(326,22,84,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kelly Knutson\",\"Short_Answer__292\":\"Ann Many Birds, Reanna Jacobs, and Yvonne Barett\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"Yes\",\"Multiple_Choice__296\":\"Other Tribe\",\"Short_Answer__297\":\"Sisseton Wahpeton Oyate\",\"Yes_or_No__298\":\"Yes\",\"Multiple_Choice__299\":\"Licensed\",\"Multiple_Choice__300\":\"3\",\"Multiple_Choice__301\":\"Stearns\",\"Short_Answer__303\":\"Maliyah\",\"Short_Answer__304\":\"Provancial\",\"Date__305\":\"09\\/04\\/2002\",\"Date__306\":\"03\\/29\\/2019\",\"Multiple_Choice__308\":\"16 Years\",\"Multiple_Choice__316\":\"3\",\"Short_Answer__317\":\"Permanency has not been achieved for subject child\'s sibling\",\"Free_Text__318\":\"Debrief with Child Protection Staff related to this case:\\r\\nStaff debriefed noted that this case was difficult as the subject child\'s mother was only in this county for a short time once the case opened and quickly left the county.  This created challenges in engaging the mother in her case planning for reunification and identifying relative placement options that would support alternate permanency planning.  Limited relatives were provided to the agency by the mother as possible relative placement options. When relatives were given as placement options it was difficult for the agency staff to get a hold of them to explore if they would be a permanency options for the subject child\'s sibling.  This agency worked to coordinate case work with the family\'s out of state Tribe in addition to the other counties in which were serving the mother and subject child\'s sibling.  Staff noted difficulties in coordinating case work including the achievement of permanency for the subject child\'s sibling with both the Tribe and other counties.  This included transferring the case to other counties so the family could be better served and getting consultation from the Tribe on other options.  Further creating barriers for staff to provide case management services to the best of their ability was mom\'s absence and inability to locate and work with mom.  \\r\\nStaff felt that the system created barriers to best serve this family together as the family was working with three counties and her sibling (the subject child) was placed somewhere else across the state.  This created challenges to maintain and preserve this sibling relationship when two counties were involved, and the siblings were placed so far away from one another.  \\r\\nFurther impacting staff\'s ability to move to permanency with the subject child\'s sibling was that the Tribal worker was very difficult to get a hold of to provide both consultation on the case and a QEW.  It was staff\'s perception that a QEW needed to attend a hearing in order for the agency to move to permanency and the Tribe would not respond and assist with a QEW, impacting movement towards permanency.  \\r\\nFurthermore, not having access to the Tribes records or knowing if South Dakota had been involved with the family impacted staff\'s ability to explore other relatives and\\/or kin options for the subject child\'s sibling as permanency options.  \\r\\nAdditionally, the subject child\'s sibling had significant needs that included mental health, trauma, and chemical dependency.  It was difficult to find a placement facility that could meet this child\'s needs.  Her high level of needs impacted her being in a lesser restrictive setting including being able to reunifying with her mother and residing with relatives.\\r\\nFurther contributing to not achieving permanency in this case are the timelines.  They are not realistic when you have a mother like this with a long history of chemical dependency problems.  It can take 30 days to obtain a rule 25 assessment and then the waitlist for treatment can be 3-4 months.  Once in treatment, it can be another 3-6 months putting you almost at the 12 month permanency timelines.  Staff indicated that they are simply not realistic with the needs of families such as this one.  \\r\\nStaff indicated challenges occurred in communicating and coordinating with the Tribe regarding if this family were Tribal members, further impacting movement towards permanency in this case.  Communication challenges continued throughout the case influencing the agency\'s ability to move towards permanency.  \\r\\nThe tribal worker indicated to agency staff that she was not able to be directly involved due to capacity and the children being off the reservation.  When agency asked about other family members as permanency options for the subject child\'s sibling, the Tribal worker further indicated to staff that the family was not good  Staff noted that it was difficult to obtain other Tribal members names as a result of the limited communication with the Tribal worker.  Staff noted that they would call, email, and fax, and the Tribal worker was very difficult to get a hold of, often not responding, and not appearing at hearings.  This impacted the agency\'s ability to plan and coordinate permanency planning options for the subject child\'s sibling.\\t\\r\\nAdditional barriers noted in this case by staff included being able to share information with other counties and with the Tribe.  Due to the number of case load tasks and documentation requirements staff noted limitations in being able to dig up additional history elsewhere that may have identified other permanency options for the subject child\'s sibling.  \\r\\nTrying to support reunification, the agency attempted to transfer jurisdiction to a county where mom was located, however, that county denied the transfer further contributing to delays in reunification and identifying others that may be able to take the child.  The agency also tried to transfer the case to the county where the subject child was placed so that the siblings could be closer, however, this did not occur and further impacted the agency achieving permanency for the subject child\'s sibling\\r\\nStaff indicated that when it is difficult to engage with families it can be can create barriers to achieving permanency for children such as in this case.   Contributing to staff feeling like they cannot engage meaningfully is their high caseloads, the requirement to time report at 100% of their time in addition to all of the documentation requirements within SSIS.  \\r\\nFurther supporting permanency not being achieved was that the subject child\'s sibling did not want to be reunified with her mother and did not want to live with her family as she did not think they would be healthy for her.  When she was 16, staff engaged her in what she wanted for permanency.   She also told staff that she felt supported in her group home and wanted to age out from there.  \\r\\n\\r\\nDebrief with CMH worker related to this case:\\r\\nStaff noted that her primary focus as a CMH worker was to provide support for subject child\'s sibling\'s mental health.  Staff reported that the subject child\'s sibling has a lot of needs including her mental health, chemical dependency and was also a victim of sex trafficking. Due to her age the main focus was on Independent Living.  Staff also indicated that they were following the recommendations of the doctor who recommended long term residential placement to best meet the subject child\'s needs.  This staff noted that in her role she has worked with very few Native American children.  Staff debriefed indicated that finding placements for children like the subject child\'s sibling was very difficult due to her needs-particularly around self-harm.  It was staff\'s perception that she would do well for a while and then sabotage her recovery.  Staff further indicated that she believed that the sibling child did not have a lot of family support but felt supported by the group home staff.  The subject child\'s sibling has also indicated to staff that she would like to age out of that group home and go on to Job Corps.  It was also noted that there are Native American workers at the group home where the child is and that they reportedly connect the sibling child to some of her cultural practices.  \\r\\nWhen relatives were explored such as the aunt and grandma, they both turned out to not be permanency options for the subject child\'s sibling.  The CMH worker noted that this was managed by the CP worker.  It was also staff\'s perception that the requirements for ICWA and relative placements was new for them as CMH staff.  \\r\\nFurther supporting the decision for the subject child\'s sibling to age out of foster care was that the child was asked what she wanted to do-what she thought was best for her and that those working with her would support that.   Initially, the child indicated (at age 17) that she wanted to try and live with her grandma.  As a result the agency began planning for this, however, shortly after the child decided that she changed her mind and indicated she would like to attend Job Corps.\",\"Free_Text__319\":\"Permanency not being achieved for the subject child\'s sibling before turning 18 was influenced by the challenges that existed for local agency staff to locate and find relatives that were able to care for the child.  Not being able to locate relatives for the child was impacted by the mother\'s location from the agency as mom lived several hours away from the county in which the child had been placed creating difficulties for the agency to engage mom in case planning and permanency planning for this child.  Furthermore, it was staff\'s perception based upon knowledge shard with them that the child\'s father had passed away.  As a result the agency did not believe that there were any possible paternal relative placement options for this child either.  Additionally, this child had complex needs that included significant trauma related to sexual exploitation, mental health, and chemical dependency needs.  It was difficult to find a placement that could meet this child\'s unique needs and this impacted the agency\'s ability to place her in a lesser restrictive setting including being able to reunifying with her mother and residing with relatives. This coupled with being unable to identify viable maternal and paternal relative placement options impacted the agency\'s ability to achieve permanency for this youth.\\r\\nFurther contributing to not achieving permanency in this case is the incongruence that occurs between federal permanency timelines and the time it takes to provide services that will support reunification.  Staff noted that timelines ae not realistic when you have a mother with a long history of chemical dependency problems.  It can take 30 days to obtain a chemical dependency assessment and once this is completed, it can take another 3-4 months then before someone can start inpatient treatment.  Once in treatment, it can be another 3-6 months putting you almost at the 12 month permanency timeline.  Staff indicated that they (permanency timelines) are simply not realistic with the needs of families that struggle with chemical dependency and are not conducive to supporting reunification within federally mandated timelines.  \\r\\nFurthermore, such timeframes and the time required to achieve of ICWA and MIFPA requirements for active efforts can impact court proceedings which can further influence planning for permanency and therefore permanency being achieved within state and federal timelines.  This can be further compounded by staff\'s perception that in order to proceed on an ICWA case they must wait for the BIA to respond with Tribal affiliation before proceeding with permanency planning and case proceedings.   \\r\\nAdditionally impacting permanency not being achieved in this case were communication and consultation barriers that occurred between the county and the tribe on permanency planning for this child. Communication and coordination barriers were influenced by staff turnover both at the county and tribal agency.  Specifically, there is only one tribal child welfare worker at the Tribe that covers both Tribal Child Protection cases within the reservation and off the reservation.  The additional ICWA\\/MIFPA related tasks places pressure on Tribal staff that already have limited resources to do the work and have not received additional resources\\/funding to ensure they can manage the tasks associated with responding to the ICWA.    \\r\\nIn cases such as this, court proceedings including the number of court proceedings, the timing of them, and the Judges knowledge of when both ICWA and MIFPA requirements have been met can lengthen the time it takes local agencies and tribal staff to plan for permanency further creating barriers to both achieving permanency and achieving permanency in accordance with state a federal performance measures.  This can be further impacted by the Judges knowledge of ICWA and MIFP, and if ICWA\\/MIFPA active efforts have been achieved in a case.  \\r\\nLastly, it was the local agencies perception in addition to their county attorney\'s perception that a Qualified Expert Witness (QEW) for the Tribe needed to be present at court in order to move toward permanency.  As a result, the agency believed that they were unable to move towards permanency for the child and continued to delay permanency court proceedings as a result.\",\"Short_Answer__320\":\"Active Efforts in accordance with MIFPA-specific to\",\"Free_Text__321\":\"Debrief with CMH Staff related to this case:\\r\\nStaff indicated that she was working with the subject child through a voluntary placement agreement to support the child\'s mental health needs.  This was the staff\'s focus of attention, which is normative practice in children\'s mental health cases. Staff reported that distance between the child\'s residential treatment and her mother was significant, creating barriers for visitation and connection.  When the subject child\'s mother lived closer to the placement she would ride with staff to the residential treatment center to visit with the subject child.  Staff indicated that typical practice within children\'s mental health cases is that the focus in on the child and that it isn\'t typical to transport family members or arrange for or provide transportation for visitation of family members when the child is in treatment.  \\r\\nFurther influencing staff not transporting family members is that it is agency policy to not transport family members of clients.  Further impacting connection to the subject child\'s Tribe and community and cultural connections was that the staff did not perceive this to be her role in both supporting mom and other relatives in both visitation and connection with the subject child as well as engaging the Tribe in the subject child\'s treatment.  While they (CMH staff) will provide support if needed to parents, they won\'t hold their hand.  Staff noted that this was what child protection does, however, they were not involved since it was a voluntary placement.  \\r\\nStaff noted that it wasn\'t really a thought to engage other relatives and they did not think mom\'s brother could support visits due to his drinking and that grandma was not able to support mom with visits. \\r\\nFurther supporting the decision to not actively engage other known family members was the perception that all relatives known to the agency had engaged in some type of abusive or neglectful behaviors towards the subject child.  Staff\'s mental model of traditional funeral practices and conditions created by poverty (moving from house to house, eating gas station food, etc.) may have been perceived as neglectful when the child was home with relatives. This may have further impacted the engagement of relatives and other tribal members as supports or placement options for the subject child.  \\r\\nStaff reported trying to recommend the subject child attending a Pow Wow while in placement as the subject child expressed interested in this, however, reported there did not seem to be followed through with. Staff also noted that the community falls short of cultural activities for Native American children.  \\r\\nEngagement with relatives in these cases is typically done for respite purposes, however, this child was in residential placement so respite was not an option and therefore relatives were not engaged.  \\r\\nFurther impacting visits with family was that the subject child was early in her residential programming and that the subject child wasn\'t ready for a visit.  Additionally, it was staff\'s perception that mom was not ready for a visit due to her drug use.  \\r\\nStaff also reported that her focus was ensuring that the subject child\'s mental health needs were met, including disability services, day treatment programming, and mental health services.  Staff noted and that she was also working to get her set up with a CADI waiver as a result of her disability as it is difficult finding group home placements and services for children like this.  Staff also indicated that within the mental health placements that they were following the recommendations from the residential treatment center and the subject child\'s doctor and that traditional cultural healing practices and engagement with the Tribe were not considered or recommended during those times.  \\r\\nDebrief with CP Staff related to this case:\\r\\nDifficulties occurred engaging the Tribal worker throughout this case and it was difficult to directly connect with the Tribal worker, despite multiple attempts and modes of communication by staff.  As a result the tribal worker did not provide any additional names of relative tribal members that may be able to care for the subject child or keep her connected to her Tribe.  \\r\\n\\r\\nFurther impacting connection with relatives and culture was that the father\'s side of the family was not considered for connection or placement.  This resulted from family not providing dad\'s side of the family\'s information to the agency.  If the family cannot or won\'t provide this information, it is normative agency practice that they would not seek out any additional information about the father and this side of the family. It was reported that the subject\'s child\'s father had also committed suicide.  As a result of it being difficult to engage the Tribe with the case, it was also difficult to seek out additional guidance regarding consultation around cultural practices and Tribal connections for the subject child.  \\r\\n\\r\\nIn addition to the above, the subject child reported that she was not connected to the Tribe and her mother reported being somewhat connected to the Tribe.  Normative practice is to defer to the family regarding their involvement with the Tribe and the connection that they have to their culture.  This can make it challenging to try and engage the Tribe and support the family in connecting with their culture and Tribe if they indicate they are not connected. Staff noted that it can be difficult to engage families with their culture when not connected before they are involved with child protection. Staff also indicated that this was first child protection case ever worked and her first ICWA case.  When this case was assigned to her in 2015 there was not a lot of guidance on what to do in these cases.  \\r\\n\\r\\nFurther contributing to barriers in connecting the subject child to her culture is the lack of Native American foster care homes.\",\"Free_Text__322\":\"Active Efforts, in accordance with ICWA\\/MIFPA, not being made; specifically to preserving connections to the child\'s culture and Tribe, as well as active efforts to engage the Tribe and family members as support and as permanency options were influenced by the perception that active efforts requirements are not the responsibility of children\'s mental health staff.  In cases such as this when it is a voluntary children\'s mental health case and a contracted children\'s mental health worker is assigned to the case, it is normative practice that staff\'s primary focus of attention is to support the mental health needs of the identified child.  This perception is supported by the coordination of guidance around active efforts requirements between DHS\'s Children\'s Mental Health Division and DHS\'s Child Safety and Permanency Division.  Until recently, coordination between Divisions has been minimal with regards to guidance around active efforts requirements.  This has contributed to ambiguity in guidance and staff not wanting to overstep boundaries and roles that can exist between child protection and children\'s mental health case management within local social service agencies in cases such as this one.  The coordination of guidance around role responsibilities of child protection workers and children\'s mental health staff has been further impacted by the resources (staff) available at DHS within the Child Safety and Permanency Division and other areas to provide guidance and training around active efforts. \\r\\nFurthermore, it isn\'t typical practice for contracted children\'s mental health staff to transport family members or arrange for or provide transportation for visitation of family members when a child is in treatment which constitutes active efforts. Impacting staff not transporting family members is that it can be a contracted provider agency\'s policy such as in this case to not allow workers to transport family members of clients.  Further impacting connection to the subject child\'s Tribe, community, and culture was that the staff did not perceive supporting mom and other relatives in both visitation and connection with the subject child, as well as engaging the Tribe in the subject child\'s treatment to be within their scope of work with Children\'s Mental Health cases.  Often, Children\'s Mental Health staff operate with the belief that this is child protection\'s responsibility.  \\r\\nAn additional influence to active efforts not being made can be staff\'s comfort level to learn about, explore, and expose themselves to others\' cultural frameworks such as in Native American cultures.  This can impact keeping Native American children connected and engaged with cultural activities such as Pow Wows and other cultural practices.  This comfort level is influenced by several factors.  There are often agency\\/union policies that don\'t allow attending such activities with clients on the weekends and after traditional business hours as this can pose risks and liabilities to the agency. This can be further supported by not having the space (emotional) to engage in these activities with clients and not having the knowledge of where to locate such activities.  Self-preservation with regards to both personal and professional boundaries can also impact staff engaging in cultural activities with clients that support active efforts.  Staff also noted that their own lack of understanding and not wanting to offend Native American clients further impacts the comfort level to explore cultural differences.  Lastly, staff\'s own cultural differences and broader sense of culture can further impact exploration of other cultures influencing how Native American children are being supported to stay connected with their Tribe and culture.\\r\\nAlso, there was a perception among staff that all relatives known to the agency had engaged in some type of abusive or neglectful behaviors toward the subject child supporting staff\'s decision to not actively engage other known family members. Staff\'s mental model of traditional funeral practices and conditions created by poverty (moving from house to house, eating gas station food, etc.) may have been perceived as neglectful when the child was home with relatives. This may have further impacted the engagement of relatives and other tribal members as supports or placement options for the subject child.\\r\\nAn additional factor that influences when active efforts are not made is that staff have the perception that they are meeting ICWA\\/MIFPA requirements when the Judge rules that active efforts have been achieved.  Varying levels of understanding and knowledge regarding fulfillment of ICWA\\/MIFPA requirements by Judges further supports active efforts not being met when the court rules that active efforts have been made when they may not have not been in accordance with ICWA\\/MIFPA.  Communication gaps between DHS and local agencies has resulted in changes being made that were not fully communicated around active effort requirements have further impacted the implementation and interpretation of active efforts requirements by local agencies.  Funding also influences active efforts not being achieved as additional resources have not been allocated to both the local agencies and Tribes to ensure additional active effort requirements are fulfilled.  For example, there has not been any additional funding provided to Tribes to support Tribal Child Welfare infrastructure in being able to meet the demands of the county agencies state and federal requirements. The additional requirements have placed demands on both the local agencies and Tribes in which both agencies struggle to have the resources to ensure active efforts are met on all cases.  \\r\\n\\r\\nAn additional factor contributing to active efforts not being fulfilled is that staff have less time to complete active effort activities due to needing to prioritize and complete the significant amount documentation for all cases, including the documentation of active efforts.  Redundancies in documentation requirements increase the amount of time needed to document active efforts.  \\r\\n\\r\\nFurther impacting active efforts not being made in this case was that the subject child reported that she was not connected to the Tribe and her mother reported being somewhat connected to the Tribe.  Normative practice for local agencies is to defer to the family regarding their involvement with the Tribe and the connection that they have to their culture.  Different interpretations around active efforts in such circumstances supports why staff perceive once someone says they are not connected to his\\/her Tribe that staff stop pursing this with the client.    This can make it challenging to try and engage the Tribe and support the family in connecting with their culture and Tribe if they indicate they are not connected. Staff noted that it can be difficult to engage families with their culture when not connected before they are involved with child protection. \\r\\nFurthermore, barriers also occurred in this case in communicating with the Tribe as the Tribal worker is very hard to reach as her availability is limited due to the scope of responsibility placed on her.  She is responsible for the Tribes Child Protection Services as well as the out of state ICWA cases and is therefore in high demand.  As a result, the local agency was unable to obtain any additional names of relative tribal members that may be able to care for the subject child or keep her connected to her Tribe.  \\r\\n\\r\\nAn additional influence into not being able to achieve active efforts is knowing who to go to at the Tribe and what constitutes active efforts.  This is impacted by local agencies knowledge of ICWA\\/MIFPA and who the Tribal contacts are for ICWA\\/MIPFPA cases.  The communication gap from DHS around revisions regarding implementation of state changes has impacted local agencies knowledge of requirements which can create further create challenges on what to do to ensure active efforts are met.  \\r\\n\\r\\nLastly, when this case was assigned to staff in 2015 a knowledge gap existed as this was staff\'s first child protection case and first ICWA case.  There was limited guidance on ICWA cases during this time, further impacting the achievement of active efforts not being made.\",\"Short_Answer__323\":\"Permanent custody to the agency occurred as permanency for the subject child\",\"Free_Text__324\":\"Debrief with CP Staff related to this case:\\r\\nStaff noted that she had good rapport with the mother and the mother also struggled with mental health issues.  The case was open for almost a year before and as a result the agency was automatically at permanency timelines due to the time that the child was out of home prior to this case opening.   This influenced the agency\'s decision to move towards permanent custody to the agency as there were not any other options as mom wasn\'t not fulfilling her case plan requirements and there were not any relatives that could care for the subject child.  Additionally, the Tribe and the mother of the subject child were supportive of this plan, however, they were not in support of a TPR. \\r\\n\\r\\nThe agency, Tribe, and mother believed that this was the best option for the subject child to ensure that she could get her mental and developmental needs met as the subject child would need ongoing assistance in her day to day functioning. This combination (dual diagnoses) made it challenging to locate placements for the subject child\\r\\n\\r\\nIt was also difficult to engage the Tribe throughout the life of the case, despite multiple efforts.  This made it difficult to obtain guidance and consultation from the Tribe throughout the case.  It was difficult to get a response back from the Tribal worker. In order to move towards permanency they ended up sending an affidavit to the Tribe for a QEW as they were never able to get one and needed one to move forward with permanency for the subject child.  Staff also noted that the staff at the Tribe did not seem to care for the mother.  The mother reported to the county worker that she did not feel supported by the tribal worker and tried to request a new worker through the Tribe.  It was reported that the tribal worker did not have anything positive to say about the family and did not provide staff at the county any other relatives or tribal options for permanency.  This further contributed to the difficulty in finding other relatives or tribal members to take the subject child given her complex needs.  \\r\\n\\r\\nFurther impacting the decision to not place with known relatives was that all relatives known to the agency had at some point been abusive or neglectful towards the subject child.    \\r\\n\\r\\nDebrief with CMH Staff related to this case:\\r\\nStaff noted that the subject child had such significant needs and that a relative would not be able to care for her and mom was not able to care for her. They tried a foster care home, however, that was unsuccessful due to the subject child\'s multiple needs, especially given her history of aggression. \\r\\n\\r\\n\\r\\n\\r\\n\\r\\nAdditional Information:\\r\\n\\r\\nReviewers were unable to talk with the Tribal worker or have her or others from the Tribe participate in the mapping.  However, the Tribal Liaison for the Tribe through the Minneapolis American Indian Center indicated that the Tribal worker is very hard to catch because she does the Tribes Child Protection Services as well as the out of state ICWA cases.   She\'s in high demand and kind of a one woman operation.\",\"Free_Text__325\":\"Permanent custody to the agency as permanency for the subject child was influenced by the subject child\'s overall complex needs. This influenced the agency\'s decision to move towards permanent custody to the agency as there were not any other options as mom wasn\'t fulfilling her case plan requirements and had identified that she was not able to care for the subject child.  There were also not any relatives that could care for the subject child due to her emotional, behavior, and developmental needs.  In addition to this, the agency tried a foster care home, however, this placement was not successful due to the subject child\'s complex and unique needs, especially given her history of aggression.   \\r\\nFurthermore, the agency, the Tribe, the subject child\'s mother, her GAL and her attorney believed that this was the best permanency option for the subject child to ensure that she could get her emotional, behavioral, and developmental needs met as the subject child would need ongoing assistance for her day to day functioning. This combination (dual diagnoses) made it challenging to locate placements for the subject child.  Further impacting the ability to find a foster care home was that there are very few foster care homes that can take a child with such complex and unique needs.  Lastly, the subject child had identified to staff that she wanted to remain in her current placement.  \\r\\n\\r\\nAs a result of the pressures associated with state and federal statutory permanency timelines, there was a need to move to permanency quickly in this case since statuary timelines had been met in the previous case in which the subject child had been placed out of the home prior to this case opening, automatically placing the agency near the 12 month permanency timeline. Furthermore, while county agencies are bound by the state and federal permanency definitions, Tribal agencies have a different definition of permanency which can also influence the final permanency decision.  \\r\\n\\r\\nLastly, communication and coordination barriers occurred between the Tribe and the local agency. It was difficult to communicate and coordinate with the Tribe throughout the life of the case.  When this happens, it is difficult to obtain guidance and consultation from the Tribe throughout the case on permanency options and planning.  It was difficult to get a response back from the Tribal worker as her availability is limited due to the scope of responsibility placed on her.  She is responsible for the Tribes Child Protection Services as well as the out of state ICWA cases and is therefore in high demand.  Staff also noted that the staff at the Tribe did not seem to have a positive relationship with the mother and did not provide staff at the county any other relatives or tribal options for permanency.  This further contributed to the difficulty in finding other relatives or tribal members for placement of the subject child given her complex needs.\",\"Multiple_Choice__346\":\"2\",\"Free_Text__347\":\"LP #1:\\r\\nFurthermore, it was staff\'s perception based upon knowledge shared with them that the child\'s father had passed away.  As a result the agency did not believe that there were any possible paternal relative placement options for this child either.\\r\\n\\r\\nThis can be further compounded by staff\'s perception that in order to proceed on an ICWA case they must wait for the BIA to respond with Tribal affiliation before proceeding with permanency planning and case proceedings.\\r\\n\\r\\nLastly, it was the local agencies perception in addition to their county attorney\'s perception that a Qualified Expert Witness (QEW) for the Tribe needed to be present at court in order to move toward permanency.  As a result, the agency believed that they were unable to move towards permanency for the child and continued to delay permanency court proceedings as a result.\\r\\n\\r\\nLP #2:\\r\\nActive Efforts, in accordance with ICWA\\/MIFPA, not being made; specifically to preserving connections to the child\'s culture and Tribe, as well as active efforts to engage the Tribe and family members as support and as permanency options were influenced by the perception that active efforts requirements are not the responsibility of children\'s mental health staff.  In cases such as this when it is a voluntary children\'s mental health case and a contracted children\'s mental health worker is assigned to the case, it is normative practice that staff\'s primary focus of attention is to support the mental health needs of the identified child.  This perception is supported by the coordination of guidance around active efforts requirements between DHS\'s Children\'s Mental Health Division and DHS\'s Child Safety and Permanency Division.\\r\\n\\r\\nFurther impacting connection to the subject child\'s Tribe, community, and culture was that the staff did not perceive supporting mom and other relatives in both visitation and connection with the subject child, as well as engaging the Tribe in the subject child\'s treatment to be within their scope of work with Children\'s Mental Health cases.  Often, Children\'s Mental Health staff operate with the belief that this is child protection\'s responsibility. \\r\\n\\r\\nAn additional influence to active efforts not being made can be staff\'s comfort level to learn about, explore, and expose themselves to others\' cultural frameworks such as in Native American cultures.  This can impact keeping Native American children connected and engaged with cultural activities such as Pow Wows and other cultural practices.  This comfort level is influenced by several factors.\\r\\n\\r\\nStaff also noted that their own lack of understanding and not wanting to offend Native American clients further impacts the comfort level to explore cultural differences.  Lastly, staff\'s own cultural differences and broader sense of culture can further impact exploration of other cultures influencing how Native American children are being supported to stay connected with their Tribe and culture.\\r\\nAlso, there was a perception among staff that all relatives known to the agency had engaged in some type of abusive or neglectful behaviors toward the subject child supporting staff\'s decision to not actively engage other known family members. Staff\'s mental model of traditional funeral practices and conditions created by poverty (moving from house to house, eating gas station food, etc.) may have been perceived as neglectful when the child was home with relatives. This may have further impacted the engagement of relatives and other tribal members as supports or placement options for the subject child.\\r\\nAn additional factor that influences when active efforts are not made is that staff have the perception that they are meeting ICWA\\/MIFPA requirements when the Judge rules that active efforts have been achieved.  Varying levels of understanding and knowledge regarding fulfillment of ICWA\\/MIFPA requirements by Judges further supports active efforts not being met when the court rules that active efforts have been made when they may not have not been in accordance with ICWA\\/MIFPA.\\r\\n\\r\\nDifferent interpretations around active efforts in such circumstances supports why staff perceive once someone says they are not connected to his\\/her Tribe that staff stop pursing this with the client.    This can make it challenging to try and engage the Tribe and support the family in connecting with their culture and Tribe if they indicate they are not connected. Staff noted that it can be difficult to engage families with their culture when not connected before they are involved with child protection. \\r\\n\\r\\nLP #3:\\r\\nFurthermore, the agency, the Tribe, the subject child\'s mother, her GAL and her attorney believed that this was the best permanency option for the subject child to ensure that she could get her emotional, behavioral, and developmental needs met as the subject child would need ongoing assistance for her day to day functioning.\",\"Multiple_Choice__348\":\"2\",\"Free_Text__349\":\"LP #1:\\r\\nIt was difficult to find a placement that could meet this child\'s unique needs and this impacted the agency\'s ability to place her in a lesser restrictive setting including being able to reunifying with her mother and residing with relatives. This coupled with being unable to identify viable maternal and paternal relative placement options impacted the agency\'s ability to achieve permanency for this youth.\\r\\n\\r\\nLP #2:\\r\\nThe coordination of guidance around role responsibilities of child protection workers and children\'s mental health staff has been further impacted by the resources (staff) available at DHS within the Child Safety and Permanency Division and other areas to provide guidance and training around active efforts.\\r\\n\\r\\nFunding also influences active efforts not being achieved as additional resources have not been allocated to both the local agencies and Tribes to ensure additional active effort requirements are fulfilled.  For example, there has not been any additional funding provided to Tribes to support Tribal Child Welfare infrastructure in being able to meet the demands of the county agencies state and federal requirements. The additional requirements have placed demands on both the local agencies and Tribes in which both agencies struggle to have the resources to ensure active efforts are met on all cases.\\r\\n\\r\\nLP #3:\\r\\nPermanent custody to the agency as permanency for the subject child was influenced by the subject child\'s overall complex needs. This influenced the agency\'s decision to move towards permanent custody to the agency as there were not any other options as mom wasn\'t fulfilling her case plan requirements and had identified that she was not able to care for the subject child.  There were also not any relatives that could care for the subject child due to her emotional, behavior, and developmental needs.  In addition to this, the agency tried a foster care home, however, this placement was not successful due to the subject child\'s complex and unique needs, especially given her history of aggression.\\r\\n\\r\\nThis combination (dual diagnoses) made it challenging to locate placements for the subject child.  Further impacting the ability to find a foster care home was that there are very few foster care homes that can take a child with such complex and unique needs.  Lastly, the subject child had identified to staff that she wanted to remain in her current placement.\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"3\",\"Free_Text__355\":\"LP #1:\\r\\nAdditionally impacting permanency not being achieved in this case were communication and consultation barriers that occurred between the county and the tribe on permanency planning for this child. \\r\\n\\r\\nLP #2:\\r\\nCommunication gaps between DHS and local agencies has resulted in changes being made that were not fully communicated around active effort requirements have further impacted the implementation and interpretation of active efforts requirements by local agencies.\\r\\n\\r\\nFurthermore, barriers also occurred in this case in communicating with the Tribe as the Tribal worker is very hard to reach as her availability is limited due to the scope of responsibility placed on her.  She is responsible for the Tribes Child Protection Services as well as the out of state ICWA cases and is therefore in high demand.  As a result, the local agency was unable to obtain any additional names of relative tribal members that may be able to care for the subject child or keep her connected to her Tribe.  \\r\\n\\r\\nAn additional influence into not being able to achieve active efforts is knowing who to go to at the Tribe and what constitutes active efforts.  This is impacted by local agencies knowledge of ICWA\\/MIFPA and who the Tribal contacts are for ICWA\\/MIPFPA cases.  The communication gap from DHS around revisions regarding implementation of state changes has impacted local agencies knowledge of requirements which can create further create challenges on what to do to ensure active efforts are met.\\r\\n\\r\\nLP #3:\\r\\nLastly, communication and coordination barriers occurred between the Tribe and the local agency. It was difficult to communicate and coordinate with the Tribe throughout the life of the case.  When this happens, it is difficult to obtain guidance and consultation from the Tribe throughout the case on permanency options and planning.  It was difficult to get a response back from the Tribal worker as her availability is limited due to the scope of responsibility placed on her.  She is responsible for the Tribes Child Protection Services as well as the out of state ICWA cases and is therefore in high demand.  Staff also noted that the staff at the Tribe did not seem to have a positive relationship with the mother and did not provide staff at the county any other relatives or tribal options for permanency.  This further contributed to the difficulty in finding other relatives or tribal members for placement of the subject child given her complex needs.\",\"Multiple_Choice__356\":\"2\",\"Free_Text__357\":\"LP #2:\\r\\nFurther impacting active efforts not being made in this case was that the subject child reported that she was not connected to the Tribe and her mother reported being somewhat connected to the Tribe.  \\r\\n\\r\\nLastly, when this case was assigned to staff in 2015 a knowledge gap existed as this was staff\'s first child protection case and first ICWA case.  There was limited guidance on ICWA cases during this time, further impacting the achievement of active efforts not being made\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"3\",\"Free_Text__359\":\"LP #1:\\r\\nFurther contributing to not achieving permanency in this case is the incongruence that occurs between federal permanency timelines and the time it takes to provide services that will support reunification.  Staff noted that timelines are not realistic when you have a mother with a long history of chemical dependency problems.  It can take 30 days to obtain a chemical dependency assessment and once this is completed, it can take another 3-4 months then before someone can start inpatient treatment.  Once in treatment, it can be another 3-6 months putting you almost at the 12 month permanency timeline.  Staff indicated that they (permanency timelines) are simply not realistic with the needs of families that struggle with chemical dependency and are not conducive to supporting reunification within federally mandated timelines.  \\r\\nFurthermore, such timeframes and the time required to achieve ICWA and MIFPA requirements for active efforts can impact court proceedings which can further influence planning for permanency and therefore permanency being achieved within state and federal timelines.\\r\\n\\r\\nLP #2:\\r\\nActive Efforts, in accordance with ICWA\\/MIFPA, not being made; specifically to preserving connections to the child\'s culture and Tribe, as well as active efforts to engage the Tribe and family members as support and as permanency options were influenced by the perception that active efforts requirements are not the responsibility of children\'s mental health staff.  In cases such as this when it is a voluntary children\'s mental health case and a contracted children\'s mental health worker is assigned to the case, it is normative practice that staff\'s primary focus of attention is to support the mental health needs of the identified child.  This perception is supported by the coordination of guidance around active efforts requirements between DHS\'s Children\'s Mental Health Division and DHS\'s Child Safety and Permanency Division.  Until recently, coordination between Divisions has been minimal with regards to guidance around active efforts requirements.  This has contributed to ambiguity in guidance and staff not wanting to overstep boundaries and roles that can exist between child protection and children\'s mental health case management within local social service agencies in cases such as this one.\\r\\n\\r\\nFurthermore, it isn\'t typical practice for contracted children\'s mental health staff to transport family members or arrange for or provide transportation for visitation of family members when a child is in treatment which constitutes active efforts. Impacting staff not transporting family members is that it can be a contracted provider agency\'s policy such as in this case to not allow workers to transport family members of clients.\\r\\n\\r\\nAn additional influence to active efforts not being made can be staff\'s comfort level to learn about, explore, and expose themselves to others\' cultural frameworks such as in Native American cultures.  This can impact keeping Native American children connected and engaged with cultural activities such as Pow Wows and other cultural practices.  This comfort level is influenced by several factors.    \\r\\n\\r\\nFurther impacting active efforts not being made in this case was that the subject child reported that she was not connected to the Tribe and her mother reported being somewhat connected to the Tribe.  Normative practice for local agencies is to defer to the family regarding their involvement with the Tribe and the connection that they have to their culture. \\r\\n\\r\\nLP #3:\\r\\nAs a result of the pressures associated with state and federal statutory permanency timelines, there was a need to move to permanency quickly in this case since statuary timelines had been met in the previous case in which the subject child had been placed out of the home prior to this case opening, automatically placing the agency near the 12 month permanency timeline. Furthermore, while county agencies are bound by the state and federal permanency definitions, Tribal agencies have a different definition of permanency which can also influence the final permanency decision.\",\"Multiple_Choice__360\":\"3\",\"Free_Text__361\":\"LP #1:\\r\\nFurther contributing to not achieving permanency in this case is the incongruence that occurs between federal permanency timelines and the time it takes to provide services that will support reunification.  Staff noted that timelines are not realistic when you have a mother with a long history of chemical dependency problems.  It can take 30 days to obtain a chemical dependency assessment and once this is completed, it can take another 3-4 months then before someone can start inpatient treatment.  Once in treatment, it can be another 3-6 months putting you almost at the 12 month permanency timeline.  Staff indicated that they (permanency timelines) are simply not realistic with the needs of families that struggle with chemical dependency and are not conducive to supporting reunification within federally mandated timelines.  \\r\\nFurthermore, such timeframes and the time required to achieve ICWA and MIFPA requirements for active efforts can impact court proceedings which can further influence planning for permanency and therefore permanency being achieved within state and federal timelines. \\r\\n\\r\\nCommunication and coordination barriers were influenced by staff turnover both at the county and tribal agency.  Specifically, there is only one tribal child welfare worker at the Tribe that covers both Tribal Child Protection cases within the reservation and off the reservation.  The additional ICWA\\/MIFPA related tasks places pressure on Tribal staff that already have limited resources to do the work and have not received additional resources\\/funding to ensure they can manage the tasks associated with responding to the ICWA.    \\r\\nIn cases such as this, court proceedings including the number of court proceedings, the timing of them, and the Judges knowledge of when both ICWA and MIFPA requirements have been met can lengthen the time it takes local agencies and tribal staff to plan for permanency further creating barriers to both achieving permanency and achieving permanency in accordance with state a federal performance measures.\\r\\n\\r\\nLP #2:\\r\\nAn additional factor contributing to active efforts not being fulfilled is that staff have less time to complete active effort activities due to needing to prioritize and complete the significant amount documentation for all cases, including the documentation of active efforts.  Redundancies in documentation requirements increase the amount of time needed to document active efforts.\\r\\n\\r\\nLP #3:\\r\\nAs a result of the pressures associated with state and federal statutory permanency timelines, there was a need to move to permanency quickly in this case since statuary timelines had been met in the previous case in which the subject child had been placed out of the home prior to this case opening, automatically placing the agency near the 12 month permanency timeline. Furthermore, while county agencies are bound by the state and federal permanency definitions, Tribal agencies have a different definition of permanency which can also influence the final permanency decision.\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,84,71,'2021-05-26 19:33:23','2021-06-01 19:05:29',NULL,'Maliyah Provancial'),(327,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"JoLynn Sundstrom\",\"Date__293\":\"12\\/12\\/2017\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"5\",\"Multiple_Choice__301\":\"Meeker\",\"Short_Answer__303\":\"Leo\",\"Short_Answer__304\":\"Martinez\",\"Date__305\":\"05\\/21\\/2017\",\"Date__307\":\"11\\/07\\/2017\",\"Multiple_Choice__308\":\"6 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,81,'2021-05-26 19:33:23','2021-05-26 18:18:13',NULL,'Leo Martinez'),(328,22,92,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kristine Frick\",\"Short_Answer__292\":\"Triage team\",\"Date__293\":\"06\\/14\\/2017\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"7\",\"Multiple_Choice__301\":\"Washington\",\"Short_Answer__303\":\"Max\",\"Short_Answer__304\":\"Vazquez\",\"Date__305\":\"12\\/01\\/2012\",\"Date__307\":\"04\\/21\\/2017\",\"Multiple_Choice__308\":\"4 Years\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Mother\'s partner\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,92,81,'2021-05-26 19:33:23','2021-05-26 18:19:03',NULL,'Max Vazquez'),(329,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"Aaron Strong\",\"Date__293\":\"11\\/09\\/2017\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"9\",\"Multiple_Choice__301\":\"Ramsey\",\"Short_Answer__303\":\"Maxine\",\"Short_Answer__304\":\"Rohrer\",\"Date__305\":\"10\\/15\\/2013\",\"Date__306\":\"09\\/14\\/2017\",\"Multiple_Choice__308\":\"13 Years\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"2\",\"Free_Text__355\":\"Discussion occurred at the mapping regarding barriers and challenges impacting communication and coordination between child protection, children\'s mental health, and community corrections.\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,81,'2021-05-26 19:33:23','2021-05-26 18:20:29',NULL,'Maxine Rohrer'),(330,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"Kimette Almon\",\"Date__293\":\"12\\/26\\/2018\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"7\",\"Multiple_Choice__301\":\"Dakota\",\"Short_Answer__303\":\"Mia\",\"Short_Answer__304\":\"McGhee\",\"Date__305\":\"12\\/23\\/2017\",\"Date__307\":\"04\\/24\\/2018\",\"Multiple_Choice__308\":\"4 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,81,'2021-05-26 19:33:23','2021-05-26 18:21:41',NULL,'Mia McGhee'),(331,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Jennifer Carlson\",\"Date__293\":\"12\\/11\\/2017\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"3\",\"Multiple_Choice__301\":\"Otter Tail\",\"Short_Answer__303\":\"McKenzie\",\"Short_Answer__304\":\"Stout\",\"Date__305\":\"10\\/21\\/2014\",\"Date__307\":\"11\\/19\\/2017\",\"Multiple_Choice__308\":\"3 Years\",\"Multiple_Choice__309\":\"2\",\"Short_Answer__310\":\"Mother\",\"Short_Answer__311\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,81,'2021-05-26 19:33:23','2021-05-26 18:22:35',NULL,'McKenzie Stout'),(332,22,84,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kelly Knutson\",\"Short_Answer__292\":\"Paul Lennander\",\"Date__293\":\"11\\/13\\/2017\",\"Multiple_Choice__294\":\"Other\",\"Yes_or_No__295\":\"No\",\"Short_Answer__297\":\"Licensed\",\"Yes_or_No__298\":\"Yes\",\"Multiple_Choice__299\":\"Licensed\",\"Multiple_Choice__300\":\"8\",\"Multiple_Choice__301\":\"Hennepin\",\"Short_Answer__303\":\"McKinley\",\"Short_Answer__304\":\"Askenette\",\"Date__305\":\"08\\/06\\/2017\",\"Multiple_Choice__308\":\"2 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Foster care parent\",\"Multiple_Choice__316\":\"2\",\"Short_Answer__317\":\"Placement capacity of shelter home\",\"Free_Text__318\":\"The human factors debriefing information was not documented at the request of the local agency due to pending litigation.  All of the local rationality information is captured in the narrative.\",\"Free_Text__319\":\"The decision to place a child in a shelter care home that was nearing capacity was influenced by no relatives being identified as immediate placement options.  While an extensive relative search was completed, many licensing barriers existed in licensing any of the relatives who were identified.  It is common in relative placement cases that the time it can take and the bureaucratic system created by both the local agency and DHS standards can influence placing children in an already licensed shelter care home versus one of a relative.  While a few of them may have been a viable options, the Judge ordered that the subject child be placed immediately into shelter care.  \\r\\nFurthermore, at this time, the placing process within the agency was for children to be immediately placed in shelter and that the shelter center locates the placement for the child\\/children based upon needs to the child and who can care for the child.  Normative practice is to defer to shelter for these decisions. Staff also noted that in placement cases they are often balancing multiple competing goals.  Such as the location and placement with a relative often takes more time, which can be difficult when operating under tight permanency timelines.  While working to accomplish concurrent planning, staff also need to make reasonable and active efforts to reunify whenever possible.  Further impacting this pressure is the best practice of placement stability.  Best practice is to ensure children are placed in stable placement as soon as possible and such practices are also measured through state and federal placement stability performance measures creating additional pressure on staff to ensure placements are stable.\",\"Short_Answer__320\":\"Placement occurred in shelter versus a relative home.\",\"Free_Text__321\":\"The human factors debriefing information was not documented at the request of the local agency due to pending litigation.  All of the local rationality information is captured in the narrative.\",\"Free_Text__322\":\"The decision to place a child in a shelter care home versus a relative home was influenced by the fact that an extensive relative search was completed, and many licensing barriers occurred for many of the relatives identified as placement resources.  It is common in relative placement cases that the time it can take and the bureaucratic system for a relative to become licensed created by both local agency and DHS standards can influence placing children in an already licensed shelter care home versus one of a relative. Additionally, normative practice for this local agency is to place children in shelter care until a relative can be identified as a placement option.  This placing process further impacted the subject child being placed in shelter care versus a relative.  While a few relatives may have been viable options, when the critical incident occurred, the Judge ordered that the subject child be placed immediately into shelter care.  Further impacting this decision was that a relative was set to take the subject child but then decided at the last minute that they could not take the child.   \\r\\nAn additional influence into the subject child being placed in shelter care versus a relative care home was the difficulty in communicating with the state of Massachusetts.  The subject child\'s mother also had an open case and other children in placement in Massachusetts.  Staff noted significant barriers in obtaining any information at all from their CPS system\\/staff related to the subject child\'s mother, siblings, their placements, and any other potential relative placement options for the subject child.  \\r\\nFurthermore, when this case came into the agency, it was assigned an initial kinship worker whom had been working to secure a relative placement for the subject child.  This initial kinship work went out on leave and the case at the time of the critical incident was transferred to another kinship worker.  This created challenges in communication around potential relative options that had been and were explored for the subject child further impacting the ability to identify and place with a viable relative option.  Furthermore, both kinship workers had made multiple attempts with relatives and all of the relatives contacted took a substantial amount of time to respond to both kinship workers.