What is all this about sub-minimum wage?

Is it a “loop hole” or an accommodation?  It depends on how you use it and who you use it for and if you are following the regulations as intended.

Don’t fall for the argument that this is a loop hole – or at least if you do, stop exploitation of those who abuse the system rather than using it to promote employment and community engagement.

White Picket Fence

Section 14 (c) of the Fair Labor Standards Act (FLSA) was not intended to be a “loop-hole” to exploit anyone.  It was also not written to apply to whole populations of people with any type of disability.  The fact that a worker may have a disability is not in and of itself sufficient to warrant the payment of a subminimum wage.

The Special Minimum Wage Provision Section 14c of the FLSA is a vital tool that allows individuals with significant disabilities to work in an environment where they are compensated commensurate with their productivity, have friendships, support and purposeful activity – this can be in any work setting that they choose.  Often, it is in community settings which also enables the employee to build natural supports.

Everyone has a right to work. Support this right for our most vulnerable citizens!

Take a look at this fence – yes, there is a problem – what is the best way to fix it?  Tear the whole fence down or fix that one board?  My vote would be to fix the board and keep the fence.  The same with Section 14 (c) – fix the problem but keep the regulation.

As with many laws and regulations set up to protect people and provide choices and alternatives, there are always those who will exploit and abuse.  This does not mean that the system was bad or caused the exploitation but that those who abuse and exploited were doing evil actions.  Those are the ones that should be held accountable for their wrong-doing – not those who are in need of choice, alternatives and protections.

We should not punish our vulnerable citizens because there are others who will exploit them.  Without certain protections in place our vulnerable citizens will be at risk of much more danger.  What we need to do is call out the evil-doers and hold them accountable for their actions.

Department of Labor fact sheet.

 

 

Person-Centered Planning – Buzz Word or Reality?

We believe in Person-Centered Planning which means looking at cultural humility and competency, taking into account the whole person, including the complexity of his or her world view.

Man walking and balancing on rope over precipice in mountains

How can this be done when advocates do not even speak to other advocates, assuming rumors they have heard about other peoples beliefs rather than talking to the people directly?  How can this be done with family, parent, and care-giving advocates are blocked from Parent to Parent groups or blocked from publicly funded advocacy agencies such as Disability Rights Washington, (Protection and Advocacy Agency for Washington Stated) or The Arc Franchises (which are non-profit but receive public funds for outreach and advocacy) – or from participating in the Developmental Disabilities Council – which is a Federal-State partnership working to plan for and with people with developmental disabilities and their families.

Connect collaborate communicate contribute

There is a huge abyss that so much hard work, passion and caring is falling into because of this lack of ability to communicate with others.

Disability advocacy should not be a tug-of-war between 2 opposing sides – but that is what has been going on for years and it seems to just be getting worse. Disability – and in particular intellectual/developmental disabilities – is a complex web of abilities, independence and inter-dependence.  Many systems, which often are in their own silos, must be pieced together to make person-centered planning work for each individual.  This is no easy task – especially when people, agencies and advocates do not communicate with each other.

In order to make things work, we need to communicate.  We may not need to agree on everything but we need to communicate so that people know and have opportunities to understand what supports and services are needed in order to function in our communities.

Without communication and listening to those who actually use the supports and services, how can we, as a community help provide appropriate resources.  Communication is critical in avoiding unintended and detrimental consequences such as the person becoming disengaged in the process.

We need to ensure that people who use the supports and services, in addition to families and caregivers, have opportunities to be involved in new program developments.  The value of their life experiences is necessary in evaluation and feedback regarding the system and advising on policy decisions.  These are the stakeholders who we need to communicate with – not just the “professionals” or service providers.

Any changes need to be transparent from planning, monitoring, implementation and evaluation of changes made, to those who will be utilizing the services.  The individual,  their families, direct support caregivers and friends are the experts that need to be heard with their collective voice of supporting the person who is the center of the plan.

 

 

 

 

 

 

“Abled” Disabled make decisions

Here is a perfect example of how people who identify as disabled act as ableist as they claim “ableds” act with regards to making decisions about their lives.

“Bickley said it’s frustrating that people without disabilities want to make decisions for others, without knowing or understanding their experiences.”

King County bans employers from paying below minimum wage to people with disabilities

To those people who are quoted in the article and the organizations they work for, it would be helpful to have discussions regarding concerns of people who are ACTUALLY affected by these changes rather than blocking them.  Stand up and listen!

“Everyone deserves equal opportunity to provide for themselves so they can be financially independent and live an independent life,” said Councilmember Dave Upthegrove, who sponsored the legislation.

Excuse me, Councilmember Upthegrove – did you happen to read the JLARC report that came out last year regarding this issue.  This ordinance has nothing to do with improving wages or helping people be financially independent and live an independent life.  That’s called “Magical Thinking” – I don’t think this ordinance is going to be magical.

