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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\\\":\\\"Termination of Services\\\",\\\"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\":\"5\\/26\\/2021 4:15:27 pm\",\"deleted_at\":null,\"report_name\":\"CY_Mains l - HC -2020 -07\"}','68.53.115.247','2021-05-26 21:15:27'),(24671,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36271,'{\"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\":\"5\\/26\\/2021 4:15:27 pm\",\"created_at\":\"5\\/26\\/2021 4:15:27 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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\":\"5\\/26\\/2021 4:15:27 pm\",\"created_at\":\"5\\/26\\/2021 4:15:27 pm\",\"id\":36289}','68.53.115.247','2021-05-26 21:15:27'),(24690,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36290,'{\"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\":\"5\\/26\\/2021 4:15:27 pm\",\"created_at\":\"5\\/26\\/2021 4:15:27 pm\",\"id\":36290}','68.53.115.247','2021-05-26 21:15:27'),(24691,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36291,'{\"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\":\"5\\/26\\/2021 4:15:27 pm\",\"created_at\":\"5\\/26\\/2021 4:15:27 pm\",\"id\":36291}','68.53.115.247','2021-05-26 21:15:27'),(24692,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36292,'{\"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\":\"5\\/26\\/2021 4:15:27 pm\",\"created_at\":\"5\\/26\\/2021 4:15:27 pm\",\"id\":36292}','68.53.115.247','2021-05-26 21:15:27'),(24693,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36293,'{\"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\":\"5\\/26\\/2021 4:15:27 pm\",\"created_at\":\"5\\/26\\/2021 4:15:27 pm\",\"id\":36293}','68.53.115.247','2021-05-26 21:15:27'),(24694,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36294,'{\"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\":\"5\\/26\\/2021 4:15:27 pm\",\"created_at\":\"5\\/26\\/2021 4:15:27 pm\",\"id\":36294}','68.53.115.247','2021-05-26 21:15:27'),(24695,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36295,'{\"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\":\"5\\/26\\/2021 4:15:27 pm\",\"created_at\":\"5\\/26\\/2021 4:15:27 pm\",\"id\":36295}','68.53.115.247','2021-05-26 21:15:27'),(24696,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36296,'{\"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\":\"5\\/26\\/2021 4:15:27 pm\",\"created_at\":\"5\\/26\\/2021 4:15:27 pm\",\"id\":36296}','68.53.115.247','2021-05-26 21:15:27'),(24697,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36297,'{\"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\":\"5\\/26\\/2021 4:15:27 pm\",\"created_at\":\"5\\/26\\/2021 4:15:27 pm\",\"id\":36297}','68.53.115.247','2021-05-26 21:15:27'),(24698,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36298,'{\"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\":\"5\\/26\\/2021 4:15:27 pm\",\"created_at\":\"5\\/26\\/2021 4:15:27 pm\",\"id\":36298}','68.53.115.247','2021-05-26 21:15:27'),(24699,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36299,'{\"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\":\"5\\/26\\/2021 4:15:27 pm\",\"created_at\":\"5\\/26\\/2021 4:15:27 pm\",\"id\":36299}','68.53.115.247','2021-05-26 21:15:27'),(24700,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36300,'{\"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\":\"5\\/26\\/2021 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21:15:28'),(24709,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36309,'{\"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\":\"5\\/26\\/2021 4:15:28 pm\",\"created_at\":\"5\\/26\\/2021 4:15:28 pm\",\"id\":36309}','68.53.115.247','2021-05-26 21:15:28'),(24710,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36310,'{\"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\":\"5\\/26\\/2021 4:15:28 pm\",\"created_at\":\"5\\/26\\/2021 4:15:28 pm\",\"id\":36310}','68.53.115.247','2021-05-26 21:15:28'),(24711,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36311,'{\"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\":\"5\\/26\\/2021 4:15:28 pm\",\"created_at\":\"5\\/26\\/2021 4:15:28 pm\",\"id\":36311}','68.53.115.247','2021-05-26 21:15:28'),(24712,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36312,'{\"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\":\"5\\/26\\/2021 4:15:28 pm\",\"created_at\":\"5\\/26\\/2021 4:15:28 pm\",\"id\":36312}','68.53.115.247','2021-05-26 21:15:28'),(24713,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36313,'{\"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\":\"5\\/26\\/2021 4:15:28 pm\",\"created_at\":\"5\\/26\\/2021 4:15:28 pm\",\"id\":36313}','68.53.115.247','2021-05-26 21:15:28'),(24714,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36314,'{\"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\":\"5\\/26\\/2021 4:15:28 pm\",\"created_at\":\"5\\/26\\/2021 4:15:28 pm\",\"id\":36314}','68.53.115.247','2021-05-26 21:15:28'),(24715,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36315,'{\"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\":\"5\\/26\\/2021 4:15:28 pm\",\"created_at\":\"5\\/26\\/2021 4:15:28 pm\",\"id\":36315}','68.53.115.247','2021-05-26 21:15:28'),(24716,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36316,'{\"report_id\":187,\"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\":\"5\\/26\\/2021 4:15:28 pm\",\"created_at\":\"5\\/26\\/2021 4:15:28 pm\",\"id\":36316}','68.53.115.247','2021-05-26 21:15:28'),(24717,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36317,'{\"report_id\":187,\"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\":\"5\\/26\\/2021 4:15:28 pm\",\"created_at\":\"5\\/26\\/2021 4:15:28 pm\",\"id\":36317}','68.53.115.247','2021-05-26 21:15:28'),(24718,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36318,'{\"report_id\":187,\"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\":\"5\\/26\\/2021 4:15:28 pm\",\"created_at\":\"5\\/26\\/2021 4:15:28 pm\",\"id\":36318}','68.53.115.247','2021-05-26 21:15:28'),(24719,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36319,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"125\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:15:28 pm\",\"created_at\":\"5\\/26\\/2021 4:15:28 pm\",\"id\":36319}','68.53.115.247','2021-05-26 21:15:28'),(24720,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36320,'{\"report_id\":187,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"126\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:15:28 pm\",\"created_at\":\"5\\/26\\/2021 4:15:28 pm\",\"id\":36320}','68.53.115.247','2021-05-26 21:15:28'),(24721,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36321,'{\"report_id\":187,\"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\":\"5\\/26\\/2021 4:15:28 pm\",\"created_at\":\"5\\/26\\/2021 4:15:28 pm\",\"id\":36321}','68.53.115.247','2021-05-26 21:15:28'),(24722,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36322,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"DV_Kelly AFC-SLC-2020-11\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36322}','68.53.115.247','2021-05-26 21:16:48'),(24723,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36323,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"11\\/24\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36323}','68.53.115.247','2021-05-26 21:16:48'),(24724,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36324,'{\"report_id\":188,\"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\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36324}','68.53.115.247','2021-05-26 21:16:48'),(24725,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36325,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36325}','68.53.115.247','2021-05-26 21:16:48'),(24726,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36326,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Kelly Adult Foster Care\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36326}','68.53.115.247','2021-05-26 21:16:48'),(24727,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36327,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Kelly Postudensek\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36327}','68.53.115.247','2021-05-26 21:16:48'),(24728,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36328,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"kellypost.987@gmail.com\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36328}','68.53.115.247','2021-05-26 21:16:48'),(24729,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36329,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":\"218-780-0445\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36329}','68.53.115.247','2021-05-26 21:16:48'),(24730,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36330,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Termination of Services\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36330}','68.53.115.247','2021-05-26 21:16:48'),(24731,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36331,'{\"report_id\":188,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"St. Louis County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36331}','68.53.115.247','2021-05-26 21:16:48'),(24732,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36332,'{\"report_id\":188,\"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\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36332}','68.53.115.247','2021-05-26 21:16:48'),(24733,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36333,'{\"report_id\":188,\"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\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36333}','68.53.115.247','2021-05-26 21:16:48'),(24734,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36334,'{\"report_id\":188,\"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\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36334}','68.53.115.247','2021-05-26 21:16:48'),(24735,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36335,'{\"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\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36335}','68.53.115.247','2021-05-26 21:16:48'),(24736,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36336,'{\"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\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36336}','68.53.115.247','2021-05-26 21:16:48'),(24737,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36337,'{\"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\":\"5\\/26\\/2021 4:16:48 pm\",\"created_at\":\"5\\/26\\/2021 4:16:48 pm\",\"id\":36337}','68.53.115.247','2021-05-26 21:16:48'),(24738,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36338,'{\"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\":\"5\\/26\\/2021 4:16:49 pm\",\"created_at\":\"5\\/26\\/2021 4:16:49 pm\",\"id\":36338}','68.53.115.247','2021-05-26 21:16:49'),(24739,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36339,'{\"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\":\"5\\/26\\/2021 4:16:49 pm\",\"created_at\":\"5\\/26\\/2021 4:16:49 pm\",\"id\":36339}','68.53.115.247','2021-05-26 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21:17:29'),(24788,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36388,'{\"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\":\"5\\/26\\/2021 4:17:29 pm\",\"created_at\":\"5\\/26\\/2021 4:17:29 pm\",\"id\":36388}','68.53.115.247','2021-05-26 21:17:29'),(24789,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36389,'{\"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\":\"5\\/26\\/2021 4:17:29 pm\",\"created_at\":\"5\\/26\\/2021 4:17:29 pm\",\"id\":36389}','68.53.115.247','2021-05-26 21:17:29'),(24790,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36390,'{\"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\":\"5\\/26\\/2021 4:17:29 pm\",\"created_at\":\"5\\/26\\/2021 4:17:29 pm\",\"id\":36390}','68.53.115.247','2021-05-26 21:17:29'),(24791,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36391,'{\"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\":\"5\\/26\\/2021 4:17:29 pm\",\"created_at\":\"5\\/26\\/2021 4:17:29 pm\",\"id\":36391}','68.53.115.247','2021-05-26 21:17:29'),(24792,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36392,'{\"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\":\"5\\/26\\/2021 4:17:29 pm\",\"created_at\":\"5\\/26\\/2021 4:17:29 pm\",\"id\":36392}','68.53.115.247','2021-05-26 21:17:29'),(24793,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36393,'{\"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\":\"5\\/26\\/2021 4:17:29 pm\",\"created_at\":\"5\\/26\\/2021 4:17:29 pm\",\"id\":36393}','68.53.115.247','2021-05-26 21:17:29'),(24794,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36394,'{\"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\":\"5\\/26\\/2021 4:17:29 pm\",\"created_at\":\"5\\/26\\/2021 4:17:29 pm\",\"id\":36394}','68.53.115.247','2021-05-26 21:17:29'),(24795,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36395,'{\"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\":\"5\\/26\\/2021 4:17:29 pm\",\"created_at\":\"5\\/26\\/2021 4:17:29 pm\",\"id\":36395}','68.53.115.247','2021-05-26 21:17:29'),(24796,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36396,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36396}','68.53.115.247','2021-05-26 21:17:30'),(24797,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36397,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36397}','68.53.115.247','2021-05-26 21:17:30'),(24798,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36398,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36398}','68.53.115.247','2021-05-26 21:17:30'),(24799,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36399,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36399}','68.53.115.247','2021-05-26 21:17:30'),(24800,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36400,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":\"dont 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 From 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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36400}','68.53.115.247','2021-05-26 21:17:30'),(24801,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36401,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36401}','68.53.115.247','2021-05-26 21:17:30'),(24802,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36402,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36402}','68.53.115.247','2021-05-26 21:17:30'),(24803,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36403,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36403}','68.53.115.247','2021-05-26 21:17:30'),(24804,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36404,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36404}','68.53.115.247','2021-05-26 21:17:30'),(24805,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36405,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36405}','68.53.115.247','2021-05-26 21:17:30'),(24806,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36406,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36406}','68.53.115.247','2021-05-26 21:17:30'),(24807,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36407,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36407}','68.53.115.247','2021-05-26 21:17:30'),(24808,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36408,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36408}','68.53.115.247','2021-05-26 21:17:30'),(24809,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36409,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36409}','68.53.115.247','2021-05-26 21:17:30'),(24810,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36410,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36410}','68.53.115.247','2021-05-26 21:17:30'),(24811,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36411,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36411}','68.53.115.247','2021-05-26 21:17:30'),(24812,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36412,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36412}','68.53.115.247','2021-05-26 21:17:30'),(24813,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36413,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36413}','68.53.115.247','2021-05-26 