(29120,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43706,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"303\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Rafael\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43706}','136.234.105.219','2021-06-01 19:46:28'),(29121,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43707,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"304\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Crayton\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43707}','136.234.105.219','2021-06-01 19:46:28'),(29122,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43708,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"305\",\"question_type\":\"Date\",\"text_answer\":\"01\\/24\\/2018\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43708}','136.234.105.219','2021-06-01 19:46:28'),(29123,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43709,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"306\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43709}','136.234.105.219','2021-06-01 19:46:28'),(29124,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43710,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"307\",\"question_type\":\"Date\",\"text_answer\":\"08\\/10\\/2018\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43710}','136.234.105.219','2021-06-01 19:46:28'),(29125,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43711,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"308\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"7 Months\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43711}','136.234.105.219','2021-06-01 19:46:28'),(29126,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43712,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"309\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43712}','136.234.105.219','2021-06-01 19:46:28'),(29127,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43713,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"310\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Mother\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43713}','136.234.105.219','2021-06-01 19:46:28'),(29128,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43714,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"311\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Mother\'s boyfriend\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43714}','136.234.105.219','2021-06-01 19:46:28'),(29129,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43715,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"312\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43715}','136.234.105.219','2021-06-01 19:46:28'),(29130,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43716,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"313\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43716}','136.234.105.219','2021-06-01 19:46:28'),(29131,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43717,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"314\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43717}','136.234.105.219','2021-06-01 19:46:28'),(29132,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43718,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"316\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43718}','136.234.105.219','2021-06-01 19:46:28'),(29133,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43719,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"317\",\"question_type\":\"Short_Answer\",\"text_answer\":\"A requested TPR was not filed by the County Attorney for an alleged father who was a registered predatory offender and a mother with an egregious harm maltreatment determination.\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43719}','136.234.105.219','2021-06-01 19:46:28'),(29134,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43720,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"318\",\"question_type\":\"Free_Text\",\"text_answer\":\"Consults between CP and CA occurred (multiple)\\r\\n\\u00e2\\u20ac\\u00a2\\tPetition written and provided to the CA\\r\\n\\u00e2\\u20ac\\u00a2\\tFiling TPR was declined \\r\\n\\u00e2\\u20ac\\u00a2\\tCA unsure if met TPR criteria\\r\\n\\u00e2\\u20ac\\u00a2\\tInexperience in both work areas; Social Services Staff and CA\'s office\\r\\n\\u00e2\\u20ac\\u00a2\\tCA no mentor assisting; Not using green book\\r\\n\\u00e2\\u20ac\\u00a2\\tCA want criminal case to go first before filing TPR\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43720}','136.234.105.219','2021-06-01 19:46:28'),(29135,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43721,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"319\",\"question_type\":\"Free_Text\",\"text_answer\":\"A Termination of Parental Rights (TPR) was not filed by county attorney (CA) under the predatory offender statute or maltreatment determined egregious harm statute although child protection (CP) staff had multiple consults with the CA throughout the life of the case regarding child safety and best interest factors.  CP Staff drafted a petition and provided it to the CA, describing the circumstances which CP perceived to meet the TPR criteria, as CP perceived they were implementing and completing the required tasks based on their interpretation of the predatory offender and egregious harm guidance, stemming from MN laws. \\r\\nBest practices prescribed for these types of cases and actual support received by CP from the CA was not congruent across the systems when CP petitioned for TPR, as the CA was not certain that criteria for TPR was met, and made the decision to not file for TPR. Both the CA and CP staff had little longevity with staff experience, and a knowledge gap presented difficulties integrating knowledge into practice, influencing the trajectory of case practice. There is a lot of information to take in when learning new roles in both professions, where professionals experience a window of time called a learning curve. \\r\\nIn regard to the CA working a new role, there is little assistance from other attorney\'s to mentor each other, and their workload influences the amount of time available for learning and interpreting laws, as in the predatory offender and egregious harm statues involved in this case.  CP\'s mental model was that the new CA was not using the green book to guide decisions either and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes.  \\r\\nThere was no legal basis under compelling reasons as the crime and egregious harm occurred in the past, and the child was presumed safe in real time. There was no present imminent harm or imminent danger to the child, therefore the CA did not prioritize filing for TPR. There was also a perception that the public places higher preference on criminal case outcomes over TPR cases, and the criminal proceedings had not been completed at the time CP drafted a petition for TPR. The CA also prioritized the criminal case proceedings over filing for TPR, as using the result of the criminal case to support meeting criteria for TPR is common practice for county attorneys.\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43721}','136.234.105.219','2021-06-01 19:46:28'),(29136,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43722,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"320\",\"question_type\":\"Short_Answer\",\"text_answer\":\"CP Intake was not screened within the 24 hour required timeframe\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43722}','136.234.105.219','2021-06-01 19:46:28'),(29137,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43723,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"321\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\u00e2\\u20ac\\u00a2\\tWait for conformed test results\\r\\n\\u00e2\\u20ac\\u00a2\\tMother move around, jurisdiction concerns, mother was hard to reach\\/ difficulty engaging to conform where reside and find the family\'s location\\r\\n\\u00e2\\u20ac\\u00a2\\tPositive for THC only = not as severe as meth, etc. \\u00e2\\u20ac\\u0153it\'s just THC\\u00e2\\u20ac\\u009d, mental model for agency\'s about what this means\\r\\n\\u00e2\\u20ac\\u00a2\\tPrevious PSOP  and CD assessment\\r\\n         -Mother declined services & no recommendations came out of the CD assessment\\r\\n\\u00e2\\u20ac\\u00a2\\tOne Primary intake worker\\r\\n         - Back up took intake info may not be as familiar \\tw\\/internal processes for intakes since it\'s not their primary role the staff commonly \\tworks every day.  \\r\\note: presumptive  Vs Confirmed results\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43723}','136.234.105.219','2021-06-01 19:46:28'),(29138,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43724,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"322\",\"question_type\":\"Free_Text\",\"text_answer\":\"Learning Point: A CP intake was not screened within 24 hours. \\r\\nContributing to the CP intake not being screened within 24 hours was the type of allegation that was reported, neglect - prenatal exposure to controlled substance. The agency made a decision to hold off on screening the maltreatment report that was entered into SSIS by a backup staff. The back-up intake worker was balancing intake responsibilities with responsibilities of their primary workload, which resulted in tradeoffs. Additionally, the backup staff was not as familiar with intake procedures, as local agency practices for prenatal exposure reports had recently changed, which occurred following changes to DHS\'s maltreatment, screening, and response path guidelines. The changes to the guidance stemmed from DHS\'s interpretation of legislative changes around prenatal exposure and best practices were also defined by the state from Legislative statutes. Also influencing was a local agency workgroup, where their input and feedback on practical implementation strategies in response to prenatal exposure allegations was incorporated into the changes to guidance. The changes in guidance can conflict with the mandate to screen reports within 24 hours, as obtaining comprehensive information at the time of the report can take longer than 24 hours to receive.  \\r\\nThe agency interpretation of guidance influenced an internal practice change, where the agency held intakes open for prenatal exposure until they received more comprehensive collateral information from the medical provider. The agency\'s new practice prioritized making screening decisions based on lab verified toxicology results versus a positive result on an initial screening. Hospitals have policies and practices that vary in regard to testing for prenatal exposure and also for when they make a report for prenatal exposure allegations to child protection. The variability suggests some hospitals test all children, where others only test when certain criteria\\/risks exist when the child is born. It is collectively known that some providers may test more mothers of marginalized groups using their mental models rooted from past experiences, creating an implicit bias. This bias subjects children of marginalized groups, and their mothers to increased toxicology testing, and potentially increases the number of reports made to child protection system when results are positive. It is also collectively known that other providers perceive there being a need to preserve the patient\\/doctor relationship which also influences a confirmed positive toxicology report being made or not. This information on testing and reporting variability across hospitals influenced the agency\'s decision to wait for lab confirmed toxicology results before screening the report.  \\r\\nThis practice change was an adaptation from how the agency previously screened out prenatal exposure reports (prior to receipt of confirmed toxicology results) in order to meet the 24 hour timeline. Further Influencing the decision to not screen within 24 hours and wait for a confirmed toxicology result, was the agency\'s past experience of getting involved and working with families based on a positive initial screen, and later receiving information that the initial screen proved to be inaccurate and was a false positive. The agency worked to find balance between two priorities, the agency\'s role to protect children from harm and keep them safe, and the agency\'s duty to protect the privacy of children and families by not getting involved unjustly when credible evidence does not suggest alleged maltreatment. This goal conflict influenced the agency\'s decision to hold off on making a screening decision. \\r\\nThe local agency\'s interpretation of all the guidance changes supported their decision to seek collateral comprehensive information, which is suggested as best practice. Understanding it takes time, and the amount of time it takes to receive confirmed toxicology results from the lab is also dependent on, which type of toxicology test the medical provider chooses to order (urine sample, meconium, or blood cord tissue). For this case, a blood cord tissue sample was chosen, which provides most accurate results of toxicology, however, takes the most time for the lab to provide a report on the confirmed toxicology results. The time needed for child protection to wait for confirmed toxicology results contributed to the delay in screening. \\r\\nThe maltreatment, intake, screening, and response path guidance also require that agencies focus on vulnerability and risk of harm by assessing the impact chemical use or misuse has on child safety and use this as the primary consideration when screening. Understanding the mother\'s use alone did not constitute an unsafe child, the agency resolved the goal conflict by prioritizing the clause about \\u00e2\\u20ac\\u02dcimpact of use or misuse on child safety\', as the guidance suggests this be the primary consideration when screening. Furthermore, the agency considered risk associated with type of drug in which results are positive, for example, response to an allegation involving THC can be different than a response to an allegation involving methamphetamine. Since the child was presumed safe, consideration was given to the best interest of the child, and the agency sought to use a trauma informed approach that honored the newborn\'s innate biological needs for physical touch, bond, and attachment with the mother, prioritizing the presumption of safety over meeting the 24 hour screening compliance metric.\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43724}','136.234.105.219','2021-06-01 19:46:28'),(29139,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43725,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"323\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43725}','136.234.105.219','2021-06-01 19:46:28'),(29140,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43726,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"324\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43726}','136.234.105.219','2021-06-01 19:46:28'),(29141,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43727,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"325\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43727}','136.234.105.219','2021-06-01 19:46:28'),(29142,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43728,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"326\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43728}','136.234.105.219','2021-06-01 19:46:28'),(29143,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43729,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"327\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43729}','136.234.105.219','2021-06-01 19:46:28'),(29144,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43730,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"328\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43730}','136.234.105.219','2021-06-01 19:46:28'),(29145,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43731,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"343\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43731}','136.234.105.219','2021-06-01 19:46:28'),(29146,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43732,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"344\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43732}','136.234.105.219','2021-06-01 19:46:28'),(29147,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43733,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"345\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:28 pm\",\"created_at\":\"6\\/1\\/2021 2:46:28 pm\",\"id\":43733}','136.234.105.219','2021-06-01 19:46:28'),(29148,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43734,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"346\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43734}','136.234.105.219','2021-06-01 19:46:29'),(29149,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43735,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"347\",\"question_type\":\"Free_Text\",\"text_answer\":\"LP1:  CP\'s mental model was that the new CA was not using \\\"the green book\\\" to guide their decisions, and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes. \\r\\nCP also developed a mental model regarding not receiving support from their CA due to a history of denial to file for TPR.\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43735}','136.234.105.219','2021-06-01 19:46:29'),(29150,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43736,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"348\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43736}','136.234.105.219','2021-06-01 19:46:29'),(29151,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43737,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"349\",\"question_type\":\"Free_Text\",\"text_answer\":\"LP1: Stevens County has limited staff employed, leaving little time for staff to mentor the CA, as priority is given to working CP cases coming into the system. When cases are exceptionally complex, staff do not sleep or sleep at the office to complete work tasks for complex cases.