Overtime Policy Leaves Home Care Patients and Workers Fretting

Conn with dogs
David Conn lives in Peoria, Ill., with his mother and two dogs, Jericho and Chieftain. (Paula Templeton)

By Shen Wu Tan

David Conn was only 22 years old in 1990 when he was hit by a car in Nashville, Tenn. Rushed to Nashville Memorial Hospital, Conn suffered both physical and mental injuries from the accident. He lay in a coma in a hospital bed for more than six months.

“It’s not like Hollywood when they wake up and they’re all together,” Paula Templeton, Conn’s mother, said. “They’re not. He had to have so much therapy and different kinds of doctors.”

The car struck Conn’s left leg, breaking the bones. And as he rode along on the car’s hood, his head violently banged against the windshield – resulting in a severe closed head injury – until he was finally thrown into the street.


After the accident, Conn underwent multiple medical procedures including a tracheotomy, which is an incision to his windpipe. In his left leg, a metal rod stretches from his knee to his ankle while a built-in shoe brace wraps around his curled right ankle.

Fifteen years after the accident, Conn started experiencing frequent seizures.

Today, Conn, now 48, lives with his mother in Peoria, Ill., and uses a walker to travel short distances and a wheelchair for longer distances. He also takes seizure medications.

For 25 years, Templeton has been her son’s home care provider, dedicating 24 hours a day to care for him. But she is paid for only 60 hours a week.

Hospital photo
In June 1990, David Conn was transferred to Methodist Hospital in Peoria, Ill., from Nashville, Tenn., after the car accident. (Paula Templeton)

With the passage of a new Illinois Home Services Program overtime policy, Templeton and other home care workers who work overtime will be required to cap their work hours to 40 hours per week, unless their patients are approved for overtime starting March 1.

According to the policy, home care patients might be eligible for overtime hours if they demonstrate an “exceptional care rate,” meet a determination of need score of 70 or higher, experience an “extraordinary circumstance” related to health or safety, or own “a court-ordered service plan that exceeds HSP costs.”

Patients with service plans that exceed 35 hours are required to hire additional home care workers.

Number of home care workers needed for service plans

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The table from DHS lists the number of home care workers patients have to hire based on their service plan hours. (Shen Wu Tan/MEDILL)

But some home care workers and patients said they don’t want to hire another home care worker. These home care workers are often the providers for family members.

Melissa Walker, a home care patient in South Holland, Ill., receives care from her mother, Elaine Walker. Melissa Walker does not agree with the overtime policy and does not want to hire another home care worker.

“I don’t like it,” Melissa Walker said. “I’m not comfortable with everybody. I wouldn’t want people I didn’t know touching me or doing stuff. Because I don’t trust everyone.”

She said she is also concerned about losing her home. Her mother solely relies on income from home services and works 119 hours a week tending to Melissa Walker and her other daughter, Dasia.

Under the overtime policy, Elaine Walker’s income would be cut by about 70 percent.

“It’s heartbreaking for me to even have to go through this when they know the care is being done. They know the needs are being met,” Elaine Walker said. “I’m home helping to give my girls a quality life.”

Using her home care pay, Elaine Walker made modifications to the house, including the construction of a ramp, to make her home more accessible and comfortable for her daughters.

In addition to a large income loss, Elaine Walker added that the policy impedes the right to hire whoever they want. “I don’t think they [Illinois government] have a right to violate my daughters’ rights by saying who they can and cannot have to do the hours that they want.”

Melissa and Dasia
Melissa Walker (left) and her sister, Dasia (right), lounge in their South Holland, Ill., home. (Elaine Walker)

The Illinois Department of Human Services estimates that there are over 27,000 patients in the home services program and roughly 33,000 active home care workers. Of the active home care workers, about 26,000 of them work in any given period.

Data provided to Access Living from the Illinois Department of Human Services reveals that an estimated 6,000 home care providers worked more than 40 hours a week at least once between July and December 2015. It is also anticipated that about 4,524 patients will need to hire additional home care workers.

Between customers and patients, about 10,524 people will be impacted by the new policy.

Despite concerns over the policy, Marianne Manko, director of communications for Illinois Department of Human Services, said she hopes the policy will positively impact home care workers and taxpayers while not affecting the level of care patients receive.

“It guarantees that employees do get time and a half,” Manko said. “But we’re asking the providers to be responsible and not wasteful with taxpayers’ dollars. If it’s not necessary for someone to work time and a half, we don’t want them to. Because we don’t know how much more this is going to cost.”

“The state is pretty serious about controlling overtime costs,” Manko continued. “But never do we want to not provide the best practices so that we can give our clients the most important services.”

Although the Illinois government assured that it is looking out for everyone’s best interests, Templeton said she is not convinced.

“It is like somebody sits up there and they don’t know or care what’s going on with all these disabled people. And they’re just telling them, ‘Well, you do this and you do that.’ I know they had to cut money somewhere, but they can cut it someplace else besides taking it away from these people who need help.”

Templeton said she doesn’t even care about getting paid overtime. She just wants the system to be left as is.

“I mean I think it’s nice if people get time and a half if they need it, but that’s not my goal. My goal is to take care of David.”

Photo at top: David Conn lives in Peoria, Ill., with his mother and two dogs, Jericho and Chieftain. (Paula Templeton)