21:17:30'),(24814,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36414,'{\"report_id\":189,\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36414}','68.53.115.247','2021-05-26 21:17:30'),(24815,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36415,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"119\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36415}','68.53.115.247','2021-05-26 21:17:30'),(24816,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36416,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36416}','68.53.115.247','2021-05-26 21:17:30'),(24817,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36417,'{\"report_id\":189,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"121\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36417}','68.53.115.247','2021-05-26 21:17:30'),(24818,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36418,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36418}','68.53.115.247','2021-05-26 21:17:30'),(24819,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36419,'{\"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\":\"5\\/26\\/2021 4:17:30 pm\",\"created_at\":\"5\\/26\\/2021 4:17:30 pm\",\"id\":36419}','68.53.115.247','2021-05-26 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21:17:30'),(24824,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36424,'{\"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\":\"5\\/26\\/2021 4:18:45 pm\",\"created_at\":\"5\\/26\\/2021 4:18:45 pm\",\"id\":36424}','68.53.115.247','2021-05-26 21:18:45'),(24825,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36425,'{\"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\":\"5\\/26\\/2021 4:19:02 pm\",\"created_at\":\"5\\/26\\/2021 4:19:02 pm\",\"id\":36425}','68.53.115.247','2021-05-26 21:19:02'),(24826,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36426,'{\"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\":\"5\\/26\\/2021 4:19:02 pm\",\"created_at\":\"5\\/26\\/2021 4:19:02 pm\",\"id\":36426}','68.53.115.247','2021-05-26 21:19:02'),(24827,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36427,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36427}','68.53.115.247','2021-05-26 21:19:10'),(24828,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36428,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36428}','68.53.115.247','2021-05-26 21:19:10'),(24829,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36429,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36429}','68.53.115.247','2021-05-26 21:19:10'),(24830,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36430,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36430}','68.53.115.247','2021-05-26 21:19:10'),(24831,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36431,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36431}','68.53.115.247','2021-05-26 21:19:10'),(24832,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36432,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36432}','68.53.115.247','2021-05-26 21:19:10'),(24833,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36433,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36433}','68.53.115.247','2021-05-26 21:19:10'),(24834,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36434,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36434}','68.53.115.247','2021-05-26 21:19:10'),(24835,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36435,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36435}','68.53.115.247','2021-05-26 21:19:10'),(24836,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36436,'{\"report_id\":190,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"St. Louis County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36436}','68.53.115.247','2021-05-26 21:19:10'),(24837,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36437,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36437}','68.53.115.247','2021-05-26 21:19:10'),(24838,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36438,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36438}','68.53.115.247','2021-05-26 21:19:10'),(24839,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36439,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36439}','68.53.115.247','2021-05-26 21:19:10'),(24840,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36440,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36440}','68.53.115.247','2021-05-26 21:19:10'),(24841,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36441,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36441}','68.53.115.247','2021-05-26 21:19:10'),(24842,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36442,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36442}','68.53.115.247','2021-05-26 21:19:10'),(24843,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36443,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36443}','68.53.115.247','2021-05-26 21:19:10'),(24844,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36444,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36444}','68.53.115.247','2021-05-26 21:19:10'),(24845,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36445,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36445}','68.53.115.247','2021-05-26 21:19:10'),(24846,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36446,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36446}','68.53.115.247','2021-05-26 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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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36460}','68.53.115.247','2021-05-26 21:19:10'),(24861,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36461,'{\"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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36461}','68.53.115.247','2021-05-26 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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\":\"5\\/26\\/2021 4:19:10 pm\",\"created_at\":\"5\\/26\\/2021 4:19:10 pm\",\"id\":36474}','68.53.115.247','2021-05-26 21:19:10'),(24875,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36475,'{\"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\":\"5\\/26\\/2021 4:19:11 pm\",\"created_at\":\"5\\/26\\/2021 4:19:11 pm\",\"id\":36475}','68.53.115.247','2021-05-26 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21:19:50'),(24890,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36490,'{\"report_id\":191,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"It was reported that the program provided inadequate staffing levels per individuals plan.  Individual eloped from the program and is currently in the hospital for mental health reasons.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36490}','68.53.115.247','2021-05-26 21:19:50'),(24891,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36491,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36491}','68.53.115.247','2021-05-26 21:19:50'),(24892,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36492,'{\"report_id\":191,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Individual left the home via the bathroom without staff knowledge.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36492}','68.53.115.247','2021-05-26 21:19:50'),(24893,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36493,'{\"report_id\":191,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"No\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36493}','68.53.115.247','2021-05-26 21:19:50'),(24894,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36494,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36494}','68.53.115.247','2021-05-26 21:19:50'),(24895,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36495,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36495}','68.53.115.247','2021-05-26 21:19:50'),(24896,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36496,'{\"report_id\":191,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Staff No Longer Employed\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36496}','68.53.115.247','2021-05-26 21:19:50'),(24897,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36497,'{\"report_id\":191,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The individual eloping from the home was influenced by the staff\\u2019s belief that the individual was bathing and that the individual was able to be in the bathroom without supervision. The individual had eloped previously, but had developed new tactics including letting the water run in the bathroom (giving the illusion of bathing\\/showering) and eloping out the bathroom window. The absence of rights restriction and societal norms regarding privacy also influenced staff\\u2019s decision not to provide direct supervision while the individual was using the bathroom. The individual was quickly adapting her behaviors to attempt elopement in ways that staff hadn\\u2019t experienced before.  The individual\\u2019s support team (guardian, case manager, etc.) also had varying views on what the individual\\u2019s needs were. Staff\\u2019s confusion around these new behaviors, the support team\\u2019s varying views and the ability to communicate with each other in real time were influencing the individual\\u2019s support plan not being updated to reflect the person\\u2019s updated safety considerations.  \\r\\n\\r\\nPer the individual\\u2019s support plan, 1:1 supervision was required. The regulatory agencies definition of 1:1 staffing is not clear and is left at the interpretation of the provider and may be outlined in the support plan. Staff has access to the support plan(s); however, they are not clear and concise. The support plan is influenced by a chain of processes and requirements: Coordinated Service and Support Plans created by the case managers are influenced by MN Choices Assessment of a person\\u2019s needs, which then impact the service hours negotiated between the lead agency and provider using DHS Form-6790. The 6790 approval process is directly influenced by the Disability Waiver Rate System (DWRS), which was created by the Minnesota legislature and implemented by the Minnesota Department of Human Services. DWRS is set in statute and is a calculator that produces a service rate based on the hours of staffing needed by the person and provided by the provider. The DWRS is additionally impacted by HCBS Medicaid Waiver requirements enforced nationally by the Centers for Medicare and Medicaid Services (CMS).\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36497}','68.53.115.247','2021-05-26 21:19:50'),(24898,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36498,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36498}','68.53.115.247','2021-05-26 21:19:50'),(24899,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36499,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36499}','68.53.115.247','2021-05-26 21:19:50'),(24900,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36500,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36500}','68.53.115.247','2021-05-26 21:19:50'),(24901,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36501,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36501}','68.53.115.247','2021-05-26 21:19:50'),(24902,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36502,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36502}','68.53.115.247','2021-05-26 21:19:50'),(24903,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36503,'{\"report_id\":191,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36503}','68.53.115.247','2021-05-26 21:19:50'),(24904,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36504,'{\"report_id\":191,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"The individual eloping from the home was influenced by the staff\\u2019s belief that the individual was bathing and that the individual was able to be in the bathroom without supervision.  The individual had eloped previously, but had developed new tactics including letting the water run in the bathroom (giving the illusion of bathing\\/showering) and eloping out the bathroom window.  The absence of rights restriction and societal norms regarding privacy also influenced staff\\u2019s decision not to provide direct supervision while the individual was using the bathroom.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36504}','68.53.115.247','2021-05-26 21:19:50'),(24905,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36505,'{\"report_id\":191,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36505}','68.53.115.247','2021-05-26 21:19:50'),(24906,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36506,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36506}','68.53.115.247','2021-05-26 21:19:50'),(24907,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36507,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36507}','68.53.115.247','2021-05-26 21:19:50'),(24908,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36508,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36508}','68.53.115.247','2021-05-26 21:19:50'),(24909,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36509,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36509}','68.53.115.247','2021-05-26 21:19:50'),(24910,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36510,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36510}','68.53.115.247','2021-05-26 21:19:50'),(24911,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36511,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36511}','68.53.115.247','2021-05-26 21:19:50'),(24912,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36512,'{\"report_id\":191,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"110\",\"question_type\":\"Free_Text\",\"text_answer\":\"The individual\\u2019s support team (guardian, case manager, etc.) also had varying views on what the individual\\u2019s needs were. Staff\\u2019s confusion around these new behaviors, the support team\\u2019s varying views and the ability to communicate with each other in real time were influencing the individual\\u2019s support plan not being updated to reflect the person\\u2019s updated safety considerations.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36512}','68.53.115.247','2021-05-26 21:19:50'),(24913,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36513,'{\"report_id\":191,\"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\":\"5\\/26\\/2021 4:19:50 pm\",\"created_at\":\"5\\/26\\/2021 4:19:50 pm\",\"id\":36513}','68.53.115.247','2021-05-26 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21:20:36'),(24948,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36548,'{\"report_id\":192,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"08\\/11\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:20:36 pm\",\"created_at\":\"5\\/26\\/2021 4:20:36 pm\",\"id\":36548}','68.53.115.247','2021-05-26 21:20:36'),(24949,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36549,'{\"report_id\":192,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"The individual was living in a large 4000 sq. ft. adult foster care home in rural northern MN.  The individual has been served by this provider for approximately 10 years and was living in this particular home for the past 4 + years.   The individual\\u2019s mother is her legal guardian.  The AFC was home to two other females at the time the termination notice was issued.  The individual is diagnosed with Prader-Willi syndrome and has some challenging behaviors associated with her diagnosis.  These behaviors kept the provider cautious about adding additional people in the home even though there was capacity to do so.  The provider stated that recently the individual was given a new medication and her behaviors had improved.  Staff indicated that the provider was discussing a more individualized living arrangement for the individual, which would have included a larger area of the home designated to the individual.  \\r\\n\\r\\nWhen concerns for COVID19 arose in March, the provider sent out letters to the guardians of the people they serve to see if the guardians wanted to provide direct care for their respective program participants.  The individual\\u2019s mother responded and indicated that she wanted to provide care for her daughter.  The original plan was that this arrangement would last for two weeks.  