[HumanSer] Work Accommodation Concerns

[sarah.meyer55 at gmail.com]

Hello,

I have been employed at a community mental health agency for 2 years now as
a therapist and it has been the most challenging experience of my life in
terms of not having effective reasonable accommodations to do my job. I will
try to keep this as brief as possible because it has become such a complex
situation but apologize in advance for the length. I will share some of the
major issues and my questions below. This is honestly a very vulnerable
message for me so I just ask for grace and some gentleness in responses.

 

Problems:

*	Despite having discussions prior to my hire and ongoing advocacy
efforts, as well as reassurances from the agency for months that they were
prioritizing accessibility to the EMR because they recognized that our
work-arounds would not be sustainable/effective, I have never had access to
use any aspect of our EMR (NextGen) with JAWS or any other screen reading
options. I believe some of the issues are that NextGen is housed on a Remote
Desktop, but most notably that the agency has never used the latest version
of the EMR which NextGen has indicated would be most likely to be
compatible/accessible with JAWS because that is where their developers have
invested their efforts to meeting accessibility guidelines/requirements.
*	The agency has indicated JAWS scripting is too expensive. They never
engaged with me or VR when trying to reach out to explore if VR could help
with some of the cost.
*	I had to fight to get them to consider work-arounds for months
because they insisted they were "so close" to providing accessibility for me
to independently access NextGen. Eventually I got them to be willing to try
using Word templates for me to do documentation, which I then sent to my
supervisor and other leadership to upload into the database. The templates
have had a lot of accessibility barriers themselves, and it has been
challenging, to say the least, to acquire information from client charts in
accessible formats. Additionally, I can't access the calendar, scheduling
features, notifications of client arrivals, communication
intra-professionally with members of other teams involved in clients' care,
etc. Other staff indicated repeatedly that they knew our work-arounds were
short-term and not truly sustainable (for me, for them, for quality client
care).
*	I've proposed other options including Aira, Seeing AI on work cell,
installation of my own provided Kurzweil 1000 and Duxbury Braille
Translation software onto work laptop to try to make various materials more
accessible, and several other accommodations proposed. I also use a Focus 40
Braille Display which has had a lot of problems not pairing via Bluetooth. I
have requested permission to transfer documents via SD card between Focus
display and laptop but have never received a solid response though they have
previously been very hesitant to allow use of flash drives or anything that
could potentially cause concerns about privacy, which I understand from
their perspective. Wired connection with laptop works better, though still
has issues, and JAWS has had other issues as well.
*	The toll of chronic inaccessibility and having to work so much extra
to compensate for these barriers, which also apply to trainings and other
aspects of the job beyond the EMR accessibility barriers, have repeatedly
exacerbated symptoms of multiple other chronic health disabilities. I
eventually had to go on an extended medical leave last year. I continually
have tried advocating and have frequently received no response, inaccurate
follow-up, dismissiveness, and have faced an often hostile and intimidating
work environment when I have tried to speak up and advocate.
*	When I returned from my leave last Fall, I truly hoped there would
be improvements; however, the agency has actually doubled down and indicated
that the supposedly temporary work-arounds, which failed miserably before,
are now the ongoing "accommodation system." They have come up with some new
methods for notifying me of client arrivals, and there has been some
improvement in support staff notifying me of scheduled client appointments
and cancellations, but this has been inconsistent. The client documentation
I've requested to prepare for sessions and help with pre-filling my
templates has at times been missing crucial information, not provided, and
is filled with accessibility problems in their efforts to convert
inaccessible PDFs into Word files. The templates I am using for completing
documentation are still in process of being revised for accessibility and
the burden has been placed on me to provide written narratives of the issues
so they can "fix them". Until recently, leadership would not meet with me,
and this has been inconsistent.
*	I've requested having a visual assistant and have yet to receive a
response.
*	The agency has been through significant transitions with "merging"
under a larger umbrella parent company which has also caused a lot of
confusion and worsened miscommunications. I also have had issues with
getting clear, accurate, timely, accessible information and determinations
of my leave time accommodation requests to manage my other health concerns,
especially during the transition to new leave management entities. I was
allowed to work remotely in the past when seeing clients, and during the
training refresher/catching up upon my return to work, but I was recently
informed that I am only allowed to conduct client sessions from the office
and only when team leader coverage, support staff, and crisis staff are on
site. (Never mind that many other staff are working hybrid due to limited
office space, work modified schedules including seeing clients past 5PM,
etc.).
*	I have been told I've been provided all the necessary accommodations
to fulfill the essential functions of my job, despite my and my medical
providers' statements that this is not accurate. I have received corrective
action notices/statements and discussions which place all the
blame/responsibility on me for problems with note timeliness, session length
(running over on time), running late to sessions, etc., without
acknowledgement of how the accessibility barriers play a significant role.
*	I am burned out but I care so much about my clients and believe I
have unique assets and skills to support them and the mission of the agency,
plus I am not fully licensed and need the supervision (I am close to being
able to apply for full LMHC licensure which would open more options).

 

Questions:

*	I know several folks here have shared about work-arounds to
compensate for inaccessibility; I am wondering where you draw the line,
especially in community mental health where the service delivery and
documentation expectations/demands are so high and able-bodied staff even
say they struggle to keep up with all of the expectations? I have never been
able to reach a full case load and service delivery because of the
accessibility barriers and how much I've struggled to keep up as a result.
It's hard to not internalize and beat myself up for not being able to put in
all of the extra time and energy to compensate, especially because of the
toll this has taken on my own physical and mental health.
*	If you have worked in a community mental health or otherwise
fast-paced, high demand setting, and had either very limited or no access to
the EMR, how did you keep up with service delivery and note timeliness
standards? How much work-life balance has been realistic? I understand this
can vary for each person. What accommodations have been non-negotiables for
you?

 

There's unfortunately more but I have already shared quite a lot here.
Please feel free to ask questions if you need additional clarification. I
readily admit I do have areas I am constantly needing to improve in,
especially when it comes to time management and being more concise (I do
have ADHD which I am still learning to navigate and again I know there is
overlap with the impact of my other chronic health disabilities; I was so
much better at pushing past my limits in school and college/grad school but
chronic override of self-care is never sustainable).

Thanks in advance for taking the time to read and share any feedback.

 

Sincerely,

Sarah

 

Sarah K. Meyer, MA, LMHCA (she/her)

(317) 402-6632

 <mailto:Sarah.meyer55 at gmail.com> Sarah.meyer55 at gmail.com

 

"Although the world is full of suffering, it is full also of the overcoming
of it. My optimism, then, does not rest on the absence of evil, but on a
glad belief in the preponderance of good and a willing effort always to
cooperate with the good, that it may prevail." ― Helen Keller