Assessment Tool for Case Managers and Adult Protective Service Workers Working with People with Disabilities: Domestic Violence, Sexual Assault, Stalking and Personal Attendant Abuse Section One: Introduction The Case Manager and Adult Protective Service Worker Assessment Tool is designed to increase awareness of issues related to domestic violence, sexual assault, stalking and personal attendant against women and men with disabilities and Deaf individuals. Specifically, the following questions address agency culture in terms of disseminating information about domestic violence against people with disabilities, cross-agency collaboration efforts, advocacy and outreach activities, skills training activities for consumers, and staff development opportunities. Goals of this Self-Assessment Tool are to assist workers in looking at their practice and agency's protocols for supporting clients with disabilities and Deaf individuals who are experiencing domestic violence / sexual assault / stalking / abuse by personal attendants and caregivers and to identify specific action steps that would increase awareness, collaboration and outreach efforts for ending these forms of violence and abuse. Types of violence include: physical violence; sexual assault; emotional/psychological abuse; financial exploitation and identity theft; destroying adaptive and/or communication equipment; refusing or neglecting to attend to an important personal need such as using the bathroom, eating or drinking; refusing to give the correct amount of medication; or threatening to do any of these above behaviors. These behaviors are considered to be violent and abusive. 11 This project is supported by Grant No. 2004-FW-AX-4019 – Office on Violence Against Women, U.S. Department of Justice. Project title: “The Oregon Violence Against Women with Disabilities Technical Assistance Center” at The Regional Research Institute, Portland State University, P.O Box 751, Portland, Oregon 97207. For more information, please contact Mary Oschwald, at 503.725.9602; oschwald@pdx.edu. Thank you for your attention to violence against women with disabilities, for your commitment to ending violence against all people, and for holding perpetrators accountable. Violence affects women and men with disabilities and Deaf individuals All women are at risk of experiencing domestic violence, sexual assault and stalking. However, women with disabilities and Deaf women are at increased risk for abuse, may experience this abuse over a longer period of time, and may have multiple perpetrators, including personal attendants who may be spouses, family members and/or professional paid assistants. We do not yet know a lot about the abuse experiences of men with disabilities and Deaf men because, to date, this area has not received much attention. However, based on what is known, there is reason to believe that abuse and violence is a real concern for men with disabilities. For many reasons, men may not talk about the violence they are experiencing because they do not want to be seen as vulnerable, they fear not being believed if they do tell someone, and may believe that nothing can be done about the violence anyway. We encourage county Adult Protective Service workers to keep men with disabilities and Deaf men in mind as you consider how you respond to domestic violence, sexual assault and stalking against men with disabilities. Mandatory reporting requirements In best practice, if you are a mandatory abuse reporter, it is important you explain this to consumers and explain what this means in the context of your working relationship with them. We encourage you to ALWAYS tell consumers if you are a mandatory reporter, and work WITH them to report the violence / abuse. Be aware of your state's statutes and laws related to domestic violence, sexual assault, stalking, financial exploitation and hate crimes against people with disabilities. If you suspect abuse, a mandated report needs to be filed with Adult Protective Services, and may also need to be reported to Law Enforcement. It is important to know who to call and how Protective Service and Law Enforcement agencies work together in your area to handle mandatory abuse reports. Self-care As an Adult Protective worker, think about ways to take care of yourself as you discuss with other staff members issues related to domestic violence, sexual assault and stalking against the people you serve. Working on issues of violence, creating safety-plans, and listening to others share their experience of surviving mistreatment can be difficult, intimidating and re-traumatizing for anyone. These conversations can be even more troubling if you are a survivor. It is important to take care of yourself and your team members. Some ways to build-in self-care activities might include: talking with your colleagues about how you are feeling, attending support groups, learning how to be an effective abuse advocate, and identifying and trying to heal from previous abuse that you may have experienced. Section Two: Self-Assessment Questions Agency Culture related to domestic violence and disability 1. How does your agency communicate awareness about domestic violence and disability and Deaf individuals? Do you have: * Posters and messages indicating that abuse towards people with disabilities is wrong? ( Yes ( No * Brochures or other information displayed about safety awareness specifically related to people with disabilities and Deaf individuals? ( Yes ( No * Abuse screening or risk assessment tools that people could use to ask themselves about abuse in their lives? ( Yes ( No * Wallet-sized abuse resource cards for people to take? ( Yes ( No * Information posted about the local help line / crisis line? ( Yes ( No Information Gathering 2. Do you include questions related to abuse, mistreatment or violence during intake assessments? ( Yes ( No 3. Throughout the relationship with the people you serve, do you routinely discuss abuse or violence with consumers? ( Yes ( No Cross-agency collaboration 4. How connected are you with agencies that work on abuse and violence prevention? In the table below, please check the appropriate box(es) to indicate how you have