In case you did not read the report, here is one quote from it

5,110 clients (73%) were employed. They worked an average of 47 hours per month and earned an average wage of $583 per month. Unemployed clients may be in the job development phase.

Clients with high support needs work fewer hours and are more likely to be unemployed

JLARC staff analysis of data for the clients in individual supported employment during fiscal year 2018 found that:

  • 44% of clients with high support needs were unemployed. This is double the rate for clients with medium support needs and five times the rate for clients with low support needs.
  • Clients with high support needs who were employed worked 21 hours per month on average. This is less than half the average hours for clients with medium support needs, and a quarter of the hours for the clients with low support needs.
  • 99% of clients with high support needs earned less than the federal poverty level.

@RealChangeNews – help us understand

 

Please, Councilmember Upthegrove, explain to us all how someone who will only be working 8 hours or less a week will enable them to make enough money to have the “independence everyone wants”

Please review the JLARC report and evaluate the changes that have already occurred before blasting ahead with more changes which will eliminate jobs and opportunities for many in this vulnerable population community.

October was National Disability Employment Awareness Month (#NDEAM).  With this, let us not forget about Person-Centered Planning and Individual Choice.

Evelyn Perez, Assistant Secretary for Developmental Disabilities Administration (DDA)  in Washington State, has started off every presentation I have seen her in the past couple of years with “We are Person-Centered and provide individual choices”  Maybe she does not understand the policies of some of the supports and services in DDA – particularly that of EMPLOYMENT FIRST in Washington State.

We believe people have choices and Washington state denies people their rights in regards to employment and community supports under DDA.  In March 2012, Washington State Legislature passed restrictive legislation with regards to employment.

Employment needs to be the first choice for adults of working age.  If after 9 months they are not satisfied and had an unsuccessful job search, only then may they request a transition to the community access program.  These are two mutually exclusive support services regardless of how few hours a person may utilize.  There is only one service option at a time.

“Please remember that Employment First does not say that people with disabilities have to work at a community job.  They can still work at a facility based program or workshop, or not work at all if that is what they really want to do.”  RTC on Community Living video “What is Employment First?

WAC 388-828-9335

How does DDA determine your employment service level?

DDA determines your employment service level using the following table:

If your

employment

support level in WAC 388-828-9205 is:

And your

employment

status in WAC 388-828-9330 is:

Then your employment service level is: And your employment service hours per month are:
None Working A 0
Working at sub-minimum wage or in job development B 0
Low Working C 4
Working at sub-minimum wage or in job development D 7
Medium Working E 7
Working at sub-minimum wage or in job development F 9
High Working G 11
Working at sub-minimum wage or in job development H 12

 

 

 

Polk and White Haven – PA Hearings

How did we come to this decision and we didn’t ask the residents or the families – and they are first”  Senator Brooks

Find out more information regarding the importance of listening to the residents, their families, guardians, care givers, community members and legislators.  There are many quality testimonies which provide a variety of different aspect of the importance of these communities.

Public hearing on the Closures of the Polk and White Haven State Centers

PA Senate Helath and Human Services Committee

A Pennsylvania Senate Health and Human Services Committee held a public hearing to address the issues of civil rights violations imposed on individuals and their families who are residents of Polk and White Haven Centers.

Thank you to the members of the Senate Health and Human Services Committee for holding this meeting.  Our voices are being heard and we appreciate the understanding and questioning for accountability and transparency from the Department regarding the process they took in their decision to evict people from their homes.

“Real life matters”  Senator Brooks

Teresa Miller, Secretary, Department of Human Services

“We’re not going to rush this process, we’re going to do it right”

I suppose this could be evidenced by how they handled the problems from Blossom:

Tragic abandonment of residents in Blossom

“This is beyond tragic. This man did not have to die, ” said Kathy Sykes, former director of intellectual disability services in Philadelphia. “This is a colossal failure of responsibility to provide basic care and supervision, a colossal systemic failure to manage a transition, a breach of trust for those who were promised their sons and daughters would be cared for, let alone have an everyday life.”

Sherry Landis, CEO, The Arc of PA testified in favor of closure of two of the 4 state Intermediate Care Facilities (ICFs).  If people’s lives were not at stake, some of her comments and inconsistent attempts to answer questions could be comical.

When questioned how the non-profit that advocates for civil rights for folks can endorse saying all centers should be closed and hence taking away the civil rights of individuals and families who’ve made a decision that this is the best option for them, Ms. Landis answered that it has always been the mission of the Arc of PA to ensure the families and the individuals are included in the community.

