If a task force gets its way, behavioral health workers in Oregon won’t have to be alone with a client they feel is unsafe — a change intended to prevent a reoccurrence of the tragic stabbing death of Haley Rogers.
Driven by an increase in violence, including the death of Rogers at a Gresham behavioral health facility last year, the state task force is working to finalize draft recommendations intended to improve behavioral health worker training and safety.
The next meeting of the 17-member group, which includes lawmakers and representatives of employers, agencies and behavioral health workers, is slated for Nov. 14. Its final recommendations are due by Dec. 1, in time for the 2025 legislative session.
The state faces a shortage of community-based treatment facilities for people with mental illness or addiction as well as workers to care for them. Rogers’ death — which came after fellow workers had shared safety concerns with management — spotlighted the violence that behavioral health workers face.
“I think we’re all aware of horrible incidents that have happened in our state where workers have either been injured or have lost their lives in their workplace,” state Rep. Travis Nelson, a Portland Democrat who chairs the task force, told The Lund Report. “And that just shouldn't happen.”
The task force was originally proposed by Sen. Chris Gorsek, a Democrat whose district includes Gresham. It eventually was folded into the legislation that recriminalized drug possession.
If adopted by lawmakers, the recommendations would require behavioral health providers to adopt safety plans and practices, provide additional safety training for employees and assess how to improve facility safety, such as through cameras or improving design and layout, or otherwise addressing security hazards.
Additionally, the recommendations would require employers to document training provided to employees as well as violent incidents directed at staff.
New regulations seek safer work environments
The task force’s recommendations include both legislation and regulations. They are intended to address shortcomings of current federal and state rules related to behavioral health workplace safety, Nelson said.
Rogers, then 26, worked at McCarthy Place, a 10-bed group home operated by Cascadia Health, when she was allegedly murdered by a resident. Workplace safety inspectors concluded the suspected resident pried open of a poorly secured kitchen drawer to get a knife while she was working alone overnight. Months later a second Cascadia employee was stabbed while on the job, surviving the injury.
“I think we’re all aware of horrible incidents that have happened in our state where workers have either been injured or have lost their lives in their workplace. And that just shouldn't happen.”
In connection with Rogers’ death, the Oregon Occupational Safety and Health division fined Cascadia $7,250.
The agency’s report faulted Cascadia for lack of training as well as staffing the facility with a single employee overnight, not providing workers with walkie talkies or body alarms and allowing a hazardous physical layout.
Cascadia, a Portland-based nonprofit, did not contest the fine and budgeted $1 million toward safety improvements.
The task force included Jeremy Lankenau, a crisis counselor at Cascadia, and Eric Sevos, the organization’s chief operating officer.
“The work of this task force directly aligns with Cascadia Health’s work and priority around safety,” Cascadia spokesperson Stephanie Tripp told The Lund Report in an email. She said the recommendations would lead to a safer environment for employees and clients.
The task force’s recommendations would apply to residential behavioral health facilities, as well as shelters and mobile crisis units. If approved, they would direct employers to have a written plan for workers who may be alone with clients. As part of these plans, employers would have to provide walkie talkies or other communication devices to workers who are alone with clients. One recommendation would be to “allow workers to require a second staff member to be present before working with a client,” according to the task force’s draft report.
The task force is also calling on lawmakers to provide grants to help behavioral health providers fund risk assessments, safety equipment and security upgrades.
The recommendations do not call for any minimum staffing mandates for behavioral health health providers, Nelson said. An earlier version of the recommendations called for changes to Medicaid reimbursement rates to cover more staff, but was taken out. The Oregon Health Authority is separately looking into how to improve behavioral health reimbursement rates.
Another important recommendation is allowing employees to report “near misses,” incidents where an employee is not harmed but still raises safety concerns.
“If you can prevent a near miss or learn from it, you may be able to prevent something more serious in the future,” Nelson said.