\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43737}','136.234.105.219','2021-06-01 19:46:29'),(29152,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43738,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"350\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43738}','136.234.105.219','2021-06-01 19:46:29'),(29153,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43739,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"351\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43739}','136.234.105.219','2021-06-01 19:46:29'),(29154,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43740,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"352\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43740}','136.234.105.219','2021-06-01 19:46:29'),(29155,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43741,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"353\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43741}','136.234.105.219','2021-06-01 19:46:29'),(29156,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43742,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"354\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43742}','136.234.105.219','2021-06-01 19:46:29'),(29157,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43743,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"355\",\"question_type\":\"Free_Text\",\"text_answer\":\"LP1: A Termination of Parental Rights (TPR) was not filed by county attorney (CA) under the predatory offender statute or maltreatment determined egregious harm statute although child protection (CP) staff had multiple consults with the CA throughout the life of the case regarding child safety and best interest factors.  CP Staff drafted a petition and provided it to the CA, describing the circumstances which CP perceived to meet the TPR criteria, as CP perceived they were implementing and completing the required tasks based on their interpretation of the predatory offender and egregious harm guidance, stemming from MN laws. \\r\\n \\r\\nThere was no legal basis under compelling reasons as the crime and egregious harm occurred in the past, and the child was presumed safe in real time. There was no present imminent harm or imminent danger to the child, therefore the CA did not prioritize filing for TPR. There was also a perception that the public places higher preference on criminal case outcomes over TPR cases, and the criminal proceedings had not been completed at the time CP drafted a petition for TPR. The CA also prioritized the criminal case proceedings over filing for TPR, as using the result of the criminal case to support meeting criteria for TPR is common practice for county attorneys.\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43743}','136.234.105.219','2021-06-01 19:46:29'),(29158,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43744,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"356\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43744}','136.234.105.219','2021-06-01 19:46:29'),(29159,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43745,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"357\",\"question_type\":\"Free_Text\",\"text_answer\":\"LP1: Best practices prescribed for these types of cases and actual support received by CP from the CA was not congruent across the systems when CP petitioned for TPR, as the CA was not certain that criteria for TPR was met, and made the decision to not file for TPR. Both the CA and CP staff had little longevity with staff experience, and a knowledge gap presented difficulties integrating knowledge into practice, influencing the trajectory of case practice. There is a lot of information to take in when learning new roles in both professions, where professionals experience a window of time called a learning curve. \\r\\nIn regard to the CA working a new role, there is little assistance from other attorney\'s to mentor each other, and their workload influences the amount of time available for learning and interpreting laws, as in the predatory offender and egregious harm statues involved in this case.  CP\'s mental model was that the new CA was not using the green book to guide decisions either and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes.\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43745}','136.234.105.219','2021-06-01 19:46:29'),(29160,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43746,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"368\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43746}','136.234.105.219','2021-06-01 19:46:29'),(29161,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43747,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"369\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43747}','136.234.105.219','2021-06-01 19:46:29'),(29162,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43748,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"358\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43748}','136.234.105.219','2021-06-01 19:46:29'),(29163,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43749,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"359\",\"question_type\":\"Free_Text\",\"text_answer\":\"LP1: A Termination of Parental Rights (TPR) was not filed by county attorney (CA) under the predatory offender statute or maltreatment determined egregious harm statute although child protection (CP) staff had multiple consults with the CA throughout the life of the case regarding child safety and best interest factors.  CP Staff drafted a petition and provided it to the CA, describing the circumstances which CP perceived to meet the TPR criteria, as CP perceived they were implementing and completing the required tasks based on their interpretation of the predatory offender and egregious harm guidance, stemming from MN laws. \\r\\nBest practices prescribed for these types of cases and actual support received by CP from the CA was not congruent across the systems when CP petitioned for TPR, as the CA was not certain that criteria for TPR was met, and made the decision to not file for TPR. Both the CA and CP staff had little longevity with staff experience, and a knowledge gap presented difficulties integrating knowledge into practice, influencing the trajectory of case practice. There is a lot of information to take in when learning new roles in both professions, where professionals experience a window of time called a learning curve. \\r\\nIn regard to the CA working a new role, there is little assistance from other attorney\'s to mentor each other, and their workload influences the amount of time available for learning and interpreting laws, as in the predatory offender and egregious harm statues involved in this case.  CP\'s mental model was that the new CA was not using the green book to guide decisions either and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes.  \\r\\nThere was no legal basis under compelling reasons as the crime and egregious harm occurred in the past, and the child was presumed safe in real time. There was no present imminent harm or imminent danger to the child, therefore the CA did not prioritize filing for TPR. There was also a perception that the public places higher preference on criminal case outcomes over TPR cases, and the criminal proceedings had not been completed at the time CP drafted a petition for TPR. The CA also prioritized the criminal case proceedings over filing for TPR, as using the result of the criminal case to support meeting criteria for TPR is common practice for county attorneys.\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43749}','136.234.105.219','2021-06-01 19:46:29'),(29164,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43750,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"360\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43750}','136.234.105.219','2021-06-01 19:46:29'),(29165,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43751,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"361\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43751}','136.234.105.219','2021-06-01 19:46:29'),(29166,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43752,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"362\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43752}','136.234.105.219','2021-06-01 19:46:29'),(29167,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43753,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"363\",\"question_type\":\"Free_Text\",\"text_answer\":\"LP1: A Termination of Parental Rights (TPR) was not filed by county attorney (CA) under the predatory offender statute or maltreatment determined egregious harm statute although child protection (CP) staff had multiple consults with the CA throughout the life of the case regarding child safety and best interest factors.  CP Staff drafted a petition and provided it to the CA, describing the circumstances which CP perceived to meet the TPR criteria, as CP perceived they were implementing and completing the required tasks based on their interpretation of the predatory offender and egregious harm guidance, stemming from MN laws. \\r\\nBest practices prescribed for these types of cases and actual support received by CP from the CA was not congruent across the systems when CP petitioned for TPR, as the CA was not certain that criteria for TPR was met, and made the decision to not file for TPR. Both the CA and CP staff had little longevity with staff experience, and a knowledge gap presented difficulties integrating knowledge into practice, influencing the trajectory of case practice. There is a lot of information to take in when learning new roles in both professions, where professionals experience a window of time called a learning curve. \\r\\nIn regard to the CA working a new role, there is little assistance from other attorney\'s to mentor each other, and their workload influences the amount of time available for learning and interpreting laws, as in the predatory offender and egregious harm statues involved in this case.  CP\'s mental model was that the new CA was not using the green book to guide decisions either and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes.  \\r\\nThere was no legal basis under compelling reasons as the crime and egregious harm occurred in the past, and the child was presumed safe in real time. There was no present imminent harm or imminent danger to the child, therefore the CA did not prioritize filing for TPR. There was also a perception that the public places higher preference on criminal case outcomes over TPR cases, and the criminal proceedings had not been completed at the time CP drafted a petition for TPR. The CA also prioritized the criminal case proceedings over filing for TPR, as using the result of the criminal case to support meeting criteria for TPR is common practice for county attorneys.\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43753}','136.234.105.219','2021-06-01 19:46:29'),(29168,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43754,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"364\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43754}','136.234.105.219','2021-06-01 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19:46:29'),(29171,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43757,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"367\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43757}','136.234.105.219','2021-06-01 19:46:29'),(29172,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'reports_answer','create',43758,'{\"report_id\":350,\"form_id\":\"22\",\"user_id\":92,\"organization_id\":13,\"question_id\":\"370\",\"question_type\":\"Yes_or_No\",\"text_answer\":\"Yes\",\"created_by\":92,\"updated_by\":92,\"updated_at\":\"6\\/1\\/2021 2:46:29 pm\",\"created_at\":\"6\\/1\\/2021 2:46:29 pm\",\"id\":43758}','136.234.105.219','2021-06-01 19:46:29'),(29173,'YHAFGQmrclsN3zm8D58LW7NWYDI7ELu04GkianfJ',80,'users','login',80,'[]','68.53.115.247','2021-06-01 20:03:06'),(29174,'4iUEJ1TGvmlzLv0NcCNC2JGOgZU7r2ZhH59M7hTv',183,'users','login',183,'[]','136.234.105.221','2021-06-01 20:15:56'),(29175,'DHpJtS3Jd7VIor7Fe3yU9Lg7zTojCzQAahVuVzg1',125,'users','login',125,'[]','24.253.46.206','2021-06-01 20:50:26'),(29176,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'users','update',92,'{\"id\":92,\"user_type_id\":\"3\",\"email\":\"kristine.frick@state.mn.us\",\"first_name\":\"Kristine\",\"last_name\":\"Frick\",\"profile_image\":null,\"status\":\"1\",\"email_verified_at\":\"2020-06-24 10:32:22\",\"last_login_at\":null,\"last_login_ip\":null,\"created_at\":\"6\\/24\\/2020 10:01:05 am\",\"updated_at\":\"6\\/24\\/2020 10:32:22 am\",\"created_by\":\"80\",\"updated_by\":92,\"deleted_at\":null}','136.234.105.219','2021-06-01 20:52:53'),(29177,'lgKpQ5tPZpNIr0WV3E9h3dK4ntK7jdMO5UtR61VG',92,'users','logout',92,'[]','136.234.105.219','2021-06-01 20:52:53'),(29178,'dURRvrTqHVpFzyUeAEnb9n4BmtOO5LzaxbviY2xK',80,'users','login',80,'[]','68.53.115.247','2021-06-02 14:31:15'),(29179,'cbG25HZmozbmbSBeJECse70vSqg5h1QVMy0l2z3Z',80,'users','update',80,'{\"id\":80,\"user_type_id\":\"1\",\"email\":\"kw@collaborative-safety.com\",\"first_name\":\"Kenny\",\"last_name\":\"Weaver\",\"profile_image\":null,\"status\":\"1\",\"email_verified_at\":\"2020-06-03 11:25:18\",\"last_login_at\":null,\"last_login_ip\":null,\"created_at\":\"6\\/3\\/2020 8:47:44 am\",\"updated_at\":\"6\\/3\\/2020 11:25:18 am\",\"created_by\":\"79\",\"updated_by\":80,\"deleted_at\":null}','68.53.115.247','2021-06-02 14:47:36'),(29180,'cbG25HZmozbmbSBeJECse70vSqg5h1QVMy0l2z3Z',80,'users','logout',80,'[]','68.53.115.247','2021-06-02 14:47:36'),(29181,'HsjqYjJVSW14ftawPCkHEdiDJf4gDLfjUkq9YSZa',80,'users','login',80,'[]','68.53.115.247','2021-06-02 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16:28:23'),(29518,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',43993,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Prior to the termination the individual was residing with this AFC provider for 15 months.  The setting was a family foster home with owner\\/operator on-site and no other residents.   The provider was newly licensed for 2 residents and this was the first individual that was placed in her home.   The individual was in his grandparents\\u2019 care prior to this AFC.  The individual is his own guardian.  \\r\\nPrior to the placement the provider had communicated with the individual\\u2019s grandparents and CADI case manager.  The provider was told that the individual was in special education in school and A few weeks after the placement the provider was given a file with additional information on the individual.  The file included police reports indicating the individual had been in physical fights.  After the placement the provider also learned that the individual had a history of stealing money, cigarettes and specifically an incident when he stole credit cards from his grandparents.   The provider also learned that he was expelled from Cloquet High School due to his behaviors and transferred to the Merit Creek Academy.  The provider stated that in conversations with the individual\\u2019s grandparents they stated that he was easily influenced by his friends.  \\r\\nThe provider stated while the individual was residing with her he would swear at her and try to physically intimidate her.  The provider noted that the individual never physically assaulted her.  The provider noted that the individual spent much of his time in his bedroom playing video games.  He ate the majority of this meals in his room alone.   Prior to COVID19, the individual was in therapy twice a week for depression and anger issues.  This moved to telehealth and soon ended all together.  The individual was also with Choice Unlimited for employment after he graduated school, but did not want to continue to work on employment.\\r\\nDue to the individual constantly isolating himself and physically intimidating behaviors the provider decided to issue a 60 day termination notice. The case manager was aware of the concerns and supported the individual moving.  The individual was not initially supportive of the move, but was excited to move once he toured the new facility.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:28:23 am\",\"created_at\":\"6\\/9\\/2021 11:28:23 am\",\"id\":43993}','68.53.115.247','2021-06-09 16:28:23'),(29519,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',43994,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:28:23 am\",\"created_at\":\"6\\/9\\/2021 11:28:23 am\",\"id\":43994}','68.53.115.247','2021-06-09 16:28:23'),(29520,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',43995,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The person\\u2019s services being terminated by the provider were influenced by the person\\u2019s behaviors and the overall \\u201cmatch\\u201d between the person and the provider. The person demonstrated physical intimidating behaviors to staff.  This would often occur when staff asked questions about concerns for the person\\u2019s decisions.  The staff was prompted to ask these questions because belongings in the home were missing.\\r\\n\\r\\nThe provider determining there wasn\\u2019t a good overall \\u201cmatch\\u201d was influenced by the following.  The adult foster care (AFC) home was a single staff person owner\\/operator.  This did not allow for staffing changes to adjust to the individual\\u2019s behaviors or staff exhaustion.  The majority of the time the individual chose to stay in their room and play video games; possibly to the level of an addiction\\/obsession.   Staff felt the individual would benefit from participating in social and recreational activities besides video games.  Staff exhausted attempts and techniques to redirect the individual to engage in other activities besides playing video games.  The provider reached out to the case manager for support services when they were struggling to redirect the person\\/address behaviors.  Due to COVID19, support services were not able to be offered.  The individual made a choice to discontinue therapy as well as employment, which led to more time in his room playing video games.  These decisions are supported by 245D (informed choice).\\r\\n\\r\\nAnother influence to the person not being a good match and services being terminated was this was the first person the provider had served since being licensed.  The provider was unfamiliar with the system and best practices for potential people to support.  Both influenced the match between the individual and provider.  \\r\\nAnother influence to the \\u201cmatch\\u201d and services being terminated was that the provider was unaware of the individual\\u2019s history\\/previous concerns with behaviors.  This was influenced by this being the first AFC the individual had resided and the case manager was unaware of the person\\u2019s history so unable to share it with provider.  The case manager did not have a clear picture of the history because they just began working the individual and the person chose not to participate in the person-centered planning process.  