The provider asked if the individual could return to the program and the individual\\u2019s mother wasn\\u2019t comfortable with her returning at that time.  The individual\\u2019s mother had previously worked for the provider.  In an effort to continue to support the individual the provider did the following: retrained the mother, employed her as a direct support staff for the individual, provided groceries and medications to the mother\\u2019s home, and provided an iPad so the individual could remain connected to others served by the provider as well as her mother being able to use the device for documentation.  The provider also provided remote support via Zoom meetings 2 hours a day, Monday through Friday.  County waiver case manager and supervisor were consulted about the alternative arrangement in response to the pandemic and they explained to the provider that they were not in support of this.  They had not been consulted until after the plan was in place.  The agency advised the provider to issue a termination notice if individual did not return to the program.  Mother and individual were notified of this recommendation and chose not to have the individual return to the program.  Mother and individual understood the termination was coming and agreed with it.  \\r\\n\\r\\nStaff reported that the provider\\u2019s management team was involved with the termination notice and issued the termination in accordance with policy\\/rules.  No previous terminations were noted.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:20:36 pm\",\"created_at\":\"5\\/26\\/2021 4:20:36 pm\",\"id\":36549}','68.53.115.247','2021-05-26 21:20:36'),(24950,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36550,'{\"report_id\":192,\"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\":\"5\\/26\\/2021 4:20:36 pm\",\"created_at\":\"5\\/26\\/2021 4:20:36 pm\",\"id\":36550}','68.53.115.247','2021-05-26 21:20:36'),(24951,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36551,'{\"report_id\":192,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The person being given a 60-day service termination was influenced by the individual\\u2019s legal guardian\\/mother deciding to not have the person return to the program after she was not comfortable with safety in the Adult Foster Care (AFC) setting during the COVID-19 pandemic and elected to provide care to the individual for a two week period. The service provider sent a letter to the individual\\u2019s mother that gave the guardian the option to provide care for two weeks to the individual in lieu of being in the AFC.  The two week timeline was based on the maximum time limit that a provider could bill for (under the guise of a \\u201ccamping trip\\u201d) and continue to hold the individual\\u2019s bed. The uncertainties of the pandemic influenced the provider to develop a creative plan to continue to support the individual in her mother\\u2019s home.  This plan included the provider having the mother become an employee to formally provide direct support to the individual.  This was influenced by the mother previously being a provider for the agency as well as what was deemed to be important to the individual.  The uncertainties of the pandemic again made timelines unclear for how long this arrangement would be appropriate.  The provider then reached out to the County to discuss the alternative plan that was currently in place.  The county couldn\\u2019t approve this alternative service delivery.  The individual\\u2019s mother was made aware of this but was still comfortable with the individual to return to an AFC setting and decided to continue to have the individual reside with her.   Based on the mother\\u2019s decision, the provider not being able to sustain the current plan and the County stance on the alternative plan the person was given a 60-day termination notice.  \\r\\nThe County\\u2019s inability to support the alternative plan was influenced by the plan\\u2019s language not matching service definitions for the service the provider was authorized to provide.  The provider was delivering residential Supported Living Services (SLS) which by regulations cannot be provided remotely.  Additionally parents cannot provide SLS in their own home and these rules were not flexible enough to accommodate the individual\\u2019s specific situation.\\r\\nThe provider\\u2019s decision to issue a service termination was additionally impacted by a  fiscal constraints.  Providers are unable to bill for long-term empty beds. The inability to bill is based on the Disability Waiver Rate System (DWRS) which already factors in absences in the daily rate but not the ability to bill for days away.  This billing constraint is impacted by CMS regulations which only allows one method of billing for absences.  This billing constraint is also impacted by the Minnesota State Legislature which chose this method of billing for absences. \\r\\nThe uncertainties surrounding the pandemic were influenced by ongoing changes to requirements and timelines that were demonstrated by ongoing changes in the Governor\\u2019s orders.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:20:36 pm\",\"created_at\":\"5\\/26\\/2021 4:20:36 pm\",\"id\":36551}','68.53.115.247','2021-05-26 21:20:36'),(24952,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36552,'{\"report_id\":192,\"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\":\"5\\/26\\/2021 4:20:36 pm\",\"created_at\":\"5\\/26\\/2021 4:20:36 pm\",\"id\":36552}','68.53.115.247','2021-05-26 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21:20:37'),(24971,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36571,'{\"report_id\":192,\"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\":\"5\\/26\\/2021 4:20:37 pm\",\"created_at\":\"5\\/26\\/2021 4:20:37 pm\",\"id\":36571}','68.53.115.247','2021-05-26 21:20:37'),(24972,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36572,'{\"report_id\":192,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"The County\\u2019s inability to support the alternative plan was influenced by the plan\\u2019s language not matching service definitions for the service the provider was authorized to provide.  The provider was delivering residential Supported Living Services (SLS) which by regulations cannot be provided remotely.  Additionally parents cannot provide SLS in their own home and these rules were not flexible enough to accommodate the individual\\u2019s specific situation.\\r\\nThe provider\\u2019s decision to issue a service termination was additionally impacted by a  fiscal constraints.  Providers are unable to bill for long-term empty beds. The inability to bill is based on the Disability Waiver Rate System (DWRS) which already factors in absences in the daily rate but not the ability to bill for days away.  This billing constraint is impacted by CMS regulations which only allows one method of billing for absences.  This billing constraint is also impacted by the Minnesota State Legislature which chose this method of billing for absences. \\r\\nThe uncertainties surrounding the pandemic were influenced by ongoing changes to requirements and timelines that were demonstrated by ongoing changes in the Governor\\u2019s orders.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:20:37 pm\",\"created_at\":\"5\\/26\\/2021 4:20:37 pm\",\"id\":36572}','68.53.115.247','2021-05-26 21:20:37'),(24973,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36573,'{\"report_id\":192,\"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\":\"5\\/26\\/2021 4:20:37 pm\",\"created_at\":\"5\\/26\\/2021 4:20:37 pm\",\"id\":36573}','68.53.115.247','2021-05-26 21:20:37'),(24974,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36574,'{\"report_id\":192,\"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\":\"5\\/26\\/2021 4:20:37 pm\",\"created_at\":\"5\\/26\\/2021 4:20:37 pm\",\"id\":36574}','68.53.115.247','2021-05-26 21:20:37'),(24975,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36575,'{\"report_id\":192,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"119\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:20:37 pm\",\"created_at\":\"5\\/26\\/2021 4:20:37 pm\",\"id\":36575}','68.53.115.247','2021-05-26 21:20:37'),(24976,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36576,'{\"report_id\":192,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:20:37 pm\",\"created_at\":\"5\\/26\\/2021 4:20:37 pm\",\"id\":36576}','68.53.115.247','2021-05-26 21:20:37'),(24977,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36577,'{\"report_id\":192,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"121\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:20:37 pm\",\"created_at\":\"5\\/26\\/2021 4:20:37 pm\",\"id\":36577}','68.53.115.247','2021-05-26 21:20:37'),(24978,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36578,'{\"report_id\":192,\"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\":\"5\\/26\\/2021 4:20:37 pm\",\"created_at\":\"5\\/26\\/2021 4:20:37 pm\",\"id\":36578}','68.53.115.247','2021-05-26 21:20:37'),(24979,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36579,'{\"report_id\":192,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"123\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:20:37 pm\",\"created_at\":\"5\\/26\\/2021 4:20:37 pm\",\"id\":36579}','68.53.115.247','2021-05-26 21:20:37'),(24980,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36580,'{\"report_id\":192,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":\"The person being given a 60-day service termination was influenced by the individual\\u2019s legal guardian\\/mother deciding to not have the person return to the program after she was not comfortable with safety in the Adult Foster Care (AFC) setting during the COVID-19 pandemic and elected to provide care to the individual for a two week period. The service provider sent a letter to the individual\\u2019s mother that gave the guardian the option to provide care for two weeks to the individual in lieu of being in the AFC.  The two week timeline was based on the maximum time limit that a provider could bill for (under the guise of a \\u201ccamping trip\\u201d) and continue to hold the individual\\u2019s bed. The uncertainties of the pandemic influenced the provider to develop a creative plan to continue to support the individual in her mother\\u2019s home.  This plan included the provider having the mother become an employee to formally provide direct support to the individual.  This was influenced by the mother previously being a provider for the agency as well as what was deemed to be important to the individual.  The uncertainties of the pandemic again made timelines unclear for how long this arrangement would be appropriate.  The provider then reached out to the County to discuss the alternative plan that was currently in place.  The county couldn\\u2019t approve this alternative service delivery.  The individual\\u2019s mother was made aware of this but was still comfortable with the individual to return to an AFC setting and decided to continue to have the individual reside with her.   Based on the mother\\u2019s decision, the provider not being able to sustain the current plan and the County stance on the alternative plan the person was given a 60-day termination notice.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:20:37 pm\",\"created_at\":\"5\\/26\\/2021 4:20:37 pm\",\"id\":36580}','68.53.115.247','2021-05-26 21:20:37'),(24981,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36581,'{\"report_id\":192,\"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\":\"5\\/26\\/2021 4:20:37 pm\",\"created_at\":\"5\\/26\\/2021 4:20:37 pm\",\"id\":36581}','68.53.115.247','2021-05-26 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21:21:09'),(24986,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36586,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"12\\/09\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:21 pm\",\"created_at\":\"5\\/26\\/2021 4:21:21 pm\",\"id\":36586}','68.53.115.247','2021-05-26 21:21:21'),(24987,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36587,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"A954660000\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:27 pm\",\"created_at\":\"5\\/26\\/2021 4:21:27 pm\",\"id\":36587}','68.53.115.247','2021-05-26 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21:21:27'),(24990,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36590,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kelly Sather\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:27 pm\",\"created_at\":\"5\\/26\\/2021 4:21:27 pm\",\"id\":36590}','68.53.115.247','2021-05-26 21:21:27'),(24991,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36591,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Stepping Stones for Living\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:27 pm\",\"created_at\":\"5\\/26\\/2021 4:21:27 pm\",\"id\":36591}','68.53.115.247','2021-05-26 21:21:27'),(24992,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36592,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Laura Flynn\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:27 pm\",\"created_at\":\"5\\/26\\/2021 4:21:27 pm\",\"id\":36592}','68.53.115.247','2021-05-26 21:21:27'),(24993,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36593,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"laura.flynn@sslduluth.com\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:27 pm\",\"created_at\":\"5\\/26\\/2021 4:21:27 pm\",\"id\":36593}','68.53.115.247','2021-05-26 21:21:27'),(24994,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36594,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:27 pm\",\"created_at\":\"5\\/26\\/2021 4:21:27 pm\",\"id\":36594}','68.53.115.247','2021-05-26 21:21:27'),(24995,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36595,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Medication Error\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:27 pm\",\"created_at\":\"5\\/26\\/2021 4:21:27 pm\",\"id\":36595}','68.53.115.247','2021-05-26 21:21:27'),(24996,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36596,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"St. Louis County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:27 pm\",\"created_at\":\"5\\/26\\/2021 4:21:27 pm\",\"id\":36596}','68.53.115.247','2021-05-26 21:21:27'),(24997,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36597,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"08\\/24\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:27 pm\",\"created_at\":\"5\\/26\\/2021 4:21:27 pm\",\"id\":36597}','68.53.115.247','2021-05-26 21:21:27'),(24998,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36598,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Tracy was outside the patio smoking. A few minutes later, the staff didn\' t see Tracy outside anymore AND he hadn \'t seen him come inside the house. Staff searched the house and then went outside to look down the street, but could not locate Tracy.\\r\\n\\r\\nStaff called the on-call supervisor, who told staff to call 911 to report a missing person. After doing so, the police officer called the house to talk with the staff and then the officer came to the house to gather more information. Staff was instructed to update the officer if Tracy returned home. Close to 1 pm, Tracy came back to the house and the staff asked him where he went. Tracy told staff that he took a cab went to the mall. Tracy was carrying pop, chips, and cookies that he had bought at the mall. He then sat down in the dining room and ate his food.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:27 pm\",\"created_at\":\"5\\/26\\/2021 4:21:27 pm\",\"id\":36598}','68.53.115.247','2021-05-26 21:21:27'),(24999,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36599,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:27 pm\",\"created_at\":\"5\\/26\\/2021 4:21:27 pm\",\"id\":36599}','68.53.115.247','2021-05-26 21:21:27'),(25000,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36600,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff did not observe the individual leave the home\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:27 pm\",\"created_at\":\"5\\/26\\/2021 4:21:27 pm\",\"id\":36600}','68.53.115.247','2021-05-26 21:21:27'),(25001,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36601,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:27 pm\",\"created_at\":\"5\\/26\\/2021 4:21:27 pm\",\"id\":36601}','68.53.115.247','2021-05-26 21:21:28'),(25002,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36602,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"12\\/09\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36602}','68.53.115.247','2021-05-26 21:21:28'),(25003,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36603,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"The day of the incident the staff person(SP) was supervising the individual who eloped as well as 3 other residents.   