{"Short_Answer__76":"Care Manager","Date__77":"01\/28\/2020","Multiple_Choice__78":"David Vukelich","Multiple_Choice__79":"Scott Schifsky","Short_Answer__80":"Peace of Mind of Duluth","Short_Answer__81":"Clayton Liend","Short_Answer__82":"clayton@pomduluth.com","Multiple_Choice__84":"Termination of Services","Multiple_Choice__85":"St. Louis County","Date__86":"11\/05\/2019","Multiple_Choice__96":"1","Short_Answer__91":"Individual was given a 60 day termination notice.","True_or_False__94":"Yes","Free_Text__98":"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.","Free_Text__100":"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.","Multiple_Choice__101":"0","Multiple_Choice__103":"2","Free_Text__104":"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.\"","Multiple_Choice__105":"0","Multiple_Choice__107":"0","Multiple_Choice__109":"2","Free_Text__110":"\"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.","Multiple_Choice__111":"0","Multiple_Choice__113":"0","Multiple_Choice__115":"3","Free_Text__116":"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.","Multiple_Choice__117":"0","Multiple_Choice__119":"0","Multiple_Choice__121":"0","Multiple_Choice__123":"0","Multiple_Choice__125":"0","Yes_or_No__432":"Yes"}