[HumanSer] Work Accommodation Concerns

Mon Jun 2 16:30:11 UTC 2025

A quick question off this topic.   All of the messages seem to be sprinkled with an equals sign to the point that they are really difficult to understand.   Is that happening to anyone else?   It is only happening to me in this chat..   Very odd.

Ginny

Virginia Duff, MD, FRCPC
Clinical Director
West End ACT Team
St. Joseph's Health Centre
Tel: 416-530-6000 ext. 3101
Fax: 416-530-6076

Unity Health cannot guarantee the security of this email. This email is intended only for the named recipient(s) and may be confidential. Any unauthorized use, dissemination or copying of this email is strictly prohibited. If you have received this email in error, please notify the sender immediately and destroy all copies of this email.

Please note that this email is not to be used for clinical matters. In any emergency, call 9-1-1 or go to the nearest urgent care center or hospital emergency department. It is recommended that you do not use email to discuss information you think is sensitive as the security of email messages is not guaranteed. The undersigned physician cannot guarantee that all electronic communications will be reviewed and responded to within any specific period of time and should not be used for medical emergencies or other time-sensitive matters.  Electronic/e-mail communication is only by the undersigned to provide appropriate mental health resources, i.e. educational materials, worksheets used for therapy. All other communication/questions or concerns will be reserved for personal appointments or over-the-telephone conversations. For scheduling or cancelling appointments for non-ACT patients, please call the Out-patient Mental Health clinic administrative staff at 416-530-6591.

On Jun 2, 2025, at 04:24, Amy ruell via HumanSer <humanser at nfbnet.org> wrote:

CAUTION: External email. Think before clicking

Hi Sarah,
So sorry you=E2=80=99re having these difficulties. I worked for a business o=
rganization which implemented an inaccessible database system and did nothin=
g to provide accommodation other than to tell me that I could not do half of=
my job and deprive me of the opportunity to have access to the materials, I=
needed to professionally complete tasks. I don=E2=80=99t want to say much p=
ublicly here, as I went to court to fight this after making numerous attempt=
s to request that they make their programs accessible. Happy to talk with yo=
u off-line if you like. Unfortunately, this is not something where legal pre=
sidents are clear. I believe you know how to get in touch with me. Please fe=
el free to call.
So sorry you are having these difficulties.
Amy.
Sent from my iPhone

On Jun 1, 2025, at 11:11=E2=80=AFPM, Sarah Meyer via HumanSer <humanser at nf=
bnet.org> wrote:
=20
=EF=BB=BFHello,
=20
I have been employed at a community mental health agency for 2 years now =3D=

as
a therapist and it has been the most challenging experience of my life =3D=

in
terms of not having effective reasonable accommodations to do my job. I =3D=

will
try to keep this as brief as possible because it has become such a =3D
complex
situation but apologize in advance for the length. I will share some of =3D=

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.
=20
=3D20
=20
Problems:
=20
*    Despite having discussions prior to my hire and ongoing advocacy
efforts, as well as reassurances from the agency for months that they =3D
were
prioritizing accessibility to the EMR because they recognized that our
work-arounds would not be sustainable/effective, I have never had access =3D=

to
use any aspect of our EMR (NextGen) with JAWS or any other screen =3D
reading
options. I believe some of the issues are that NextGen is housed on a =3D
Remote
Desktop, but most notably that the agency has never used the latest =3D
version
of the EMR which NextGen has indicated would be most likely to be
compatible/accessible with JAWS because that is where their developers =3D=

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 =3D
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 =3D
for me
to independently access NextGen. Eventually I got them to be willing to =3D=

