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Could This Happen In Your Agency? |
 Volume 6 Issue 4 - Spring 2000 A Publication of the TRIC/PLUK Library Editor: LeeAnn Logan llogan@pluk.org Librarian: Janice Sand jsand@pluk.org |
TRIC/PLUK Library 516 N 32nd St Billings, MT 59101-60031-800-222-7585 in MT 406-255-0540 (voice/TT) FAX: 406-255-0523E-mail: triclibrary@pluk.org URL: http://www.pluk.org |
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The 21st Annual Montana Conference on
Developmental Disabilities will be held at the Billings Plaza Holiday
Inn Grand Montana on November 1-3, 2000. More information to follow.
Contact Perry Jones at (406) 444-2995 for more
information.•••
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Article
Could This Happen In Your Agency?
&endash;reprinted from Ancor Links - volume 29, number 8
At about 11:30 a.m. on a hot summer's day, a van driver with an escort drove Bill Doe (not his real name) and seven other people on their regular daily trip from the group home in which they lived to a day program some distance away. They arrived later than usual because several of the people had medical appointments that day. As several of the people in the van were being escorted into the facility, one of the people bolted and ran down the street. This distracted the driver and the escort so no one noticed that Mr. Doe had not left the van with the others.
Day Center policy requires the escort to sign each person into a day-book on an individual sheet. No one signed in for Doe that day so, assuming he had gone to a doctor's appointment, a staff member wrote "absent" on Doe's sheet.
The van dropped one remaining individual at another day center and returned to the group home about 3:30 p.m. Staff members did not realize until 4:50 p.m., when all of the other people who live in the home returned in a different van following their daytime activities, that Doe was missing. A search was immediately initiated and the van driver returned to the day center where Doe usually worked, thinking he might have wandered off. From there, the driver drove around hoping to see the missing man, stopping to search a wooded area near the day center. He also decided to search the 15-passenger van, and at last found Doe curled up on its long rear seat. The dark tinted windows had prevented anyone from seeing Doe in the van earlier. He was pronounced dead at the scene.
The van's air conditioning was turned off with the windows shut while the van was parked during the day. The Post quoted the owner of the home where Doe lived as saying, "He had a habit of going back to the back seat and lying down. Nobody realized that he had done that at that time."
"He's tall," 5 foot 11. "We could not understand why they couldn't see him back there," Doe's brother told Washington Post writers Sewell Chan and Martin Weil. "It sounds like negligence. They had too many opportunities to perform the simple procedure of a head count, or checking the bus to make sure there was no one aboard.. . .they're being too careless."
The city's Medicaid Administrator agreed that "it's sort of hard to understand" what happened and "how this guy was left in the van without someone realizing it."
Doe, the youngest of nine children, was born with cerebral palsy and had severe mental retardation, functioning at the level of about a 3 year old at the time of his death at age 41. His brother said that Doe could not hear and was partially blind after the removal of a cataract two years ago. In addition, he was diabetic and had hypertension, the brother told the Post. Doe entered the city's institution at age 4 and remained there until it closed in 1993, when he moved to a "medium supervision home."
At the time of this incident, city officials were looking at Bill Doe's long standing illnesses as well as the heat as potential causes of his death. They also had not ruled out "other things that are not suggested by his background or history," Post reporters were told.
The agency involved in this death is not one of those criticized for rampant abuse and neglect in a series of Washington Post articles earlier this year. Officials from the DC Department of Human Services have regularly described this agency as one of the best in the city. The 18 year old company receives Medicaid funding to provide housing and transportation to more than 60 people in seven group homes in the District. In fact, the Mental Retardation and Developmental Disabilities Administration gave the company awards for its high quality of services in 1987 and 1994.
Steps taken to prevent reoccurrence
The group home agency involved in this incident has changed its procedures, as has the day center. The home's employees will be required to check to assure that everyone has entered a facility, and the center will now call the home where an absent client lives the first day that individual does not appear, even though anywhere from 10 to 30 percent of the 550 people the agency serves each day may be absent.
The city's Medicaid agency has also issued a new directive advising providers to inquire immediately when an individual does not arrive for their day program or treatment.
Could this happen in your agency?
Are staff required to conduct head counts when the people they support are transported from the place where they live to a job site or a day program? Or on their return? Are vehicles checked after each use to assure that no one has remained inside?
Long, hot summers result in hundreds of deaths across the nation, but a careful system of extra checks and balances must be in place wherever vulnerable individuals receive support. Occurrences such as this can happen in any agency. Use this tragic incident to strengthen your own agency's procedures to assure that this never happens again.•••
IABA Workshop
The Developmental Disabilities Program in concert with Spring Meadow Resources, Inc. is sponsoring a three day Institute for Applied Behavior Analysis (IABA) workshop on May 16-18, 2000 at the Cavanaugh's Colonial Hotel Best Western in Helena. The first two days are sessions entitled Nonaversive Behavioral Support and Basic Principles of Positive Programming (5/16) and Behavioral Assessment and Advanced Support Strategies (5/17) These two sessions compliment each other and attenders are encouraged to attend both sessions.