\",\"Multiple_Choice__346\":\"2\",\"Free_Text__347\":\"LP 1-Additionally, licensing staff conduct regular check-ins with relative placements to understand how they are feeling about taking other children and how things are going overall. This process supports a perception of trust that everything is going okay in the foster care home.  In this case, the provider was self-reporting that things were going well and that she could take an additional child and that she did not need additional support.  \\r\\n\\r\\nFurthermore, this provider had taken care of a number if infants such as the subject child that were high needs and drug exposed.  As a result, staff were confident in her ability to take another child.\",\"Multiple_Choice__348\":\"2\",\"Free_Text__349\":\"LP 1- In this case, the provider was self-reporting that things were going well and that she could take an additional child and that she did not need additional support.  However, at the time that the subject child was in placement, there were only two licensing workers carrying shelter caseloads (leaving them with 30-40 cases a piece).  As a result quarterly face-to-face check-ins with providers went to every other quarter face-to-face check-ins with phone calls during the other two quarters.\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"3\",\"Free_Text__353\":\"LP 2-An additional influence into the subject child being placed in shelter care versus a relative care home was the difficulty in communicating with the state of Massachusetts.  The subject child\'s mother also had an open case and other children in placement in Massachusetts.  Staff noted significant barriers in obtaining any information at all from their CPS system\\/staff related to the subject child\'s mother, siblings, their placements, and any other potential relative placement options for the subject child.\",\"Multiple_Choice__354\":\"3\",\"Free_Text__355\":\"LP 3-\\r\\nAn additional influence into the subject child being placed in shelter care versus a relative care home was the difficulty in communicating with the state of Massachusetts.  The subject child\'s mother also had an open case and other children in placement in Massachusetts.  Staff noted significant barriers in obtaining any information at all from their CPS system\\/staff related to the subject child\'s mother, siblings, their placements, and any other potential relative placement options for the subject child.  \\r\\n\\r\\nFurthermore, when this case came into the agency, it was assigned an initial kinship worker whom had been working to secure a relative placement for the subject child.  This initial kinship work went out on leave and the case at the time of the critical incident was transferred to another kinship worker.  This created challenges in communication around potential relative options that had been and were explored for the subject child further impacting the ability to identify and place with a viable relative option.  Furthermore, both kinship workers had made multiple attempts with relatives and all of the relatives contacted took a substantial amount of time to respond to both kinship workers.\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__358\":\"2\",\"Free_Text__359\":\"LP 1-While an extensive relative search was completed, many licensing barriers existed in licensing any of the relatives who were identified.  It is common in relative placement cases that the time it can take and the bureaucratic system created by both the local agency and DHS standards can influence placing children in an already licensed shelter care home versus one of a relative.\\r\\n\\r\\nFurthermore, at this time, the placing process within the agency was for children to be immediately placed in shelter and that the shelter center locates the placement for the child\\/children based upon needs to the child and who can care for the child.  Normative practice is to defer to shelter for these decisions. \\r\\n\\r\\nLP 2-The decision to place a child in a shelter care home versus a relative home was influenced by the fact that an extensive relative search was completed, and many licensing barriers occurred for many of the relatives identified as placement resources.  It is common in relative placement cases that the time it can take and the bureaucratic system for a relative to become licensed created by both local agency and DHS standards can influence placing children in an already licensed shelter care home versus one of a relative. Additionally, normative practice for this local agency is to place children in shelter care until a relative can be identified as a placement option.  This placing process further impacted the subject child being placed in shelter care versus a relative.  \\r\\n\\r\\nLP 2-Additionally, normative practice for this local agency is to place children in shelter care until a relative can be identified as a placement option.  This placing process further impacted the subject child being placed in shelter care versus a relative.  While a few relatives may have been viable options, when the critical incident occurred, the Judge ordered that the subject child be placed immediately into shelter care.\",\"Multiple_Choice__360\":\"2\",\"Free_Text__361\":\"LP 1- Staff also noted that in placement cases they are often balancing multiple competing goals.  Such as the location and placement with a relative often takes more time, which can be difficult when operating under tight permanency timelines.  While working to accomplish concurrent planning, staff also need to make reasonable and active efforts to reunify whenever possible.  Further impacting this pressure is the best practice of placement stability.  Best practice is to ensure children are placed in stable placement as soon as possible and such practices are also measured through state and federal placement stability performance measures creating additional pressure on staff to ensure placements are stable.\",\"Multiple_Choice__362\":\"2\",\"Free_Text__363\":\"Further impacting placement with this particular home was that there are never enough homes to take drug exposed infants.  \\r\\n\\r\\nLP 2-The decision to place a child in a shelter care home versus a relative home was influenced by the fact that an extensive relative search was completed, and many licensing barriers occurred for many of the relatives identified as placement resources.  It is common in relative placement cases that the time it can take and the bureaucratic system for a relative to become licensed created by both local agency and DHS standards can influence placing children in an already licensed shelter care home versus one of a relative. Additionally, normative practice for this local agency is to place children in shelter care until a relative can be identified as a placement option.  This placing process further impacted the subject child being placed in shelter care versus a relative.\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,84,71,'2021-05-26 19:33:23','2021-06-01 19:05:54',NULL,'McKinley Askenette'),(333,22,92,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kristine Frick\",\"Short_Answer__292\":\"Brenda Mahoney\",\"Date__293\":\"04\\/17\\/2018\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"8\",\"Multiple_Choice__301\":\"Hennepin\",\"Short_Answer__303\":\"Miangel\",\"Short_Answer__304\":\"Scott\",\"Date__305\":\"11\\/29\\/2004\",\"Date__307\":\"02\\/11\\/2018\",\"Multiple_Choice__308\":\"13 Years\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__316\":\"3\",\"Short_Answer__317\":\"CP intakes not same or similar allegation (2\\/9 & 2\\/11 CP intakes) were referred to current workgroup.\",\"Free_Text__318\":\"The 2\\/9\\/2018 predatory offender (24 hour response) and 2\\/11\\/2018 critical incident overdose (5 day response) allegations were referred to current workgroup nearing the end of 45 day timeline, however it was not closed yet. \\r\\no\\tWorker was getting ready to close the family assessment, when worker discovered on a background check that the father to the sibling children had an egregious harm incident to a child not in this family in another state. As a result a new CP intake was made for this allegation based on predatory offender statute to screen in as 24 hour face to face. At this time, the track changed to a CP Family Investigation from Assessment. \\r\\no\\tStaff\'s perspective is that either intake\\/screening can open a new workgroup or can refer to current workgroup when the same worker is assigned to a case. \\r\\n\\u00ef\\u201a\\u00a7\\tWorker flips response tracks from assessment to investigation if new allegation is a 24 hour response. \\r\\no\\tIntake protocol is to refer new intakes to current worker even if their workgroup has been open for longer than 45 days.\\r\\n\\u00ef\\u201a\\u00a7\\tReports came in near 45 day case closure timeline, however closing a case in the 45 day timeframe was not priority. \\r\\n\\u00ef\\u201a\\u00a7\\tStaff had to keep the workgroup active and open beyond 45 days due to the nature of how information was learned and evolved over time. \\r\\n\\u00ef\\u201a\\u00a7\\tObtaining records from out of state about the egregious harm\\/ predatory offender went over 45 day timeline. \\r\\n\\u00e2\\u20ac\\u00a2\\tPractice is for the case\\/family stay with the original worker on the case and document under one workgroup versus document in two workgroups. \\r\\no\\tAvoid having to document same information in duplicate workgroups for the family and maximizing time more efficiently to keep all together in one workgroup.\\r\\no\\tKeeping same worker with the family for all new intakes is viewed as a strength of continuity of care and being client focused. The preference to keep the same families with staff that they are working with or have worked with in the past due to rapport and working relationship established.\",\"Free_Text__319\":\"An accepted procedural drift away from guidance to not close the family\'s workgroup within 45 days, influenced the two CP intakes (not same or similar allegations) to be referred to the open workgroup in SSIS. Considering the new allegations and information within the CP intakes was learned and being documented by the frontline staff working with the family, the agency\'s decision to prioritize continuity of care for the children and family was made, versus opening a new assessment for the allegations as the frontline staff already had the knowledge regarding the new allegations, as he\\/she reported them.\\r\\n\\r\\nLocal agency practice within the intake and screening unit considers the totality of the circumstances, and has discretion to either open a new workgroup if an already open assessment\\/investigation is near 45 days, or they can refer to the current workgroup when an assessment\\/investigation is not closed. Commonly, the intake and screening unit consults with the Family Assessment\\/Family Investigation (FA\\/FI) unit, and refers CP intakes to the same FA\\/FI unit who has a frontline staff already assigned and actively working with the family in an open workgroup. Priority is placed on continuity of care for the family, regardless if the workgroup is near the 45 day case closure timeline. This agency practice of one frontline assessment\\/investigation staff assigned to work all allegations, beyond the 45 day case closure timeline, is a procedural adaptation that is viewed as best practice and a strength, as it is client focused and reduces trauma for families coping with child protection involvement in their lives. The sacrifice decision to not meet the 45 day compliance measure, was perceived to ease the pressure of needing to meet face to face timelines for allegations referred to an open assessment\\/investigation, as staff believed SSIS reports only track face to face compliance for the first screened in CP Intake, and not for any others in which are referred to an already open workgroup. This workaround was believed to not impact face to face contact requirements that was tied to the legislative withhold funding when face to face compliance metrics are not met by the agency.  \\r\\n\\r\\nDocumentation practices are also simplified and more efficient for one frontline staff when they can chronologically document the information they are learning about the family under one workgroup over time. The tradeoff decision to not open an additional workgroup as a result of the new allegations that were made near the 45 day timeframe was made because with every new workgroup opened, there are a multitude of tasks to complete and document in SSIS (i.e. Safety Decision Making tools, ICWA screening tools, etc.). In effort to reduce workload tasks and requirements driven by both MN Statues\\/Admin Rule and DHS guidance around the requirements for assessment and investigations, avoiding duplication of the same information being documented in multiple places better supports frontline staff\'s daily work as well as the agency\'s ability to retain staff and reduce turnover.\\r\\nResearch and best practice around continuity of care resulting in safe and healthy outcomes for children and families presented a competing priority and pressure for the local agency to adapt to in this case. Furthermore, this research and best practice presents a goal conflict for child welfare staff regarding the need for pursing the continuity of care while simultaneously trying to meet the requirements to open and document new CP intakes and allegations on the same family. In cases such as this a procedural adaptation was made by the local agency to refer the CP intakes to the open workgroup (although near the 45 day timeline) to support continuity of care for the family.\",\"Short_Answer__320\":\"Face to face contact regarding 2\\/11 CP intake Allegation: Neglect (access to alcohol, controlled substance, or prescription drugs) to subject child by the father occurred after 5 days.\",\"Free_Text__321\":\"The CP intake was initially screened out and later screened in as a 5 day response, therefore the worker perceived it as a lower priority.\\r\\no\\tPrioritized as lower risk based on the nature of the allegations and response path being family assessment.\\r\\n\\u00ef\\u201a\\u00a7\\tResponse type of family assessment \\u00e2\\u20ac\\u201c 5 day is used per protocol for all allegations unless staff learn of egregious harm, fatality\\/near fatality, predatory offender, sexual abuse or any other major injury.  \\r\\no\\tFive day responses are less priority for staff because of the intense nature of all other cases received, most are severe abuse\\/neglect\\/egregious harm type cases that require staff to responds within the same day to meet 24 hour response.\",\"Free_Text__322\":\"As a result of this CP intake initially being screened out and later screened in as a 5 day response, the worker perceived it as a lower priority and prioritized meeting face to face requirements for other cases with allegations with safety and risk concerns that were higher. Supporting that this was a lower priority case was the identified allegation and the response path assignment to family assessment. Unless staff learn of egregious harm, fatality\\/near fatality, predatory offender, sexual abuse or any other major injury, the local agency uses a 5 day response per protocol for allegations such as this one. At the time of the incident, the severity of the incident was not believed to be near fatal based upon the information received in the report.  Five day responses are less of a priority for staff because of the intense nature of all other cases received by this Family Assessment\\/Family Investigation (FA\\/FI) specialty unit, which most cases involve severe abuse\\/neglect\\/egregious harm, and substantial harm that require staff to respond within the same day to meet the 24 hour face to face response timeframe. The implementation of the Department\'s Intake, Screening, and Response Path guidelines expanded the number of cases that require a 24 hour face to face response, particularly those allegations that are within the predatory offender statute. As a result, the agency experienced more cases being screened in for a 24 hour face to face response, which impacted the time staff have available to respond to 5 day response cases since they are a lower priority. Due to the high number of cases assigned to this FA\\/FI unit, it was not uncommon for supervisors to direct staff to place lower priority on cases like this one to ensure higher priority cases are managed first.  \\r\\n\\r\\nFurther impacting the delay in face to face contact with the alleged victim was that the frontline staff had just made face to face contact with the child two days prior. Additionally, the frontline staff was the professional who learned and reported the new allegation for the critical incident. The staff had knowledge about the child being in the hospital at the time the information was learned, and the staff had not received a cross report from law enforcement, therefore, there was a presumption of safety since the hospital was caring for the victim child. Also supporting the decision to delay face to face contact was that staff did not want to cause additional trauma to the child and her family after the critical incident. At the time of the report the incident was not believed to be a near fatal event, however, the severity of the incident being near fatal was learned when the frontline staff was able to receive medical records regarding the incident, which occurred later in the investigation. The pressure to meet prescribed practice written in statute and admin rule around meeting for face to face timelines in circumstances when a child is presumably safe in a hospital setting, is not aligned or supporting the work.\",\"Short_Answer__323\":\"Face to face contact was not documented regarding 3\\/9\\/2018 allegation of educational neglect, and it did not occur.\",\"Free_Text__324\":\"CP Worker made a collateral contact with the reporter, and learned there was nothing new being reported about the twin half- sibling\'s truancy. Reporter felt obligated to report again due to the number of absences that one twin sibling had accumulated since the reporter last reported Ed neglect in January. \\r\\n\\u00e2\\u20ac\\u00a2\\tFurther supporting face to face contact not being made in this case was that work was being done as prescribed and expected in regards to addressing Ed neglect concerns. Worker was actively supporting the family\'s needs around getting the children\'s attendance to improve. She worked with the school to set up transportation for the children to increase children\'s ability to attend consistently. \\r\\n\\u00e2\\u20ac\\u00a2\\tThe 3\\/9 allegation was same or similar allegation already assessed in January on 1\\/11, and 1\\/30 under this same workgroup\\r\\n\\u00e2\\u20ac\\u00a2\\tPriority is on making new face to face contacts for 24 hour reports when they are referred to current workgroup, not 5 day response reports for same or similar allegations that are already being assessed in current workgroup.\",\"Free_Text__325\":\"Face to face contact regarding 3\\/9\\/2018 allegation of educational neglect not occurring was that the 3\\/9 allegation was same or similar allegation already assessed in January on 1\\/11, and 1\\/30 under this same workgroup.  Further influencing face to face contact not occurring in this case was that the CP Worker made a collateral contact with the reporter, and learned there was nothing new being reported about the twin half- sibling\'s truancy. Reporter felt obligated to report again due to the number of absences that one twin sibling had accumulated since the reporter last reported Ed neglect in January.  Also impacting face to face contact not being made in this case was that work was being done as prescribed and expected in regards to addressing Ed neglect concerns.  Staff was actively supporting the family\'s needs around getting the children\'s attendance to improve.  An additional face to face contact would not have changed the trajectory of work in this case as the educational neglect allegations had already been assessed and ongoing work with the family was being conducted.    \\r\\nFurthermore, staff believed that the investigation around the educational neglect allegations had been completed, although not officially closed within SSIS.  As a result staff\'s interpretation of this new allegation was that it was screened in and the allegations had already been assessed.  Therefore, not requiring an additional face to face to be completed since this was perceived by staff to be a duplicate report and therefore guidance (Intake, Screening, and Response Path Guidelines) would indicate that a report of this type can be screened out as already assessed which would not require face to face to contact.  \\r\\nAdditionally, priority is placed on making new face to face contacts for 24 hour reports when they are referred to current workgroup, not 5 day response reports for same or similar allegations that are already being assessed in current workgroup.\",\"Multiple_Choice__346\":\"3\",\"Free_Text__347\":\"LP1 - The sacrifice decision to not meet the 45 day compliance measure, was perceived to ease the pressure of needing to meet face to face timelines for allegations referred to an open assessment\\/investigation, as staff believed SSIS reports only track face to face compliance for the first screened in CP Intake, and not for any others in which are referred to an already open workgroup. This workaround was believed to not impact face to face contact requirements that was tied to the legislative withhold funding when face to face compliance metrics are not met by the agency.\\r\\n\\r\\nLP3 - Furthermore, staff believed that the investigation around the educational neglect allegations had been completed, although not officially closed within SSIS.  As a result staff\'s interpretation of this new allegation was that it was screened in and the allegations had already been assessed.  Therefore, not requiring an additional face to face to be completed since this was perceived by staff to be a duplicate report and therefore guidance (Intake, Screening, and Response Path Guidelines) would indicate that a report of this type can be screened out as already assessed which would not require face to face to contact.\",\"Multiple_Choice__348\":\"1\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"2\",\"Free_Text__355\":\"LP2 - Staff did not receive a cross report from law enforcement and as a result they were not aware of the critical incident occurring and the severity of the incident being near fatal.  \\r\\n\\r\\nDelays in accessing child protection reports from another state (Michigan) around predatory offender\\/ egregious harm allegation\",\"Multiple_Choice__356\":\"3\",\"Free_Text__357\":\"LP2 - CP investigator was not aware of the severity of the child\'s condition at the time of the critical incident. Critical incident was originally screened out, and later screened in as a 5 day response. The life threatening nature of the incident was not known to the worker until 1 month after the incident when medical records were received and was not cross reported by law enforcement.\",\"Multiple_Choice__368\":\"2\",\"Free_Text__369\":\"Delay in obtaining medical records was approximately 1 month after critical incident occurred. Prior to receipt of the medical records severity of the overdose was not known to be near fatality.\",\"Multiple_Choice__358\":\"3\",\"Free_Text__359\":\"LP1 - Prescribed practice around continuity of care for children and with DHS requirements for new CP intakes to not be referred to an already opened workgroup near the 45 day case closure timeline. \\r\\n\\r\\nLP1- Research and best practice around continuity of care resulting in safe and healthy outcomes for children and families presented a competing priority and pressure for the local agency to adapt to in this case. Furthermore, this research and best practice presents a goal conflict for child welfare staff regarding the need for pursing the continuity of care while simultaneously trying to meet the requirements to open and document new CP intakes and allegations on the same family. In cases such as this a procedural adaptation was made by the local agency to refer the CP intakes to the open workgroup (although near the 45 day timeline) to support continuity of care for the family.  \\r\\n\\r\\nLP2 - As a result of this CP intake initially being screened out and later screened in as a 5 day response, the worker perceived it as a lower priority and prioritized meeting face to face requirements for other cases with allegations with safety and risk concerns that were higher. Supporting that this was a lower priority case was the identified allegation and the response path assignment to family assessment. Unless staff learn of egregious harm, fatality\\/near fatality, predatory offender, sexual abuse or any other major injury, the local agency uses a 5 day response per protocol for allegations such as this one. At the time of the incident, the severity of the incident was not believed to be near fatal based upon the information received in the report.  Five day responses are less of a priority for staff because of the intense nature of all other cases received by this FA\\/FI specialty unit, which most cases involve severe abuse\\/neglect\\/egregious harm, and substantial harm that require staff to respond within the same day to meet the 24 hour face to face response timeframe. The implementation of the Department\'s Intake, Screening, and Response Path guidelines expanded the number of cases that require a 24 hour face to face response, particularly those allegations that are within the predatory offender statute.  As a result, the agency experienced more cases being screened in for a 24 hour face to face response, which impacted the time staff have available to respond to 5 day response cases since they are a lower priority. Due to the high number of cases assigned to this FA\\/FI unit, it was not uncommon for supervisors to direct staff to place lower priority on cases like this one to ensure higher priority cases are managed first.  \\r\\n\\r\\nLP2 - Further impacting the delay in face to face contact with the alleged victim was that the frontline staff had just made face to face contact with the child two days prior. Additionally, the frontline staff was the professional who learned and reported the new allegation for the critical incident. The staff had knowledge about the child being in the hospital at the time the information was learned, and the staff had not received a cross report from law enforcement, therefore, there was a presumption of safety since the hospital was caring for the victim child. Also supporting the decision to delay face to face contact was that staff did not want to cause additional trauma to the child and her family after the critical incident. At the time of the report the incident was not believed to be a near fatal event, however, the severity of the incident being near fatal was learned when the frontline staff was able to receive medical records regarding the incident, which occurred later in the investigation. The pressure to meet prescribed practice written in statute and admin rule around meeting for face to face timelines in circumstances when a child is presumably safe in a hospital setting, is not aligned or supporting the work. \\r\\n\\r\\nLP3- Also impacting face to face contact not being made in this case was that work was being done as prescribed and expected in regards to addressing Ed neglect concerns.  Staff was actively supporting the family\'s needs around getting the children\'s attendance to improve. An additional face to face contact would not have changed the trajectory of work in this case as the educational neglect allegations had already been assessed and ongoing work with the family was being conducted.\\r\\n\\r\\nLP3 - Furthermore, staff believed that the investigation around the educational neglect allegations had been completed, although not officially closed within SSIS.  As a result staff\'s interpretation of this new allegation was that it was screened in and the allegations had already been assessed.  Therefore, not requiring an additional face to face to be completed since this was perceived by staff to be a duplicate report and therefore guidance (Intake, Screening, and Response Path Guidelines) would indicate that a report of this type can be screened out as already assessed which would not require face to face to contact.\",\"Multiple_Choice__360\":\"3\",\"Free_Text__361\":\"LP1 - Documentation practices are also simplified and more efficient for one frontline staff when they can chronologically document the information they are learning about the family under one workgroup over time. The tradeoff decision to not open an additional workgroup as a result of the new allegations that were made near the 45 day timeframe was made because with every new workgroup opened, there are a multitude of tasks to complete and document in SSIS (i.e. Safety Decision Making tools, ICWA screening tools, etc.). In effort to reduce workload tasks and requirements driven by both MN Statues\\/Admin Rule and DHS guidance around the requirements for FA\\/FI, avoiding duplication of the same information being documented in multiple places better supports frontline staff\'s daily work as well as the agency\'s ability to retain staff and reduce turnover.\\r\\n\\r\\nLP2- Five day responses are less of a priority for staff because of the intense nature of all other cases received by this FA\\/FI specialty unit, which most cases involve severe abuse\\/neglect\\/egregious harm, and substantial harm that require staff to respond within the same day to meet the 24 hour face to face response timeframe. The implementation of the Department\'s Intake, Screening, and Response Path guidelines expanded the number of cases that require a 24 hour face to face response, particularly those allegations that are within the predatory offender statute.  