Wednesday, June 18, 2008

Here's Solution Focussed Action

The State of New York has taken some serious steps in their effort to eradicate the domestic violence, sexual exploitation, medical and other types of neglect, and financial exploitation of adults with developmental disabilities. I'm going to withold my own opinions until I've heard from some other folks.

OMRDD Unveils Aggressive Campaign to Reduce Abuse and Neglect

ALBANY, NY (06/18/2008)(readMedia)

The Office of Mental Retardation and Developmental Disabilities (OMRDD) released a multifaceted approach to reducing serious incidents, abuse and neglect in its service system, Commissioner Diana Jones Ritter announced today.

Foremost in this new effort is the creation of the Division of Workforce and Talent Development, which is designed to bring leadership, heightened investment and oversight to the agency, enhancing it’s capacity to develop and sustain the relationship which is critical to success for people who have developmental disabilities. Research shows that the best way to both prevent abuse and promote richer lives is to strengthen and nourish the relationships between individuals with developmental disabilities and those that care for them. To achieve these goals, OMRDD, with more than 90,000 staff in state and voluntary programs, is expanding and refocusing training and supervision.

“OMRDD’s core mission is to help people with developmental disabilities lead richer lives. Obviously, this is severely undermined each time a person with a developmental disability is the victim of abuse or neglect or the focus of a serious, reportable incident,” said Commissioner Ritter. “My leadership team and I have committed to reducing the number of such incidents. We realize the work our committed, hardworking and dedicated staff perform can be highly stressful, so we must work with a broad set of partners to ensure that our direct-care workers are not only well-trained, but also have the proper foundations of support.”

The quality of care for people with developmental disabilities is tied to the positive relationships in that person’s life – especially those with staff who are deeply involved in their daily lives. The vast majority of those who care for the developmentally disabled are good and caring people. However, research has found when an individual is abused by staff, there are several negative effects. In addition to physical or psychological injury to the victim and the penalties to staff whom are responsible, another result which may be even more devastating relates to the destruction of the very essence of that helping relationship. Abuse harms the relationship and thereby harms the hope, both of which are needed in order to thrive. It is with this in mind that OMRDD is accelerating the development and implementation of the following tactical plan:

• Expansion and refocused training and supervision of key, stress-intensive living or program environments. It has been demonstrated that many instances of abuse, neglect or serious reportable incidents are a by-product of situational stress or environmental circumstances that cause some staff to behave in unacceptable ways. To ensure all direct contact staff – especially those working in highly stressful situations – are properly trained and supervised, OMRDD has invested in expanded training for its developmental aides and their supervisors.

• Expansion and refocusing of training for staff of its voluntary provider agencies. This new focus isdesigned to enhance staff skills both in developing the positive, mission-driven skills needed in their work, and also to provide individual and supervisory tools that help them deal with the stress of their day-to-day working environment.

• Engaging in discussions with OMRDD workforce and labor/management groups on ways to reduce stress in the working environment and to better manage the fallout when staff is determined to have acted in an unacceptable manner.

• The creation of the new Division of Workforce and Talent Development. Already this new Division has taken on the following challenges:

Established mandated core training topics for Developmental Assistant supervisors
Refined the Competencies to which Developmental Aides are trained
Created a workgroup to reengineer the Developmental Aide Traineeship
Revised OMRDD’s approach to training staff to intervene during behavioral crises
Received a multi-year grant from the federal government to examine a wide range of direct support workforce issues including training, career paths and improving recruitment and retention of workers; and developing a workforce that serves self-directing individuals.

Established an accessible and cost efficient online training institute.
Assess the impact of current recruitment efforts on staff.
Commissioner Ritter has also created a new Office of Investigations and Internal Affairs to improve its capacity to investigate reports of abuse and neglect, among other incidents.

OMRDD is reaching out to partner with external groups who have expertise in workforce issues, abuse and neglect, and organizational cultures. The University at Albany School of Social Welfare, Center for Intellectual Disabilities and its Dean, Professor Katharine H. Briar-Lawson, have pledged such a partnership.

“This kind of collaboration brings some of the most respected practitioners to the issue, as well as creates a learning partnership for both our staff and the students in this prestigious school of social work,” said Commissioner Ritter. “As I have said many times since becoming Commissioner, OMRDD has a solid history. However, I believe we have been unable to go from ‘good’ to ‘great’ by the insularity of so much of its work. A hallmark of my time as Commissioner will be not just transparency, but broad partnership and collaboration.”

Eventually, these partnerships will grow beyond the initial partnership with the University at Albany, to help establish a corporate culture within the OMRDD funded system where there will be zero tolerance for abuse and neglect. This abuse prevention strategy will be embedded in the agency’s overall quality management strategy, focusing on staff and their interactions with people with disabilities.
This new effort will involve a three- part approach:

1) The Risk Appraisal portion will use well-established national research on institutional abuse to create a Risk Appraisal Profile for each unit. OMRDD will be using CDDDSO as a prototype for this approach. Having developed a profile of the risk factors for each unit, the agency will work in a collaborative manner with employees, unions, management, individuals and self-advocates to develop the second component;

2) A Prescriptive Prevention Strategy for each unit within the facility that is directly reflective of that unit’s risk profile. Actions in this area will include all levels of the organization and may involve such things as staff training, reevaluation of client groupings, staff counseling and support, anticipation of seasonal factors, and raising the awareness of staff to the issues involved in abuse prevention.

The intent in the Prescriptive Package is not to focus on any individual, staff or system-related problem, but rather to approach the problems jointly in an effort to reduce or eliminate, to the greatest extent possible, the factors which make it more likely that abuse will occur.

3) An Abuse Awareness Campaign will be a system-wide public education and marketing campaign, which OMRDD will again pilot in the Capital District. Aimed at staff of all levels, the theme of this portion of the project will be the preservation and enhancement of dignity and respect for individuals in our care. To the extent that we are able to positively impact upon the nature of the relationship between individuals and staff and promote a heightened awareness on the part of staff to the importance of maintaining people’s dignity and respect, we will decrease the likelihood that staff will abuse individuals or tolerate abusive behavior from their peers.

“Everyone benefits by enhancing the staff to consumer relationship and promoting the highest level of dignity, respect and value between consumers and staff,” said Commissioner Ritter. “The satisfaction of the staff will increase when they feel better about their relationship with those they support, the individuals in our care will thrive upon the increased positive interactions with staff. Furthermore, administration will become increasingly sensitive to the many factors which they must balance to maintain and enhance quality of care.”

This new strategy will be developed as a prototype within the Capital District Developmental Disabilities Services Office which is located in Niskayuna, N.Y.. A project team has been identified which includes the CD DDSO director and deputy directors and appropriate managers and staff from OMRDD’s Executive Office and Divisions of Workforce and Talent Development and Quality Management.

A local advisory board involving self-advocates, families, the CDDDSO Board of Visitors, and the workforce, among others, will be developed to support this effort.

The risk assessment phase of this project will begin during the summer. Performance measures are being developed to track these measures impact on staff-to-person interactions and relationships as well as incidence levels of reported and substantiated allegations of abuse, neglect and serious reportable incidents.

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