1. Introduction Behavioral Health Services Copy of Horizon ... · 2369 DELCO - Housing Assistance ... What is the primary setting in which you perform ... Copy of Horizon House Inc.Workplace

Dear Behavioral Health Services Employee,

As part of Horizon House's commitment to workplace safety, we have convened an agency-wideWorkplace Safety and Violence Prevention Committee. This committee is tasked with theenhancement of Horizon House's current workplace violence prevention program.

We have developed a survey which we would like all employees to complete. The purpose of thissurvey is to better understand the extent to which Horizon House staff members are exposed toviolence in the course of their job duties. We believe that threats of violence and violent incidentsmay be under-reported. Your input is critical to the development of an accurate picture of what ourstaff is experiencing, so that we can take the appropriate measures to reduce the risk of violence.We are also asking you to share your ideas about how to make the workplace safer for ouremployees. You may choose to remain anonymous, or to provide your name so that we can follow-up with you on your ideas to prevent violence, or on incidents that you report in the survey.

This survey asks questions about a range of work-related violence. It includes questions aboutverbal violence, threats, aggressive behavior and violent acts. When completing this survey, pleasekeep the following definitions in mind:

A THREAT is an expression of intent to inflict pain, injury, or other harm. The expression may beverbal or non-verbal. The threat of harm may be explicit or implied e.g., the casual mention of aweapon.

VERBAL VIOLENCE describes a verbal attack directed towards you with the intent to intimidate orharm. It DOES NOT include situations where someone may be displaying behaviors such asventing frustration, displaying anger, shouting or cursing in which you are not the target.

PHYSICAL AGGRESSION includes acts such as pushing, shoving,or backing you up against a wall,in which no physical injury occurs.

PHYSICAL ASSAULT is a physical contact that results in injury. The injury may be major or minore.g., mild soreness, scratches or bruises, or hair that has been pulled out, would be included.

A WEAPON is ANY inanimate object used in a threatening manner or to inflict harm.

WORKPLACE is defined as any location, either permanent or temporary, where an employeeperforms any work-related duties, including:

-office buildings and facilities,their surroundings and parking lots;

1. Introduction

Copy of Horizon House Inc.Workplace Safety and Violence Prevention Employee Survey:Behavioral Health Services

1

-community settings where participants are seen or agency business is conducted;-any locations, including homes of participants or participants’ family members, where agencybusiness is conducted;-public transportation, when accompanied by a participant;-any vehicles when they are being used for Horizon House business.

Thank you for taking the time to complete this survey to help us enhance workplace safety.Completion of this survey will take about 20 - 25 minutes.

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This survey is anonymous. However, if you would like to provide your name so that we can followup with you regarding your responses, please feel free to do so in the space provided below. Weare asking everybody to provide information about gender, service and position because researchindicates that the risk of violence may vary based on these factors. As a result, violence preventionstrategies will need to be tailored to individual services, sites and positions.

2. A. About You and Your Service


1. What is your gender?

Female

Male

Other (please specify)

2. If you work in Montgomery, Lehigh, Berks or Bucks County,what is your home cost center?

2511 MONTCO S&C

2521 MONTCO ACT 601 DeKalb Street

2522 MONTCO AIR 131 Mill Grove Drive

2523 MONTCO SP Program

2524 MONTCO Crisis Residential

2541 LEHIGH CO CRS 910 E Emmaus Ave

2542 LEHIGH CO CRR 2128-30 N. Lehigh St

2543 LEHIGH CO SAL 449-D Willow St

2551 BERKS CO CHIPPS 550 Pearl St

2552 BUCKS CO CHIPPS (8-10 p residence)

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3. If you work in CHESTER County, what is your home cost center?