As a result, the agency experienced more cases being screened in for a 24 hour face to face response, which impacted the time staff have available to respond to 5 day response cases since they are a lower priority. Due to the high number of cases assigned to this FA\\/FI unit, it was not uncommon for supervisors to direct staff to place lower priority on cases like this one to ensure higher priority cases are managed first.  \\r\\n\\r\\nLP3 - Priority is placed on making new face to face contacts for 24 hour reports when they are referred to current workgroup, not 5 day response reports for same or similar allegations that are already being assessed in current workgroup.\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"3\",\"Free_Text__367\":\"LP1 - An accepted procedural drift away from guidance to not close the family\'s workgroup within 45 days, influenced the two CP intakes (not same or similar allegations) to be referred to the open workgroup in SSIS. Considering the new allegations and information within the CP intakes was learned and being documented by the frontline staff working with the family, the agency\'s decision to prioritize continuity of care for the children and family was made, versus opening a new assessment for the allegations as the frontline staff already had the knowledge regarding the new allegations, as he\\/she reported them.\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,92,81,'2021-05-26 19:33:23','2021-05-26 18:24:46',NULL,'Miangel Scott'),(334,22,92,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kristine Frick\",\"Short_Answer__292\":\"Aaron Strong\",\"Date__293\":\"05\\/01\\/2018\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"4\",\"Multiple_Choice__301\":\"Stearns\",\"Short_Answer__303\":\"Miko\",\"Short_Answer__304\":\"Monroe\",\"Date__305\":\"09\\/05\\/2017\",\"Date__307\":\"03\\/06\\/2018\",\"Multiple_Choice__308\":\"6 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Mother\'s boyfriend\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"2\",\"Free_Text__367\":\"Procedural drift away from policy and DHS guidance occurred when the local agency screened out a Child Maltreatment report for prenatal exposure, however,  local agency did not screen in for Child Welfare services and offer services to the mother of the unborn child.\\r\\n- Mother allegedly tested positive for THC at the local hospital. The CP Intake was screened out - no allegation meets maltreatment criteria.\\r\\n-Noted by triage team that practices are inconsistent across the state for prenatal exposure to unborn children when \\\"just THC\'.\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,92,81,'2021-05-26 19:33:23','2021-05-26 18:28:14',NULL,'Miko Monroe'),(335,22,92,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kristine Frick\",\"Short_Answer__292\":\"JoLynn Sundstrom\",\"Date__293\":\"01\\/05\\/2018\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Short_Answer__297\":\"Legally Unlicensed\",\"Yes_or_No__298\":\"Yes\",\"Multiple_Choice__299\":\"Legally Unlicensed\",\"Multiple_Choice__300\":\"5\",\"Short_Answer__303\":\"Miles\",\"Short_Answer__304\":\"Tyson\",\"Date__305\":\"07\\/20\\/2017\",\"Date__307\":\"01\\/04\\/2018\",\"Multiple_Choice__308\":\"6 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Legally unlicensed childcare provider\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"2\",\"Free_Text__351\":\"SSIS feature to change response paths from Facility to Family Investigation took place, however the victim children were not added within the SSIS system.\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"1\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"2\",\"Free_Text__359\":\"Intake, Screening, and response path guidelines, directs local agencies to make a new CP intake report, screen it, and refer to current workgroup or open new workgroup when new child victims are added to an investigation, however in this case that did not occur for the children of the offender.\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,92,71,'2021-05-26 19:33:23','2021-06-01 19:06:11',NULL,'Miles J. Tyson'),(336,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Tracy Nielsen\",\"Date__293\":\"02\\/04\\/2020\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"9\",\"Multiple_Choice__301\":\"Ramsey\",\"Short_Answer__303\":\"Miracle\",\"Short_Answer__304\":\"Gillmore\",\"Date__305\":\"03\\/04\\/2016\",\"Date__307\":\"01\\/13\\/2020\",\"Multiple_Choice__308\":\"3 Years\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,81,'2021-05-26 19:33:23','2021-05-26 18:29:41',NULL,'Miracle Gillmore'),(337,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"Jennifer Carlson\",\"Date__293\":\"06\\/12\\/2018\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"8\",\"Multiple_Choice__301\":\"Hennepin\",\"Short_Answer__303\":\"Misty\",\"Short_Answer__304\":\"Payne\",\"Date__305\":\"06\\/22\\/2017\",\"Date__306\":\"01\\/21\\/2018\",\"Multiple_Choice__308\":\"6 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"2\",\"Free_Text__359\":\"Supporting the decision to make a maltreatment determination regarding inadequate supervision for unsafe sleep was the fact that the mother admitted to using Cocaine and alcohol prior to the critical incident.  Per local agency practice, maltreatment determinations for unsafe sleep are substantiated if the caregiver was under the influence of drugs or alcohol at the time of the incident.\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,81,'2021-05-26 19:33:23','2021-05-26 18:30:23',NULL,'Misty Payne'),(338,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Triage Team\",\"Date__293\":\"12\\/11\\/2017\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"9\",\"Multiple_Choice__301\":\"Ramsey\",\"Short_Answer__303\":\"Mykel\",\"Short_Answer__304\":\"Powell\",\"Date__305\":\"07\\/16\\/2017\",\"Date__307\":\"11\\/22\\/2017\",\"Multiple_Choice__308\":\"4 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,81,'2021-05-26 19:33:23','2021-05-26 18:35:47',NULL,'Mykel Powell'),(339,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"Jennifer Carlson\",\"Date__293\":\"07\\/17\\/2017\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"8\",\"Multiple_Choice__301\":\"Hennepin\",\"Short_Answer__303\":\"Nahly\",\"Short_Answer__304\":\"Ronquillo-Romero\",\"Date__305\":\"11\\/12\\/2005\",\"Date__306\":\"09\\/30\\/2016\",\"Multiple_Choice__308\":\"10 Years\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,81,'2021-05-26 19:33:23','2021-05-26 18:35:09',NULL,'Nahly Ronquillo'),(340,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"Triage Review\",\"Date__293\":\"05\\/11\\/2018\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"8\",\"Multiple_Choice__301\":\"Hennepin\",\"Short_Answer__303\":\"Naomi\",\"Short_Answer__304\":\"Wallace\",\"Date__305\":\"08\\/20\\/2016\",\"Date__307\":\"03\\/06\\/2018\",\"Multiple_Choice__308\":\"1 Year\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Babysitter\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,81,'2021-05-26 19:33:23','2021-05-26 18:36:39',NULL,'Naomi Wallace'),(341,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Triage Team\",\"Date__293\":\"04\\/14\\/2020\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"8\",\"Multiple_Choice__301\":\"Hennepin\",\"Short_Answer__303\":\"Nelson\",\"Short_Answer__304\":\"Schladetzky\",\"Date__305\":\"10\\/24\\/2011\",\"Date__306\":\"12\\/1\\/2020\",\"Multiple_Choice__308\":\"8 Years\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,81,'2021-05-26 19:33:23','2021-05-26 18:37:28',NULL,'Nelson Schladetzky'),(342,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Triage Team\",\"Date__293\":\"07\\/10\\/2019\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"8\",\"Multiple_Choice__301\":\"Hennepin\",\"Short_Answer__303\":\"Noah\",\"Short_Answer__304\":\"Pucci-Hoyos\",\"Date__305\":\"04\\/01\\/2019\",\"Date__307\":\"06\\/05\\/2019\",\"Multiple_Choice__308\":\"2 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,81,'2021-05-26 19:33:23','2021-05-26 18:41:20',NULL,'Noah Pucci-Hoyos'),(343,22,92,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kristine Frick\",\"Short_Answer__292\":\"Sarah Storm\",\"Date__293\":\"09\\/27\\/2016\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Short_Answer__297\":\"Licensed\",\"Yes_or_No__298\":\"Yes\",\"Multiple_Choice__299\":\"Licensed\",\"Multiple_Choice__300\":\"7\",\"Multiple_Choice__301\":\"Washington\",\"Short_Answer__303\":\"Noah\",\"Short_Answer__304\":\"Spiess\",\"Date__305\":\"08\\/23\\/2015\",\"Date__307\":\"07\\/01\\/2016\",\"Multiple_Choice__308\":\"11 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Licensed Daycare Provider\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"1\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"2\",\"Free_Text__359\":\"Area of Learning:  Temporary immediate suspension.\\r\\nLocal Review Recommendation: The local mortality review team recommended legislation to give agencies more authority to enforce temporary immediate suspensions of unlicensed foster homes (monetary penalties, criminal charge, etc.).\\r\\n\\r\\nThe following people participated in the Ramsey County Local review:\\r\\nTami Baker\\r\\nKristen Jackelen\\r\\nBecky Knighton\\r\\nChris Murphy\\r\\nNissa Knutson\\r\\nJohn Hanna\\r\\nGeorge Joyer\\r\\nAlice Swenson\\r\\nLaura Miles\\r\\nLauren Otanez\\r\\nJake Peterson\\r\\nSarah Cory\\r\\nAaron Strong\",\"Multiple_Choice__360\":\"1\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,92,71,'2021-05-26 19:33:23','2021-06-01 19:06:27',NULL,'Noah Spiess'),(344,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"Triage Review\",\"Date__293\":\"10\\/20\\/2017\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Short_Answer__297\":\"Licensed\",\"Yes_or_No__298\":\"Yes\",\"Multiple_Choice__299\":\"Licensed\",\"Multiple_Choice__300\":\"7\",\"Multiple_Choice__301\":\"Scott\",\"Short_Answer__303\":\"Nolan\",\"Short_Answer__304\":\"McNally\",\"Date__305\":\"03\\/09\\/2017\",\"Date__307\":\"09\\/14\\/2017\",\"Multiple_Choice__308\":\"6 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Daycare provider\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,71,'2021-05-26 19:33:23','2021-06-01 19:06:52',NULL,'Nolan McNally'),(345,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"Triage Team\",\"Date__293\":\"07\\/27\\/2018\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"4\",\"Multiple_Choice__301\":\"Wright\",\"Short_Answer__303\":\"Nolan\",\"Short_Answer__304\":\"Muonio\",\"Date__305\":\"04\\/30\\/2015\",\"Date__306\":\"06\\/03\\/2018\",\"Multiple_Choice__308\":\"3 Years\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Mother\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"2\",\"Free_Text__359\":\"There is absent, conflicting, or vague guidance regarding maltreatment determinations on inadequate supervision specific to drowning fatalities\\/near fatalities. It was noted that the determination was made based upon the subject child being unsupervised for a period of 5-30 minutes.  It is unclear where the local agency made the assumption from that if the child was left being unsupervised for a period of 5-30 minutes that this becomes a qualifying criteria for a maltreatment determination.  This is the specific piece that seems vague or absent. It also seems that similar critical incidents have occurred without a maltreatment determination being made.\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,81,'2021-05-26 19:33:23','2021-05-26 18:42:47',NULL,'Nolan Muonio'),(346,22,84,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kelly Knutson\",\"Short_Answer__292\":\"Paul Lennander\",\"Date__293\":\"01\\/29\\/2018\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"4\",\"Multiple_Choice__301\":\"Stearns\",\"Short_Answer__303\":\"Owen\",\"Short_Answer__304\":\"Ware Podgurski\",\"Date__305\":\"08\\/12\\/2017\",\"Date__307\":\"02\\/18\\/2018\",\"Multiple_Choice__308\":\"5 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__316\":\"1\",\"Short_Answer__317\":\"A child protection report was not made following the previous diagnosis of \\u00e2\\u20ac\\u0153failure to thrive\\u00e2\\u20ac\\u009d.\",\"Free_Text__318\":\"There was not a debrief that occurred as the learning point was beyond the scope of CP.\",\"Free_Text__319\":\"A child protection report not being made by the medical provider following a previous diagnosis of \\u00e2\\u20ac\\u0153failure to thrive\\u00e2\\u20ac\\u009d was influenced by the medical providers experience with child maltreatment.  Contributing to a report not being made was the ambiguity of the threshold and understanding of when and where to report when there is a diagnosis of \\u00e2\\u20ac\\u0153failure to thrive\\u00e2\\u20ac\\u009d.  In cases such as this, barriers can also exist when accessing professional expertise to provide clarity around a \\u00e2\\u20ac\\u0153failure to thrive\\u00e2\\u20ac\\u009d diagnosis and what diagnosis and treatment rise to the level of a child protection report.  This can also make it difficult for providers to know when to make a child protection report.\\r\\n\\r\\nAdditional circumstances, such as the need to preserve the relationship with the family and ensure that the family will follow through with routine medical care can further support a medical provider not making a child protection report in a case like this.  Mom\'s active engagement and consistent follow through with the child\'s routine medical care supported a report not being made.  Furthermore, the mother in this case was already engaged with routine medical care for the child.  \\r\\n\\r\\nFurther supporting a report not being made is that there is subjectivity in the definition of \\u00e2\\u20ac\\u0153failure to thrive\\u00e2\\u20ac\\u009d as well as a variety of diagnoses and treatment for failure to thrive situations. Additionally, the definition of \\u00e2\\u20ac\\u0153failure to thrive\\u00e2\\u20ac\\u009d under general neglect embedded within the Intake, Screening, and Response Path guidelines can also influence individual\'s understanding of what meets the threshold to report.\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"2\",\"Free_Text__359\":\"Contributing to a report not being made was the ambiguity of the threshold and understanding of when and where to report when there is a diagnosis of \\u00e2\\u20ac\\u0153failure to thrive\\u00e2\\u20ac\\u009d. In cases such as this, barriers can also exist when accessing professional expertise to provide clarity around a \\u00e2\\u20ac\\u0153failure to thrive\\u00e2\\u20ac\\u009d diagnosis and what diagnosis and treatment rise to the level of a child protection report. This can also make it difficult for providers to know when to make a child protection report.\\r\\n\\r\\nFurther supporting a report not being made is that there is subjectivity in the definition of \\u00e2\\u20ac\\u0153failure to thrive\\u00e2\\u20ac\\u009d as well as a variety of diagnoses and treatment for failure to thrive situations. Additionally, the definition of \\u00e2\\u20ac\\u0153failure to thrive\\u00e2\\u20ac\\u009d under general neglect embedded within the Intake, Screening, and Response Path guidelines can also influence individual\'s understanding of what meets the threshold to report.\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,84,81,'2021-05-26 19:33:23','2021-05-26 18:43:33',NULL,'Owen Ware Podgurski'),(347,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Triage Team\",\"Date__293\":\"04\\/15\\/2018\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Short_Answer__297\":\"Unlicensed\",\"Yes_or_No__298\":\"Yes\",\"Multiple_Choice__299\":\"Unlicensed\",\"Multiple_Choice__300\":\"7\",\"Multiple_Choice__301\":\"Anoka\",\"Short_Answer__303\":\"Phoenix\",\"Short_Answer__304\":\"Lincoln\",\"Date__305\":\"11\\/06\\/2017\",\"Date__306\":\"02\\/04\\/2018\",\"Multiple_Choice__308\":\"2 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Daycare Provider\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,71,'2021-05-26 19:33:23','2021-06-01 19:07:44',NULL,'Phoenix Lincoln'),(348,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"Paul Lennander\",\"Date__293\":\"07\\/18\\/2018\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"8\",\"Multiple_Choice__301\":\"Hennepin\",\"Short_Answer__303\":\"Princeton\",\"Short_Answer__304\":\"Johnson\",\"Date__305\":\"05\\/12\\/2018\",\"Date__307\":\"06\\/21\\/2018\",\"Multiple_Choice__308\":\"<1 Month\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,81,'2021-05-26 19:33:23','2021-05-26 18:44:56',NULL,'Princeton Johnson'),(349,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Wendy Woessner\",\"Date__293\":\"06\\/16\\/2018\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"9\",\"Multiple_Choice__301\":\"Ramsey\",\"Short_Answer__303\":\"Prophecy\",\"Short_Answer__304\":\"Watley\",\"Date__305\":\"03\\/19\\/2018\",\"Date__306\":\"04\\/14\\/2018\",\"Multiple_Choice__308\":\"<1 Month\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Mother\",\"Multiple_Choice__316\":\"2\",\"Short_Answer__317\":\"Father not added as participant in workgroup\",\"Free_Text__318\":\"It was learned that the social workers are typically responsible for adding any additional participants that they come across during an assessment or investigation. These situations often arise as a result of minimal information being available at intake and additional information about sibs\\/parents\\/relatives coming in during assessment\\/investigation interviews. At the time of the critical incident, after-hours staff had responded to the report and conducted initial interviews. There was then a transition of the case back to her and she was to conduct the additional interview with the child\'s father as the on-call worker was unable to do so. The worker reported not adding the father to the participants in SSIS was an oversight on her part, however stated that the dad wasn\'t technically living in the apartment, so that may have been part of why she didn\'t add him. She reported that her caseload was heavy at the time due to rotating schedule for assignment of new cases and turnover rates and she often times has to sacrifice some things being done over others to ensure safety for children on her case load. Additionally, she stated that this is not one of those things that would pop up on a data clean-up in SSIS, further supporting why she never caught that the father wasn\'t added.\",\"Free_Text__319\":\"The father not being added as a participant in the workgroup was influenced by worker transitions within the agency as well as SSIS functionality and workload levels. The critical incident case came into the agency during after-hours. The after-hours process was new for the agency and was in process regarding smoothing out the progression of case duties when cases come in after-hours. As a result of this, the after-hours worker is responsible for completing initial interviews when needed and is also tasked with gathering as much information as available at the time and sharing this information with the worker that takes the case from there. In this case, the father was not able to be interviewed during the after-hours response as he was not a resident of the home. When the case was transferred from the after-hours worker to the assigned investigator, communication gaps existed regarding family information and as a result, it was not relayed that the father was not added as a participant. In addition to this, the investigator that received the case from the after-hours worker was experiencing high caseload levels due to turnover within the agency. This caseload was managed through a rotation schedule for getting cases, which doesn\'t account for cases the worker already has. As a result of this high caseload pressure, the worker was sacrificing some case duties, in this case adding participants, in order to prioritize safety for children on her caseload. \\r\\nFinally, at completion of a case, there is a case consultation with supervisors. It was reported that the consultations do not pertain to every detail of the case. Supporting this oversight in not adding the father as a participant was the fact that while closing the case in SSIS, there is not a data-cleanup function that pertains to father-related fields, so the worker was not directed to add him. Generally, SSIS is focused on mothers and not fathers.\",\"Short_Answer__320\":\"Sibling children not placed per agency policy\",\"Free_Text__321\":\"The worker reported that she initially received this case as a THC positive newborn (family assessment response). She went and completed a face to face with the mother and child and was able to conduct a short, not exhaustive, assessment of safety for the other children, which she identified as safe and healthy. Safe sleep was discussed. When the case came in after the critical incident, it was received by agency after-hours staff, which was just recently added to Ramsey County\'s work tasks as it was previously contracted out. This new process created gaps in communication and transition between workers. Due to a snowstorm, the after-hours staff was unable to make it to the children\'s home. The after-hours worker had questioned the need for removal of the children given their ages, and that LE had not identified a need for removal at the time of the incident, but was told that it was agency policy to remove siblings when a child dies and neglect is suspected.\\r\\n\\r\\nAfter the attempt to place the children in shelter was hampered by an April snowstorm, there was no further conversation regarding the need to remove the children. The worker provided risk and safety assessments regarding the sibling children during subsequent home visits and did not identify the need to remove. The worker stated she looks at removal of children on a case-to-case basis, however believed it to be typical of other staff to remove other children after a child death and then figure out next steps after that. The worker was unsure if policy existed around placement of remaining children when a child death occurs.\",\"Free_Text__322\":\"The sibling children to the subject child not being placed after the critical incident was influenced by agency procedures, having multiple workers on the case and Law Enforcement\'s (LE) response to the incident. When the case came in after the critical incident, it was received by agency after-hours staff, which was just recently added to the agency\'s work tasks as it was previously contracted out. This new process created gaps in communication during transitions between after-hour workers and subsequently-assigned FA\\/FI workers. Due to a snowstorm, the after-hours staff was unable to make it to the children\'s home during the after-hours response. The after-hours worker had questioned the need for removal of the children at the time given their ages, and also because LE had not identified a need for removal at the time of the incident. The case was then assigned to an agency staff that was working with the family in a family assessment workgroup at the time and that worker subsequently conducted in-home face to face contact with the family and identified the children as safe. In situations such as this, after a home visit and assessment that children are safe, manager overrides may occur. \\r\\nRegarding policy within the agency concerning removal of children after a child death suspected due to neglect, it was identified that the policy was not \\u00e2\\u20ac\\u0153transferred well\\u00e2\\u20ac\\u009d to staff and thus, the worker had no knowledge of the policy. Without this knowledge, the worker assessed the need for removal on a case-to-case basis. In this case, the worker provided risk and safety assessments regarding the sibling children during subsequent home visits and did not identify the need to remove.\",\"Multiple_Choice__346\":\"2\",\"Free_Text__347\":\"Learning Point 2:\\r\\nThe after-hours worker had questioned the need for removal of the children at the time given their ages, and also because LE had not identified a need for removal at the time of the incident.\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"2\",\"Free_Text__353\":\"Learning Point 1: \\r\\nWhile closing the case in SSIS, there is not a data-cleanup function that pertains to father-related fields, so the worker was not directed to add him. Generally, SSIS is focused on mothers and not fathers.\",\"Multiple_Choice__354\":\"3\",\"Free_Text__355\":\"Learning Point 1:\\r\\nWhen the case was transferred from the after-hours worker to the assigned investigator, communication gaps existed regarding family information and as a result, it was not relayed that the father was not added as a participant.\",\"Multiple_Choice__356\":\"2\",\"Free_Text__357\":\"Learning Point 2:\\r\\nRegarding policy within the agency concerning removal of children after a child death suspected due to neglect, it was identified that the policy was not \\u00e2\\u20ac\\u0153transferred well\\u00e2\\u20ac\\u009d to staff and thus, the worker had no knowledge of the policy.\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"2\",\"Free_Text__359\":\"Learning Point 1:\\r\\nThe after-hours process was new for the agency and was in process regarding smoothing out the progression of case duties when cases come in after-hours.\\r\\n\\r\\nLearning Point 2:\\r\\nWhen the case came in after the critical incident, it was received by agency after-hours staff, which was just recently added to the agency\'s work tasks as it was previously contracted out. This new process created gaps in communication during transitions between after-hour workers and subsequently-assigned FA\\/FI workers.\",\"Multiple_Choice__360\":\"2\",\"Free_Text__361\":\"Learning Point 1:\\r\\nThe investigator that received the case from the after-hours worker was experiencing high caseload levels due to turnover within the agency. This caseload was managed through a rotation schedule for getting cases, which doesn\'t account for cases the worker already has. As a result of this high caseload pressure, the worker was sacrificing some case duties, in this case adding participants, in order to prioritize safety for children on her caseload.\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"1\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,81,'2021-05-26 19:33:23','2021-05-26 18:45:55',NULL,'Prophecy Watley'),(350,22,92,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kristine Frick\",\"Short_Answer__292\":\"Kari Rude\",\"Date__293\":\"12\\/13\\/2018\",\"Date__342\":\"04\\/09\\/2019\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Yes_or_No__298\":\"No\",\"Multiple_Choice__300\":\"3\",\"Multiple_Choice__301\":\"Stevens\",\"Short_Answer__303\":\"Rafael\",\"Short_Answer__304\":\"Crayton\",\"Date__305\":\"01\\/24\\/2018\",\"Date__307\":\"08\\/10\\/2018\",\"Multiple_Choice__308\":\"7 Months\",\"Multiple_Choice__309\":\"2\",\"Short_Answer__310\":\"Mother\",\"Short_Answer__311\":\"Mother\'s boyfriend\",\"Multiple_Choice__316\":\"2\",\"Short_Answer__317\":\"A requested TPR was not filed by the County Attorney for an alleged father who was a registered predatory offender and a mother with an egregious harm maltreatment determination.\",\"Free_Text__318\":\"Consults between CP and CA occurred (multiple)\\r\\n\\u00e2\\u20ac\\u00a2\\tPetition written and provided to the CA\\r\\n\\u00e2\\u20ac\\u00a2\\tFiling TPR was declined \\r\\n\\u00e2\\u20ac\\u00a2\\tCA unsure if met TPR criteria\\r\\n\\u00e2\\u20ac\\u00a2\\tInexperience in both work areas; Social Services Staff and CA\'s office\\r\\n\\u00e2\\u20ac\\u00a2\\tCA no mentor assisting; Not using green book\\r\\n\\u00e2\\u20ac\\u00a2\\tCA want criminal case to go first before filing TPR\",\"Free_Text__319\":\"A Termination of Parental Rights (TPR) was not filed by county attorney (CA) under the predatory offender statute or maltreatment determined egregious harm statute although child protection (CP) staff had multiple consults with the CA throughout the life of the case regarding child safety and best interest factors.  CP Staff drafted a petition and provided it to the CA, describing the circumstances which CP perceived to meet the TPR criteria, as CP perceived they were implementing and completing the required tasks based on their interpretation of the predatory offender and egregious harm guidance, stemming from MN laws. \\r\\nBest practices prescribed for these types of cases and actual support received by CP from the CA was not congruent across the systems when CP petitioned for TPR, as the CA was not certain that criteria for TPR was met, and made the decision to not file for TPR. Both the CA and CP staff had little longevity with staff experience, and a knowledge gap presented difficulties integrating knowledge into practice, influencing the trajectory of case practice. There is a lot of information to take in when learning new roles in both professions, where professionals experience a window of time called a learning curve. \\r\\nIn regard to the CA working a new role, there is little assistance from other attorney\'s to mentor each other, and their workload influences the amount of time available for learning and interpreting laws, as in the predatory offender and egregious harm statues involved in this case.  CP\'s mental model was that the new CA was not using the green book to guide decisions either and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes.  \\r\\nThere was no legal basis under compelling reasons as the crime and egregious harm occurred in the past, and the child was presumed safe in real time. There was no present imminent harm or imminent danger to the child, therefore the CA did not prioritize filing for TPR. There was also a perception that the public places higher preference on criminal case outcomes over TPR cases, and the criminal proceedings had not been completed at the time CP drafted a petition for TPR. The CA also prioritized the criminal case proceedings over filing for TPR, as using the result of the criminal case to support meeting criteria for TPR is common practice for county attorneys.