>I own a Medicaid home care agency in 13 states. We serve low income families and our caregivers

There's an extreme selection bias there. If you run an agency that works with low income families you're not going to see a representative sample of the overall population.

> There's an extreme selection bias there.

Maybe. Unfortunately, what digitaltrees wrote here is ambiguous. It could also be read as this:

Our caregivers serve low income families. Those caregivers, who are our employees, earn $12-18/hr which is above minimum wage. Our employees absolutely struggle. Our employees are the ones using food banks and housing assistance because many are one car repair away from homelessness.

digitaltrees: which interpretation is correct?

I think the latter interpretation is correct. As in digitaltrees runs a business that does not pay its employees a living wage, who then have to rely on food banks and housing assistance.

If you read the rest of the comment you’ll find it’s about their employees rather than their clientele.