2412 Chester County SLA

2413 CRR: Pine Drive

2461 Peer Support Center

2462 CSP

2463 Common Ground

2465 Creative Expressions - Art Mentoring

2466 Creative Expressions - Training

2471 CHESCO S&C

4. If you work in PHILADELPHIA county, what is your home cost center?

2001 BHS Administration

2101 BHS Philadelphia Mgmt

2111 Residential Subs

2112 Residential Admin.

2113 Tenant Services Coordinator

2117 SIL

2120 PCBH: Mifflin Court

2130 SSL: Spruce St.

2131 PCBH: Chester Manor

2140 SSL: 6th St.

2141 CRR: Chelten Ave.

2142 SIL: Oak Lane Apts. (Limekiln) (HUD)

2143 SIL: 12th St. (HUD)

2144 SR: 6th St (HUD)

2150 Susquehanna Park

2161 Outpatient Services

2165 Outpatient Common Ground

2167 Caton Village

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2170 Wellness Alliance

2174 Mobile Psych Rehab

2175 Peer Support Program

2180 Targeted Case Mgmt. Service

2181 Targeted Case Mangmt.

2182 ACT Team 1

2183 ACT Team 2

2190 BHS Clinical Mgmt.

2191 SAMHSA Project Health

2193 PEACE

2261 EMP: General

2272 Environmental Serv.

2273 Mailroom

2274 Industry Integrated Employment

2275 Food Services

2276 Supported Employment

2277 Education Plus

2280 Youth Employment Program

2601 CBH/DHS RTFA General Admin

2604 CBH/DHS RTFA 229 S. 46thth St.

2607 CBH/DHS 504-506 S. 42nd. St

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5. If you work in DELAWARE County, what is your home cost center?

2311 General

2312 CRR: Prospect Park

2313 Supp. Living Serv. (scattered) –

2314 Spec. Res Homeless DELCO Lemon

2315 SLS: Nyack Ave

2316 Supp. Living Services

2318 Malin Rd

2361 SPC6

2362 Mobile Psych Rehab

2363 Providence House

2364 Peer Specialists

2365 Path: Housing First

2366 Psych Rehab Assessment

2367 SPC7 Program

2368 EASR (HUD)

2369 DELCO - Housing Assistance

2370 DELCO - Upland Woods

2372 DELCO MH CT Project

2373 SHP Reallocation Project

2380 H.O.P.E. (PACT)

2381 DELCO ACT

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6. If you work in Delaware State, what is your home cost center?

4110 Residential Subs

4111 Bennett House GH

4112 Wilson Rd GH

4113 Old Baltimore Pike GH

4131 Rep Payee Mgmt

4132 Devonshire

4161 Supported Employment

4172 Outpatient Newark

4173 Outpatient Middletown

4182 ACT HOPE

4183 ACT Vision

4184 ACT NAVIGATOR

4185 ACT ALLIANCE

4186 ACT PATHWAYS

7. What position do you hold? (all positions are listed alphabetically)

Behavior Health Specialist

Behavior Health Clinician

Benefits Specialist

Case Manager

Clinical Coordinator

Clinical Services Specialist

Clinical Specialist

Clinical Supervisor

Clinical Trainer

Clinician-Registered Nurse

Community Integration and Employment Manager

Co-occurring Service Supervisor

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Crisis Worker

D&A Professional

D&A Specialist

Dining Services Training Coordinator

Director ACT

Director Adolescent Services

Director Chester County Services

Director Delaware/Chester County

Director of Educational Support Services

Director, Montgomery County & Lehigh County

Director PACT

Director Philadelphia County

Director Program Operations

Director Residential Services

Director Vocational Services

Director Special Projects

Director Substance Abuse and Outpatient

Director Susquehanna Park

Director Targeted Case Management

Employment Assistant

Employment Development Specialist

Employment Professional

Employment Rehab Coordinator

Employment Specialist

House Manager

Housing Specialist

Intensive Case Manager

Intensive Case Management Assistant

Job Developer

LPN

Lead Mental Health Professional

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Lead Peer Support Specialist

Lead Primary Counselor

Lead Psychiatric Nurse

Manager

Manager Targeted Case Management

Mental Health Clinician

Mental Health Professional

Mental Health Specialist

Mobile Psych Rehab Specialist

Occupational Therapist

Occupational Trainer

Outpatient Assessment Specialist

Outpatient Counselor

Peer Support Specialist

Primary Counselor

Program Coordinator

Program Director

Program Manager

Psychiatric Nurse

Psychiatrist

Psych Rehab Specialist

Recovery Coach

Recovery Support Specialist

Registered Nurse

Rehabilitation Advisor

Rehabilitation Coordinator

Rehabilitation Counselor

Rehabilitation Counselor II

Rehabilitation Counselor iii

Rehabilitation Counselor IV

Rehabilitation Specialist

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Residence Manager

Resident Support Specialist

Residential Coordinator

Residential Living Specialist

Resource Manager IV

Senior Employment Coordinator

Senior Resource Manager

Supervisor

Supervisor Environmental Services

Team Coordinator

Team Leader

Team Leader Mobile Psych Rehab

Tenant Services Coordinator


8. What is the primary setting in which you perform your job?

Horizon House administrative office

House House satellite office

My program site

Horizon House residential site

Participant’s home

On another organization’s premises

In the community

9. OPTIONAL-If you would like to provide your name, please do so below

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The following questions ask about your personal experience with threats of violence and/or actualexperience with verbal and/or physical violence in the course of performing your job duties. We arealso interested in knowing whether there have been times when you have FELT threatened, eventhough no threat was made.