SP doesn\\u2019t work at this home regularly.  The individual was outside smoking and told staff that he was going to walk to a convenience store located nearby the home.  SP advised the individual to take a \\u201cwalkie talkie\\u201d with him.   SP was cleaning the bathroom and never directly observed the individual leave the residence or confirm whether he took the walkie talkie with him.  The SP stated that there is a plan in place that supports this individual going to the convenience store unsupervised, with a walkie talkie for a period of 30 minutes.  Approximately 30 minutes later he noticed the individual had not returned to the home.  SP noted that the individual had not taken the walkie talkie with him.  SP stated there is protocol in place when the individual doesn\\u2019t return after 30 minutes.  Following protocol, the SP called the agency\\u2019s crisis staff.  The convenience store was contacted and they informed staff that the individual had not been to the store.  SP was advised to call 911 and did.  Shortly after the 911 call was placed, the individual returned to the home via taxi cab.  The individual disclosed that he took a cab to get McDonald\\u2019s and went to the mall.  The individual had recently received money from a renter\\u2019s rebate.  The individual manages their own spending money and the day of the incident he had $400(est.)in cash in his possession.  The agency has assisted the individual to go to other places besides the local convenience store.  On the day of the incident SP stated that the individual did not express a desire to go anywhere else.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36603}','68.53.115.247','2021-05-26 21:21:28'),(25004,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36604,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36604}','68.53.115.247','2021-05-26 21:21:28'),(25005,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36605,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff was preoccupied, cleaning the bathroom during the time the individual left the home.  From the bathroom the staff did not have a vantage point to see the patio area where the individual was smoking prior to leaving the home.  The staff cleaning the bathroom was influenced by the provider assigning staff multiple duties such as cleaning, cooking, etc. Staff cleans the home as the home is required to be safe and sanitary which is also part of the licensing requirements through Minnesota Statutes, 245D.  The staffing ratio at the time of the incident also influenced the staff performing multiple duties.  There was a 1:4 ratio with no other staff on duty, so staff was supporting the four individuals as well as completing other support related tasks such as cleaning. \\r\\n\\r\\nOther contributing factors to staff cleaning in an area where they were unable to observe the individual was that staff had no concerns that the individual would leave without confirming with staff and taking the walkie talkie. The individual frequently smoked outside without leaving, in particular, the individual had not previously left the house without telling this staff person. The individual mentioned they might go to the convenience store and staff asked him to take a walkie talkie with, which also influenced staff\\u2019s comfortability in cleaning the bathroom as the staff assumed he would take the walkie talkie if he left. The Staff\'s perception that the individual would follow alone time protocol was supported  by the individual\\u2019s plan which allowed him to go for a 30 minute walk without staff supervision.   This unsupervised time is driven from the CSSP which allows for unsupervised time and individual\\u2019s team developing specific parameters around unsupervised time.  The individual is his own guardian  which directly impacted the development of the CSSP and specific parameters around unsupervised time.   Per the individual\\u2019s 6790, they were not allocated one-on-one supervision which has a reciprocal relationship with  the person\\u2019s CSSP.  The 6790 is a tool created by DHS to implement the Disability Waiver Rate Setting statutes, created by the Minnesota Legislature, which provides a calculation for the person\\u2019s service rates based on  the staff ratios required of the provider. The ratios and rates in a 6790 are negotiated between the provider and the case manager based on the needs for supervision a person has in their CSSP and the provider\\u2019s assessment of the staff a person needs as well as the staff they have available. \\r\\n\\r\\nThe individual being outside prior to elopement was also influenced by a provider rule of no smoking in the home.  This rule was created to comply with the Minnesota Clean Air Act, which legislatively prohibits smoking in many public places. The rule is reinforced by DHS not allowing smoking in a licensed facility.  Society in general is aware of concerns for smoking in homes.  These concerns influenced DHS provider rules along and the Minnesota Clean Indoor Act.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36605}','68.53.115.247','2021-05-26 21:21:28'),(25006,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36606,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36606}','68.53.115.247','2021-05-26 21:21:28'),(25007,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36607,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36607}','68.53.115.247','2021-05-26 21:21:28'),(25008,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36608,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36608}','68.53.115.247','2021-05-26 21:21:28'),(25009,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36609,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36609}','68.53.115.247','2021-05-26 21:21:28'),(25010,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36610,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36610}','68.53.115.247','2021-05-26 21:21:28'),(25011,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36611,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36611}','68.53.115.247','2021-05-26 21:21:28'),(25012,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36612,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff was preoccupied, cleaning the bathroom during the time the individual left the home. From the bathroom the staff did not have a vantage point to see the patio area where the individual was smoking prior to leaving the home.  The staff cleaning the bathroom was influenced by the provider assigning staff multiple duties such as cleaning, cooking, etc. Staff cleans the home as the home is required to be safe and sanitary which is also part of the licensing requirements through Minnesota Statutes, 245D.  The staffing ratio at the time of the incident also influenced the staff performing multiple duties.  There was a 1:4 ratio with no other staff on duty, so staff was supporting the four individuals as well as completing other support related tasks such as cleaning. \\r\\n\\r\\nOther contributing factors to staff cleaning in an area where they were unable to observe the individual was that staff had no concerns that the individual would leave without confirming with staff and taking the walkie talkie. The individual frequently smoked outside without leaving, in particular, the individual had not previously left the house without telling this staff person. The individual mentioned they might go to the convenience store and staff asked him to take a walkie talkie with, which also influenced staff\'s comfortability in cleaning the bathroom as the staff assumed he would take the walkie talkie if he left. The Staff\'s perception that the individual would follow alone time protocol was supported  by the individual\\u2019s plan which allowed him to go for a 30 minute walk without staff supervision.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36612}','68.53.115.247','2021-05-26 21:21:28'),(25013,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36613,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36613}','68.53.115.247','2021-05-26 21:21:28'),(25014,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36614,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36614}','68.53.115.247','2021-05-26 21:21:28'),(25015,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36615,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36615}','68.53.115.247','2021-05-26 21:21:28'),(25016,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36616,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36616}','68.53.115.247','2021-05-26 21:21:28'),(25017,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36617,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"107\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36617}','68.53.115.247','2021-05-26 21:21:28'),(25018,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36618,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36618}','68.53.115.247','2021-05-26 21:21:28'),(25019,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36619,'{\"report_id\":193,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"109\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36619}','68.53.115.247','2021-05-26 21:21:28'),(25020,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36620,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36620}','68.53.115.247','2021-05-26 21:21:28'),(25021,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36621,'{\"report_id\":193,\"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\":\"5\\/26\\/2021 4:21:28 pm\",\"created_at\":\"5\\/26\\/2021 4:21:28 pm\",\"id\":36621}','68.53.115.247','2021-05-26 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21:23:40'),(25144,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36744,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"cgroebner@mymrci.org\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36744}','68.53.115.247','2021-05-26 21:23:40'),(25145,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36745,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36745}','68.53.115.247','2021-05-26 21:23:40'),(25146,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36746,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36746}','68.53.115.247','2021-05-26 21:23:40'),(25147,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36747,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36747}','68.53.115.247','2021-05-26 21:23:40'),(25148,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36748,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"03\\/19\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36748}','68.53.115.247','2021-05-26 21:23:40'),(25149,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36749,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Wednesday March 13, 2019 at approximately 1:40pm, staff 1 noticed VA leave the Department 123 work area. Staff 1 stepped outside the room and saw VA going into the women\\u2019s bathroom located off of the production floor nearest to Department 123.  Staff 1 checked on VA at about 1:45pm and saw that VA was in the handicap stall with their green jacket off.  Staff 1 asked if VA was OK and they replied \\u201cyeah\\u201d and also asked if VA needed anything and they said \\u201cno\\u201d.  Staff 1 then went back to that same bathroom to assist another individual at approximately 1:50pm and VA was still in the same stall.  Staff 1 went back to the room at about 1:55pm.  It should be noted that the VA had been diagnosed with a mild UTI on Sunday 3\\/10\\/19 and was sent home early on Monday 3\\/11\\/19 due to them not feeling well.  VA also came in late on Tuesday, 3\\/12\\/19.  \\r\\n\\r\\nVA has eloped in the past, VA takes her lunch box with her.  Because of that, VA is required to leave the lunch box in the Team Leader\\u2019s office.  At approximately 2:00pm, staff 1 notice VA\\u2019s lunch box was still in the office.  Support Specialist Staff 2 went to that same bathroom that VA was in approximately 2:05pm and that VA was no longer in the bathroom.  A bus drive for the day program was driving the buss back to the program and notice someone in a green jacket standing in the street on Map Drive around 2pm.  There are no sidewalks on Map Drive.  Staff recognized the person as the VA and immediately called her supervisor at the program. And drove back to where the VA was walking.  It was reported that two \\u201cgood Samaritans\\u201d pulled over and stopped the VA on the sidewalk along stadium drive, which is the road that connects with Map Drive, and started walking with her back to the program until the staff arrived.  \\r\\n\\r\\nAt 2:07 the Supervisor received a phone call from the transportation supervisor stating VA was found walking on the sidewalk along Stadium Drive and was being walked back to the program\\u2019s building.  The program supervisor ran outside and saw VA with about four other program staff walking with VA.  The supervisor walked alongside VA all the way back to the office and the VA waited in the office until was time for VA to board the bus to go home.  While the office, VA was ask if VA thought what happened was safe and the VA said, \\u201cNo\\u201d. The VA was asked why it wasn\\u2019t and safe and the response was \\u201cI could get hurt\\u201d. Supervisor asked VA if it will ever happen again and VA shook their head \\u201cno\\u201d. Supervisor walked VA to the bus and fastened seatbelt and sat patiently until the bus departed.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36749}','68.53.115.247','2021-05-26 21:23:40'),(25150,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36750,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36750}','68.53.115.247','2021-05-26 21:23:40'),(25151,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36751,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff didn\\u2019t continuously monitor the person in bathroom and the person eloped without being seen\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36751}','68.53.115.247','2021-05-26 21:23:40'),(25152,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36752,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36752}','68.53.115.247','2021-05-26 21:23:40'),(25153,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36753,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"2019-07-10 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36753}','68.53.115.247','2021-05-26 21:23:40'),(25154,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36754,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"VA has worked at the employment program for 10 years and the staff interviewed reported they have worked with her for most of that time.  Over this 10 years the VA lived with an aunt, then in an adult foster care setting (near her employment program) and at the time of the incident was living in an apartment.  \\r\\n\\r\\nVA enjoyed coloring\\/crafts, being outside, working, having attention and encouragement from staff.  VA enjoyed food (lunch at work and wouldn\\u2019t necessarily heat up a meal that typically would be a meal to heat up).\\r\\n\\r\\nVA has a staffing ratio at the employment program of a 1:3, most individuals there have 1:6 or 1:7.  At home VA had a 2:1 staffing ratio.  The 2:1 at home was higher because VA was more physically aggressive at home than at work.  Less aggression towards male staff-staff interviewed stated VA has less male staff at residence than at the employment program.  \\r\\n\\r\\nThe employment program has 200 individuals in their facility and approximately 45 in the area where VA works.  The day of the event there was 7-8 staff in the area for all of those individuals being served.  \\r\\n\\r\\nThe elopement protocol at the employment program was for the staff to have eyes on VA, except in the bathroom and just do 5 minute checks.  Keep the lunch and duffle bag in the supervisor\\u2019s office.  VA would have no antecedents prior to elopements or other incidents of maladaptive behavior (this day was no different.  The team agreed to this plan including the guardians (parents).\\r\\n\\r\\nVA works at the employment program Monday-Friday from 9am-3pm and typically VA shows signs of being done with work at around 2pm.  The day of the incident the VA had arrive late or had not been ready when the bus arrived to pick her up.  This was a common occurrence.  \\r\\n\\r\\nWhen at work the VA was a great worker completing piece work on the work floor.  That day there was not a lot of work available and the group had been doing other craft activities (VA enjoyed).  It is believed that VA had a possible UTI infection and VA had a history of GERD\\/esophagus issues (causing her to vomit and cause pain), however VA could not verbalize their needs all of the time.  Verbal skills were limited.  Over the time VA worked at the employment program they were able to get her to improve her verbal skills by encouraging VA to use her words.  If she were sick and she was about to vomit VA would attempt to express this to the employment staff and sometimes ask them for a Tums.  \\r\\n\\r\\nThe VA did not take the duffle bag or lunch when the elopement occurred which typically the VA would not have left the building without either of the bags.  The VA never was able to explain the reason for elopement, however the staff believe there is a Kwik Trip nearby that was the direction VA was headed and her previous residence was near the employment program.  VA did things with no antecedents and would do things for attention.  The staff believe potentially VA was not feeling well and potentially wanted to go outside because VA really enjoyed being outside.  Staff went outside after receiving phone call from transportation company and got the VA from the Good Samaritan that was walking with VA.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36754}','68.53.115.247','2021-05-26 21:23:40'),(25155,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36755,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36755}','68.53.115.247','2021-05-26 21:23:40'),(25156,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36756,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.  It is the providers practice to allow all of the individual\\u2019s privacy in the restroom as this is influenced by societal norms.  The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\u2019s office.  Additionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio. Thus the ratio allows the county to manage the budget allocation they are given by the state and federal allocations which is determined through the legislation.  Overall legislation determines the rates that are set which then is strengthened by MNCHOICES to determine the needs are met, thus to create the staffing patterns for the provider in the support plan.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36756}','68.53.115.247','2021-05-26 21:23:40'),(25157,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36757,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36757}','68.53.115.247','2021-05-26 21:23:40'),(25158,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36758,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36758}','68.53.115.247','2021-05-26 21:23:40'),(25159,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36759,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36759}','68.53.115.247','2021-05-26 21:23:40'),(25160,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36760,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36760}','68.53.115.247','2021-05-26 21:23:40'),(25161,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36761,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36761}','68.53.115.247','2021-05-26 21:23:40'),(25162,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36762,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36762}','68.53.115.247','2021-05-26 21:23:40'),(25163,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36763,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\u2019s office.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36763}','68.53.115.247','2021-05-26 21:23:40'),(25164,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36764,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36764}','68.53.115.247','2021-05-26 21:23:40'),(25165,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36765,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36765}','68.53.115.247','2021-05-26 21:23:40'),(25166,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36766,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36766}','68.53.115.247','2021-05-26 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This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36777}','68.53.115.247','2021-05-26 21:23:40'),(25178,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36778,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36778}','68.53.115.247','2021-05-26 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pm\",\"id\":36786}','68.53.115.247','2021-05-26 21:23:40'),(25187,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36787,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"126\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36787}','68.53.115.247','2021-05-26 21:23:40'),(25188,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36788,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:40 pm\",\"created_at\":\"5\\/26\\/2021 4:23:40 pm\",\"id\":36788}','68.53.115.247','2021-05-26 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21:23:59'),(25199,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36799,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36799}','68.53.115.247','2021-05-26 21:23:59'),(25200,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36800,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"03\\/19\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36800}','68.53.115.247','2021-05-26 21:23:59'),(25201,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36801,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Wednesday March 13, 2019 at approximately 1:40pm, staff 1 noticed VA leave the Department 123 work area. Staff 1 stepped outside the room and saw VA going into the women\\u2019s bathroom located off of the production floor nearest to Department 123.  Staff 1 checked on VA at about 1:45pm and saw that VA was in the handicap stall with their green jacket off.  Staff 1 asked if VA was OK and they replied \\u201cyeah\\u201d and also asked if VA needed anything and they said \\u201cno\\u201d.  Staff 1 then went back to that same bathroom to assist another individual at approximately 1:50pm and VA was still in the same stall.  Staff 1 went back to the room at about 1:55pm.  It should be noted that the VA had been diagnosed with a mild UTI on Sunday 3\\/10\\/19 and was sent home early on Monday 3\\/11\\/19 due to them not feeling well.  VA also came in late on Tuesday, 3\\/12\\/19.  \\r\\n\\r\\nVA has eloped in the past, VA takes her lunch box with her.  Because of that, VA is required to leave the lunch box in the Team Leader\\u2019s office.  At approximately 2:00pm, staff 1 notice VA\\u2019s lunch box was still in the office.  Support Specialist Staff 2 went to that same bathroom that VA was in approximately 2:05pm and that VA was no longer in the bathroom.  A bus drive for the day program was driving the buss back to the program and notice someone in a green jacket standing in the street on Map Drive around 2pm.  There are no sidewalks on Map Drive.  Staff recognized the person as the VA and immediately called her supervisor at the program. And drove back to where the VA was walking.  It was reported that two \\u201cgood Samaritans\\u201d pulled over and stopped the VA on the sidewalk along stadium drive, which is the road that connects with Map Drive, and started walking with her back to the program until the staff arrived.  \\r\\n\\r\\nAt 2:07 the Supervisor received a phone call from the transportation supervisor stating VA was found walking on the sidewalk along Stadium Drive and was being walked back to the program\\u2019s building.  The program supervisor ran outside and saw VA with about four other program staff walking with VA.  The supervisor walked alongside VA all the way back to the office and the VA waited in the office until was time for VA to board the bus to go home.  While the office, VA was ask if VA thought what happened was safe and the VA said, \\u201cNo\\u201d. The VA was asked why it wasn\\u2019t and safe and the response was \\u201cI could get hurt\\u201d. Supervisor asked VA if it will ever happen again and VA shook their head \\u201cno\\u201d. Supervisor walked VA to the bus and fastened seatbelt and sat patiently until the bus departed.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36801}','68.53.115.247','2021-05-26 21:23:59'),(25202,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36802,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36802}','68.53.115.247','2021-05-26 21:23:59'),(25203,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36803,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff didn\\u2019t continuously monitor the person in bathroom and the person eloped without being seen\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36803}','68.53.115.247','2021-05-26 21:23:59'),(25204,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36804,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36804}','68.53.115.247','2021-05-26 21:23:59'),(25205,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36805,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"07\\/10\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36805}','68.53.115.247','2021-05-26 21:23:59'),(25206,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36806,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"VA has worked at the employment program for 10 years and the staff interviewed reported they have worked with her for most of that time.  Over this 10 years the VA lived with an aunt, then in an adult foster care setting (near her employment program) and at the time of the incident was living in an apartment.  \\r\\n\\r\\nVA enjoyed coloring\\/crafts, being outside, working, having attention and encouragement from staff.  VA enjoyed food (lunch at work and wouldn\\u2019t necessarily heat up a meal that typically would be a meal to heat up).\\r\\n\\r\\nVA has a staffing ratio at the employment program of a 1:3, most individuals there have 1:6 or 1:7.  At home VA had a 2:1 staffing ratio.  The 2:1 at home was higher because VA was more physically aggressive at home than at work.  Less aggression towards male staff-staff interviewed stated VA has less male staff at residence than at the employment program.  \\r\\n\\r\\nThe employment program has 200 individuals in their facility and approximately 45 in the area where VA works.  The day of the event there was 7-8 staff in the area for all of those individuals being served.  \\r\\n\\r\\nThe elopement protocol at the employment program was for the staff to have eyes on VA, except in the bathroom and just do 5 minute checks.  Keep the lunch and duffle bag in the supervisor\\u2019s office.  VA would have no antecedents prior to elopements or other incidents of maladaptive behavior (this day was no different.  The team agreed to this plan including the guardians (parents).\\r\\n\\r\\nVA works at the employment program Monday-Friday from 9am-3pm and typically VA shows signs of being done with work at around 2pm.  The day of the incident the VA had arrive late or had not been ready when the bus arrived to pick her up.  This was a common occurrence.  \\r\\n\\r\\nWhen at work the VA was a great worker completing piece work on the work floor.  That day there was not a lot of work available and the group had been doing other craft activities (VA enjoyed).  It is believed that VA had a possible UTI infection and VA had a history of GERD\\/esophagus issues (causing her to vomit and cause pain), however VA could not verbalize their needs all of the time.  Verbal skills were limited.  Over the time VA worked at the employment program they were able to get her to improve her verbal skills by encouraging VA to use her words.  If she were sick and she was about to vomit VA would attempt to express this to the employment staff and sometimes ask them for a Tums.  \\r\\n\\r\\nThe VA did not take the duffle bag or lunch when the elopement occurred which typically the VA would not have left the building without either of the bags.  The VA never was able to explain the reason for elopement, however the staff believe there is a Kwik Trip nearby that was the direction VA was headed and her previous residence was near the employment program.  VA did things with no antecedents and would do things for attention.  The staff believe potentially VA was not feeling well and potentially wanted to go outside because VA really enjoyed being outside.  Staff went outside after receiving phone call from transportation company and got the VA from the Good Samaritan that was walking with VA.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36806}','68.53.115.247','2021-05-26 21:23:59'),(25207,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36807,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36807}','68.53.115.247','2021-05-26 21:23:59'),(25208,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36808,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.  It is the providers practice to allow all of the individual\\u2019s privacy in the restroom as this is influenced by societal norms.  The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\u2019s office.  Additionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio. Thus the ratio allows the county to manage the budget allocation they are given by the state and federal allocations which is determined through the legislation.  Overall legislation determines the rates that are set which then is strengthened by MNCHOICES to determine the needs are met, thus to create the staffing patterns for the provider in the support plan.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36808}','68.53.115.247','2021-05-26 21:23:59'),(25209,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36809,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36809}','68.53.115.247','2021-05-26 21:23:59'),(25210,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36810,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36810}','68.53.115.247','2021-05-26 21:23:59'),(25211,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36811,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36811}','68.53.115.247','2021-05-26 21:23:59'),(25212,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36812,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36812}','68.53.115.247','2021-05-26 21:23:59'),(25213,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36813,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36813}','68.53.115.247','2021-05-26 21:23:59'),(25214,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36814,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36814}','68.53.115.247','2021-05-26 21:23:59'),(25215,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36815,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\u2019s office.