The case manager and team reached out to the local high school in an attempt to learn more about the person. The teacher most familiar with the individual was unavailable to speak with the case manager or provider as it was the summer (school closed).  This influenced the lack of history and ability to determine the appropriateness of the match between the individual.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:28:23 am\",\"created_at\":\"6\\/9\\/2021 11:28:23 am\",\"id\":43995}','68.53.115.247','2021-06-09 16:28:23'),(29521,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',43996,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:28:23 am\",\"created_at\":\"6\\/9\\/2021 11:28:23 am\",\"id\":43996}','68.53.115.247','2021-06-09 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16:29:12'),(29566,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44041,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Individual was issued a 60 day termination notice.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:29:12 am\",\"created_at\":\"6\\/9\\/2021 11:29:12 am\",\"id\":44041}','68.53.115.247','2021-06-09 16:29:12'),(29567,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44042,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:29:12 am\",\"created_at\":\"6\\/9\\/2021 11:29:12 am\",\"id\":44042}','68.53.115.247','2021-06-09 16:29:12'),(29568,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44043,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"01\\/12\\/2021\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:29:12 am\",\"created_at\":\"6\\/9\\/2021 11:29:12 am\",\"id\":44043}','68.53.115.247','2021-06-09 16:29:12'),(29569,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44044,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Prior to the termination the individual was residing with this AFC provider for 15 months.  The setting was a family foster home with owner\\/operator on-site and no other residents.   The provider was newly licensed for 2 residents and this was the first individual that was placed in her home.   The individual was in his grandparents\\u2019 care prior to this AFC.  The individual is his own guardian.  \\r\\nPrior to the placement the provider had communicated with the individual\\u2019s grandparents and CADI case manager.  The provider was told that the individual was in special education in school and A few weeks after the placement the provider was given a file with additional information on the individual.  The file included police reports indicating the individual had been in physical fights.  After the placement the provider also learned that the individual had a history of stealing money, cigarettes and specifically an incident when he stole credit cards from his grandparents.   The provider also learned that he was expelled from Cloquet High School due to his behaviors and transferred to the Merit Creek Academy.  The provider stated that in conversations with the individual\\u2019s grandparents they stated that he was easily influenced by his friends.  \\r\\nThe provider stated while the individual was residing with her he would swear at her and try to physically intimidate her.  The provider noted that the individual never physically assaulted her.  The provider noted that the individual spent much of his time in his bedroom playing video games.  He ate the majority of this meals in his room alone.   Prior to COVID19, the individual was in therapy twice a week for depression and anger issues.  This moved to telehealth and soon ended all together.  The individual was also with Choice Unlimited for employment after he graduated school, but did not want to continue to work on employment.\\r\\nDue to the individual constantly isolating himself and physically intimidating behaviors the provider decided to issue a 60 day termination notice. The case manager was aware of the concerns and supported the individual moving.  The individual was not initially supportive of the move, but was excited to move once he toured the new facility.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:29:12 am\",\"created_at\":\"6\\/9\\/2021 11:29:12 am\",\"id\":44044}','68.53.115.247','2021-06-09 16:29:12'),(29570,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44045,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:29:12 am\",\"created_at\":\"6\\/9\\/2021 11:29:12 am\",\"id\":44045}','68.53.115.247','2021-06-09 16:29:12'),(29571,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44046,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The person\\u2019s services being terminated by the provider were influenced by the person\\u2019s behaviors and the overall \\u201cmatch\\u201d between the person and the provider. The person demonstrated physical intimidating behaviors to staff.  This would often occur when staff asked questions about concerns for the person\\u2019s decisions.  The staff was prompted to ask these questions because belongings in the home were missing.\\r\\n\\r\\nThe provider determining there wasn\\u2019t a good overall \\u201cmatch\\u201d was influenced by the following.  The adult foster care (AFC) home was a single staff person owner\\/operator.  This did not allow for staffing changes to adjust to the individual\\u2019s behaviors or staff exhaustion.  The majority of the time the individual chose to stay in their room and play video games; possibly to the level of an addiction\\/obsession.   Staff felt the individual would benefit from participating in social and recreational activities besides video games.  Staff exhausted attempts and techniques to redirect the individual to engage in other activities besides playing video games.  The provider reached out to the case manager for support services when they were struggling to redirect the person\\/address behaviors.  Due to COVID19, support services were not able to be offered.  The individual made a choice to discontinue therapy as well as employment, which led to more time in his room playing video games.  These decisions are supported by 245D (informed choice).\\r\\n\\r\\nAnother influence to the person not being a good match and services being terminated was this was the first person the provider had served since being licensed.  The provider was unfamiliar with the system and best practices for potential people to support.  Both influenced the match between the individual and provider.  \\r\\nAnother influence to the \\u201cmatch\\u201d and services being terminated was that the provider was unaware of the individual\\u2019s history\\/previous concerns with behaviors.  This was influenced by this being the first AFC the individual had resided and the case manager was unaware of the person\\u2019s history so unable to share it with provider.  The case manager did not have a clear picture of the history because they just began working the individual and the person chose not to participate in the person-centered planning process.  The case manager and team reached out to the local high school in an attempt to learn more about the person. The teacher most familiar with the individual was unavailable to speak with the case manager or provider as it was the summer (school closed).  This influenced the lack of history and ability to determine the appropriateness of the match between the individual.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:29:12 am\",\"created_at\":\"6\\/9\\/2021 11:29:12 am\",\"id\":44046}','68.53.115.247','2021-06-09 16:29:12'),(29572,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44047,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:29:12 am\",\"created_at\":\"6\\/9\\/2021 11:29:12 am\",\"id\":44047}','68.53.115.247','2021-06-09 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The setting was a family foster home with owner\\/operator on-site and no other residents.   The provider was newly licensed for 2 residents and this was the first individual that was placed in her home.   The individual was in his grandparents\\u2019 care prior to this AFC.  The individual is his own guardian.  \\r\\nPrior to the placement the provider had communicated with the individual\\u2019s grandparents and CADI case manager.  The provider was told that the individual was in special education in school and A few weeks after the placement the provider was given a file with additional information on the individual.  The file included police reports indicating the individual had been in physical fights.  After the placement the provider also learned that the individual had a history of stealing money, cigarettes and specifically an incident when he stole credit cards from his grandparents.   The provider also learned that he was expelled from Cloquet High School due to his behaviors and transferred to the Merit Creek Academy.  The provider stated that in conversations with the individual\\u2019s grandparents they stated that he was easily influenced by his friends.  \\r\\nThe provider stated while the individual was residing with her he would swear at her and try to physically intimidate her.  The provider noted that the individual never physically assaulted her.  The provider noted that the individual spent much of his time in his bedroom playing video games.  He ate the majority of this meals in his room alone.   Prior to COVID19, the individual was in therapy twice a week for depression and anger issues.  This moved to telehealth and soon ended all together.  The individual was also with Choice Unlimited for employment after he graduated school, but did not want to continue to work on employment.\\r\\nDue to the individual constantly isolating himself and physically intimidating behaviors the provider decided to issue a 60 day termination notice. The case manager was aware of the concerns and supported the individual moving.  The individual was not initially supportive of the move, but was excited to move once he toured the new facility.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:30:03 am\",\"created_at\":\"6\\/9\\/2021 11:30:03 am\",\"id\":44095}','68.53.115.247','2021-06-09 16:30:03'),(29621,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44096,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:30:03 am\",\"created_at\":\"6\\/9\\/2021 11:30:03 am\",\"id\":44096}','68.53.115.247','2021-06-09 16:30:03'),(29622,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44097,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The person\\u2019s services being terminated by the provider were influenced by the person\\u2019s behaviors and the overall \\u201cmatch\\u201d between the person and the provider. The person demonstrated physical intimidating behaviors to staff.  This would often occur when staff asked questions about concerns for the person\\u2019s decisions.  The staff was prompted to ask these questions because belongings in the home were missing.\\r\\n\\r\\nThe provider determining there wasn\\u2019t a good overall \\u201cmatch\\u201d was influenced by the following.  The adult foster care (AFC) home was a single staff person owner\\/operator.  This did not allow for staffing changes to adjust to the individual\\u2019s behaviors or staff exhaustion.  The majority of the time the individual chose to stay in their room and play video games; possibly to the level of an addiction\\/obsession.   Staff felt the individual would benefit from participating in social and recreational activities besides video games.  Staff exhausted attempts and techniques to redirect the individual to engage in other activities besides playing video games.  The provider reached out to the case manager for support services when they were struggling to redirect the person\\/address behaviors.  Due to COVID19, support services were not able to be offered.  The individual made a choice to discontinue therapy as well as employment, which led to more time in his room playing video games.  These decisions are supported by 245D (informed choice).\\r\\n\\r\\nAnother influence to the person not being a good match and services being terminated was this was the first person the provider had served since being licensed.  The provider was unfamiliar with the system and best practices for potential people to support.  Both influenced the match between the individual and provider.  \\r\\nAnother influence to the \\u201cmatch\\u201d and services being terminated was that the provider was unaware of the individual\\u2019s history\\/previous concerns with behaviors.  This was influenced by this being the first AFC the individual had resided and the case manager was unaware of the person\\u2019s history so unable to share it with provider.  The case manager did not have a clear picture of the history because they just began working the individual and the person chose not to participate in the person-centered planning process.  The case manager and team reached out to the local high school in an attempt to learn more about the person. The teacher most familiar with the individual was unavailable to speak with the case manager or provider as it was the summer (school closed).  This influenced the lack of history and ability to determine the appropriateness of the match between the individual.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:30:03 am\",\"created_at\":\"6\\/9\\/2021 11:30:03 am\",\"id\":44097}','68.53.115.247','2021-06-09 16:30:03'),(29623,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44098,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:30:03 am\",\"created_at\":\"6\\/9\\/2021 11:30:03 am\",\"id\":44098}','68.53.115.247','2021-06-09 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16:30:16'),(29670,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44145,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Prior to the termination the individual was residing with this AFC provider for 15 months.  The setting was a family foster home with owner\\/operator on-site and no other residents.   The provider was newly licensed for 2 residents and this was the first individual that was placed in her home.   The individual was in his grandparents\\u2019 care prior to this AFC.  The individual is his own guardian.  \\r\\nPrior to the placement the provider had communicated with the individual\\u2019s grandparents and CADI case manager.  The provider was told that the individual was in special education in school and A few weeks after the placement the provider was given a file with additional information on the individual.  The file included police reports indicating the individual had been in physical fights.  After the placement the provider also learned that the individual had a history of stealing money, cigarettes and specifically an incident when he stole credit cards from his grandparents.   The provider also learned that he was expelled from Cloquet High School due to his behaviors and transferred to the Merit Creek Academy.  The provider stated that in conversations with the individual\\u2019s grandparents they stated that he was easily influenced by his friends.  \\r\\nThe provider stated while the individual was residing with her he would swear at her and try to physically intimidate her.  The provider noted that the individual never physically assaulted her.  The provider noted that the individual spent much of his time in his bedroom playing video games.  He ate the majority of this meals in his room alone.   Prior to COVID19, the individual was in therapy twice a week for depression and anger issues.  This moved to telehealth and soon ended all together.  The individual was also with Choice Unlimited for employment after he graduated school, but did not want to continue to work on employment.\\r\\nDue to the individual constantly isolating himself and physically intimidating behaviors the provider decided to issue a 60 day termination notice. The case manager was aware of the concerns and supported the individual moving.  The individual was not initially supportive of the move, but was excited to move once he toured the new facility.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:30:16 am\",\"created_at\":\"6\\/9\\/2021 11:30:16 am\",\"id\":44145}','68.53.115.247','2021-06-09 16:30:16'),(29671,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44146,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:30:16 am\",\"created_at\":\"6\\/9\\/2021 11:30:16 am\",\"id\":44146}','68.53.115.247','2021-06-09 16:30:16'),(29672,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44147,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The person\\u2019s services being terminated by the provider were influenced by the person\\u2019s behaviors and the overall \\u201cmatch\\u201d between the person and the provider. The person demonstrated physical intimidating behaviors to staff.  This would often occur when staff asked questions about concerns for the person\\u2019s decisions.  The staff was prompted to ask these questions because belongings in the home were missing.\\r\\n\\r\\nThe provider determining there wasn\\u2019t a good overall \\u201cmatch\\u201d was influenced by the following.  The adult foster care (AFC) home was a single staff person owner\\/operator.  This did not allow for staffing changes to adjust to the individual\\u2019s behaviors or staff exhaustion.  The majority of the time the individual chose to stay in their room and play video games; possibly to the level of an addiction\\/obsession.   Staff felt the individual would benefit from participating in social and recreational activities besides video games.  Staff exhausted attempts and techniques to redirect the individual to engage in other activities besides playing video games.  The provider reached out to the case manager for support services when they were struggling to redirect the person\\/address behaviors.  Due to COVID19, support services were not able to be offered.  The individual made a choice to discontinue therapy as well as employment, which led to more time in his room playing video games.  These decisions are supported by 245D (informed choice).\\r\\n\\r\\nAnother influence to the person not being a good match and services being terminated was this was the first person the provider had served since being licensed.  The provider was unfamiliar with the system and best practices for potential people to support.  Both influenced the match between the individual and provider.  \\r\\nAnother influence to the \\u201cmatch\\u201d and services being terminated was that the provider was unaware of the individual\\u2019s history\\/previous concerns with behaviors.  