-- Table structure for table `reports_bkp_25052021`
--

CREATE TABLE `reports_bkp_25052021` (
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  `tab_id` int(10) unsigned DEFAULT NULL,
  `question_type` text CHARACTER SET utf8mb4 COLLATE utf8mb4_unicode_ci,
  `text_answer` text CHARACTER SET utf8mb4 COLLATE utf8mb4_unicode_ci,
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  `other_answer` tinyint(4) NOT NULL DEFAULT '0',
  `status` tinyint(4) NOT NULL DEFAULT '1',
  `created_by` int(10) unsigned DEFAULT NULL,
  `updated_by` int(10) unsigned DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  `deleted_at` timestamp NULL DEFAULT NULL,
  `report_name` text CHARACTER SET utf8mb4 COLLATE utf8mb4_unicode_ci
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--
-- Dumping data for table `reports_bkp_25052021`
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INSERT INTO `reports_bkp_25052021` VALUES (1,1,157,NULL,29,NULL,NULL,'{\"Free_Text__1\":\"Ans of Q1\",\"Short_Answer__2\":\"Short answer\",\"Date__3\":\"03\\/17\\/2021\",\"Number__4\":\"10\",\"True_or_False__5\":\"True\",\"Yes_or_No__6\":\"Yes\",\"Multiple_Choice__7\":\"Choice_5\",\"Multiple_Select__8\":{\"Choice 5\":\"Choice 5\"},\"Free_Text__9\":\"Test Q9 Free text\",\"Short_Answer__10\":\"Trigger answer of q10\",\"Number__11\":\"10\",\"True_or_False__12\":\"False\",\"Multiple_Choice__13\":\"Choice_2\",\"Multiple_Select__14\":{\"Choice 3\":\"Choice 3\"},\"Free_Text__15\":\"Answer of Q1 tab 2\",\"Date__16\":\"03\\/17\\/2021\"}',NULL,0,1,157,157,'2021-03-17 12:45:34','2021-03-17 13:01:11',NULL,'Test 1'),(2,2,157,NULL,29,NULL,NULL,'',NULL,0,1,157,157,'2021-03-17 13:22:54','2021-03-17 13:22:54',NULL,''),(3,3,81,NULL,28,NULL,NULL,'',NULL,0,1,81,81,'2021-03-17 14:13:12','2021-03-17 14:13:43',NULL,'Test review1'),(4,4,81,NULL,31,NULL,NULL,'{\"Date__22\":\"03\\/30\\/2021\",\"Free_Text__48\":\"Notes from the mapping here if needed\",\"Multiple_Choice__47\":\"1\",\"Multiple_Choice__23\":\"1\",\"Multiple_Choice__25\":\"0\",\"Multiple_Choice__27\":\"2\",\"Free_Text__28\":\"Documentation............................\",\"Multiple_Choice__29\":\"1\",\"Multiple_Choice__31\":\"1\",\"Multiple_Choice__33\":\"0\",\"Multiple_Choice__35\":\"0\",\"Multiple_Choice__37\":\"1\",\"Multiple_Choice__39\":\"2\",\"Free_Text__40\":\"Service Availability.............................................\",\"Multiple_Choice__41\":\"1\",\"Multiple_Choice__43\":\"0\",\"Multiple_Choice__45\":\"1\"}',NULL,0,1,81,81,'2021-03-30 17:14:52','2021-04-21 02:58:07',NULL,'Delete this'),(5,7,81,NULL,13,NULL,NULL,'{\"Multiple_Choice__158\":\"2\",\"Short_Answer__159\":\"test lp1\",\"Free_Text__160\":\"Debrief 1 info here\",\"Free_Text__161\":\"Words words words\"}',NULL,0,1,81,81,'2021-04-02 14:54:29','2021-04-12 16:24:42',NULL,'New test review'),(6,6,81,NULL,10,NULL,NULL,'',NULL,0,1,81,81,'2021-04-02 14:58:04','2021-04-02 14:58:04',NULL,'Test Review'),(7,6,81,NULL,10,NULL,NULL,'{\"Short_Answer__76\":\"Test123\"}',NULL,0,1,81,81,'2021-04-02 14:58:04','2021-04-02 14:58:04',NULL,'Test Review'),(8,6,81,NULL,10,NULL,NULL,'',NULL,0,1,81,81,'2021-04-02 14:58:57','2021-04-02 14:58:57',NULL,'Review 345'),(9,6,81,NULL,10,NULL,NULL,'',NULL,0,1,81,81,'2021-04-02 15:15:07','2021-04-02 15:15:07',NULL,'New review'),(10,6,81,NULL,10,NULL,NULL,'',NULL,0,1,81,81,'2021-04-02 18:14:16','2021-04-02 18:14:16',NULL,'DfbaDSFb'),(11,13,81,NULL,10,NULL,NULL,'{\"Short_Answer__76\":\"Test 123456\",\"Date__77\":\"04\\/12\\/2021\",\"Multiple_Choice__78\":\"Aric Gregg\",\"Multiple_Choice__79\":\"Charles Young\",\"Short_Answer__80\":\"New Hope LLC\",\"Short_Answer__81\":\"Bill Hope\",\"Short_Answer__82\":\"Bill@newhopellc.com\",\"Short_Answer__83\":\"507-867-5309\",\"Multiple_Choice__84\":\"Staff Sleeping on Duty\",\"Multiple_Choice__85\":\"Blue Earth County\",\"Date__86\":\"04\\/01\\/2021\",\"Free_Text__87\":\"Staff found sleeping on duty by incoming staff. Resident 1 was found in the kitchen pulling food from the refrigerator.\",\"Multiple_Choice__96\":\"2\",\"Short_Answer__91\":\"Test LP1\",\"True_or_False__94\":\"Yes\",\"Date__97\":\"04\\/12\\/2021\",\"Free_Text__98\":\"Debrief info\",\"Free_Text__100\":\"Narrative LP1\",\"Short_Answer__127\":\"Test LP1\",\"Yes_or_No__128\":\"Yes\",\"Date__129\":\"04\\/12\\/2021\",\"Free_Text__130\":\"HFD2\",\"Free_Text__132\":\"Case Narrative2\",\"Multiple_Choice__101\":\"2\",\"Free_Text__102\":\"test\",\"Multiple_Choice__103\":\"2\",\"Free_Text__104\":\"test\",\"Multiple_Choice__105\":\"2\",\"Free_Text__106\":\"test\",\"Multiple_Choice__107\":\"2\",\"Free_Text__108\":\"test\",\"Multiple_Choice__109\":\"2\",\"Free_Text__110\":\"test\",\"Multiple_Choice__111\":\"2\",\"Free_Text__112\":\"test\",\"Multiple_Choice__113\":\"2\",\"Free_Text__114\":\"test\",\"Multiple_Choice__115\":\"2\",\"Free_Text__116\":\"test\",\"Multiple_Choice__117\":\"2\",\"Free_Text__118\":\"test\",\"Multiple_Choice__119\":\"2\",\"Free_Text__120\":\"test\",\"Multiple_Choice__121\":\"2\",\"Free_Text__122\":\"test\",\"Multiple_Choice__123\":\"2\",\"Free_Text__124\":\"test\",\"Multiple_Choice__125\":\"2\",\"Free_Text__126\":\"test\"}',NULL,0,1,81,81,'2021-04-12 15:48:22','2021-04-13 20:58:35',NULL,'Test - KW - Blue Earth'),(12,14,81,NULL,10,NULL,NULL,'',NULL,0,1,81,81,'2021-04-12 19:46:31','2021-04-12 19:46:31',NULL,'sdthwrty'),(13,16,158,NULL,38,NULL,NULL,'',NULL,0,1,158,158,'2021-04-14 05:06:37','2021-04-14 05:06:37',NULL,'Test1'),(14,17,158,NULL,38,NULL,NULL,'{\"Free_Text__280\":\"1\",\"Short_Answer__281\":\"2\",\"Date__282\":\"04\\/14\\/2021\",\"True_or_False__283\":\"Yes\",\"Yes_or_No__284\":\"Yes\",\"Free_Text__285\":\"6\",\"Free_Text__286\":\"7\"}',NULL,0,1,158,158,'2021-04-14 07:00:10','2021-04-14 07:00:27',NULL,'Test 2'),(15,19,81,NULL,13,NULL,NULL,'',NULL,0,1,81,81,'2021-04-15 19:38:51','2021-04-15 19:38:51',NULL,'Test review'),(16,21,81,NULL,31,NULL,NULL,'{\"Date__22\":\"04\\/21\\/2021\",\"Free_Text__48\":\"These are notes related to this particular review\",\"Multiple_Choice__47\":\"2\",\"Short_Answer__336\":\"LP one\",\"Short_Answer__337\":\"LP 2\",\"Free_Text__339\":\"Identified relevant conditional factors (identified during Systems Mapping) and discuss\\/capture strategies that are used to overcome those factors (e.g., high turnover)\",\"Free_Text__340\":\"Discussions that team members felt advantageous to think through\\r\\nMeaningful discussion that was identified by team members to support learning\\r\\nInformation that was discussed that team members think would be beneficial for others to receive\",\"Free_Text__341\":\"Relevant considerations are discussed with the Systems Mapping Team and documented by the Reviewer\\r\\nConsiderations will be collected for the purpose of informing formal recommendations which are an output of the Systems Review process\\r\\nFeatures of meaningful considerations are that they are High Level and Unintended Consequences are considered\",\"Multiple_Choice__23\":\"1\",\"Multiple_Choice__25\":\"1\",\"Multiple_Choice__27\":\"0\",\"Multiple_Choice__29\":\"0\",\"Multiple_Choice__31\":\"2\",\"Free_Text__32\":\"Place associated info gathered through mapping here\",\"Multiple_Choice__33\":\"1\",\"Multiple_Choice__35\":\"0\",\"Multiple_Choice__37\":\"1\",\"Multiple_Choice__39\":\"2\",\"Free_Text__40\":\"Place associated info gathered through mapping here\",\"Multiple_Choice__41\":\"1\",\"Multiple_Choice__43\":\"1\",\"Multiple_Choice__45\":\"1\"}',NULL,0,1,81,81,'2021-04-21 03:02:11','2021-04-21 03:08:41',NULL,'Demo review 4.21.21'),(17,21,81,NULL,31,NULL,NULL,'{\"Date__22\":\"05\\/04\\/2021\",\"Free_Text__48\":\"Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.\",\"Multiple_Choice__47\":\"1\",\"Short_Answer__336\":\"Learning Point 1\",\"Free_Text__339\":\"Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.\",\"Free_Text__340\":\"Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.\",\"Free_Text__341\":\"Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.\",\"Multiple_Choice__23\":\"0\",\"Multiple_Choice__25\":\"1\",\"Free_Text__26\":\"thsarthsrt5h\",\"Multiple_Choice__27\":\"0\",\"Multiple_Choice__29\":\"1\",\"Multiple_Choice__31\":\"2\",\"Free_Text__32\":\"Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.\",\"Multiple_Choice__33\":\"0\",\"Multiple_Choice__35\":\"1\",\"Multiple_Choice__37\":\"0\",\"Multiple_Choice__39\":\"2\",\"Free_Text__40\":\"Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.\",\"Multiple_Choice__41\":\"3\",\"Free_Text__42\":\"Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.\",\"Multiple_Choice__43\":\"2\",\"Free_Text__44\":\"Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.\",\"Multiple_Choice__45\":\"0\"}',NULL,0,1,81,81,'2021-04-21 15:24:31','2021-05-13 01:16:06',NULL,'TEST review demo'),(18,20,81,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Kristine Frick\",\"Short_Answer__292\":\"Johnny Test\",\"Date__293\":\"05\\/06\\/2021\"}',NULL,0,1,81,81,'2021-04-22 14:17:41','2021-05-12 13:31:09',NULL,'This can be deleted'),(19,22,81,NULL,13,NULL,NULL,'{\"Multiple_Choice__291\":\"Ryan Hartneck\",\"Short_Answer__292\":\"Brittany\",\"Date__293\":\"09\\/08\\/2020\",\"Date__342\":\"04\\/22\\/2021\",\"Multiple_Choice__294\":\"Fatality\",\"Yes_or_No__295\":\"Yes\",\"Multiple_Choice__296\":\"Other Tribe\",\"Short_Answer__297\":\"Quest\",\"Yes_or_No__298\":\"Yes\",\"Multiple_Choice__299\":\"Unlicensed\",\"Multiple_Choice__300\":\"9\",\"Multiple_Choice__301\":\"Pope\",\"Short_Answer__303\":\"Jane\",\"Short_Answer__304\":\"Doe\",\"Date__305\":\"02\\/03\\/2020\",\"Date__306\":\"07\\/01\\/2020\",\"Multiple_Choice__308\":\"4 Months\",\"Multiple_Choice__309\":\"1\",\"Short_Answer__310\":\"Mom\",\"Multiple_Choice__316\":\"1\",\"Short_Answer__317\":\"Test LP1\",\"Free_Text__318\":\"HFD1 info\",\"Free_Text__319\":\"LP1 Narrative information\",\"Multiple_Choice__346\":\"1\",\"Multiple_Choice__348\":\"2\",\"Free_Text__349\":\"Example from narrative describing the Demand-Resource Mismatch\",\"Multiple_Choice__350\":\"1\",\"Multiple_Choice__352\":\"1\",\"Multiple_Choice__354\":\"0\",\"Multiple_Choice__356\":\"0\",\"Multiple_Choice__368\":\"0\",\"Multiple_Choice__358\":\"0\",\"Multiple_Choice__360\":\"1\",\"Multiple_Choice__362\":\"0\",\"Multiple_Choice__364\":\"1\",\"Multiple_Choice__366\":\"3\",\"Free_Text__367\":\"Info from narrative describing the drift\",\"Yes_or_No__370\":\"Yes\"}',NULL,0,1,81,81,'2021-04-22 16:43:59','2021-04-22 16:48:08',NULL,'Test Review 4.22.21'),(20,15,81,NULL,10,NULL,NULL,'{\"Short_Answer__76\":\"201905316\",\"Date__77\":\"08\\/15\\/2019\",\"Multiple_Choice__78\":\"Jill Tilbury\",\"Multiple_Choice__79\":\"Charles Young\",\"Short_Answer__80\":\"Progressive Living Inc\",\"Short_Answer__82\":\"nicole.s@progressivelivinginc.net\",\"Multiple_Choice__84\":\"Medication Error\",\"Multiple_Choice__85\":\"Blue Earth County\",\"Date__86\":\"07\\/20\\/2019\",\"Free_Text__87\":\"on 7\\/20\\/19 It had been reported to On-call that a scheduled 2 medication had 2 tablets gone missing. Staff reported this to On-call right away in the AM. DCC complained about staff on the Overnight not being awake when he was attempting to wake them up for a PRN. Staff administered an Acetaminophen to DCC at 5:00am. It is suspected that the staff on the overnight were asleep not supervising DCC and after administering the medication DCC reported the staff went back to the couch to sleep after he took his PRN. Staff may have not locked up the office and DCC may have gotten the keys from the key lockbox by breaking into it to get the schedule 2 medication. DCC has in the past requested multiple times from staff stating he has not gotten this medication. DCC has had a problem with medication seeking.\",\"Multiple_Choice__96\":\"1\",\"Short_Answer__91\":\"Staff did not count medications per provider policy\",\"True_or_False__94\":\"Yes\",\"Date__97\":\"09\\/13\\/2019\",\"Free_Text__98\":\"\\\"Staff 1 worked a double shift (working at other homes within agency) prior to arriving at 11pm and then came to work the overnight shift at the location of the incident.  Staff 2 stated this was the first shift of the day for them.  The provider\\u2019s shift are from 11p-7am; 7am-3pm; 3pm-11pm.  Both staff were float staff for several homes throughout the agency, however they had worked in this home prior to the event.  Staff 1 worked for the provider for over a year and Staff 2 had worked for the provider since February.  Each of the staff works approximately 40-48 hours per week.  Provider has a policy for a 2:4 staffing ratio at the home and both staff remain awake.  \\r\\n\\r\\nProvider\\u2019s policy is to go into the office and count medications upon arriving for a shift.  While in the office they are to also read the daily log notes on the people supported in the home.  The 11pm staff arrived for their shift, neither staff person had reviewed the notes from the previous shift or counted the medications.  This had been the pattern that staff did not typically check meds and\\/or notes when they arrived to the home because the norm was the individuals were awake and needed support.  The staff started interacting with the individuals in the home because many of them were awake on this evening and required the staff\\u2019s attention. Individual 1 typically was not awake and in the common area of the home, however they were on this evening.  \\r\\n\\r\\nIndividual 2 (with alone time) from the residence called and stated he needed a ride home.  Staff 1 left to go get individual 2.  Staff 1 did not take the office keys with them when they left the home.  Staff 1 did not know if the office was locked at this time.  \\r\\n\\r\\n\\r\\nWhen both staff arrive Individual 1 was typically in their room and this night the individual was awake more during the night and was talking to Staff 2 about videos games and film animation.  Individual 1 has no alone time.  Individual 1 is very planful, smart, he works at a department store, likes animation or playing videos games, funny, jokester, and typically calm.  \\r\\n\\r\\nAt 5am Individual 1 came to Staff 1 for a PRN and staff was watching YouTube videos.  The office is locked at all times per policy from the provider and staff carry the keys on a lanyard (on their person at all times).  One set of keys per two staff.  If keys are locked inside of the office there is another set in a lockbox (with a key code to get in).  Once in the office, the medications are set up per person in a \\u201cfile cabinet like\\u2019 with another set of keys required to get into the medications.  When staff 1 went into the office for the medications the office and the medications were all locked.  Staff 1 gave individual 1 medications and went back to watching youtube from 5am-6am.  Staff 1 was unable recall if they had fallen asleep.   Staff 1 was very tired due to the length of time they had worked during their shift and the previous two shifts at another home.  \\r\\n\\\"\",\"Free_Text__100\":\"\\\"Staff did not count meds per provider policy was influenced by numerous factors.  The norm is to interact with the awake individuals and on this day there was someone awake which is impacted by staff wanting to support the individual based off of the plan of care created by the team and further influenced by societal norms to engage with others and implementing person centered culture mandated by DHS and CMS.  An additional factor was Individual 2 being in the community and needed transportation home. Staff 1 left the home to pick up Individual 2, thus leaving staff 2 alone with an awake Individual 1 who requires a 24-plan of care supported by norms to interact with others and person centered practices.  One element was there was no staff overlap upon both staff arriving to the home which resulted in staff prioritizing interaction with the individuals over counting medications.  