Caregivers in Oregon group homes are asking Governor Tina Kotek to fire their boss, the Oregon Department of Human Services manager who oversees direct support crisis specialists. The request comes after these workers continue to face long hours, little pay and severe understaffing. Currently, there is a vacancy rate of almost 15%. Christina Sydenstricker-Brown is a direct support crisis specialist and the president of the union representing these workers. She joins us to share what has changed since the Oregon Capital Chronicle initially broke this story and why they are taking the dramatic step of calling for their boss to be fired.
This transcript was created by a computer and edited by a volunteer.
Dave Miller: From the Gert Boyle Studio at OPB, this is Think Out Loud. I’m Dave Miller. Caregivers in Oregon group homes are asking Governor Tina Kotek to fire their boss, the Oregon Department of Human Services manager who oversees direct support crisis specialists. They say they continue to face understaffing, long hours, unsafe working conditions and low pay. Christina Sydenstricker-Brown is a direct support crisis specialist and the president of the union representing these workers. We first talked back in March – that was before her union’s call to fire Sierra Rawson, the director of the Stabilization and Crisis Unit.
I should note that we did request conversations with Rawson or other DHS officials. They declined but gave us a statement. I’ll read some of that as we go. Christina Sydenstricker-Brown, welcome back to Think Out Loud.
Christina Sydenstricker-Brown: Thank you. I’m happy to be here.
Dave Miller: It’s great to have you on. Can you just first remind us what the Stabilization and Crisis Unit is?
Sydenstricker-Brown: Yeah. Stabilization and Crisis Unit is group home-style work. They’re individuals with IDD [Intellectual/Developmental Disabilities]. A lot of them are double, triple, diagnosed. They have mental illnesses as well, and very high functioning behavioral individuals that require a one-on-one staffing. A lot of two-on-one staffing, sometimes three-on-one staffing in the community.
We are up I-5, so all the way up to Gresham, all the way down to Eugene. We have 19 homes. We support two medical-fragile homes up in the Portland area as well. And that support is a little different. Those individuals are very fragile. A lot of G tube traits, they have to be moved to side liers, to prone position, to other side liers, so they don’t break down and get bed sores. So that style of work is a little different, very much so appreciated though and needed within our agency.
On a day-to-day basis, we take care of the individuals getting their needs met, what that requires… each individual is different. They all have their own positive behavior support plan that we follow, as well as activities that they do out in the community. They go to school, some of them go to the movies, they go to the beach, they go to the zoo, they have fun trips, they have appointments that we provide them with. We take them to DBT [Dialectical Behavioral Therapy], we take them to psych appointments. We take them to their PCP [Primary Care Physician], get all the medications that they need. The day starts out where you, you pass pills to your individuals to get them going for the day, you feed them the meals that they require for the day, and then you transport them to where they need to be for the day. You help them through their daily, what we call ‘baseline,’ would be a great day. We try to keep them at baseline so we don’t have crises. And so that’s what we’re there to do, is to support our individuals, to give them the best life possible that they can have.
Miller: One of the big issues that we talked about back in March is worker safety. Can you remind us what caregivers have been dealing with?
Sydenstricker-Brown: So we’re in a staffing crisis, and we have been for some time now. It’s the worst I’ve ever seen in my 25 years of working for SACU [Stabilization and Crisis Unit]. We are coming to work and our grave yarders are working day shift with our day shift people that are showing up and then they go home after working doubles and then the day shift people are staying and working swing shift and then the swing shift people are staying and working graveyard to meet the numbers that we need in order to run it successfully, and for our individuals to be as safe as possible and for the staff to go home safely.
So we’ve been in the staffing crisis for some time. We’ve asked for some help with the staffing crisis. We really haven’t seen any change since I talked to you in March. And so it’s just disheartening.