This was influenced by this being the first AFC the individual had resided and the case manager was unaware of the person\\u2019s history so unable to share it with provider.  The case manager did not have a clear picture of the history because they just began working the individual and the person chose not to participate in the person-centered planning process.  The case manager and team reached out to the local high school in an attempt to learn more about the person. The teacher most familiar with the individual was unavailable to speak with the case manager or provider as it was the summer (school closed).  This influenced the lack of history and ability to determine the appropriateness of the match between the individual.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:30:16 am\",\"created_at\":\"6\\/9\\/2021 11:30:16 am\",\"id\":44147}','68.53.115.247','2021-06-09 16:30:16'),(29673,'d6hm9w8ih0pIdN47qdpV8UosIfFyVgkTeEUIOPWY',81,'reports_answer','create',44148,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/9\\/2021 11:30:16 am\",\"created_at\":\"6\\/9\\/2021 11:30:16 am\",\"id\":44148}','68.53.115.247','2021-06-09 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Johnny\",\"last_name\":\"Test\",\"profile_image\":null,\"status\":\"1\",\"email_verified_at\":\"2020-06-10 10:12:11\",\"last_login_at\":null,\"last_login_ip\":null,\"created_at\":\"6\\/9\\/2020 9:37:57 am\",\"updated_at\":\"5\\/26\\/2021 9:45:26 am\",\"created_by\":\"80\",\"updated_by\":81,\"deleted_at\":null}','68.53.115.247','2021-06-11 18:53:55'),(29733,'xW1mRYPv1M2gMamGmglyN286tV07GjxYmTrhcsnn',81,'users','logout',81,'[]','68.53.115.247','2021-06-11 18:53:55'),(29734,'qIceSc6UFYZGBi5Qkqj1Qdcg06F1bHsOJFLZlT2l',80,'users','login',80,'[]','68.53.115.247','2021-06-11 18:53:59'),(29735,'ThASZEPeAA6eSCtVcxv5ihPibVGeaDkPiwvfffVA',80,'questions','update',84,'{\"id\":84,\"organization_id\":\"10\",\"form_id\":null,\"tab_id\":\"9\",\"heading\":\"Incident Type\",\"question_text\":\"Incident Type\",\"question_type\":\"Multiple_Choice\",\"question_option\":\"Elopement,Medication Error,Staff Sleeping on Duty,Wheelchair Safety,Use of Prone Restraint,245D Service Termination\\/Suspension,COVID\",\"triggered_question\":null,\"is_triggered\":0,\"display_order\":\"10\",\"status\":1,\"created_by\":\"9\",\"updated_by\":80,\"created_at\":\"12\\/9\\/2020 2:59:38 am\",\"updated_at\":\"6\\/11\\/2021 1:54:29 pm\",\"deleted_at\":null}','68.53.115.247','2021-06-11 18:54:29'),(29736,'ThASZEPeAA6eSCtVcxv5ihPibVGeaDkPiwvfffVA',80,'users','update',80,'{\"id\":80,\"user_type_id\":\"1\",\"email\":\"kw@collaborative-safety.com\",\"first_name\":\"Kenny\",\"last_name\":\"Weaver\",\"profile_image\":null,\"status\":\"1\",\"email_verified_at\":\"2020-06-03 11:25:18\",\"last_login_at\":null,\"last_login_ip\":null,\"created_at\":\"6\\/3\\/2020 8:47:44 am\",\"updated_at\":\"6\\/3\\/2020 11:25:18 am\",\"created_by\":\"79\",\"updated_by\":80,\"deleted_at\":null}','68.53.115.247','2021-06-11 18:54:35'),(29737,'ThASZEPeAA6eSCtVcxv5ihPibVGeaDkPiwvfffVA',80,'users','logout',80,'[]','68.53.115.247','2021-06-11 18:54:35'),(29738,'bZJwa1Aw00vyCDDaqk26EBPNj2LaweLmWULYnSeY',81,'users','login',81,'[]','68.53.115.247','2021-06-11 18:54:39'),(29739,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44179,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"12\\/16\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:54:55 pm\",\"created_at\":\"6\\/11\\/2021 1:54:55 pm\",\"id\":44179}','68.53.115.247','2021-06-11 18:54:55'),(29740,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports','update',186,'{\"id\":186,\"form_id\":\"23\",\"user_id\":\"81\",\"question_id\":null,\"organization_id\":\"10\",\"tab_id\":null,\"question_type\":null,\"text_answer\":\"{\\\"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\\\":\\\"245D Service Termination\\\\\\/Suspension\\\",\\\"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\\\"}\",\"mcq_answer\":null,\"other_answer\":\"0\",\"status\":\"1\",\"created_by\":\"81\",\"updated_by\":81,\"created_at\":\"5\\/25\\/2021 1:14:26 am\",\"updated_at\":\"6\\/11\\/2021 1:55:24 pm\",\"deleted_at\":null,\"report_name\":\"CY_Harry Meyering-BEC-2019-11\"}','68.53.115.247','2021-06-11 18:55:24'),(29741,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44180,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Care Manager\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:24 pm\",\"created_at\":\"6\\/11\\/2021 1:55:24 pm\",\"id\":44180}','68.53.115.247','2021-06-11 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18:55:24'),(29746,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44185,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Emily Britz \\/ Tana Helleksen\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:24 pm\",\"created_at\":\"6\\/11\\/2021 1:55:24 pm\",\"id\":44185}','68.53.115.247','2021-06-11 18:55:24'),(29747,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44186,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"ebritz \\/ thelleksen \\/@harrymeyeringcenter.org\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:24 pm\",\"created_at\":\"6\\/11\\/2021 1:55:24 pm\",\"id\":44186}','68.53.115.247','2021-06-11 18:55:24'),(29748,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44187,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:24 pm\",\"created_at\":\"6\\/11\\/2021 1:55:24 pm\",\"id\":44187}','68.53.115.247','2021-06-11 18:55:24'),(29749,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44188,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"245D Service Termination\\/Suspension\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:24 pm\",\"created_at\":\"6\\/11\\/2021 1:55:24 pm\",\"id\":44188}','68.53.115.247','2021-06-11 18:55:24'),(29750,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44189,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Blue Earth County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:24 pm\",\"created_at\":\"6\\/11\\/2021 1:55:24 pm\",\"id\":44189}','68.53.115.247','2021-06-11 18:55:24'),(29751,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44190,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:24 pm\",\"created_at\":\"6\\/11\\/2021 1:55:24 pm\",\"id\":44190}','68.53.115.247','2021-06-11 18:55:24'),(29752,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44191,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:24 pm\",\"created_at\":\"6\\/11\\/2021 1:55:24 pm\",\"id\":44191}','68.53.115.247','2021-06-11 18:55:24'),(29753,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44192,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:24 pm\",\"created_at\":\"6\\/11\\/2021 1:55:24 pm\",\"id\":44192}','68.53.115.247','2021-06-11 18:55:24'),(29754,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44193,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Person\'s services were terminated due to challenging behavior\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44193}','68.53.115.247','2021-06-11 18:55:25'),(29755,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44194,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44194}','68.53.115.247','2021-06-11 18:55:25'),(29756,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44195,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44195}','68.53.115.247','2021-06-11 18:55:25'),(29757,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44196,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44196}','68.53.115.247','2021-06-11 18:55:25'),(29758,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44197,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44197}','68.53.115.247','2021-06-11 18:55:25'),(29759,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44198,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"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.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44198}','68.53.115.247','2021-06-11 18:55:25'),(29760,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44199,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44199}','68.53.115.247','2021-06-11 18:55:25'),(29761,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44200,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"128\",\"question_type\":\"Yes_or_No\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44200}','68.53.115.247','2021-06-11 18:55:25'),(29762,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44201,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"129\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44201}','68.53.115.247','2021-06-11 18:55:25'),(29763,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44202,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"130\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44202}','68.53.115.247','2021-06-11 18:55:25'),(29764,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44203,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"131\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44203}','68.53.115.247','2021-06-11 18:55:25'),(29765,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44204,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"132\",\"question_type\":\"Free_Text\",\"text_answer\":\"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.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44204}','68.53.115.247','2021-06-11 18:55:25'),(29766,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44205,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44205}','68.53.115.247','2021-06-11 18:55:25'),(29767,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44206,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"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.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44206}','68.53.115.247','2021-06-11 18:55:25'),(29768,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44207,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44207}','68.53.115.247','2021-06-11 18:55:25'),(29769,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44208,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44208}','68.53.115.247','2021-06-11 18:55:25'),(29770,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44209,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"105\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44209}','68.53.115.247','2021-06-11 18:55:25'),(29771,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44210,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"106\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44210}','68.53.115.247','2021-06-11 18:55:25'),(29772,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44211,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"107\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44211}','68.53.115.247','2021-06-11 18:55:25'),(29773,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44212,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"108\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44212}','68.53.115.247','2021-06-11 18:55:25'),(29774,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44213,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"109\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44213}','68.53.115.247','2021-06-11 18:55:25'),(29775,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44214,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"110\",\"question_type\":\"Free_Text\",\"text_answer\":\"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.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44214}','68.53.115.247','2021-06-11 18:55:25'),(29776,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44215,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"111\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44215}','68.53.115.247','2021-06-11 18:55:25'),(29777,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44216,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"112\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44216}','68.53.115.247','2021-06-11 18:55:25'),(29778,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44217,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"113\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44217}','68.53.115.247','2021-06-11 18:55:25'),(29779,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44218,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"114\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44218}','68.53.115.247','2021-06-11 18:55:25'),(29780,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44219,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"115\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44219}','68.53.115.247','2021-06-11 18:55:25'),(29781,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44220,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"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.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44220}','68.53.115.247','2021-06-11 18:55:25'),(29782,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44221,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"117\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44221}','68.53.115.247','2021-06-11 18:55:25'),(29783,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44222,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"118\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44222}','68.53.115.247','2021-06-11 18:55:25'),(29784,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44223,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"119\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44223}','68.53.115.247','2021-06-11 18:55:25'),(29785,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44224,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":\"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.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44224}','68.53.115.247','2021-06-11 18:55:25'),(29786,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44225,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"121\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44225}','68.53.115.247','2021-06-11 18:55:25'),(29787,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44226,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"122\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44226}','68.53.115.247','2021-06-11 18:55:25'),(29788,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44227,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"123\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44227}','68.53.115.247','2021-06-11 18:55:25'),(29789,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44228,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44228}','68.53.115.247','2021-06-11 18:55:25'),(29790,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44229,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"125\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44229}','68.53.115.247','2021-06-11 18:55:25'),(29791,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44230,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"126\",\"question_type\":\"Free_Text\",\"text_answer\":\"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\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44230}','68.53.115.247','2021-06-11 18:55:25'),(29792,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'reports_answer','create',44231,'{\"report_id\":186,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"432\",\"question_type\":\"Yes_or_No\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:55:25 pm\",\"created_at\":\"6\\/11\\/2021 1:55:25 pm\",\"id\":44231}','68.53.115.247','2021-06-11 18:55:25'),(29793,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'users','update',81,'{\"id\":81,\"user_type_id\":\"3\",\"email\":\"mrkjweaver@gmail.com\",\"first_name\":\"1 Johnny\",\"last_name\":\"Test\",\"profile_image\":null,\"status\":\"1\",\"email_verified_at\":\"2020-06-10 10:12:11\",\"last_login_at\":null,\"last_login_ip\":null,\"created_at\":\"6\\/9\\/2020 9:37:57 am\",\"updated_at\":\"5\\/26\\/2021 9:45:26 am\",\"created_by\":\"80\",\"updated_by\":81,\"deleted_at\":null}','68.53.115.247','2021-06-11 18:57:22'),(29794,'EJr248Wwzk8qfHkiGOKFNUHQaGxekFtU3ePHIwph',81,'users','logout',81,'[]','68.53.115.247','2021-06-11 18:57:22'),(29795,'OjGWU1fWQ8s12ZklqPPOLNv8vzN4ND7t5piZkXZr',80,'users','login',80,'[]','68.53.115.247','2021-06-11 18:57:27'),(29796,'2jGgeTNAWqytPbY6LR5NsIq4TmilDeS2dUAs4vpK',80,'users','update',80,'{\"id\":80,\"user_type_id\":\"1\",\"email\":\"kw@collaborative-safety.com\",\"first_name\":\"Kenny\",\"last_name\":\"Weaver\",\"profile_image\":null,\"status\":\"1\",\"email_verified_at\":\"2020-06-03 11:25:18\",\"last_login_at\":null,\"last_login_ip\":null,\"created_at\":\"6\\/3\\/2020 8:47:44 am\",\"updated_at\":\"6\\/3\\/2020 11:25:18 am\",\"created_by\":\"79\",\"updated_by\":80,\"deleted_at\":null}','68.53.115.247','2021-06-11 18:58:03'),(29797,'2jGgeTNAWqytPbY6LR5NsIq4TmilDeS2dUAs4vpK',80,'users','logout',80,'[]','68.53.115.247','2021-06-11 18:58:03'),(29798,'CxiDy8Z29z4x5XJfV3l7059keh04PJugSvE7i1R6',81,'users','login',81,'[]','68.53.115.247','2021-06-11 18:58:08'),(29799,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44232,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"07\\/28\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:58:40 pm\",\"created_at\":\"6\\/11\\/2021 1:58:40 pm\",\"id\":44232}','68.53.115.247','2021-06-11 18:58:40'),(29800,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44233,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"05\\/29\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:01 pm\",\"created_at\":\"6\\/11\\/2021 1:59:01 pm\",\"id\":44233}','68.53.115.247','2021-06-11 18:59:01'),(29801,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports','update',187,'{\"id\":187,\"form_id\":\"23\",\"user_id\":\"81\",\"question_id\":null,\"organization_id\":\"10\",\"tab_id\":null,\"question_type\":null,\"text_answer\":\"{\\\"Short_Answer__76\\\":\\\"CY_Mains\'l-HC-2020-07\\\",\\\"Date__77\\\":\\\"07\\\\\\/28\\\\\\/2020\\\",\\\"Multiple_Choice__78\\\":\\\"Charles Young\\\",\\\"Short_Answer__80\\\":\\\"Mains\'l Services\\\",\\\"Short_Answer__81\\\":\\\"Kelly Boser McBroom\\\",\\\"Short_Answer__82\\\":\\\"kbmcbroom@mainsl.com\\\",\\\"Short_Answer__83\\\":\\\"763-494-4553\\\",\\\"Multiple_Choice__84\\\":\\\"245D Service Termination\\\\\\/Suspension\\\",\\\"Multiple_Choice__85\\\":\\\"Hennepin County\\\",\\\"Date__86\\\":\\\"05\\\\\\/29\\\\\\/2020\\\",\\\"Multiple_Choice__96\\\":\\\"1\\\",\\\"Short_Answer__91\\\":\\\"Service termination was issued\\\",\\\"True_or_False__94\\\":\\\"Yes\\\",\\\"Free_Text__100\\\":\\\"The