The set wages and benefits which was indicative of the care plan therefore influenced by norms to interact with others and person centered practices.   \\r\\n\\r\\nThe final factor was both staff thought Individual 1 had no history of medication seeking supported by their staff not knowing the individual plan for medications due to being trained in several homes with several individuals\\u2019 plans to follow and also being fatigued because the staff had to work overtime prior to this shift.  The agency being shorted staffed is complicated to the set wages and benefits, low unemployment, thus constraining the college employees (seasonal) and this is byproduct of DWRS which was put in place by the legislature.  Contributing factors that further supported the provider\\u2019s policy for the work of the direct care staff 1 and 2 was the nurse\\u2019s license in providing some position to the policy.  Overall the nurse\\u2019s license is regulated by legislation and statute.   \\\"\",\"Multiple_Choice__101\":\"0\",\"Multiple_Choice__103\":\"0\",\"Multiple_Choice__105\":\"0\",\"Multiple_Choice__107\":\"0\",\"Multiple_Choice__109\":\"0\",\"Multiple_Choice__111\":\"0\",\"Multiple_Choice__113\":\"0\",\"Multiple_Choice__115\":\"2\",\"Free_Text__116\":\"\\\"The norm is to interact with the awake individuals and on this day there was someone awake which is impacted by staff wanting to support the individual based off of the plan of care created by the team and further influenced by societal norms to engage with others and implementing person centered culture mandated by DHS and CMS.  \\r\\n\\r\\nOne element was there was no staff overlap upon both staff arriving to the home which resulted in staff prioritizing interaction with the individuals over counting medications.  \\\"\",\"Multiple_Choice__117\":\"0\",\"Multiple_Choice__119\":\"0\",\"Multiple_Choice__121\":\"0\",\"Multiple_Choice__123\":\"0\",\"Multiple_Choice__125\":\"2\",\"Free_Text__126\":\"The final factor was both staff thought Individual 1 had no history of medication seeking supported by their staff not knowing the individual plan for medications due to being trained in several homes with several individuals\\u2019 plans to follow and also being fatigued because the staff had to work overtime prior to this shift.\"}',NULL,0,1,81,81,'2021-04-23 15:52:49','2021-04-23 16:20:03',NULL,'JT_Progressive Living-BEC-2019-08'),(21,23,81,NULL,10,NULL,NULL,'{\"Short_Answer__76\":\"Care Manager\",\"Date__77\":\"12\\/16\\/2019\",\"Multiple_Choice__78\":\"Charles Young\",\"Multiple_Choice__79\":\"Kristie Pittman\",\"Short_Answer__80\":\"Harry Meyering\",\"Short_Answer__81\":\"Emily Britz \\/ Tana Helleksen\",\"Short_Answer__82\":\"ebritz \\/ thelleksen \\/@harrymeyeringcenter.org\",\"Multiple_Choice__84\":\"Termination of Services\",\"Multiple_Choice__85\":\"Blue Earth County\",\"Multiple_Choice__96\":\"2\",\"Short_Answer__91\":\"Person\'s services were terminated due to challenging behavior\",\"True_or_False__94\":\"Yes\",\"Free_Text__100\":\"\\\"Influencing why the ICF\\/DD provider terminated this person\\u2019s services due to challenging behavior was that the person was posing a safety risk to others in the home. The other 3 individuals in the home were considered to be more vulnerable to abuse due to their lower functioning levels, and so the person posed a greater risk to them. The provider had to balance their responsibility to protect the health and safety of three people in the home with their responsibility to meet the needs of the person whose services they terminated. The guardians of the other 3 individuals had an expectation that the provider would keep them safe, and due to their higher vulnerability the guardians expressed their concern often in this instance. Another impact to the provider\\u2019s responsibility for people\\u2019s health and safety include county case managers assigning this function to providers via the CSSP. Unique to ICF\\/DDs is that they are licensed by both the Department of Human Services and the Minnesota Department of Health. Both Departments require providers to protect the health and safety of the people they serve. Minnesota Statutes 245D outlines the requirements for providers enforced by DHS while MDH relies on other statutory requirements in Minnesota statutes 144 and Rule. A unique requirement enforced by MDH is that ICF\\/DDs are expected to protect the people they serve from \\u201cimmediate jeopardy\\u201d. The provider in this instance noted that many times in the past they had been asked after a critical incident how they were going to protect the people they served from \\u201cimmediate jeopardy\\u201d in the future, so this mandate shaped the perception of the provider\\u2019s managers and supervisors whenever a health and safety concern arose and placed pressure on them to prioritize their response in a way that would satisfy MDH reviewers. The provider in this instance noted that terminating the person\\u2019s services was part of their response as to how they would respond to MDH\\u2019s questioning of how they were protecting the health and safety of the other people in the home. Between the requirements of DHS and MDH as well as the expectations of the guardians and case managers, the provider felt a strong need to act in this situation and felt that termination was the only way they could keep the majority of the people in the home safe. \\r\\nThe provider noted that the team had explored the possibility of implementing rights restrictions with the individual, but the team determined they wouldn\\u2019t be possible due to the requirements of 245D surrounding rights restrictions, or wouldn\\u2019t be sufficient to meet the safety needs of the person and others in the home. Due to the ineffectiveness of a rights restriction, the provider felt they had few options to address the person\\u2019s challenging behavior. \\r\\nAnother influence as to why the provider terminated a person\\u2019s services due to challenging behavior was that the person\\u2019s challenging behavior did not dissipate as expected after the person moved to the home. While it was known prior to intake that the person sometimes exhibited challenging behavior, there was an assumption by the team that this environment would likely help decrease the triggers that impacted the challenging behavior in the past. \\r\\nA number of factors were identified that  person\\u2019s challenging behavior not dissipating. For one, the provider noted that the staff at the site were trained more on meeting the medical needs of the other people in the home than de-escalating challenging behavior. While Minnesota Statutes 245D and the Positive Supports Rule (9544) required the provider to ensure their staff had training and were competent on positive support strategies, de-escalation techniques and the use of restrictive interventions, because the other people in the home didn\\u2019t exhibit challenging behavior, the focus of their training was centered more on medical needs than \\u2018behavioral needs\\u2019. The provider also noted that the staff felt a fear to administer pro re nata (PRN) medication to the person during mental health episodes due to the stigma of providing medication at these times and the training and reporting requirements of the Positive Supports Rule. The Positive Supports Rule (MN Rule 9544) requires providers to report the use of PRN medications when administered in a behavioral situation, and there was a belief among staff that the use of PRNs in this manner were not ok because they required reporting. \\r\\nThe provider \\u2013 and the person\\u2019s team - expected the person\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. Additionally, the person\\u2019s case manager \\u2013 who would typically be expected to also help find needed services \\u2013 was very busy and unable to devote much time to the person\\u2019s case. A number of influences as to why case managers would be busy were identified \\u2013 between high case load and recent federal and state initiatives changing services. MnCHOICES, HCBS rule and person-centered planning initiatives were all noted as positive changes, but changes that took a lot of time away from case managers to learn and meet the new requirements. This program was located in southern Minnesota, and the team noted that this region in particular has a scarcity of mental health resources. The provider and the team did find a neuropsych practitioner that was willing to work with the person, but unfortunately they were too far away and the drive was too long. This made it hard to make regular meetings and implement the neuropsych\\u2019s recommendations. Additionally, the provider was able to bring the person to a nearby hospital during challenging episodes, but noted that any interventions offered by the hospital unfortunately were ineffective.\\r\\nAlong with the lack of mental health resources, the provider also noted there was a lack of behavioral resources available to the person. Some practitioners had recommended that the person be admitted to an inpatient facility where they could try a \\u201cmed holiday\\u201d \\u2013 taking the person off all their meds and slowly re-introducing medication to determine their effectiveness. The provider could only find 1 program in the state that offered \\u201cmed holidays\\u201d, and that program had only 9 beds and waiting list of 25 people. The mapping team noted that the Jensen Settlement, which limited community base intensive services and the interventions they could use, influenced the lack of behavioral services like this one. \\r\\nWithout interventions that met the needs of the person, coupled with the lack of training of the staff, the provider noted their staff were stressed at the site. They often times engaged in power struggles with the individual and spent time trying to keep the other 3 residents safe. The provider did note that one option they wanted to explore before terminating the person\\u2019s services was to find out if they could obtain 1 on 1 staffing for the individual, but didn\\u2019t know who to ask or where to start. ICF\\/DD rates have many regulations and oftentimes hard to navigate they noted. The provider noted that the ability to obtain reimbursement beyond the facility\\u2019s establish rate was a mystifying process.\",\"Yes_or_No__128\":\"Yes\",\"Free_Text__132\":\"\\\"Influencing why this person was placed in what was seen as an atypical placement was that the person had never stayed at an ICF\\/DD before and the other people in the home were seen as having more medical needs than behavioral challenges. Despite these differences, the team, including the case manager, guardian and the provider thought this could be a good fit for the person because they could have more attention from staff and the person wouldn\\u2019t see the other roommates as a \\u2018threat\\u2019. \\r\\nAnother factor into this placement was that the provider had an open ICFs\\/DD bed. The fact it was an ICF\\/DD bed was one of the reasons why the bed was open. The providers in the room noted that there isn\\u2019t much interest in ICF\\/DD beds any more. Regionally, statewide and nationally, ICF or other institutional placements are seen as undesirable and passed over for foster care or other community-based settings. A number of factors have influenced this opinion about ICFs\\/DDs, including; public sentiment shifting away from institutions and large settings; the HCBS settings rule which has required systems to move towards community settings; the Minnesota Olmstead Plan which reflects the Supreme Court\\u2019s 1999 Olmstead ruling determining people should be served in the \\u201cmost integrated setting\\u201d, and; the Jensen Settlement Agreement which resulted in both Minnesota\\u2019s Olmstead Plan and the closure of some institutional services.\\r\\nAnother factor as to why this person was placed in an atypical placement was that the provider was willing to take a risk by accepting someone who didn\\u2019t fit the typical profile for this home. They were willing to take a risk because they did have an open ICF\\/DD bed that needed to be filled and hadn\\u2019t had much interest from other people in. The provider was also willing to take a risk because they determined the person could do well at the site.  This determination impacted the placement and was impacted by a number of factors. While the other people in the home didn\\u2019t have similar needs as this person, the team thought this might work well in this case. The other five people in the home had higher Activities of Daily Living (ADL) needs than this person so it was thought the person wouldn\\u2019t add much to the staff\\u2019s workload in this area. The five people also exhibited challenging behavior that was more easily redirected and managed by staff, so it was thought the house wouldn\\u2019t be overwhelming for staff to manage challenging behavior in the home as a whole. Additionally, it seemed to the provider that the person\\u2019s challenging behavior appeared manageable. This was due to a number of influences such as the case manager reporting there weren\\u2019t major recent behavioral concerns and the paperwork received from the person\\u2019s previous provider before intake. Beyond the concerns around the person\\u2019s challenging behavior, the paperwork from the previous provider supported the new provider\\u2019s assessment that the person could do well at this site. The person\\u2019s psychiatrist also weighed in and supported this particular placement, contributing to this assessment.\\r\\nAlong with the provider being willing to take a risk by accepting the person\\u2019s placement in this atypical setting was that both the case manager and the person\\u2019s guardian were willing to take a risk by placing the person in a home that didn\\u2019t fit the \\u2018typical\\u2019 profile. The person had failed at multiple community-based settings before so they both reported being interested in trying something different. Their options were likely limited too because this region has a lack of residential placement beds, which is also the trend statewide. This lack of residential beds is seen as influenced by a statewide moratorium on foster care beds as well as a moratorium on ICF\\/DD beds. The providers in the room also noted that the current statewide workforce shortage prohibits them from opening new programs as well as influences the closure of other residential sites. Without staff, programs cannot open or even stay open as providers can\\u2019t meet the supervision needs of the people living there.\",\"Multiple_Choice__101\":\"2\",\"Free_Text__102\":\"Unique to ICF\\/DDs is that they are licensed by both the Department of Human Services and the Minnesota Department of Health. Both Departments require providers to protect the health and safety of the people they serve. Minnesota Statutes 245D outlines the requirements for providers enforced by DHS while MDH relies on other statutory requirements in Minnesota statutes 144 and Rule. A unique requirement enforced by MDH is that ICF\\/DDs are expected to protect the people they serve from \\u201cimmediate jeopardy\\u201d. The provider in this instance noted that many times in the past they had been asked after a critical incident how they were going to protect the people they served from \\u201cimmediate jeopardy\\u201d in the future, so this mandate shaped the perception of the provider\\u2019s managers and supervisors whenever a health and safety concern arose and placed pressure on them to prioritize their response in a way that would satisfy MDH reviewers. The provider in this instance noted that terminating the person\\u2019s services was part of their response as to how they would respond to MDH\\u2019s questioning of how they were protecting the health and safety of the other people in the home. Between the requirements of DHS and MDH as well as the expectations of the guardians and case managers, the provider felt a strong need to act in this situation and felt that termination was the only way they could keep the majority of the people in the home safe.