The provider – and the person’s team - expected the person’s 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’s 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. 
Along 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 “med holiday” – 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 “med holidays”, 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. 

Another 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’t 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’t had much interest from other people in

Along with the provider being willing to take a risk by accepting the person’s placement in this atypical setting was that both the case manager and the person’s guardian were willing to take a risk by placing the person in a home that didn’t fit the ‘typical’ 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’t meet the supervision needs of the people living there.