provider issuing a person a service termination as necessary for her welfare and her needs couldn\\\\u2019t be met was strongly influenced by the fact that available external mental health and crisis services required a person to be in danger of losing their housing. The provider noted that they did not have an actual intention of terminating the person\\\\u2019s services, but instead wanted to ensure that the person could access needed mental health services. The case manager had difficulty in finding other providers to work with her due to a lack of appropriate crisis services available statewide and so requested that the provider issue the service termination to help access alterative crisis and mental health services. People with a residential placement are deprioritized on crisis service waiting lists as priority must be given to people without or in danger of losing housing. There are also few locked facilities in Minnesota, which the team thoughtT this person could need to help manage the person\\\\u2019s escalating elopement and physical aggression concerns. This lack of locked facilities in Minnesota is impacted by the state\\\\u2019s regulations that focus on providing services in a least restrictive setting, the Olmstead vs. LC lawsuit, Minnesota\\\\u2019s Olmstead Plan, Minnesota Statute 245D and the Jensen Settlement \\\\u2013 which created the need for Minnesota\\\\u2019s Olmstead Plan and the stronger focus on utilizing less restrictive settings. Minnesota\\\\u2019s Moratorium on foster care and other residential settings (ICF\\\\\\/DDs) also prevented providers from opening settings that were sometimes seen as more restrictive settings, leaving fewer options for people who may need this type of environment. \\\\r\\\\nThe person had a primary diagnosis of developmental disability, which exempted her from accessing some of the mental health services the team thought she needed, such as IRTS \\\\u2013 which will only serve people with an MH diagnosis. Due to the confusion and\\\\\\/or disagreement among professionals involved with this person regarding whether the person\\\\u2019s interfering behavior was psychiatric or behaviorally based, obtaining a specific diagnosis was difficult. MA doesn\\\\u2019t allow for multidisciplinary assessments, so her team was not able to meet and work out a specific diagnosis or plan. Some professionals diagnosed her as primarily having a developmental disability (neurocognitive disorder) while others diagnosed her as primarily having a mental health disorder. Shortly before the termination was issued, one clinician diagnosed her with a primary mental health disorder, which the professional saw as primarily contributing to the person\\\\u2019s escalating and dangerous interfering behavior.  The person\\\\u2019s primary diagnosis couldn\\\\u2019t be resolved amongst the professionals, impacting the person\\\\u2019s inability to access mental health services. \\\\r\\\\nThe provider issuing a person a service termination as necessary for her welfare and her needs couldn\\\\u2019t be met was influenced by the person\\\\u2019s interfering behavior which was escalating and dangerous. The person regularly physically aggressed towards her roommates and staff. The other people in the home were considered vulnerable, and the provider has a responsibility to safeguard the health and safety of all residents \\\\u2013 as well as their staff. This responsibility is assigned to providers by Minnesota Statutes 245D, the statute governing an HCBS provider\\\\u2019s license. The responsibility is also assigned to providers by the Coordinated Service and Support Plans created by lead agency or contracted HCBS case managers. Along with endangering the other people in the home, the person also trespassed routinely on neighbor\\\\u2019s property and even their homes and called 911 often. Due to these 911 calls, the person was transported to the hospital often but rarely admitted. It was determined through a functional behavior assessment that the person enjoyed going to the hospital and receiving attention from the EMTs and hospital staff. This desire led to the person often falsely reporting medical concerns to the 911 dispatchers. When it was determined that the person didn\\\\u2019t have an actual medical concern, the hospitals and EMT would discharge or refuse services because they won\\\\u2019t serve someone in crisis if the underlying cause is \\\\u201cbehavioral\\\\u201d rather than medical. MA rules require hospitals to provide care if a person is a danger to themselves or others, and the medical professionals felt that the person\\\\u2019s issues were attention-seeking in nature and not a serious health or mental health concern. When the person eventually could not access medical and EMT services due to her false reporting, she started calling on issues that law enforcement would typically respond to. Her behavior escalated to eloping from the home and laying in the road despite oncoming traffic. Due to her size, staff were unable to move or remove her from this position without law enforcement assistance. The law enforcement officers involved reportedly eventually grew frustrated responding to issues they thought the residence should handle, and refused to work with the person.\\\\r\\\\nThe interventions that were implemented with the person by the provider appeared to not be effective. The provider\\\\u2019s philosophy was to avoid restrictive interventions such as restraint or rights restrictions. Because of the person\\\\u2019s demeanor and size, the provider also didn\\\\u2019t think restrictive interventions would safely resolve the person\\\\u2019s interfering behavior. This philosophy to avoid restrictive interventions was influenced by person-centered philosophy\\\\\\/ethics, as well as the requirements in the licensing statute MN Stat. 245D. Those interventions that were tried, such as positive support strategies and even increasing the person\\\\u2019s staffing to 1:1 did not decrease the incidence and intensity of the person\\\\u2019s interfering behaviors. The person had a person-centered plan created with them, and in that planning process it was determined that the person wanted to live alone, something the provider tried to work with the person to help them work towards a more independent placement. But the fact that the person wasn\\\\u2019t living in a preferred setting was believed to contribute to the person\\\\u2019s escalating interfering behavior. The provider requested support in the area of mental health training and staffing, but these services were either unavailable or not as intense as the provider was seeking. This lack of services was influenced by lower wages and compensation for these services. These lower wages were seen as lower than needed due to a statewide workforce shortage that increased the demand for staff which, in turn, increased the wages in other service sectors so that HCBS services were less desirable for workers. HCBS rates are mainly determined by Minnesota Statutes governing the Disability Waiver Rate Setting requirements. Creating higher wages\\\\\\/HCBS reimbursement required action by the Minnesota Legislature. \\\\r\\\\nThe provider was pressured to act in this situation due to the escalating and dangerous behavior and the neighbor\\\\u2019s concerns about their own welfare and placing pressure on the provider to prevent the behaviors and pressure from law enforcement to act. While the provider didn\\\\u2019t intend to actually terminate services, it appeared as though the only way to access needed crisis and mental health services for the person was to issue a service termination.\\\",\\\"Multiple_Choice__103\\\":\\\"2\\\",\\\"Free_Text__104\\\":\\\"The provider requested support in the area of mental health training and staffing, but these services were either unavailable or not as intense as the provider was seeking. This lack of services was influenced by lower wages and compensation for these services. These lower wages were seen as lower than needed due to a statewide workforce shortage that increased the demand for staff which, in turn, increased the wages in other service sectors so that HCBS services were less desirable for workers. HCBS rates are mainly determined by Minnesota Statutes governing the Disability Waiver Rate Setting requirements. Creating higher wages\\\\\\/HCBS reimbursement required action by the Minnesota Legislature.\\\",\\\"Multiple_Choice__115\\\":\\\"3\\\",\\\"Free_Text__116\\\":\\\"The provider issuing a person a service termination as necessary for her welfare and her needs couldn\\\\u2019t be met was influenced by the person\\\\u2019s interfering behavior which was escalating and dangerous. The person regularly physically aggressed towards her roommates and staff. The other people in the home were considered vulnerable, and the provider has a responsibility to safeguard the health and safety of all residents \\\\u2013 as well as their staff. This responsibility is assigned to providers by Minnesota Statutes 245D, the statute governing an HCBS provider\\\\u2019s license. The responsibility is also assigned to providers by the Coordinated Service and Support Plans created by lead agency or contracted HCBS case managers.\\\",\\\"Multiple_Choice__119\\\":\\\"3\\\",\\\"Free_Text__120\\\":\\\"The provider issuing a person a service termination as necessary for her welfare and her needs couldn\\\\u2019t be met was strongly influenced by the fact that available external mental health and crisis services required a person to be in danger of losing their housing. The provider noted that they did not have an actual intention of terminating the person\\\\u2019s services, but instead wanted to ensure that the person could access needed mental health services. The case manager had difficulty in finding other providers to work with her due to a lack of appropriate crisis services available statewide and so requested that the provider issue the service termination to help access alterative crisis and mental health services. People with a residential placement are deprioritized on crisis service waiting lists as priority must be given to people without or in danger of losing housing. There are also few locked facilities in Minnesota, which the team thoughtT this person could need to help manage the person\\\\u2019s escalating elopement and physical aggression concerns. This lack of locked facilities in Minnesota is impacted by the state\\\\u2019s regulations that focus on providing services in a least restrictive setting, the Olmstead vs. LC lawsuit, Minnesota\\\\u2019s Olmstead Plan, Minnesota Statute 245D and the Jensen Settlement \\\\u2013 which created the need for Minnesota\\\\u2019s Olmstead Plan and the stronger focus on utilizing less restrictive settings. Minnesota\\\\u2019s Moratorium on foster care and other residential settings (ICF\\\\\\/DDs) also prevented providers from opening settings that were sometimes seen as more restrictive settings, leaving fewer options for people who may need this type of environment.\\\",\\\"Yes_or_No__432\\\":\\\"Yes\\\"}\",\"mcq_answer\":null,\"other_answer\":\"0\",\"status\":\"1\",\"created_by\":\"81\",\"updated_by\":81,\"created_at\":\"5\\/24\\/2021 7:44:26 pm\",\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"deleted_at\":null,\"report_name\":\"CY_Mains l - HC -2020 -07\"}','68.53.115.247','2021-06-11 18:59:13'),(29802,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44234,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"CY_Mains\'l-HC-2020-07\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44234}','68.53.115.247','2021-06-11 18:59:13'),(29803,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44235,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"07\\/28\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44235}','68.53.115.247','2021-06-11 18:59:13'),(29804,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44236,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Charles Young\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44236}','68.53.115.247','2021-06-11 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18:59:13'),(29817,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44249,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44249}','68.53.115.247','2021-06-11 18:59:13'),(29818,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44250,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44250}','68.53.115.247','2021-06-11 18:59:13'),(29819,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44251,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44251}','68.53.115.247','2021-06-11 18:59:13'),(29820,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44252,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The provider issuing a person a service termination as necessary for her welfare and her needs couldn\\u2019t be met was strongly influenced by the fact that available external mental health and crisis services required a person to be in danger of losing their housing. The provider noted that they did not have an actual intention of terminating the person\\u2019s services, but instead wanted to ensure that the person could access needed mental health services. The case manager had difficulty in finding other providers to work with her due to a lack of appropriate crisis services available statewide and so requested that the provider issue the service termination to help access alterative crisis and mental health services. People with a residential placement are deprioritized on crisis service waiting lists as priority must be given to people without or in danger of losing housing. There are also few locked facilities in Minnesota, which the team thoughtT this person could need to help manage the person\\u2019s escalating elopement and physical aggression concerns. This lack of locked facilities in Minnesota is impacted by the state\\u2019s regulations that focus on providing services in a least restrictive setting, the Olmstead vs. LC lawsuit, Minnesota\\u2019s Olmstead Plan, Minnesota Statute 245D and the Jensen Settlement \\u2013 which created the need for Minnesota\\u2019s Olmstead Plan and the stronger focus on utilizing less restrictive settings. Minnesota\\u2019s Moratorium on foster care and other residential settings (ICF\\/DDs) also prevented providers from opening settings that were sometimes seen as more restrictive settings, leaving fewer options for people who may need this type of environment. \\r\\nThe person had a primary diagnosis of developmental disability, which exempted her from accessing some of the mental health services the team thought she needed, such as IRTS \\u2013 which will only serve people with an MH diagnosis. Due to the confusion and\\/or disagreement among professionals involved with this person regarding whether the person\\u2019s interfering behavior was psychiatric or behaviorally based, obtaining a specific diagnosis was difficult. MA doesn\\u2019t allow for multidisciplinary assessments, so her team was not able to meet and work out a specific diagnosis or plan. Some professionals diagnosed her as primarily having a developmental disability (neurocognitive disorder) while others diagnosed her as primarily having a mental health disorder. Shortly before the termination was issued, one clinician diagnosed her with a primary mental health disorder, which the professional saw as primarily contributing to the person\\u2019s escalating and dangerous interfering behavior.  The person\\u2019s primary diagnosis couldn\\u2019t be resolved amongst the professionals, impacting the person\\u2019s inability to access mental health services. \\r\\nThe provider issuing a person a service termination as necessary for her welfare and her needs couldn\\u2019t be met was influenced by the person\\u2019s interfering behavior which was escalating and dangerous. The person regularly physically aggressed towards her roommates and staff. The other people in the home were considered vulnerable, and the provider has a responsibility to safeguard the health and safety of all residents \\u2013 as well as their staff. This responsibility is assigned to providers by Minnesota Statutes 245D, the statute governing an HCBS provider\\u2019s license. The responsibility is also assigned to providers by the Coordinated Service and Support Plans created by lead agency or contracted HCBS case managers. Along with endangering the other people in the home, the person also trespassed routinely on neighbor\\u2019s property and even their homes and called 911 often. Due to these 911 calls, the person was transported to the hospital often but rarely admitted. It was determined through a functional behavior assessment that the person enjoyed going to the hospital and receiving attention from the EMTs and hospital staff. This desire led to the person often falsely reporting medical concerns to the 911 dispatchers. When it was determined that the person didn\\u2019t have an actual medical concern, the hospitals and EMT would discharge or refuse services because they won\\u2019t serve someone in crisis if the underlying cause is \\u201cbehavioral\\u201d rather than medical. MA rules require hospitals to provide care if a person is a danger to themselves or others, and the medical professionals felt that the person\\u2019s issues were attention-seeking in nature and not a serious health or mental health concern. When the person eventually could not access medical and EMT services due to her false reporting, she started calling on issues that law enforcement would typically respond to. Her behavior escalated to eloping from the home and laying in the road despite oncoming traffic. Due to her size, staff were unable to move or remove her from this position without law enforcement assistance. The law enforcement officers involved reportedly eventually grew frustrated responding to issues they thought the residence should handle, and refused to work with the person.