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36815}','68.53.115.247','2021-05-26 21:23:59'),(25216,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36816,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36816}','68.53.115.247','2021-05-26 21:23:59'),(25217,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36817,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36817}','68.53.115.247','2021-05-26 21:23:59'),(25218,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36818,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36818}','68.53.115.247','2021-05-26 21:23:59'),(25219,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36819,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36819}','68.53.115.247','2021-05-26 21:23:59'),(25220,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36820,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36820}','68.53.115.247','2021-05-26 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21:23:59'),(25223,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36823,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36823}','68.53.115.247','2021-05-26 21:23:59'),(25224,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36824,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36824}','68.53.115.247','2021-05-26 21:23:59'),(25225,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36825,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36825}','68.53.115.247','2021-05-26 21:23:59'),(25226,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36826,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36826}','68.53.115.247','2021-05-26 21:23:59'),(25227,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36827,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36827}','68.53.115.247','2021-05-26 21:23:59'),(25228,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36828,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36828}','68.53.115.247','2021-05-26 21:23:59'),(25229,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36829,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.  \\r\\n\\r\\nAdditionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36829}','68.53.115.247','2021-05-26 21:23:59'),(25230,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36830,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36830}','68.53.115.247','2021-05-26 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21:23:59'),(25237,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36837,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36837}','68.53.115.247','2021-05-26 21:23:59'),(25238,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36838,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36838}','68.53.115.247','2021-05-26 21:23:59'),(25239,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36839,'{\"report_id\":196,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"126\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36839}','68.53.115.247','2021-05-26 21:23:59'),(25240,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36840,'{\"report_id\":196,\"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\":\"5\\/26\\/2021 4:23:59 pm\",\"created_at\":\"5\\/26\\/2021 4:23:59 pm\",\"id\":36840}','68.53.115.247','2021-05-26 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21:24:42'),(25247,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36847,'{\"report_id\":197,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36847}','68.53.115.247','2021-05-26 21:24:42'),(25248,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36848,'{\"report_id\":197,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Mary T\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36848}','68.53.115.247','2021-05-26 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21:24:42'),(25257,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36857,'{\"report_id\":197,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff assisted the person to leave for an overnight with people they had concerns about\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36857}','68.53.115.247','2021-05-26 21:24:42'),(25258,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36858,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36858}','68.53.115.247','2021-05-26 21:24:42'),(25259,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36859,'{\"report_id\":197,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"10\\/13\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36859}','68.53.115.247','2021-05-26 21:24:42'),(25260,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36860,'{\"report_id\":197,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff #1: This staff has worked with this person for quite some time and this person has lived with this provider for over 14 years.  The staff informed during the debriefing she is the Manager and did not find out about what had happened until the Monday after this person left the residence on Saturday.  This Manager had received a phone call about that this person had left because she has the ability to do so, although this person had been asked not to due to COVID and the provider\\u2019s policy was no visitors were allowed in the staff, even family.  The staff stated it was reported to her that this person had asked to get ready, her aunt and uncle were coming to get her for a visit, and she was going to go.  The staff reported to this Manager they did not feel comfortable, however they could not make her stay in the home and the aunt and uncle came to get her and assisted her in the process, as she is non-ambulatory.  The staff stated they did not know she had family in Duluth and did not know she was going when she had left the house on Friday before the weekend.  Staff reported they called the known uncle and asked who these people in Duluth were and if they indeed were family members and the known uncle reported they were not family.  The person had misinformed the staff working who allowed her to go.  The Manager also stated staff reported to her they did not feel comfortable allowing her to go, aside from COVID, because they did not appear to be family, however this person seemed to be happy when the individuals came to pick her up.  It was reported to the Manager the staff had taken pictures of the car and the license plate number and the people as they were leaving the home on Saturday.  The Manager drove to Duluth to pick up the individual at the hospital as she had been transported there via ambulance after sitting in the restaurant informing the server she needed help via her iPad.  The individual had given her check card to the people who had picked her up and they had financially exploited her when they took her to Duluth.  \\r\\n\\r\\nStaff #2\\r\\n\\r\\nStaff had arrived to work at 8am on Saturday after picking up this extra shift (at the time this was his first month working for this provider).  This staff was informed by the overnight staff and the lead staff that this person was to get ready, that she was leaving, and the staff would need to help her get ready as well as pack her things for the weekend.  This staff person has had difficulties working this individual in the past as she calls this staff person names and is verbally aggressive through her iPad to the staff person.  Due to the person being non-ambulatory, it is the house policy to reposition her every two hours.  On this day the staff was going to change her brief and get her ready to leave for the day, she would not turn off her iPad prior to the changing to occur.  The staff wanted to be respectful and it is HIPAA policies as well as house policy to turn off the video when the staff are assisting.  Staff stated the person they would assist when she turned off her iPad so staff left the room and came back.  The person still would not turn off the iPad and began to call the staff names.  This staff gave 30 minutes this time and the person still had not gotten off the iPad and continued to call him names and verbal aggressions.  The staff person had asked Manager previously how to handle these matters and was aware of what was happening and continued to try to work with this person so they would not call staff names and how staff could assist better.  The staff went into the person\\u2019s room a third time and covered the iPad with a pillow during the dressing and changing process and continued to assist her with getting ready to be picked up for the day.  When the people arrived to pick up this person staff did not allow them into the house due to COVID and the new policies for no visitors.  The visitors assisted the person into the car with her and her wheelchair.  The staff did not say anything about it to anyone else as the lead staff had informed him what to do and the overnight staff had provided instructions on this was what was planned for this person\\u2019s day.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36860}','68.53.115.247','2021-05-26 21:24:42'),(25261,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36861,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36861}','68.53.115.247','2021-05-26 21:24:42'),(25262,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36862,'{\"report_id\":197,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"A factor into why staff assisted the person to leave for an overnight with people they had concerns about was that the person wanted to leave with the people (claiming to be family). The person she left with claimed to be the person\\u2019s uncle, which the person herself confirmed and she appeared to trust him. There was a perception that since the person was a family member, visiting with the person would be less risky than if the person was unrelated. The lead staff at the home also determined this trip was important to the person. The provider agency trusted the lead staff in this home and had been working to implement a person-centered philosophy which prioritized weighing supporting things that were important to the people they served over what was important for them. This philosophy was impacted by the statewide emphasis placed on supported decision making and person-centered thinking, the latter of which was supported by provider requirements in the provider\\u2019s licensing statute, Minnesota Statutes 245D. The provider had worked with this person for 14 years, so the relationship with the person influenced the provider to make supporting the person\\u2019s own decisions even stronger.  Influencing the lead staff to determine the trip was important to supporting the person was that it appeared that assisting the person to have a safe trip seemed to mitigate risk versus allowing the person to leave without assistance. The person appeared to be determined to go, and without help from the provider, it seemed more likely issues might arise. Mitigating risk is a priority for all HCBS providers for a number of reasons: Case managers assign this priority to providers in Coordinated Service and Support Plan, Minnesota Statutes 245D requires providers to ensure the health, safety and well-being of the people they serve, and providers could be liable to lawsuits, investigations or insurance claims if a person they serve is harmed. If someone is harmed while in the care of a provider, that provider could be found in violation of the Vulnerable Adult Act and additional penalties may be brought upon a provider by the Department of Human Services. \\r\\nAnother was that the provider felt they did not have a choice but to assist her in leaving. The person was their own guardian and had the power to make many choices independently.  Additionally, the person had attempted to leave with this person in the past, and the provider determined they would weigh what was important to the person over what was important for the person. This decision was impacted by the provider\\u2019s person-centered philosophy, which in turn was impacted by statewide emphasis on supported decision-making and person-centered thinking. This emphasis came from a number of sources including advocacy organizations and DHS, which released best practice guidance on both and enforced person-centered planning requirements governing providers in Minnesota Statutes Chapter 245D. The provider\\u2019s concerns about the person leaving with the person did not seem to outweigh the provider\\u2019s desire to empower and support the person.   \\r\\nAn additional influence into why the staff assisted the person to leave an overnight with people they had concerns about was that the staff wanted to empower the person during this time since they had attempted to leave with this person in the past. Although the provider had a practice in place to not allow people to take overnights at the time due to the threat of COVID-19 and MDH guidance on COVID-19 for residential programs, the provider determined they would weigh what was important to over what was important for the person. The provider\\u2019s person-centered philosophy, influenced by the statewide emphasis on supported decision making and person-centered thinking influenced this decision by the provider. Additionally, the provider staff determined the concerns they had about the person leaving weren\\u2019t enough to take restrictive actions and weigh safety over the person\\u2019s own choice. Implementing restrictions on a person\\u2019s rights could create the liability of providers being incompliant with the conditions of Minnesota Statutes, Chapter 245D enforced by the Department of Human Services.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36862}','68.53.115.247','2021-05-26 21:24:42'),(25263,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36863,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36863}','68.53.115.247','2021-05-26 21:24:42'),(25264,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36864,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36864}','68.53.115.247','2021-05-26 21:24:42'),(25265,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36865,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36865}','68.53.115.247','2021-05-26 21:24:42'),(25266,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36866,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36866}','68.53.115.247','2021-05-26 21:24:42'),(25267,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36867,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36867}','68.53.115.247','2021-05-26 21:24:42'),(25268,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36868,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:42 pm\",\"created_at\":\"5\\/26\\/2021 4:24:42 pm\",\"id\":36868}','68.53.115.247','2021-05-26 21:24:42'),(25269,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36869,'{\"report_id\":197,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"A factor into why staff assisted the person to leave for an overnight with people they had concerns about was that the person wanted to leave with the people (claiming to be family). The person she left with claimed to be the person\\u2019s uncle, which the person herself confirmed and she appeared to trust him. There was a perception that since the person was a family member, visiting with the person would be less risky than if the person was unrelated. \\r\\n\\r\\nMore??\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:24:43 pm\",\"created_at\":\"5\\/26\\/2021 4:24:43 pm\",\"id\":36869}','68.53.115.247','2021-05-26 21:24:43'),(25270,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36870,'{\"report_id\":197,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:24:43 pm\",\"created_at\":\"5\\/26\\/2021 4:24:43 pm\",\"id\":36870}','68.53.115.247','2021-05-26 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21:24:43'),(25277,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36877,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:43 pm\",\"created_at\":\"5\\/26\\/2021 4:24:43 pm\",\"id\":36877}','68.53.115.247','2021-05-26 21:24:43'),(25278,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36878,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:43 pm\",\"created_at\":\"5\\/26\\/2021 4:24:43 pm\",\"id\":36878}','68.53.115.247','2021-05-26 21:24:43'),(25279,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36879,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:43 pm\",\"created_at\":\"5\\/26\\/2021 4:24:43 pm\",\"id\":36879}','68.53.115.247','2021-05-26 21:24:43'),(25280,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36880,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:43 pm\",\"created_at\":\"5\\/26\\/2021 4:24:43 pm\",\"id\":36880}','68.53.115.247','2021-05-26 21:24:43'),(25281,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36881,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:43 pm\",\"created_at\":\"5\\/26\\/2021 4:24:43 pm\",\"id\":36881}','68.53.115.247','2021-05-26 21:24:43'),(25282,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36882,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:43 pm\",\"created_at\":\"5\\/26\\/2021 4:24:43 pm\",\"id\":36882}','68.53.115.247','2021-05-26 21:24:43'),(25283,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36883,'{\"report_id\":197,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"A factor into why staff assisted the person to leave for an overnight with people they had concerns about was that the person wanted to leave with the people (claiming to be family). The person she left with claimed to be the person\\u2019s uncle, which the person herself confirmed and she appeared to trust him. There was a perception that since the person was a family member, visiting with the person would be less risky than if the person was unrelated. The lead staff at the home also determined this trip was important to the person. The provider agency trusted the lead staff in this home and had been working to implement a person-centered philosophy which prioritized weighing supporting things that were important to the people they served over what was important for them. This philosophy was impacted by the statewide emphasis placed on supported decision making and person-centered thinking, the latter of which was supported by provider requirements in the provider\\u2019s licensing statute, Minnesota Statutes 245D. The provider had worked with this person for 14 years, so the relationship with the person influenced the provider to make supporting the person\\u2019s own decisions even stronger.  