|
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: 1044799-SUD (Substance-Use Disorder) Investigator(s): Emily Kearns/Scott Brandt Suspected Maltreatment Reported: It was reported that a staff person (SP) had an intimate relationship with a vulnerable adult (VA) while the VA received services at a facility and the relationship continued after the VA was discharged from the facility. Date of Incident(s): Prior to December 2023 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 law enforcement records; and through five interviews conducted with the VA, two facility staff persons (P1 and P2), the SP, and a community person (CP). The VA’s plans showed that s/he was receiving residential treatment services from the facility for a substance abuse disorder. The VA was working on building skills to help with impulse control and wished to have structure and routine for activities related to sobriety. The VA reported being triggered by aggressive individuals resulting in post-traumatic stress disorder (PTSD) from a past incident. The SP worked at the facility from June 2022 to October 26, 2023. The VA resided at the facility from July 10 until September 22, 2023, when s/he was arrested and went to jail and was discharged from the facility. The CP provided the following information: · On December 6, 2023, the CP and the VA talked. The VA was “emotionally upset” and told the CP that the VA had an “emotional relationship” with the SP, who “bailed” the VA out of jail. The VA received monthly disability checks and signed one of the checks over to the SP and let him/her keep the money. · The VA was “emotionally vulnerable” during the last year and said that the SP “turn[ed]” on the VA and demanded money. The VA felt emotionally “taken advantage of” at the facility. During the course of the investigation, other concerns were brought forward which occurred when the VA was no longer receiving services at the facility. The concerns included that the SP bailed the VA out of jail, that the SP accepted the VA’s Social Security/Disability checks, that the SP and the VA communicated with one another via text message, and that the SP verbally abused the VA to the point that the VA was emotionally distraught and attempted to end his/her life. The VA provided the following information: · While the VA was at the facility, if the VA had medication issues, the SP was the “go-to.” The VA did not know how the SP treated other clients at the facility and did not feel that the SP treated the VA “differently” than other clients. There was no “sneakiness” with the VA and the SP while the VA was at the facility. The SP was “there to help me” when the VA went to jail. · After the VA was released from jail, the VA talked to the CP about concerns regarding the VA’s time at the facility. The VA told the CP that s/he could not get “this bullshit out of my head” about the SP. The VA “opened up” for the first time to someone when s/he talked to the CP. The VA explained to the CP that the SP “befriended” the VA, but then when the SP began “pulling in” the VA, the SP “was like F you. Bye.” This was very hard on the VA. The SP was “not aware” that the VA “saw something” in the SP. The VA felt like s/he had a “bond” and could talk to the SP about anything. The VA realized the “connection” after s/he was discharged from the facility. The VA said that the “only thing [the VA and the SP] didn’t have” was the “sexual” part of the relationship, due to the VA being in jail. · While the VA was in jail, the VA and the SP communicated over the phone, via “texters,” and the SP visited the VA in-person three times. A texter was described by the VA as a jail-authorized device that was used to send and receive text messages from jail to another person’s phone, similar to a cell phone. Money needed to be put on to the device for the VA to use the device. The text communication between the SP and VA when the VA was in jail was initiated by the SP as the VA could not initiate contact from jail. The content of the texts between the VA and the SP “could be about anything.” The VA felt like the SP was “being a good person” by talking to the VA but then later felt like the SP was not a “good person.” · The VA was in jail but said, “The bottom line is that we did have a relationship,” and that there was “always a paper trail” and a “digital trail.” The VA said that s/he was only at the jail for a month and approximately $2,000 was put on a phone at the jail for the VA to make calls and about $600 was put on the “texter” for the VA to receive and send text messages. When the VA arrived at jail, jail staff persons told the VA that somebody had made a “deposit on the texter.” The VA did not know anyone in that area and was “confused.” · The VA completed his/her sentence, and the VA was released from jail without posting bail and went to a different treatment facility. The VA denied that the SP paid the VA’s bail. The VA was released for finishing his/her sentence. · The VA did not give the SP his/her Social Security/Disability checks as was initially reported, but instead said s/he asked the SP to collect the VA’s mail including the checks to make sure the VA’s mail would not be returned to the sender