\\r\\nThe interventions that were implemented with the person by the provider appeared to not be effective. The provider\\u2019s philosophy was to avoid restrictive interventions such as restraint or rights restrictions. Because of the person\\u2019s demeanor and size, the provider also didn\\u2019t think restrictive interventions would safely resolve the person\\u2019s interfering behavior. This philosophy to avoid restrictive interventions was influenced by person-centered philosophy\\/ethics, as well as the requirements in the licensing statute MN Stat. 245D. Those interventions that were tried, such as positive support strategies and even increasing the person\\u2019s staffing to 1:1 did not decrease the incidence and intensity of the person\\u2019s interfering behaviors. The person had a person-centered plan created with them, and in that planning process it was determined that the person wanted to live alone, something the provider tried to work with the person to help them work towards a more independent placement. But the fact that the person wasn\\u2019t living in a preferred setting was believed to contribute to the person\\u2019s escalating interfering behavior. The provider requested support in the area of mental health training and staffing, but these services were either unavailable or not as intense as the provider was seeking. This lack of services was influenced by lower wages and compensation for these services. These lower wages were seen as lower than needed due to a statewide workforce shortage that increased the demand for staff which, in turn, increased the wages in other service sectors so that HCBS services were less desirable for workers. HCBS rates are mainly determined by Minnesota Statutes governing the Disability Waiver Rate Setting requirements. Creating higher wages\\/HCBS reimbursement required action by the Minnesota Legislature. \\r\\nThe provider was pressured to act in this situation due to the escalating and dangerous behavior and the neighbor\\u2019s concerns about their own welfare and placing pressure on the provider to prevent the behaviors and pressure from law enforcement to act. While the provider didn\\u2019t intend to actually terminate services, it appeared as though the only way to access needed crisis and mental health services for the person was to issue a service termination.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44252}','68.53.115.247','2021-06-11 18:59:13'),(29821,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44253,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44253}','68.53.115.247','2021-06-11 18:59:13'),(29822,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44254,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"129\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44254}','68.53.115.247','2021-06-11 18:59:13'),(29823,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44255,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"130\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44255}','68.53.115.247','2021-06-11 18:59:13'),(29824,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44256,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"131\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44256}','68.53.115.247','2021-06-11 18:59:13'),(29825,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44257,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"132\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44257}','68.53.115.247','2021-06-11 18:59:13'),(29826,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44258,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44258}','68.53.115.247','2021-06-11 18:59:13'),(29827,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44259,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44259}','68.53.115.247','2021-06-11 18:59:13'),(29828,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44260,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44260}','68.53.115.247','2021-06-11 18:59:13'),(29829,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44261,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":\"The provider requested support in the area of mental health training and staffing, but these services were either unavailable or not as intense as the provider was seeking. This lack of services was influenced by lower wages and compensation for these services. These lower wages were seen as lower than needed due to a statewide workforce shortage that increased the demand for staff which, in turn, increased the wages in other service sectors so that HCBS services were less desirable for workers. HCBS rates are mainly determined by Minnesota Statutes governing the Disability Waiver Rate Setting requirements. Creating higher wages\\/HCBS reimbursement required action by the Minnesota Legislature.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44261}','68.53.115.247','2021-06-11 18:59:13'),(29830,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44262,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"105\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44262}','68.53.115.247','2021-06-11 18:59:13'),(29831,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44263,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"106\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44263}','68.53.115.247','2021-06-11 18:59:13'),(29832,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44264,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"107\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44264}','68.53.115.247','2021-06-11 18:59:13'),(29833,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44265,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"108\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:13 pm\",\"created_at\":\"6\\/11\\/2021 1:59:13 pm\",\"id\":44265}','68.53.115.247','2021-06-11 18:59:13'),(29834,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44266,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"109\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:14 pm\",\"created_at\":\"6\\/11\\/2021 1:59:14 pm\",\"id\":44266}','68.53.115.247','2021-06-11 18:59:14'),(29835,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44267,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"110\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:14 pm\",\"created_at\":\"6\\/11\\/2021 1:59:14 pm\",\"id\":44267}','68.53.115.247','2021-06-11 18:59:14'),(29836,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44268,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"111\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:14 pm\",\"created_at\":\"6\\/11\\/2021 1:59:14 pm\",\"id\":44268}','68.53.115.247','2021-06-11 18:59:14'),(29837,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44269,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"112\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:14 pm\",\"created_at\":\"6\\/11\\/2021 1:59:14 pm\",\"id\":44269}','68.53.115.247','2021-06-11 18:59:14'),(29838,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44270,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"113\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:14 pm\",\"created_at\":\"6\\/11\\/2021 1:59:14 pm\",\"id\":44270}','68.53.115.247','2021-06-11 18:59:14'),(29839,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44271,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"114\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:14 pm\",\"created_at\":\"6\\/11\\/2021 1:59:14 pm\",\"id\":44271}','68.53.115.247','2021-06-11 18:59:14'),(29840,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44272,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"115\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:14 pm\",\"created_at\":\"6\\/11\\/2021 1:59:14 pm\",\"id\":44272}','68.53.115.247','2021-06-11 18:59:14'),(29841,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44273,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"The provider issuing a person a service termination as necessary for her welfare and her needs couldn\\u2019t be met was influenced by the person\\u2019s interfering behavior which was escalating and dangerous. The person regularly physically aggressed towards her roommates and staff. The other people in the home were considered vulnerable, and the provider has a responsibility to safeguard the health and safety of all residents \\u2013 as well as their staff. This responsibility is assigned to providers by Minnesota Statutes 245D, the statute governing an HCBS provider\\u2019s license. The responsibility is also assigned to providers by the Coordinated Service and Support Plans created by lead agency or contracted HCBS case managers.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:14 pm\",\"created_at\":\"6\\/11\\/2021 1:59:14 pm\",\"id\":44273}','68.53.115.247','2021-06-11 18:59:14'),(29842,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44274,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"117\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:14 pm\",\"created_at\":\"6\\/11\\/2021 1:59:14 pm\",\"id\":44274}','68.53.115.247','2021-06-11 18:59:14'),(29843,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44275,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"118\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:14 pm\",\"created_at\":\"6\\/11\\/2021 1:59:14 pm\",\"id\":44275}','68.53.115.247','2021-06-11 18:59:14'),(29844,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44276,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"119\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:14 pm\",\"created_at\":\"6\\/11\\/2021 1:59:14 pm\",\"id\":44276}','68.53.115.247','2021-06-11 18:59:14'),(29845,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44277,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":\"The provider issuing a person a service termination as necessary for her welfare and her needs couldn\\u2019t be met was strongly influenced by the fact that available external mental health and crisis services required a person to be in danger of losing their housing. The provider noted that they did not have an actual intention of terminating the person\\u2019s services, but instead wanted to ensure that the person could access needed mental health services. The case manager had difficulty in finding other providers to work with her due to a lack of appropriate crisis services available statewide and so requested that the provider issue the service termination to help access alterative crisis and mental health services. People with a residential placement are deprioritized on crisis service waiting lists as priority must be given to people without or in danger of losing housing. There are also few locked facilities in Minnesota, which the team thoughtT this person could need to help manage the person\\u2019s escalating elopement and physical aggression concerns. This lack of locked facilities in Minnesota is impacted by the state\\u2019s regulations that focus on providing services in a least restrictive setting, the Olmstead vs. LC lawsuit, Minnesota\\u2019s Olmstead Plan, Minnesota Statute 245D and the Jensen Settlement \\u2013 which created the need for Minnesota\\u2019s Olmstead Plan and the stronger focus on utilizing less restrictive settings. Minnesota\\u2019s Moratorium on foster care and other residential settings (ICF\\/DDs) also prevented providers from opening settings that were sometimes seen as more restrictive settings, leaving fewer options for people who may need this type of environment.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:14 pm\",\"created_at\":\"6\\/11\\/2021 1:59:14 pm\",\"id\":44277}','68.53.115.247','2021-06-11 18:59:14'),(29846,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44278,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"121\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:14 pm\",\"created_at\":\"6\\/11\\/2021 1:59:14 pm\",\"id\":44278}','68.53.115.247','2021-06-11 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18:59:50'),(29869,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44301,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Prior to the termination the individual was residing with this AFC provider for 15 months.  The setting was a family foster home with owner\\/operator on-site and no other residents.   The provider was newly licensed for 2 residents and this was the first individual that was placed in her home.   The individual was in his grandparents\\u2019 care prior to this AFC.  The individual is his own guardian.  \\r\\nPrior to the placement the provider had communicated with the individual\\u2019s grandparents and CADI case manager.  The provider was told that the individual was in special education in school and A few weeks after the placement the provider was given a file with additional information on the individual.  The file included police reports indicating the individual had been in physical fights.  After the placement the provider also learned that the individual had a history of stealing money, cigarettes and specifically an incident when he stole credit cards from his grandparents.   The provider also learned that he was expelled from Cloquet High School due to his behaviors and transferred to the Merit Creek Academy.  The provider stated that in conversations with the individual\\u2019s grandparents they stated that he was easily influenced by his friends.  \\r\\nThe provider stated while the individual was residing with her he would swear at her and try to physically intimidate her.  The provider noted that the individual never physically assaulted her.  The provider noted that the individual spent much of his time in his bedroom playing video games.  He ate the majority of this meals in his room alone.   Prior to COVID19, the individual was in therapy twice a week for depression and anger issues.  This moved to telehealth and soon ended all together.  The individual was also with Choice Unlimited for employment after he graduated school, but did not want to continue to work on employment.\\r\\nDue to the individual constantly isolating himself and physically intimidating behaviors the provider decided to issue a 60 day termination notice. The case manager was aware of the concerns and supported the individual moving.  The individual was not initially supportive of the move, but was excited to move once he toured the new facility.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:50 pm\",\"created_at\":\"6\\/11\\/2021 1:59:50 pm\",\"id\":44301}','68.53.115.247','2021-06-11 18:59:50'),(29870,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44302,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:50 pm\",\"created_at\":\"6\\/11\\/2021 1:59:50 pm\",\"id\":44302}','68.53.115.247','2021-06-11 18:59:50'),(29871,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44303,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The person\\u2019s services being terminated by the provider were influenced by the person\\u2019s behaviors and the overall \\u201cmatch\\u201d between the person and the provider. The person demonstrated physical intimidating behaviors to staff.  This would often occur when staff asked questions about concerns for the person\\u2019s decisions.  The staff was prompted to ask these questions because belongings in the home were missing.\\r\\n\\r\\nThe provider determining there wasn\\u2019t a good overall \\u201cmatch\\u201d was influenced by the following.  The adult foster care (AFC) home was a single staff person owner\\/operator.  This did not allow for staffing changes to adjust to the individual\\u2019s behaviors or staff exhaustion.  The majority of the time the individual chose to stay in their room and play video games; possibly to the level of an addiction\\/obsession.   Staff felt the individual would benefit from participating in social and recreational activities besides video games.  Staff exhausted attempts and techniques to redirect the individual to engage in other activities besides playing video games.  The provider reached out to the case manager for support services when they were struggling to redirect the person\\/address behaviors.  Due to COVID19, support services were not able to be offered.  The individual made a choice to discontinue therapy as well as employment, which led to more time in his room playing video games.  These decisions are supported by 245D (informed choice).\\r\\n\\r\\nAnother influence to the person not being a good match and services being terminated was this was the first person the provider had served since being licensed.  The provider was unfamiliar with the system and best practices for potential people to support.  Both influenced the match between the individual and provider.  \\r\\nAnother influence to the \\u201cmatch\\u201d and services being terminated was that the provider was unaware of the individual\\u2019s history\\/previous concerns with behaviors.  This was influenced by this being the first AFC the individual had resided and the case manager was unaware of the person\\u2019s history so unable to share it with provider.  The case manager did not have a clear picture of the history because they just began working the individual and the person chose not to participate in the person-centered planning process.  The case manager and team reached out to the local high school in an attempt to learn more about the person. The teacher most familiar with the individual was unavailable to speak with the case manager or provider as it was the summer (school closed).  This influenced the lack of history and ability to determine the appropriateness of the match between the individual.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:50 pm\",\"created_at\":\"6\\/11\\/2021 1:59:50 pm\",\"id\":44303}','68.53.115.247','2021-06-11 18:59:50'),(29872,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44304,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:50 pm\",\"created_at\":\"6\\/11\\/2021 1:59:50 pm\",\"id\":44304}','68.53.115.247','2021-06-11 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18:59:56'),(29919,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44351,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Prior to the termination the individual was residing with this AFC provider for 15 months.  The setting was a family foster home with owner\\/operator on-site and no other residents.   The provider was newly licensed for 2 residents and this was the first individual that was placed in her home.   The individual was in his grandparents\\u2019 care prior to this AFC.  The individual is his own guardian.  \\r\\nPrior to the placement the provider had communicated with the individual\\u2019s grandparents and CADI case manager.  The provider was told that the individual was in special education in school and A few weeks after the placement the provider was given a file with additional information on the individual.  The file included police reports indicating the individual had been in physical fights.  