“It has nothing to do with being a non-profit but it has everything to do with the people that are families and members of who we represent.  This is their desire, it’s not my desire Senator, it’s their desire ”

“They can’t be isolated if they are in a neighborhood”

Sherry Landis, CEO, The Arc of PA

Clearly, The Arc of PA does not represent the residents of Polk and White Haven Centers since it is not their desire to move – this is an action that is being imposed on them and violates their civil rights.

5:35.0 – 10:41 Dr. James Latronica

10:53 – 16:08  Celia Feinsten, Exec. Director, Temple Institute on Disabilities

16:20 – 19:50  Sherry Landis, CEO, The Arc of PA

19:59 – 29:14Carl Solano, Attorney, and Former Guardian

29:42 – 37:11 Gregory Smith, MS, President of White Haven Center Board of Trustees, Consultant and Behavioral and Health Care Services

40:10 – 43:37 Rep. James comments and question to doctor regarding healthcare outcomes and the response.

43:50  – 46:32  Senator Hutchinson questioning Sherry Landis, CEO, The Arc of PA

47:05 – 53:11  Senator Street asking question – Mr. Solano answered regarding previous situations with trying to find community homes. Senator Brooks asks follow up to Celia Feinsten and Sherry Landis

53:21 – 55:41  Rep Gerald Mullery questions trauma transfer – Dr. Latronica gives excellent answer

55:50 – 1:05:54 Rep Toohil has questions for panel regarding isolation in private settings –  Sherry Landis gives her response “to be isolated when living in neighborhood is difficult”

When questioned about the under trained staff and high turnover rate – a high rate which would mean the staff are not trained and experienced, Ms. Landis responded:

“under trained staff member?” I can’t answer for the providers – we’re not a provider but I can honestly say a provider is going to do an extremely good job and make sure their staff is trained if they are going to put the lives of their people in their hands? “

Senator Brooks wraps up with concerns regarding mortality rate and cherry picking data.

1:06.50  – 1:17.30 John Hirschauer, Fellow, National Review

1:17.40 – 1:26.30    Susan Jennings – Keeping Individuals with Intellectual Disabilities Safe (KIIDS)

1:26.45 – 1:27.19  Irene McCabe Says “Thank You” – sister of Polk resident

1:27.23  – 1:43.45    Hugh Dwyer, Exec Director, Voice of Reason (VOR)

  • 1:35.35 – 1:37.35- Appendix J for Federal Regulations and Group Homes are left up to the state.

1:43.38 – 1:47.50  Rep James has a question regarding Olmstead Act – answers provided by Hugo Dwyer, Susan Jennings and John Hirschauer

1:48.52 – 1:52.12  Bill Bailey, Psychological Support Specialist – Polk State Center

1:52.13 – 1:55.45  Maria Ferrey, Qualified Intellectual Disability Professional (QIDP),  Residential Services Supervisor, White Haven State Center

1:55.55  – 1:59.34  Darrin Spann, Assistant Director, AFSCME Council 13

1:59.42 – 2:01.38  Bill Hill, President AFSCME 2334 White Haven State Center,  impassioned speech about professional skills and community

2:01.50  – 2:04.36 Tammy Luce, Residential Service Aide, Polk State Center, President of AFSCME 1050

2:07.30  – 2:16.55 Randy Seitz, President/CEO Penn-Northwest Developmental Corporation – economic impact in the community if Polk Center closed

2:18.00 – 2:35.17 Teresa Miller, Secretary, Department of Human Services and Kristin Aherns, Deputy Secretary, Office of Developmental Programs

2:35.18 – 2:43.40 –  Senator John Yudichak  – questions Secretary Miller regarding community and closure, the department is taking the choice away from residents

2:46.46 – 2:53.27    Senator Lisa Baker questions the decision making process

2:53.35 – 2:56.55  Rep. R. Lee James – questions Teresa Miller, Secretary on resident choices

2:57.04  – 3:05.53   Rep.  Gerald Mullery – Criticism of decision is well deserved- report is due on November 1 to the Governor but the Secretary knows nothing about it or that data is even being collected.

3:05.54 -3:11.02  Senator Hutchinson questions Teresa Miller

I’m even more dismayed now about how this decision was made than I was when I walked in here.  Who made the decision? Senator Hutchinson

In closing,  do you think that it’s an accurate portrayal to talk about the declining populations at the state centers when admissions have virtually closed down?

Hit the Pause Button

“Never Events”

Dangerous situation on city roads

As previously reported, PeaceHealth St. Joseph Medical Center in Bellingham, Washington was found to be out of compliance regarding the use of restraints, seclusion, isolation, patient care and emergency services in an investigation by the Washington State Department of Health.

One critical issue that this investigation missed was the issue of elopement of a vulnerable adult who ran out of the hospital, barefoot and in scrubs, and was later found over 2 miles away.  This event is called a “Never Event” by the Patient Safety Network of the US Department of Health and Human Services.