collaborated with the following agencies during the past year. Agency name This agency exists but don't know much about them Have assisted a consumer to get in touch with the agency or made referral phone calls Gave out information to a consumer about the services / supports provided by this agency We have a contact person identified who we work with at this agency We developed a protocol for working together with this agency Attended a wrkshop they hosted Someone from this agency did an in-service at our agency We provided training to this agency Other ways we collaborated with this agency Local domestic violence shelters/safe houses Local domestic violence/sexual assault crisis line Agency name This agency exists but don't know much about them Have assisted a consumer to get in touch with the agency or made referral phone calls Gave out information to a consumer about the services / supports provided by this agency We have a contact person identified who we work with at this agency We developed a protocol for working together with this agency Attended a wrkshop they hosted Someone from this agency did an in-service at our agency We provided training to this agency Other ways we collaborated with this agency Men’s resource/ support center DV program through police depart-ment or DA's office National DV crisis line National sexual assault crisis line Agency name This agency exists but don't know much about them Have assisted a consumer to get in touch with the agency or made referral phone calls Gave out information to a consumer about the services / supports provided by this agency We have a contact person identified who we work with at this agency We developed a protocol for working together with this agency Attended a wrkshop they hosted Someone from this agency did an in-service at our agency We provided training to this agency Other ways we collaborated with this agency Violence aware- ness support groups for women Rape crisis / sexual assault program Men's Batterer Interven-tion Program Home-less Shelter Agency name This agency exists but don't know much about them Have assisted a consumer to get in touch with the agency or made referral phone calls Gave out information to a consumer about the services / supports provided by this agency We have a contact person identified who we work with at this agency We developed a protocol for working together with this agency Attended a wrkshop they hosted Someone from this agency did an in-service at our agency We provided training to this agency Other ways we collaborated with this agency Area Agencies on Aging Crime Victim's Assist-ance Program in DA's office Other agencies Other agencies 5. How connected are you with agencies that work on disability rights and advocacy issues to support people with disabilities? In the table below, please check the appropriate box(es) to indicate how you have collaborated with the following agencies during the past year. Agency name This agency exists but don't know much about them Assisted a consumer to get in touch with the agency or made referral phone calls Gave out information to a consumer about the services / supports provided by this agency We have a contact person identified who we work with at this agency Developed a protocol for working together with this agency Attended a work-shop they hosted Some-one from this agency did an in-service at our agency Provided training to this agency Other ways we work with this agency Center for Indepen-dent Living (CIL) - disability provider agency Arc agency United Cerebral Palsy (UCP) Agency name This agency exists but don't know much about them Assisted a consumer to get in touch with the agency or made referral phone calls Gave out information to a consumer about the services / supports provided by this agency We have a contact person identified who we work with at this agency Developed a protocol for working together with this agency Attended a work-shop they hosted Some-one from this agency did an in-service at our agency Provided training to this agency Other ways we work with this agency Legal Aid Other local Disability Advocacy Groups / Agencies State Protection and Advocacy agencies - (i.e., Oregon Advocacy Center) State Medicaid and Waiver Program Agency name This agency exists but don't know much about them Assisted a consumer to get in touch with the agency or made referral phone calls Gave out information to a consumer about the services / supports provided by this agency We have a contact person identified who we work with at this agency Developed a protocol for working together with this agency Attended a work-shop they hosted Some-one from this agency did an in-service at our agency Provided training to this agency Other ways we work with this agency Develop-mental Disability Brokerage Parent Groups Other disability provider and advocacy agencies? Others Others? Advocacy and Outreach Activities 6. Does the county have formal advocacy priorities established related to abuse or violence (for example: outreach to shelters, development of advocacy materials to educate community members)? ( Yes ( No ( Not sure If yes, please describe: _____________________________________ 7. Does any CM or APS workers participate on committees, task forces or other community coordinating or oversight groups that are working on abuse and domestic violence issues? ( Yes ( No ( Not sure If yes, please describe: _____________________________________ 8. Do you have the opportunity to volunteer at organizations focusing on domestic violence issues (for example, at a shelter or crisis line)? ( Yes ( No ( Not sure If yes, please describe: _____________________________________ 9. During the past year, has any county staff participated in advocacy activities related to increasing abuse awareness or stopping abuse (for example, a marched against violence, visited legislators, written a newsletter article about violence, trained other organizations about disability and abuse)? ( Yes ( No ( Not sure If yes, please describe: _____________________________________ 10. What types of support groups, trainings, classes, etc. related to abuse awareness / violence prevention do you provide? * Recognizing abuse / violence ( Yes ( No ( Not sure * Safety-planning and other strategies to deal with abuse / violence ( Yes ( No ( Not sure * Reclaiming one's life after an abusive relationship ( Yes ( No ( Not sure * Training for personal assistants on identifying abuse and violence ( Yes ( No ( Not sure * Training for consumers on how to manage the relationships with personal assistants (such as how to recruit, hire, supervise, direct, pay, etc. a personal assistant). ( Yes ( No ( Not sure * Other support groups ( Yes ( No If yes, what is the focus? _______________________________ * ( Don't offer any support groups on this topic at this time 11. Are there staff members who could facilitate a safety-awareness / violence prevention support group for consumers or co-facilitate a violence / disability workshop with a domestic violence advocate? ( Yes ( No ( Not sure If yes, please indicate their names. ___________________________ Skills Training 12. Does county staff provide skill training related domestic violence, sexual assault or stalking, provide referrals to agencies that do? (for example, skill related to:) * Identifying violence, abuse and mistreatment ( Yes ( No ( Not sure * Reporting violence to the police and Adult Protective Services ( Yes ( No ( Not sure * Knowing who to call for help in staying safe and getting out of a violent relationship ( Yes ( No ( Not sure * Working with your guardian or representative payee so they do not control you. ( Yes ( No ( Not sure * Learning how to TELL someone about the abuse / violence in your life ( Yes ( No ( Not sure * Create a safety-plan / safety-kit to help you during violent episodes ( Yes ( No ( Not sure * Becoming aware of "red-flags" that indicates an abusive or potentially abusive person ( Yes ( No ( Not sure Staff Training 13. Is education about abuse and domestic violence against people with disabilities and Deaf individuals a part of: * Initial staff orientation? ( Yes ( No ( Not sure * On-going staff education? ( Yes ( No ( Not sure 14. Is there an established protocol for staff to follow in supporting consumers in abuse or violence-related crises (for example, to do safety planning, abuse reporting or to contact community resources? ( Yes ( No ( Not sure If yes, what protocols do you have? __________________________ 15. Is there anyone designated at a county office who has experience in dealing with abuse or violence and who staff can go to if they have concerns or questions? ( Yes ( No ( Not sure 16. Do new staff members go through a screening process before getting hired that determines whether or not they have been perpetrators? ( Yes ( No ( Not sure 17. Do new employees go through a criminal background check? ( Yes ( No ( Not sure 18. In addition to the various activities already mentioned, describe any other things that county Adult Protective Service workers or Case Managers already do to address violence and abuse? ____________________________________________________________ 19. Thinking about your responses to these questions, do you think you personally may be able to enhance your advocacy with people with disabilities and Deaf individuals in managing abuse and domestic violence? ( Yes ( No ( Not sure If yes, what do you think are the most important things that you could do? A. _____________________________________________________ B. _____________________________________________________ 20. Finally, do you think there are additional activities that your agency could do to increase its effectiveness in assisting people with disabilities and Deaf individuals who are survivors of domestic violence, sexual assault and/or stalking? ( Yes ( No ( Not sure If yes, what do you think are the most important things that your county office could do? A. _____________________________________________________ B. _____________________________________________________ Section Three: Strategic Planning Guide In your work as Case Managers and Adult Protective Service workers, you already provide a great deal of support, prevention and intervention work related to issues of domestic violence, sexual assault, stalking and personal attendant against women and men with disabilities and Deaf individuals. These prevention / intervention activities may include: educating and empowering consumers, advocating for improvement of community supports and policies, working with domestic violence programs to establish accessible shelters or safe houses, and training personal assistants and consumers to identify domestic violence, sexual assault and stalking. The final section of this Self-Assessment Tool gives some additional ideas of what County staff could do, and may highlight what you are already doing, to address the problem of abuse and domestic violence against women and men with disabilities and Deaf individuals. General support for a consumer who is a survivor of domestic violence, sexual assault and/or stalking. * listen without judging their situation * do not immediately step in to "help" if they have not specifically asked for your help * assure them that the violence they are experiencing is NOT their fault * offer concrete support and follow-through when they ask for help * provide resource numbers and be with them during the phone call if they want your support * incorporate safety-planning activities during your working relationship Leaving an abusive relationship: Ways to support the consumer/survivor * work with the consumer/survivor to create an individualized safety-plan * discuss what would go into a safety-kit (e.g. additional medications, support people phone numbers, money, financial account information, clothes, assistive equipment items, etc.) * help strategize about who is a trusted friend / family member / relative * help arrange for back-up personal assistance if needed * help arrange other details (transportation, housing, shelter stay, healthcare, etc.) Training opportunities for increasing awareness of domestic violence, sexual assault and stalking against women and men with disabilities and Deaf individuals * locate or purchase violence prevention resources to have in the branch office * talk to your colleagues and co-workers about what they know and how they advocate