Miller: DHS did send us this, in response to this particular question of staffing, they wrote this:
“Both private and government agencies are currently struggling to recruit and hire direct care workers. Despite these challenges, thanks to deliberate and focused recruitment and hiring efforts, the current vacancy rates for direct care positions in SACU homes is 8.58%. This is down from 14.7% earlier this year and we remain committed to continuing these efforts to bolster the SACU workforce.”
I’m hoping you can help me understand the discrepancy here, because they point to an 8.6% vacancy rate as opposed to 14.7%, the number that you mentioned in an email to the governor less than a month ago. Has it gone down that much in a month, or are you talking about different ways to calculate vacancy rates?
Sydenstricker-Brown: So there’s different ways to calculate vacancy rates. That is very true. But they did do a hiring. They had a big hiring event that happened in May and out of 40 people, they were able to hire 15 or so [who] made it through. That requires the training that they do for three weeks. It requires the numbers that they can only have in the training room at the same time with new employees, on top of staff, every two years, have to get recertified. And so they’re going through training as well.
So in reality, those numbers seem good but they’re not because we failed to respect the fact that people are on administrative leave, people are on SAIF. People are ‘modified working,’ and people have protective leave FML. And so with that, it’s at least an extra 4%. This should be added on to that vacancy rate and that is constant throughout the day-to-day work. We have at least 1,800 hours just at my home alone of scheduled overtime this month. So, the number…
Miller: This is an issue that we talked about the last time we were on. Does ‘scheduled’ mean in a sense, ‘mandatory?’
Sydenstricker-Brown: Yes, because they schedule it so that you have opportunity to sign up for it, so you know prior to the overtime, but if nobody fills those holes, it becomes mandatory. Yes.
Miller: 1,800 hours. What does that mean for you for the next month? What are you going to be doing in terms of shifts?
Sydenstricker-Brown: So, I typically work every day. I come to work. I stay, I don’t go home. I work 80 hours a week. I come in on my days off on occasion to make sure the individuals get their needs met so that certain appointments, meeting with parents, and you have to take them up to Portland area just to meet their goals. It requires the staff. Most all of our individuals are two on one to be supported in the community. So to be able to do these outings, and make appointments that they have scheduled, that need to be done, you need the staff. Otherwise, we’re sitting in the house and we’re short staffed and nobody’s doing anything except for what we are capable of to entertain within the home, which is arts and crafts, playing basketball outside, gardening a little bit, taking care of some chickens, but that gets old every day. And they have these needs that need to be met, these goals have to be met.
And so it’s a lot of balancing which one is more priority than the other? It’s communication with our managers. Ok. What are we gonna cancel? What are we gonna do? How are we gonna make this work?
Miller: As you noted, there has been some hiring recently, and in their statement, they noted something that we’ve talked about in this show a lot, which is that in the public and private sectors, staffing and hiring have been really serious challenges. What more do you want the state to do? What do you want them to do that they have not already done?
Sydenstricker-Brown: I would appreciate it if they would recognize the true vacancy rate number, not just the vacancy of the number of that position being open.
Miller: You’re saying that they’re not being clear enough about the number of people who are actually showing up for work on any given week?
Sydenstricker-Brown: Yes.
Miller: But what about hiring itself? What do you think it would take to hire more people – I mean, enough people that you wouldn’t be in this cycle of overtime?
Sydenstricker-Brown: I would say at least anywhere from 60 to 45 bodies the agency needs more of, in order to be fully staffed. Another issue is [that] we follow their positive behavior, support plan, and in order to follow that it requires more staff than what we have at the home. And that, alone too, doesn’t help with us. We struggle trying to get those things met when you don’t have the staff or the bodies to do the work.
