, per hour

Caregivers the client hires directly

2×

The agency rate against the local median aide wage

$16.32 an hour, May 2025

$32.56

Homemaker, per hour

Fee schedule rate, not the average the federal rule asks for

Missouri Medicaid fee schedule, per hour

Personal care Agency Advanced Personal Care (T1019TF) $32.68

Personal care Agency Basic Personal Care – Agency Model (T1019) $32.56

Homemaker Agency or individual Homemaker (S5130) $32.56

Personal care Self-directed Personal Care Assistance – Consumer Directed Model (T1019U2) $20.92

Personal care Agency or individual Personal Care Assistance (T1019U6) $18.52

What is left of a Medicaid hour?

Medicaid rate $32.68

Caregiver wage $16.32

Payroll taxes, workers’ comp and benefits 20%

Paid hours you cannot bill (travel, training) 10%

$10.92left per billed hour for the office and profit · Logicly estimate

Caregiver labor costs $21.76 per billed hour: $16.32 an hour plus 20% payroll costs, spread over the 90% of paid hours you can bill.

Labor per billed hour = wage × (1 + payroll costs) ÷ (1 − unbilled share). The wage starts at the median aide wage for the Cape Girardeau, MO-IL; the other two start at the example values in our home care rate calculator. Replace them with your own.

Home and Community Based Services Manual: 3.00 Appendix 1 Services Units and Rates (opens in a new tab) . Fee schedule rate, not the average the federal rule asks for: the most or the set amount the state pays per unit, converted to an hour. The federal rule (42 CFR 447.203) asks states for the average actually paid per hour. Fee-for-service rates; managed care plans negotiate their own. 5 other rows in the state's documents (habilitation, respite, daily, per-visit and group rates, and figures we could not confirm) are not shown. Checked October 27, 2026. Our Missouri home care rates page lists the state's fee schedule per unit and private-pay prices.

Logicly’s reading

Missouri's Medicaid fee schedule pays agencies $18.52–32.68 an hour for personal care, 2 times the local median aide wage. That is the rate on the state's fee schedule, not the average actually paid, which the federal rule asks states to publish and Missouri has not yet.

Medicaid rates by state

43 states and DC with a rate we could check

Since July 2026 every state must publish what its Medicaid program pays per hour on average for personal care, homemaker and home health aide services. Each state posts it in its own format. Where a state hasn't, we show its fee schedule rate and say so. Where a state pays different rates by program or region, the table shows the lowest to the highest.

Agency personal care, highest published average per hour

Rhode Island $45.27
Oregon $43.29
Washington $42.92
Florida $41.92
Maine $37.44
Arizona $36.00
New Mexico $33.68
Pennsylvania $31.87
Kentucky $30.40
North Dakota $30.37
Colorado $30.36
Texas $29.24
North Carolina $27.46
West Virginia $27.00
Maryland $25.58
Virginia $23.44
Alabama $22.07
Illinois $18.75

All states, per hour

Vermont Fee schedule $51.91 Not published Not published Not published

Rhode Island Average paid $44.10–45.27 $20.94 $40.58–67.95 Not published

South Dakota Fee schedule $44.08 $44.08 $44.08 $44.08

Oregon Average paid $39.40–43.29 $20.00–24.00 Not published Not published

Washington Average paid $42.92 $37.56 Not published Not published

Florida Average paid $20.93–41.92 $31.51–31.77 Not published Not published

Maine Average paid $37.44 Not published $28.04 $41.60

Alaska Fee schedule $37.20 $37.20 Not published Not published

Montana Fee schedule $36.76–36.92 $30.28–31.64 $31.36 Not published

Arizona Average paid $27.20–36.00 $27.20 Not published Not published

Wyoming Fee schedule $35.64 $15.20 $25.96 $41.44

Indiana Fee schedule $34.36 $34.36 $30.72–31.72 Not published

New Mexico Average paid $33.68 Not published Not published $45.23

Missouri Fee schedule $18.52–32.68 $20.92 $32.56 Not published

Pennsylvania Average paid $29.98–31.87 Not published $24.55 $58.41–63.25

Ohio Fee schedule $28.96–30.92 $13.76 $23.96 Not published

District of Columbia Fee schedule $30.76–30.80 Not published Not published $30.76

