{"report_id":226,"form_id":"23","user_id":81,"organization_id":10,"question_id":"100","question_type":"Free_Text","text_answer":"St. Louis County (Provider-Stepping Stones for Living)\r\nNarrative-Staff Sleeping\r\n\r\nLearning point: One staff fell asleep during the day shift. \r\n\r\nA DSP was found sleeping during the day shift while supervising two VAs. No harm came to VAs as a result. The staff sleeping was influenced by environmental factors in the home as well as outside factors. \r\n\r\nOne environmental factor in the home the day of the incident was that there were less people for the DSP to supervise than normal. There is usually an additional person to supervise, as the staffing ratio was 1:3. The third person was at an activity at the time. Due to this, the house was more quiet than usual which allowed for a more relaxed environment that lent itself to rest. For residents of the home, their needs are defined by assessment results and outlined in a Community Services and Support Plan. The level of staffing needed to address these needs is agreed to by provider and lead agency via a rate management worksheet called a 6790. The rates for the services which take into account shared and individual staffing are then entered into and set by the Disability Waiver Rates System (DWRS). \r\nAnother environmental factor in the home was the daily program consisted of unstructured home time and TV watching. That day, the house was quiet and there was unstructured TV watching time. Programs or daily schedules for residents are outlined in their CSSP and supported by policies that emphasize and protect personal preference. Personal preference and control over one\u2019s schedule is a tenant of the federal Home and Community Based Services Rule which governs HCBS providers. Additionally, residential providers are required to carry a 245D license which secures a person\u2019s right to choose activities they prefer and have a say in their daily schedule. This unstructured time was an additional factor that led to a quiet house in which the staff experienced down time, leading to sleep. \r\nOutside factors that contributed to staff sleeping were also present. One outside factor is that the DSP was experiencing homelessness and was exhausted from that life stressor. It is not uncommon for DSPs to experience intermittent homelessness. In the Northeast MN region, there is a lack of affordable housing, housing resources and coordination. The governmental body that oversees housing and distribution of housing resources is Housing and Urban Development. \r\nAnother outside factor is the DSP was working extra shifts as the provider had unfilled shifts available. In doing so, the DSP\u2019s basic needs such as having a roof over his head were met. He picked up extra shifts also because the provider was offering overtime pay. The fact the provider had unfilled shifts is due to the well-known and highly publicized state and national workforce shortage.","created_by":81,"updated_by":81,"updated_at":"5\/26\/2021 5:24:21 pm","created_at":"5\/26\/2021 5:24:21 pm","id":38380}