Thursday, August 6, 2020
Aug. 6, 2020

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Nurses say abuse hotline has barriers to mandatory reporting

They say system needs to fix long wait times on End Harm Line

By , Columbian staff writer
Published:

Three local nurses say wait times of up to an hour are creating a barrier to the mandatory reporting of child abuse.

Peigi Huseby, Giedre Babarskiene and Tatyana Sinitsyna, all registered nurses with Kaiser Permanente Cascade Park Medical Office, said hold times are almost always 40 to 60 minutes when they place a call to the End Harm Line. The hotline, dedicated to suspected abuse or neglect of vulnerable children and adults, is run by the Department of Children, Youth and Families. Clark County’s intake line can be reached at 1-888-713-6115.

All three nurses, who said they are not speaking on behalf of Kaiser Permanente, have serious concerns about child safety issues created by the hold times. Huseby said sometimes waits are so long, nurses have to hang up and call again later in the day because they can’t tend to other patients.

According to data provided by the state, reports of child abuse and neglect rose by 31 percent from 2010 to 2017. In 2017 the Children’s Administration, which is part of the department, received an average of nearly 9,900 calls per month reporting “possible child abuse and neglect or requesting services for children and families,” according to a reference guide.

“This system is creating a huge barrier to children’s needs being addressed,” said Huseby, who first encountered the problem when she started working as a nurse in Vancouver in 2012. “They know this is a barrier, and they have done nothing about it.”

Stephanie Frazier is the agency’s administrator for intake for Region Six, which includes Clark County. She said reports made to Region Six have gone up every year from 2010 to 2017, but staff hasn’t increased in an equal proportion.

The state has provided funding for Frazier to hire two more staffers, which will give her 15 people.

“I have been area administrator for intake since the middle of last September,” Frazier said. “I’m not sure how much two staff is going to affect it. … I hope that we can bring call times down.”

Huseby has been told she can be heard more quickly if she waits to call early in the morning, but abuse is supposed to be reported as soon as it’s suspected.

“If I wait until the next day at 8:30 a.m., God only knows what could happen,” Huseby said.

The three nurses say they call the line about once a week. Huseby has reported a parent shooting a gun in the house with children present, a father who strikes his children at the dinner table and drags them upstairs, plus emotionally abusive parents and parents who use drugs with their minor children. Huseby said almost all reports carry significant amounts of risk, but no matter how serious, Huseby is still met with 40- to 60-minute wait times.

Huseby said she hasn’t encountered people who don’t make reports because of the problems, but added she has heard medical staff say in passing that “it’s impossible to make a report, so why bother?”

Babarskiene said the wait times are frustrating.

“We’re concerned about children,” Babarskiene said. “It takes 45 minutes, at least, or the call gets dropped, or we have to end the call, and try calling them again,”

“I assume you call a hotline and somebody picks up the phone — you’re not on hold for close to an hour,” added Sinitsyna. “The expectation is I’ll call someone and make a report, and it will get taken care of if it needs to get taken care of.”

Hotline history

The End Harm Line was run by the Washington State Department of Social and Health Services until July, when responsibility switched to the newly formed Department of Children, Youth and Families.

Huseby said the hold times have been an issue under each department. She first encountered the issue in 2012. Three years later, Huseby wrote a letter to Jennifer Strus, the children’s administration assistant secretary for DSHS, outlining the issue. That letter was signed by about 13 of her clinic’s staff.

“This wait time makes it often either very difficult or impossible to report, as patients are waiting to be seen and we are not able to stay on the phone for such a prolonged period of time waiting,” Huseby wrote. “This creates serious safety issues for our most vulnerable population.”

In July, there were three intake regions added, bringing the total to six. All are on call from 8 a.m. to 4:30 p.m. weekdays.

When one calls the End Harm Line, they select their intake region from a phone tree, or they can call their region directly. The call is then placed in a queue and is answered in order, Frazier said. The call stays in the queue until an agent answers. Any calls that are left in the call queue at the end of the day are answered and dealt with, even if it means the agent stays after 4:30 p.m. A central intake handles reports on weekends, nights and holidays.

Solutions sought

Region Six covers Clark, Cowlitz, Skamania, Lewis, Wahkiakum, Pacific, Thurston, Grays Harbor, Mason, Jefferson and Clallam counties.

Frazier said she’s aware of the issue, and that educators, doctors, nurses, law enforcement and other mandatory reporters have all complained about hold times.

“We’ve had concerns about wait times from every one of those agencies,” Frazier said. “It’s not just exclusive to just this one that Peigi has reported.”

DCYF spokesperson Debra Johnson said the agency is advocating for more support from the Legislature, which is why they were able to add staffers this year.

Huseby has spoken about the issue with state Rep. Chris Corry, R-Yakima, whose district includes a small part of eastern Clark County. Corry sits on the Human Services & Early Learning Committee, and he and his wife are licensed foster parents. Corry said he’s spoken with DCYF about the End Harm Line issues, and does want to solve the problem.

Corry said he thinks there’s legislative fixes that can be helpful, but explained he doesn’t think spending money for extra staff is necessarily the best approach. Corry said it’s also important to focus on the processes, technology and whether everything is as efficient as possible.

“I’m not always the biggest proponent of ‘Hey, let’s throw more money at a problem’ because oftentimes that’s not the solution,” Corry said.

Corry said he sees how this can also create other issues for medical facilities if nurses are delaying treatment of patients when they’re on hold. Corry, whose mother and grandmother were nurses, said he doesn’t think nurses would ever not report abuse because of the wait times, but also expressed disappointment that’s even a possibility.

“I don’t think that would happen, but it’s a logical conclusion that they would say, ‘It’s pointless,’ ” Corry said. “I don’t think they would ever give up, but I worry that the idea would even cross their minds.”

Huseby, who has been trying to change the system for about seven years now, said she’s skeptical anything will improve in the near future.

“It’s a huge danger to children,” Huseby said. “Children are getting hurt. Children are getting messed up. We say, ‘Oh, children, they’re our future.’ No. I feel like we are ignoring and maltreating the most vulnerable members of our society.”

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