\",\"Short_Answer__320\":\"CP Intake was not screened within the 24 hour required timeframe\",\"Free_Text__321\":\"\\u00e2\\u20ac\\u00a2\\tWait for conformed test results\\r\\n\\u00e2\\u20ac\\u00a2\\tMother move around, jurisdiction concerns, mother was hard to reach\\/ difficulty engaging to conform where reside and find the family\'s location\\r\\n\\u00e2\\u20ac\\u00a2\\tPositive for THC only = not as severe as meth, etc. \\u00e2\\u20ac\\u0153it\'s just THC\\u00e2\\u20ac\\u009d, mental model for agency\'s about what this means\\r\\n\\u00e2\\u20ac\\u00a2\\tPrevious PSOP  and CD assessment\\r\\n         -Mother declined services & no recommendations came out of the CD assessment\\r\\n\\u00e2\\u20ac\\u00a2\\tOne Primary intake worker\\r\\n         - Back up took intake info may not be as familiar \\tw\\/internal processes for intakes since it\'s not their primary role the staff commonly \\tworks every day.  \\r\\note: presumptive  Vs Confirmed results\",\"Free_Text__322\":\"Learning Point: A CP intake was not screened within 24 hours. \\r\\nContributing to the CP intake not being screened within 24 hours was the type of allegation that was reported, neglect - prenatal exposure to controlled substance. The agency made a decision to hold off on screening the maltreatment report that was entered into SSIS by a backup staff. The back-up intake worker was balancing intake responsibilities with responsibilities of their primary workload, which resulted in tradeoffs. Additionally, the backup staff was not as familiar with intake procedures, as local agency practices for prenatal exposure reports had recently changed, which occurred following changes to DHS\'s maltreatment, screening, and response path guidelines. The changes to the guidance stemmed from DHS\'s interpretation of legislative changes around prenatal exposure and best practices were also defined by the state from Legislative statutes. Also influencing was a local agency workgroup, where their input and feedback on practical implementation strategies in response to prenatal exposure allegations was incorporated into the changes to guidance. The changes in guidance can conflict with the mandate to screen reports within 24 hours, as obtaining comprehensive information at the time of the report can take longer than 24 hours to receive.  \\r\\nThe agency interpretation of guidance influenced an internal practice change, where the agency held intakes open for prenatal exposure until they received more comprehensive collateral information from the medical provider. The agency\'s new practice prioritized making screening decisions based on lab verified toxicology results versus a positive result on an initial screening. Hospitals have policies and practices that vary in regard to testing for prenatal exposure and also for when they make a report for prenatal exposure allegations to child protection. The variability suggests some hospitals test all children, where others only test when certain criteria\\/risks exist when the child is born. It is collectively known that some providers may test more mothers of marginalized groups using their mental models rooted from past experiences, creating an implicit bias. This bias subjects children of marginalized groups, and their mothers to increased toxicology testing, and potentially increases the number of reports made to child protection system when results are positive. It is also collectively known that other providers perceive there being a need to preserve the patient\\/doctor relationship which also influences a confirmed positive toxicology report being made or not. This information on testing and reporting variability across hospitals influenced the agency\'s decision to wait for lab confirmed toxicology results before screening the report.  \\r\\nThis practice change was an adaptation from how the agency previously screened out prenatal exposure reports (prior to receipt of confirmed toxicology results) in order to meet the 24 hour timeline. Further Influencing the decision to not screen within 24 hours and wait for a confirmed toxicology result, was the agency\'s past experience of getting involved and working with families based on a positive initial screen, and later receiving information that the initial screen proved to be inaccurate and was a false positive. The agency worked to find balance between two priorities, the agency\'s role to protect children from harm and keep them safe, and the agency\'s duty to protect the privacy of children and families by not getting involved unjustly when credible evidence does not suggest alleged maltreatment. This goal conflict influenced the agency\'s decision to hold off on making a screening decision. \\r\\nThe local agency\'s interpretation of all the guidance changes supported their decision to seek collateral comprehensive information, which is suggested as best practice. Understanding it takes time, and the amount of time it takes to receive confirmed toxicology results from the lab is also dependent on, which type of toxicology test the medical provider chooses to order (urine sample, meconium, or blood cord tissue). For this case, a blood cord tissue sample was chosen, which provides most accurate results of toxicology, however, takes the most time for the lab to provide a report on the confirmed toxicology results. The time needed for child protection to wait for confirmed toxicology results contributed to the delay in screening. \\r\\nThe maltreatment, intake, screening, and response path guidance also require that agencies focus on vulnerability and risk of harm by assessing the impact chemical use or misuse has on child safety and use this as the primary consideration when screening. Understanding the mother\'s use alone did not constitute an unsafe child, the agency resolved the goal conflict by prioritizing the clause about \\u00e2\\u20ac\\u02dcimpact of use or misuse on child safety\', as the guidance suggests this be the primary consideration when screening. Furthermore, the agency considered risk associated with type of drug in which results are positive, for example, response to an allegation involving THC can be different than a response to an allegation involving methamphetamine. Since the child was presumed safe, consideration was given to the best interest of the child, and the agency sought to use a trauma informed approach that honored the newborn\'s innate biological needs for physical touch, bond, and attachment with the mother, prioritizing the presumption of safety over meeting the 24 hour screening compliance metric.\",\"Multiple_Choice__346\":\"3\",\"Free_Text__347\":\"LP1:  CP\'s mental model was that the new CA was not using \\\"the green book\\\" to guide their decisions, and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes. \\r\\nCP also developed a mental model regarding not receiving support from their CA due to a history of denial to file for TPR.\",\"Multiple_Choice__348\":\"3\",\"Free_Text__349\":\"LP1: Stevens County has limited staff employed, leaving little time for staff to mentor the CA, as priority is given to working CP cases coming into the system. When cases are exceptionally complex, staff do not sleep or sleep at the office to complete work tasks for complex cases.\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"3\",\"Free_Text__355\":\"LP1: A Termination of Parental Rights (TPR) was not filed by county attorney (CA) under the predatory offender statute or maltreatment determined egregious harm statute although child protection (CP) staff had multiple consults with the CA throughout the life of the case regarding child safety and best interest factors.  CP Staff drafted a petition and provided it to the CA, describing the circumstances which CP perceived to meet the TPR criteria, as CP perceived they were implementing and completing the required tasks based on their interpretation of the predatory offender and egregious harm guidance, stemming from MN laws. \\r\\n \\r\\nThere was no legal basis under compelling reasons as the crime and egregious harm occurred in the past, and the child was presumed safe in real time. There was no present imminent harm or imminent danger to the child, therefore the CA did not prioritize filing for TPR. There was also a perception that the public places higher preference on criminal case outcomes over TPR cases, and the criminal proceedings had not been completed at the time CP drafted a petition for TPR. The CA also prioritized the criminal case proceedings over filing for TPR, as using the result of the criminal case to support meeting criteria for TPR is common practice for county attorneys.\",\"Multiple_Choice__356\":\"3\",\"Free_Text__357\":\"LP1: Best practices prescribed for these types of cases and actual support received by CP from the CA was not congruent across the systems when CP petitioned for TPR, as the CA was not certain that criteria for TPR was met, and made the decision to not file for TPR. Both the CA and CP staff had little longevity with staff experience, and a knowledge gap presented difficulties integrating knowledge into practice, influencing the trajectory of case practice. There is a lot of information to take in when learning new roles in both professions, where professionals experience a window of time called a learning curve. \\r\\nIn regard to the CA working a new role, there is little assistance from other attorney\'s to mentor each other, and their workload influences the amount of time available for learning and interpreting laws, as in the predatory offender and egregious harm statues involved in this case.  CP\'s mental model was that the new CA was not using the green book to guide decisions either and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes.\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"3\",\"Free_Text__359\":\"LP1: A Termination of Parental Rights (TPR) was not filed by county attorney (CA) under the predatory offender statute or maltreatment determined egregious harm statute although child protection (CP) staff had multiple consults with the CA throughout the life of the case regarding child safety and best interest factors.  CP Staff drafted a petition and provided it to the CA, describing the circumstances which CP perceived to meet the TPR criteria, as CP perceived they were implementing and completing the required tasks based on their interpretation of the predatory offender and egregious harm guidance, stemming from MN laws. \\r\\nBest practices prescribed for these types of cases and actual support received by CP from the CA was not congruent across the systems when CP petitioned for TPR, as the CA was not certain that criteria for TPR was met, and made the decision to not file for TPR. Both the CA and CP staff had little longevity with staff experience, and a knowledge gap presented difficulties integrating knowledge into practice, influencing the trajectory of case practice. There is a lot of information to take in when learning new roles in both professions, where professionals experience a window of time called a learning curve. \\r\\nIn regard to the CA working a new role, there is little assistance from other attorney\'s to mentor each other, and their workload influences the amount of time available for learning and interpreting laws, as in the predatory offender and egregious harm statues involved in this case.  CP\'s mental model was that the new CA was not using the green book to guide decisions either and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes.  \\r\\nThere was no legal basis under compelling reasons as the crime and egregious harm occurred in the past, and the child was presumed safe in real time. There was no present imminent harm or imminent danger to the child, therefore the CA did not prioritize filing for TPR. There was also a perception that the public places higher preference on criminal case outcomes over TPR cases, and the criminal proceedings had not been completed at the time CP drafted a petition for TPR. The CA also prioritized the criminal case proceedings over filing for TPR, as using the result of the criminal case to support meeting criteria for TPR is common practice for county attorneys.\",\"Multiple_Choice__360\":\"1\",\"Multiple_Choice__362\":\"3\",\"Free_Text__363\":\"LP1: A Termination of Parental Rights (TPR) was not filed by county attorney (CA) under the predatory offender statute or maltreatment determined egregious harm statute although child protection (CP) staff had multiple consults with the CA throughout the life of the case regarding child safety and best interest factors.  CP Staff drafted a petition and provided it to the CA, describing the circumstances which CP perceived to meet the TPR criteria, as CP perceived they were implementing and completing the required tasks based on their interpretation of the predatory offender and egregious harm guidance, stemming from MN laws. \\r\\nBest practices prescribed for these types of cases and actual support received by CP from the CA was not congruent across the systems when CP petitioned for TPR, as the CA was not certain that criteria for TPR was met, and made the decision to not file for TPR. Both the CA and CP staff had little longevity with staff experience, and a knowledge gap presented difficulties integrating knowledge into practice, influencing the trajectory of case practice. There is a lot of information to take in when learning new roles in both professions, where professionals experience a window of time called a learning curve. \\r\\nIn regard to the CA working a new role, there is little assistance from other attorney\'s to mentor each other, and their workload influences the amount of time available for learning and interpreting laws, as in the predatory offender and egregious harm statues involved in this case.  CP\'s mental model was that the new CA was not using the green book to guide decisions either and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes.  \\r\\nThere was no legal basis under compelling reasons as the crime and egregious harm occurred in the past, and the child was presumed safe in real time. There was no present imminent harm or imminent danger to the child, therefore the CA did not prioritize filing for TPR. There was also a perception that the public places higher preference on criminal case outcomes over TPR cases, and the criminal proceedings had not been completed at the time CP drafted a petition for TPR. The CA also prioritized the criminal case proceedings over filing for TPR, as using the result of the criminal case to support meeting criteria for TPR is common practice for county attorneys.\",\"Multiple_Choice__364\":\"1\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,92,92,'2021-05-26 19:33:23','2021-06-01 19:37:30',NULL,'Rafael Crayton'),(351,22,92,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kristine Frick\",\"Short_Answer__292\":\"Lynn Shafer\",\"Date__293\":\"09\\/21\\/2016\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"8\",\"Multiple_Choice__301\":\"Hennepin\",\"Short_Answer__303\":\"Rainy\",\"Short_Answer__304\":\"Darden\",\"Date__305\":\"09\\/17\\/2016\",\"Date__307\":\"09\\/17\\/2016\",\"Multiple_Choice__308\":\"<1 Month\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Mother\",\"Multiple_Choice__316\":\"1\",\"Short_Answer__317\":\"CP Intake was not made for allegation of neglect (failure to protect from serious endangerment) to subject child\'s half-brother by Aunt\'s former husband in the 3\\/30\\/15 -CP Family Assessment.\",\"Free_Text__318\":\"Information obtained during the Debrief regarding Learning Point:\\r\\n\\u00e2\\u20ac\\u00a2\\tFamily dynamics are convoluted and intertwined coupled by SSIS database challenges \\r\\n\\u00e2\\u20ac\\u00a2\\tComplexity of family dynamics impacted how to document in SSIS, along with two family assessments overlapping.  \\r\\n\\u00e2\\u20ac\\u00a2\\tCP Intake sets up the participants and victim children in SSIS\\r\\no\\tCP intake came in around 4pm on Friday (03\\/27). The CP intake was entered into SSIS and screened in for family assessment on Monday (03\\/30). \\r\\n\\u00e2\\u20ac\\u00a2\\tKnowledge of complex social services history for subject child\'s half-brother was limited by accessibility of intakes and workgroups as all of them do not appear in the \\u00e2\\u20ac\\u02dcassociated workgroups feature\' of SSIS.  \\r\\no\\tNot associated because documented under the legal guardian, which was the subject child\'s half-brother\'s deceased grandmother \\r\\no\\tMNCIS was used, MGA Court Records online did not exist in 2015\\r\\no\\tProcess of accessing court documents for subject child\'s half-brother entailed calling the clerk, who could sometimes find requested information, but sometimes could not. \\r\\n\\u00e2\\u20ac\\u00a2\\tBelief about family assessments being less severe allegations and lower safety risk, a softer approach, and perceived to be voluntary work with families, similar to PSOP cases. \\r\\n\\u00e2\\u20ac\\u00a2\\tBecause maltreatment determinations are not made for family assessments, attention was on providing services to the family, especially legal permanency for the subject child\'s half-brother through guardianship with his Aunt.\\r\\n\\u00e2\\u20ac\\u00a2\\tThis family assessment was lower priority on workers caseload due to the nature of the allegations, perception of family assessment being voluntary, and that there was a family assessment workgroup open with the subject child\'s half-brother already (opened on March 4), where the professional was already providing services regarding legal permanency. \\r\\n\\u00e2\\u20ac\\u00a2\\tThe subject child\'s half-brother was included as a participant on the FA, therefore the he would qualify for CP Family Assessment - Case Management. \\r\\n\\u00e2\\u20ac\\u00a2\\tGuidance on how to add victim child and\\/or allegation to a victim child in an already open FA\\/FI had changed around March 2015, it did not make sense to the professional to make a new CP report for allegation of neglect (failure to protect from serious endangerment) to subject child\'s half-brother by Aunt\'s former husband. \\r\\no\\tTime and attention to the new guidance about how to document in SSIS was not priority for the professional because the goal was to work with the family to address needs and provide services. \\r\\no\\tThe professional believed the Aunt was following through with expectations in regard to establishing legal permanency for the subject child\'s half-brother. \\r\\no\\tIt did not make sense to make a CP intake because it would have been documented under the deceased grandmother\'s name and the professional would have to duplicate documentation between the workgroups. This would have been time intensive and hard for the professional to track. \\r\\no\\tThe workaround met the goal of getting the child and family the services they needed, and did not require the worker to document in two separate family assessment workgroups.\\r\\n\\u00ef\\u201a\\u00a7\\tLess confusing since would have had to document under the deceased grandmother in SSIS\\r\\no\\tThe SSIS technicality was not priority. \\r\\n\\u00ef\\u201a\\u00a7\\tMondays were especially stressful for assessment workers\\/investigators, because the intake backlog from Friday late afternoon and over the weekend was entered and distributed amongst the assessment\\/investigation units for assignment to assessment workers\\/investigators.\\r\\n\\u00ef\\u201a\\u00a7\\tThere was a significant amount of family assessments\\/investigations backlogged and ready to be assigned as well. There were not enough assessment workers\\/investigators available to work the influx number of cases being screened in. \\r\\n\\u00ef\\u201a\\u00a7\\tThe time to juggle notes back and forth in SSIS for companion cases would not have been productive given the totality of the circumstances.\",\"Free_Text__319\":\"SCIR Narrative - Hennepin County\\r\\nLP: CP intake was not made for allegation of neglect (failure to protect from serious endangerment) to subject child\'s half-brother by Aunt\'s former husband in the 3\\/30\\/2015 CP Family Assessment.\\r\\nIn March 2015, resource constraints existed for the local agency. The local agency was overwhelmed with reports being made to the child protection (CP) system, resulting in an influx of CP intake reports, approximately 400, backlogged and waiting to be screened. Family assessment (FA) and investigations also had a backlog of cases pending assignment to staff. While triaging priority for case assignment from the backlogs, the agency concurrently experienced production pressure to meet data metrics for the amount of reports receiving FA response. Local agencies were not only motivated to comply and meet a certain percentage rate conveyed by the state, but also to produce a successful percentage rate, as the results of the agency\'s success was published in a formal report, released by the state for all local agencies to see the results, intensifying the pressure for the local agency to meet this demand. \\r\\nStaying aware of new DHS guidance changes and having the time to comprehend how to implement them, was a duty that staff were not always able to stay up-to-date on.  The amount changes being made to state guidance, stemming from the Governor\'s Task Force recommendations, along with high caseload sizes, there was not time to learn the new technical guidance. Trying to meet timelines for cases backlogged in the intake\\/screening and assessment\\/investigation units was prioritized and the main focus of the agency.\\r\\nStaff were faced with a goal conflict, to work the case in accordance to local agency normative practice and expected family assessment response best practice guidance (engagement with children and families to meet their needs), versus following the DHS technical requirement to document a new CP Intake for new allegations. Knowing that documenting the CP Intake would contribute to the backlog and not change the course of work with the family influenced the local agency\'s decision to prioritize family engagement over the documentation requirement.  Additionally, there was a belief about neglect being viewed as a less severe allegation.  The belief was that safety risk was lower than other allegations and neglect reports commonly were assigned FA response. This notion combined with the fact that less attention was paid to the allegation details and identifying victim children in family assessment cases, since maltreatment determinations are not made in family assessment response, supported decision not to make a new CP report as well. Instead staff prioritized engagement, assessing safety, risk, needs and recommending services for the family. Ultimately, the documentation requirement is\\/was not aligned with the work the staff were conducting with the family in an already open family assessment workgroup (opened on 03\\/04\\/2015) and the child was able to continue receiving CP Case Management (field services).\\r\\nWhen staff received a new case assignment, they took the report at face value, trusting how the allegations and victim children were identified and documented in the CP intake by the CP intake worker. A procedural adaptation was made to not document the allegation of neglect under the deceased grandmother\'s name in a new CP intake in SSIS in order to cope with production pressure and efficiently manage worker caseload. Additionally, the staff believed the Aunt would follow through and complete establishing legal custody for the child. Making a new CP report for the neglect allegation (labelling the intake and workgroup under the maternal grandmother\'s name in SSIS), did not align with the trajectory of work being completed with the family at the time. There was not a feature in SSIS available to link workgroups when they are labelled under different names, and duplicating documentation of same information in separate workgroups in SSIS was time intensive for staff. This enhanced the agency\'s decision to make the procedural adaptation.\",\"Multiple_Choice__346\":\"3\",\"Free_Text__347\":\"Local agency belief about allegation of neglect and FA response being less severe. Additionally, there was a belief about neglect being viewed as a less severe allegation. The belief was that safety risk was lower than other allegations and neglect reports commonly were assigned FA response. This notion combined with the fact that less attention was paid to the allegation details and identifying victim children in family assessment cases, since maltreatment determinations are not made in family assessment response, supported decision not to make a new CP report as well.\",\"Multiple_Choice__348\":\"3\",\"Free_Text__349\":\"The local agency was overwhelmed with reports being made to the child protection (CP) system, resulting in an influx of CP intake reports, approximately 400, backlogged and waiting to be screened.\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"3\",\"Free_Text__353\":\"Ultimately, the documentation requirement is\\/was not aligned with the work the staff were conducting with the family in an already open family assessment workgroup (opened on 03\\/04\\/2015) and the child was able to continue receiving CP Case Management (field services).\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"3\",\"Free_Text__359\":\"-Staying aware of new DHS guidance changes and having the time to comprehend how to implement them, was a duty that staff were not always able to stay up-to-date on.  The amount changes being made to state guidance, stemming from the Governor\'s Task Force recommendations, along with high caseload sizes, there was not time to learn the new technical guidance. Trying to meet timelines for cases backlogged in the intake\\/screening and assessment\\/investigation units was prioritized and the main focus of the agency.\\r\\n\\r\\n-Staff were faced with a goal conflict, to work the case in accordance to local agency normative practice and expected family assessment response best practice guidance (engagement with children and families to meet their needs), versus following the DHS technical requirement to document a new CP Intake for new allegations.\\r\\n\\r\\n-Ultimately, the documentation requirement is\\/was not aligned with the work the staff were conducting with the family in an already open family assessment workgroup (opened on 03\\/04\\/2015) and the child was able to continue receiving CP Case Management (field services).\",\"Multiple_Choice__360\":\"3\",\"Free_Text__361\":\"While triaging priority for case assignment from the backlogs, the agency concurrently experienced production pressure to meet data metrics for the amount of reports receiving FA response. Local agencies were not only motivated to comply and meet a certain percentage rate conveyed by the state, but also to produce a successful percentage rate, as the results of the agency\\u2019s success was published in a formal report, released by the state for all local agencies to see the results, intensifying the pressure for the local agency to meet this demand. The amount changes being made to state guidance, stemming from the Governors Task Force recommendations, along with high caseload sizes, there was not time to learn the new technical guidance Knowing that documenting the CP Intake would contribute to the backlog and not change the course of work with the family influenced the local agency\\u2019s decision to prioritize family engagement over the documentation requirement.\",\"Multiple_Choice__364\":\"1\",\"Multiple_Choice__366\":\"3\",\"Free_Text__367\":\"A procedural adaptation was made to not document the allegation of neglect under the deceased grandmother\'s name in a new CP intake in SSIS in order to cope with production pressure and efficiently manage worker caseload. Additionally, the staff believed the Aunt would follow through and complete establishing legal custody for the child. Making a new CP report for the neglect allegation (labelling the intake and workgroup under the maternal grandmother\'s name in SSIS), did not align with the trajectory of work being completed with the family at the time. There was not a feature in SSIS available to link workgroups when they are labelled under different names, and duplicating documentation of same information in separate workgroups in SSIS was time intensive for staff. This enhanced the agency\'s decision to make the procedural adaptation.\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,92,81,'2021-05-26 19:33:23','2021-05-26 18:53:30',NULL,'Rainy Darden'),(352,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Jenny Anderson\",\"Date__293\":\"04\\/04\\/2018\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"3\",\"Multiple_Choice__301\":\"Morrison\",\"Short_Answer__303\":\"Reese\",\"Short_Answer__304\":\"St Martin\",\"Date__305\":\"12\\/09\\/2016\",\"Date__307\":\"12\\/20\\/2017\",\"Multiple_Choice__308\":\"1 Year\",\"Multiple_Choice__309\":\"2\",\"Short_Answer__310\":\"Mother\",\"Short_Answer__311\":\"Father\",\"Multiple_Choice__316\":\"1\",\"Short_Answer__317\":\"CP Intake not screened-in though it met screen-in criteria (Neglect \\u00e2\\u20ac\\u201c chronic and severe use of alcohol\\/controlled substances)\",\"Free_Text__318\":\"N\\/A - mapped after mapping team identified the learning point.\",\"Free_Text__319\":\"The intake not being screened-in when it met screen-in criteria was influenced by the agency\'s knowledge of the family, the information contained in the report and law enforcement\'s (LE) response to the report. The agency had had previous intakes and workgroups with the family and was aware of the family\'s dynamics. Due to this, the agency questioned the motives and credibility of the reporter as there had been a history of reports made by both parents against the other. Additionally, there was a considerable amount of time (months) between when the alleged incident occurred and when it was actually reported to child services. Utilizing county attorney\'s input, coupled with DHS\'s ambiguity on consideration of reporting timeframes, the agency identified the report as non-current maltreatment and subsequently screened-out the report. \\r\\nDHS also emphasized coordination with LE when possible. As a result of this coordination, it is common for the agency to rely on interactions between LE and the families to assist in making screening decisions. LE did not identify concerns for safety for the children, further supporting the agency to not identify the need to screen-in this case and intervene.