Billable Smoke

Billable units. Productivity. These are the things that plague every social worker. It is, after all, the only way to determine that progress is being made. At least that is how the bureaucrats-excuse me, supervisors see things. Case workers, though, see productivity as job security.

I was sitting in a tiny board room at the far side of the women's homeless shelter, freezing my ass off, listening to one of the clinical supervisor's monotone speech about what CAN and what CANNOT be considered a billable unit of service. The dull lull of her voice pulled at my eyelids, insisting that they shut as I took another loud gulp of my cheap, lukewarm coffee. Putting forth my best effort, I leaned into the table, faking interest in the day's discussion.

"Our productivity is very low," the supervisor stated, emphasizing 'low' by drawing out the 'oh' sound and leaning her torso forward as though she might fall, "All across the board, we are spending LESS than fifty percent of our time working with clients on billable units. This is NOT acceptable. So, while we are all here, we are going to put our heads together to see how we can change this number. Any ideas?" The room echoed this last statement momentarily, finally pinching off to a dead silence. The supervisor pushed her glasses forward to look over top of them. With her eyebrows raised and her arms crossed, she waited for someone to speak up.

"Well," the child therapist started, "maybe we need to talk about what can be billed and what cannot." Scrutinizing the therapist from behind the spectacles, the supervisor considered the statement. Deciding that it was a valid point, she dove into the subject.

"If you talk with a client about housing issues, you can bill for this. If you help a client find a job, you can bill for this. If you testify in court or talk to a probation officer on behalf of a client, you can bill for it." The supervisor rattled off the list of what can be billed, as I quietly tuned out. I decided that I didn't need to listen to this lecture. After reviewing last month's statistics, I felt confident that I knew what I could bill on my time sheet. After all, I had the highest rate of productivity in the agency. Still, it wasn't above fifty percent, so I was forced-like everyone else-to attend.

Really, what I was thinking about was cigarettes. In particular, how badly I wanted one. Looking to the clock, I realized I had at least another twenty minutes until I would be able to smoke. So, I continued to sit quietly, chewing on a straw and tapping my foot impatiently.

"You CANNOT bill for driving someone to court. Or to the hospital. Or to work. The State doesn't pay us to be a taxi service. Is all of this clear to everyone?" The group obliged their supervisor a half-hearted reply that indicated one thing: not only did they understand this; they were sick of hearing it, as well.

"Good, then I expect to see results. The last thing that I wanted to mention, and this came down from the executives, was in regard to our smoking policy. We have a designated smoking area for staff and a designated smoking area for residents. Please keep it this way. It is set up like this for a reason." Looking around, I realized that this statement was directed to me, given that I was the only smoker in the room. Overall, there were only two smoking staff members. The other worked for administration. I decided put my boss to the test.

"Do you think you could give us that reason?" I asked sweetly. Whipping her dark-haired head in my direction, she fired her answer with the accuracy of a trained hit man.

"It just doesn't look very professional to have our staff out huffing one down with the clients."

"Why?" All eyes in the room turned to me with an impatient glare.

"Why don't you come to my office and we'll discuss this, since it doesn't really apply to anyone in here but you?" There was a collective exhale from the group as they gathered pens and papers to get back to work. I, too, exhaled; relieved that I had a good excuse to take a rain check on my meeting with our leader.

After making my excuse, "I'm sorry; I have to meet with a client (bullshit). Can we do it another time," I hurried back to my office where I rummaged for my precious tobacco. Looking straight forward, not wanting to be distracted from my mission, I rushed toward the red, windowless door that read: STAFF ONLY. Stepping outside into the beautiful, spring sunshine, I felt my spirits lift.

For me, there is nothing that a long drag on a cigarette can't fix. Apparently, I wasn't the only smoker with this idea in mind. Soon, I was joined by the receptionist, who flung herself into one of the plastic lawn chairs to my left.

"So, what do you think they will do once this new smoking ban goes into effect?" Over the past few months, the good citizens of Ohio-ever mindful of good health practices-voted that smoking should not be aloud in public. This, of course, means that all businesses in the state must discontinue smoking sections in their facilities. Damn the luck.

"I have no idea. I mean, good luck telling any of our clients they can't smoke. I wonder if a shelter is considered public. After all, it is their home. I don't really care. I just need to move to a 'right to smoke' state," I muttered. Suddenly, the red door swung open, startling the two of us. It was one of the shelter workers, looking haggard and frantic.

