I contributed to an amicus brief on home healthcare about my experience as a disabled, trans person. For me, my trans queer identity plays a central role in my homecare. I receive 20 hours of care, each day, through my MLTC (managed long term care provider). Over 56 hours each week involve intimate aspects of my daily routine – bathing, getting dressed, using the toilet. Each state has different rules for paying homecare workers, but due to the federal ruling by the DOL, these workers must now receive overtime if they work over 40 hours a week. Sounds great, right? It’s not, because many will be losing a significant amount of pay, as a result.

Home healthcare workers are typically paid by funds through Medicaid, which are implemented on a state level. The federal ruling by the DOL would apply to every government funded homecare program. However, the ruling ignores why there was a special exception for overtime in the first place. Many workers work more than 40 hours a week, and most states do not have money allocated for overtime. The special exception ensured they could work overtime hours without overtime pay. With the DOL ruling, this means that many states will be implementing restrictions that cap home health care workers at 40 hours. Rather than providing a benefit by giving workers overtime pay, the DOL has effectively shut them off from receiving any overtime hours. Many states, such as Texas, have started to cap hours, as a result.

Finding reliable home healthcare workers can be difficult enough, so when disabled individuals find excellent, reliable workers they often schedule those workers for the majority of their hours. For some, it can be so difficult to find workers, so one or two people do all of their hours. In most states, home healthcare workers are paid minimum wage, which is around $9 per hour. Many are women without a college education, some without high school. Many are people of color. These individuals rely on the fact they can work 60, 80, even 100 hours a week. They rely on this income, because they do not make a living wage otherwise. With their hours cut down to 40 (or 39 ½ in Texas) per week, many of these individuals will have to either quit their job completely because they cannot afford to live, or take on a second or third job, so they can continue to live. This, of course, will also put further strain on the disabled people for whom they work, especially if they have to quit.

For those of us with disabilities who are also LGBTQ, the issue is further compounded. This is especially true for those of us who are transgender or otherwise gender nonconforming. I have two primary home healthcare workers who do most of my care. One has worked for me for 13 years, and she works over 80 hours a week. The other has worked for me for the past five years. I trust both of them to treat me with dignity and respect. These are individuals I can trust to not harm my transgender body. Finding other workers who are trans friendly, who I can trust to help me, and can trust with my safety has proven to be difficult. With the low pay, a lot of non-skilled workers with zero experience apply, and not everybody is as friendly when they find out I’m transgender.

As a transgender person, I have to worry about every person who comes into contact with my body. My safety is at risk with every new person I hire to take care of me. Not everyone is as accepting of trans people, or as willing to work with someone in such an intimate fashion who is trans. We are talking about the person who has to wipe my rear end for me, and you better be sure that I must trust the person who does that. That individual will also be seeing my naked, trans body every single day they work, with its scars so prevalent – an obvious sign of my trans-ness, my otherness. I do not have the luxury of hiring just anyone. My life is at risk if I choose the wrong person, a person who decides they do not like trans people, after all. I cannot take such hiring decisions lightly. My life depends upon it.

With these regulations, a worker who has worked for me for over a decade is at risk of losing over half her hours. She has the potential to lose over half of her pay. I have the potential to lose the safety I have known, with her performing my most intimate care routines. I have the potential of losing the dignity I receive by having her work for me. I have the potential to lose a feeling of safety, knowing that I will not be harmed during my home care routine. All of it is because the DOL has made it clear that these issues do not matter. The Supreme Court is not even going to look over the case. They will not even see my story, or understand the danger this ruling places upon trans disabled people – on any disabled person, really. Homecare needs to be safe for all of us, and the government has failed us on that.

Believe me, if I thought the state could afford it, I would support the overtime ruling in a heartbeat. Our home healthcare workers deserve so much more money than they receive. The work they do is often difficult, often very physical, and can sometimes be quite complicated. However, the states are choosing instead to cut hours, which will cut salaries, safety, and program efficiency. Many disabled people are going to struggle to find enough people to cover all of their shifts now. Some people will die as a result. The DOL has done a great disservice to the disability community, and we must fight this ruling. My big question is, at what cost?

Contact Dominick Evans