Public Hearing on Workplace Safety and Security

Testimony of Gregory Case, RC II, M.S.

on behalf of the

New York State Public Employees Federation, AFL-CIO

June 24, 2003

    My name is Gregory Case, and I work for the Central New York Developmental Disabilities Services Office (Central NY DDSO) as a Rehabilitation Counselor II. I serve as Council Leader of Division 189, which has over 300 Public Employees Federation members in Herkimer, Lewis, and Oneida Counties. In addition, I am the statewide PEF Chair of the PEF/OMRDD Labor/Management Committee, which represents over 4,600 PEF members from Melville to Perrysburg.

    I know you are hearing from union brothers and sisters across the state over the course of this month. Therefore, I would like to focus my own remarks on the safety and security needs of state employees serving developmentally disabled people and their families in their own homes. And, because I know the local area best, I will refer to the eastern region of the Central NY DDSO to illustrate my remarks (i.e. Herkimer, Lewis, Madison and Oneida Counties).

    As you may know, OMRDD has shifted its delivery of services in many divergent and dramatic ways over the course of the past ten years. Beginning in 1991, New York State entered into its first Home and Community Based Services Waiver (HCBS Waiver) agreement with the Federal government. In 1995, the HCBS Waiver became the primary mechanism by which OMRDD conducts its delivery of state-operated services. In addition to the conversion of homes and programs to the Individualized Service Environment under the HCBS Waiver, tens of thousands of developmentally disabled New Yorkers became eligible to apply for funded services in their own homes. As a result, there are well over 800 developmentally disabled people served in their own homes by state employees here in the eastern region of the Central NY DDSO.

    In the process of this shift, we have seen the emergence of safety and security risks to workers serving in roles of community-based service coordinators, as well as to those providing residential habilitation services, occupational therapy, physical therapy. Such risks range from dangers associated with traveling in isolated rural areas to those associated with violence while delivering services to developmentally disabled people and their families.

    In preparing for today’s presentation, I interviewed fifteen state employees who function as service coordinators (a.k.a. case managers), serving clients who live on their own or with their own families. Of the fifteen, twelve (80%) were able to relate at least one experience of encountering an at-risk situation. The experiences of ten employees are summarized in the attached appendix.

    To summarize the "findings" of the twelve interviews, a total of twenty-eight separate at-risk experiences and events were described, surrounding twenty-seven individuals or families.

    The intent here is not to draw general conclusions. Rather, I believe these interviews clearly illustrate the very real existence of risks regularly encountered by many state employees serving developmentally disabled people and their families in their own homes.

    Addressing the risks and dangers posed to workers is no small task. Workers and their supervisors struggle with this issue continuously. In some cases, workers have been approved to make home visits in pairs. In other cases, workers have become "street-wise," and based on their experiences have learned the precautions necessary to remain safe.

    In the aftermath of two of the worst case situations, PEF Division 189 confronted Central NY DDSO Management with the identified hazards, dangers, and risks. As a result, labor and management worked together in joint development of a response to the situations which I will term "critical incidents" or "violent critical incidents." Today, we have in place:

    The point of highlighting these local experiences is two-fold. First, local OMRDD management has cooperatively worked with labor when confronted with violent critical incidents. Second, we have demonstrated that labor and management can work cooperatively and effectively in developing tailored responses to violent critical incidents.

    The concern I have today is that all these initiatives have taken place in the wake of two violent critical incidents that have seriously affected the lives of hard working, dedicated employees. This is clearly an after-the-barn-door-is-closed approach. More to the point, if this DDSO, or OMRDD as an agency, has a plan to address critical incidents or violent critical incidents, it is a closely guarded secret. In fact, to my knowledge, OMRDD does not even track on-the-job injuries, let alone critical incidents involving employees as targets. Further, only one office in OMRDD tracks critical incidents, and that is the above-referenced local service coordination and support staff office.

    In my view, there are only three ways OMRDD will be moved to address critical incidents and violent critical incidents. The first way, and also the most preferable, is the establishment of a statewide standard that covers all public workplaces and public employees. Second, and less likely, is legislation requiring OMRDD to work with labor in developing and implementing a safety and security plan. The third way, which I pray never becomes the trigger, is the occurrence of a tragedy.

I would support and work for standards that would accomplish the following:

    In summary, safety and security among public employees working with developmentally disabled people and their families in their own homes is emerging as a serious concern. Employees’ lives are deeply affected by the experience of critical incidents and violent critical incidents. Since progress in addressing the very real safety and security needs of employees is nearly negligible, I have reached the conclusion that both a statewide workplace violence standard and legislation is necessary to move OMRDD and each of its DDSO components to collect necessary data and to plan and implement an appropriate and effective safety and security plan.

    Once again, thank you for arranging this hearing, and providing the opportunity for us to discuss this important topic.

APPENDIX

Examples of Critical Incidents and Violent Critical Incidents

In the Eastern Region of the Central New York DDSO

    Worker R.P. describes a middle-aged man who lives in his own apartment, abuses alcohol, and is dually-diagnosed. This man needs multiple face-to-face visits and assistance each month in order to function with minimum effectiveness in the community. He is volatile and unstable, with a history of assaultive behavior, especially toward women. R.P. reports that she must phrase her conversations carefully so as not to trigger a threatening or violent reaction on the part of the client. She cites experiencing added threats while teaching the man to shop for groceries. The man invariably engages in directing ethnic or racist slurs toward other shoppers in the store. Not only is this socially inappropriate, but it also puts both client and worker at risk.