"Betty is back from court. She's pretty upset. Do you think you could talk to her?" Reluctantly, I crushed out my half-smoked Marlboro Light and followed the worker. As she had said, Betty was pretty upset. The thin, thirty-something was pacing the floor in front of my office ferociously, wringing her pale hands and talking under her breath. Her blonde hair hung in her face so that only her nose and mouth were fully visible.

"What's up Betty? You don't look too happy."

"No," she started loudly, "they took my boy. Took him!" Her hands were trembling as the tears fell over her dry and cracked lips. I started to usher her into my office before other residents and staff became alarmed, but she put up her hands in protest.

"Will you just come with me to smoke?" She asked so quietly, that I nearly didn't hear her. Disregarding my earlier meeting, like usual, I accompanied my client, careful to keep my pack of cigarettes hidden in my coat pocket. We strolled around the corner to the front door and headed into the court yard. I checked behind me cautiously as Betty pushed open the sliding glass door with a sign that read: CLIENT SMOKING AREA.

"So, what happened?" I asked her while making myself comfortable in the teak wood chaise lounge. I carefully slid a smoke out from my pocket without removing the pack and handed it to my client. She took it willingly, as she had every other time I offered. It was awful to be a smoker with no money, just like it would be for any other addict with no money.

"They said that I just wasn't smart enough to take care of him."

"Not smart enough? Are you sure that is what they said?" Betty's nine-month-old son had been in foster care since he was born after he tested positive for crack at the hospital. Betty swears that she didn't smoke when she was pregnant. She said it must have been her boyfriend's smoke blowing in her face. I didn't believe that story and neither did the judge, but since that time, she has really tried hard to clean up her act.

"Well, they said that they decided this because of that psychology test that I took. That it said I was low functioning."

"Did they say anything else? I can't imagine that being the only reason." I took another cautious drag from my smoke as I listened to her story.

"Well, they said that I was taking too long to complete all this stuff," she started to laugh a little, "I told the judge when he asked that he'd have a hard time with finishing it, too." She had a point, although I never admitted it to her. Her parenting classes at the Goodwill took five months to complete. Her drug treatment program took four months to complete. Then, she went and told off the Job and Family Services case worker; which landed her six months of anger management. On top of all this, she was required to find full-time employment and suitable housing, take drug tests and psychological exams, and meet with the lawyers and the case workers. With an eleventh grade education, finding full-time employment was a challenge. Without full-time employment, finding affordable housing was impossible.

"How are the foster parents reacting to this?"

"Oh, they told me that I could see 'im," she sniffled, stamping out her cigarette butt on the cement. Without a second thought, I handed her another one.

"Well, that's a bonus. At least you know that they are nice people." At that moment, I heard the door open behind us and I closed my eyes, waiting to hear the familiar voice.

"Hi Beatrice, how are you?" my supervisor smeared thickly. Irritation welled inside of me as I told myself not to remind the boss that the woman prefers Betty. No one calls her Beatrice, unless they read it straight from her client chart.

"Oh, I'm real good, ma'am," Betty offered as she politely rose from her chair.

"Oh, no need to get up; I just need to talk to you," she said, nodding her head at me.

Betty took her seat again as I slowly turned to stare at my boss. I knew what was coming and I was happy to have finished a cigarette before she started to reprimand me. In a fit of nicotine withdraw; I might have gotten fired for what I would say.

"Didn't we just talk about this?" she said sternly as the door to the courtyard clicked shut behind us.

"Yes, we did. But, she was having a rough day and I was trying to increase my productivity." I was certain that my pitiful excuse wouldn't fly, but it was worth a shot.

"You know, there are lots of ways to increase your productivity that does not include smoking. Furthermore, the state isn't going to like seeing, 'smoked cigarette with client' on a progress note. That isn't their idea of case management." By this time we had rounded the corner and entered her office, taking our usual seats across from each other.

"I just wanted her to be comfortable. She was having a bad day and needed a smoke," I smiled mischievously, "So, I gave her two."

"Just don't let the administration staff see you do that."

"What is the big deal?"

"It just doesn't look professional. This is a business and we need to maintain ourselves as such."

"Well, for Betty, this is her home. Professional equals uncomfortable." Fortunately, my boss received a call at that very moment. She wafted her hand carelessly in the air to dismiss me. As I walked back toward my office, I ran into Katie. Katie was a little nineteen year old college drop out with a nightmare for a boyfriend and no other family. She had been in the shelter for about two weeks at this point and was having trouble adjusting to the place. She complained chronically of insomnia and anxiety and today was no different.

"Hi Kate, how's it going?"

