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MALTREATMENT INVESTIGATION MEMORANDUM Minnesota Statutes, section 626.557, subdivision 1 states, “The legislature declares that the public policy of this state is to protect adults who, because of physical or mental disability or dependency on institutional services, are particularly vulnerable to maltreatment.”
License Number and Program Type: 1089816-SUD (Substance Use Disorder) Investigator(s): Deb Neubauer-Hoffman 651-431-6567 Suspected Maltreatment Reported: It was reported that a staff person (SP) and a vulnerable adult (VA) had a romantic relationship that involved kissing while the VA received services at the facility. After the VA was discharged, the relationship became sexual. Date of Incident(s): April and May, 2022 Nature of Alleged Maltreatment Pursuant to Minnesota Statutes, section 626.557, subdivision 9c, paragraph (b), and Minnesota Statutes, section 626.5572, subdivision 15, and subdivision 2, paragraph (c); and subdivision 17, paragraph (a): Any sexual contact or penetration between a facility staff person or a person providing services in the facility and a resident, patient, or client of that facility. Sexual contact is defined by Minnesota Statutes, section 609.341, as the intentional touching of the intimate parts with sexual or aggressive intent. 'Intimate parts' includes the primary genital area, groin, inner thigh, buttocks, and breast. The failure or omission by a caregiver to supply a vulnerable adult with care or services, including but not limited to food, clothing, shelter, health care, or supervision which is reasonable and necessary to obtain or maintain the vulnerable adult's physical or mental health or safety, considering the physical and mental capacity or dysfunction of the vulnerable adult and which is not the result of an accident or therapeutic conduct. Summary of Findings: Pertinent information for this investigation was obtained remotely, including documentation from the facility; and through four interviews conducted with facility staff persons (P1, P2 and the SP) and the VA. Facility information showed that the VA was diagnosed with substance use disorder and described him/herself as intelligent, charismatic, educated, caring, and empathetic. The VA’s leisure activities that affected his/her substance use included gambling. An assessment showed that the VA stated that circumstances that generally led to relapse included “co-dependency, every time, it is a relationship, a [person of opposite sex] latching on to me.” The VA’s Discharge Summary showed that s/he successfully completed treatment in 27 days, and upon discharge, the VA resided at a sober living facility. The facility was located in a rural, lakeside community with the main structure consisting of two adjoining facilities that were connected by an extended hallway separated by a fire door. The facility served individuals 18 and over. Staff persons were onsite 24 hours per day and were to be awake during overnight hours. A Critical Incident report stated that on November 21, 2022, the VA called the facility and told facility staff persons (P3 and P4) that the VA and the SP started a relationship when the VA received services from the facility (April to May, 2022). During that time, the SP told the VA that s/he had “feelings” for the VA and could not work with the VA professionally anymore. Despite that conversation, the VA would “hang out” in the SP’s office every day. The VA said that the SP and VA kissed “a few times.” After the VA’s discharge, the VA and the SP dated, engaged in sexual contact, and lived together. The SP also co-signed for an auto loan for the VA. The relationship ended on November 18, 2022, and the VA said “that it has really messed with [him/her],” causing him/her to relapse. The VA provided the following information when interviewed by this investigator:
· The “first week” that the VA was at the facility, a “relationship” started between the SP and the VA. The second week, the SP said that s/he talked to his/her supervisor (P2) and told P2 that s/he could not be the VA’s “therapist” because the SP had “feelings” for the VA; however, they could be “friends.” After that, the VA’s therapist was changed to P2. The third week, the SP “kissed” the VA’s cheek when the VA was in the SP’s office. · After the SP was no longer the VA’s therapist, the VA and other clients frequently went to the SP’s office and listened to music. The VA said, “We would all go in there.” When asked by this investigator if the SP asked the VA to come into his/her office or if the VA went on his/her own, the VA responded that s/he and the SP talked about whether or not the VA should come into the SP’s office and the SP told the VA, “We can hang out, we can be friends.” · The VA talked to P2 about the SP and P2 told the VA that this was “not the first time” that the SP had feelings for a client. Given that information, the VA believed the facility “should have been more strict” and “made sure [the SP] and [the VA] did not have contact, professional or nonprofessional.” · The VA and the SP planned to “ramp it up” after the VA’s discharge and “we agreed we would start a relationship.” After discharge from the facility (May 3, 2022), the VA resided at a “sober house” until May 28, 2022. The SP ended his/her employment at the facility so the VA and SP could be together. The VA then moved in to the SP’s apartment. · After the VA’s discharge and during the course of their relationship, the SP provided $3,000 for a down payment on a vehicle for the VA and co-signed on the loan. · Around October 2022, the relationship “petered out” and the VA moved out of the SP’s apartment. The VA said that s/he had nowhere to live, was “pissed off,” and asked the SP to “borrow [the VA] $500.” The VA admitted s/he told the SP if s/he borrowed the VA $500, the VA would “leave [the SP] alone.” · When asked by this investigator if there were any law enforcement reports related to the VA’s relationship with the SP, the VA said, “No,” s/he did not want to “screw [the SP] over by bringing out the truth.” The VA’s Notes documented the following information:
· On April 22, 2022, the SP documented that s/he met with the VA to discuss a boundary conflict with therapeutic and ethical boundary issues between the SP and VA. The VA’s therapy was switched to another staff person (P2). · On April 25, 2022, P2 documented that s/he observed the VA in the SP’s office “with the door open” listening to music. The VA invited P2 and two other clients to come into the SP’s office to listen to music. · On April 30, 2022, the SP documented that the VA entered the SP’s office and the SP “reminded” the VA about the boundary concerns and limitations of interaction “due to conflict” between [the SP and VA]. The VA said that s/he understood and would bring future concerns or questions to another staff person (P2). P1 said that the SP “did a lot of music therapy” and there were times when clients would listen to music in the SP’s office. As a result, P1 discussed “boundaries” with the SP because “just to hang out would not be professional.” P1 knew that the VA was one of the clients that was “hanging out” in the SP’s office. P1 believed it was the SP’s idea to switch the VA’s therapist from the SP to P2. P2 said that the SP came to him/her and said there were “feelings” between the SP and the VA. To avoid “becoming unprofessional,” the VA was switched to working with P2 to “put that boundary” between client and therapist. P2 was aware that after the switch, the SP and VA “crossed paths” if the SP “picked up” a group or when the VA and other clients went to the SP’s office to listen to music. P2 said there were two to three other clients who “really liked” the SP and came in and out of the SP’s office “quite a bit” to listen to music. P2 believed that the SP “joked around or got too casual a little too much” when interacting with clients. P2 said that professional boundaries and ethics were “made clear” in monthly trainings and staff persons were aware they could not have “any kind of relationship until after a minimum of two years” from the time the client was discharged. When P2 was asked about a conversation between the VA and P2 where the VA asked about any prior attraction between the SP and other clients, P2 recalled a brief conversation about this but did not remember the details. However, P2 admitted telling the VA that the VA was not the only one the SP was attracted to; however, in the other circumstance, “nothing happened” between the SP and the other client. The SP provided the following information: · When the VA was initially admitted to the facility, the SP was assigned as the VA’s therapist. However, within the first week, the SP identified a “level of attraction” between him/herself and the VA so s/he talked to his/her supervisors (P2 and P3) and the VA’s therapy was switched to P2. After that, the SP’s “contact was limited” while the VA remained at the facility. For example, the SP had “informal music therapy” and the VA “frequently” came to the SP’s office and sat on a couch and listened to music. The SP said that the door was always “open” and frequently other clients were also present. P2’s office was directly across from the SP’s office. · When asked by this investigator about kissing the VA at the facility, the SP described one incident where the SP was using a computer and the VA was standing over the SP’s shoulder, also looking at the computer. As the SP turned around, towards the VA, the SP’s lips “brushed” the VA’s neck/shoulder “because [the VA] was so close.” The SP denied kissing the VA while s/he was a client at the facility. · The SP said s/he received training that “developing a relationship with a patient is a no-no.” After the VA was discharged, the SP ended his/her employment at the facility and the VA moved into the SP’s apartment. The SP gave the VA several thousand dollars that s/he believed the VA would pay back. After the VA relapsed and became “paranoid,” the relationship ended after approximately four months. · In November 2022, the VA sent the SP multiple text messages and “admitted” that s/he watched the SP from outside his/her apartment to see who was coming and going. The SP said there was one text message where the VA “blackmailed” the SP stating if the SP did not give the VA $500, the VA was going to “have a negative impact on [the SP’s] life and end my career.” The VA threatened to send “photos of a sexual nature” if the SP did not give the VA $500. After the relationship ended and the SP received multiple text messages from the VA, the SP filed a Petition for Harassment Restraining Order related to the VA’s behavior. A string of text messages from the VA to the SP dated November 18, 2022, showed that the VA said, “I’m going to make a deal with you. I need you to chime me $500, I’ll pay it back as soon as possible like within the month. For doing this in return I’ll never do anything to negatively affect your life or career.” The VA stated s/he needed to “know [the SP’s] answer by ten.” If the SP did not provide the money, the VA said s/he was going to “post all the good times we had” on the facility’s Facebook page and send the SP a sexually explicit photo that the VA had of the SP. Later that day another text message from the VA said, “You still have 50 minutes left. I mean that’s really a lot to lose versus 500 bucks . . .” and “I know you are not going to respond I don’t need to wait any longer. I really thought 500 bucks was not too bad of a deal to save your career, I’ll send the emails now.” A police department Incident Report showed that law enforcement was called on November 18, 2022, regarding the VA’s communication and observation of the SP from outside the SP’s apartment. A law enforcement officer (LEO) advised the SP to “get a restraining order” and a Petition for Harassment Restraining Order was filed. A facility policy, Staff Personal Relationships, prohibited “the development of personal or sexual relationships with clients during the period the client is receiving psychotherapy or within the two-year period following the date of last psychotherapy session. This prohibition applies whether or not the provider has formerly terminated the professional relationship.” Facility records showed the SP was trained regarding establishing and maintaining professional boundaries, confidentiality, and the Reporting of Maltreatment of Vulnerable Adults Act. Conclusion: Regarding sexual abuse: Information from the VA and the SP showed that sexual contact between the SP and the VA occurred after the VA was discharged from the facility. Given that the VA was no longer receiving inpatient services and thus was no longer determined to be a vulnerable adult, there was a preponderance of the evidence that the SP and the VA did not have sexual contact while the VA received services from the facility. It was determined that sexual abuse did not occur (any sexual contact or penetration between a facility staff person or a person providing services in the facility and a resident, patient, or client of that facility. Sexual contact is defined by Minnesota Statutes, section 609.341, as the intentional touching of the intimate parts with sexual or aggressive intent. 'Intimate parts' includes the primary genital area, groin, inner thigh, buttocks, and breast). Regarding neglect: Information showed that shortly after the VA’s admission, the SP and the VA admitted an attraction to each other resulting in the SP no longer working as the VA’s therapist. Despite that change, there was intermittent contact between the VA and the SP and on one occasion the SP documented that s/he “reminded” the VA about boundary concerns and limitations of their interactions. P1 and P2 each provided information about the SP’s boundary issues related to a former client and/or clients being in the SP’s office listening to music. However, there was no information about relationship concerns between the VA and the SP after the SP was no longer the VA’s therapist. The VA provided inconsistent information in that s/he told P3 and P4 that s/he and the SP kissed “a few times” yet told this investigator that it occurred once, when the SP kissed the VA on the VA’s cheek in the SP’s office. The SP denied kissing the VA at the facility, although admitted his/her lips brushed the VA’s neck/shoulder on one occasion due to the VA’s proximity when they were together looking at a computer. After the VA’s discharge, the SP ended his/her employment at the facility and the VA moved into the SP’s apartment. After the relationship ended and the VA moved out of the SP’s apartment.
Although the SP had “feelings” for the VA while the VA received services from the facility and the SP’s conduct of allowing the VA to reside at his/her apartment and engaging in a relationship with the VA after his/her discharge was inconsistent with the standards of a professional caregiver in a facility licensed by the Department of Human Services, and was a violation of the facility’s policies and procedures, given that other than the SP allowing the VA to “hang out” in his/her office, there was no information that the SP had other boundary issues with the VA while the VA was receiving services; and that when the SP and the VA lived together and had a sexual relationship, the VA was no longer receiving services and the SP did not meet the definition of a caregiver at that time, there was not a preponderance of the evidence whether the SP failed to supply the VA with care or services required to maintain the VA’s physical or mental health or safety. It was not determined whether neglect occurred (the failure or omission by a caregiver to supply a vulnerable adult with care or services, including but not limited to food, clothing, shelter, health care, or supervision which is reasonable and necessary to obtain or maintain the vulnerable adult's physical or mental health or safety, considering the physical and mental capacity or dysfunction of the vulnerable adult and which is not the result of an accident or therapeutic conduct). Action Taken by Facility: The facility completed an internal review and determined that policies and procedures were adequate and once the report was made, policies and procedures were followed. The facility also determined there was no additional staff training needed. The SP no longer worked at the facility. Action Taken by Department of Human Services, Office of Inspector General: No further action taken.
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