\",\"Multiple_Choice__346\":\"2\",\"Free_Text__347\":\"The agency had had previous intakes and workgroups with the family and was aware of the family\'s dynamics. Due to this, the agency questioned the motives and credibility of the reporter as there had been a history of reports made by both parents against the other.\\r\\n\\r\\nDHS also emphasized coordination with LE when possible. As a result of this coordination, it is common for the agency to rely on interactions between LE and the families to assist in making screening decisions. LE did not identify concerns for safety for the children, further supporting the agency to not identify the need to screen-in this case and intervene.\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"2\",\"Free_Text__359\":\"Additionally, there was a considerable amount of time (months) between when the alleged incident occurred and when it was actually reported to child services. Utilizing county attorney\'s input, coupled with DHS\'s ambiguity on consideration of reporting timeframes, the agency identified the report as non-current maltreatment and subsequently screened-out the report.\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,81,'2021-05-26 19:33:23','2021-05-26 18:54:12',NULL,'Reese St Martin'),(353,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"Jenny Anderson\",\"Date__293\":\"02\\/14\\/2017\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"3\",\"Multiple_Choice__301\":\"Crow Wing\",\"Short_Answer__303\":\"Riley\",\"Short_Answer__304\":\"Peterson\",\"Date__305\":\"10\\/11\\/2016\",\"Date__306\":\"11\\/21\\/2016\",\"Multiple_Choice__308\":\"<1 Month\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,81,'2021-05-26 19:33:23','2021-05-26 18:54:59',NULL,'Riley Peterson'),(354,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"Triage review\",\"Date__293\":\"07\\/02\\/2019\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"9\",\"Multiple_Choice__301\":\"Ramsey\",\"Short_Answer__303\":\"Riley\",\"Short_Answer__304\":\"Taylor\",\"Date__305\":\"08\\/21\\/2014\",\"Date__306\":\"05\\/04\\/2019\",\"Multiple_Choice__308\":\"4 Years\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,81,'2021-05-26 19:33:23','2021-05-26 19:04:46',NULL,'Riley Taylor'),(355,22,92,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kristine Frick\",\"Short_Answer__292\":\"JoLynn Sundstrom\",\"Date__293\":\"03\\/04\\/2017\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"7\",\"Multiple_Choice__301\":\"Dakota\",\"Short_Answer__303\":\"Riley\",\"Short_Answer__304\":\"Vititoe\",\"Date__305\":\"01\\/04\\/2015\",\"Date__307\":\"02\\/13\\/2017\",\"Multiple_Choice__308\":\"2 Years\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Mother\'s boyfriend\",\"Multiple_Choice__316\":\"1\",\"Short_Answer__317\":\"While conducting a family assessment for neglect (inadequate supervision), additional signs of suspected abuse\\/neglect were noted to the 2 year old sibling child and a Child Protection report did not occur.\",\"Free_Text__318\":\"Debrief information\\u00e2\\u20ac\\u201c Local Rationality - Knowledge factors, strategic factors, and attentional dynamics\\r\\nThe worker received this family assessment assignment on a Friday, and felt the family assessment went as good as it could have. The worker works a four 10 hour shift (Tuesday-Friday) every week, with Monday off.  The worker\'s perception is that this was a routine assessment in that after assignment, he\\/she cross reported the case to law enforcement as Family Assessment workers always do per local agency norm. Law enforcement combines their investigative\\/assessment efforts with the worker depending on the allegation type, and\\/or if there is extensive historical law enforcement contacts with a given family, and\\/or if there are other safety risks posed to the worker. The worker noted the working relationship between his\\/herself and LE is good.\\r\\nThe worker did not anticipate LE would want to attend the home visit\\/initial face to face contact for this case as it was for neglect \\u00e2\\u20ac\\u201c inadequate supervision to 9 and 6 year olds.  Law enforcement did not join the FA worker for the initial contact with the family. There is a mutual understanding between this experienced (30 years) Family Assessment worker and local law enforcement. If the worker does not hear from Llaw enforcement after he\\/she makes the cross report, the worker moves forward without them - making meeting timelines a top priority. In some situations the worker will check in with them after making initial face to face upon their request to report any concerns. The worker noted an advantage of having experience working with local law enforcement as she knows the types of situations they typically want to jointly assess\\/investigate.   \\r\\nThe worker noted there is a 5 day expectation to meet face to face timelines for family assessments, but prefers to reach out by noon each day to schedule a time to meet with caregivers for each new report she receives. This worker prefers to make face to face contact as soon as possible for each report. This worker was able to connect with the mother and scheduled a time to meet at the home the afternoon of the same day the report was received. The worker noted the mother was not guarded, she was cooperative, answered her call and scheduled with her for the same day. The mother allowed her to come into the home, speak to the children, and observe the 2 year old\'s body without resisting the worker\'s request to do so. From the worker\'s years of experience, the mother was forthcoming with information and appeared genuine in her responses. The worker credits comforting approach of using a telephone call to present his\\/herself in a cordial manner when setting up a time to meet with the caregiver as being most helpful in gathering trustworthy information from caregivers.\\r\\nThe worker observed marks and bruises to the 2 year old and asked the mother about all of them.  There was a \\u00c2\\u00bd-inch scratch on his forehead and a 2-inch scratch mark on his back, which Mother said that he got it from his dad\'s when he was there on January 20th \\/ 21st and that he fell out of a high chair.  Mother didn\'t really know how he fell out, but he had the scratch mark when he returned to her care on the 21st.  The 2 year old also had a huge egg on his head. Father told the babysitter, that the subject child fell out of the high chair and his back fell onto a metal dry crate. Father told the mother that he fell out of the high chair. Mother is not going to allow the child to go to his father\'s home anymore because of this incident with the high chair.  \\r\\nThere was a quarter-sized bruise on the right side of his forehead and 1-inch scratch mark on the right side of his face. Mother did not know how he got those marks.  Subject child also had a quarter-sized and dime-sized bruise on the left side of his face.  Mother said that he got the dime-sized bruise on Tuesday or Wednesday when her live-in boyfriend gave the subject child a bath and he hit the soap dispenser when he kept trying to stand up in the bath.  \\r\\nSibling sister reported the subject child had fallen down the steps on Wednesday (two days prior) at supper time.  Sibling brother reported subject child \\u00e2\\u20ac\\u0153head butts\\u00e2\\u20ac\\u009d his sibling brother.    \\r\\nAs part of the safety assessment, the worker took photos of the marks and bruises observed on the 2 year old and uploaded them to the agency\'s electronic file system. Other professionals who have rights to the electronic file system can access the photos, and other \\u00e2\\u20ac\\u0153hard file\\u00e2\\u20ac\\u009d documents stored on the electronic file system. The agency does not have paper copied of \\u00e2\\u20ac\\u0153hard files\\u00e2\\u20ac\\u009d. The worker noted it is not always the practice norm to take photos of scratches\\/bruises.  He\\/she explained in this case, the scratches\\/bruises raised concern that he\\/she wanted to have them documented and saved for the safety assessment.   \\r\\nWhen considering the potential of possible abuse\\/neglect during an open family assessment, if the worker believes the level of injury meets criteria for a making a new allegation\\/CP report, the worker can consult with peers, his\\/her supervisor and\\/or the intake.  The worker will most often use supervisor consult first, and of it is then believed that potential for abuse\\/neglect meets criteria to make a CP report, the supervisor and worker will decide with intake if a new allegation warrants a new report. The worker did not feel the injuries warranted making a new Child Protection Report after asking the mother and siblings about the 2 year olds scratches\\/bruises. \\r\\nAlthough the worker noted caseload size depends on many variables, the timing of this Family Assessment came at a time when caseload sizes typically increase between February \\u00e2\\u20ac\\u201c April.  Yet, the worker indicated caseload size always feels manageable to him\\/her. There are 13 staff who take Family Assessment type cases. During these busier months of February \\u00e2\\u20ac\\u201c April it is not uncommon for FA workers to receive 8-12 new cases a month. \\r\\nWhen the allegation of physical abuse for the 2 year old child came into Child Protection during the open Family Assessment, this had the most significant impact on his\\/her work.  The Family Assessment work with the family ended sooner than the 45 day timeframe, since the investigation into the near fatal injury to the 2 year old took precedence. The worker consulted with his\\/her supervisor and completed dictating her contacts for the case so the dictations could be sent in for transcription.   \\r\\nContact with non-custodial parents who do not reside in the same home as the child is guided by a County Attorney\'s Office protocol.  The protocol recommends the family assessment worker make contact with the alleged perpetrator, and non-custodial parents of identified victim children in the family assessment because they have the right to know about allegations. There is an exception for some domestic violence situations, but in this case the mother was compliant with providing the names and contact information about all the children\'s fathers. \\r\\nIt is important to note that the 2 year old child observed to have scratches and bruises was not an alleged victim of the Family Assessment allegation of neglect\\u00e2\\u20ac\\u201c inadequate supervision.\",\"Free_Text__319\":\"A Child protection family assessment response to the family\'s home was conducted regarding allegations of neglect (inadequate supervision) involving the two older children. Staff focused attention on the older children and the neglect allegation during the initial face to face home visit.  The staff also focused attention on assessing immediate threats to safety and risk of maltreatment to  all the children during the initial contact with the family. During the initial safety and risk assessment, the staff observed and documented the marks and bruises on the 2 year old. The staff also took photos of the injuries and uploaded them to the case file as part of the staff\'s ongoing safety and risk assessments under the open family assessment. The older children and mother provided explanations of how the two year old child received the injuries, which were perceived by the staff as being accidental in nature, and as not occurring in the mother\'s home. The staff perceived the mother\'s demeanor to be non\\u00e2\\u20ac\\u0090defensive and willing to engage with the worker\'s requests. The mother\'s protective capacities were assessed and determined to be protective, as the mother verbalized a safety plan regarding the two year old sibling child. The mother was deemed to be a safe caregiver with no immediate danger or safety risk present in her home following the initial face to face home visit. The totality of the information learned in real time by the staff, influenced the staff to not make a child protection report regarding the 2 year olds injuries.\\r\\nThe staff\'s many years of experience working in child welfare, along with, interpretation of statute and exercising ethical professional judgement about when mandated reporting is required, influenced the staff to not make a new report. Guided  MN statute 626.556 Reporting of Maltreatment of Minors definitions of \\u00e2\\u20ac\\u02dcAccidental\', \\u00e2\\u20ac\\u02dcNeglect\', \\u00e2\\u20ac\\u02dcPhysical Abuse\', and \\u00e2\\u20ac\\u02dcThreatened Injury\', along with 626.556 Subd. 3 \\u00e2\\u20ac\\u02dcPersons mandated to report; persons voluntarily report\', contributed to the staff\'s interpretation of the threshold to report or not report.. Knowledge factors accessed and available to the staff at the time influenced the staff\'s perception regarding not meeting the statutory definitions; the staff did not have \\u00e2\\u20ac\\u0153a reason to believe\\u00e2\\u20ac\\u009d that the 2 year old was a new victim, as that the marks\\/bruises on the 2 year old child were not perceived as being a result of suspected maltreatment based on the explanations provided by the mother and older children corroborating statements about the marks\\/bruises\' accidental nature.\\r\\nFurthermore, obtaining knowledge by using proven engagement strategies from experience, including not having law enforcement present during the initial face to face home visit, was the staff\'s priority using the family assessment approach. The staff\'s ability to gather credible information in order to assess safety and risk, in addition to the family\'s strengths and needs, was perceived as more successful when law enforcement was not present, and shaped the staff\'s mental model around credibility of the information the staff learned at the time. \\r\\n\\tAssessing initial safety and risk without law enforcement present in this case enabled the staff to remain involved with the family, and to operate under the presumption that continued monitoring of safety and risk would occur, as the mother was compliant and was willing to cooperate with the staff\'s requests during the initial home visit. The staff also prioritized using the least invasive approach and least restrictive intervention with the family, which also contributed to the staff\'s decision not to make a new CP report. The staff did not believe there was a need to control for an immediate safety threat, as the marks\\/bruises observed on the 2 year old child did not meet the burden of proof as defined in state statute at that moment in time.  The staff considered needing more time to understand the full extent of the circumstances, and that future work with the family would expose any potential safety and risk to the children while the staff continued work under the open family assessment.\",\"Multiple_Choice__346\":\"3\",\"Free_Text__347\":\"1.) The staff\'s decision not to make a new report after observation of marks\\/bruises on the 2 year old child was influenced by the staff\'s many years of experience working FA response cases, and the staff\'s perception that the marks\\/bruises did not rise to the level of making a new CP report . \\r\\n\\r\\n2.) Guided by the staff\'s interpretation of 626.556 Reporting of Maltreatment of Minors definitions of \\u00e2\\u20ac\\u02dcAccidental\', \\u00e2\\u20ac\\u02dcNeglect\', \\u00e2\\u20ac\\u02dcPhysical Abuse\', and \\u00e2\\u20ac\\u02dcThreatened Injury\', along with 626.556 Subd. 3 \\u00e2\\u20ac\\u02dcPersons mandated to report; persons voluntarily report\', contributed to the staff\'s interpretation of the threshold to report or not report.  The staff\'s many years of experience working in child welfare, along with exercising ethical professional judgement about when mandated reporting is required influenced the staff to not make a new report. The staff did not have a reason to believe new allegations and\\/or a new victim child existed based on the information known at the time.  \\r\\n3.)The family assessment response to the family\'s home was regarding allegations of neglect (inadequate supervision) involving the two older children, which the staff focused attention on during the initial face to face. The staff also focused attention on assessing immediate safety and future risk of maltreatment of all the children during the initial contact with the family. The staff observed and documented the marks and bruises on the 2 year old. The staff also took photos of the injuries and uploaded them to the case file as part of the staff\'s ongoing safety and risk assessments under the open family assessment.\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"1\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"3\",\"Free_Text__359\":\"1.) Staff worked to balance FA engagement approach with the family and meeting the FA response timeline within 5 days. Scheduling the initial contact with the children and family was top priority for the staff, as best family assessment guidance requires staff to schedule with caregivers prior to making an unexpected home visit. The staff\'s mental model shaped by past experience woking family assessments is to complete scheduling home visits for new reports as soon as possible in order to meet the pressure of 5 day initial face to face timeline.\\r\\n\\r\\n2.)Guided by the staff\'s interpretation of 626.556 Reporting of Maltreatment of Minors definitions of \\u00e2\\u20ac\\u02dcAccidental\', \\u00e2\\u20ac\\u02dcNeglect\', \\u00e2\\u20ac\\u02dcPhysical Abuse\', and \\u00e2\\u20ac\\u02dcThreatened Injury\', along with 626.556 Subd. 3 \\u00e2\\u20ac\\u02dcPersons mandated to report; persons voluntarily report\', contributed to the staff\'s interpretation of the threshold to report or not report.  The staff\'s many years of experience working in child welfare, along with exercising ethical professional judgement about when mandated reporting is required influenced the staff to not make a new report. The staff did not have a reason to believe new allegations and\\/or a new victim child existed based on the information known at the time.\",\"Multiple_Choice__360\":\"1\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"3\",\"Free_Text__367\":\"Using engagement strategies to access the family and build working relationships in order to assess the family\'s strengths and needs, without law enforcement present, was a successful practice that enabled the staff to remain involved with the family to continue monitoring for risk to safety using least restrictive intervention.  The staff prioritized using the family assessment engagement protocol with the mother by calling the mother first to schedule a time that worked to meet and avoiding the need to make an unexpected home visit to meet the 5 day face to face timeline. Scheduling initial face to face home visits for newly assigned reports -as soon as possible- was a practice norm that the staff had developed to balance best FA practice while also successfully meeting the day response timeline. Furthermore, the staff was able to schedule and meet with the family in the same day, which was a Friday, and the staff also had the following Monday off work.  The staff cross reported the report to law enforcement, and responded under the presumption that law enforcement would not join in the initial face to face for an allegation of neglect, and to facilitate best engagement for a working relationship with the client.\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,92,81,'2021-05-26 19:33:23','2021-05-26 19:05:34',NULL,'Riley Vititoe'),(356,22,92,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kristine Frick\",\"Short_Answer__292\":\"Meg Carriveau\",\"Date__293\":\"10\\/25\\/2017\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"8\",\"Multiple_Choice__301\":\"Hennepin\",\"Short_Answer__303\":\"Robert\",\"Short_Answer__304\":\"McClendon Jr.\",\"Date__305\":\"01\\/13\\/2017\",\"Date__306\":\"05\\/17\\/2017\",\"Multiple_Choice__308\":\"4 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__316\":\"4\",\"Short_Answer__317\":\"No Documentation of interview being offered with the alleged father in the CP FA\",\"Free_Text__318\":\"The father was upset about CP involvement and controlling.  The mother informed the worker that the father was aware of the worker\'s request to meet on 1\\/18.  The worker\'s contact information was provided to the mother to give to the father, and the mother advised she would give the card to him, but he would decide if he wanted to contact the worker or not. The worker recalled the father to be involved, but controlling.  The mother indicated the alleged father signed recognition of parentage and the birth certificate for the subject child. Typical practice when a father is willing to engage with the worker, is for the worker to encourage him to meet so the worker can explain how to establish his rights as the father.\",\"Short_Answer__320\":\"Child Protection Family Assessment case used face to face contacts from prior Child welfare case.\",\"Free_Text__321\":\"Case was open as child welfare assessment on 12\\/20\\/2016 for prenatal exposure concerns to unborn child. CW assessment was reassigned to new worker on 01\\/17\\/2017 due to previous worker out on extended leave.  (Previous worker had made face to face contact with mother in December).  Worker uses an engagement approach during the child welfare assessment prior to baby\'s birth to build rapport and offer services for the mother. Also gather\'s names of relatives for future reference if needed. Worker did not identify risk to any sibling children and did not note significant history for the mother or father. \\r\\n\\r\\nChild was born on 01\\/13\\/2017. Face to face observation of the subject child and interview with the mother occurred. PSOP services were discussed on 1\\/18.  \\r\\nMultiple attempts to reach hospital social worker occurred on 1\\/18, 1\\/26, and 1\\/30. On 1\\/30, reached the hospital social worker, and learned the mother tested positive for THC, no other illicit drugs. Worker make new CP report when learned mother tested positive for THC. \\r\\n1\\/30\\/2017 \\u00e2\\u20ac\\u201c Family Assessment opened and case notes for face to face contacts were documented from previous work with the mother and observation of the child on 1\\/18 face to face during the child welfare assessment. Meconium for subject child was not screened. Hospital did not make new report to Child Protection about the birth of the baby and the mother testing positive for THC at time of child\'s birth. The CW Assessment completed and closed on 2\\/21\\/2017. \\r\\n\\r\\nIt is common practice for an open child welfare assessment for prenatal exposure to close and open as a family assessment at time of child\'s birth (depending on results of mother and newborns tox screens). For this case the mother tested positive for THC and child\'s meconium was not tested, so opening family assessment is common procedure, noting that the hospital hadn\'t reported either. The mother was cooperative, and was aware of the expectations from the child welfare assessment. It made sense to the worker to use the previous contacts given the flow of the already opened CW Assessment and opening of the FA assessment.\",\"Short_Answer__323\":\"Documentation of numerous attempts made, and a significant amount of time spent, accessing medical record from the local hospital.\",\"Free_Text__324\":\"The decision to determine maltreatment, (or not), was dependent on context included within a specific medical record regarding a doctor appointment day prior to child\'s death.   \\r\\n\\r\\nIt was learned that it took multiple contacts and a lot of persistence to receive the medical record needed. Investigations writes request via County Letterhead, including the statute which allows them access to medical records during an open CP investigation. The amount of time spent trying to access the records is somewhat how operations typically go between the hospital and child protection investigations, but this particular case it created significant concern due to the amount of time spent waiting on getting the information needed. The ME report typically takes 2-3 months to receive for child death cases and this occurred for this investigation.\\r\\n\\r\\nThe medical records department follows a strict procedure of releasing only exact date and clinic location where care received for an individual.  The information requested is included on County Letterhead, with the Statute allowing investigations access to the child\'s records. A release of information is not needed, but if specific date or location is not known where child received medical care, the information will not be included just by providing a child\'s name. It is not possible to request all records without including dates, so if there was a discrepancy in exact date, or an exact location where care was received, this becomes problematic. Ultimately, the decision to find maltreatment was delayed due to amount of time it took to obtain access to the specific medical record that was needed to inform preponderance of evidence to use in determining maltreatment.\\r\\nTimeline: \\r\\n9\\/6\\/2017 -Consult occurred with upper management about next steps for the investigation and if preponderance of evidence met or not met. Need medical records to understand context of parents\' awareness and education of risk to their infant.\\r\\n9\\/7\\/2017- Requested medical records\\r\\n9\\/12\\/2017 -Follow up call to medical records department. Request for records is being processed. Medical records department cannot fax medical records due to protected health information. They can mail them when ready. \\r\\n9\\/12\\/2017 \\u00e2\\u20ac\\u201c Collateral hospital social worker contact informs about a different clinic and resident provider who saw the subject child. Social worker could not release the record, but shared verbally the context of what education and directives were given to the caregivers by the doctor.  \\r\\n10\\/2\\/2017 -Follow up call to medical records department. Medical records included 600+ pages of medical records information and were mailed on 9\\/21\\/2017. \\r\\n10\\/6\\/2017 \\u00e2\\u20ac\\u201c Receipt of 600+ pages of medical records information; Consultation with supervisor regarding medical documentation not including needed medical note from doctor appointment. New request sent back to medical records department at local hospital. \\r\\n10\\/13\\/2017 \\u00e2\\u20ac\\u201c Worker walk to local hospital and hand delivered a written request for medical note for subject child\'s doctor appointment that took place at the specific location on the specific date. The records personnel reported they do not provide documentation in hand, but was able to print off the medical notes and provided to the worker. Department was waiting on the medical notes from doctor appointment to determine whether to make maltreatment finding or not. It was dependent on what was included in the context of the medical appointment note.\",\"Free_Text__325\":\"Debrief only\\/ No Map\\/ Mapping team decision to score this area of learning using the systems analysis tool.\",\"Short_Answer__326\":\"Case referred to PSOP case management rather than family assessment case management\",\"Free_Text__327\":\"Consult with CP Supervisor determined to close the family assessment and make a referral to PSOP. Cases that involve just THC, most likely won\'t open to field, and they may or may not open to PSOP.  \\r\\nThere was an internal protocol to follow about making the PSOP referral at that time which the worker completed. PSOP was a contracted service through a community agency.\",\"Free_Text__328\":\"Debrief only\\/ No Map\\/ Mapping team decide to score this area of learning using the systems analysis tool.\",\"Multiple_Choice__368\":\"2\",\"Free_Text__369\":\"LP3: Documentation of numerous attempts and a significant amount of time being spent to access medical records from the local hospital, which delayed a decision about maltreatment. \\r\\nIt took CP worker multiple contacts and a lot of persistence to receive the medical record needed.  Investigations writes request via County Letterhead, included in the context of the Letter is the statute which allows them access to medical records during an open CP investigation. The amount of time that was spent trying to access the records was somewhat typical, but it does not support the work CP is trying to achieve, especially for this particular case, the time spent trying to obtain the medical records created a barrier, and caused delay in CP investigator being able to make a maltreatment determination. A significant amount of time was spent waiting on getting the information needed. The hospital\'s medical records department follows a strict procedure of releasing only exact date and clinic location where care received for an individual. The information requested is included on County Letterhead, with the Statute allowing investigations access to the child\'s records. A release of information is not needed, But if specific date or location is not known where child received medical care, the information will not be included just by providing a child\'s name. It is not possible to request all records without including dates, so if there was a discrepancy in exact date, or an exact location where care was received, this becomes problematic. Ultimately, the decision to find maltreatment was delayed due to amount of time it took to obtain access to the specific medical records needed to inform preponderance of evidence.\",\"Multiple_Choice__358\":\"2\",\"Free_Text__359\":\"Unsafe sleep critical incident. Maltreatment determined for Neglect - Inadequate supervision to subject child by the alleged father.