When you respond to the questions below, please keep in mind the following definitions:

A THREAT is an expression of intent to inflict pain, injury, or other harm. The expression may beverbal or non-verbal. The threat of harm may be explicit or implied e.g., the casual mention of aweapon.

VERBAL VIOLENCE describes a verbal attack directed towards you with the intent to intimidate orharm. It DOES NOT include situations where someone may be displaying behaviors such asventing frustration, displaying anger, shouting or cursing in which you are not the target.

PHYSICAL AGGRESSION includes acts such as pushing, shoving, or backing you up against a wall,in which no physical injury occurs.

PHYSICAL ASSAULT is a physical contact that results in injury. The injury may be major or minore.g., mild soreness, scratches or bruises, or hair that has been pulled out, would be included

A WEAPON is ANY inanimate object used in a threatening manner or to inflict harm

WORKPLACE is defined as any location, either permanent or temporary, where an employeeperforms and work-related duties, including:

-office buildings and facilities, their surroundings and parking lots;-community settings where participants are seen or agency business is conducted,-any locations, including homes of participants or participants’ family members, where agencybusiness is conducted-public transportation, when accompanied by a participant;-any vehicles when they are being used for Horizon House business.

Questions 10-32 address situations in which you were directly or indirectly threatened with physicalharm, you FELT at risk of physical harm even though there was no direct or indirect threat, orexperienced verbal violence in the course of performing your job duties.

Questions 33-51 focus on whether you have ever experienced physical aggression and/or aphysical assault in the course of performing your job duties.

3. B. Your Experience of Workplace Violence


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Questions 52-58 focus on how safe you feel at work and suggestions you have for increasing thesafety of your workplace.

10. Have you ever been threatened with PHYSICAL HARM by a person in the course of performing yourjob duties at Horizon House?

Yes

No

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4.


11. Has this happened more than once?

Yes

No

12. When did this happen? (check all that apply)

Within last 12 months

1-5 years ago

6-10 years ago

More than 10 years ago


13. Who threatened you? (Check all that apply)

Participant

Friend of participant

Relative of participant

Another staff member

Your own relative

Your own acquaintance

Community member

14. Did this person(s) have a known history of violence?

Yes

No

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15. Was a WEAPON involved?(a WEAPON is any inanimate object used in a threatening manner or toinflict harm)

Yes

No

16. If yes, what was the weapon?


17. Where did the threat(s) take place?



My program site




In the community

18. Did you submit an incident report(s)?

Yes

No

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19. If you did not submit an incident report, what was the reason(s)? (Check all that apply)

Fear of reprisal from participant

Fear of disapproval by colleagues

Fear that I would be blamed for the incident

Fear of disapproval by administration

Didn’t know I was supposed to

Didn’t have time to complete the paperwork

Didn't think it would make a difference

It happens all the time. I'd have to write too many reports!

Didn’t think the person was responsible for their actions due to psychiatric/psychological state

20. Did you file a police report?

Yes

No


21. If you did not file a police report(s), please indicate why (check all that apply)




Didn’t know I could press charges

Lack of supervisory support

Thought it was against agency policy

Fear of complexity of the legal system


Didn’t think the person was responsible for their actions due to their psychiatric/psychological state

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22. Have you ever been the target of VERBAL VIOLENCE at your Horizon House workplace? (VERBALVIOLENCE describes a verbal attack directed towards you with the intent to intimidate or harm. It DOESNOT include situations where someone may be displaying behaviors such as venting frustration, displayinganger, shouting or cursing in which you are not the target.

Yes

No

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5.


23. If yes, more than once?

Yes

No

24. How recently did this occur? (check all that apply)


1-5 years ago

6-10 years ago


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6.



25. Who verbally attacked you? (check all that apply)

Participant




Your own relative


Person from the community


26. Where did this happen? (check all that apply)



My program site




In the community

27. Have you ever FELT in imminent danger of physical harm by a person at a Horizon House workplace?

Yes

No

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7.