\",\"Multiple_Choice__109\":\"2\",\"Free_Text__110\":\"The provider \\u2013 and the person\\u2019s team - expected the person\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. Additionally, the person\\u2019s case manager \\u2013 who would typically be expected to also help find needed services \\u2013 was very busy and unable to devote much time to the person\\u2019s case. A number of influences as to why case managers would be busy were identified \\u2013 between high case load and recent federal and state initiatives changing services.\",\"Multiple_Choice__115\":\"3\",\"Free_Text__116\":\"Influencing why the ICF\\/DD provider terminated this person\\u2019s services due to challenging behavior was that the person was posing a safety risk to others in the home. The other 3 individuals in the home were considered to be more vulnerable to abuse due to their lower functioning levels, and so the person posed a greater risk to them. The provider had to balance their responsibility to protect the health and safety of three people in the home with their responsibility to meet the needs of the person whose services they terminated.\",\"Multiple_Choice__119\":\"3\",\"Free_Text__120\":\"\\\"The provider \\u2013 and the person\\u2019s team - expected the person\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. \\r\\nAlong with the lack of mental health resources, the provider also noted there was a lack of behavioral resources available to the person. Some practitioners had recommended that the person be admitted to an inpatient facility where they could try a \\u201cmed holiday\\u201d \\u2013 taking the person off all their meds and slowly re-introducing medication to determine their effectiveness. The provider could only find 1 program in the state that offered \\u201cmed holidays\\u201d, and that program had only 9 beds and waiting list of 25 people. The mapping team noted that the Jensen Settlement, which limited community base intensive services and the interventions they could use, influenced the lack of behavioral services like this one. \\r\\n\\r\\nAnother factor as to why this person was placed in an atypical placement was that the provider was willing to take a risk by accepting someone who didn\\u2019t fit the typical profile for this home. They were willing to take a risk because they did have an open ICF\\/DD bed that needed to be filled and hadn\\u2019t had much interest from other people in\\r\\n\\r\\nAlong with the provider being willing to take a risk by accepting the person\\u2019s placement in this atypical setting was that both the case manager and the person\\u2019s guardian were willing to take a risk by placing the person in a home that didn\\u2019t fit the \\u2018typical\\u2019 profile. The person had failed at multiple community-based settings before so they both reported being interested in trying something different. Their options were likely limited too because this region has a lack of residential placement beds, which is also the trend statewide. This lack of residential beds is seen as influenced by a statewide moratorium on foster care beds as well as a moratorium on ICF\\/DD beds. The providers in the room also noted that the current statewide workforce shortage prohibits them from opening new programs as well as influences the closure of other residential sites. Without staff, programs cannot open or even stay open as providers can\\u2019t meet the supervision needs of the people living there.\\\"\",\"Multiple_Choice__125\":\"2\",\"Free_Text__126\":\"Without interventions that met the needs of the person, coupled with the lack of training of the staff, the provider noted their staff were stressed at the site. They often times engaged in power struggles with the individual and spent time trying to keep the other 3 residents safe\",\"Yes_or_No__432\":\"Yes\"}',NULL,0,1,81,81,'2021-04-29 02:16:29','2021-04-29 02:25:44',NULL,'CY_Harry Meyering-BEC-2019-11'),(22,23,81,NULL,10,NULL,NULL,'{\"Short_Answer__76\":\"201901929\",\"Date__77\":\"05\\/22\\/2019\",\"Multiple_Choice__78\":\"Jill Tilbury\",\"Multiple_Choice__79\":\"Kristie Pittman\",\"Short_Answer__80\":\"MRCI\",\"Short_Answer__81\":\"Cathy Groebner\",\"Short_Answer__82\":\"cgroebner@mymrci.org\",\"Multiple_Choice__84\":\"Elopement\",\"Multiple_Choice__85\":\"Blue Earth County\",\"Date__86\":\"03\\/19\\/2019\",\"Free_Text__87\":\"\\\"Wednesday March 13, 2019 at approximately 1:40pm, staff 1 noticed VA leave the Department 123 work area. Staff 1 stepped outside the room and saw VA going into the women\\u2019s bathroom located off of the production floor nearest to Department 123.  Staff 1 checked on VA at about 1:45pm and saw that VA was in the handicap stall with their green jacket off.  Staff 1 asked if VA was OK and they replied \\u201cyeah\\u201d and also asked if VA needed anything and they said \\u201cno\\u201d.  Staff 1 then went back to that same bathroom to assist another individual at approximately 1:50pm and VA was still in the same stall.  Staff 1 went back to the room at about 1:55pm.  It should be noted that the VA had been diagnosed with a mild UTI on Sunday 3\\/10\\/19 and was sent home early on Monday 3\\/11\\/19 due to them not feeling well.  VA also came in late on Tuesday, 3\\/12\\/19.  \\r\\n\\r\\nVA has eloped in the past, VA takes her lunch box with her.  Because of that, VA is required to leave the lunch box in the Team Leader\\u2019s office.  At approximately 2:00pm, staff 1 notice VA\\u2019s lunch box was still in the office.  Support Specialist Staff 2 went to that same bathroom that VA was in approximately 2:05pm and that VA was no longer in the bathroom.  A bus drive for the day program was driving the buss back to the program and notice someone in a green jacket standing in the street on Map Drive around 2pm.  There are no sidewalks on Map Drive.  Staff recognized the person as the VA and immediately called her supervisor at the program. And drove back to where the VA was walking.  It was reported that two \\u201cgood Samaritans\\u201d pulled over and stopped the VA on the sidewalk along stadium drive, which is the road that connects with Map Drive, and started walking with her back to the program until the staff arrived.  \\r\\n\\r\\nAt 2:07 the Supervisor received a phone call from the transportation supervisor stating VA was found walking on the sidewalk along Stadium Drive and was being walked back to the program\\u2019s building.  The program supervisor ran outside and saw VA with about four other program staff walking with VA.  The supervisor walked alongside VA all the way back to the office and the VA waited in the office until was time for VA to board the bus to go home.  While the office, VA was ask if VA thought what happened was safe and the VA said, \\u201cNo\\u201d. The VA was asked why it wasn\\u2019t and safe and the response was \\u201cI could get hurt\\u201d. Supervisor asked VA if it will ever happen again and VA shook their head \\u201cno\\u201d. Supervisor walked VA to the bus and fastened seatbelt and sat patiently until the bus departed.  \\\"\",\"Multiple_Choice__96\":\"1\",\"Short_Answer__91\":\"Staff didn\\u2019t continuously monitor the person in bathroom and the person eloped without being seen\",\"True_or_False__94\":\"Yes\",\"Date__97\":\"07\\/10\\/2019\",\"Free_Text__98\":\"\\\"VA has worked at the employment program for 10 years and the staff interviewed reported they have worked with her for most of that time.  Over this 10 years the VA lived with an aunt, then in an adult foster care setting (near her employment program) and at the time of the incident was living in an apartment.  \\r\\n\\r\\nVA enjoyed coloring\\/crafts, being outside, working, having attention and encouragement from staff.  VA enjoyed food (lunch at work and wouldn\\u2019t necessarily heat up a meal that typically would be a meal to heat up).\\r\\n\\r\\nVA has a staffing ratio at the employment program of a 1:3, most individuals there have 1:6 or 1:7.  At home VA had a 2:1 staffing ratio.  The 2:1 at home was higher because VA was more physically aggressive at home than at work.  Less aggression towards male staff-staff interviewed stated VA has less male staff at residence than at the employment program.  \\r\\n\\r\\nThe employment program has 200 individuals in their facility and approximately 45 in the area where VA works.  The day of the event there was 7-8 staff in the area for all of those individuals being served.  \\r\\n\\r\\nThe elopement protocol at the employment program was for the staff to have eyes on VA, except in the bathroom and just do 5 minute checks.  Keep the lunch and duffle bag in the supervisor\\u2019s office.  VA would have no antecedents prior to elopements or other incidents of maladaptive behavior (this day was no different.  The team agreed to this plan including the guardians (parents).\\r\\n\\r\\nVA works at the employment program Monday-Friday from 9am-3pm and typically VA shows signs of being done with work at around 2pm.  The day of the incident the VA had arrive late or had not been ready when the bus arrived to pick her up.  This was a common occurrence.  \\r\\n\\r\\nWhen at work the VA was a great worker completing piece work on the work floor.  That day there was not a lot of work available and the group had been doing other craft activities (VA enjoyed).  It is believed that VA had a possible UTI infection and VA had a history of GERD\\/esophagus issues (causing her to vomit and cause pain), however VA could not verbalize their needs all of the time.  Verbal skills were limited.  Over the time VA worked at the employment program they were able to get her to improve her verbal skills by encouraging VA to use her words.  If she were sick and she was about to vomit VA would attempt to express this to the employment staff and sometimes ask them for a Tums.  \\r\\n\\r\\nThe VA did not take the duffle bag or lunch when the elopement occurred which typically the VA would not have left the building without either of the bags.  The VA never was able to explain the reason for elopement, however the staff believe there is a Kwik Trip nearby that was the direction VA was headed and her previous residence was near the employment program.  VA did things with no antecedents and would do things for attention.  The staff believe potentially VA was not feeling well and potentially wanted to go outside because VA really enjoyed being outside.  Staff went outside after receiving phone call from transportation company and got the VA from the Good Samaritan that was walking with VA.  \\\"\",\"Free_Text__100\":\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.  It is the providers practice to allow all of the individual\\u2019s privacy in the restroom as this is influenced by societal norms.  The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\u2019s office.  Additionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio. Thus the ratio allows the county to manage the budget allocation they are given by the state and federal allocations which is determined through the legislation.  Overall legislation determines the rates that are set which then is strengthened by MNCHOICES to determine the needs are met, thus to create the staffing patterns for the provider in the support plan.\",\"Multiple_Choice__101\":\"2\",\"Free_Text__102\":\"The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\u2019s office.\",\"Multiple_Choice__103\":\"0\",\"Multiple_Choice__105\":\"0\",\"Multiple_Choice__107\":\"0\",\"Multiple_Choice__109\":\"0\",\"Multiple_Choice__111\":\"0\",\"Multiple_Choice__113\":\"0\",\"Multiple_Choice__115\":\"3\",\"Free_Text__116\":\"\\\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.  \\r\\n\\r\\nAdditionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio.\\\"\",\"Multiple_Choice__117\":\"0\",\"Multiple_Choice__119\":\"0\",\"Multiple_Choice__121\":\"0\",\"Multiple_Choice__123\":\"2\",\"Free_Text__124\":\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.\",\"Multiple_Choice__125\":\"0\",\"Yes_or_No__432\":\"Yes\"}',NULL,0,1,81,81,'2021-04-29 02:23:07','2021-04-29 02:28:09',NULL,'JT_MRCI-BEC-2019-05'),(23,23,81,NULL,10,NULL,NULL,'{\"Short_Answer__76\":\"201900985\",\"Date__77\":\"05\\/15\\/2019\",\"Multiple_Choice__78\":\"Kristie Pittman\",\"Multiple_Choice__79\":\"Jill Tilbury\",\"Short_Answer__80\":\"Haugbeck Support Services\",\"Short_Answer__81\":\"Mike Beckius\",\"Short_Answer__82\":\"mikebeckius@gmail.com\",\"Multiple_Choice__84\":\"Elopement\",\"Multiple_Choice__85\":\"Blue Earth County\",\"Date__86\":\"11\\/13\\/2018\",\"Free_Text__87\":\"\\\"Staff was meeting at another location with client\\u2019s guardian\\/mother. Client called her guardian\\/mother asking to have a private phone call, guardian reminded her that she could not do that, client abruptly ended the call.   A few minutes later a call came in that client ran away from the house.  Staff left to go look and kept in contact with guardian who was tracking client with the GPS on clients phone.   Staff arrived to clients location to a fire truck and someone directing traffic.  Staff was informed that client was struck by a vehicle and taken to the hospital by ambulance. \\r\\n\\r\\nIncident described by direct care staff.  Client came home from work and took phone without asking staff.  She locked herself in her room with the phone.  Staff knocked and asked her to open door, but did she did not respond.  Staff knocked again and explained to her the pone rules.  Client opened the door and yelled at staff using inappropriate words.  She then said she wanted to have a private phone call, locked herself in her room.  Staff unplugged the phone (per protocol) .  Client came out pissed and started kicking the pone and throwing it on the floor.  She picked the phone up and said she hated staff and that she was leaving.  