{"report_id":234,"form_id":"23","user_id":81,"organization_id":10,"question_id":"100","question_type":"Free_Text","text_answer":"The crowd size, unfamiliarity with the State Fair and the person, impacted staff losing sight of the individual. When the staff lost sight of the person, his attention was divided between his 10-year-old son and the person. Staff brought their son along on the outing because the person offered for him to come along. The person likely offered because if staff was unable to work the person would be unable to go to the fair as the person overheard a conversation the staff had about his son not having childcare on the day of the Fair. The provider was experiencing a staff shortage and would not have been able to find another staff to go to the fair with the person. \r\n\r\nAnother contributing factor to losing sight of the person was that staff did not perceive a risk of losing the person because there was no elopement history. Therefore, staff felt comfortable bringing their son. Staff also knew the person\u2019s high level abilities to be independent and capabilities to navigate the scooter, which further supported their decision to have divided attention between the person and their son.  The provider has a policy that allows staff to use judgment\/interpretation of the Coordinated Services & Support Plan (CSSP) as long as staff is attentive to the persons needs without direct line of sight. The provider allows this room for staff judgment because it gives staff the space and ability to support each person as they need and choose. \r\n\r\nThe Case Manager approved the decision not to require a line of sight on the person while out in the community. The person\u2019s history of challenging behaviors influenced the Guardian\u2019s directive to the Case Manager not to include any alone time in the CSSP and the Case Manager's decision to include a 1:1 staffing ratio on public outings in the CSSP. This requirement was an influence on how the provider selected staff for the outing. An industry wide staffing shortage impacted the providers\u2019 ability to hire and retain part-time, intermittent, 1:1 activities staff. The HCBS Rule on Community Inclusion and Person Centered Planning and Person Centered Thinking influenced the Case Manager and provider roles to meet these standards when staffing for outings in the community.","created_by":81,"updated_by":81,"updated_at":"5\/25\/2021 11:22:32 am","created_at":"5\/25\/2021 11:22:32 am","id":17744}