28. If yes, more than once?

Yes

No

29. How recently did this occur? (check all that apply)

Within the last 12 months

1-5 years ago

6-10 years ago



30. Whom did you feel endangered by? (Check all that apply)

Participant




Your own relative



31. Did this person have a known history of violence?

Yes

No

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32. Where did this happen? (check all that apply)



My program site




In the community

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Questions 33-51 focus on whether you have ever experienced physical aggression and/or physicalassault in the course of your work for Horizon House. In this section, we distinguish betweenPHYSICAL AGGRESSION(being pushed, shoved or grabbed, but not being injured) and PHYSICALASSAULT (physical contact that results in injury. The injury may be major or minor e.g., mildsoreness, scratches or bruises would be included).

8. Physical Aggression and Assault


33. Have you ever experienced PHYSICAL AGGRESSION in the course of performing your Horizon Houseduties? (Physical aggression is defined as aggressive physical contact that does not result in an injury e.g.,shoving, pushing, grabbing)

Yes

No

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9.


34. If yes, have you experienced physical aggression more than once?

Yes

No


35. Who engaged in the physical aggression ? (check all that apply)

Participant




Your own relative




36. Where did this happen?



My program site




In the community

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37. Did this person have a known history of violence?

Yes

No

38. Did you file an incident report?

Yes

No


39. If you answered no, please indicate the reason(s) why below (check all that apply)



Fear that I would be blamed for the incident


Didn’t know I was supposed to



It happens all the time. I'd have to write too many reports!

Didn’t think the person was responsible for their actions due to psychiatric/psychological state

40. Have you ever been PHYSICALLY ASSAULTED in the course of performing your Horizon House jobduties? (Physical assault is defined as physical contact that results in injury. The injury may be major orminor e.g., mild soreness, scratches or bruises.

Yes

No

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10.


41. If yes, have you been physically assaulted more than once?

Yes

No


42. Who physically assaulted you? (check all that apply)

Participant




Your own relative



43. Was a weapon involved? (A weapon is any inanimate object used in a threatening manner or to inflictharm)

Yes

No

44. If yes, what was the weapon?

45. How recently did the physical assault(s) take place? (check all that apply)


1-5 years ago

6-10 years ago


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46. Where did the physical assaults take place? (Check all that apply)



My program site




In the community

47. Did the person(s) who physically assaulted you have a previous history of violence?

Yes

No

48. Did you file an incident report?

Yes

No

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11.



49. If you answered No, please indicate the reasons why below (Check all that apply)


Fear that I would get blamed




Didn't know I was supposed to

It happens all the time - I'd have to write too many reports

Didn't have time to complete the paperwork

Didn't think the person was responsible for their actions due to their psychiatric/psychological state

50. Did you file a police report?

Yes

No

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12.



51. If you answered No, please indicate the reason(s) why below. (check all that apply)




Didn’t know I could press charges

Lack of supervisory support

Thought it was against agency policy

Fear of complexity of the legal system


Didn’t think the person was responsible for their actions due to their psychiatric/psychological state

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Questions 52-58 focus on how safe from violence you feel in the course of performing your jobduties, whether there are specific work policies, practices or conditions that make you feel unsafe,and what could be done to increase your feelings of safety from violence at work.

13. C. How safe from violence do you feel at work?


52. How safe from violence do you feel in the course of performing your job duties?

Very safe

Moderately safe

Neither safe or unsafe

Moderately unsafe

Very unsafe

53. If you checked "Moderately unsafe" or "Very unsafe", please describe any policies, practices orconditions that contribute to you feeling unsafe from workplace violence at Horizon House.

54. Have you completed the CPI Non-violent Crisis Prevention Training?

Yes

No

55. If yes, do you think it provided you with useful violence prevention tools?

Yes

No

56. What kinds of additional training would be helpful?

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57. Please share your thoughts about any changes you think could be made to reduce the risk of violenceto Horizon House staff e.g., changes in policies, procedures, practices, office layouts, staffing, etc.

58. Please use this space to make any additional comments about how the potential of violence or actualviolence has impacted you in your job.

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Documents

1. Introduction Behavioral Health Services Copy of Horizon ... · 2369 DELCO - Housing Assistance ... What is the primary setting in which you perform ... Copy of Horizon House Inc.Workplace