How COVID-19 impacts Portage County’s in-home disability support providers

Although she’s now mostly working from home, Christina West spends chucks of her days conversing with Portage County residents about what sorts of needs she can help them accommodate. She serves on Ravenna’s city council and has worked as Service and Support Administrator (SSA) at Portage County’s Board of Developmental Disabilities for 15 years, helping a steadily growing pool of folks who need accommodations navigate the public and private entities that can provide them. While West was in college, she worked as a Direct Support Professional (DSP), someone who provides help with day-to-day activities to folks with disabilities. The board provides over 900 Portage County residents of all ages with varying degrees of financial assistance, help with life skills and anything else they may need. 

What made you want to pursue a career in this field?

So I was raised in this field. My mom retired from a sheltered workshop, and I used to go visit her all the time at work, and I loved it. I love people, and I love helping, so it just seemed right. My mom really taught me that there was so much that people had to offer. You learn so much from other people. So yeah, she would bring people to our house for holidays, you know, that might not have had family, we would go visit, we would have birthday parties, those kind of things. So she introduced me to the field. And I actually started at YSU in Special Ed. I was going to go to be a teacher, and I decided that was not my cup of tea. I cannot teach. So I decided to go for social work instead. And that’s how I kind of ended up making my way through to being an SSA.

I want to wrap my head around better how the board functions and what kind of services it provides. I was doing some research, and I noticed you guys have the day school that you’re opening up, and then you also have, you know, direct support professionals that work in home with people. So what are some of the other core operations that the board oversees?

The DODD, the Ohio Department of Developmental Disabilities, is a great website to look for to see what we do. So a lot of our money funnels down from there. Our rules, the Ohio revised code, all that funnels down from there, but we provide the Family Support Services Program, which is funding for people that are eligible to access different things like specialty camps, equipment they might need in their home, you know, particular things that their health insurance doesn’t cover. The biggest thing probably that we oversee is the waiver program, which is that individual options waiver, level one waiver, that’s a Medicaid piece that pays for services, and that’s what pays for those DSP services. The county board oversees all that. We authorize it, we monitor it, we make sure that those services are being provided effectively. So anybody that’s a DSP doesn’t work directly for the county board. Someone hires them on. The county board authorizes the services and then it’s up to the agencies, or that provider, to provide the services that’s identified in the service plan. So that’s kind of how that comes down, and how it involves us. 

So as far as your particular position as a Service and Support Administrator, you’re an individual who pairs up community members with certain agencies, right?

There’s 20 SSAs in Portage County. We all kind of have a different role. Because of my background with transition and transition youth, I tend to have more high school kids that are kind of, they’re not kids anymore, but you know, exploring what their future’s gonna look like. College, work, whatever. My role might look a little bit different than my co-workers. So, you know, for me, it might be helping someone apply for Medicaid, Social Security, maybe explore guardianship alternatives, you know, provide them with community resources. Looking at what food banks are available, what can the Center of Hope do? Because those are things we don’t necessarily have, but we have that information and can share it with people. Transportation’s huge. Trying to find transportation to work, doctor’s appointments, those kind of things.

Something that I kind of wanted to highlight too is, you know, when talking about how the pandemic has impacted the work that you guys do at the board, what sorts of challenges does the pandemic present specifically for folks with different disabilities?

I would say we’ve done a pretty good job with continuing to work. Is it great? No, absolutely not. This isn’t great for anyone, but we’ve been able to continue our work. I think a lot of people that we do serve, they might have routines. Maybe they don’t like the face masks, they don’t like the feeling on their faces, trying to understand and explain those things. When DeWine started closing things down, we did get some guidance from the state. That was nice to be able to have as far as our day programs go, as far as our residential facilities go. But I just think that for someone that might go to Applebee’s every Thursday night, explaining to them why they can’t go to Applebee’s every Thursday night is tough. That’s me. Why couldn’t I go to Applebee’s? And so I can’t imagine having a cognitive disability and not being able to understand, “What do you mean, I can’t go to the bowling alley? What do you mean, I can’t go to the movies?” I think even people that don’t have disabilities struggle with this anyways, so if you put a disability on top of it, I can’t even imagine how difficult it has been. So you know, we drew a lot of attention throughout the pandemic to people in nursing homes, to our firefighters, police, teachers, but again, going back to that DSP piece, you know, going into people’s homes and not being able to leave and take them places, and go do fun things. It’s not fun to sit at home. I’m not sure I could be a DSP right now. When I did direct care, I floated everywhere. I got to work with a lot of different people. Right now, with COVID, a lot of agencies are requiring the same people to work with the same people. That’s not good on either end. So I think that’s a struggle too. 

