I live in King George where the pay is much lower than in the surrounding counties of Spotsylvania and Stafford. As a result, there are no caregivers to hire in King George. Anybody who lives here and is in that line of work,drives  twenty minutes north where the pay is $2 or more per hour. And yet it is illegal to tip, supplement, or pay for gas to get anybody to drive . out here. The system punishes the rural counties by making it impossible to find help.