Addressing the Harassment, Abuse, and Discrimination of Caregivers

Low-wage workers, especially women, immigrants, and people of color are particularly vulnerable to harassment, abuse, and discrimination in the workplace. For caregivers, the isolated and often intimate nature of our work can put us even more at risk. In 2020 our Union championed the Harassment, Abuse, and Discrimination (HADit) law for all caregivers.

IP Guidelines for addressing harassment, abuse, and discrimination while working as a caregiver

What is HADit?

Why the HADit law is needed

IP Guidelines for addressing harassment, abuse, and discrimination while working as a caregiver

Washington State DSHS and Consumer Direct (CDWA), in partnership with SEIU 775, have created reporting-guidelines for IPs who are experiencing harassment, abuse, or discrimination while providing care to a client.

The guidelines identify three levels of risk and provide recommendations on steps you can take if you find yourself in one of these situations. Feeling uncomfortable or unsafe due to harassment, abuse, or discrimination? Follow these guidelines and techniques:

Level 1

If you feel uncomfortable with the behavior of the client or somebody else in the household, but do not feel that your safety is at risk, it is recommended that you:

  • Express concerns – If you feel comfortable, ask the client or other individual in the household to stop the behavior and explain that you are feeling uncomfortable.
  • Re-read the client’s CARE assessment to see if the unwanted behavior is addressed in the plan and if there are interventions listed to help you address their behavior(s).
    • Need a new copy of the care plan?
      • If you’re receiving a paycheck from IPOne, contact the client’s case manager
      • If you’re receiving a paycheck from CDWA, call the Consumer Direct (CDWA) hotline at 877-532-8542
  • Contact the case manager or Consumer Direct (CDWA) hotline for suggestions or to report new, unwanted behaviors.

Level 2

If you feel unsafe with the behavior of the client or somebody else in the household, but do not want or need to immediately leave the situation, it’s recommended that you:

  • Contact the case manager or Consumer Direct (CDWA) hotline and report the behaviors causing you to feel unsafe. Provide details to help the case manager or Consumer Direct representative understand the situation.
  • Contact the case manager’s office or Consumer Direct (CDWA) hotline and ask to speak to a supervisor if you cannot reach your client’s case manager or if you are dissatisfied with the case manager’s or Consumer Direct’s assistance.
  • Consider accessing specialized training to help you better understand the client’s unique behavioral needs. To learn more about training options, contact the Training Partnership, your client’s case manager, or the Consumer Direct (CDWA) hotline.
  • If you no longer wish to provide care for the client, contact the case manager or call the Consumer Direct (CDWA) hotline and share that you no longer feel safe caring for this client.

Level 3

If you feel unsafe with the behavior of the client or somebody else in the household and want or need to immediately leave the situation, it is recommended that you:

  • Leave the home then immediately call the client’s case manager or the Consumer Direct (CDWA) hotline to let them know that you left and explain your concerns with the situation. If there are concerns about the client being alone and you are unable to contact the client’s case manager, attempt to contact a supervisor or other DSHS/Area Agency on Aging (AAA) staff member. If leaving the client alone will put them in immediate danger call 911.
  • Review all the interventions listed in level 1 and 2.
  • If you no longer wish to provide care for the client, contact the case manager or call the Consumer Direct (CDWA) hotline and share that you no longer feel safe caring for this client.

What happens when IPs contact a case manager or the Consumer Direct (CDWA) hotline to report their concerns?

The case manager or Consumer Direct (CDWA) representative will:

  • Listen to your specific and unique concerns about your experience and work with you to find possible solutions.
  • Know how to support you if your primary language is not English.
  • Document known behaviors and interventions on the care plan and update the plan as new information is received.

The case manager or Consumer Direct (CDWA) representative may:

  • Work with the client and suggest additional resources for them, like client training or a nursing referral.
  • Contact a client or family member to get more information about the conduct or behaviors and explore possible interventions.
  • Contact the client directly to remind the client of their responsibilities to provide a safe and discrimination-free working environment for you. If the situation does not improve, make another report to the case manager or Consumer Direct (CDWA).

Additional IP Guideline Resources

What is HADit?