It’s interesting talking about DSPs’ work right now. A friend of mine had a son who was on the autism spectrum, and he was nonverbal, so touch was incredibly important for him, and, you know, just trying to imagine folks that are in that position where touch is such an important communicative device for them. How are DSPs dealing with this right now? Are they able to, you know, touch the people that they work with? What’s been going on with DSPs as far as being in home?

They haven’t changed a thing. They’re continuing to provide services. So if they need to help someone with a bath, they’re helping someone with a bath. If they need to, you know, lightly touch someone on their shoulder to calm them down, they’re doing that. I mean, I think that’s the amazing thing about this job right now is they continually step up. Because, let’s be honest, when we’re supporting people, we’re not just giving them a bath. I mean, there’s that dignity and respect that goes along with it, right? So you have to have a good relationship with that person. You have to trust that person. You have to be able to have a conversation with that person. And so it’s not just that physical thing that’s happening. So none of that could stop. That had to keep on going. You know, you kind of have a trust with someone that’s cooking your dinners. You have a trust with someone who’s driving you to your doctor’s appointments, because that’s still happened, or takes care of you when you’re not feeling well. So I don’t think DSPs changed one bit throughout the pandemic.

Do you think that puts them at a higher risk for COVID?

So the way we serve people with disabilities has completely changed over the years. Just like how we serve education, children’s services, how we take care of folks in our prisons, right? It’s all changed.

There’s people with disabilities out there that completely understand what’s going on, and just like everyone else, say, “I don’t buy it. I’m not wearing a stinking mask.” So there could be staff that go and work with them knowing that this person doesn’t buy it. So I think that it really is individual. Because the people that we serve are that. They’re people, and they have the same thoughts and rights and, you know, morals and values as other people out there. And so some people might be a little more risky to work with than others. Some people, and I say “people,” not “people with disabilities.” Some people, it’s easy to explain why you need to wear a mask. Some people want nothing to do with it. Some people understand what social distancing is, and some people are going to parties every night. I mean, so really, do I think it’s any more risky being a DSP? Probably not.

You mentioned a little bit about routines earlier. I understand that oftentimes routine can be very important for especially people on the autism spectrum. Has it been difficult to sort of explain that to them? What’s that process been like?

A lot of families and providers have used a lot of social stories to try to explain that process, but also trying to really think outside the box and use what we have. We’re talking to each other via Zoom. I have a young woman on my caseload that we scheduled once a week on Friday, just to touch base. And we would do something fun every week, so it might be crazy hat day, because she was just so depressed and so tired of being in the house, and just wanting to go see her boyfriend, and that was it. So I think just being creative, you know, and utilizing those resources. Special Olympics did some great things through the internet. Unified Resources, which is through Family and Community Services, they were doing a lot of virtual things. So just kind of utilizing what we could, and then also just recommending to people, you know, “Hey, you know what I did this morning? I get up every morning and I go for a walk.” You know, having those conversations. What are people doing to get through this? I think it’s hard because you have to work really hard to establish a different routine. And guess what, when this is all said and done, hopefully soon, it’s going to change again. And so explaining why it wasn’t OK last week to go to Applebee’s, but it’s OK this week. That’s a struggle too. So it’s a lot of communication and figuring out what works with each individual person.

Well, that wraps up a lot of the questions that I had for you. Is there anything else that you feel like I missed or other stuff you wanted to touch on?

I think really, truly making sure that you highlight how grateful the county board is, and just myself truly, for those that have continued to work through COVID. It has been hard for all of us, and to go into someone’s home, when we’re not going into each other’s homes, is such a huge thing. I’m not sure that we could express how grateful we are just because this has been hard on everyone.