She then got ready and left the house. \\r\\n\\\"\",\"Multiple_Choice__96\":\"1\",\"Short_Answer__91\":\"Staff did not pursue person when they eloped\",\"True_or_False__94\":\"Yes\",\"Date__97\":\"06\\/24\\/2019\",\"Free_Text__98\":\"\\\"Client is a 25 year old female diagnosed with fetal alcohol syndrome and reactive attachment disorder. She had been living in a corporate foster care since 2014. She lives with her identical twin sister. Her mother is her legal guardian. In September 2019, client had a crises placement due to increase in behaviors. \\r\\n\\r\\nCouple months prior to incident, client\'s behaviors not as predictable. Client had medication changes, was demonstrating suicidal ideation (superficial cutting) and was eloping 1 to 2 times a week. Staff report they use to be able to tell when client was going to elope and then it became harder to identify antecedents leading up to elopement. \\r\\n\\r\\nClient had an incident prior to this incident of running into Mankato and meeting up with a young man that she later accused of abusing her. Staff followed her until she reached a crowded area around Mankato State campus. Distance was over 6 miles. Client is in good physical shape. \\r\\n\\r\\nThere are 2-3 staff on evening shift. Home has 4 clients. Direct care staff involved in incident are no longer employed with provider. Staff reports a long history of elopement. \\r\\n\\r\\nA team (consisting of a case manager, guardian, house manager and administrative staff) developed an elopement protocol. Staff meetings occurred bi-weekly to address behaviors and concerns about client. Client\'s guardian had attended staff meetings to assist in training staff on how to work with her daughter. \\r\\n\\r\\nElopement protocol states that staff are to follow client during daytime hours when safe. Protocol directs staff not to follow when dark outside as this is a safety concern for staff. On day of incident, staff followed protocol and called supervisor. \\r\\n\\r\\nClient has a protocol in place where she can ask to go on a run. Protocol specifically states how long and where client can run. CLient can not go on a planned run after dark. When she asked she always comes back. Protocol in place so staff can identify the difference. \\r\\n\\r\\nClient would call guardian\\/mom when not happy with what staff was doing. Mom would change the rules\\/programs that were established when her daughter was upset. Guardian\\/mom directed day to day activities and would tell staff what things her daughter should do that day. The consistency of protocols were difficult for staff to follow due to the changes in decision making process being made by the guardian\\/mom. Program direct reports that as guardian become more inconsistent with following programs that elopement increased. \\\"\",\"Free_Text__100\":\"\\\"Direct care staff not following the person who eloped from the facility was influenced foremost by the person\\u2019s elopement protocol. At the time of the elopement it was dark outside and the protocol directed staff to not follow when dark. Contributing to the staff\\u2019s decision not to follow the person was the team\\u2019s (case manager, guardian, provider staff) desire to ensure the safety of staff and the person which was impacted by the person\\u2019s history of exhibiting challenging behaviors when followed. When staff followed the person in past elopements, the person ran further and was difficult to find. The person\\u2019s home was in a rural location which also impacted staff\\u2019s decision to not follow in the dark due to safety concerns. The elopement protocol was developed by the provider and approved by the guardian and case manager. Staff were intimidated by the guardian, which influenced the staff\\u2019s decision to follow protocol the guardian helped create. Direct care staff not following during the elopement was further supported by the person wearing a tracking watch that allowed staff to track the person and not always rely on following them.\\r\\n\\r\\nThere are a lack of crises services and placement options available in the area of the person\\u2019s home. Because of this, the provider created the elopement protocol as a way to try to balance the support and safety of the person. Limited state funding for crises services impacted the provider\\u2019s decision to create an elopement protocol. This is further influenced by the provider\\u2019s license requirements of 245A and 245D to safeguard the person\\u2019s health, safety and well-being.\\\"\",\"Multiple_Choice__101\":\"0\",\"Multiple_Choice__103\":\"0\",\"Multiple_Choice__105\":\"0\",\"Multiple_Choice__107\":\"0\",\"Multiple_Choice__109\":\"0\",\"Multiple_Choice__111\":\"0\",\"Multiple_Choice__113\":\"0\",\"Multiple_Choice__115\":\"3\",\"Free_Text__116\":\"Direct care staff not following the person who eloped from the facility was influenced foremost by the person\\u2019s elopement protocol. At the time of the elopement it was dark outside and the protocol directed staff to not follow when dark. Contributing to the staff\\u2019s decision not to follow the person was the team\\u2019s (case manager, guardian, provider staff) desire to ensure the safety of staff and the person which was impacted by the person\\u2019s history of exhibiting challenging behaviors when followed. When staff followed the person in past elopements, the person ran further and was difficult to find. The person\\u2019s home was in a rural location which also impacted staff\\u2019s decision to not follow in the dark due to safety concerns.\",\"Multiple_Choice__117\":\"1\",\"Multiple_Choice__119\":\"3\",\"Free_Text__120\":\"There are a lack of crises services and placement options available in the area of the person\\u2019s home. Because of this, the provider created the elopement protocol as a way to try to balance the support and safety of the person.\",\"Multiple_Choice__121\":\"0\",\"Multiple_Choice__123\":\"0\",\"Multiple_Choice__125\":\"0\",\"Yes_or_No__432\":\"Yes\"}',NULL,0,1,81,81,'2021-04-29 02:28:57','2021-04-29 02:32:03',NULL,'KP_HaugBeck-BEC-2019-05'),(24,23,81,NULL,10,NULL,NULL,'{\"Short_Answer__76\":\"201904216\",\"Date__77\":\"07\\/15\\/2019\",\"Multiple_Choice__78\":\"Kristie Pittman\",\"Multiple_Choice__79\":\"Jill Tilbury\",\"Short_Answer__80\":\"REM Heartland - Couger Court\",\"Short_Answer__81\":\"Devin Nelson\",\"Short_Answer__83\":\"507-223-4410\",\"Multiple_Choice__84\":\"Medication Error\",\"Multiple_Choice__85\":\"Blue Earth County\",\"Date__86\":\"06\\/01\\/2019\",\"Free_Text__87\":\"On 6-8-2019, it was discovered that the person had been receiving only half of the prescribed dosage of her Mycophenolate.  The missed medications were then found in the medication cabinet.  Person received half of 9am and 3pm prescribed dosage from 6-1-2019 to 6-7-2019.\",\"Multiple_Choice__96\":\"1\",\"Short_Answer__91\":\"Person received half of the prescribed dosage of medication.\",\"True_or_False__94\":\"Yes\",\"Date__97\":\"08\\/14\\/2019\",\"Free_Text__98\":\"\\\"Staff 1 has been working for the company for the past 4 years and her role is a direct care staff. Staff 1 typically picks up of the medication from the pharmacy.  Sometimes Staff 1\\u2019s supervisor picks up the medications.  The staff who picks up the medications is responsible for organizing and separating the medications.  This medication usually come with one pill in two separate bubble packs and sometimes it will come with two pills in one bubble pack.  The person receives this medication at 9am and 3pm.  \\r\\n\\r\\nStaff 1 picked up the medication and then organized them.  Staff 1 felt that she put the correct medication and dosage in person\\u2019s medication area in the locked medication cabinet.  Staff does not recall anything out of the norm when organizing medications.  She said she was not distracted and that it was quiet at the house.  Staff 1said all medications are kept in each person\\u2019s area in the medication cabinet. Staff 1 said it is common practice for this facility for the first person who gives medication on the first of each month to double check that the medications were set up correctly. \\r\\n\\r\\nDebriefing with Staff #2 on 8-21-2019\\r\\n\\r\\nStaff 2 has worked for the company for the past 35 years and has held various position within the company.  Staff currently works the overnight shift which is from 10pm to 9am.  She is very familiar with the person and her medications as she has been with that group home for a long time.  \\r\\n\\r\\nOn the morning of June 1st, Staff 2 went to give 9am medications and noted that something \\u201cappeared off\\u201d with the medications. The medication typically comes in two single bubble packs, but there was only one bubble pack with one pill in the 9am medication. She said however that they do occasionally come with two pills in one bubble pack.  Staff 2 checked the dosage and then checked the 3pm medication and reported that they were the same, so she concluded that the dosage must have changed.  \\r\\n\\r\\nStaff 2 was not aware of the current procedure for storing extra medications.  Staff 2 said in the past when she held a different position that she would lock extra medications in the office desk. \\\"\",\"Free_Text__100\":\"\\\"The person receiving half of the prescribed dosage of medication for six days was influenced by Staff 1 believing that they set up the medications correctly after receiving them from the pharmacy.  An additional feature that influenced staff believing that the medications were set up correctly, was the medications were not always packaged the same when they came from the pharmacy.  Therefore, staff did not question when there was only one bubble pack for the person\\u2019s 9am medications and one bubble pack for person\\u2019s 3pm medications.  Staff 2 was the first staff to give medications after staff 1 set up medications in the med drawer for the month.   Staff 2 believed medications were set up correctly was influenced by the belief that the person\\u2019s medication dosage must have changed because of the way the meds were packaged.  Contributing to the staff\\u2019s belief that medication dosage changed was further influenced by the person\\u2019s 3pm medication dosage matching the 9am medication dosage.  This was further supported by staff 2 not finding the second bubble pack in the person\\u2019s medication drawer, which was the house norm for storing all medications.  Staff 2 also believed that staff 1 set up medications correctly.  \\r\\n \\r\\nAn additional factor that had other staff following staff 2\\u2019s lead in only giving half the med, rather than following medication protocol and ensuring that the med label and the Medication Administration Record (MAR) match the dosage in the bubble pack, is that there are a lot of policies for staff to know. This provider\\u2019s medication policies had changed due to the acquisition of another company, which then had both companies revise their policies to match each other. The introduction of 245D also required this provider to revise their medication administration policies. In the absence of stable policies the staff likely followed the veteran staff\\u2019s actions and assumed if there was a med change the veteran staff would have known as well as followed policies. \\r\\n\\\"\",\"Multiple_Choice__101\":\"2\",\"Free_Text__102\":\"This was further supported by staff 2 not finding the second bubble pack in the person\\u2019s medication drawer, which was the house norm for storing all medications. Staff 2 also believed that staff 1 setup medications correctly.\",\"Multiple_Choice__103\":\"0\",\"Multiple_Choice__105\":\"0\",\"Multiple_Choice__107\":\"0\",\"Multiple_Choice__109\":\"0\",\"Multiple_Choice__111\":\"0\",\"Multiple_Choice__113\":\"3\",\"Free_Text__114\":\"The person receiving half of the prescribed dosage of medication for six days was influenced by Staff 1 believing that they set up the medications correctly after receiving them from the pharmacy. An additional feature that influenced staff believing that the medications were set up correctly, was the medications were not always packaged the same when they came from the pharmacy Therefore, staff did not question when there was only one bubble pack for the person\\u2019s 9am medications and one bubble pack for person\\u2019s 3pm medications.\",\"Multiple_Choice__115\":\"0\",\"Multiple_Choice__117\":\"0\",\"Multiple_Choice__119\":\"0\",\"Multiple_Choice__121\":\"0\",\"Multiple_Choice__123\":\"3\",\"Free_Text__124\":\"\\\"Staff 2 believed medications were set up correctly was influenced by the belief that the person\\u2019s medication dosage must have changed because of the way the meds were packaged.  Contributing to the staff\\u2019s belief that medication dosage changed was further influenced by the person\\u2019s 3pm medication dosage matching the 9am medication dosage.  \\r\\n\\r\\nAn additional factor that had other staff following staff 2\\u2019s lead in only giving half the med, rather than following medication protocol and ensuring that the med label and the Medication Administration Record (MAR) match the dosage in the bubble pack, is that there are a lot of policies for staff to know. In the absence of stable policies the staff likely followed the veteran staff\\u2019s actions and assumed if there was a med change the veteran staff would have known as well as followed policies.\",\"Multiple_Choice__125\":\"0\",\"Yes_or_No__432\":\"Yes\"}',NULL,0,1,81,81,'2021-04-29 02:32:49','2021-04-29 02:36:05',NULL,'KP_REM Heartland-BEC-2019-07'),(25,23,81,NULL,10,NULL,NULL,'{\"Short_Answer__76\":\"201905293\",\"Date__77\":\"09\\/16\\/2019\",\"Multiple_Choice__78\":\"Kristie Pittman\",\"Multiple_Choice__79\":\"Charles Young\",\"Short_Answer__80\":\"REM Heartland, Inc. - Chastworth\",\"Short_Answer__81\":\"Lori Larson\",\"Short_Answer__82\":\"Lori.Larson@TheMentorNetwork.com\",\"Multiple_Choice__84\":\"Staff Sleeping on Duty\",\"Multiple_Choice__85\":\"Blue Earth County\",\"Date__86\":\"07\\/19\\/2019\",\"Free_Text__87\":\"As the only staff present in the facility, David laid down after Damon went to bed at approximately 8:00 pm. He inadvertently fell asleep and was awoken by the night shift staff when they reported for their shift at approximately 9:50 pm. Damon was apparently asleep the entire time, but his staffing ratios only for 1 hour of alone time during the day and sleeping night staff.\",\"Multiple_Choice__96\":\"1\",\"Short_Answer__91\":\"Staff was sleeping during an evening shift\",\"True_or_False__94\":\"No\",\"Multiple_Choice__99\":\"Staff No Longer Employed\",\"Free_Text__100\":\"\\\"This house had an asleep overnight shift that began at 10pm, as directed by the CSSPs for the four people living in the home. The staff fell asleep at 8pm when all was quiet, and all the people were presumably in their rooms for the night. The people being served in this house demonstrated low needs which allowed them to have unsupervised time, contributing to the staff feeling comfortable to lie down. An additional factor into the staff laying down was that the staff was tired.  This staff had fallen asleep on previous shifts and disclosed to management that he was tired due to a personal situation that left him homeless. The staff typically slept in his car during this period.  The provider tried to work with him to move to the overnight position which would allow him to sleep but he did not accept this offer.  The provider noted that the overnight shift made nearly $5 less per hour, which was one of the influences into the person staying on the awake shift.  The provider was experiencing a staff shortage which is one of the factors into why they wanted to work with the staff to find a position that would meet both of their needs. An additional influence in staff falling asleep is that the staff laid down to try out a newly purchased weighted blanket   \\r\\n\\r\\nAll clients in the home had their needs assessed by MnCHOICES, which supported the individuals having sleep staff as well as alone time. The provider had seen this house as a potential house to replace overnight staff with remote monitoring technology due to the low needs of the individuals. The provider\\u2019s push for more alone time and remote monitoring was impacted by their efforts to allow the dignity of risk by providing more opportunities for people they serve to have a choice and control over their lives.  The effort to encourage dignity of risk was influenced by statewide person-centered planning requirements and emphasis. However, one guardian was resistant to remote monitoring but compromised by allowing the person alone time in their plan.  It was common knowledge among staff that the clients demonstrated low needs, contributing to the staff feeling comfortable to lie down. \\r\\n\\r\\nThe staff\\u2019s unwillingness to move to the overnight shift was influenced by the lower rate of pay that asleep staff were paid. The sleep rate is factored into the provider\\u2019s overall reimbursement negotiated with the county through the 6790 and provides a lower rate asleep than awake hours. The 6790-negotiation process is influenced by the rates determined by the Legislature in the Disability Waiver Rate System and the assessed needs identified in MnCHOICES and the resulting supervision levels identified in the CSSP.