{"report_id":205,"form_id":"23","user_id":81,"organization_id":10,"question_id":"100","question_type":"Free_Text","text_answer":"The provider terminating a person\u2019s services due to challenging behaviors was influenced by the behaviors escalating in frequency and intensity since service admission.  This was further supported by the person making multiple suicide threats, acts of self-harm by burning themselves, and threats to burn the house down.  The person did not have a history of fire starting prior to admission which further supports the intensity of his escalating behaviors.  The person seemed motivated by the attention he received from his grandmother\/guardian and the hospital.  Person was hospitalized twice and released quickly on two occasions prior to the threat to burn the house down.  On one occasion, law enforcement responded to the providers 911 call and stated that they were not a taxi services and did not provide any mental health support.  Police in the area were overtaxed with 911 calls related to mental health and COVID calls.  In addition to that, at the time of this call, law enforcement from across the state were reporting to Minneapolis to assist with the George Floyd incident, impacting the providers view that law enforcement may not assist.  \r\n\r\nThe guardian and provider agreed that the safety of the person, others in the home, and staff could not be maintained.  This agreement was influenced by the provider attempting to remove all objects that were deemed dangerous.  Room searches were conducted regularly to remove dangerous objects. After the person returned from the hospital, they were still in possession of a lighter.  This further supported their decision that they could not prevent him from self-harm and fire starting behavior or maintain the safety and protection of all involved. \r\n\r\nProviders have a responsibility to protect the health and wellbeing of all people in the home was another influence to the service termination.  Providers responsibility for safety is directed by MnCHOICES and required by the CSSP of each person and as well as the requirement of 245D.   This was supported by the Guardian who was worried about the provider\u2019s safety and the safety of the other person who had just recently moved into the home, resulting in the guardian refusing to allow the person to return to the home.\r\n\r\nThe person being served had several ER visits for suicidal ideation and behaviors and was not given in-patient psychiatric care. Provider and guardian had exhausted available services and felt that service termination was seen as a way to help person obtain in-patient psychiatric services.   COVID-19 Pandemic influenced hospitals to discharge quickly, due to the demand for mental health resources in the area, resulting in person being released from hospital and not receiving the psychiatric attention the team thought he needed, further impacting providers decision to terminate services","created_by":81,"updated_by":81,"updated_at":"5\/25\/2021 10:11:35 am","created_at":"5\/25\/2021 10:11:35 am","id":15188}