Patient protection events
Discharge or release of a patient/resident of any age, who is unable to make decisions, to other than an authorized person
Patient death or serious disability associated with patient elopement (disappearance)
Patient suicide, attempted suicide, or self-harm resulting in serious disability, while being cared for in a health care facility

It is clear from the medical record, investigation, reports from local police and family/guardian that the hospital was well aware that this patient was a vulnerable adult under a guardianship yet when this person left the hospital and the hospital staff was well aware that he ran out of the exit while being escorted to the restroom,  the hospital did not notify anyone.  Does this hospital have a policy regarding missing patients such as a special code called?  That is the standard of care and apparently this hospital does not practice up to the standard of care.

I have contacted the DOH team which did this investigation asking questions why this critical event was missed and not addressed in the investigation.  I am still awaiting a response.

I am so thankful that the outcome was not what we see in the photo below – but given the circumstances, this was a real possibility by the “Never Event”

Body of a young child covered by a sheet“.

Stuck in the Hospital – Seclusion violations

PeaceHealth St. Joseph Medical Center, Bellingham, Washington

Bed for restraining psychiatric patiens

Our Developmental Disability Services are failing us.  As more and more people are being left at hospitals with no place else to go, one hospital has violated patient rights by using restraints and seclusion and not practicing up to the standard of care.

This needs to be corrected and other hospitals should take note that this harmful treatment can cause physical and emotional harm and deterioration to these individuals.

MEDICARE COMPLAINT INVESTIGATION

The Washington State Department of Health in accordance with Medicare Conditions of Participation set forth in 42 CFR 482 for Hospitals, found St. Joseph Hospital (PeaceHealth in Bellingham, Washington) NOT IN COMPLIANCE with the following conditions:

 

42 CFR 482.13 (e)(4)(i)  – Patient Rights:  Restraint or Seclusion

The use of restraint or seclusion must be in accordance with a written modification to the patient’s plan of care.

  • Failure to create or modify a plan of care for a patient placed in seclusion could lead to physical deterioration and delay in obtaining appropriate treatments

42 CFR 482.13 (e)(9) –  Patient Rights:  Restraint or Seclusion

Restraint must be discontinued at the earliest possible time regardless of the length of time identified on the order

  • Failure to remove a patient from seclusion after staff observed him to be re-directable  or without significant disruptive behavior, can lead to physical and emotional harm to the patient

 

wrist restraint is applied and locked to a wrist

 

42 CFR 482.13 (e)(12) – Patient Rights – Restraint or Seclusion

When restraint or seclusion is used for the management of violent or self-destructive behavior that jeopardizes the immediate physical safety of the patient, a staff member, or others, the patient must be seen face-to-face within 1 hour after the initiation of the intervention – by a 1. Physician or other licensed independent practitioner, or 2, Registered nurse or physician assistant who has been trained in accordance with the requirement specified in paragraph (f) of this section.

  • Failure to perform or document a one-hour post application evaluation on a patient during use of physical restraints or seclusion for violent behavior can lead to possible abuse, assault, and self-injury or poor patient outcome.

solitary confinement.jpeg

42 CFR 482.55(a)(3) – Emergency Services Policies 

The policies and procedures governing medical care provided in the emergency service or department are established by and are a continuing responsibility of the medical staff.

  • Failure to perform a complete initial assessment can lead to obtaining inaccurate patient information resulting in an ineffective plan of care, treatment or services.

STATE COMPLAINT INVESTIGATION

The Washington State Department of Health in accordance with Washington Administrative Code (WAC), Chapter 246-320 Hospital Licensing, conducted this complaint investigation and violations were found pertinent to this complaint.

WAC 246-320-226 (3)(f) Patient Care Services – Restraints/Seclusion

  • The Washington Administrative Code was not met as evidenced by the fact the hospital failed to ensure staff performed and documented on-hour face-to-face evaluation after initiation of restraint or seclusion for patients exhibiting violent behavior, as observed in 3 out of 7 patient records reviewed.
  • Seclusion was used preemptively and failed to remove patient from seclusion after staff observed him to be re-directable or without significant disruptive behavior.  This can lead to physical and emotional harm to the patient.
  • Failure to initiate or modify a plan of care for a patient placed in seclusion could lead to physical deterioration and delay in obtaining appropriate treatments.

WAC 246-320-281 (4) Emergency Services – Standard of Care. 

If providing emergency services, hospitals must use hospital policies and procedures which define standards of care.

Failure to perform a complete initial assessment can lead to obtaining inaccurate patient information resulting in an ineffective plan of care, treatment or services.

#waleg #disabilities @DdOmbuds  @SFrameK5

St. Joseph Hospital Medicare and State Complaint Investigation regarding Patient Restraint, Seclusion, Emergency Services 2019