"Awful, I haven't slept in two days and the doctor at the clinic can't get me in for about two more weeks. Not to mention this place is getting to me."

"Why?" I hated to even ask, but it was my job. She followed down the corridor, sliding her feet along the carpet behind me.

"I don't know, it doesn't seem like anyone likes me," she whimpered.

"What do you mean, 'no one likes you'?"

"I don't know...everyone that works here...I mean, no offense, but jeez! Everyone is so stuffy in here. You'd think that the sky would fall down if you forgot to put socks on your feet!"

"Well, we have to have rules for your protection." I hated to patronize her, but I did it anyhow.

"I know, but I ain't like you people," she grumbled.

"And how is that?" She looked around anxiously before she continued.

"I don't know. People look at me like I'm stupid or something."

"I doubt that people think that way. I think you feel that way." It was a half-truth, really. I knew exactly what she meant, but didn't have it in me to come out and say it. It was an overall feeling of being judged.

A few days later, I was sitting in the waiting room, chatting with the receptionists as they watched two clients head out for a smoke break.

"You know what never ceases to amaze me," one of the non-smoking secretaries spouted.

"What's that," the other, a smoker, asked.

"These residents don't have jobs; don't have a place to live. They can't even buy groceries for themselves. But, dammit, they got the cash for smokes, don't they?"

"Not usually," the smoking secretary replied, "if they did, they wouldn't bum them from me."

"I just don't understand it," the woman said, shaking her head.

"I do," I chirped, "It's the only solace they have left. Just like the television. Everyone always complains that the television is on all the time. 'And none of these ladies have a place to go'," I chided mockingly, "It's an escape for them. Television and smokes are to the poor, what timeshares and yoga are to the middle class. Give a break. You don't have to live here."

"I just don't understand it," she said again.

"No one would expect you to," the smoking secretary said, "You're not a smoker."

As the two women went back to clicking away on their computers, I strolled out to the client smoking section. Having completely forgotten my discussion several days prior, I instinctually pulled a Marlboro from my pocket.

"Girl, I am so glad you are out here," Shinequa chirped, "You are not going to believe what happened today!"

"Oh, this'll be a good one," I joked.

"I am celebrating my in-DE-pend-ENCE! My restraining order went through and they served him the papers and they picked him up on the warrant," she informed with a toothy grin. I gave her a high five and we stood up to do a victory dance. Just as it was starting to get good and loud, our celebration was dashed.

"Hey," the child care worker beckoned, "you have a phone call." The courtyard fell uncomfortably silent and the residents scurried to take their seats once more. Without notice, the child care worker turned on her heel and walked back into the building. Making a funny face at Shinequa, I walked inside to take the phone call.

After hanging up with an irritable parole officer, I started to work on my billable units, giggling to myself. As I counted up the hours, I realized that sixty-five percent of my billable productivity was from sitting outside with the clients to smoke against my boss' wishes.

"You better watch sitting outside with them to smoke, you'll get in trouble." The child care worker had startled me into dribbling my coffee on my newly completed paperwork. Looking up to her as I clumsily blotted the coffee stain, I gave her an honest opinion on her comment.

"I'm not too worried about it."

The child care worker shrugged and smiled ruefully before reminding me,

"It won't matter in a month or two because no one will be able to smoke here." With that statement, she turned on her heel and walked back to the main office. I gritted my teeth at the realization and reverted my attention to my paperwork. A half an hour or more passed before I lifted my head once more to see Kim, one of the older residents, try to shift past my office without being noticed. It didn't work.

"Kim," I hollered as she walked past the door, "do you ever think you might meet with me?" Kim had blown off every appointment we had scheduled for nearly two weeks. I wasn't sure what her problem was, but it was becoming a problem for me. I ushered her into my office promptly, hoping to get a straight answer on this.

"What's up?" I asked, leaning back in my chair and propping my feet on the corner of the desk.

"With what?" Kim crossed her arms defensively and I rattled my brain to figure out the problem.

"You avoid me. You bail on our appointments. Hell, I haven't seen you since we had that meeting with my supervisor and your probation officer."

"I know," she said flatly, turning her head to stare at the wall to her left. She shifted uncomfortably in her chair and began to pick at her thumb nail.

"Is there a reason? I thought everything was going well."

"Yeah, great," she muttered, rolling her eyes, "ya'll on my ass like crazy. Gangin' up on me and shit."

"Are you talking about the other week? When we had that meeting? I didn't know that you thought that." Kim looked at me, dumbfounded, and this time I squirmed in the chair.

