direct support professional

registered nurse

community manager

clinician

director of behavioral health

Citizen Advocates

When I worked this position many moons ago, I was incredibly excited to start at first. I worked at two different houses in Malone, and I was okay with the mandates and gladly accepted the overtime on one condition: let me adjust my schedule during my scheduled day shift to accommodate for the overtime. This was for both my own benefit and for the house's benefit, as I didn't want to become unable to work from the exhaustion of all this overtime, become sick from it and have to call in, or just lose my mind from feeling like I'm never home!

So there I was, working 8am-11pm Monday-Friday every other day at the minimum, and when I asked if it would be okay for me to come in later the next day, since there was never an issue having staff for day shift, I would get scolded like a child. I would be told I have to work my regular shift on top of being mandated directly after. The burnout was REAL, happened faster than I would have liked, and hit harder than a semi-truck. I ended up just struggling with the balance but keeping an "It is what it is" attitude and got through it. 

I had a couple final straws that broke the camel's back so to speak. The biggest one was I made it very known how much I was struggling to balance the plan writing for two separate houses as one person and being mandated at one of the houses to the point where I couldn't NOT be there. If I did go to my other house I was working at, a majority of the time I would be called back to the other one and told I wasn't supposed to leave in the first place! How am I supposed to balance a case load when I can't move amongst the houses during my regular shift without the worry of being within ratio? I finally had a sit down meeting with upper management and the manager of the house I couldn't go to at the time and told them both that in order for me to get my work done, I should not have to count in the ratio for either house when I am there so I can go in, do my work, and be done with it. It would have provided a better balance for me and would have made so much more sense. I stated that if this wasn't possible, then you'd end up needing a separate Plan Writer position for both houses, rather than dump that caseload onto one person and expect them to keep up with it. 

Instead of being met with compassion and understanding from the upper management, I was met with judgement and ridicule. I was told if I wasn't "working the floor so much," I would have been able to do my job a lot better. Excuse me? You want me to NOT know the clients I'm helping? How are they supposed to work with me to make their treatment plans and set up their goals if we don't interact beside me approaching them asking them what they wanted to accomplish? I said if you didn't want me to work on the floor so much, count me out of the ratio so I don't get mandated and won't be forced to do so! Obviously, that didn't work as I don't work there anymore. It still irks me that there was no compromise to help me perform my job duties better, as I was a HUGE advocate for myself and did enjoy my job immensely. 

This is a company and should remind individuals that the worker is an expendable person. On the surface, it appears to be a supportive environment with the incentives a company offers, the more a company has to use tactics or rewards to illicit the response they want, the more conditioned the ethics will be thrown by the wayside for the sake of your own license
Examples:
-they will increase your caseload to go over and beyond 75 cases to over 110 in less than 3 months -they will have one day to go over company policies and procedures, but no typical check in or a trainer provided during the on boarding process within you 30/60/90 days.
-The benefits offered in the community have the poorest health ratings and patient care. 
-If you are recruited, prepare to be tested and belittled by the supervisor of the clinic, it will be told numerous times that an intern is groomed to do what and how they want a specific way. Smaller caseload than the typical hire even after 6 months 
-The intern then later hired, will have a different standard in their notes a smaller caseload and retained to have the best one-to-one experience. 
-The clinical supervisor will have little to no interaction during the on boarding process. If failing to comply by any standard it will be told on day. 75 with less than two weeks to improve.
-No diversity of staff and lack of cultural competency, no trainings in regards to this
-Prepare to sit in a room for two weeks and read a “documentation guide” but not real training with there EHR
-Expect at the Saranac Lake location to have information about yourself to be looked up by the clinical supervisor and senior clinician online. Then in a workplace gathering share personal information. 
-Toxic workplace culture and treated differently if BIPOC or multiracial
-To misrepresent the area in Saranac Lake as an area that is safe, but has racist and verbally abusive graffiti in public to where the inclusive director had to move out of the area for her personal safety. People can have racial demarcations and wear or display racist inappropriate symbols-in public, in sessions and wear in the community. 
-Extremely high turnover rate at specific locations-in just five months-6 people left therapists, TCM, PRS, CS, etc.

I joined Citizen Advocates in 2016 as a clinician, working directly with individuals in need and gaining a strong foundation in front-line behavioral health care. From the very beginning, I was surrounded by leadership who not only believed in my potential but consistently created space for my professional growth. I was encouraged to take on new responsibilities, beginning with recruiting and supervising, which helped shape my early leadership skills.

Over the years, I have been fortunate to progress through multiple roles—Clinician Team Lead, Malone Clinic Manager, Associate Director, Director of Behavioral Health for the ADK Region, and ultimately Senior Director of Behavioral Health overseeing a broad portfolio of programs. With each transition, my leaders invested in me, challenged me, and supported my development. They encouraged me to grow into the leader I aspired to be and consistently provided the guidance, mentorship, and opportunities necessary to get there.

Citizen Advocates has been a place where I have felt valued, supported, and trusted. My experience has been overwhelmingly positive, and I am truly grateful for the organization’s commitment to cultivating internal talent and fostering professional advancement. I am proud of the work we do, the teams I’ve had the privilege to lead, and the impact we make in our communities.

I am genuinely pleased with my experience at Citizen Advocates and deeply appreciative of the leaders who helped shape my journey.

Citizen Advocates provides a wealth of important services to our community, and in any one of those programs you will find passionate people dedicated to providing those services... but that is where the good news ends.