The session on May 18 is new to the state of Montana&endash;Emergency Management & Reactive Strategies Within a Nonaversive Framework. This session will impart skills to staff who deal with persons who can and do become out of control. "The Best Emergency Management is not to have one in the first place".
All sessions run from 9:00 am [sharp] through 4:30 pm. Please come at 8:30 AM on 5/16 for registration/name badge purposes.
This three day event would be useful for a wide range of staff. Direct service workers, Field Service Specialists, case managers, program managers and others involved in the client planning process are potential attenders. Family Support Specialists, parents, special education teachers and aides would also benefit from the skills imparted.
Can't attend all three days? If you've never been to an IABA training session, you owe it to yourself to come to the two day session on 5/16 and 5/17. The IABA offers some of the best training available in the field of applied behavior analysis, and Tom Willis is internationally recognized as a leader in the field.
WORKSHOP REGISTRATION
DDP and SMR are teaming up to offer this training at about two thirds the normal cost. Even more savings are available based on our ability to negotiate sleeping rooms at the low state rate of $36.40. Double occupancy rates offer even greater savings. Your registration fee covers the IABA workshop fee, rental of meeting space, workshop hand outs and coffee, tea and decaf. All attenders of this training will be required to pre-register. A registration form is enclosed. Registrations will be accepted on a first come, first served basis. Registration forms and remittance must be received by 5/1/00.
Books from the IABA will be for sale onsite in Helena.
CANCELLATION POLICY
Written cancellations received by Heather Lambert at the DDP central office prior to 5/1/00 will be fully refunded. Staff substitutions are welcome. Registrants canceling after 5/1/00 will not be eligible for a refund; the agency is encouraged to send substitutes. In the event you elect to send one or more substitutes, please call Heather Lambert, IABA Registrar in DDP central office. She can be reached at: phone-(444-2664), fax-(444-0230) or e-mail <hlambert@state.mt.us>. Please indicate the name of the person(s) who cannot attend, and the name(s) of the substitute(s), including work mailing address and work phone number.
You should make your room reservations as soon as possible. There will be other events taking place in Helena in mid-May, and it will be difficult or impossible to obtain rooms at state rates if you do not act quickly. The low room rates are guaranteed only until 4/15/00. After that, room rates may increase. When making your room reservations, let the reservation desk know that you are part of the IABA training group, and verify that you will be charged $36.40 per night for single occupancy or confirm the posted rates per person for double occupancy, bed tax inclusive.
Want to know more about the IABA? Check out their website at <http://www.iaba.com>. Information regarding the upcoming training event in Helena can be reviewed under "Training and Seminars"; the three day Helena session is identical to those cities with matching seminar titles (e.g., Iowa City, Iowa).
Feel free to call Perry Jones at 444-5662 if you have any training related questions. His e-mail address is pjones@state.mt.us.
HELENA IABA ROOM BLOCKS AT THE $36.40 SINGLE OCCUPANCY RATE Room charges listed include bed tax, reservations must be made on or before 4/15/00 to receive these discounts.
Registration fee is $120 for the 5/16, 5/17 two day session, $60 for the 5/18 one day session and $180 for all three days.
Checks should be made payable to Spring Meadow Resources. Heather Lambert 444-2995 (phone) or 444-0230 (fax) or hlambert@state.mt.us (e-mail) if you choose to send a substitute in the event of a cancellation.
Please do not hesitate to call Perry Jones at 444-5662 if you have questions or concerns.
QUALITY CORNER
DD Case Managers: If you have things to add to this section, please send them to me. I will compile, edit, and send articles and information on to Lee Ann. Contact: James Driggers at (406) 444-2995.
New Study Pinpoints Risks of Fetal Alcohol
Syndrome
(Note: I saw this in the NASDDDS publication, "Beyond the
Beltway", and thought it worth repeating.)
A "single drinking binge by a pregnant woman can be enough to
permanently damage the brain of her unborn child." According to a new
study, Fetal Alcohol Syndrome, which is the leading known cause of
mental retardation, results from excess alcohol consumption during a
woman's pregnancy. The resulting damage to the fetus is characterized
by lifelong retardation, growth deficiencies, central nervous system
dysfunction and craniofacial abnormalities. A 1996 Institute of
Medicine reported that about 20 percent of women who drink do not
stop drinking during pregnancy. Approximately one in every 1,000
infants born in the United States are born with fetal alcohol
syndrome. The estimated life time cost of medical and support
services for a person born with fetal alcohol syndrome range around
$1.4 million according to the National Organization on Fetal Alcohol
Syndrome.