\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,92,81,'2021-05-26 19:33:23','2021-05-26 19:06:15',NULL,'Robert McClendon Jr'),(357,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"Jess VanKuyk\",\"Date__293\":\"09\\/01\\/2019\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"9\",\"Multiple_Choice__301\":\"Ramsey\",\"Short_Answer__303\":\"Marietta\",\"Short_Answer__304\":\"Rudolph\",\"Date__305\":\"05\\/28\\/2018\",\"Date__306\":\"12\\/18\\/2018\",\"Multiple_Choice__308\":\"6 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,81,'2021-05-26 19:33:23','2021-05-26 20:16:59',NULL,'Rudolph, Marietta'),(358,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Triage Team\",\"Date__293\":\"05\\/07\\/2018\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"6\",\"Multiple_Choice__301\":\"Rice\",\"Short_Answer__303\":\"Safwan\",\"Short_Answer__304\":\"Ali\",\"Date__305\":\"03\\/04\\/2014\",\"Date__307\":\"03\\/06\\/2018\",\"Multiple_Choice__308\":\"4 Years\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Friend\\/Neighbor\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,81,'2021-05-26 19:33:23','2021-05-26 20:17:49',NULL,'Safwan Ali'),(359,22,84,NULL,13,NULL,NULL,NULL,NULL,0,1,84,84,'2021-05-26 19:33:23','2021-05-26 20:18:51',NULL,'Samuel Olsen'),(360,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Tracy Nielsen\",\"Date__293\":\"06\\/26\\/2019\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"4\",\"Multiple_Choice__301\":\"Sherburne\",\"Short_Answer__303\":\"Spencer\",\"Short_Answer__304\":\"Parker\",\"Date__305\":\"04\\/08\\/2018\",\"Date__306\":\"04\\/15\\/2019\",\"Multiple_Choice__308\":\"1 Year\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,81,'2021-05-26 19:33:23','2021-05-26 20:19:02',NULL,'Spencer Parker'),(361,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Jennifer Carlson\",\"Date__293\":\"12\\/18\\/2017\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"8\",\"Multiple_Choice__301\":\"Hennepin\",\"Short_Answer__303\":\"Staci\",\"Short_Answer__304\":\"Bowdry\",\"Date__305\":\"12\\/02\\/2017\",\"Date__306\":\"12\\/18\\/2017\",\"Multiple_Choice__308\":\"<1 Month\",\"Multiple_Choice__309\":\"2\",\"Short_Answer__310\":\"Mother\",\"Short_Answer__311\":\"Father\",\"Multiple_Choice__316\":\"1\",\"Short_Answer__317\":\"Information in case record documents that maltreatment was determined, however no maltreatment determination was made\",\"Free_Text__318\":\"Debriefed worker indicated that this was the first case that she had ever worked on her own. She had recently moved from the Induction Unit to the Assessment Unit and had shadowed a fellow worker for 1-2 months prior to working a case solo (she previously worked in probation). She reported that in the Induction Unit, the training is focused on Field case work (case management) and does not train on how to complete assessments\\/investigations. She reported that this was the only case she had on her caseload at that time and that there was sufficient information to find maltreatment determinations on the child\'s father and uncle. Maltreatment determinations are always staffed with supervisors and both the worker and the supervisor agreed that the determinations were appropriate; additionally stating that supervision is \\u00e2\\u20ac\\u0153always available.\\u00e2\\u20ac\\u009d The worker went on to share that while her intentions were to click \\u00e2\\u20ac\\u0153yes\\u00e2\\u20ac\\u009d in SSIS to indicate maltreatment was found, she clicked \\u00e2\\u20ac\\u0153no\\u00e2\\u20ac\\u009d instead. As a result of clicking \\u00e2\\u20ac\\u0153no\\u00e2\\u20ac\\u009d, SSIS generated a Notice of Determination (NOD) letter that stated that maltreatment did not occur. When this document is generated by the SSIS system, the only thing a worker must do is put in the allegation detail and the final letter is created. She indicated that these letters do not have a redundancy that the FA letters do, as they have you click additional times to specify whether ongoing services for the family are indicated.\",\"Free_Text__319\":\"The agency documenting that maltreatment was determined however no formal maltreatment determination being made was influenced by multiple systemic contributions. These included the worker being new to the position, supervisor availability, external pressure and accessibility to training. The agency was experiencing high ongoing worker caseloads and subsequently, high worker turnover due to work demands. This turnover and available openings in field unit influenced the agency to make field-related case work a priority in the Induction Unit (training unit for new staff). As a result of this emphasis, Induction Unit staff did not receive specialized training on how to conduct investigations. This was the worker\'s first solo investigation case after leaving the Induction Unit. The worker also hadn\'t completed Foundations Training where a more comprehensive training on completing investigations occurs. Circumstances around the time of the Governor\'s Task force influenced long waitlist for Foundations Training. Not being able to attend Foundation Training as a result of the waitlist further impacted the worker\'s unfamiliarity with the investigations process. \\r\\n\\r\\nOnce investigations are completed, there was a process in the agency where cases needed to be reviewed by supervisors to ensure the case was completed accurately. This process was delayed as supervisors also had competing demands. They were balancing meetings and committee attendance with supervision and consultation for staff. This resulted in less time for supervisors to engage in case compliance\\/oversight.\\r\\n\\r\\nDuring this time, the Governor\'s Task Force had recently made many recommendations regarding CW (child welfare) practice in the State. These recommendations, including new intake screening guidelines, resulted in more cases being screened in and additional media attention and community group scrutiny on the CW system. This, coupled with the Federal CFSR and subsequent PIP\'s, put pressure on managers and supervisors to implement change. This pressure was then overtly put on the worker completing the investigation to be more efficient.\\r\\n\\r\\nWith the agency staff being new to the CW system, the worker had minimal familiarity with the SSIS system and had only one day of training on the use of SSIS. The unfamiliarity with the system led to the staff making the assumption that she had clicked \\u00e2\\u20ac\\u0153yes\\u00e2\\u20ac\\u009d that maltreatment was determined.  The worker shared that her intentions were to click \\u00e2\\u20ac\\u0153yes\\u00e2\\u20ac\\u009d in SSIS to indicate maltreatment was found; however, she clicked \\u00e2\\u20ac\\u0153no\\u00e2\\u20ac\\u009d instead. As a result of clicking \\u00e2\\u20ac\\u0153no\\u00e2\\u20ac\\u009d, SSIS generated a Notice of Determination (NOD) letter that stated that maltreatment did not occur. When this document is generated by the SSIS system, the only thing a worker must do is put in the allegation detail and the final letter is created.\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"2\",\"Free_Text__349\":\"The agency was experiencing high ongoing worker caseloads and subsequently, high worker turnover due to work demands.\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"3\",\"Free_Text__357\":\"This turnover and available openings in field unit influenced the agency to make field-related case work a priority in the Induction Unit (training unit for new staff). As a result of this emphasis, Induction Unit staff did not receive specialized training on how to conduct investigations. \\r\\n\\r\\nThe worker also hadn\'t completed Foundations Training where a more comprehensive training on completing investigations occurs. \\r\\n\\r\\nNot being able to attend Foundation Training as a result of the waitlist further impacted the worker\'s unfamiliarity with the investigations process. \\r\\n\\r\\nWith the agency staff being new to the CW system, the worker had minimal familiarity with the SSIS system and had only one day of training on the use of SSIS. The unfamiliarity with the system led to the staff making the assumption that she had clicked \\u00e2\\u20ac\\u0153yes\\u00e2\\u20ac\\u009d that maltreatment was determined.\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"1\",\"Multiple_Choice__360\":\"2\",\"Free_Text__361\":\"Once investigations are completed, there was a process in the agency where cases needed to be reviewed by supervisors to ensure the case was completed accurately. This process was delayed as supervisors also had competing demands. They were balancing meetings and committee attendance with supervision and consultation for staff. This resulted in less time for supervisors to engage in case compliance\\/oversight.\\r\\n\\r\\nThis, coupled with the Federal CFSR and subsequent PIP\'s, put pressure on managers and supervisors to implement change. This pressure was then overtly put on the worker completing the investigation to be more efficient.\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"2\",\"Free_Text__365\":\"Once investigations are completed, there was a process in the agency where cases needed to be reviewed by supervisors to ensure the case was completed accurately. This process was delayed as supervisors also had competing demands. They were balancing meetings and committee attendance with supervision and consultation for staff. This resulted in less time for supervisors to engage in case compliance\\/oversight.\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,81,'2021-05-26 19:33:23','2021-05-26 20:19:41',NULL,'Staci Bowdry'),(362,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"Tracy Nielson\",\"Date__293\":\"08\\/02\\/2016\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"6\",\"Multiple_Choice__301\":\"Goodhue\",\"Short_Answer__303\":\"Sunni\",\"Short_Answer__304\":\"Betzold\",\"Date__305\":\"06\\/20\\/2015\",\"Date__307\":\"05\\/20\\/2016\",\"Multiple_Choice__308\":\"10 Months\",\"Multiple_Choice__309\":\"2\",\"Short_Answer__310\":\"Mother\",\"Short_Answer__311\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"2\",\"Free_Text__355\":\"The hospital reported the near fatality to the local agency 5 days after the incident occurred.  The report being made 5 days after the incident occurred impacted the agency\'s ability to ensure immediate safety of the subject child and the surviving siblings.\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,81,'2021-05-26 19:33:23','2021-05-26 20:20:21',NULL,'Sunni Betzold');
INSERT INTO `reports` VALUES (363,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Jennifer Carlson\",\"Date__293\":\"09\\/08\\/2016\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Short_Answer__297\":\"Unlicensed\",\"Yes_or_No__298\":\"Yes\",\"Multiple_Choice__299\":\"Unlicensed\",\"Multiple_Choice__300\":\"9\",\"Multiple_Choice__301\":\"Ramsey\",\"Short_Answer__303\":\"Susannah\",\"Short_Answer__304\":\"Crider\",\"Date__305\":\"01\\/22\\/2016\",\"Date__306\":\"08\\/08\\/2016\",\"Multiple_Choice__308\":\"7 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Caregiver\",\"Multiple_Choice__316\":\"1\",\"Short_Answer__317\":\"Cross report of incident from Law Enforcement (LE) to Child Protective Services (CPS) did not occur\",\"Free_Text__318\":\"No debrief occurred on this LP due to the LP being outside the CW system\",\"Free_Text__319\":\"Law Enforcement (LE) not cross reporting to CPS after the critical incident was influenced by the unique processes and role of LE, access to mandated reporter training and circumstances regarding the incident. LE shared that child\'s condition was initially called out as a medical concern and after being notified by hospital staff that they were unsuccessful in life-saving efforts, the case became a child death investigation. When this occurs, this becomes the priority for the LE agency and the focus becomes finding justice, not the more nuanced job duties such as cross-reporting that are much lower priority. Additionally, there are organizational processes within LE regarding cross-reports being made. The process typically goes through several staff (i.e., officer to sergeant to administrative support staff) in order to get the cross-report made. The LE agency\'s administration makes the final determination on whether to cross-report to CPS. Since this reporting process starts with the responding officer(s), the officer\'s perception of the situation also influences whether a cross-report is made. In this case, the officer was unsure of the origin of the child\'s injuries (appeared to be an accident), the child was not being cared for by a parent at the time of the incident and the officer did not want to cause additional trauma to the family by potentially initiating a CPS response by cross-reporting in error. All circumstances that impacted a CP report being made. Also, it was believed by LE that they had mitigated risk to other children by informing the families not to bring their kids back to the unlicensed daycare. Furthermore, unlicensed daycare homes such as this one receive less oversight and direction by the state for when incidents like this one occur. For example, there is not a requirement to notify CPS or licensing of the critical incident. As a result, this limited oversight further impacts reports not being made when incidents occur in unlicensed daycare homes.  \\r\\n\\r\\nFurther impacting cross-reporting not occurring are the complexities of how\\/when to report suspected child abuse and neglect as well as general access to that mandated reporter training to accurately understand reporting requirements. Also, nuances in the mandated reporter statute (MN statute 626.556) results in a lack of clarity in mandated reporting rules creating inconsistent reporting practices. This, coupled with accessibility to training, impacts cross-reporting to CPS. Additionally, local CPS agencies provide the mandated reporter training to local partners when it is requested. Due to the need to complete daily CPS duties, the added requirement to provide mandated reporter training creates additional demands on local agencies. Since agencies do not have the resources to provide the mandated reporter training it is difficult to provide any type of ongoing training for those local partners. \\r\\n\\r\\nAdditionally in these cases, the demographics of families, and biases associated with those demographics, may result in cross-reports not being made. In this case, other mandated reporters, such as hospital and medical examiner\'s office, also did not cross-report the child\'s condition to CPS.\",\"Multiple_Choice__346\":\"3\",\"Free_Text__347\":\"Since this reporting process starts with the responding officer(s), the officer\'s perception of the situation also influences whether a cross-report is made. In this case, the officer was unsure of the origin of the child\'s injuries (appeared to be an accident), the child was not being cared for by a parent at the time of the incident and the officer did not want to cause additional trauma to the family by potentially initiating a CPS response by cross-reporting in error.\",\"Multiple_Choice__348\":\"2\",\"Free_Text__349\":\"local CPS agencies provide the mandated reporter training to local partners when it is requested. Due to the need to complete daily CPS duties, the added requirement to provide mandated reporter training creates additional demands on local agencies. Since agencies do not have the resources to provide the mandated reporter training it is difficult to provide any type of ongoing training for those local partners.\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"2\",\"Free_Text__355\":\"there are organizational processes within LE regarding cross-reports being made. The process typically goes through several staff (i.e., officer to sergeant to administrative support staff) in order to get the cross-report made. The LE agency\'s administration makes the final determination on whether to cross-report to CPS\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"2\",\"Free_Text__359\":\"unlicensed daycare homes such as this one receive less oversight and direction by the state for when incidents like this one occur. For example, there is not a requirement to notify CPS or licensing of the critical incident. \\r\\n\\r\\nnuances in the mandated reporter statute (MN statute 626.556) results in a lack of clarity in mandated reporting rules creating inconsistent reporting practices.\",\"Multiple_Choice__360\":\"2\",\"Free_Text__361\":\"Law Enforcement (LE) not cross reporting to CPS after the critical incident was influenced by the unique processes and role of LE, access to mandated reporter training and circumstances regarding the incident. LE shared that child\'s condition was initially called out as a medical concern and after being notified by hospital staff that they were unsuccessful in life-saving efforts, the case became a child death investigation. When this occurs, this becomes the priority for the LE agency and the focus becomes finding justice, not the more nuanced job duties such as cross-reporting that are much lower priority.\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,71,'2021-05-26 19:33:23','2021-06-01 19:08:02',NULL,'Susannah Crider'),(364,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Triage Team\",\"Date__293\":\"01\\/11\\/2019\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"8\",\"Multiple_Choice__301\":\"Hennepin\",\"Short_Answer__303\":\"Sylas\",\"Short_Answer__304\":\"Farnsworth\",\"Date__305\":\"08\\/31\\/2018\",\"Date__306\":\"10\\/30\\/2018\",\"Multiple_Choice__308\":\"2 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,81,'2021-05-26 19:33:23','2021-05-26 18:51:47',NULL,'Sylas Farnsworth'),(365,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"JoLynn Sundstrom\",\"Date__293\":\"03\\/13\\/2017\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"4\",\"Multiple_Choice__301\":\"Stearns\",\"Short_Answer__303\":\"Syncere\",\"Short_Answer__304\":\"Moore\",\"Date__305\":\"10\\/15\\/2015\",\"Date__306\":\"03\\/09\\/2016\",\"Multiple_Choice__308\":\"5 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Mother\",\"Multiple_Choice__316\":\"2\",\"Short_Answer__317\":\"1.\\tFace to face contact with alleged offender never occurred\",\"Free_Text__318\":\"The child protection investigator participated in the debriefing and shared the following information.\\r\\n\\r\\nAfter receiving intake of the child\'s fatality, the CP worker contacted LE to coordinate the investigation. CP worker indicated that at that time, he was asked to hold off on interviewing the child\'s mother. Due to the child\'s cousin\'s being present at the time of the child\'s death, the CP worker reached out to a neighboring Human Services Agency to connect with a worker that was working with that family. Safety of those children were assessed and ensured by that agency. In regards to coordination between CP and LE, the worker indicated that outside of this case, it usually occurs. The worker went on to state that there were multiple LE investigators on the case as there was a LE investigator that had established a relationship with the child\'s mother in the past and they were coordinating this between themselves. \\r\\n\\r\\nThe worker indicated that delays in finding maltreatment on the case was partially due to the inability to obtain the ME report. When LE obtained the report, he was informed by them that they were unsure if they could share the report with CP. The worker never made contact with the mother, however used the LE interview with her to complete his investigation. To his knowledge, LE had one interview with her and never made contact with her thereafter. It is believed that she left the state.\",\"Free_Text__319\":\"Face to face contact not occurring with the alleged offender was influenced by state statute 626.556 Subd. 10 (b)(5), and Admin Rule 9560.0220 Subp. 4 which allows the local agency to defer to law enforcement on making contact with an alleged offender during an open criminal investigation. As a result of this, the local agency honored law enforcement\'s request to delay the interview and face to face contact with the alleged offender in this case as to not interfere with the current criminal investigation.  \\r\\nFurthermore, the multiple tasks required by law enforcement during an investigation contributed to a lengthy investigation that delayed when law enforcement allowed the local agency to proceed with making face to face contact with the alleged offender. At the time the agency was allowed to make contact with the alleged offender, the offender was no longer available as a result of moving out of state; however, the agency made multiple attempts to contact the alleged offender prior to learning of their move out of state. \\r\\nAdditional contributing factors that further impacted the agency\'s decision to delay contact with the alleged offender included the local agency not being involved in law enforcement\'s multidisciplinary team (MDT) regarding the planning of this investigation. Local agencies are not typically part of law enforcement MDT\'s. Non-normative practices between the local agency and law enforcement further supported the alleged offender not being seen. Normative practice in these investigations would include coordination in conducting a joint interview and ongoing communication throughout the investigation.\",\"Short_Answer__320\":\"2.\\tPrevious concerns of the condition of the child\'s home not reported to child protection\",\"Free_Text__321\":\"No debriefing took place on this Learning Point.\",\"Free_Text__322\":\"The decision to not report the condition of the child\'s home was influenced by the public health worker\'s experience of child protection reports not being screened in after a report is made.  Further supporting the decision to not report the condition of the child\'s home was the public health worker\'s interpretation of state statute that governs mandated reporting for suspected child abuse and neglect. She did not believe that the conditions met the threshold to report. The public health worker\'s understanding of state statute was influenced by the subjective statutory language within 626.556 Subd. 3(a) that states \\u00e2\\u20ac\\u0153Has reason to believe\\u00e2\\u20ac\\u009d a child is being neglected and\\/or abused.\\r\\n\\r\\nThe public health worker\'s interpretation of state statute was impacted by their awareness of where to access available trainings within the agency. Quality and consistency of these trainings also varied, further supporting her reason to not seek them out. Per state statute, local agencies are responsible for providing mandated reporter training within their agency; however, multiple competing priorities, such as the need to get day-to-day work done to serve clients and to fulfill their job duties can make this statutory requirement burdensome for the local agency.\",\"Multiple_Choice__346\":\"3\",\"Free_Text__347\":\"Learning Point #2: Further supporting the decision to not report the condition of the child\'s home was the public health worker\'s interpretation of state statute that governs mandated reporting for suspected child abuse and neglect. She did not believe that the conditions met the threshold to report.\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"2\",\"Free_Text__355\":\"Learning Point #1: Additional contributing factors that further impacted the agency\'s decision to delay contact with the alleged offender included the local agency not being involved in law enforcement\'s multidisciplinary team (MDT) regarding the planning of this investigation.\",\"Multiple_Choice__356\":\"1\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"3\",\"Free_Text__359\":\"Learning Point #1: Face to face contact not occurring with the alleged offender was influenced by state statute 626.556 Subd. 10 (b)(5), and Admin Rule 9560.0220 Subp. 4 which allows the local agency to defer to law enforcement on making contact with an alleged offender during an open criminal investigation.\\r\\n\\r\\nLearning Point #2: The public health worker\'s understanding of state statute was influenced by the subjective statutory language within 626.556 Subd. 3(a) that states \\u00e2\\u20ac\\u0153Has reason to believe\\u00e2\\u20ac\\u009d a child is being neglected and\\/or abused.\",\"Multiple_Choice__360\":\"0\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,81,'2021-05-26 19:33:23','2021-05-26 18:51:07',NULL,'Syncere Moore'),(366,22,92,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kristine Frick\",\"Short_Answer__292\":\"Colette Roesler\",\"Date__293\":\"07\\/05\\/2017\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Short_Answer__297\":\"Licensed\",\"Yes_or_No__298\":\"Yes\",\"Multiple_Choice__299\":\"Licensed\",\"Multiple_Choice__300\":\"9\",\"Multiple_Choice__301\":\"Ramsey\",\"Short_Answer__303\":\"Talayia\",\"Short_Answer__304\":\"Sabillon-Suazo\",\"Date__305\":\"02\\/01\\/2017\",\"Date__306\":\"06\\/06\\/2017\",\"Multiple_Choice__308\":\"4 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Non-relative foster care provider\",\"Multiple_Choice__316\":\"2\",\"Short_Answer__317\":\"Screening of 2\\/3\\/2017 CP intake occurred beyond 24-hour timelines.\",\"Free_Text__318\":\"\\u00e2\\u20ac\\u00a2\\tToo many unknowns at the time the report was made \\r\\no\\tLimited knowledge at first, go off information had at the time, it was difficult to know because the mother used a false identity, and claimed to live in Wisconsin.\\r\\n\\u00e2\\u20ac\\u00a2\\tMother and Father were not honest about identity and home address at time the report was made, and attempted to mislead and confuse the CP Systems in WI and MN. \\r\\n\\u00e2\\u20ac\\u00a2\\tPrevious report was made on 2\\/1 that was screened out and referred to the jurisdiction the parents alleged as their home address in Wisconsin. \\r\\n\\u00e2\\u20ac\\u00a2\\tGetting the information back on 2\\/3 in a new CP Intake increased the suspicion of suspected child abuse and neglect; report was screened in. Worker believed it was timely screened, but also stated she gave to her supervisor who she had been consulting with about the intake information. \\r\\n\\u00e2\\u20ac\\u00a2\\tThe worker reported she would not have authority to make changes to information documented in the CP intake.\\r\\n\\u00e2\\u20ac\\u00a2\\tWisconsin do things differently than MN, no police holds. Ramsey County Intake requested to place infant on a hold, but WI Law enforcement does not place holds on children. \\r\\n\\u00e2\\u20ac\\u00a2\\tOnce the Child Maltreatment Report was screened in the investigator learned the mother\'s real identity and that information was used to make changes to the Child Maltreatment report; Mother\'s identity and previous TLC\'s\\/TPR was not known until after the CP investigation was opened\\r\\n\\u00e2\\u20ac\\u00a2\\tTPR look up in SSIS is not reliable\\r\\n\\u00e2\\u20ac\\u00a2\\tIdentifying people is not reliable in SSIS\\r\\n\\u00e2\\u20ac\\u00a2\\tIn Feb. 2017, there was pressure to complete screening within the allotted 24 hour timeframe, which the team of screeners prioritized. \\r\\n\\u00e2\\u20ac\\u00a2\\tWorker was not certain why SSIS shows 3 days in between the open and close date on the intake. It is not uncommon to gather information to see if the information meets criteria before closing the intake; but if the timeline is near the 24 hour mark, the report is screened with what information could be gathered.\\r\\n\\u00e2\\u20ac\\u00a2\\tMeeting the 24 hour screening timeline is priority, however it is one the worker does not believe increases safety, and can sometimes feel like it is in place to hold staff accountable versus trust the professionals doing the work; understandable to have checks and balances enmeshed in guidance though.  \\r\\n\\u00e2\\u20ac\\u00a2\\tThe worker did not know how the technical change of the mother\'s name was corrected in the SSIS system  \\r\\n\\u00e2\\u20ac\\u00a2\\tIt was presumed that the SSIS Helpdesk would have likely had to be involved because the SSIS CP Intakes would not be merged for an circumstance like this\\r\\n\\u00e2\\u20ac\\u00a2\\tPossible a new CP intake would have been created?\\r\\n\\u00e2\\u20ac\\u00a2\\tThe worker is one of 6 screeners who document all the intakes coming into Ramsey County and screen them as a team or with supervisor; they are also responsible for all calls that come in not related to child protection; The screeners do not have a support staff or receptionist to field calls.\",\"Free_Text__319\":\"The CP intake being screened beyond the 24-hour timelines was influenced by multiple states and jurisdictions being involved with the family.  The last known address for the family was in the State of Wisconsin; consequently, a CP report that came into the local agency in MN two days prior to the 2\\/3\\/2017 report was screened out and referred to Wisconsin\'s CP system.  When the 2\\/3\\/2017 report came in, the worker believed the report was screened in within the 24-hour timeline as she had consulted with her supervisor and gave the report to her.  Additionally, the parents did not provide current or correct information regarding their identity and home address, further contributing to the confusion as to who had jurisdiction over the CP intake.\\r\\n\\r\\nFurther influencing the screening of the CP intake occurring beyond the 24-hour timelines was the fact that the report came in on a Friday and the local agency does not have the ability to screen reports after regular business hours.  In addition to the report coming in on Friday, the worker\'s high caseload, coupled with the need to verify participants in the case and determine jurisdiction, added complexity to screening the report within the 24-hour timelines. Complicating factors included two states being involved, as well as the ambiguity of the family\'s home address, which further support the report not being screened timely.\\r\\n\\r\\nScreeners felt an added pressure to prioritize screening reports within 24-hour timelines in order to meet this metric.  Due to this added pressure, the worker was unclear as to why SSIS showed the report being screened outside of the 24-hour timelines.  