for women and men with disabilities and Deaf individuals who are or have experienced domestic violence, sexual assault or stalking * attend a violence-awareness training workshop hosted by your own agency or your local domestic violence / rape crisis / sexual assault prevention program * ask consumers about ways they would feel most comfortable talking about abuse / violence * work with your branch managers to incorporate violence awareness / prevention strategies throughout each piece of the county program Ways to assist a consumer who needs emergency equipment. * connect them with the local Durable Medical Equipment provider * temporarily loan them equipment * draw on emergency funds designated for this use * help pay for repairs Ways to assist a consumer who needs emergency back-up personal assistance. * actively assist the consumer/survivor in locating alternative attendant services * refer to an established PA registry * find out from other consumers how they located emergency back-up PA's * work with the person to make an emergency contact sheet that includes family and friends and natural support networks - these people could be notified in the future as emergency back-up PA's and be included in the consumer's overall safety plan * contact a Certified Nursing Association or the Visiting Nurses Association if they provide any emergency back-up PA 10 Things Advocates & Agencies Can Do to Ensure Inclusive Services 1. Organizational Commitment: As an organization, develop a written statement that demonstrates your commitment to serving survivors of domestic violence, sexual assault, stalking and personal attendant abuse who have disabilities. Include this statement on outreach materials and ensure all staff and volunteers are aware of the commitment. Share your commitment with local agencies who also serve people with disabilities to ensure they know you are a resource for referrals and trainings. Commit to hiring staff, recruiting volunteers, and seeking out board members who have disabilities for their expertise. 2. Attitudes: Be aware of stereotypes both positive and negative (“People with developmental disabilities are like children” or “People with developmental disabilities are all sweet and gentle.”) that impact your behaviors and assumptions when working with survivors with disabilities. Interrupt jokes and language that reinforce negative stereotypes of people with disabilities. Address your own fears of discomforts, and seek out additional training and information if you feel you’d be uncomfortable working with a survivor with a disability. 3. Support Groups: Do what you can to ensure your support groups are open to anyone who needs support and information. Access goes beyond physical access to include things such as materials being modified based on an individual’s need. 4. Internal Training: Commit to ongoing internal training such as including working with survivors with disabilities in your volunteer training and for staff/volunteer in-service trainings. Trainings may include basic training of working with survivors with disabilities (cross-disability), to more specific trainings such as working with survivors with psychiatric disabilities, survivors who are Deaf, blind, and so forth. 5. Community Partnerships: Partner with local agencies that serve people with disabilities such as local Centers for Independent Living; Area Agencies on Aging; schools, clubs or churches for people who are Deaf; and so forth. Hold open houses and invite community partners to learn about the services you offer. Seek cross-training opportunities. Get to know the names and faces of people at other agencies who can assist with resources, problem-solving, technical assistance on access issues, and so forth. 6. Phone Access: Often agencies have a TTY and yet no one is quite sure how to use it properly. Get appropriate training, and know how to use phone relay services. Have a policy and resource list for interpreters who can respond in emergency situations. 7. Language: Avoid words such as “retarded.” (Instead, “person with a developmental disability.”) Only refer to a disability if it is relevant to the conversation. 8. Interpersonal Respect: Speak to the client and maintain eye contact with her or him even if the person has a personal assistant or friend with them. If you don’t understand someone’s speech ask them to repeat themselves. Don’t pretend to understand if you don’t. Let them know what they are saying is important and demonstrate that you’re willing to be patient. 9. Outreach: Develop outreach materials that include photos of people with disabilities. Disseminate outreach materials in places where people with disabilities may go for services such as Centers for Independent Living or Durable Medical Equipment suppliers. Offer outreach materials in alternative formats such as audio tapes, large print, and Braille. Invite people to call you about accommodations they may need to access services. Include statistics that are inclusive of abuse against women with disabilities. Post flyers or posters that demonstrate you are aware of—and trained to—work with survivors of violence who have disabilities. 10. Community Advocacy: Ensure that courtrooms, exam rooms where forensic exams are conducted, restraining order rooms, and so forth are accessible. Work with women who will be in court to ensure reasonable accommodations will be met per ADA standards. Self-Assessment Tool Participant Feedback Form Please give us your feedback about this self-assessment Tool. 1. How useful is it for building abuse awareness? 1 2 3 4 Very useful Quite useful Sort of useful Not very useful Comments: 2. How useful is it to identify additional ways to support consumers? 1 2 3 4 Very useful Quite useful Sort of useful Not very useful Comments: 3. How easy are the questions to understand? 1 2 3 4 Very easy Quite easy Sort of easy Not very easy Please point out particular questions that need re-wording and any alternative wording that you can suggest. 3. Are there any missing questions or topics? Please describe them. 4. Please share any other comments or ways to improve this tool. Thank you for completing this questionnaire. ?? ?? ?? ?? 1 7 13