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 =3D
templates
have had a lot of accessibility barriers themselves, and it has been
challenging, to say the least, to acquire information from client charts =3D=

in
accessible formats. Additionally, I can't access the calendar, =3D
scheduling
features, notifications of client arrivals, communication
intra-professionally with members of other teams involved in clients' =3D
care,
etc. Other staff indicated repeatedly that they knew our work-arounds =3D
were
short-term and not truly sustainable (for me, for them, for quality =3D
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 =3D=

more
accessible, and several other accommodations proposed. I also use a =3D
Focus 40
Braille Display which has had a lot of problems not pairing via =3D
Bluetooth. I
have requested permission to transfer documents via SD card between =3D
Focus
display and laptop but have never received a solid response though they =3D=

have
previously been very hesitant to allow use of flash drives or anything =3D=

that
could potentially cause concerns about privacy, which I understand from
their perspective. Wired connection with laptop works better, though =3D
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 =3D
other
aspects of the job beyond the EMR accessibility barriers, have =3D
repeatedly
exacerbated symptoms of multiple other chronic health disabilities. I
eventually had to go on an extended medical leave last year. I =3D
continually
have tried advocating and have frequently received no response, =3D
inaccurate
follow-up, dismissiveness, and have faced an often hostile and =3D
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 =3D
indicated
that the supposedly temporary work-arounds, which failed miserably =3D
before,
are now the ongoing "accommodation system." They have come up with some =3D=

new
methods for notifying me of client arrivals, and there has been some
improvement in support staff notifying me of scheduled client =3D
appointments
and cancellations, but this has been inconsistent. The client =3D
documentation
I've requested to prepare for sessions and help with pre-filling my
templates has at times been missing crucial information, not provided, =3D=

and
is filled with accessibility problems in their efforts to convert
inaccessible PDFs into Word files. The templates I am using for =3D
completing
documentation are still in process of being revised for accessibility =3D
and
the burden has been placed on me to provide written narratives of the =3D
issues
so they can "fix them". Until recently, leadership would not meet with =3D=

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 =3D
determinations
of my leave time accommodation requests to manage my other health =3D
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 =3D
recently
informed that I am only allowed to conduct client sessions from the =3D
office
and only when team leader coverage, support staff, and crisis staff are =3D=

on
site. (Never mind that many other staff are working hybrid due to =3D
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 =3D
corrective
action notices/statements and discussions which place all the
blame/responsibility on me for problems with note timeliness, session =3D
length
(running over on time), running late to sessions, etc., without
acknowledgement of how the accessibility barriers play a significant =3D
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 =3D
agency,
plus I am not fully licensed and need the supervision (I am close to =3D
being
able to apply for full LMHC licensure which would open more options).
=20
=3D20
=20
Questions:
=20
*    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 =3D
even
say they struggle to keep up with all of the expectations? I have never =3D=

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 =3D
result.
It's hard to not internalize and beat myself up for not being able to =3D
put in
all of the extra time and energy to compensate, especially because of =3D
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 =3D
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 =3D=

this
can vary for each person. What accommodations have been non-negotiables =3D=

for
you?
=20
=3D20
=20
There's unfortunately more but I have already shared quite a lot here.
Please feel free to ask questions if you need additional clarification. =3D=

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 =3D=

is
overlap with the impact of my other chronic health disabilities; I was =3D=

so
much better at pushing past my limits in school and college/grad school =3D=

but
chronic override of self-care is never sustainable).
=20
Thanks in advance for taking the time to read and share any feedback.
=20
=3D20
=20
Sincerely,
=20
Sarah
=20
=3D20
=20
Sarah K. Meyer, MA, LMHCA (she/her)
=20
(317) 402-6632
=20
<mailto:Sarah.meyer55 at gmail.com> Sarah.meyer55 at gmail.com
=20
=3D20
=20
"Although the world is full of suffering, it is full also of the =3D
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." =3DAF Helen Keller
=20
=3D20
=20
_______________________________________________
HumanSer mailing list
HumanSer at nfbnet.org
http://nfbnet.org/mailman/listinfo/humanser_nfbnet.org
To unsubscribe, change your list options or get your account info for Huma=
nSer:
http://nfbnet.org/mailman/options/humanser_nfbnet.org/aruell%40comcast.net=

_______________________________________________
HumanSer mailing list
HumanSer at nfbnet.org
http://nfbnet.org/mailman/listinfo/humanser_nfbnet.org
To unsubscribe, change your list options or get your account info for HumanSer:
http://nfbnet.org/mailman/options/humanser_nfbnet.org/ginny.duff%40unityhealth.to

This email is intended only for the named recipient(s) and may be confidential. Any unauthorized use, dissemination or copying of this email is strictly prohibited. If you have received this email in error, please notify the sender immediately and destroy all copies of this email.