Influencing the lead staff to determine the trip was important to supporting the person was that it appeared that assisting the person to have a safe trip seemed to mitigate risk versus allowing the person to leave without assistance. The person appeared to be determined to go, and without help from the provider, it seemed more likely issues might arise. Mitigating risk is a priority for all HCBS providers for a number of reasons: Case managers assign this priority to providers in Coordinated Service and Support Plan, Minnesota Statutes 245D requires providers to ensure the health, safety and well-being of the people they serve, and providers could be liable to lawsuits, investigations or insurance claims if a person they serve is harmed. If someone is harmed while in the care of a provider, that provider could be found in violation of the Vulnerable Adult Act and additional penalties may be brought upon a provider by the Department of Human Services. \\r\\n\\r\\nAnother was that the provider felt they did not have a choice but to assist her in leaving. The person was their own guardian and had the power to make many choices independently.  Additionally, the person had attempted to leave with this person in the past, and the provider determined they would weigh what was important to the person over what was important for the person. This decision was impacted by the provider\\u2019s person-centered philosophy, which in turn was impacted by statewide emphasis on supported decision-making and person-centered thinking. This emphasis came from a number of sources including advocacy organizations and DHS, which released best practice guidance on both and enforced person-centered planning requirements governing providers in Minnesota Statutes Chapter 245D. The provider\\u2019s concerns about the person leaving with the person did not seem to outweigh the provider\\u2019s desire to empower and support the person.   \\r\\nAn additional influence into why the staff assisted the person to leave an overnight with people they had concerns about was that the staff wanted to empower the person during this time since they had attempted to leave with this person in the past. Although the provider had a practice in place to not allow people to take overnights at the time due to the threat of COVID-19 and MDH guidance on COVID-19 for residential programs, the provider determined they would weigh what was important to over what was important for the person. The provider\\u2019s person-centered philosophy, influenced by the statewide emphasis on supported decision making and person-centered thinking influenced this decision by the provider. Additionally, the provider staff determined the concerns they had about the person leaving weren\\u2019t enough to take restrictive actions and weigh safety over the person\\u2019s own choice. Implementing restrictions on a person\\u2019s rights could create the liability of providers being incompliant with the conditions of Minnesota Statutes, Chapter 245D enforced by the Department of Human Services.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:24:43 pm\",\"created_at\":\"5\\/26\\/2021 4:24:43 pm\",\"id\":36883}','68.53.115.247','2021-05-26 21:24:43'),(25284,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36884,'{\"report_id\":197,\"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\":\"5\\/26\\/2021 4:24:43 pm\",\"created_at\":\"5\\/26\\/2021 4:24:43 pm\",\"id\":36884}','68.53.115.247','2021-05-26 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21:25:27'),(25299,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36899,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Jill Tilbury\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36899}','68.53.115.247','2021-05-26 21:25:27'),(25300,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36900,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Charles Young\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36900}','68.53.115.247','2021-05-26 21:25:27'),(25301,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36901,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Progressive Living Inc\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36901}','68.53.115.247','2021-05-26 21:25:27'),(25302,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36902,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36902}','68.53.115.247','2021-05-26 21:25:27'),(25303,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36903,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"nicole.s@progressivelivinginc.net\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36903}','68.53.115.247','2021-05-26 21:25:27'),(25304,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36904,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36904}','68.53.115.247','2021-05-26 21:25:27'),(25305,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36905,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Medication Error\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36905}','68.53.115.247','2021-05-26 21:25:27'),(25306,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36906,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36906}','68.53.115.247','2021-05-26 21:25:27'),(25307,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36907,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"07\\/20\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36907}','68.53.115.247','2021-05-26 21:25:27'),(25308,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36908,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"on 7\\/20\\/19 It had been reported to On-call that a scheduled 2 medication had 2 tablets gone missing. Staff reported this to On-call right away in the AM. DCC complained about staff on the Overnight not being awake when he was attempting to wake them up for a PRN. Staff administered an Acetaminophen to DCC at 5:00am. It is suspected that the staff on the overnight were asleep not supervising DCC and after administering the medication DCC reported the staff went back to the couch to sleep after he took his PRN. Staff may have not locked up the office and DCC may have gotten the keys from the key lockbox by breaking into it to get the schedule 2 medication. DCC has in the past requested multiple times from staff stating he has not gotten this medication. DCC has had a problem with medication seeking.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36908}','68.53.115.247','2021-05-26 21:25:27'),(25309,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36909,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36909}','68.53.115.247','2021-05-26 21:25:27'),(25310,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36910,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff did not count medications per provider policy\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36910}','68.53.115.247','2021-05-26 21:25:27'),(25311,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36911,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36911}','68.53.115.247','2021-05-26 21:25:27'),(25312,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36912,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"09\\/13\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36912}','68.53.115.247','2021-05-26 21:25:27'),(25313,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36913,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff 1 worked a double shift (working at other homes within agency) prior to arriving at 11pm and then came to work the overnight shift at the location of the incident.  Staff 2 stated this was the first shift of the day for them.  The provider\\u2019s shift are from 11p-7am; 7am-3pm; 3pm-11pm.  Both staff were float staff for several homes throughout the agency, however they had worked in this home prior to the event.  Staff 1 worked for the provider for over a year and Staff 2 had worked for the provider since February.  Each of the staff works approximately 40-48 hours per week.  Provider has a policy for a 2:4 staffing ratio at the home and both staff remain awake.  \\r\\n\\r\\nProvider\\u2019s policy is to go into the office and count medications upon arriving for a shift.  While in the office they are to also read the daily log notes on the people supported in the home.  The 11pm staff arrived for their shift, neither staff person had reviewed the notes from the previous shift or counted the medications.  This had been the pattern that staff did not typically check meds and\\/or notes when they arrived to the home because the norm was the individuals were awake and needed support.  The staff started interacting with the individuals in the home because many of them were awake on this evening and required the staff\\u2019s attention. Individual 1 typically was not awake and in the common area of the home, however they were on this evening.  \\r\\n\\r\\nIndividual 2 (with alone time) from the residence called and stated he needed a ride home.  Staff 1 left to go get individual 2.  Staff 1 did not take the office keys with them when they left the home.  Staff 1 did not know if the office was locked at this time.  \\r\\n\\r\\n\\r\\nWhen both staff arrive Individual 1 was typically in their room and this night the individual was awake more during the night and was talking to Staff 2 about videos games and film animation.  Individual 1 has no alone time.  Individual 1 is very planful, smart, he works at a department store, likes animation or playing videos games, funny, jokester, and typically calm.  \\r\\n\\r\\nAt 5am Individual 1 came to Staff 1 for a PRN and staff was watching YouTube videos.  The office is locked at all times per policy from the provider and staff carry the keys on a lanyard (on their person at all times).  One set of keys per two staff.  If keys are locked inside of the office there is another set in a lockbox (with a key code to get in).  Once in the office, the medications are set up per person in a \\u201cfile cabinet like\\u2019 with another set of keys required to get into the medications.  When staff 1 went into the office for the medications the office and the medications were all locked.  Staff 1 gave individual 1 medications and went back to watching youtube from 5am-6am.  Staff 1 was unable recall if they had fallen asleep.   Staff 1 was very tired due to the length of time they had worked during their shift and the previous two shifts at another home.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36913}','68.53.115.247','2021-05-26 21:25:27'),(25314,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36914,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36914}','68.53.115.247','2021-05-26 21:25:27'),(25315,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36915,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff did not count meds per provider policy was influenced by numerous factors.  The norm is to interact with the awake individuals and on this day there was someone awake which is impacted by staff wanting to support the individual based off of the plan of care created by the team and further influenced by societal norms to engage with others and implementing person centered culture mandated by DHS and CMS.  An additional factor was Individual 2 being in the community and needed transportation home. Staff 1 left the home to pick up Individual 2, thus leaving staff 2 alone with an awake Individual 1 who requires a 24-plan of care supported by norms to interact with others and person centered practices.  One element was there was no staff overlap upon both staff arriving to the home which resulted in staff prioritizing interaction with the individuals over counting medications.  The set wages and benefits which was indicative of the care plan therefore influenced by norms to interact with others and person centered practices.   \\r\\n\\r\\nThe final factor was both staff thought Individual 1 had no history of medication seeking supported by their staff not knowing the individual plan for medications due to being trained in several homes with several individuals\\u2019 plans to follow and also being fatigued because the staff had to work overtime prior to this shift.  The agency being shorted staffed is complicated to the set wages and benefits, low unemployment, thus constraining the college employees (seasonal) and this is byproduct of DWRS which was put in place by the legislature.  Contributing factors that further supported the provider\\u2019s policy for the work of the direct care staff 1 and 2 was the nurse\\u2019s license in providing some position to the policy.  Overall the nurse\\u2019s license is regulated by legislation and statute.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36915}','68.53.115.247','2021-05-26 21:25:27'),(25316,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36916,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36916}','68.53.115.247','2021-05-26 21:25:27'),(25317,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36917,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36917}','68.53.115.247','2021-05-26 21:25:27'),(25318,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36918,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36918}','68.53.115.247','2021-05-26 21:25:27'),(25319,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36919,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36919}','68.53.115.247','2021-05-26 21:25:27'),(25320,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36920,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36920}','68.53.115.247','2021-05-26 21:25:27'),(25321,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36921,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36921}','68.53.115.247','2021-05-26 21:25:27'),(25322,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36922,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36922}','68.53.115.247','2021-05-26 21:25:27'),(25323,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36923,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36923}','68.53.115.247','2021-05-26 21:25:27'),(25324,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36924,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36924}','68.53.115.247','2021-05-26 21:25:27'),(25325,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36925,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36925}','68.53.115.247','2021-05-26 21:25:27'),(25326,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36926,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36926}','68.53.115.247','2021-05-26 21:25:27'),(25327,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36927,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36927}','68.53.115.247','2021-05-26 21:25:27'),(25328,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36928,'{\"report_id\":198,\"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\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36928}','68.53.115.247','2021-05-26 21:25:27'),(25329,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',36929,'{\"report_id\":198,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"109\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:25:27 pm\",\"created_at\":\"5\\/26\\/2021 4:25:27 pm\",\"id\":36929}','68.53.115.247','2021-05-26 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increase on the to visit note and informed staff. The med sheet was never updated and Staff are suppose to follow the\\r\\nmed sheet.