\",\"Multiple_Choice__101\":\"0\",\"Multiple_Choice__103\":\"3\",\"Free_Text__104\":\"\\\"The provider tried to work with him to move to the overnight position which would allow him to sleep but he did not accept this offer.  The provider noted that the overnight shift made nearly $5 less per hour, which was one of the influences into the person staying on the awake shift.  The provider was experiencing a staff shortage which is one of the factors into why they wanted to work with the staff to find a position that would meet both of their needs. \\r\\n\\r\\nThe staff\\u2019s unwillingness to move to the overnight shift was influenced by the lower rate of pay that asleep staff were paid. The sleep rate is factored into the provider\\u2019s overall reimbursement negotiated with the county through the 6790 and provides a lower rate asleep than awake hours\\\"\",\"Multiple_Choice__105\":\"0\",\"Multiple_Choice__107\":\"0\",\"Multiple_Choice__109\":\"0\",\"Multiple_Choice__111\":\"0\",\"Multiple_Choice__113\":\"0\",\"Multiple_Choice__115\":\"2\",\"Free_Text__116\":\"All clients in the home had their needs assessed by MnCHOICES, which supported the individuals having sleep staff as well as alone time. The provider had seen this house as a potential house to replace overnight staff with remote monitoring technology due to the low needs of the individuals. The provider\\u2019s push for more alone time and remote monitoring was impacted by their efforts to allow the dignity of risk by providing more opportunities for people they serve to have a choice and control over their lives.  The effort to encourage dignity of risk was influenced by statewide person-centered planning requirements and emphasis. However, one guardian was resistant to remote monitoring but compromised by allowing the person alone time in their plan.  It was common knowledge among staff that the clients demonstrated low needs, contributing to the staff feeling comfortable to lie down.\",\"Multiple_Choice__117\":\"0\",\"Multiple_Choice__119\":\"0\",\"Multiple_Choice__121\":\"0\",\"Multiple_Choice__123\":\"3\",\"Free_Text__124\":\"\\\"The staff fell asleep at 8pm when all was quiet, and all the people were presumably in their rooms for the night. The people being served in this house demonstrated low needs which allowed them to have unsupervised time, contributing to the staff feeling comfortable to lie down.\\r\\n\\r\\nIt was common knowledge among staff that the clients demonstrated low needs, contributing to the staff feeing comfortable to lie down.  An additional influence in staff falling asleep is that the staff laid down to try out a newly purchased weighted blanket\",\"Multiple_Choice__125\":\"3\",\"Free_Text__126\":\"An additional factor into the staff laying down was that the staff was tired.  This staff had fallen asleep on previous shifts and disclosed to management that he was tired due to a personal situation that left him homeless. The staff typically slept in his car during this period\",\"Yes_or_No__432\":\"Yes\"}',NULL,0,1,81,81,'2021-04-29 02:36:28','2021-04-29 02:39:59',NULL,'KP_REM Heartland-BEC-2019-09'),(26,23,81,NULL,10,NULL,NULL,'{\"Short_Answer__76\":\"201907799\",\"Date__77\":\"12\\/16\\/2019\",\"Multiple_Choice__78\":\"Kristie Pittman\",\"Short_Answer__80\":\"REM Heartland, Inc. - Cougar Drive\",\"Multiple_Choice__84\":\"Medication Error\",\"Multiple_Choice__85\":\"Blue Earth County\",\"Date__86\":\"10\\/19\\/2019\",\"Free_Text__87\":\"\\\"The individual was setting up her medication for the week on Tuesday 10\\/15\\/19. The individual stated that she\\r\\ntook the bottle of pills from the box of medication that staff left unattended. Individual stated on 10\\/20\\/19 that she took 30 pills on 10\\/17\\/19\\r\\nand took 19 pills on 10\\/19\\/19. The medication was Hydroxyzine 25mg capsules. The individual did not have any apparent side effects from\\r\\ntaking the medications.\\\"\",\"Multiple_Choice__96\":\"1\",\"Short_Answer__91\":\"Staff left person unsupervised duirng medication setup\",\"True_or_False__94\":\"No\",\"Multiple_Choice__99\":\"Staff No Longer Employed\",\"Free_Text__100\":\"\\\"Person was left unsupervised during medication set up was influenced by DSP perception that the people who are their own guardians can direct their own services.  Person was their own guardian. Also contributing to the staff\\u2019s perception is the training they receive on person center planning which is a requirement of 245D.  The training offered to staff is impacted by the funding that is allowed in the Disability Waiver Rate Setting Tool, which doesn\\u2019t always capture the training staff may need to support a person with mental health issues. \\r\\n Also influencing the staff to leave someone unsupervised that there were 4 people in the home and the time of the day at the home was busy.  Staff are responsible for ensuring the safety of all people in the home which is a requirement by the CSSP of each person as well as the requirements of 245D. \\r\\nFurther impacting staff leaving the person unsupervised during medication setup is that staff at the home would often prioritize the needs of the other 3 people in the home due to their higher and lower autonomy.  . The moratorium decreased the number of beds available and created a bed shortage.\\r\\nThe final influence as to why the staff left the person unsupervised was the staff was comfortable leaving the person alone.  The person was high functioning and their own guardian.  Person being served had no history of abusing medications while residing in the home and no history of issues during medication set up influencing staff to have a trusting relationship with the person further impacting the staff being comfortable leaving the person unsupervised during medication set up.  The person had chosen to set up their medications independently with supervision.  The provider was assigned responsibility for medication set up with supervision by the case manager and agreed to by the person.  The mental health professionals involved did agree that there was a need for medication set up assistance, influencing why the provider was assigned medication set up responsibilities. The person\\u2019s MnCHOICES assessment did identify a need for medication responsibilities, which in turn was impacted by the levels of medication responsibilities identified in 245D.  The case manager\\u2019s awareness of the person\\u2019s history, which included a previous suicide attempt, further impacted the case manager assigning the provider medication set up assistance responsibility.\",\"Multiple_Choice__101\":\"3\",\"Free_Text__102\":\"\\\"Person was left unsupervised during medication set up was influenced by DSP perception that the people who are their own guardians can direct their own services\\r\\n Person being served had no history of abusing medications while residing in the home and no history of issues during medication set up influencing staff to have a trusting relationship with the person further impacting the staff being comfortable leaving the person unsupervised during medication set up.  \\\"\",\"Multiple_Choice__103\":\"3\",\"Free_Text__104\":\"\\\"\\r\\n\\r\\nThe training offered to staff is impacted by the funding that is allowed in the Disability Waiver Rate Setting Tool, which doesn\\u2019t always capture the training staff may need to support a person with mental health issues. \\r\\n\\\"\",\"Multiple_Choice__105\":\"0\",\"Multiple_Choice__107\":\"0\",\"Multiple_Choice__109\":\"0\",\"Multiple_Choice__111\":\"0\",\"Multiple_Choice__113\":\"0\",\"Multiple_Choice__115\":\"0\",\"Multiple_Choice__117\":\"0\",\"Multiple_Choice__119\":\"2\",\"Free_Text__120\":\"\\\"Impacting the mix of personal needs in the home that providers have serving people with different diagnosis in one home more often since the foster care moratorium took effectThe moratorium decreased the number of beds available and created a bed shortage.\\r\\n\\\"\",\"Multiple_Choice__121\":\"0\",\"Multiple_Choice__123\":\"2\",\"Free_Text__124\":\"Further impacting staff leaving the person unsupervised during medication setup is that staff at the home would often prioritize the needs of the other 3 people in the home due to their higher and lower autonomy\",\"Multiple_Choice__125\":\"0\",\"Yes_or_No__432\":\"Yes\"}',NULL,0,1,81,81,'2021-04-29 02:40:27','2021-04-29 02:43:48',NULL,'KP_REM Heartland-BEC-2019-12'),(27,18,160,NULL,39,NULL,NULL,'{\"Multiple_Choice__287\":\"Brittany Lochner\",\"Short_Answer__288\":\"Janet Bowman, Jen Goodman, Wendy Woessner, Jess VanKuyk\",\"Multiple_Choice__425\":\"CFSR Item 6 - Permanency: 24 months\",\"Multiple_Choice__290\":\"SCIR\",\"Date__289\":\"10\\/29\\/2020\",\"Yes_or_No__372\":\"No\",\"Yes_or_No__375\":\"No\",\"Multiple_Choice__377\":\"9\",\"Multiple_Choice__378\":\"Ramsey\",\"Short_Answer__380\":\"Isabella\",\"Short_Answer__381\":\"Anderson\",\"Date__382\":\"06\\/20\\/2015\",\"Multiple_Choice__383\":\"2\",\"Short_Answer__384\":\"The subject child has been in foster care (in the pre-adoptive home) for 4 years, free for adoption for 3 years, and adoption has not been finalized.\",\"Free_Text__385\":\"The agency was committed to having all of the children remain in the same placement and prioritized the children being adopted by the grandparents. Following the TPR and when the children were all in grandparents\\u2019 home, the plan was for the grandparents to adopt the children. After about a year, the grandparents started reporting that the siblings\\u2019 behavior was too much for them to handle. The agency worked to support the grandparents and the children\\u2019s placements through frequent visits\\/conversations with the grandparents, engaging therapeutic foster care services, coaching and mentoring for the grandparents. According to the worker, the children had been in 10-11 placements and they were trying to salvage the placement so the children could stay together and be adopted by their grandparents and stay connected to their birth family. The agency felt that the placement was never stable enough to finalize adoption and did everything they could to keep all of the children in the grandparents\\u2019 home. They agency felt they would get to a point where they were ready to move forward with the adoption and then the grandparents would ask for more time. It appeared that the house was divided and the grandparents did not share the same goal for adoption. From the worker\\u2019s perspective, the grandparents were always committed to adopting the subject child and not as consistent with wanting to adopt the siblings. It came to a point during a recent court hearing that the Judge told the grandparents that they needed to make a decision as to whether or not they would adopt the 9-year old. Ultimately, they decided not to pursue adoption of either sibling. The agency is moving forward with adoption of the subject child with the grandparents.\",\"Free_Text__386\":\"Items identified during the mapping supporting adoption not being finalized after child being in foster care for 4 years, and free for adoption for 3 years, included a pressure to place with relatives, pressure to keep siblings together, child\\u2019s needs not being able to be met, and additional pressures placed on caregiver\\u2019s family.   \\r\\nPressure to place with relatives was supported by the courts\\u2019 role in the process. The court and DHS are responsible for approving sibling separations and those decisions are influenced by the federal measures of AFSA. Adherence to those measures supported the agency\\u2019s decision making process regarding preference for relative placements as opposed to non-relative placement. The grandfather wanted to adopt the siblings; however, the grandmother was apprehensive about adopting the siblings because she was the sole caregiver at times while the grandfather was working. The grandparents needed assistance for which the agency was unable to provide due to the unavailability of expertise to do so. \\r\\nThe competing priorities of placement stability versus sibling separation were influenced by the pressure to keep siblings together as outlined by the Sibling Bill of Rights (M.S. 260C.008). An additional factor contributing to pressures to keep the siblings together came from the recommendations by the Guardian ad Litem, which was guided by Minnesota statute 260C.212 subd. 2\\r\\nWhile the family wanted to finalize adoption, given their attachment to the child, their inability to meet the child\\u2019s needs supported their reluctance to move forward with the adoption. Due to the child\\u2019s need for permanency, an ultimatum was given by the courts for the caregivers to make a decision regarding adoption. The child\\u2019s behaviors and the grandmother being placed in the role as the primary caregiver without needed breaks, placed additional pressure on the family which influenced their decision to not adopt the child. Factors that contributed to these pressures included the children needing to be homeschooled due to COVID 19 and the grandfather being out of the home due to employment. Additionally, the family was reluctant to have providers in their home in order to reduce their exposure to the COVID virus.\\r\\nDue to the needs and age of the child, the child required many services to manage his needs. Services were often not available and when available, not consistent. Services often required pretesting or assessment to determine eligibility, however, these assessments often had a waitlist.  The grandparent\\u2019s lack of understanding about the children\\u2019s diagnosis and social interactions supported their inability to manage the child\\u2019s behaviors and needs and contributed to their reluctance to finalize adoption.\",\"Short_Answer__387\":\"Sibling separation and placement stability\",\"Free_Text__388\":\"The agency was committed to keeping all of the children together. When the dynamics of the household began to change, the worker indicated he worked closely with the Guardian ad Litem (GAL) to consult with and assist in providing support for the grandparents and the children. Therapeutic foster care services were put in place to support the grandparents and the siblings. The worker felt this was a challenging case for the siblings as they have needs that required additional support, which was difficult for the grandparents to manage at times. When decisions needed to be made whether to move the siblings, the worker stated that he consulted with his supervisor, the GAL and the agency\\u2019s screening team. In regards to the 12-year old, the grandparents didn\\u2019t feel they could meet his needs and requested that he move and once this occurred, the grandparents made the decision not to pursue adoption of the 12-year old. About a year after the 12-year old left the home, the grandparents began telling the worker that the 9-year old\\u2019s needs are becoming too much for them. The worker felt that the grandma was overwhelmed with having to home school the kids (during the pandemic), the grandpa being out of the home for work, and being confined to the house added stress to the grandma, which may have supported the grandparents decision to not pursue adoption with the 9-year old as well.\\r\\nThe worked stated that they couldn\\u2019t force the grandparents to adopt if they weren\\u2019t ready.\",\"Free_Text__389\":\"Items identified during the mapping supporting sibling separation and placement stability included a pressure to place with relatives, pressure to keep siblings together, child\\u2019s need and additional pressures placed on caregiver\\u2019s family.   \\r\\nPressure to place with relatives was supported by the courts\\u2019 role in the process. The court and DHS are responsible for approving sibling separations and those decisions are influenced by the federal measures of AFSA. Adherence to those measures supports the agency\\u2019s decision making process regarding preference for relative placements as opposed to non-relative placement.\\r\\nThe competing priorities of placement stability versus sibling separation were influenced by the pressure to keep siblings together as outlined by the Sibling Bill of Rights (M.S. 260C.008). An additional factor contributing to pressures to keep the siblings together came from the recommendations by the Guardian ad Litem, which was guided by Minnesota statute 260C.212 subd. 2\\r\\nWhile the family wanted to finalize adoption given their attachment to the child, their inability to meet the child\\u2019s needs supported their reluctance to move forward with the adoption. Due to the child\\u2019s need for permanency, an ultimatum was given by the courts for the caregivers to make a decision regarding adoption. The child\\u2019s behaviors and the grandmother being placed in the role as the primary caregiver without needed breaks, placed additional pressure on the family which influenced their decision to not adopt the child. Factors that contributed to these pressures included the children needing to be homeschooled due to COVID 19 and the grandfather being out of the home due to employment. Additionally, the family was reluctant to have providers in their home in order to reduce their exposure to the COVID 19 virus.\\r\\nDespite the caregivers having an attachment to the older sibling, they were unable to meet his needs, prompting the necessity of an outside placement, requiring sibling separation  A year after the sibling separation, a sibling child began exhibiting similar behaviors, again posing challenges to the family to meet his needs  Due to the challenging needs of the child, the caregivers determined they were not able to meet his needs, which led to another placement disruption and the siblings being separated.\",\"Multiple_Choice__400\":\"2\",\"Free_Text__401\":\"LP #1: Items identified during the mapping supporting adoption not being finalized after child being in foster care for 4 years, and free for adoption for 3 years, included a pressure to place with relatives, pressure to keep siblings together, child\\u2019s needs not being able to be met, and additional pressures placed on caregiver\\u2019s family.   \\r\\nPressure to place with relatives was supported by the courts\\u2019 role in the process. The court and DHS are responsible for approving sibling separations and those decisions are influenced by the federal measures of ASFA. Adherence to those measures supported the agency\\u2019s decision making process regarding preference for relative placements as opposed to non-relative placement. \\r\\n\\r\\nLP #2: Items identified during the mapping supporting sibling separation and placement stability included a pressure to place with relatives, pressure to keep siblings together, child\\u2019s need and additional pressures placed on caregiver\\u2019s family.   \\r\\nPressure to place with relatives was supported by the courts\\u2019 role in the process. The court and DHS are responsible for approving sibling separations and those decisions are influenced by the federal measures of AFSA. Adherence to those measures supports the agency\\u2019s decision making process regarding preference for relative placements as opposed to non-relative placement.\",\"Multiple_Choice__402\":\"2\",\"Free_Text__403\":\"LP #1: The grandparents needed assistance for which the agency was unable to provide due to the unavailability of expertise to do so (clarify what kind of assistance and from whom \\u2013 internal or external).\",\"Multiple_Choice__404\":\"0\",\"Multiple_Choice__406\":\"0\",\"Multiple_Choice__408\":\"0\",\"Multiple_Choice__410\":\"0\",\"Multiple_Choice__412\":\"0\",\"Multiple_Choice__414\":\"2\",\"Free_Text__415\":\"LP #1: The court and DHS are responsible for approving sibling separations and those decisions are influenced by the federal measures of ASFA. Adherence to those measures supported the agency\\u2019s decision making process regarding preference for relative placements as opposed to non-relative placement. \\r\\n\\r\\nThe competing priorities of placement stability versus sibling separation were influenced by the pressure to keep siblings together as outlined by the Sibling Bill of Rights (M.S. 260C.008). An additional factor contributing to pressures to keep the siblings together came from the recommendations by the Guardian ad Litem, which was guided by Minnesota statute 260C.212 subd. 2\\r\\n\\r\\nLP #2: . The court and DHS are responsible for approving sibling separations and those decisions are influenced by the federal measures of AFSA. Adherence to those measures supports the agency\\u2019s decision making process regarding preference for relative placements as opposed to non-relative placement.\\r\\nThe competing priorities of placement stability versus sibling separation were influenced by the pressure to keep siblings together as outlined by the Sibling Bill of Rights (M.S. 260C.008). An additional factor contributing to pressures to keep the siblings together came from the recommendations by the Guardian ad Litem, which was guided by Minnesota statute 260C.212 subd. 2\",\"Multiple_Choice__416\":\"0\",\"Multiple_Choice__418\":\"2\",\"Free_Text__419\":\"LP #1: Due to the needs and age of the child, the child required many services to manage his needs. Services were often not available and when available, not consistent. Services often required pretesting or assessment to determine eligibility, however, these assessments often had a waitlist.  The grandparent\\u2019s lack of understanding about the children\\u2019s diagnosis and social interactions supported their inability to manage the child\\u2019s behaviors and needs and contributed to their reluctance to finalize adoption.\",\"Multiple_Choice__420\":\"0\",\"Multiple_Choice__422\":\"0\",\"Yes_or_No__424\":\"Yes\"}',NULL,0,1,160,160,'2021-04-30 13:05:28','2021-05-03 16:34:46',NULL,'Ramsey Pilot'),(28,18,160,NULL,39,NULL,NULL,'{\"Multiple_Choice__287\":\"Brittany Lochner\",\"Short_Answer__288\":\"Janet Bowman, Jen Goodman, Wendy Woessner, Jess VanKuyk\",\"Multiple_Choice__425\":\"CFSR Item 6 - Permanency: 24 months\",\"Multiple_Choice__290\":\"SCIR\",\"Date__289\":\"10\\/27\\/2020\",\"Yes_or_No__372\":\"No\",\"Yes_or_No__375\":\"No\",\"Multiple_Choice__377\":\"4\",\"Multiple_Choice__378\":\"Wright\",\"Short_Answer__380\":\"Brooke\",\"Short_Answer__381\":\"Dahlheimer\",\"Date__382\":\"04\\/17\\/2009\",\"Multiple_Choice__383\":\"2\",\"Short_Answer__384\":\"The subject child was in placement for 3 years, 9 months prior to adoption being finalized.\",\"Free_Text__385\":\"The children were in a pre-adoptive home with an aunt and uncle when the case was transferred to the A\\/G worker. The worker did not identify any barriers in getting the adoption placement agreement (APA) signed by the aunt and uncle. Once the APA was signed, the worker indicated that things started to change. The aunt and uncle separated and the children stayed with the aunt. The agency was navigating through which one of them would adopt the children and ultimately, they both still wanted to adopt them. The agency consulted with DHS and it was determined to continue to pursue the aunt for adoption. The aunt signed a second APA and the worker continued to gather supporting documentation to accompany the APA, while working on completing the social\\/medical history. The worker stated that they had court hearings every 3 months during this time and did not feel the court contributed to the delay in getting the adoption finalized.\\r\\n\\r\\nThe worker talked about the amount of paperwork and time it takes to gather supporting documentation when working on an adoption. She indicated that getting the social\\/medical history filled out \\u201cgood enough\\u201d takes the most time; however, they have made some changes and are now having the ongoing worker get a start on the social\\/medical history and gathering the documentation to help speed up the process once it gets transferred to the A\\/G worker.\",\"Free_Text__386\":\"The subject child being in placement for 3 years, 9 months prior to adoption being finalized was influenced by complexity of cases for children who have been in OOHP, the amount of documentation, placing with relatives, and the ability of training to meet the needs of staff.  The complexity of these cases can create confusion of timelines for adoption finalization. Due to this complexity, agencies utilize support through consultation with other agencies, which may lead to misunderstandings and inconsistent practice regarding requirements of the licensing of families. Timelines for these cases are guided by statute and these statutory timelines may not be realistic for completing all aspects needed to finalize adoption. There are various influences contributing to the difficulty in meeting these timelines, including; the county attorney\\u2019s workload, the need to have exact information for the completion of court documents, and other court processes such as CHIPS cases and trials taking precedence over other court cases. \\r\\n\\r\\nAnother factor that influences the perception that timelines may not be realistic is the size of DHS. It can be difficult to identify where to go for assistance when needed and after finding this, agencies may need to contact multiple program areas within DHS to move forward; adding time to adoption finalization. Additionally, staffing levels at DHS lengthen the time it takes to process background studies and social histories and sometimes, more time is needed to adjust information on the background studies, ultimately leading to the time it takes to finalize adoption. After this information is processed, there also exists legal constraints; incomplete information results in the need for court orders to be amended and permanency finalization cannot be completed until all information is accurate. Further supporting the perception that timelines may not be realistic.\\r\\n\\r\\nAn additional influence into the length of time it takes for adoption to be finalized is the fact that social history information doesn\\u2019t automatically get pulled from SSIS, which results in workers having to manually locate this information. This information comes from many different sources; including other workers within the agency, as well as, other various medical, health, and educational records. Getting complete information from all of these sources can be difficult and it takes time depending on where this information is held. Pressure to place with relatives also exists at all levels of our system, which can influence the time it takes for adoption to be finalized (i.e. state statute, Judges, state and local levels). The time it takes to locate relatives, assess the ability to meet the child\\u2019s needs, and navigate through the uniqueness that each family brings, can lengthen the time it takes in the overall effort to finalize adoption.\\r\\n\\r\\nFurthermore, in relation to adoption, trainings are broad and may not teach what needs to be completed on each case and, although trainings exist, local agencies are not always aware of when these trainings are offered by DHS. Specifically, trainings are typically focused on Northstar and paperwork duties. Often times, non-relative providers have had training and supports prior to receiving a placement and this may not be the case for relative providers. Because of this, relative providers may require more support during onboarding and throughout the placement.\",\"Short_Answer__387\":\"The children experienced a placement disruption after being in relative\\/pre-adoptive home for 24 months.\",\"Free_Text__388\":\"The worker indicated that when the children were initially placed in foster care, they were placed with the siblings paternal grandparents and then the children went back home with the mother on a trial home visit for approximately 2 months. The children returned to foster care in February 2017 and were placed with an aunt and uncle (pre-adoptive home). The aunt and uncle separated in the summer\\/fall of 2018 and the children went to live with the aunt. At this point, the aunt and uncle both wanted to pursue adoption of the children and the agency was working with them to try and make that happen. However, following consultation within the agency and with DHS, it was determined that the agency would move forward with the aunt for adoption. The worker stated that the children and the aunt reported no concerns during home visits, which supported the agency continuing to pursue adoption with the aunt. During a home visit in January 2019, the siblings reported that things weren\\u2019t going very well in the aunt\\u2019s home and asked to move with the paternal grandparents. During this time, the grandparents had filed a petition with the court requesting that the children be placed with them. The agency continued efforts with the aunt; however, after talking with the children, the aunt, and the grandparents, it was decided that the children would move into the grandparents\\u2019 home, which took place in January 2019. The agency was hesitant to place and pursue adoption with the grandparents due to past experiences; however, they moved forward and the children were adopted in May 2020.\",\"Free_Text__389\":\"The children experienced a placement disruption after being in a relative\\/pre-adoptive home for 24 months which was influenced by the provider and child requesting a change in placement. Supporting a request for a change in placement was the availability of services, including culturally sensitive services to support children and families (i.e. transportation, mental health, etc.), coupled with the needs of the family and the children. Specifically, the services available did not match the needs of the child, including mental health and trauma related services. These services not being available for the child created additional stressors in the family environment. Additionally, in some cases, added stressors within the family and the absence of supportive services may increase the possibility of abuse and neglect occurring. When abuse and\\/or neglect occurs within a family, this can influence a provider or child requesting a change in placement. Additionally, a change in the family situation also supported the provider and the child requesting a change in placement.\\r\\nThere was also an existence of pressure to place the sibling group with relatives, which was supported by statutory and state guidance, such as, the Best Interest Factors and the Sibling Bill of Rights. This pressure to place with relatives creates gaps in training for prospective foster care providers and also impacts staff availability to provide the training to the providers, prior to a child being placed in their home. The availability of staff to provide support to families was influenced by the time it takes to enter required data into the system (SSIS, paperwork, etc.) and confusion about who provides the support when there are multiple workers on a case, which can contribute to a placement disruption.\",\"Multiple_Choice__400\":\"2\",\"Free_Text__401\":\"LP #1: The subject child being in placement for 3 years, 9 months prior to adoption being finalized was influenced by complexity of cases for children who have been in OOHP, the amount of documentation, placing with relatives, and the ability of training to meet the needs of staff.  