Additionally, it is not uncommon for the screener to gather more information to see if the information meets criteria before closing the intake; however, if it is near the 24-hour timeline, normative practice is to screen the report with the information the screener has at the time.  Screeners are responsible for all calls that come into the agency, which include those that are not specific to child protection, placing additional responsibilities on the screeners.\",\"Short_Answer__320\":\"CP Intake made on June 7. 2017 for suspected neglect (inadequate supervision) regarding a licensing violation incident that occurred on May 2, 2017.\",\"Free_Text__321\":\"\\u00e2\\u20ac\\u00a2\\tIt was a chaotic environment that day, the 2 year old being outside unnoticed by the foster mother was circumstantial, isolated, and atypical.  \\r\\n\\u00e2\\u20ac\\u00a2\\tThe front door was observed to be left open for the delivery of a freezer multiple times after the foster mother had repeatedly closed it. The door had a chime alarm which was dismissed as the delivery professionals coming in and out of the door.\\r\\n\\u00e2\\u20ac\\u00a2\\tThe 2 year old was somewhat higher need; very active and impulsive with his behavior.\\r\\n\\u00e2\\u20ac\\u00a2\\tThe foster home had been licensed since 1999; Foster mother was reliable and resourceful. Had adopted children, had taken in many children as a Traditional placement option and as a Substitute shelter care placement option\\r\\n\\u00e2\\u20ac\\u00a2\\tNever had a violation in the past\\r\\n\\u00e2\\u20ac\\u00a2\\tFoster mother was an active in Ramsey County Training initiatives; Helping teach parents\\/supervising visitation for children and parents in her home\\r\\n\\u00e2\\u20ac\\u00a2\\tThe foster home was described as \\u00e2\\u20ac\\u0153one of Ramsey County\'s best\\u00e2\\u20ac\\u009d providers.  \\r\\n\\u00e2\\u20ac\\u00a2\\tMay 2 \\u00e2\\u20ac\\u201c Worker consulted with supervisor and colleagues about the child not being supervised at the moment when she approached the home.  A correction order was decided to be appropriate at that time; A CP intake\\/Child Maltreatment report was not made on May 2.  \\r\\n\\u00e2\\u20ac\\u00a2\\tTypical normative process would be for CP Program worker to collaborate with Lic Social Worker prior to the placement about the number of children and needs of all the children placed in the foster home at the time. \\r\\n\\u00e2\\u20ac\\u00a2\\tA shortage of foster home placement options places pressure on CP Program workers to find placement option for children, and would contact the foster provider directly asking if there was space for substitute shelter care. \\r\\n\\u00e2\\u20ac\\u00a2\\tThe pressure behind the needed placement would make the provider feel guilty, especially if mention of a \\u00e2\\u20ac\\u0153variance\\u00e2\\u20ac\\u009d was stated, she didn\'t like to say no.\\r\\n\\u00e2\\u20ac\\u00a2\\tPlacements for children with higher behavioral needs aren\'t meeting criteria of residential, or if they are there are wait lists; so many foster homes are managing high needs children with added supports \\r\\n\\u00e2\\u20ac\\u00a2\\tAfter hours placements would sometimes occur before the licensing worker was made aware. \\r\\n\\u00e2\\u20ac\\u00a2\\tLic worker believed the foster mother would\'ve felt obligated to keep trying to help the overwhelmed system with shortage of placement options, because she was committed to raising the foster kids.\\r\\n\\u00e2\\u20ac\\u00a2\\tFoster home\'s only violation\\/corrective action order was the May 2 corrective action order.\\r\\n\\u00e2\\u20ac\\u00a2\\tNot all corrective action orders are CP reports\\r\\n\\u00e2\\u20ac\\u00a2\\t Foster home was current on all trainings, and had just received SUID\\/Unsafe sleep training and abusive head trauma just prior to the child fatality incident. \\r\\n\\u00e2\\u20ac\\u00a2\\tThe child fatality was \\u00e2\\u20ac\\u0153unfortunate and shocking\\u00e2\\u20ac\\u009d; the lic worker was out on medical leave when she learned of the child\'s death.\",\"Free_Text__322\":\"A CP report made on June 7, 2017, for suspected neglect regarding a licensing violation incident that occurred on May 2, 2017 was influenced a local agency response using defensive practice, as the critical incident occurred on June 6, 2017. At the time of the licensing violation on May 2, prior to the critical incident, the local agency made the decision to issue a correction order to the foster home rather than make a CP intake report for suspected neglect. The decision to not make a CP report was made through consultation between the worker, colleagues, and a supervisor. Supporting the consultation between agency staff was the belief that not every licensing violation is a CP report, as well as, the perception that the CP system would be inundated if every incident was reported.  \\r\\n\\r\\nFurther supporting a CP report being made on June 7, 2017 for an incident that occurred on May 2, 2017 was the fact that the foster mother reported that she was having a freezer delivered that day and the delivery people were coming in and out of the house, making the door alarm go off each time. The foster mother did shut the door behind the delivery people when it was left open as they went in and out. At the time, she was also vacuuming the house to get ready for the foster child\'s parents to come for a visit. Given this information, the staff\'s perception was that the safety risk did not reach the threshold of needing to make a CP report, and the child escaping outside when the door was left open was considered to be accidental in nature.\\r\\n\\r\\nAdditionally, the worker was new and was still learning the process of making a CP report.  This was also influenced by the guidance and interpretation of the guidance in regards to making a CP report.  Overarching this was the foster care licensing statute which supported a consult between the licensing social worker and a CP screener to discuss an incident and determine what action needed to be taken.  Normative practice for when these consultations occur is for the information to be documented on a form, rather than documenting it in SSIS.\",\"Multiple_Choice__346\":\"2\",\"Free_Text__347\":\"LP1: The supervisor supported the staff by taking the 2\\/3\\/2017 CP intake off the staff\'s workload and the staff believed the report was screened timely within the 24 hour timeline. \\r\\nLP2: Supporting the consultation between agency staff was the belief that not every licensing violation is a CP report, as well as, the perception that the CP system would be inundated if every incident was reported.  \\r\\nFurther supporting a CP report being made on June 7, 2017 for an incident that occurred on May 2, 2017 was the fact that the foster mother reported that she was having a freezer delivered that day and the delivery people were coming in and out of the house, making the door alarm go off each time. The foster mother did shut the door behind the delivery people when it was left open as they went in and out. At the time, she was also vacuuming the house to get ready for the foster child\'s parents to come for a visit. Given this information, the staff\'s perception was that the safety risk did not reach the threshold of needing to make a CP report, and the child escaping outside when the door was left open was considered to be accidental in nature.\",\"Multiple_Choice__348\":\"2\",\"Free_Text__349\":\"LP1: The CP intake being screened beyond the 24-hour timeline was influenced by jurisdictional complexity in this case. There were multiple states and several county jurisdictions identified as having responsibility to serve the family. Further adding to the jurisdictional complexity was the fact that the parents did not provide current or correct information regarding their identities and home address. This contributed to the confusion as to who had jurisdiction over the CP intake, and subsequently it took the agency more than 24 hours to decipher the facts before the agency was able to screen in the 2\\/3\\/2017 CP intake. \\r\\nThe agency had knowledge of the family, as a CP intake had been reported to the local agency on 2\\/1\\/2017, which was screened out and referred to Wisconsin\'s CP system due to the last known address for the family being located in the State of Wisconsin. When the 2\\/3\\/2017 report came in, staff consulted with their supervisor about the complexity of jurisdiction that needed attention for the case and gave the CP intake to their supervisor. The intake and screening workload was high at this time and the staff did not have time to dedicate to the complexity around jurisdiction. Therefore, the supervisor supported the staff by taking the 2\\/3\\/2017 CP intake off the staff\'s workload and the staff believed the report was screened timely within the 24 hour timeline.\",\"Multiple_Choice__350\":\"2\",\"Free_Text__351\":\"LP2: Overarching this was the foster care licensing statute which supported a consult between the licensing social worker and a CP screener to discuss an incident and determine what action needed to be taken.  Normative practice for when these consultations occur is for the information to be documented on a form, rather than documenting it in SSIS.\",\"Multiple_Choice__352\":\"2\",\"Free_Text__353\":\"Staff experienced a SSIS glitch\\/SSIS was down at the time of the critical incident. This posed a barrier for frontline staff, as the agency could not access information, and the inability to access information delayed staff in learning relevant history about the participants in this case. The technology barrier posed concern, as staff made decisions without having access to all information available, due to not being able to access it, and there was urgency to safety plan at the time of the critical incident.\",\"Multiple_Choice__354\":\"2\",\"Free_Text__355\":\"LP1: The CP intake being screened beyond the 24-hour timeline was influenced by jurisdictional complexity in this case. There were multiple states and several county jurisdictions identified as having responsibility to serve the family. Further adding to the jurisdictional complexity was the fact that the parents did not provide current or correct information regarding their identities and home address. This contributed to the confusion as to who had jurisdiction over the CP intake, and subsequently it took the agency more than 24 hours to decipher the facts before the agency was able to screen in the 2\\/3\\/2017 CP intake. \\r\\nLP1: The supervisor supported the staff by taking the 2\\/3\\/2017 CP intake off the staff\'s workload and the staff believed the report was screened timely within the 24 hour timeline. \\r\\n\\r\\nOther: Coordination of interviews regarding child death investigation were conducted separately by law enforcement and child protection.\",\"Multiple_Choice__356\":\"2\",\"Free_Text__357\":\"LP2: The worker was new and was still learning the process of making a CP report.\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"2\",\"Free_Text__359\":\"LP1: The CP intake being screened beyond the 24-hour timeline was influenced by jurisdictional complexity in this case. There were multiple states and several county jurisdictions identified as having responsibility to serve the family. Further adding to the jurisdictional complexity was the fact that the parents did not provide current or correct information regarding their identities and home address. This contributed to the confusion as to who had jurisdiction over the CP intake, and subsequently it took the agency more than 24 hours to decipher the facts before the agency was able to screen in the 2\\/3\\/2017 CP intake. \\r\\n\\r\\nLP1: Further contributing to the delay in screening was the fact that the report came in on a Friday. At the time, the local agency did not have the ability to screen reports after regular business hours. On Mondays, screeners felt added pressure to prioritize screening reports within 24-hours in order to meet the compliance metric, as CP reports accumulated over the weekend, increasing Monday\'s workload every week. It is not uncommon for screeners to gather more information using collateral contacts or contacting the reporter prior to making a screening decision. Yet if a CP intake is nearing the end of the 24-hour timeline, the agency\'s normative practice is to screen the report with the information the screener has been able to gather at the time. \\r\\n\\r\\nLP2: Additionally, the worker was new and was still learning the process of making a CP report.  This was also influenced by the guidance and interpretation of the guidance in regards to making a CP report.  Overarching this was the foster care licensing statute which supported a consult between the licensing social worker and a CP screener to discuss an incident and determine what action needed to be taken.  Normative practice for when these consultations occur is for the information to be documented on a form, rather than documenting it in SSIS.\",\"Multiple_Choice__360\":\"3\",\"Free_Text__361\":\"LP1: The agency had knowledge of the family, as a CP intake had been reported to the local agency on 2\\/1\\/2017, which was screened out and referred to Wisconsin\'s CP system due to the last known address for the family being located in the State of Wisconsin. When the 2\\/3\\/2017 report came in, staff consulted with their supervisor about the complexity of jurisdiction that needed attention for the case and gave the CP intake to their supervisor. The intake and screening workload was high at this time and the staff did not have time to dedicate to the complexity around jurisdiction. Therefore, the supervisor supported the staff by taking the 2\\/3\\/2017 CP intake off the staff\'s workload and the staff believed the report was screened timely within the 24 hour timeline. \\r\\nFurther contributing to the delay in screening was the fact that the report came in on a Friday. At the time, the local agency did not have the ability to screen reports after regular business hours. On Mondays, screeners felt added pressure to prioritize screening reports within 24-hours in order to meet the compliance metric, as CP reports accumulated over the weekend, increasing Monday\'s workload every week. It is not uncommon for screeners to gather more information using collateral contacts or contacting the reporter prior to making a screening decision. Yet if a CP intake is nearing the end of the 24-hour timeline, the agency\'s normative practice is to screen the report with the information the screener has been able to gather at the time. The local agencies intake and screening staff were responsible for answering all the calls that came into the agency. The calls include those that are not specific to child protection. This universal answering coverage for the agency placed additional pressure on screeners at times when a 24-hour timeline screening decision needed to be made, especially when reports had complicating factors like this CP intake did (unknown information\\/ jurisdiction issue\\/ screener & supervisor had little to no time to gather additional information). \\r\\n\\r\\nLP2: Supporting the consultation between agency staff was the belief that not every licensing violation is a CP report, as well as, the perception that the CP system would be inundated if every incident was reported.\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"2\",\"Free_Text__367\":\"LP2: A CP report made on June 7, 2017, for suspected neglect regarding a licensing violation incident that occurred on May 2, 2017 was influenced a local agency response using defensive practice, as the critical incident occurred on June 6, 2017. At the time of the licensing violation on May 2, prior to the critical incident, the local agency made the decision to issue a correction order to the foster home rather than make a CP intake report for suspected neglect. The decision to not make a CP report was made through consultation between the worker, colleagues, and a supervisor. Supporting the consultation between agency staff was the belief that not every licensing violation is a CP report, as well as, the perception that the CP system would be inundated if every incident was reported.\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,92,71,'2021-05-26 19:33:23','2021-06-01 19:08:23',NULL,'Talayia Sabillon-Suazo'),(367,22,90,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Aaron Strong\",\"Date__293\":\"09\\/09\\/2016\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"8\",\"Multiple_Choice__301\":\"Hennepin\",\"Short_Answer__303\":\"Trinity\",\"Short_Answer__304\":\"Shelby\",\"Date__305\":\"08\\/04\\/2015\",\"Date__306\":\"03\\/24\\/2016\",\"Multiple_Choice__308\":\"7 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Father\",\"Multiple_Choice__316\":\"3\",\"Short_Answer__317\":\"Multidisciplinary team (MDT) or supervisor consult at point of screening was not done as required by policy.\",\"Free_Text__318\":\"It was learned during the debriefing that screening staff were allowed to screen most intakes individually without consultation of a multidisciplinary team or supervisor.  Staff are encouraged to utilize supervisor consultation as needed for screening decisions.\",\"Free_Text__319\":\"Not utilizing consultation with a MDT or supervisor at the point of screening the child protection report was influenced by staff\'s discretionary use for when to use a MDT or supervisor for screening consultation.  The agency\'s procedural adaptation of allowing screeners to discretionarily consult with a MDT or supervisor which deviates from state policy was governed by an overall increase in screening staff\'s workload, affecting staff\'s time to access and utilize a MDT or supervisor for screening consultation.  This increase in staff\'s workload has been impacted by recent changes to the Minnesota Intake, Screening, and Response Path Guidelines resulting from legislative changes following the recommendations made by the Governor\'s Task Force on the Protection of Children.  These changes have expanded intake and screening requirements for local agencies, leading to an increase in intake and screening related tasks. Recent media coverage on high profile child protection cases coupled with the local agency\'s press release on their 24 hour child protection coverage has also generated an increase in the volume of calls received by the local child welfare agency further contributing to an increase in screening staff\'s workloads.  Furthermore, procedural changes made by the agency requiring screening staff to thoroughly document all calls as intakes into SSIS (Social Service Information System) has also added to screening staff\'s workload.  This process has lengthened the time for staff to complete their required tasks, compromising the efficiency of their works as entering all of this information in SSIS is a burdensome process for staff.  This efficiency thoroughness tradeoff has further impacted staff\'s time to seek out a MDT or supervisor for screening consultation when needed. \\r\\n\\r\\nAlso influencing the agency\'s procedural adaptation of allowing screeners to discretionarily consult with a MDT or supervisor was the limited availability of supervisors for consultation. Limited supervisory consultation time was impacted by increased workload demands for supervisors that included, only two supervisors being on per shift, the number of staff supervised, and a meeting culture in the agency that affected supervisor\'s availability due to attending multiple meetings per week.\",\"Short_Answer__320\":\"Intake placed in pending status for 22 hours\",\"Free_Text__321\":\"The intake received on 3\\/23\\/2016 was taken by the screener by phone and placed in pending status. Per the supervisor, this is not an uncommon practice (for non-immediate response cases) as screeners often receive high volumes of calls and are given the ability to prioritize those calls based on allegation\\/circumstances.\",\"Free_Text__322\":\"The worker\'s limited experience with child abuse reports to understand the complexities of screening decisions and inconsistent policy guidance provided by the Minnesota Department of Human Services influenced the intake being placed in pending status for 22 hours.  As a result of the increased volume of child welfare calls received by the agency during this time and the demand to thoroughly complete all intake and screening related tasks staff had less time available to attend training to understand the complexities of child protection screening decisions. Without adequate training, knowledge, and experience to recognize the emergent details within a child protection report, the report may have been seen as a lower priority for the screening staff and thus placed in pending status until consultation with a supervisor or MDT could occur.  The overall increase in volume of child welfare calls also influenced the screening supervisor\'s in making a sacrifice decision for staff to prioritize the completion of workload tasks over attending training.  Furthermore, the high volume of calls taken by screeners reduced the time and opportunity to utilize a MDT or supervisor for consultation further explaining this intake being placed in pending status until consultation with a MDT or supervisor could occur.\",\"Short_Answer__323\":\"Signs of abuse previously identified by child care facility were not reported to child protection.\",\"Free_Text__324\":\"No debriefing took place on this finding.\",\"Free_Text__325\":\"Barriers to reporting signs of child abuse by the child care facility may have been influenced by the fear of retaliation by caregivers of the child which could include caregivers removing their child from the agency.  The decision to not report previous signs of abuse may have been further impacted by an overall distrust of the child protection system, as some child care facilities perceive that nothing is done when they do report child abuse and neglect. Often times the relationship that is developed between caregivers and child care staff influences staff\'s mental model of when to make child protection reports as to not second guess the parent\'s explanation of how injuries occurred, further justifying staff\'s decisions to not report signs of suspected child abuse.  The cumbersome process of calling to report child abuse that includes long waits and calls being held in the que for lengthy periods of time also affects child care agencies not reporting signs of suspected abuse and neglect to the local agency.\",\"Multiple_Choice__346\":\"2\",\"Free_Text__347\":\"Finding 3: Often times the relationship that is developed between caregivers and child care staff influences staff\'s mental model of when to make child protection reports as to not second guess the parent\'s explanation of how injuries occurred, further justifying staff\'s decisions to not report signs of suspected child abuse.\",\"Multiple_Choice__348\":\"1\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"2\",\"Free_Text__355\":\"Finding 3: The decision to not report previous signs of abuse may have been further impacted by an overall distrust of the child protection system, as some child care facilities perceive that nothing is done when they do report child abuse and neglect.\",\"Multiple_Choice__356\":\"3\",\"Free_Text__357\":\"Finding 2: As a result of the increased volume of child welfare calls received by the agency during this time and the demand to thoroughly complete all intake and screening related tasks staff had less time available to attend training to understand the complexities of child protection screening decisions.\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"2\",\"Free_Text__359\":\"Finding 2: The worker\'s limited experience with child abuse reports to understand the complexities of screening decisions and inconsistent policy guidance provided by the Minnesota Department of Human Services influenced the intake being placed in pending status for 22 hours.\",\"Multiple_Choice__360\":\"2\",\"Free_Text__361\":\"Finding 1: The agency\'s procedural adaptation of allowing screeners to discretionarily consult with a MDT or supervisor which deviates from state policy was governed by an overall increase in screening staff\'s workload, affecting staff\'s time to access and utilize a MDT or supervisor for screening consultation.\\r\\n\\r\\nFinding 2: The overall increase in volume of child welfare calls also influenced the screening supervisor\'s in making a sacrifice decision for staff to prioritize the completion of workload tasks over attending training.  Furthermore, the high volume of calls taken by screeners reduced the time and opportunity to utilize a MDT or supervisor for consultation further justifying this intake being placed in pending status until consultation with a MDT or supervisor could occur\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"2\",\"Free_Text__365\":\"Finding 1: Supervisor availability was impacted by increased workload demands, which includes the number of staff supervised, a meeting culture in the agency, which impacts their availability due to attending multiple meetings per week, and only two supervisors being on per shift.\",\"Multiple_Choice__366\":\"2\",\"Free_Text__367\":\"Finding 1: The agency\'s procedural adaptation of allowing screeners to discretionarily consult with a MDT or supervisor which deviates from state policy was governed by an overall increase in screening staff\'s workload, affecting staff\'s time to access and utilize a MDT or supervisor for screening consultation.\\r\\n\\r\\nFinding 2: The high volume of calls taken by screeners reduced the time and opportunity to utilize a MDT or supervisor for consultation further justifying this intake being placed in pending status until consultation with a MDT or supervisor could occur.\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,90,81,'2021-05-26 19:33:23','2021-05-26 18:33:12',NULL,'Trinity Shelby'),(368,22,91,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Brittany Lochner\",\"Short_Answer__292\":\"Karilee Pietz\",\"Date__293\":\"07\\/13\\/2017\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"No\",\"Multiple_Choice__300\":\"9\",\"Multiple_Choice__301\":\"Ramsey\",\"Short_Answer__303\":\"Tyrell\",\"Short_Answer__304\":\"Wooten\",\"Date__305\":\"03\\/27\\/2014\",\"Date__306\":\"06\\/25\\/2017\",\"Multiple_Choice__308\":\"3 Years\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Mother\'s partner\",\"Multiple_Choice__316\":\"1\",\"Short_Answer__317\":\"A CP report was not made following the 3-year old being seen in the emergency room and having two head contusions that the mother could not explain.\",\"Free_Text__318\":\"There was no debrief completed on this learning point due to the learning point being specific to a system outside of the child welfare system.\",\"Free_Text__319\":\"A child protection report not being made following the 3-year old being seen in the emergency room and having two head contusions, which the mother could not explain was influenced by the age of the child, as well as location of the injury on the subject child\'s head.  These injuries on a 3-year old can also be explained as a result of normative childhood activities.  Additionally, the severity of the injury did not meet the perceived threshold required for medical personnel to make a child protection report.  Multiple competing priorities were occurring in the emergency room where the child was seen which further impacted the report not being made.  This included the time it takes to make a child protection report, the number of designated people in the emergency department to make child protection reports, as well as, the time the provider spends with a patient is historically shorter in the emergency department versus an appointment with a primary care provider.\\r\\n\\r\\nAn additional influence supporting a child protection report not being made was the fact that the subject child was seen at a different hospital and by a provider who was not familiar with the family, making it difficult to understand the child\'s medical history.  Furthermore, in situations like this, it can be difficult to access medical records at the time of the emergency room visit to better understand the child due to the limited amount of time spent in the emergency room.    Lastly, the decision to not make a child protection report was further impacted by the fact that the threshold for mandated reporting can be subjective.\",\"Multiple_Choice__346\":\"0\",\"Multiple_Choice__348\":\"0\",\"Multiple_Choice__350\":\"0\",\"Multiple_Choice__352\":\"0\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"2\",\"Free_Text__359\":\"The severity of the injury did not meet the perceived threshold required for medical personnel to make a child protection report.\\r\\nThe decision to not make a child protection report was further impacted by the fact that the threshold for mandated reporting can be subjective, as defined in 626.556 subd. 3.\",\"Multiple_Choice__360\":\"2\",\"Free_Text__361\":\"Multiple competing priorities were occurring in the emergency room where the child was seen which further impacted the report not being made.  This included the time it takes to make a child protection report, the number of designated people in the emergency department to make child protection reports, as well as, the time the provider spends with a patient is historically shorter in the emergency department versus an appointment with a primary care provider.\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"0\",\"Multiple_Choice__366\":\"0\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,91,81,'2021-05-26 19:33:23','2021-05-26 18:32:13',NULL,'Tyrell Wooten'),(369,22,92,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kristine Frick\",\"Short_Answer__292\":\"Triage Team\",\"Date__293\":\"11\\/01\\/2016\",\"Multiple_Choice__294\":\"Near Fatality\",\"Yes_or_No__295\":\"No\",\"Short_Answer__297\":\"Legally Unlicensed\",\"Yes_or_No__298\":\"Yes\",\"Multiple_Choice__299\":\"Legally 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--