After the placement the provider also learned that the individual had a history of stealing money, cigarettes and specifically an incident when he stole credit cards from his grandparents.   The provider also learned that he was expelled from Cloquet High School due to his behaviors and transferred to the Merit Creek Academy.  The provider stated that in conversations with the individual\\u2019s grandparents they stated that he was easily influenced by his friends.  \\r\\nThe provider stated while the individual was residing with her he would swear at her and try to physically intimidate her.  The provider noted that the individual never physically assaulted her.  The provider noted that the individual spent much of his time in his bedroom playing video games.  He ate the majority of this meals in his room alone.   Prior to COVID19, the individual was in therapy twice a week for depression and anger issues.  This moved to telehealth and soon ended all together.  The individual was also with Choice Unlimited for employment after he graduated school, but did not want to continue to work on employment.\\r\\nDue to the individual constantly isolating himself and physically intimidating behaviors the provider decided to issue a 60 day termination notice. The case manager was aware of the concerns and supported the individual moving.  The individual was not initially supportive of the move, but was excited to move once he toured the new facility.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:56 pm\",\"created_at\":\"6\\/11\\/2021 1:59:56 pm\",\"id\":44351}','68.53.115.247','2021-06-11 18:59:56'),(29920,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44352,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:56 pm\",\"created_at\":\"6\\/11\\/2021 1:59:56 pm\",\"id\":44352}','68.53.115.247','2021-06-11 18:59:56'),(29921,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44353,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The person\\u2019s services being terminated by the provider were influenced by the person\\u2019s behaviors and the overall \\u201cmatch\\u201d between the person and the provider. The person demonstrated physical intimidating behaviors to staff.  This would often occur when staff asked questions about concerns for the person\\u2019s decisions.  The staff was prompted to ask these questions because belongings in the home were missing.\\r\\n\\r\\nThe provider determining there wasn\\u2019t a good overall \\u201cmatch\\u201d was influenced by the following.  The adult foster care (AFC) home was a single staff person owner\\/operator.  This did not allow for staffing changes to adjust to the individual\\u2019s behaviors or staff exhaustion.  The majority of the time the individual chose to stay in their room and play video games; possibly to the level of an addiction\\/obsession.   Staff felt the individual would benefit from participating in social and recreational activities besides video games.  Staff exhausted attempts and techniques to redirect the individual to engage in other activities besides playing video games.  The provider reached out to the case manager for support services when they were struggling to redirect the person\\/address behaviors.  Due to COVID19, support services were not able to be offered.  The individual made a choice to discontinue therapy as well as employment, which led to more time in his room playing video games.  These decisions are supported by 245D (informed choice).\\r\\n\\r\\nAnother influence to the person not being a good match and services being terminated was this was the first person the provider had served since being licensed.  The provider was unfamiliar with the system and best practices for potential people to support.  Both influenced the match between the individual and provider.  \\r\\nAnother influence to the \\u201cmatch\\u201d and services being terminated was that the provider was unaware of the individual\\u2019s history\\/previous concerns with behaviors.  This was influenced by this being the first AFC the individual had resided and the case manager was unaware of the person\\u2019s history so unable to share it with provider.  The case manager did not have a clear picture of the history because they just began working the individual and the person chose not to participate in the person-centered planning process.  The case manager and team reached out to the local high school in an attempt to learn more about the person. The teacher most familiar with the individual was unavailable to speak with the case manager or provider as it was the summer (school closed).  This influenced the lack of history and ability to determine the appropriateness of the match between the individual.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:56 pm\",\"created_at\":\"6\\/11\\/2021 1:59:56 pm\",\"id\":44353}','68.53.115.247','2021-06-11 18:59:56'),(29922,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44354,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 1:59:56 pm\",\"created_at\":\"6\\/11\\/2021 1:59:56 pm\",\"id\":44354}','68.53.115.247','2021-06-11 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19:01:47'),(29965,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44397,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"11\\/05\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44397}','68.53.115.247','2021-06-11 19:01:47'),(29966,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44398,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44398}','68.53.115.247','2021-06-11 19:01:47'),(29967,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44399,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44399}','68.53.115.247','2021-06-11 19:01:47'),(29968,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44400,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Individual was given a 60 day termination notice.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44400}','68.53.115.247','2021-06-11 19:01:47'),(29969,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44401,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44401}','68.53.115.247','2021-06-11 19:01:47'),(29970,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44402,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44402}','68.53.115.247','2021-06-11 19:01:47'),(29971,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44403,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"The individual had been served by this agency for 14 years.  He was in an AFC home with 3 other males.  Prior to the termination the individual was having increased sexual behaviors towards staff.  This included both verbal comments that were inappropriate and\\/or sexual in nature and physical contact with staff that was also inappropriate.  The individual was also using social media to make sexual comments towards staff.  \\r\\nThere was a specific incident in the community (Holiday gas station) where the individual allegedly touched a juvenile\\u2019s buttocks.  The individual was criminally charged and there is currently a pending criminal matter.  There was a similar incident that occurred prior to this at Wal-Mart where the individual grabbed a woman\\u2019s buttocks.  He was not charged during this incident.\\r\\nFollowing the criminal charges, the agency set parameters for the individual which included attending therapy and to cease inappropriate conversations with staff.  The agency identified a provider for therapy and had scheduled an appointment for the individual.  The individual did not attend his appointment by continuing to reschedule the appointment without good reason.  With input from the house manager, program coordinator, manager and the president the agency issued the 60 day termination notice with the intention of dropping the termination if the individual resumed therapy and complied with the other parameters.  The individual did not resume therapy and ended up moving to another facility.  \\r\\nPrior to the termination there multiple meetings with the individual\\u2019s expanded support team to discuss how they could better support him in his current setting.  His support team concurred with the 60 day termination notice because at the time all other options had been exhausted.  The individual claims he didn\\u2019t know about the termination, exercised his right to appeal, and the matter is still pending.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44403}','68.53.115.247','2021-06-11 19:01:47'),(29972,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44404,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44404}','68.53.115.247','2021-06-11 19:01:47'),(29973,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44405,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The individual being issued a termination notice was influenced by the individual\\u2019s increased frequency of sexualized behaviors including sexualized behaviors towards staff which led to staff experiencing sexual harassment.  In response to the increase in the individual\\u2019s behaviors the provider and individual created a behavior agreement.  This agreement included the individual working with a therapeutic practitioner as well as working to reduce the sexualized behaviors.  The individual is their own guardian and did not think they needed to change, would often skip therapy meetings and chose not to comply with the behavior agreement.  The individual\\u2019s computer usage also influenced the increase in sexualized behaviors as they were using social media\\/internet in way that was sexually inappropriate and harassing.  Along with the previously mentioned factors, the lack of effectiveness of the behavior interventions led to the provider issuing the termination notice.  Person-centered requirements guided the provider to honor the individual\\u2019s choices during this process which influenced the person not comply with the behavior agreements.  Additionally the individual was criminally charged in regards to an incident in where they sexually assaulted a minor in the community.  The court did not order treatment for this individual which influenced the individual\\u2019s thought they didn\\u2019t need to change their behaviors as well as a continuation of increased sexual behaviors.  \\r\\nAn additional influence that led to the provider issuing the termination notice was that the individual\\u2019s formal support team including the case manager was involved throughout this process and in the end supported the termination.\\r\\n245D Individual Rights & Person-Centered requirements required that a legal representative consent with any rights restriction, and as the person did not think they needed to change a rights restriction was not an option. The rights afforded to a person in 245D supported the individual in not having rights restrictions as well as honoring their choices.  \\r\\nFurther contributing to the person being given a 60 day termination notice was that staffing the home was difficult.  In regards to the increased sexual behaviors and sexual harassment this led to staff reporting their work environment as hostile and increased the difficulty in staffing the home.  Adding to the difficulty in staffing the home was that the provider attempted to staff the home with males and a statewide workforce shortage.  Staffing only with males decreased the pool of applicants for the home.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44405}','68.53.115.247','2021-06-11 19:01:47'),(29974,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44406,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44406}','68.53.115.247','2021-06-11 19:01:47'),(29975,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44407,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"129\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44407}','68.53.115.247','2021-06-11 19:01:47'),(29976,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44408,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"130\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44408}','68.53.115.247','2021-06-11 19:01:47'),(29977,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44409,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"131\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44409}','68.53.115.247','2021-06-11 19:01:47'),(29978,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44410,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"132\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44410}','68.53.115.247','2021-06-11 19:01:47'),(29979,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44411,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44411}','68.53.115.247','2021-06-11 19:01:47'),(29980,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44412,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44412}','68.53.115.247','2021-06-11 19:01:47'),(29981,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44413,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44413}','68.53.115.247','2021-06-11 19:01:47'),(29982,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44414,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":\"\'don\'t count this as a \\\"2\\\" - notes below are to help with tracking some of things we\'re seeing around people tending to prefer certain types of staff\\r\\n\\r\\nFrom narrative: \\\"Adding to the difficulty in staffing the home was that the provider attempted to staff the home with males and a statewide workforce shortage.  Staffing only with males decreased the pool of applicants for the home.\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44414}','68.53.115.247','2021-06-11 19:01:47'),(29983,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44415,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"105\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44415}','68.53.115.247','2021-06-11 19:01:47'),(29984,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44416,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"106\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44416}','68.53.115.247','2021-06-11 19:01:47'),(29985,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44417,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"107\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44417}','68.53.115.247','2021-06-11 19:01:47'),(29986,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44418,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"108\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44418}','68.53.115.247','2021-06-11 19:01:47'),(29987,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44419,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"109\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44419}','68.53.115.247','2021-06-11 19:01:47'),(29988,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44420,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"110\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Note: individual being their own guardian is considered part of the \'support team\' and them not following through on agreement impacts the teamwork. Guardian, case manager, and provider weren\'t all on the same page.\\\"\\r\\n\\r\\nThis agreement included the individual working with a therapeutic practitioner as well as working to reduce the sexualized behaviors.  The individual is their own guardian and did not think they needed to change, would often skip therapy meetings and chose not to comply with the behavior agreement.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44420}','68.53.115.247','2021-06-11 19:01:47'),(29989,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44421,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"111\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44421}','68.53.115.247','2021-06-11 19:01:47'),(29990,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44422,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"112\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44422}','68.53.115.247','2021-06-11 19:01:47'),(29991,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44423,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"113\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44423}','68.53.115.247','2021-06-11 19:01:47'),(29992,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44424,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"114\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44424}','68.53.115.247','2021-06-11 19:01:47'),(29993,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44425,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"115\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:47 pm\",\"created_at\":\"6\\/11\\/2021 2:01:47 pm\",\"id\":44425}','68.53.115.247','2021-06-11 19:01:47'),(29994,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44426,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"This agreement included the individual working with a therapeutic practitioner as well as working to reduce the sexualized behaviors.  The individual is their own guardian and did not think they needed to change, would often skip therapy meetings and chose not to comply with the behavior agreement.  The individual\\u2019s computer usage also influenced the increase in sexualized behaviors as they were using social media\\/internet in way that was sexually inappropriate and harassing.  Along with the previously mentioned factors, the lack of effectiveness of the behavior interventions led to the provider issuing the termination notice.  Person-centered requirements guided the provider to honor the individual\\u2019s choices during this process which influenced the person not comply with the behavior agreements.  \\r\\n\\r\\n245D Individual Rights & Person-Centered requirements required that a legal representative consent with any rights restriction, and as the person did not think they needed to change a rights restriction was not an option. The rights afforded to a person in 245D supported the individual in not having rights restrictions as well as honoring their choices.