{"Short_Answer__76":"201900985","Date__77":"05\/15\/2019","Multiple_Choice__78":"Kristie Pittman","Multiple_Choice__79":"Jill Tilbury","Short_Answer__80":"Haugbeck Support Services","Short_Answer__81":"Mike Beckius","Short_Answer__82":"mikebeckius@gmail.com","Multiple_Choice__84":"Elopement","Multiple_Choice__85":"Blue Earth County","Date__86":"11\/13\/2018","Free_Text__87":"Staff was meeting at another location with client\u2019s guardian\/mother. Client called her guardian\/mother asking to have a private phone call, guardian reminded her that she could not do that, client abruptly ended the call.   A few minutes later a call came in that client ran away from the house.  Staff left to go look and kept in contact with guardian who was tracking client with the GPS on clients phone.   Staff arrived to clients location to a fire truck and someone directing traffic.  Staff was informed that client was struck by a vehicle and taken to the hospital by ambulance. \r\n\r\nIncident described by direct care staff.  Client came home from work and took phone without asking staff.  She locked herself in her room with the phone.  Staff knocked and asked her to open door, but did she did not respond.  Staff knocked again and explained to her the pone rules.  Client opened the door and yelled at staff using inappropriate words.  She then said she wanted to have a private phone call, locked herself in her room.  Staff unplugged the phone (per protocol) .  Client came out pissed and started kicking the pone and throwing it on the floor.  She picked the phone up and said she hated staff and that she was leaving.  She then got ready and left the house.","Multiple_Choice__96":"1","Short_Answer__91":"Staff did not pursue person when they eloped","True_or_False__94":"Yes","Date__97":"06\/24\/2019","Free_Text__98":"Client is a 25 year old female diagnosed with fetal alcohol syndrome and reactive attachment disorder. She had been living in a corporate foster care since 2014. She lives with her identical twin sister. Her mother is her legal guardian. In September 2019, client had a crises placement due to increase in behaviors. \r\n\r\nCouple months prior to incident, client's behaviors not as predictable. Client had medication changes, was demonstrating suicidal ideation (superficial cutting) and was eloping 1 to 2 times a week. Staff report they use to be able to tell when client was going to elope and then it became harder to identify antecedents leading up to elopement. \r\n\r\nClient had an incident prior to this incident of running into Mankato and meeting up with a young man that she later accused of abusing her. Staff followed her until she reached a crowded area around Mankato State campus. Distance was over 6 miles. Client is in good physical shape. \r\n\r\nThere are 2-3 staff on evening shift. Home has 4 clients. Direct care staff involved in incident are no longer employed with provider. Staff reports a long history of elopement. \r\n\r\nA team (consisting of a case manager, guardian, house manager and administrative staff) developed an elopement protocol. Staff meetings occurred bi-weekly to address behaviors and concerns about client. Client's guardian had attended staff meetings to assist in training staff on how to work with her daughter. \r\n\r\nElopement protocol states that staff are to follow client during daytime hours when safe. Protocol directs staff not to follow when dark outside as this is a safety concern for staff. On day of incident, staff followed protocol and called supervisor. \r\n\r\nClient has a protocol in place where she can ask to go on a run. Protocol specifically states how long and where client can run. CLient can not go on a planned run after dark. When she asked she always comes back. Protocol in place so staff can identify the difference. \r\n\r\nClient would call guardian\/mom when not happy with what staff was doing. Mom would change the rules\/programs that were established when her daughter was upset. Guardian\/mom directed day to day activities and would tell staff what things her daughter should do that day. The consistency of protocols were difficult for staff to follow due to the changes in decision making process being made by the guardian\/mom. Program direct reports that as guardian become more inconsistent with following programs that elopement increased.","Free_Text__100":"Direct care staff not following the person who eloped from the facility was influenced foremost by the person\u2019s elopement protocol. At the time of the elopement it was dark outside and the protocol directed staff to not follow when dark. Contributing to the staff\u2019s decision not to follow the person was the team\u2019s (case manager, guardian, provider staff) desire to ensure the safety of staff and the person which was impacted by the person\u2019s history of exhibiting challenging behaviors when followed. When staff followed the person in past elopements, the person ran further and was difficult to find. The person\u2019s home was in a rural location which also impacted staff\u2019s decision to not follow in the dark due to safety concerns. The elopement protocol was developed by the provider and approved by the guardian and case manager. Staff were intimidated by the guardian, which influenced the staff\u2019s decision to follow protocol the guardian helped create. Direct care staff not following during the elopement was further supported by the person wearing a tracking watch that allowed staff to track the person and not always rely on following them.\r\n\r\nThere are a lack of crises services and placement options available in the area of the person\u2019s home. Because of this, the provider created the elopement protocol as a way to try to balance the support and safety of the person. Limited state funding for crises services impacted the provider\u2019s decision to create an elopement protocol. This is further influenced by the provider\u2019s license requirements of 245A and 245D to safeguard the person\u2019s health, safety and well-being.","Multiple_Choice__101":"0","Multiple_Choice__103":"0","Multiple_Choice__105":"0","Multiple_Choice__107":"0","Multiple_Choice__109":"0","Multiple_Choice__111":"0","Multiple_Choice__113":"0","Multiple_Choice__115":"3","Free_Text__116":"Direct care staff not following the person who eloped from the facility was influenced foremost by the person\u2019s elopement protocol. At the time of the elopement it was dark outside and the protocol directed staff to not follow when dark. Contributing to the staff\u2019s decision not to follow the person was the team\u2019s (case manager, guardian, provider staff) desire to ensure the safety of staff and the person which was impacted by the person\u2019s history of exhibiting challenging behaviors when followed. When staff followed the person in past elopements, the person ran further and was difficult to find. The person\u2019s home was in a rural location which also impacted staff\u2019s decision to not follow in the dark due to safety concerns.","Multiple_Choice__117":"1","Multiple_Choice__119":"3","Free_Text__120":"There are a lack of crises services and placement options available in the area of the person\u2019s home. Because of this, the provider created the elopement protocol as a way to try to balance the support and safety of the person.","Multiple_Choice__121":"0","Multiple_Choice__123":"0","Multiple_Choice__125":"0","Yes_or_No__432":"Yes"}