Kentucky Average paid $30.40 Not published $35.24 Not published

North Dakota Average paid $28.59–30.37 $23.32 $27.64–28.54 $46.24–49.92

Colorado Average paid $27.51–30.36 $27.51–29.15 $25.56–36.75 $49.79

Utah Fee schedule $18.48–30.00 Not published $24.88–32.08 Not published

Texas Average paid $29.24 Not published Not published $18.44

Oklahoma Fee schedule $26.32–28.24 Not published Not published Not published

Minnesota Fee schedule $24.88–28.04 Not published $31.60 Not published

North Carolina Average paid $23.84–27.46 $23.85 Not published $37.55

West Virginia Average paid $27.00 Not published Not published Not published

Iowa Fee schedule $26.76 Not published $26.20 Not published

New Jersey Fee schedule $26.68 Not published Not published Not published

Tennessee Fee schedule $26.36 Not published Not published Not published

Maryland Average paid $25.58 Not published Not published Not published

Connecticut Fee schedule $25.52 Not published $22.04 Not published

Georgia Fee schedule $22.08–25.52 $25.52 Not published Not published

Wisconsin Fee schedule $25.04 Not published Not published Not published

Nevada Fee schedule $25.00 Not published $25.00 Not published

South Carolina Fee schedule $16.28–25.00 $16.20 Not published Not published

Idaho Fee schedule $24.44 Not published $21.04 Not published

Virginia Average paid $19.91–23.44 $15.34–19.80 Not published Not published

Alabama Average paid $17.72–22.07 Not published $17.36 $27.00

Arkansas Fee schedule $20.48 Not published Not published Not published

Louisiana Fee schedule $19.08 Not published Not published Not published

Illinois Average paid $18.75 Not published $29.63–31.40 $21.75–32.10

Nebraska Fee schedule $15.00 Not published Not published Not published

California Average paid Not published Not published $33.29–38.46 Not published

Delaware Fee schedule Not published Not published Not published $41.92

Hawaii Not published yet Not published Not published Not published Not published

Kansas Not published yet Not published Not published Not published Not published

Massachusetts Not published yet Not published Not published Not published Not published

Michigan Not published yet Not published Not published Not published Not published

Mississippi Not published yet Not published Not published Not published Not published

New Hampshire Not published yet Not published Not published Not published Not published

New York Not published yet Not published Not published Not published Not published

19 states published the average the federal rule asks for and we checked it against the state's own document; for 25 more we show the state's fee schedule rate instead. Not published yet or not checked as of October 27, 2026: Hawaii, Kansas, Massachusetts, Michigan, Mississippi, New Hampshire and New York. Rows a state reports for agencies and individual caregivers alike count as agency rates. Left out: per-diem, adult day and group rates, nursing visits some states file under home health aide, rows with no claims, and figures outside $10 to $80 an hour. Each state name links to its document.

Logicly’s reading

Missouri's agency rate of $32.68 is 7th highest of the 24 states whose fee schedule we show. Fee schedule rates run from $15.00 to $51.91 an hour.

Neighbouring counties

The markets next door

Cape Girardeau 16,567 +13.2% 5.2% 55.0 $16.32

Stoddard 6,095 +3.8% 9.2% 88.8 $14.83

Perry 4,266 +12.7% 5.0% Not published $14.83

Wayne 2,980 +5.1% 7.6% Not published $14.83

Madison 2,778 +10.6% 6.6% Not published $14.83

Bollinger 2,428 +5.5% 10.3% 21.4 $16.32

Each county links to its own report. BLS withholds job counts where a county has too few employers to publish without identifying them.

Logicly’s reading

Cape Girardeau, Madison and Perry have faster senior growth than Bollinger. If you serve more than one county, these are the places to look next.

Notes and sources

Government data only: Every figure is published by the Census Bureau, the Bureau of Labor Statistics or a state Medicaid agency. Ratios, growth and shares are worked out from those counts.
Logicly estimate: Only the “What is left of a Medicaid hour” result, from the inputs you set.
Home care: Industry 624120: non-medical home care, homemaker and companion services, and adult day programs. Medicare home health is 621610.
Seniors: People 65 and over. A self-care difficulty is difficulty bathing or dressing; an independent living difficulty is difficulty doing errands alone.
Medicaid rates: Fee-for-service rates from each state's own document, checked twice: the figure, its page or row, and the line it sits on. Averages are what states reported under 42 CFR 447.203(b)(2)(iii); a fee schedule rate is the most or the set amount a state pays per unit, converted to an hour. Some states keep these files on a contractor's site that their own page links to. Managed care rates are not included. Checked October 27, 2026.
Not included: Puerto Rico and the US territories are not in this release.
Sources: Census population estimates, vintage 2025 · American Community Survey 2020–2024 · County Business Patterns 2023 · BLS QCEW 2019–2025 · BLS OEWS May 2025 · Census county adjacency 2024 · state Medicaid payment rate disclosures and fee schedules, 2025–2026.

Logicly builds this report from public government data. When the Census Bureau and BLS publish new figures we build a new edition.

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