There is a thick, solid line between the leadership team and front-line/ground-level employees. That line represents multiple points of disparity, some of the largest being:
  - Transparent, two-way communication
  - Understanding/setting realistic expectations
  - Professional development/support
  - Consistent work-from-home flexibility
  - Consistent, fair compensation

The climate is massively political, nepotistic, and out-of-touch with its workforce's needs. Their current company culture initiative would truly be a step in the right direction if it wasn't weaponized by leadership when their employees do not meet overwhelming expectations. There is no consistent approach to project management, with most leaders just continuously adding work onto their employees' plates and assigning arbitrary deadlines (or worse expecting employees to set their own deadlines with no guidance).

Unless they can recognize the disparities of that line and make some very significant changes soon, Citizen Advocates is staring down the barrel of a chronic staffing crisis at best & a mass exodus at worst. I truly hope they do make a change - our community needs the services & support Citizen Advocates offers, but their workforce needs to be taken care of too.

I began my career with Citizen Advocates seven years ago, and throughout that time I have had the opportunity to work in several different departments and gain a deeper understanding of the wide range of valuable services the organization provides. Each role has allowed me to grow both professionally and personally while giving me a greater appreciation for the impact Citizen Advocates has within the community.

One of the things that stands out most about Citizen Advocates is the incredible company culture. The organization fosters a supportive, collaborative, and welcoming environment where employees truly feel valued and encouraged to succeed. The leadership team is deeply committed not only to delivering high-quality services and support to clients, but also to investing in the growth and development of their employees.

Whether someone is looking to strengthen their skills and expand their knowledge within their current role or pursue opportunities in leadership, Citizen Advocates provides encouragement, guidance, and opportunities for advancement. It is an organization that genuinely cares about both the people it serves and the employees who help carry out its mission every day.

I made the difficult decision to leave my previous employer after ten years because I no longer saw a path for professional growth. Since joining Citizen Advocates, I have been incredibly grateful for the opportunities, mentorship, and leadership development I’ve received. In just two and a half years, I’ve been able to grow from Manager, to Associate Director, and now to Director — a trajectory that reflects both the agency’s investment in staff and the environment we create for people to learn, stretch, and lead.

I am genuinely proud of the work we do here. Our teams show up every day for our patients and our communities, often under challenging circumstances, and it is meaningful to be part of an organization that values innovation, integrity, and whole-person care. While the work can be demanding, it is deeply rewarding — emotionally, professionally, and yes, financially. I feel fortunate to contribute to an agency where the mission is clear, the impact is visible, and the opportunity for growth continues to be real.

Caring for individuals with ID/DD is extremely rewarding. As an RN with this agency your duties include direct nursing care and assessments, coordination of care with outside providers, medication management (ordering, inventory, requesting Rx, logging in medication, producing paper and electronic MAR's for DSP documentation of administration, producing patient specific plans for each and every diagnosis and medication (there is no electronic system to assist with prompting or production), produce dozens of similarly reoccurring assessments and reports for each patient, as well as provide training to all (unlicenced minimally oriented staff) in every aspect of patient care, including ADMINISTRATION OF MEDICATION. All off this plus more, you are required to pick up additional residences and caseload when other nurses are out or inevitably quit, have multiple bosses/managers none of whom agree on what your job is, and would prefer you do what suits them best. Having joined the agency during the COVID 19 pandemic, I hope that what I experienced was only a result of the extreme position all of healthcare is facing at this time.  

A typical day starts out with clocking in early meeting with your peers and your comrades to see how the previous hours have gone and what needs to be done. Meeting with the team lead to verify all the set of duties. The workplace culture is very friendly, we are all kind to each other and respect each other’s lives. Our duties and responsibilities at all times are respected and completed on time on each shift. The most enjoyable part of the job is seeing the residents with smiles on their faces participating in their  daily chores of the home, or being able to play a game with their friends there at the home or with a staff member and the smiles that result from the group, you see their face light up smiles from ear to ear. The hardest part of the job is seeing the residence get frustrated and walk from wall to wall with nothing to do, no sense of direction and no structure of what to do next or how to do it  or when to do it, because they don’t know how, just tears your heart apart.



Working at Citizen Advocates gives me valuable experience in the human services field and allowed me to build strong relationships with both coworkers and clients. The work was meaningful and rewarding, especially being able to support individuals in the community and make a positive impact in their daily lives.

I have gained many skills that helped me grow professionally and personally. Like many positions in this field, the work could be demanding at times, but it also provided opportunities to learn patience, communication, crisis management, and teamwork.

Overall, I appreciate the experience and opportunities I have had during my time with the organization and am grateful for the connections and knowledge I gained along the way. I look forward to continuing to grow with the agency.

I currently work at Citizen Advocates. The reason i am trying to leave is because they overwork their staff and just keep wanting more. It seems like you cant ever do enough for this company and you are not paid enough for the work they expect you to do. There is unfair treatment of staff too. I have seen people just sitting around and not doing their work, while the staff that care are busting their tails trying to get all of the work done. Nothing happens if you do complain because the company is severely under staffed and they cannot afford to lose more staff. The company also keeps cutting the budget so we are going without less and less. This job will do if you need a paycheck and you do not mind dealing with the mentally handicapped. Which speaking of the people we take care of, they are the best part of the job! I say that with all of my heart. The consumers who you will take care of are truly amazing, it is not their fault the company itself is not very good. The only reason i continue to break myself and work 12-17 hours per day 5 days a week is because of them. these people need a lot but it is not their fault they were born this way.

Top Job Titles	Average Salary
Direct support professional 57 salaries reported	$18.45 per hour
Registered nurse 19 salaries reported	$42.46 per hour
Community manager 10 salaries reported	$64,732 per year
Clinician 22 salaries reported	$81,625 per year
Director of behavioral health 18 salaries reported	$111,761 per year

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