March 29, 2023

Senate guts bill to better track direct support professional abuse of people with disabilities


Article origination IPB News
In 2022, the state identified “low wages and poor benefits” as a “top challenge” contributing to a shortage of certified nursing assistants, home health aides, direct support professionals and other similar roles. - Brandon Smith/IPB News

In 2022, the state identified “low wages and poor benefits” as a “top challenge” contributing to a shortage of certified nursing assistants, home health aides, direct support professionals and other similar roles.

Brandon Smith/IPB News

Direct support professionals (DSPs) can provide a critical service to people in Indiana with disabilities by providing in-home and group-setting care. DSPs can be parents or loved ones of the person they’re caring for.

But in some cases, DSPs abuse and neglect those they’re supposed to care for and, advocates say, often get away with it by switching jobs.

House Bill 1342 originally would have created a registry within the Indiana Division of Disability and Rehabilitative Services (DDRS) to better record and track substantiated cases of abuse by DSPs.

“Say a direct support professional is a bad actor, the goal to me is to try to let other providers know and to make substantiated cases of abuse, neglect known,” said Rep. Julie Olthoff (R-Crown Point), the bill’s author. “The whole bill idea came to me from an incident that happened [in my district] and they couldn't prosecute the worker because you can't prove malice. So the mom said, ‘Yeah, OK, I get that.’ But then when she saw that worker down the street on another provider, she was like, ‘wait a second. That's not good. That's not safe. That's not protecting these individuals with disabilities.’”

It sailed through the House with ease, but a Senate committee voted to strip that provision out entirely. The author of the amendment, Sen. Stacey Donato (R-Logansport), also sponsored the Senate bill.

Donato said she was “sad” to be removing the registry portion, but felt it was needed to ensure the remaining part of the bill – which focuses on standardized training for direct support providers – could pass.

Olthoff said the amendment was a response to organizations that employ DSPs fearing the proposed registry would create liability. She attempted a similar bill last year which also failed to get traction.

“I think providers are afraid that if a worker doesn't get hired by another provider, that it would be their fault,” she said in an interview Monday. “And so you could say alright, well, maybe that’s a good thing and it's not a good fit for that worker to be within the industry.”

Olthoff added she doesn’t believe DSPs with alleged abuse reports in her proposed registry would or should always be forced out of the field entirely.

“In my opinion, even if there is a substantiated case posted where a provider could go look at it, that doesn't mean another provider couldn't hire that person,” she said. “So that person maybe got in trouble in a group home one-on-one, but may be a great employee, say, at a bigger facility where … there's just more people around.”

Emily Munson, a lawyer with Indiana Disability Rights, said “concerns about liability regarding aggrieved DSPs added to a potential registry has historically been the reason Indiana has not created a DSP abuse and neglect registry.”

“However, if you look to another segment of the disability community, those receiving services through home health aides, [the Indiana Department of Health] does have an appeal process and maintains a registry of abusive and/or neglectful workers with that certification,” said Munson in an email. “If IDOH is not being sued regularly by aggrieved home health aides, I find it hard to believe DDRS would be regularly sued by DSPs.”

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Ledrena Girton, of Indianapolis, is a certified nursing assistant and direct support professional for her own adult daughter with an intellectual disability and others outside of her family.

Girton said she has advocated for a registry for years – and watched past bills attempting to create one fail repeatedly.

“We need to know who these people are. And it needs to be updated quickly, because what they do is they hurt people, they steal from people and then they get caught. And then they leave and then they go to another agency.” Girton said. “So people are leaving one home health care agency, going to another and doing the same thing.”

What remains in the current version of HB 1342 are provisions creating statewide DSP training standards and a certification pathway. DSPs are currently required to be trained, but each provider can do the training differently. Create a statewide standard is still very valuable to both Girton and Olthoff.

“There have been too many accidents, too many deaths ... People need to be trained on what to do, what not to do, and they also need to know the language, how to speak to people,” Girton said.

She and Olthoff also believe that the training and certification in the bill would create opportunities for DSPs to be better paid.

“And then you will have more individuals making more money so that they can take care of their families,” Girton said. “I am providing home health care, the transportation to doctor's appointments, grocery shopping, cooking and washing clothes, things like that. So [my daughter] has no money to do anything. My home health service takes up all of her [state funding].”

In 2022, the state identified "low wages and poor benefits” as a “top challenge,” contributing to a shortage of certified nursing assistants, home health aides, direct support professionals and other similar roles. A 2017 report from the President’s Committee for People with Intellectual Disabilities argued that “responding to the direct support workforce crisis” would ensure “a qualified, competent and stable workforce reducing injuries, illnesses and critical incidents of abuse and neglect.”

Olthoff said she is working to get abuse-tracking language back in the bill before it heads to the governor’s desk.

“I’m fighting as hard as I can. And so I'm still hopeful,” Olthoff said. “I don't think anybody has completely left the discussion, but we haven't come to a great place for sure. So the encouraging part is the discussions are ongoing.”

There is an existing incident reporting system that abuse cases are reported to in Indiana, but Olthoff said providers can’t check that. Prior to the Senate committee’s gutting of HB 1342, she had spoken to the committee about a plan to modify the existing system to theoretically, more cheaply achieve the same results as the proposed registry.

“It’s trying to find what's right and what's good and what won't have unintended consequences for anybody,” she said. “But actually, if you're a bad actor, I might not feel so sorry for you. You know, it's just not a good fit.”

The bill heads to the Senate Appropriations Committee next. Olthoff will have a few more opportunities to add language back into the bill before it either heads to the governor’s desk or dies with the end of the session.

Adam is our labor and employment reporter. Contact him at arayes@wvpe.org or follow him on Twitter at @arayesIPB.

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