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Office of Mental Health

Home and Community Based Services Waiver
Guidance Document
Division of Children and Families

300.1B

ICC Agency Worker Safety Policy and Protocols

Policy

Each ICC Agency must be committed to providing a safe working environment for all workers, including subcontractor workers. ICC Agencies must establish written safety policy and protocols to be followed by ICC’s and other HCBS Waiver services workers when conducting home visits or otherwise engaged with children and families in the community. These must be periodically reviewed with all Waiver workers.  Such communication must be documented.

Required Elements of a Worker Safety Policy

Training

Training is recommended for ICC’s and other ICC Agency Waiver service and subcontractor staff in how to deal with potentially assaultive persons encountered in the community (whether clients or other community members). Employee participation in all training sessions must be documented.

Accountability System

There must be a system  to account for the location of all ICC’s and HCBS Waiver service workers at all times when they are in the field both during usual hours and in after-hours situations. Follow-up must be provided for any reported threatening situation.

Means To Summon Assistance

ICC’s and other Waiver service workers must be provided with means and instructions to readily summon assistance when necessary.

Accompanied Visits

Protocols must include the provision for accompanied visits when there is a history of assaultive behavior or other significant risk potential.

Risk Analysis

The Worker Safety Policy must include methodology and timeframes for analysis of risks and for establishing safety interventions as needed.

Additional Elements

The Worker Safety Protocols which follow illustrate requirements and is included as a prototype. ICC Agencies may add to this to address specific concerns.

Worker Safety Protocols in the Home and Community

HCBS Waiver workers are issued a cellular telephone or a pager upon hire. Once they are assigned a case load and begin to make home visits or begin working in the community, each worker will complete a daily log of their itinerary. The daily log will include destinations (addresses), and anticipated arrival and departure times. The ICC Supervisor or designee will monitor this log.

Prior to the initial home visit in unfamiliar areas, the worker will learn about the client/family and environment in which the client lives.  To evaluate risks, the worker will visit the unfamiliar areas by car, checking for available street parking, unusual or dangerous activities at or near the client’s home or meeting place, and indications of dogs at or near the address. The ICC and ICC Supervisor together will analyze risk and identify safety needs.  This information will be shared in writing with subcontractors.

In cases where there is a known history of assaultive behavior (and/or alcohol/substance abuse), the worker will be accompanied to the home by another worker or supervisor. During or after that home visit, the program director and/or the program administrator will evaluate whether services can be safely provided in the home.  If the home is deemed unsafe, the worker and family will mutually agree to meet at another location outside of the home, i.e., local community center, park, library etc. The worker will keep the safety of the child(ren) in mind at all times and will file a child abuse report to the State Central Register if they suspect that the child(ren) is (are) in imminent danger.

Workers will “dress down” and wear comfortable clothes and shoes to assure the ability to move quickly.  Workers will avoid wearing or carrying valuables to decrease becoming a target for robbery. One hand will be kept free to fend off attack. Workers will utilize local law enforcement for information and protection and will always keep local law enforcement telephone number readily available.  (Call 911 in emergency situations; this is to be programmed for speed dialing as feasible.)

During the home visit, workers will keep the pager and cellular telephone turned on to enhance their ability to seek help if needed.  The program director will wear a pager and keep it on while staff are working in the field to be easily accessible in the event of an emergency.  If for any reason a worker is unable to make a call, themselves, to their supervisor or law enforcement, they will have a list of emergency numbers on their person to enable someone else to make the telephone call on their behalf.

Once in the client/family home, the worker  will immediately locate the exits, notice how the exit door locks,  always sit or stand close to the exit and will assure that the exits are not blocked.  If the door locks with a key, the key must remain in the door. Workers will ask if dogs are in the home and if there are dangerous dogs in the neighborhood, and will look for signs of the same (dog leash, bowls, dog house, etc). Staff will look for potential weapons and signs of potentially dangerous behaviors including alcohol containers, drug paraphernalia, etc. Clients are not to be interviewed in the kitchen as there are too many potential weapons; clients are to be interviewed in the living room. Clients must be encouraged to sit in a soft comfortable chair while the worker always sits at the edge of a chair to ensure quick standing and exit, if necessary.

When transporting a child/family in a vehicle, they must be encouraged to sit in the rear back right side to prevent them from sitting close enough to take the steering wheel. Items are to be placed in the front seat and rear left seat to prevent the client from using those seats. (An item that could be used as a weapon should not be allowed.) If transporting more than one client, staff will use their best judgment in seating arrangement, always keeping safety in mind.  Workers will engage in light, non-clinical conversation only while driving and will make every effort to get to the destination quickly. If for any reason the worker feels unsafe with the client after arrival at the destination, the worker must contact his/her supervisor and alert others at that location to the concerns.  In the event that it is not safe for the worker to transport the client back to her/his home, the client is informed and an attempt is made to make other transportation arrangements, if safe to do so. In such instances, the worker will return to the office, meet with his/her supervisor or a supervisor’s designee and file an employee incident report. Workers will contact law enforcement (911) anytime their safety is at risk.

Comments or questions about the information on this page can be directed to the Home and Community Based Waiver Program.