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:48 pm\",\"created_at\":\"6\\/11\\/2021 2:01:48 pm\",\"id\":44426}','68.53.115.247','2021-06-11 19:01:48'),(29995,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44427,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"117\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:48 pm\",\"created_at\":\"6\\/11\\/2021 2:01:48 pm\",\"id\":44427}','68.53.115.247','2021-06-11 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19:01:48'),(30000,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44432,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"122\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:48 pm\",\"created_at\":\"6\\/11\\/2021 2:01:48 pm\",\"id\":44432}','68.53.115.247','2021-06-11 19:01:48'),(30001,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44433,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"123\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:48 pm\",\"created_at\":\"6\\/11\\/2021 2:01:48 pm\",\"id\":44433}','68.53.115.247','2021-06-11 19:01:48'),(30002,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44434,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:48 pm\",\"created_at\":\"6\\/11\\/2021 2:01:48 pm\",\"id\":44434}','68.53.115.247','2021-06-11 19:01:48'),(30003,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44435,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"125\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:01:48 pm\",\"created_at\":\"6\\/11\\/2021 2:01:48 pm\",\"id\":44435}','68.53.115.247','2021-06-11 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19:01:48'),(30006,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44438,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"08\\/15\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:02:16 pm\",\"created_at\":\"6\\/11\\/2021 2:02:16 pm\",\"id\":44438}','68.53.115.247','2021-06-11 19:02:16'),(30007,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44439,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"07\\/23\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:02:44 pm\",\"created_at\":\"6\\/11\\/2021 2:02:44 pm\",\"id\":44439}','68.53.115.247','2021-06-11 19:02:44'),(30008,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44440,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"09\\/24\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:04 pm\",\"created_at\":\"6\\/11\\/2021 2:03:04 pm\",\"id\":44440}','68.53.115.247','2021-06-11 19:03:04'),(30009,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44441,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201905337\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:09 pm\",\"created_at\":\"6\\/11\\/2021 2:03:09 pm\",\"id\":44441}','68.53.115.247','2021-06-11 19:03:09'),(30010,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44442,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"08\\/15\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:09 pm\",\"created_at\":\"6\\/11\\/2021 2:03:09 pm\",\"id\":44442}','68.53.115.247','2021-06-11 19:03:09'),(30011,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44443,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"David Vukelich\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:09 pm\",\"created_at\":\"6\\/11\\/2021 2:03:09 pm\",\"id\":44443}','68.53.115.247','2021-06-11 19:03:09'),(30012,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44444,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Scott Schifsky\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:09 pm\",\"created_at\":\"6\\/11\\/2021 2:03:09 pm\",\"id\":44444}','68.53.115.247','2021-06-11 19:03:09'),(30013,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44445,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Pinewood-Duluth\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:09 pm\",\"created_at\":\"6\\/11\\/2021 2:03:09 pm\",\"id\":44445}','68.53.115.247','2021-06-11 19:03:09'),(30014,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44446,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Dana Tchida\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:09 pm\",\"created_at\":\"6\\/11\\/2021 2:03:09 pm\",\"id\":44446}','68.53.115.247','2021-06-11 19:03:09'),(30015,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44447,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"dana@pinewoodcloq-duluth.com\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:09 pm\",\"created_at\":\"6\\/11\\/2021 2:03:09 pm\",\"id\":44447}','68.53.115.247','2021-06-11 19:03:09'),(30016,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44448,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44448}','68.53.115.247','2021-06-11 19:03:10'),(30017,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44449,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Elopement\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44449}','68.53.115.247','2021-06-11 19:03:10'),(30018,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44450,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"St. Louis\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44450}','68.53.115.247','2021-06-11 19:03:10'),(30019,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44451,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"07\\/23\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44451}','68.53.115.247','2021-06-11 19:03:10'),(30020,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44452,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Theresa Reilly (TR) was found outside approximately of a city block away from the Pinewood building by staff\\r\\nSteve Anderson (SA) who was heading out to a job site. TR was at the business 4th Street Auto attempting to open a vehicle door (she\\r\\nlikes to go on car rides). SA was able to gain her attention and asked her to come with him back to Pinewood. She complied and\\r\\naccompanied SA back to Pinewood.\\r\\n\\r\\nEarlier that morning, the \\\"daily schedule\\\" created by staff Sherri Ross (SR) had listed staff Sherrill McDonald (SM) to provide supervision\\r\\nfor TR. TR is not a 1:1, however she requires close supervision as she has a history of elopements. SM had spoken to SR earlier in the\\r\\nmorning, before any clients had arrived, and told her she was not able to provide supervision for TR because she would be busy working\\r\\non a project in a separate area from where TR was going to be. SR was going to make the change on the \\\"daily schedule\\\" but got busy\\r\\nwith other things and forgot to update it with a different staff for TR\'s supervision. With no eligible staff listed for TR s supervision, TR was\\r\\nable to leave the building unnoticed. It is unknown exactly what time TR left Pinewood, but other staff member Connie Lepak (CL) reported\\r\\nthat she had last interacted with TR at 9:10am. SA reported that when he found TR it was approximately 9:15am.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44452}','68.53.115.247','2021-06-11 19:03:10'),(30021,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44453,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44453}','68.53.115.247','2021-06-11 19:03:10'),(30022,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44454,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff was not aware the individual left the program.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44454}','68.53.115.247','2021-06-11 19:03:10'),(30023,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44455,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44455}','68.53.115.247','2021-06-11 19:03:10'),(30024,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44456,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"09\\/24\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44456}','68.53.115.247','2021-06-11 19:03:10'),(30025,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44457,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Pinewood debriefing.  9\\/24\\/2019\\r\\nLearning point:  The staff was not aware that the individual left the program.\\r\\n\\r\\nDebrief SP1:   The day of the incident SP1 provided direct supervision of the individual in the early morning as the individual would ride with SP1 in her vehicle to drop off a different employee for off-site work.  SP1 had been doing this most of the summer as this staff person was not able to drive the company vehicles due to age restrictions.  SP1 returned to the facility with the individual around 9:00a.m. and the individual returned to her program area in the basement of the facility.  \\r\\nSP1 was not providing direct supervision to the individual beyond the ride in her vehicle.  SP1 did state that she makes a schedule every week that reflects which staff will be in what program areas.  She stated there is one individual that requires 1:1 supervision and the individual that eloped does not require 1:1 supervision, but the agency does designate a staff person to supervise her as she has a history of elopement.  SP1 stated that she creates this schedule (paper\\/electronic document) and on the day of the incident SP3 was scheduled to supervise the individual who eloped.  SP1 stated that there are generally a lot of changes to the schedule throughout the week, so staff utilizes a whiteboard to reflect the changes.  SP1 stated that there are approximately 11-14 clients and approximately 4 staff providing supervision.  \\r\\nIn regards to the individual\\u2019s behaviors, SP1 describes her as \\u201cninja like.\\u201d  SP1 stated that the individual will attempt to leave the program daily and some days she is really determined to leave and will make numerous attempts throughout the day.  \\r\\nSP1 was unaware that the individual left the program\\/building.\\r\\nDebrief SP2:  SP2 confirms SP1\\u2019s history of events.  SP2 stated that she has been working with the individual for 19 years and is very familiar with her behaviors.  \\r\\nSP2 was supervising multiple individuals in the program area the day of the incident and was unaware that the individual left the program\\/building.\\r\\n\\r\\nDebrief SP3:  SP3 was identified on the paper schedule as the staff person who would be working with the individual the day of the alleged incident.  SP3 stated that she was also scheduled to learn a different job duty the day of the incident, so she informed others that she was going to be working in an office that day. \\r\\nShe also noted that the physical location of the staff desk upstairs doesn\\u2019t provide the optimal vantage point to the entrances\\/exits.  \\r\\nSP3 was unaware that the individual left the program\\/building.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44457}','68.53.115.247','2021-06-11 19:03:10'),(30026,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44458,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44458}','68.53.115.247','2021-06-11 19:03:10'),(30027,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44459,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff\'s awareness that the individual left the program was influenced by Staff 3\'s assignments to two tasks, supervising the individual and completing a training. Staff 1 created staff assignments on paper. The paper schedule was not updated to reflect the staffing change after Staff 3 told Staff 1 they needed to complete the training instead of supervising. An additional influence was Staff 1 being new to the role of making staff assignments. This new role was further complicated as the staff assignments change frequently to support the varied needs of individuals. The facility also utilizes a whiteboard for staff assignments. As changes are made to the assignment schedule, the whiteboard is updated to reflect the changes. The whiteboard and paper schedules do not match once there are changes to the whiteboard. \\r\\n\\r\\nThe individual\\u2019s behaviors influenced staff\'s awareness of the individual leaving the facility.  The individual moves around a lot during her time in the program area and was described as elusive.  Staff indicated that the individual deliberately observes staff and when staff appears to be distracted or less attentive she will attempt to leave the program area. There are up to 17 participants and 5 staff in the program area at any given time. This ratio influences each staff person to provide support and supervision to multiple participants in the program area. Ideally, the provider said they\'d have more staff, but this staff to person ratio is typical. This ratio is influenced by a workforce shortage across the region and state that has impacted the provider\'s ability to increase their staff ratio. Per the individual\\u2019s 6790, they did not require one-on-one supervision impacting the decision to assign one staff to this individual. The 6790 is influenced by the DWRS which provides a calculation for the person\\u2019s service rates and the staff ratios required of day service facilities (DSFs) in Minn. Stat. 245D. The recent push by the legislature over the last few years shifting from daily and partial day payment in DSFs to community- and unit-based funding made the process of negotiating a 6790 more complex. This push to community- and unit-based employment was influenced by a number of national and regional initiatives such as the HCBS Final Rule, the Workforce Investment and Opportunities Act, the Minnesota Olmstead Plan and recent lawsuits regarding congregate work by the Department of Justice. The provider noted that adapting to this change influenced the business of the program and frequent staff changes as they moved to work with some clients in the community and some at their congregate site, which required staff to move around and pivot roles frequently. \\r\\n\\r\\nAlthough the individual\'s plan does not require 1:1 staffing, the day program assigned a specific staff person to supervise the individual on this day. The assigned staff person was unable provide 1:1 supervision to the individual as they were also required to supervise\\/support other people. The program area was described as busy and distracting.  Some participants are more vocal adding to the distractions and some participants require higher supervision than others including one-to-one supervision. Such distractions further supported staff not realizing that the individuals had left the home. The building has three levels and multiple exits which impacts staff\'s ability to see all exits while supporting people. The doors do have chimes; however, the staff have become desensitized to the chimes as the staff, people served, and community members use the entrances and exits frequently.  The doors are equipped with alarms because providers are responsible for the health, safety and well-bring of individuals served. Local fire codes influenced requirements for exits being unlocked and able to be used in case of emergency. The facility fire codes are influenced by 245D and city fire codes. The fire code says that exit doors shall have the ability to be opened from inside in case of a fire. This contributed to the individual\'s ability to exit the program.  As a result of the multiple exits with chimes continually occurring, staff have been desensitized to them. This desensitization further impacted staff not realizing that the individual left the program. The chimes were implemented as a result of the building needing multiple exits which is governed by the agency\\u2019s requirement to support the health, safety, and well-being of residents through the adherence to the fire codes.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44459}','68.53.115.247','2021-06-11 19:03:10'),(30028,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44460,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44460}','68.53.115.247','2021-06-11 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19:03:10'),(30039,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44471,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"107\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44471}','68.53.115.247','2021-06-11 19:03:10'),(30040,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44472,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"108\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44472}','68.53.115.247','2021-06-11 19:03:10'),(30041,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44473,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"109\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44473}','68.53.115.247','2021-06-11 19:03:10'),(30042,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44474,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"110\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff\'s awareness that the individual left the program was influenced by Staff 3\'s assignments to two tasks, supervising the individual and completing a training.  The paper schedule was not updated to reflect the staffing change after Staff 3 told Staff 1 they needed to complete the training instead of supervising.  This new role was further complicated as the staff assignments change frequently to support the varied needs of individuals.  The facility also utilizes a whiteboard for staff assignments. As changes are made to the assignment schedule, the whiteboard is updated to reflect the changes. The whiteboard and paper schedules do not match once there are changes to the whiteboard. \\r\\nThe individual\\u2019s behaviors influenced staff\'s awareness of the individual leaving the facility.  The individual moves around a lot during her time in the program area and was described as elusive.  Staff indicated that the individual deliberately observes staff and when staff appears to be distracted or less attentive she will attempt to leave the program area. There are up to 17 participants and 5 staff in the program area at any given time. This ratio influences each staff person to provide support and supervision to multiple participants in the program area. Ideally, the provider said they\'d have more staff, but this staff to person ratio is typical.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44474}','68.53.115.247','2021-06-11 19:03:10'),(30043,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44475,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"111\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44475}','68.53.115.247','2021-06-11 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The doors do have chimes; however, the staff have become desensitized to the chimes as the staff, people served, and community members use the entrances and exits frequently.  The doors are equipped with alarms because providers are responsible for the health, safety and well-bring of individuals served.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44488}','68.53.115.247','2021-06-11 19:03:10'),(30057,'C8q6wjMIRej7eHiNnaceHs9v55w8VQydKZAncFf3',81,'reports_answer','create',44489,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"125\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"6\\/11\\/2021 2:03:10 pm\",\"created_at\":\"6\\/11\\/2021 2:03:10 pm\",\"id\":44489}','68.53.115.247','2021-06-11 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