\\r\\n\\r\\nThere was a couple days where VA did give the right dosage because AP gave it to her himself. Nurse discovered this on Thursday Morning 09\\/19\\/2019 and informed Reporter of the mistake.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37010}','68.53.115.247','2021-05-26 21:26:48'),(25411,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37011,'{\"report_id\":200,\"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\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37011}','68.53.115.247','2021-05-26 21:26:48'),(25412,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37012,'{\"report_id\":200,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Medication Error over an Extended Period of Time\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37012}','68.53.115.247','2021-05-26 21:26:48'),(25413,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37013,'{\"report_id\":200,\"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\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37013}','68.53.115.247','2021-05-26 21:26:48'),(25414,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37014,'{\"report_id\":200,\"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\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37014}','68.53.115.247','2021-05-26 21:26:48'),(25415,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37015,'{\"report_id\":200,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"The VA has had Type 1 diabetes since they were 6 years old and now is 44 years old.  The VA lives in an adult foster care setting for the past seven years with three other individuals.  The VA enjoys walking the dog, going to work 5 days a week, and being active in the community.  \\r\\n\\r\\nThe VA has a protocol that all staff are trained on and due to this regimen it is difficult to have any fill in staff cover shifts at the adult foster care home.  The VA completes the blood sugar checks without assistance from staff with an Accuchek machine.  The machine then tells the staff how much insulin is required at that time depending on how many carbs the VA is going to eat at that meal time for both medications.  The VA gets novolox 4x\\/day and the tuojeo 1x\\/day at dinner.   The protocol goes onto say if the numbers are within this range give this much insulin and if they are within this much give this amount.  The VA takes two different types of insulin along with several other medications. This protocol is listed on the computer within the MAR system that the provider utilizes to document medications and communications amongst the staff.   \\r\\n\\r\\nThe staff will then \\u201cdial up\\u201d the insulin for the VA and they will give themselves the insulin injections.  The insulin medications are not labeled with the amount of units that are to be given due to the variances based off of the blood sugar numbers and the amount of carbs that are about to be eaten by the VA.  The VA is aware of the regimen and understands the necessity to take her insulin each day. \\r\\n\\r\\nThe VA is unable to feel the effects of having blood sugar numbers out of the normal range (80-120) and their numbers will reach as high as 300-400 without any signs (dizzy, light headed, sweaty, etc.).  The VA understands when their numbers are high if they exercise they can reduce the numbers.  The VA had a checkup with their doctor regarding the blood sugar being high, although the staff will educate the VA on proper eating choices and the VA exercises frequently.  The doctor stated the Tuojeo needed to go from 15 units to 17 units at dinner time.  The supervisor of the house had taken the VA to the appointment and came home and documented this in the MAR and in the staff notes of the change and had given the VA the change in medications when giving the medication that evening.  The supervisor gave the other staff the information to follow.  \\r\\n\\r\\nThe nurse found the error in the medications after different staff had worked and not just the supervisor and the staff that was informed on 8\\/29\\/19 after the VA went to the doctor appointment.  The supervisor had been doing compliance checks once a week of the medications, however did not see it because the medications and the MAR don\\u2019t match because they never have matched because of the variances in the medication that is given based off what the numbers are and how many carbs are being eaten.  There are many moving parts to giving the insulin medications while the staff also must follow the protocol.  The staff typically give the medication after the supervisor has left for the day as well due to the supervisor working from 9a-5pm and the VA gets this medication at dinner time.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37015}','68.53.115.247','2021-05-26 21:26:48'),(25416,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37016,'{\"report_id\":200,\"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\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37016}','68.53.115.247','2021-05-26 21:26:48'),(25417,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37017,'{\"report_id\":200,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff not providing the correct medication dosage to an individual was influenced by the staff being unware of the increase in the medication dosage. A contributing factor to the unawareness of the increase was that information was not communicated to the staff in the transition time because there is not enough time available to read the health progress notes.  The short amount of staff transition time is impacted by the provider not building transition time into the staff schedules due to contributing factors of the weather, the staff\\u2019s second job, and the labor laws.  The other influencer is the CSSP and the 6790 does not allow the ability of the rate system to pay the provider more to have staff overlap on the shift change.  Another contributor of the staff not being able to communicate during the transition is there are several documentation points for communication for each individual living in the home thus requirements set for by licensing 245D.  \\r\\n\\r\\nStaff giving the incorrect dosage was also influenced by the documentation was not completed in the Medical Administration Record (MAR). At this home, it was the supervisor\\u2019s role to update medication changes in the MAR.  The individual\\u2019s medication administration had complexities to giving the medications that were not relayed in the MAR as the individual was to receive two different types of insulin and staff relied on the previous MAR to provide the medication.  The influence of the MAR not being updated is the provider experiencing frequent lapses in internet connectivity (which occurred frequently at the residence) and the MAR is an electronic document, thus the documentation is in two places and not reviewed by all staff.  The supervisor had relied on the protocol for the med changes that is given by the physician, which has an outside influence of the pharmaceutical laws that informs the physician on how to write the protocols.  \\r\\n\\r\\nA final influence to staff giving the incorrect dosage was that they were using an \\u201cold\\u201d prescription because the physician did not change the prescription with the pharmacy.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37017}','68.53.115.247','2021-05-26 21:26:48'),(25418,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37018,'{\"report_id\":200,\"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\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37018}','68.53.115.247','2021-05-26 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21:26:48'),(25425,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37025,'{\"report_id\":200,\"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\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37025}','68.53.115.247','2021-05-26 21:26:48'),(25426,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37026,'{\"report_id\":200,\"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\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37026}','68.53.115.247','2021-05-26 21:26:48'),(25427,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37027,'{\"report_id\":200,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"105\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37027}','68.53.115.247','2021-05-26 21:26:48'),(25428,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37028,'{\"report_id\":200,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"106\",\"question_type\":\"Free_Text\",\"text_answer\":\"A contributing factor to the unawareness of the increase was that information was not communicated to the staff in the transition time because there is not enough time available to read the health progress notes.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37028}','68.53.115.247','2021-05-26 21:26:48'),(25429,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37029,'{\"report_id\":200,\"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\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37029}','68.53.115.247','2021-05-26 21:26:48'),(25430,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37030,'{\"report_id\":200,\"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\":\"5\\/26\\/2021 4:26:48 pm\",\"created_at\":\"5\\/26\\/2021 4:26:48 pm\",\"id\":37030}','68.53.115.247','2021-05-26 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The individual\\u2019s medication administration had complexities to giving the medications that were not relayed in the MAR as the individual was to receive two different types of insulin and staff relied on the previous MAR to provide the medication.  The influence of the MAR not being updated is the provider experiencing frequent lapses in internet connectivity (which occurred frequently at the residence) and the MAR is an electronic document, thus the documentation is in two places and not reviewed by all staff.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:26:49 pm\",\"created_at\":\"5\\/26\\/2021 4:26:49 pm\",\"id\":37046}','68.53.115.247','2021-05-26 21:26:49'),(25447,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37047,'{\"report_id\":200,\"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\":\"5\\/26\\/2021 4:26:49 pm\",\"created_at\":\"5\\/26\\/2021 4:26:49 pm\",\"id\":37047}','68.53.115.247','2021-05-26 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21:28:18'),(25464,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37064,'{\"report_id\":201,\"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\":\"5\\/26\\/2021 4:28:18 pm\",\"created_at\":\"5\\/26\\/2021 4:28:18 pm\",\"id\":37064}','68.53.115.247','2021-05-26 21:28:18'),(25465,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37065,'{\"report_id\":201,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff unable to redirect a person from departing on a bus to Chicago.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:28:18 pm\",\"created_at\":\"5\\/26\\/2021 4:28:18 pm\",\"id\":37065}','68.53.115.247','2021-05-26 21:28:18'),(25466,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37066,'{\"report_id\":201,\"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\":\"5\\/26\\/2021 4:28:18 pm\",\"created_at\":\"5\\/26\\/2021 4:28:18 pm\",\"id\":37066}','68.53.115.247','2021-05-26 21:28:18'),(25467,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37067,'{\"report_id\":201,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"10\\/14\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:28:18 pm\",\"created_at\":\"5\\/26\\/2021 4:28:18 pm\",\"id\":37067}','68.53.115.247','2021-05-26 21:28:18'),(25468,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37068,'{\"report_id\":201,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff unable to redirect a person from departing on a bus to Chicago.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:28:18 pm\",\"created_at\":\"5\\/26\\/2021 4:28:18 pm\",\"id\":37068}','68.53.115.247','2021-05-26 21:28:18'),(25469,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37069,'{\"report_id\":201,\"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\":\"5\\/26\\/2021 4:28:18 pm\",\"created_at\":\"5\\/26\\/2021 4:28:18 pm\",\"id\":37069}','68.53.115.247','2021-05-26 21:28:18'),(25470,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37070,'{\"report_id\":201,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff was unable to redirect a person from departing on a bus to Chicago and this was influenced by wanting to go to Chicago to visit their sister. This matter was complicated given the person wouldn\\u2019t communicate with staff present.  All efforts to redirect the person were unsuccessful while exhausting all other safe alternatives. The person was earlier hospilatized regarding mental health and aggression and the staff was hesitant at the moment and didn\\u2019t want to anger the person further. Another contributing factor was that the person received a COVID stimulous check that created the means for the visit to Chicago.    \\r\\n\\r\\nStaff being unable to redirect the person was influenced by the provider ultimately determining the risk was low to take the trip without staff. After many unsuccessful attempts to redirect, the provider reviewed the person\\u2019s risk management plan and it was affirmed. Contributing factors that further influenced the staffs\\u2019 decision to remain at the bus station was the expectation of the lead agency and CSSP was not to follow a person to another state while eloping and assure full communication with all team members and agency staff.\\r\\n\\r\\nAnother influence to the inability to redirect was that staff were hesistant to anger the person. This was further supported by the person having a history of aggressive behavior. The person wouldn\\u2019t communicate with the staff present and they were hesitant to coherse the person too much in their efforts to support him in being safe. Staff also did offer to support this trip at a future date with proper planning to assure health and safety. This moment was further complicated by contacting the hospital who stated there was nothing they or staff could do given the person was his own guardian which further limited staff in their efforts to help him return home.\\r\\n\\r\\nAn additional feature that impacted the support lended to the person was the agency\\u2019s practice of person-centered efforts in trying to find balance of what was important to and for the person while making decisions at that moment. Their operating philosophy supported personal freedoms and choices based on experiences over time.  There is also an overall systemic expectation that providers support experiences, choices, and the person\\u2019s rights.   \\r\\n\\r\\nStaff being unable to redirect was influenced by the provider exhausting all safe alternatives. The person is their own guardian and did have a provisional discharge from the program.  Furthermore, COVID and the Governor\\u2019s stay at home order also influenced the person\\u2019s decision to leave as his routine was limited to low activity. This elopement influenced the agency, team, and staff present to honor the person\\u2019s civil rights which connected directly to their philosophy of protecting his rights which put him in charge of making the decision to leave on the bus.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:28:18 pm\",\"created_at\":\"5\\/26\\/2021 4:28:18 pm\",\"id\":37070}','68.53.115.247','2021-05-26 21:28:18'),(25471,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37071,'{\"report_id\":201,\"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\":\"5\\/26\\/2021 4:28:18 pm\",\"created_at\":\"5\\/26\\/2021 4:28:18 pm\",\"id\":37071}','68.53.115.247','2021-05-26 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