I really wish that the recruitment would be more honest and upfront about the job that is at hand and the reality of the real work that we do. I feel like there’s a mishap of the way they advertise for our work. Like my home... if you Google it, it’s a ‘nursing home.’ This is not a ‘nursing home,’ this is a crisis group home. This is a Stabilization and Crisis Unit for individuals with challenging behaviors and that deserve the best quality of life and we’re failing that piece because they’re not advertising correctly. And I feel if they were to advertise the job as what it really is, you wouldn’t have people hired and then they turn around, they leave because they’re like, ‘Oh, I didn’t sign up for this.’ And so that’s what’s frustrating. I feel like they kind of get not told the exact truth of what they’re getting themselves into.
Miller: Do you think as many people would apply if they knew the truth about what the job actually entailed?
Sydenstricker-Brown: I’m not sure about that, but I think that you would maybe see more people apply that are more into that behavioral functioning of a day, that have [gone] to school for that type of work…
Miller: As opposed to hiring people who then realize that the job is not at all what they wanted?
Sydenstricker-Brown: Yeah. Some people think it’s like a CNA [Certified Nurses Aide] job, more of a nursing home style type of job, more IDD individuals – and our individuals are diagnosed IDD, but they also have these mental illnesses...
Miller: Intellectual and Developmental Disabilities?
Sydenstricker-Brown: Yes.
Miller: I wanna go back to this safety question because that’s something that you talked about back in March. I know that that’s a piece of it and it’s related to staffing, which ended up talking about a fair amount just now. But we did ask DHS specifically about your safety concerns as well. And this was their response:
“We are committed to supporting the health, safety and well-being of our workforce and the individuals we serve. We take the safety concerns of the union seriously. There is much being done to support and improve safety in SACU homes. Some of these efforts include the safety manager touring homes across the state to address concerns, rapidly addressing any environment modifications needed to provide individual care and safely support resident needs when they enter a home, and expanding training, both for staff and for supervisors.”
What do you think of these efforts?
Sydenstricker-Brown: I don’t know anything about the training staff in more of that area. The problem is that we don’t have enough staff to even do the fix ups that need to happen, or like we have a broken shower that’s been broken for almost a year that needs to be fixed - it’s all cracked and that’s dangerous and that could be used as a weapon, or they could save it to use for themselves as a self-harm object. So there’s a lot of things that need to be fixed in a timely manner and it’s not happening in a timely manner. They’ve known about our shower for some time now and it’s still broken, and this August was a year. So to me, I don’t believe that all that they had said is truthful. I haven’t seen it myself.
Miller: We did reach out to the governor’s office about this, since a little under a month ago, your union wrote a letter to her saying, “We don’t have confidence in the director of our unit. We think she should be replaced.”
We got a two-sentence response. They wrote this:
“The governor takes the concerns outlined in the letter very seriously and values the hardworking staff at the Stabilization and Crisis Unit. Her office has been following up with AFSCME, your union, and Oregon Department of Human Services.”
How much of this in your mind is about one leader as opposed to larger policies?
Sydenstricker-Brown: I feel that Sierra Rawlins as a leader… that she should have a direction and she should be focused on making the employees feel safe and making sure that the individuals that we support, which is our job that we’re able to do, on a day-to-day basis. And I feel like the lack of support and the unwillingness to try and communicate with us, when we asked her deliberately about funding and going to the legislature and working together, it was silent, and we still haven’t had a response about that.
I have done this in the past, I mean, our agency, we built it and we got more funding. I wanna say 2016 [or] 2017, we did that together and we went together to legislature, and we fought for more funding for more staff and more positions. And so I feel that there’s a lack of responsibility that she hasn’t taken on, that she needs to. And as a director of SACU, it’s really important for us to be able to do our job and support our individuals. These are vulnerable individuals that have a lack of skill that really need the training. So that requires staff and it requires a safe environment to do this in and that lack has been gone for some time.
Miller: Christina, thanks very much.
Sydenstricker-Brown: You’re welcome.
Miller: Christina Sydenstricker-Brown is the president of the union of caregivers who provide residential treatment for Oregonians with intellectual and developmental disabilities, along with mental health diagnoses. The union announced a vote of no confidence against the leader of the state agency that oversees their work.
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