Several months ago, the same client visited a local DDSO office to report that his check from his Representative Payee had not arrived in the mail. His manner was belligerent. S.H., an experienced Social Worker who functions as an office supervisor, addressed the matter and the client left the office. The next day he returned with the same complaint. On this occasion he was even more agitated, belligerent, and angry. The odor of alcohol was detected. S.H. again addressed the concern, and was able to persuade the client to leave the office. In the process, however, the client became highly agitated, aggressive, and angry. The anger was turned on S.H., in the form of shoving her against the office wall. This resulted in an injury to the supervisor. Police were called. The client departed before the police arrived.

    Worker R.P. recounts the following series of events.

    C.M. reports on two risky locations:

    Worker C.K. relates her experiences with a rural family who has a developmentally disabled child. The father’s first act on the first visit was to display his unlocked gun and knife collection to the worker, and explain that he keeps would-be hunters at bay by firing over their heads. Further, the man was frank in his personal remarks toward C.K. C.K. reports being somewhat unnerved when the father informed her that cell phones do not work in that area of the county. The worker has managed to continue to provide needed services to the child by teaming with a physical therapist who also provides services. Both professionals draw clear boundaries regarding the parent’s behavior, and set up time frames for visits carefully. Significantly, the father now keeps his weapons under lock and key.

    Workers C.K. and K.E. each provide services to a developmentally disabled mother and her young developmentally disabled daughter. It is a risky setting, as there is a history of shootings at houses on either side of the clients’ home, and the mother’s boyfriend has a known history of drug arrests.

    Worker R.D. reports on a young developmentally disabled woman who lives with her mother and step-brother. Her own brother was recently shot in the neighborhood, and died in the family home. Coincidentally, R.D. had visited the home about 7 p.m. the evening of the shooting, and the brother was murdered at around 11 p.m. R.D. continues to keep in touch with a neighborhood coalition set up to fight back against such tragedies and violence.

    R.D. describes the situation of two severely developmentally disabled adult clients living with both parents. R.D. recently completed a home visit with the family at about 5:30 p.m., and a shooting occurred in front of the house at about 7 p.m.

    R.D. also reports on a nonverbal autistic teen and his younger brother living with his single mother. An arson fire destroyed a nearby house. R.D. recounted arriving for a face-to-face visit the next day, with the smell of smoke heavy in the air.

    R.D. also faces the challenges of an older, dually-diagnosed teen who was referred to the Central New York DDSO by the mental health system due to his developmental disability. The youth’s parents are deceased. While he is cared for by his grandmother, a number of older brothers and uncles are present, accompanied by alcohol and drug abuse. This youth receives psychoactive medication by injection on a monthly basis. The worker often requires the aid of one of the men in the family to "catch" the young man, in order to transport him to the psychiatric clinic office.

    L.B. relates the experience of visiting a developmentally disabled client at his home, with houses burned on either side of the home and the history of a shooting on the corner still fresh in the family’s mind.

    S.B. described four situations where she visits developmentally disabled clients:

    Worker P.F. reports that a young developmentally disabled woman, who is clinicially depressed and a drug abuser who resides alone, with her mother serving as Representative Payee, continues to use drugs despite undergoing rehabilitation several times. On a recent visit the young woman was nowhere to be found. Upon contacting her mother, P.F. learned that the young woman was most likely staying with "friends," also drug abusers. P.F. is aware the young woman is staying at a very risky location. Visiting the client at this location would undoubtedly put the worker at risk, and the client at even greater risk. She left word with the mother and the local "Welcome Hall" that the young woman should contact her.

    Worker B.G. provides services to a teen-aged client who is dually-diagnosed, and lives at home with his mother. B.G. reports that the young man states to her that he hears voices and belongs to a satanic cult. More ominously, he has threatened to kill his mother and brother. Recently, the Children’s Mobile Assessment Team (CMAT) was called to the young man’s specialized day program twice in one week. The CMAT found the client to be stable at the times of their visits, and no action was therefore taken. Meanwhile, the young man’s mother will not consider placement. While B.G. is somewhat concerned about the level of risk for herself, she is more worried about the safety of the mother and brother.

    B.G. further relates the experience of providing monthly face-to-face services to a middle-aged developmentally disabled man over an extended period of months. She began to notice that each time she arrives, she sees a man standing in the doorway across the hall with his gaze fixed on her. She was uncomfortable with this situation and asked her client to meet her at a safe location. Later, she learned from the client’s landlord that the man across the hall was evicted for exhibiting extremely bizarre behavior.

    Worker K.E. assists a young developmentally disabled woman who lives with her boyfriend in a challenging neighborhood. During face-to-face visits to the apartment, the boyfriend accompanies K.E. to and from her car due to the risk posed by several men living in and loitering around the young woman’s home. The men make threatening and unsavory remarks to K.E. as she arrives and departs.

    Worker K.E. recounts that upon arrival for a visit with a developmentally disabled child, the mother warns, "You don’t want to be here right now." The worker knows this code means the alcohol-abusing step-father is in an unstable state. K.E. whisks the child to a safe location for their monthly face-to-face visit, and returns only long enough to leave the child in the care of her mother.

    K.E. reports that at another home of a developmentally disabled client, she is never certain of the situation in the surrounding neighborhood. She is careful to not divulge her scheduled visit to the home too far in advance, as the client may inadvertently tip off one or more of the neighbors. Further, she must get updated information from the client on the situation in the neighborhood immediately prior to the visit, as nearby drug transactions may be in progress.

    Worker K.E. describes the situation at the home of a developmentally disabled man who is legally blind, where strangers have approached her demanding to know who she is and what business she has at the location. In addition to the risk, K.E. states that traveling there in a State vehicle alerts and alarms men in the neighborhood. Inside the home of the client, there are holes in the windows and walls that appear to have been caused by bullets.