The complexity of these cases can create confusion of timelines for adoption finalization. Due to this complexity, agencies utilize support through consultation with other agencies, which may lead to misunderstandings and inconsistent practice regarding requirements of the licensing of families.\",\"Multiple_Choice__402\":\"2\",\"Free_Text__403\":\"LP #1: Additionally, limited staffing levels at DHS lengthen the time it takes to process background studies and social histories and sometimes, more time is needed to adjust information on the background studies, ultimately leading to the time it takes to finalize adoption. \\r\\n\\r\\nLP #2: This pressure to place with relatives creates gaps in training for prospective foster care providers and also impacts staff availability to provide the training to the providers, prior to a child being placed in their home. The availability of staff to provide support to families was influenced by the time it takes to enter required data into the system (SSIS, paperwork, etc.) and confusion about who provides the support when there are multiple workers on a case, which can contribute to a placement disruption.\",\"Multiple_Choice__404\":\"0\",\"Multiple_Choice__406\":\"2\",\"Free_Text__407\":\"LP #1: An additional influence into the length of time it takes for adoption to be finalized is the fact that social history information doesn\\u2019t automatically get pulled from SSIS, which results in workers having to manually locate this information\",\"Multiple_Choice__408\":\"2\",\"Free_Text__409\":\"LP #1: Another factor that influences the perception that timelines may not be realistic is the size of DHS. It can be difficult to identify where to go for assistance when needed and after finding this, agencies may need to contact multiple program areas within DHS to move forward; adding time to adoption finalization. \\r\\n\\r\\nThis information comes from many different sources; including other workers within the agency, as well as, other various medical, health, and educational records. Getting complete information from all of these sources can be difficult and it takes time depending on where this information is held.\\r\\n\\r\\nLP #2: . The availability of staff to provide support to families was influenced by the time it takes to enter required data into the system (SSIS, paperwork, etc.) and confusion about who provides the support when there are multiple workers on a case, which can contribute to a placement disruption\",\"Multiple_Choice__410\":\"2\",\"Free_Text__411\":\"LP #1: Furthermore, in relation to adoption, trainings are broad and may not teach what needs to be completed on each case and, although trainings exist, local agencies are not always aware of when these trainings are offered by DHS. Specifically, trainings are typically focused on Northstar and paperwork duties. Often times, non-relative providers have had training and supports prior to receiving a placement and this may not be the case for relative providers.\",\"Multiple_Choice__412\":\"0\",\"Multiple_Choice__414\":\"2\",\"Free_Text__415\":\"LP #1: Timelines for these cases are guided by statute and these statutory timelines may not be realistic for completing all aspects needed to finalize adoption. \\r\\n\\r\\nPressure to place with relatives also exists at all levels of our system, which can influence the time it takes for adoption to be finalized (i.e. state statute, Judges, state and local levels).\\r\\n\\r\\nLP #2: There was also an existence of pressure to place the sibling group with relatives, which was supported by statutory and state guidance, such as, the Best Interest Factors and the Sibling Bill of Rights.\",\"Multiple_Choice__416\":\"2\",\"Free_Text__417\":\"LP #1: There are various influences contributing to the difficulty in meeting these timelines, including; the county attorney\\u2019s workload, the need to have exact information for the completion of court documents, and other court processes such as CHIPS cases and trials taking precedence over other court cases. \\r\\n\\r\\nThe time it takes to locate relatives, assess the ability to meet the child\\u2019s needs, and navigate through the uniqueness that each family brings, can lengthen the time it takes in the overall effort to finalize adoption.\\r\\n\\r\\nLP #2: The availability of staff to provide support to families was influenced by the time it takes to enter required data into the system (SSIS, paperwork, etc.) and confusion about who provides the support when there are multiple workers on a case, which can contribute to a placement disruption.\",\"Multiple_Choice__418\":\"2\",\"Free_Text__419\":\"LP #2: The children experienced a placement disruption after being in a relative\\/pre-adoptive home for 24 months which was influenced by the provider and child requesting a change in placement. Supporting a request for a change in placement was the availability of services, including culturally sensitive services to support children and families (i.e. transportation, mental health, etc.), coupled with the needs of the family and the children. Specifically, the services available did not match the needs of the child, including mental health and trauma related services.\",\"Multiple_Choice__420\":\"0\",\"Multiple_Choice__422\":\"0\",\"Yes_or_No__424\":\"Yes\"}',NULL,0,1,160,160,'2021-04-30 13:36:55','2021-05-03 16:35:35',NULL,'Wright Pilot'),(29,21,81,NULL,31,NULL,NULL,'{\"Date__22\":\"03\\/23\\/2021\",\"Free_Text__48\":\"Notes here\",\"Multiple_Choice__47\":\"2\",\"Short_Answer__336\":\"Learning Point 1\",\"Short_Answer__337\":\"Learning point 2\",\"Multiple_Choice__23\":\"1\",\"Multiple_Choice__25\":\"3\",\"Free_Text__26\":\"Resources within the agency are not compatible with the needs of staff\",\"Multiple_Choice__27\":\"0\",\"Free_Text__28\":\"Resources within the agency are not compatible with the needs of staff\",\"Multiple_Choice__29\":\"2\",\"Free_Text__30\":\"An absence or deficiency in the equipment, tools and or technology utilized to carry out safe work practices\"}',NULL,0,1,81,81,'2021-04-30 16:18:43','2021-05-12 16:41:40',NULL,'Test Review 123ABC'),(30,18,159,NULL,39,NULL,NULL,'{\"Multiple_Choice__287\":\"Ryan Hartneck\",\"Short_Answer__288\":\"Niki Hoglund, Steve Johnson, Jennifer Carlson\",\"Multiple_Choice__425\":\"CFSR Item 6 - Permanency: 24 months\",\"Multiple_Choice__290\":\"SCIR\",\"Date__289\":\"10\\/29\\/2020\",\"Yes_or_No__372\":\"No\",\"Yes_or_No__375\":\"No\",\"Multiple_Choice__377\":\"8\",\"Multiple_Choice__378\":\"Hennepin\",\"Short_Answer__380\":\"Ethan\",\"Short_Answer__381\":\"Sampson\",\"Date__382\":\"08\\/20\\/2007\",\"Multiple_Choice__383\":\"1\",\"Short_Answer__384\":\"Subject child remained in OOHP from 1\\/1\\/2019 to 12\\/31\\/2019 without finalization of permanency\",\"Free_Text__385\":\"Agency staff shared that while the subject child has been making interpersonal progress, there are inherent barriers to finalization of permanency (in this case adoption). Notable, these barriers include the child\\u2019s age and size. The staff shared that the child\\u2019s age of 13 at this time makes it a little harder for recruiting a forever home as he is larger and harder to contain, and this coupled with a developmental disability (FAS), make his day to day process functioning slower. For example, prospective adoptive families need to consider the subject child\\u2019s ability to be left alone. While at age 13 he technically could be home alone for a short period of time, his disability creates an unsafe situation in doing so as his processing is slower, and may not allow the child to realize the danger in some decision making. Staff also shared that simply reading about the child, their diagnosis and limitations, rather than seeing and interacting with the child, may not allow a prospective family to really grasp the whole personality of the child, reducing the likelihood for an adoption match. For this reason, more in-person meetings with children and potential adoptive parents would be helpful. It was also noted that outreach for homes in more rural areas may present challenges regarding both services (specifically for this child, FAS services) and community identification. This child is African American and adoption and residence in a community where he looks different than others may be a consideration for potential forever homes. Lastly, the Covid-19 pandemic has created fewer opportunities for adoption recruitment as in-person events and activities have either been cancelled or significantly limited.\",\"Free_Text__386\":\"Subject child remaining in OOHP from 1\\/1\\/2019 to 12\\/31\\/2019 without finalization of permanency was influenced by children\\u2019s special needs and services, recruitment efforts and also education for workers.\\r\\nChildren with special needs seeking adoption experience multiple factors that contribute to delays in adoption finalization. The specific needs of the children can influence available resources for that child (both service related and permanency). Often times the needs of the child(ren) can intimidate prospective families. This is manifested through a general lack of awareness of developmental disabilities and the services available for children and families of children with special needs. Barriers to receiving education and accessibility to mentors for families about developmental disability services include care beyond the age of 18 for children and also the understanding of waivered and related services. These barriers contribute to a reduced willingness and\\/or ability to care for children with special needs and ultimately, a lack of available foster homes for these children. One factor that has influenced both recruitment efforts and selection of children with special needs for adoption is the initial introduction of the child to the family. Typically, a prospective adoptive family\\u2019s first information about a child is the written summary on the child. This information includes the child\\u2019s disabilities, if any, and the possible needs\\/services that children may need. This written information, without the ability to see the child\\u2019s personality, may prevent the potential adoptive parents from getting the full picture of who the child really is. The current Covid-19 pandemic has also hindered recruitment efforts as in-person meetings and events have been cancelled. Additionally, the age of and size of the child can be influencing factors in finding an adoptive home and finalization of that adoption. For children with special needs, including those that have physical outbursts, the size of the child and a parent\\u2019s ability to intervene during an episode may be reduced. It is also common that the older the child, the harder it is to recruit adoptive homes.\",\"Multiple_Choice__400\":\"0\",\"Multiple_Choice__402\":\"0\",\"Multiple_Choice__404\":\"0\",\"Multiple_Choice__406\":\"0\",\"Multiple_Choice__408\":\"2\",\"Free_Text__409\":\"One factor that has influenced both recruitment efforts and selection of children with special needs for adoption is the initial introduction of the child to the family. Typically, a prospective adoptive family\\u2019s first information about a child is the written summary on the child. This information includes the child\\u2019s disabilities, if any, and the possible needs\\/services that children may need. This written information, without the ability to see the child\\u2019s personality, may prevent the potential adoptive parents from getting the full picture of who the child really is.\",\"Multiple_Choice__410\":\"2\",\"Free_Text__411\":\"Often times the needs of the child(ren) can intimidate prospective families. This is manifested through a general lack of awareness of developmental disabilities and the services available for children and families of children with special needs. Barriers to receiving education and accessibility to mentors for families about developmental disability services include care beyond the age of 18 for children and also the understanding of waivered and related services.\",\"Multiple_Choice__412\":\"0\",\"Multiple_Choice__414\":\"0\",\"Multiple_Choice__416\":\"0\",\"Multiple_Choice__418\":\"2\",\"Free_Text__419\":\"Example 1: Often times the needs of the child(ren) can intimidate prospective families. This is manifested through a general lack of awareness of developmental disabilities and the services available for children and families of children with special needs. Barriers to receiving education and accessibility to mentors for families about developmental disability services include care beyond the age of 18 for children and also the understanding of waivered and related services. These barriers contribute to a reduced willingness and\\/or ability to care for children with special needs and ultimately, a lack of available foster homes for these children.\\r\\n\\r\\nExample 2: The current Covid-19 pandemic has also hindered recruitment efforts as in-person meetings and events have been cancelled. Additionally, the age of and size of the child can be influencing factors in finding an adoptive home and finalization of that adoption. For children with special needs, including those that have physical outbursts, the size of the child and a parent\\u2019s ability to intervene during an episode may be reduced. It is also common that the older the child, the harder it is to recruit adoptive homes.\",\"Multiple_Choice__420\":\"0\",\"Multiple_Choice__422\":\"0\",\"Yes_or_No__424\":\"Yes\"}',NULL,0,1,159,159,'2021-05-03 16:03:05','2021-05-03 16:04:13',NULL,'Hennepin Pilot'),(31,18,159,NULL,39,NULL,NULL,'{\"Multiple_Choice__287\":\"Ryan Hartneck\",\"Short_Answer__288\":\"Niki Hoglund, Steve Johnson, Jennifer Carlson\",\"Multiple_Choice__425\":\"CFSR Item 6 - Permanency: 24 months\",\"Multiple_Choice__290\":\"SCIR\",\"Date__289\":\"10\\/27\\/2020\",\"Yes_or_No__372\":\"No\",\"Yes_or_No__375\":\"No\",\"Multiple_Choice__377\":\"5\",\"Multiple_Choice__378\":\"Des Moines Valley\",\"Short_Answer__380\":\"Keyira\",\"Short_Answer__381\":\"Wagner\",\"Date__382\":\"09\\/29\\/2005\",\"Multiple_Choice__400\":\"0\",\"Multiple_Choice__402\":\"0\",\"Multiple_Choice__404\":\"0\",\"Multiple_Choice__406\":\"0\",\"Multiple_Choice__408\":\"0\",\"Multiple_Choice__410\":\"0\",\"Multiple_Choice__412\":\"0\",\"Multiple_Choice__414\":\"0\",\"Multiple_Choice__416\":\"0\",\"Multiple_Choice__418\":\"0\",\"Multiple_Choice__420\":\"0\",\"Multiple_Choice__422\":\"0\",\"Yes_or_No__424\":\"Yes\"}',NULL,0,1,159,159,'2021-05-03 16:21:25','2021-05-03 16:51:31',NULL,'DVHHS Pilot'),(32,18,81,NULL,39,NULL,NULL,'{\"Multiple_Choice__287\":\"Ryan Hartneck\",\"Short_Answer__288\":\"Test case\",\"Multiple_Choice__425\":\"Rate of experiencing child protection\",\"Multiple_Choice__290\":\"SLR\",\"Date__289\":\"05\\/06\\/2021\",\"Free_Text__390\":\"None\",\"Multiple_Choice__383\":\"1\",\"Short_Answer__384\":\"LP1\",\"Free_Text__385\":\"Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Elit eget gravida cum sociis natoque penatibus et magnis. Proin nibh nisl condimentum id. Leo in vitae turpis massa sed elementum tempus egestas. Ac turpis egestas sed tempus urna et. Convallis convallis tellus id interdum velit laoreet id donec ultrices. Hac habitasse platea dictumst quisque sagittis purus sit amet volutpat. Augue neque gravida in fermentum et sollicitudin ac. Phasellus faucibus scelerisque eleifend donec pretium vulputate sapien. Egestas pretium aenean pharetra magna ac. Fermentum leo vel orci porta non pulvinar neque laoreet suspendisse. Suspendisse ultrices gravida dictum fusce ut placerat orci nulla. Sed risus ultricies tristique nulla aliquet. Sed id semper risus in hendrerit gravida. At consectetur lorem donec massa sapien.