"Who wouldn't feel that way? I mean, it's cool, dealing with you and all. And I can handle the P.O. just fine. But, I felt like a kid that had to go to the principal's office or something. I have been here for two months and your boss don't even know my name. She passes me in the hall every day and she don't know my name! That's messed up. I'm fine. I can handle myself and I don't need anyone up in my shit."

"I know. But, does it really matter if my boss knows your name? I know your name." I tried to make light of the situation, but it wasn't going to fly.

"It matters if she is the one telling me that I could get kicked out of this place if I don't follow what the P.O. says. She don't even know what's up with my case and she gonna threaten me like that? Hell, I'll go live on the street. No one'll tell me what to do then."

"Let's go smoke and hash this out." A big smile spread across Kim's face and I felt confident that all things could be settled over a cigarette or two.

"So, all that aside...what has been going on with you?" I asked her as I climbed over the side of the bench to take a seat. Over several cigarettes, Kim updated me on her state of affairs. As it turned out, she managed to get a job at a local convenience store and had been looking at various apartment options. In addition, she had enrolled in school to get her G.E.D. So she was right, she didn't need my help. Just as she started to fill me in on her love life and the mess she was making of it, the supervisor beckoned me in such a fashion that I jumped up immediately.

She was silent as I followed her to her office and she waited patiently for me to take a seat before she shut the door. I could tell by her demeanor that I was in trouble. Taking a seat behind her desk, she rummaged through a hurricane of papers before sliding one over to me. I glanced quickly to the top of the page.

STAFF DISCIPLINARY WARNINGThis member has been told REPEATEDLY to discontinue fraternizing with clients in the designated client smoking area. This staff member continues to disregard prior verbal warnings. This write up acts as a written warning in which further disciplinary action will be taken if this warning is not heeded.

Rolling my eyes discreetly, I reached for a pen from the little mug on her desk. Just above the "staff signature" section, was a blank space for employee comments. I was not going to turn this back in without giving my two cents.

EMPLOYEE COMMENTSIn many cases, much billable case management is performed in the client smoking area. I find that it is easier to meet with a client in THEIR comfort zone as opposed to having them meet in my office. This helps to create informality and puts me on the same level as the client. Regardless of rules of smoking, I find that this is an active way to connect with our population and it helps to break down the client versus staff stigma.

Silently, I signed my name and placed the sheet upon her desk. She skimmed the comments and placed the paper in front of her. Clasping her fingers and placing them under her chin, she leaned forward to respond.

"You know, I am not really sure why you continue to blatantly break this rule," she complained, "you can't imagine how irritated I was to see you sitting outside with," she paused to rummage through a list of resident names, "Cathy."

"Kim," I corrected, "her name is Kim. And I sat out there with her because it was the first time I managed to track her down in about two weeks."

"Well," the supervisor sighed, "if she isn't meeting with you, write her up. Plain and simple. For as long as you have worked here, you have always been reluctant to do that. Write ups are in place so that we can control what happens here. Use them. You are going to have to get used to this. Pretty soon, no one will be smoking here. Then what will you do?" I shook my head as a response, weakly apologized, and left her office.

Several months later, I found myself face to face with a very head strong twenty year- old. Handing her a write up for failing to meet with me, I quickly checked my roster to be sure that I had her name correct.

"You know," she growled, "this is bullshit. I've been doing everything that I am supposed to. I don't need some pencil pusher trying to manage my life. I need to do that for myself."

"Yeah," I paused, checking her name again, "Dorothy, but you also need to meet with me to let me know what you are doing."

"Dorothy," she repeated, rolling her eyes, "ain't no person in this world that calls me that. I've been here for a month and you don't even know my name. It's Ann, my middle name. That's what I go by." The client scribbled her signature forcefully on the paper and slid it back to me.

With that meeting over, and only minutes left in my day, I decided to leave a little early to enjoy the weather. I walked out of my office, careful to lock up, and headed for the exit. As I pushed the door open, I was greeted by my supervisor.

"See you later, Juls," Kitty said, "Tomorrow we'll work on some of those billing pages."

"Yep," I replied, as I stepped into the sun and rummaged my pocket for a smoke. The door clicked shut behind me and I was only barely aware of the sign that had been posted last month on the front of it.

NOTICEIn accordance with Ohio state law, no person(s) shall be permitted to smoke on the premises. If any person is suspected of breaking this law, please notify the supervisor immediately.

Someone had used a permanent, black marker to write "BULLSHIT" over the sign.