A new study lead by Dr. John Olney, Professor of Psychiatry at Washington University School of Medicine in St. Louis, identifies the time from the sixth month of pregnancy through the second to third year of life as the period when a developing fetus or young child is the "most vulnerable" to consumption of alcohol. The study further found that it only takes "one drinking binge" or episode of intoxication during the period of vulnerability to cause the damage associated with Fetal Alcohol Syndrome. The prudent policy would be to "have no alcohol during pregnancy."
During this vulnerable period, the connections between neurons are being built. This "brain growth spurt" that occurs over a prolong period of time in humans can be seriously damaged by extended contact with alcohol that lasts four or more hours. Brain cells in a developing fetus and young child die by the millions when intoxication occurs. The study further indicates anesthetics possibly could have the same effects on young children and that there is a further need to assess the safety of anesthetics given when a child's brain is still developing. Information for this article was obtained from a February 10th, MSNBC Health story posted at http://www.msnbc.com/news/368599.asp. The study can be found in the February 2000 edition of the journal, SCIENCE.
New Rules on Tube Feeding
In case you haven't heard, a new rule went into effect on
February 03, 2000 which allows tube-feeding to be a delegated
activity. This means that a person can be tube-fed by paid
habilitation or other staff, as long as the staff doing the feeding
have been so delegated by a nurse. Previously, tube-feeding has been
a task which was not delegable, and had to be performed by a nurse.
This new rule applies to a "gastrostomy tube feeding by way of a
non-acute, well-healed, patent, percutaneous insertion site older
than two months..." Some nurses are willing to delegate this task,
and others are not. In any event, this is a very positive step for a
number of people with whom we work. For more information, please
contact Daphne Crosbie at the DD Central Office
(444-2995).
Restriction on Firearms
Debbie Heerdt from Bozeman recently had a discussion with the
Bureau of Alcohol, Tobacco and Firearms (ATF) about an individual's
ability to possess a firearm. Some people, as it turns out, cannot
legally receive or possess firearms. That includes an individual who
has been "adjudicated as a mental defective or has been committed to
a mental institution." The initial interpretation from the ATF is
that the term "mental defective" includes people who have been found
to have marked subnormal intelligence. In the case in Bozeman, the
AFT felt that because the State of Montana determined that the
individual was eligible for DD Services, that individual "may never
purchase or possess a firearm." Nothing, they say, including firearm
safety classes, can overcome this prohibition.
This presents a dilemma for case managers who may know of a person on their caseload who has a hunting rifle used for hunting with their family, for example. It would be difficult to disarm the person, of course, or even tell a family that the individual can no longer own their rifle. And yet case managers feel obligated to inform people about the law. We will write a policy clarification about the role that a case manager should play in this situation.
See you at the Case Management Training in Helena on May 2-4.--James •••
IS MY ATTITUDE WORTH CATCHING?
by Lori Wertz and Novelene
Martin
What does my attitude have to do with how I do my job? Why is my attitude anyone else's business? How do we decide who has a "good attitude" or a "bad attitude"? According to the dictionary, attitude is defined as "a mental condition with regard to a fact or state; a feeling or emotion toward a fact or state." So how can we measure attitude?
While attitude may be difficult to put into a measurable objective, it is often described in terms of behavior. Many of us can identify staff and co-workers who have a "good attitude." These are the folks who generally make a positive statement about their job, their co-workers and the people they serve. They are supportive, not easily ruffled and willing to assist at the drop of a hat. They are excited to try new things and want work to be fun. These are the staff who follow not just the rules but the ethics of the profession. They don't need confrontation and they don't need to control their environment or the people around them in order to feel good about their performance. These folks are secure in the job they do and know that they make a difference.
We can also readily identify the people we know with "bad attitudes." These are the dark clouds that enter a room and create a storm. The "behavioral attitude" can include making disparaging remarks about co-workers, persons receiving services, organizations, etc. These are the shadow warriors who look for situations where they can confront others, are quick to point fingers, lay blame and generally undermine other people's sense of self esteem to create an environment of fear and suspicion. These folks seem to love a crisis and may even create violent or confrontational situations with others while at the same time playing the part of a victim. In turn, these "victims" can validate their attitudes-"we're helpless", "it is someone else's fault", "it isn't my job/responsibility"
Why would we want to be helpless and not in control of our lives?
Each and every day, we need to ask ourselves: "Is my attitude worth catching?" Do I come to work each day, complaining about low wages, poor working conditions, too much demand and not enough time, challenging consumers, and and and and ....If my job is so miserable, what am I still doing here? Does this attitude influence my co-workers? The consumers? The Agency? The system? All of that can be answered with a resounding YES. Just as the flu can be contagious, so can one's attitude.
So how can I make my attitude worth catching? In the video entitled "FISHES", there were some simple suggestions from the workers at the Pike Street Market. As the name implies, these folks work at a fish market-and do some of the slimiest, stinkiest, most unappealing work you might imagine. Yet, they are having a great time! Their secret? It involves a four step process:
This might sound basic but the simple truth is: the choice is ours. Let's go out and make our attitudes worth catching!•••
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