\\r\\n\\r\\nOrnare suspendisse sed nisi lacus sed viverra. Bibendum ut tristique et egestas quis ipsum. Viverra justo nec ultrices dui sapien eget mi proin. Et tortor at risus viverra. Aenean euismod elementum nisi quis eleifend quam adipiscing vitae. Proin nibh nisl condimentum id venenatis a condimentum. Fames ac turpis egestas sed tempus urna. Ipsum faucibus vitae aliquet nec ullamcorper sit. Faucibus et molestie ac feugiat sed lectus vestibulum mattis. Odio ut sem nulla pharetra diam sit amet nisl. Enim sit amet venenatis urna. Massa vitae tortor condimentum lacinia quis vel eros. Pulvinar elementum integer enim neque volutpat ac tincidunt vitae semper. Tortor pretium viverra suspendisse potenti. Condimentum lacinia quis vel eros donec ac odio tempor. In est ante in nibh. Volutpat lacus laoreet non curabitur gravida arcu. Nec dui nunc mattis enim ut tellus.\\r\\n\\r\\nConvallis posuere morbi leo urna molestie at elementum. Odio eu feugiat pretium nibh ipsum consequat nisl. Dolor sit amet consectetur adipiscing elit. Dignissim enim sit amet venenatis urna cursus eget. Velit dignissim sodales ut eu sem. Diam donec adipiscing tristique risus nec feugiat in. Phasellus vestibulum lorem sed risus ultricies tristique. Eu consequat ac felis donec. Venenatis lectus magna fringilla urna porttitor rhoncus dolor. Eu scelerisque felis imperdiet proin fermentum leo vel orci porta. Feugiat in ante metus dictum.\\r\\n\\r\\nSenectus et netus et malesuada fames ac turpis egestas. Eget arcu dictum varius duis at consectetur lorem. Semper auctor neque vitae tempus quam pellentesque nec. Morbi tempus iaculis urna id volutpat lacus laoreet non. Felis eget velit aliquet sagittis id. Quam viverra orci sagittis eu. In est ante in nibh mauris cursus mattis. Aliquam etiam erat velit scelerisque in dictum non. Quam elementum pulvinar etiam non quam lacus suspendisse. Ipsum dolor sit amet consectetur adipiscing elit ut. Et ultrices neque ornare aenean euismod elementum nisi. Congue nisi vitae suscipit tellus mauris a. Ac turpis egestas integer eget aliquet nibh praesent tristique magna. Placerat vestibulum lectus mauris ultrices eros.\\r\\n\\r\\nAccumsan tortor posuere ac ut consequat semper viverra. A erat nam at lectus urna duis convallis. Habitasse platea dictumst vestibulum rhoncus est. Nibh praesent tristique magna sit amet purus gravida quis blandit. Mattis rhoncus urna neque viverra justo nec ultrices dui. Quis vel eros donec ac odio tempor orci dapibus ultrices. Rhoncus mattis rhoncus urna neque viverra justo nec ultrices dui. Augue eget arcu dictum varius duis at consectetur. Malesuada fames ac turpis egestas maecenas pharetra convallis posuere morbi. Duis convallis convallis tellus id interdum velit laoreet. Purus gravida quis blandit turpis cursus in. Sed faucibus turpis in eu mi. Nisi est sit amet facilisis magna etiam. Aenean et tortor at risus viverra adipiscing. Natoque penatibus et magnis dis parturient. Iaculis urna id volutpat lacus laoreet. Posuere urna nec tincidunt praesent semper feugiat nibh. Risus viverra adipiscing at in. Nisl nisi scelerisque eu ultrices vitae auctor eu.\",\"Free_Text__386\":\"Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Elit eget gravida cum sociis natoque penatibus et magnis. Proin nibh nisl condimentum id. Leo in vitae turpis massa sed elementum tempus egestas. Ac turpis egestas sed tempus urna et. Convallis convallis tellus id interdum velit laoreet id donec ultrices. Hac habitasse platea dictumst quisque sagittis purus sit amet volutpat. Augue neque gravida in fermentum et sollicitudin ac. Phasellus faucibus scelerisque eleifend donec pretium vulputate sapien. Egestas pretium aenean pharetra magna ac. Fermentum leo vel orci porta non pulvinar neque laoreet suspendisse. Suspendisse ultrices gravida dictum fusce ut placerat orci nulla. Sed risus ultricies tristique nulla aliquet. Sed id semper risus in hendrerit gravida. At consectetur lorem donec massa sapien.\\r\\n\\r\\nOrnare suspendisse sed nisi lacus sed viverra. Bibendum ut tristique et egestas quis ipsum. Viverra justo nec ultrices dui sapien eget mi proin. Et tortor at risus viverra. Aenean euismod elementum nisi quis eleifend quam adipiscing vitae. Proin nibh nisl condimentum id venenatis a condimentum. Fames ac turpis egestas sed tempus urna. Ipsum faucibus vitae aliquet nec ullamcorper sit. Faucibus et molestie ac feugiat sed lectus vestibulum mattis. Odio ut sem nulla pharetra diam sit amet nisl. Enim sit amet venenatis urna. Massa vitae tortor condimentum lacinia quis vel eros. Pulvinar elementum integer enim neque volutpat ac tincidunt vitae semper. Tortor pretium viverra suspendisse potenti. Condimentum lacinia quis vel eros donec ac odio tempor. In est ante in nibh. Volutpat lacus laoreet non curabitur gravida arcu. Nec dui nunc mattis enim ut tellus.\\r\\n\\r\\nConvallis posuere morbi leo urna molestie at elementum. Odio eu feugiat pretium nibh ipsum consequat nisl. Dolor sit amet consectetur adipiscing elit. Dignissim enim sit amet venenatis urna cursus eget. Velit dignissim sodales ut eu sem. Diam donec adipiscing tristique risus nec feugiat in. Phasellus vestibulum lorem sed risus ultricies tristique. Eu consequat ac felis donec. Venenatis lectus magna fringilla urna porttitor rhoncus dolor. Eu scelerisque felis imperdiet proin fermentum leo vel orci porta. Feugiat in ante metus dictum.\\r\\n\\r\\nSenectus et netus et malesuada fames ac turpis egestas. Eget arcu dictum varius duis at consectetur lorem. Semper auctor neque vitae tempus quam pellentesque nec. Morbi tempus iaculis urna id volutpat lacus laoreet non. Felis eget velit aliquet sagittis id. Quam viverra orci sagittis eu. In est ante in nibh mauris cursus mattis. Aliquam etiam erat velit scelerisque in dictum non. Quam elementum pulvinar etiam non quam lacus suspendisse. Ipsum dolor sit amet consectetur adipiscing elit ut. Et ultrices neque ornare aenean euismod elementum nisi. Congue nisi vitae suscipit tellus mauris a. Ac turpis egestas integer eget aliquet nibh praesent tristique magna. Placerat vestibulum lectus mauris ultrices eros.\\r\\n\\r\\nAccumsan tortor posuere ac ut consequat semper viverra. A erat nam at lectus urna duis convallis. Habitasse platea dictumst vestibulum rhoncus est. Nibh praesent tristique magna sit amet purus gravida quis blandit. Mattis rhoncus urna neque viverra justo nec ultrices dui. Quis vel eros donec ac odio tempor orci dapibus ultrices. Rhoncus mattis rhoncus urna neque viverra justo nec ultrices dui. Augue eget arcu dictum varius duis at consectetur. Malesuada fames ac turpis egestas maecenas pharetra convallis posuere morbi. Duis convallis convallis tellus id interdum velit laoreet. Purus gravida quis blandit turpis cursus in. Sed faucibus turpis in eu mi. Nisi est sit amet facilisis magna etiam. Aenean et tortor at risus viverra adipiscing. 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19:12:17',NULL),(166,5,41,NULL,'level_5','Learning Point(s)','Pre-identified focus of systemic analysis. (Ex.Policy or practice deviation, other areas of practice that would benefit from study)',1,80,80,'2021-05-20 19:12:17','2021-05-20 19:12:17',NULL),(167,1,42,NULL,'level_1','Government and Regulatory Body','Factors influenced by legislation or mandated standards',1,80,80,'2021-05-20 20:30:59','2021-05-20 20:30:59',NULL),(168,2,42,NULL,'level_2','External Entities','Influencing Factors that exist outside organization',1,80,80,'2021-05-20 20:30:59','2021-05-20 20:30:59',NULL),(169,3,42,NULL,'level_3','Organizational Factors (Central)','Operations that are controlled within the central operations',1,80,80,'2021-05-20 20:30:59','2021-05-20 20:30:59',NULL),(170,4,42,NULL,'level_4','Organizational Factors (Regional)','Contextual features of the region and operations',1,80,80,'2021-05-20 20:30:59','2021-05-20 20:30:59',NULL),(171,5,42,NULL,'level_5','Processes Conditions Actor Activities','Local (front-line) environment in which work was carried out',1,80,80,'2021-05-20 20:30:59','2021-05-20 20:30:59',NULL);

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-- Table structure for table `reviews`
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20:42:04',80,146,NULL),(147,3,'Danielle.Salvatore@ocfs.ny.gov','$2y$10$Ce0wNVC1xnAVi77Cct2wO.FG41pf47DIlgHXZolGxinBWheiyLo0W','Danielle','Salvatore',NULL,1,'wf8w1Zb2LMt8bZhBlSUsomQNlWoLOOKXX5EASFs1wwQdjHcyDuYxPkK8sFUy','2020-11-16 14:56:07',NULL,NULL,'2020-11-12 17:43:34','2020-11-16 14:56:07',80,147,NULL),(148,3,'Emma.Gryner@ocfs.ny.gov','$2y$10$E5M1SAg8/vkcR8x5B7x9.OQeVCFwImGYxBRrT06iLZKwO/QYcD99W','Emma','Gryner',NULL,1,'BWbkKRuwC8Fuf6dS1KBzihbnjwRLD9gRatWcV1Qpu40sUgbXSNsXtlT3Yect','2020-12-14 18:24:40',NULL,NULL,'2020-11-12 17:44:16','2020-12-14 18:24:40',80,148,NULL),(149,3,'Laura.Naumiec@ocfs.ny.gov','$2y$10$LB7m.VpL3vx44tdr7LWncuqAE8appbCRqapXvyY51UGdWPHlUYo6y','Laura','Naumiec',NULL,1,'UWRJYr5vq5s93rbTUIE4QVGa4hRazN8XjQodfvPfVzaGQlPGFGBN9ebffYvk','2020-11-18 20:38:29',NULL,NULL,'2020-11-12 17:44:49','2020-11-18 20:38:29',80,149,NULL),(150,3,'Christine.McNall@ocfs.ny.gov','$2y$10$7SqSZNMEtB76UNSle944k.RmjmAO.i73etfSM9FyY0V7BYie4YdCe','Christine','McNall',NULL,1,'qzSI0zcLKTLNhlmKDtbWuckcTrtYQoBbSLRT4zKEQwwCjTWgyW9uvN2X9Jtb','2020-11-13 17:39:28',NULL,NULL,'2020-11-12 17:45:26','2020-11-13 17:39:28',80,150,NULL),(151,3,'anduvall@utah.gov','$2y$10$uyvSjx6GMVK89tczcZ0/eeZX.58j1nPr8Ho69.o8ii80bT4KlAbVu','Aimee','Duvall',NULL,1,'x3PqcOs0Sn6CaJpHnbdXS6l5vuBhAEmTiHooDog5K21L7Dxwmqm4Bfqh5qgE','2021-01-05 19:53:31',NULL,NULL,'2021-01-05 19:14:45','2021-01-05 19:53:31',80,151,NULL),(152,3,'jmendelson@utah.gov','$2y$10$InaosEJ58NzC.fTOPagNneCHUezFD6hmeTA879p5FaPd6FG1JlA3q','Jenny','Mendelson',NULL,1,'tdHFUhtXwo0varsGePRd95Tc2b9wTexUuxyUAPhL3ac8BReiqbun6OxsPSa9','2021-02-01 15:43:39',NULL,NULL,'2021-01-25 21:14:27','2021-02-01 15:43:39',80,152,NULL),(153,3,'Emily.L.Lawrence@ChildAdvocate.nh.gov','$2y$10$U.hgk4ZCkjjcCJSr7dY5Ae9236hyxkNhNvk/wLBAQZIt3Sct0wexa','Emily','Lawrence',NULL,1,'2GD9KQCSE9fcbudX440bOjNSaQNoRGK5B4UxAGwiqIU8xShU3ERM84OO1ISX','2021-02-02 16:57:30',NULL,NULL,'2021-02-02 16:51:06','2021-02-02 16:57:30',80,153,NULL),(154,3,'Moira.K.ONeill@ChildAdvocate.nh.gov',NULL,'Moira','O\'Neill',NULL,0,NULL,NULL,NULL,NULL,'2021-02-02 16:51:52','2021-02-02 16:51:52',80,80,NULL),(155,3,'Jason.M.Taylor@ChildAdvocate.nh.gov','$2y$10$isF3WTI0SU672ARgIv6uiuTz9soJcyCmVHZGeUrZUPafpixtWa71.','Jason','Taylor',NULL,1,'XskOe1hpenxMcTBMUrp84fHwyUyCnUtonRqudMHfkEL0KVAz2yQqwNZBQSkh','2021-02-02 17:36:31',NULL,NULL,'2021-02-02 16:57:00','2021-02-02 17:36:31',80,155,NULL),(156,3,'Tamika.Young@dcf.nj.gov','$2y$10$uhalU.Vvh9mV3wZvtVzmHejnts3fY5JM4Nns6GVGTUeDYU1yKkbfC','Tamika','Young',NULL,1,'dsndWAKKxoEPu8bLPNtzu7l9zS4yaoYcDnPRCND7HKc17y29ttq600Gz94Nq','2021-02-17 20:41:09',NULL,NULL,'2021-02-17 20:08:53','2021-04-05 16:00:41',80,0,NULL),(157,3,'rahuldevdigital1@yopmail.com','$2y$10$3dWR9cg2F95/4Xakrjo/aOFGPoEL6swbYab3R.qRrf77e18Td5jHq','Rahul','Devdigital',NULL,1,'VeMYGB5Fjs0ettnRHeUbtwwkkiPZkeKQZQo22ZTxIML1wlH35hsMO5kTIEiR','2021-03-17 11:09:05',NULL,NULL,'2021-03-17 11:08:05','2021-03-17 14:33:57',1,157,'2021-03-17 14:33:57'),(158,3,'devdigitaltest1@yopmail.com','$2y$10$0MHpj/Koyl7PPfKl0CEzVOjVmlBn1YZfzHkwZfVw6KKZLtB6TqYKu','Devdigital','test',NULL,1,'RvI59HmHCpBLbkbXiYoWlT5F4zjly3RXNKPSihjU03WaWpuG5WsCbOVTiq3P','2021-04-14 04:30:50',NULL,NULL,'2021-04-14 04:29:19','2021-04-14 09:24:43',1,158,'2021-04-14 09:24:43'),(159,3,'ryan.hartneck1@state.mn.us','$2y$10$tZUMnRTDxfQoLfdRIzlQP.KhTV2BLHrWZaQyooBq9tUzknAvMdIbm','Ryan','Hartneck',NULL,1,'2HgO9Ort3u8co0hkcIEHM5nP0tvvWGT40l4KLQQqkbu3fdmcPSZQfgC59CHX','2021-04-28 14:31:56',NULL,NULL,'2021-04-16 17:27:10','2021-04-28 14:31:56',80,159,NULL),(160,3,'Brittany.lochner1@state.mn.us','$2y$10$4Irqm.gEIdN2wx3f/wussOLFfE.RWcyrBty4yZPKOS5n16VPGvsra','Brittany','Lochner',NULL,1,'QAx17U0w0lHdY7m6dXD8uGT3y4APVu1Biy8BNzFrhLMuSbCf0f3rrxcnFmw2','2021-04-22 15:52:12',NULL,NULL,'2021-04-16 17:28:37','2021-04-22 15:52:13',80,160,NULL),(161,3,'Tonia.m.lofton@state.mn.us','$2y$10$rjfpwnIG5oKsUprCCqr6ze4YpBFwZoMegpNsRm47NSMpQVfPHFzRm','Tonia','Lofton',NULL,1,'Dp3jtDMALJTGdr7Lbal5xzahI2TxJLpVPYQK50Ow3UTG5xXLQFrSC8LCpFCf','2021-04-22 21:43:39',NULL,NULL,'2021-04-22 20:33:10','2021-04-22 21:43:39',80,161,NULL),(162,3,'samantha.comaris@racinecounty.com','$2y$10$U.ZxXorqEWZl7mshrTAx7edpkJTwBumskqTic71P6vA/ozDkExgiq','Samantha','Comaris',NULL,1,'Peqzoovw9MKuQ4ImuXD3RH8Wj04Ib41Tw3kpNtJxkUy1dDMQ0tp9nFHShzvg','2021-04-27 13:53:09',NULL,NULL,'2021-04-23 20:31:01','2021-04-27 13:53:09',80,162,NULL),(163,3,'Darcy.paproth@racinecounty.com','$2y$10$YYcs39sq9zlEWeMyh1xbVu67jgKpozpiiXKowAGFHwNcKNUYy.WMy','Darcy','Paproth',NULL,1,'RLE0xVQtvjofn9rHevrqZ7i3DlTLQcSIOXdBtUTlounEGD2ysHLzeoCpAaBG','2021-04-27 14:00:56',NULL,NULL,'2021-04-23 20:32:33','2021-04-27 14:00:56',80,163,NULL),(164,3,'megan.rico@racinecounty.com','$2y$10$qovQxGts/x2CP9pn/.mG4.65FTuKtwcSluhM/eSMbiyD4WgyWpagW','Megan','Rico',NULL,1,'O9Xl7dLGTmoYcDfwlNK6PvFqB5ll9TR20kDoXe7lXCNnEL29GLqZYKgsttS1','2021-04-23 21:50:55',NULL,NULL,'2021-04-23 20:33:20','2021-04-23 21:50:55',80,164,NULL),(165,3,'Ofelia.ruiz@racinecounty.com','$2y$10$KCceeahlGpxbAsPw3Xww8eLrAvjAI2DDIZ/3xcd6gN/9Ys4hUIHcC','Ofelia','Ruiz',NULL,1,'1AbwpcPOjbu9OJ4OQJkmRpyYKlg1v0RwtTvpPceZuLfPqLb4o6eHo8t2QB9K','2021-04-27 14:16:47',NULL,NULL,'2021-04-23 20:34:09','2021-04-27 14:16:47',80,165,NULL),(166,3,'lsanders@co.ottertail.mn.us','$2y$10$TofETdc3d1n4q5AjUqo8yOrDQc3FExkg2hCuMVNoqMn3DOAhObLDu','Laurie','Sanders',NULL,1,'bhiohujkVTayf5f2IMMqpLG0du8MtgcYGhCIEMf2pHqsmbomKr7flTiFPg8l','2021-04-27 14:17:26',NULL,NULL,'2021-04-23 20:34:59','2021-05-25 18:09:05',80,166,NULL),(167,3,'nlee@co.ottertail.mn.us','$2y$10$Bg.MfWRKL4Os8rT6iw.wJOWZUQZzv.ge5DEQTScPaNx4JXZMtGLJW','Nicole','Lee',NULL,1,'Pqiar5Ih5KftI5dEeJzg9Jhlqhb6sd5lKACEnAHccZu13Bo7YgMjjjLWooQy','2021-04-27 14:15:33',NULL,NULL,'2021-04-23 20:36:02','2021-04-27 14:15:33',80,167,NULL),(168,3,'kkambel@co.ottertail.mn.us','$2y$10$VAg3.iXXvO4pcVekF2rJcexbXAnv50eiLq9QtV6bk9iFz7skfeZze','Kim','Kambel-Seufert',NULL,1,'u9u34z5Rln756pZ1PghcfqaZMhwyHBC1zi8jByP0Fts2ltrxwoHumCYONQS2','2021-04-23 20:45:59',NULL,NULL,'2021-04-23 20:38:23','2021-04-23 20:45:59',80,168,NULL),(169,3,'elien@co.ottertail.mn.us','$2y$10$bAM7T3Gxj5J1516Tck.HfeJUy0hbWs9HgjJg1ZIpiflv93MqYZU3G','Eric','Lien',NULL,1,'0g7t7N7CPS7DUpGPnPNMJ3L7E7JJW0AAsNBeNdjVasMzPmfzIf98lm8w7qhL','2021-04-26 15:39:50',NULL,NULL,'2021-04-23 20:39:14','2021-04-26 15:39:50',80,169,NULL),(170,3,'Tonia.M.Lofton1@state.mn.us','$2y$10$0KxCl0Yvg741ZpHGgAXjvOFGpLf8ZAniZDvMLiLBLcx1ye5Or/r4S','Tonia','Lofton','bbb9ceb64a0ff89706f54af4753133ab318872c6.jpg',1,'oQTLHOvuP2ywOJUcOA4a4soBd6SxRQfgvk3kCdRjzS9vXJ3W9UNSQq2M8yxh','2021-04-28 14:36:32',NULL,NULL,'2021-04-28 14:05:04','2021-04-28 15:07:43',80,170,NULL),(171,3,'jennifer.goodman@state.mn.us','$2y$10$Kp8UoTpnrP4pZmM06G/69.kas8P6D3ukRyPqioE2mVZF78Mv0OP1a','Jennifer','Goodman',NULL,1,'0RKZuGn02qJbceca8PK4jYobwK6xjKYYWLazW57fHEaKqjV6rxSsbiuA6NYc','2021-05-05 16:29:25',NULL,NULL,'2021-05-05 15:19:26','2021-05-05 16:29:25',80,171,NULL),(172,3,'janet.bowman@state.mn.us','$2y$10$ON2WHv6HQIgS4YkrBvpi2ue15K6slu0tuaFii1EkC2bYulfV2xKPi','Janet','Bowman',NULL,1,'isAsfWmmsAPJ3ZbTidGunRnRKMarQNV7P9CXgczj2dgsUhXi86rtefiYAKdi','2021-05-05 17:40:48',NULL,NULL,'2021-05-05 15:19:52','2021-05-05 17:40:48',80,172,NULL),(173,3,'Nichola.hoglund@state.mn.us','$2y$10$fduovaszCfGtdoYVBUbhbuplxplsjIUsg34j0fE2sVrZXEcb9Jiva','Nichola','Hoglund',NULL,1,'05vqe8QiJEt92LEaJ47CBlVFxCw8zARqvtF3jE8NcKxUKC3YkKqcB7ZZIkMF','2021-06-09 18:01:45',NULL,NULL,'2021-05-05 15:20:28','2021-06-09 18:01:45',80,173,NULL),(174,3,'Hassan.ugas@state.mn.us',NULL,'Hassan','Ugas',NULL,0,NULL,NULL,NULL,NULL,'2021-05-05 15:20:54','2021-05-05 15:20:54',80,80,NULL),(175,3,'ruth.a.clinard@state.mn.us',NULL,'Ruth','Clinard',NULL,0,NULL,NULL,NULL,NULL,'2021-05-05 15:21:27','2021-05-05 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