In 2018, an SEIU 775 caregiver reported to our Union a harrowing story of the harassment and discrimination they faced while working as a caregiver. At the time, their livelihood, housing, safety, and dignity were at risk, and there was little we as a Union could do to help them because of the lack of structures in place to address harassment, abuse, and discrimination of caregivers.

Unfortunately, the experience they went through was only one of many reported to us in the past year alone.

That’s why, in September 2019, SEIU 775 launched our HADit campaign: to address harassment, abuse, and discrimination of caregivers and make the care environment safer for everyone.

Hundreds of members from across the state went to Olympia in January and February of 2020 to talk to their legislators, thousands sent emails and called our elected representatives, and some brave members went before lawmakers and shared their stories with their heads held high, knowing the entire Union was supporting them.

In April 2020, Washington state Gov. Jay Inslee signed our landmark HADit legislation into law, which will protect caregivers and clients for years to come.

What caregivers passed

  • Passing this law was a HUGE first step. The law now requires:
  • Prior information for in-home caregivers to feel more prepared: All covered employers, DSHS, and their agents are now required to inform workers of instances of abusive conduct or challenging behaviors.
  • Recording and reporting: Employers are now required to keep a record of any reported incidents of abusive conduct or discrimination. Incidents of challenging behaviors are not required to be recorded or reported.
  • Enforcement: Labor and Industries will investigate to ensure compliance with the policy, prevention plan, informing workers, and reporting requirements.
  • Prevention plans: By July 1, 2021, all home care agencies and the Consumer Direct Employer must implement a prevention plan to reduce workplace violence including clear processes for emergency responses and leaving unsafe situations.
  • Training and future policy workgroup: A multi-stakeholder workgroup, including caregivers, will be convened to recommend by December 1, 2021, additional policy recommendations and training for workers, clients, and agency supervisors.
  • Comprehensive written policy: By July 1, 2021, all employers must have written policies about how they will address instances of discrimination, abusive conduct, and challenging behaviors. Policies must be delivered to caregivers at least annually, in a way that everyone can understand.
  • In addition to the work we did in Olympia, all our agencies have also implemented some version of our HADit asks into each of our contracts, including some or all the following:
  • Advanced notice of known client behavior: When a client’s behaviors have been reported to the agency, new workers assigned to the client will be advised if those behaviors have made care challenging
  • Clear rules for reporting: Known policies and procedures for reporting health and safety issues: a specific chain of communication, documentation of issues, and employer follow-up.
  • Safety equipment provided: Safety equipment that is needed for job performance will be provided per the client’s care plans.
  • Client-Specific Training: Some clients require special training (e.g., operation of Hoyer lifts in the home), and this puts the onus on the employer to provide training.
  • Paid shifts for leaving due to health or safety concerns: If an employee feels that their health or safety is compromised in the home, employees may leave their shift, contact their supervisor, and still be compensated for their shift (assuming that their concern is validated). In any case, employees will not be retaliated against for leaving a shift

Why the HADit law is needed

Low-wage workers, especially women, immigrants, and people of color are particularly vulnerable to harassment, abuse, and discrimination in the workplace. For caregivers, the isolated and often intimate nature of our work can put us even more at risk.

For caregivers who have experienced harassment, abuse, and discrimination, the impact is more than an immediate reaction. It also affects our health, wellbeing, and quality of care. Negative health outcomes include depression, flashbacks, sleeplessness, traumatic stress disorder, and poorer physical health, which can last for years after the incident. It also leads to increased turnover among direct care workers and lower quality of care for clients.

Prevalence of harassment, abuse, and discrimination of Washington state SEIU 775 caregivers:

  • 47% reported Verbal Abuse
  • 24% reported Physical Violence
  • 12% reported Sexual Harassment (Parent Providers were not asked about this)

Harassment, abuse, and discrimination of caregivers are something that can and should be addressed. We’re going to keep working to make sure:

  • Everyone feels safe at work and while giving and receiving care.
  • Everyone feels respected when giving and receiving care.
  • Everyone can continue to strengthen the long-term care workforce and system in our state.
  • Caregivers are empowered to provide the best quality care possible.

Together, we can build a better future for all of us.

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