and said that the SP never “demanded” money from the VA. · When asked if the VA felt like s/he had a “therapeutic” relationship with the SP, the VA stated that in the beginning, s/he thought it was therapeutic, but more recently, the relationship between the SP and the VA was “not professional.” Once “feelings” started, it “changed.” · The SP said, “I love you,” to the VA while the VA was in jail. The SP “always” had access to the VA’s phone number and gave the VA a “note” while at the facility that said, “Your past does not determine your future,” and it was signed by the SP. · The biggest thing that the SP did to the VA that was “not therapeutic” was that the SP “probed” and “messed with” the VA’s feelings and emotions that the VA had been trying to deal with his/her “entire life” and when the VA began to “get on top of” things, the SP “yanked it right back out, like look what I can do. That’s not funny.” The SP “opened the door and let [the VA] in,” and one night it was “one way” and the next day it was “blown back” and changed. When asked why it changed, the VA said that the SP said it had something to do with the SP’s former significant other. The VA could not give a date as to when things “changed” between the VA and SP, but it was towards the end of November 2023. There was “currently” no communication between the SP and the VA. · The VA had three prior suicide attempts, but they were prior to the VA’s arrival at the facility and not related to the SP. P1 was not aware of any “inappropriate” relationships between the VA and staff persons but stated that staff persons were trained to not exchange personal information with clients and staff persons completed boundary training. P2 provided the following information: · Staff persons were not supposed to approach clients outside of the facility and were not supposed to have contact with them, including electronic communication, for two years after the client was discharged. · P2 was contacted by the VA while the VA was in jail approximately two days after the VA was discharged from the facility. The VA was “worried” about his/her Social Security/Disability check and asked if there was a way for it to be forwarded to the VA at jail. P2 told the VA to call back and speak with someone at the front desk who could help with that. P2 stated that “as far as [s/he] knew” the check was forwarded to the VA. · Clients’ personal belongings were generally held at the facility for 30 days after discharge and then whomever the client had authorized to pick up the belongings, could pick up the belongings. P2 reiterated that it “had to be” the client who called to name the person who would be picking up his/her belongings. P2 stated that s/he did not know who picked up the VA’s belongings. P2 stated that it would not be “common practice” for a staff person to arrange any of that with the VA. The same applied to the mail, including the VA’s Social Security/Disability checks. · P2 said that s/he was not aware of the VA being involved with any staff persons “on a personal level” and stated that the people that P2 worked with had “good boundaries.” Later, when asked if P2 knew if any staff persons had been in touch with the VA after the VA left the facility, P2 named the SP and added that maybe this was because the SP worked with the VA’s probation officer regarding the VA’s medications, which were left behind at the facility. · P2 stated that s/he was “almost positive” that during one room search, the VA was found to have two cell phones in his/her possession. · When asked if there was any additional information that P2 could provide, P2 stated that what s/he told this investigator was “all” that s/he knew. The SP provided the following information: · Some of the SP’s duties were medication passing, weekly meetings, managing new client appointments, bringing clients to appointments, uploading urinalysis results, and other day-to-day things. · “It depend[ed]” on whether or not staff persons could have contact with clients outside of work based on “who initiated” the conversation. If a client initiated a conversation outside of the facility, staff persons “could talk to them.” The SP was “not aware” of any facility policies regarding or prohibiting personal relationships with current or former clients. The SP stated that s/he was not aware that “in this line of work” clients and staff persons were typically not supposed to have communication for two years post-discharge. · Front desk staff persons had been giving out other staff persons’ phone numbers “a couple of different times.” It was not “typical” for clients to have access to staff persons’ phone numbers unless the phone numbers were given out “by mistake.” There was no list of staff persons’ personal phone numbers for clients to reach out to if they needed help. The SP never gave out his/her phone number to anyone. · The SP “did not” have a relationship with a client “at the facility” or a client who “was at” the facility. The SP stated that s/he “would need more information” when asked about a former client having the SP’s phone number and the SP’s communication with former clients. The SP stated that s/he “still sees” former clients due to where s/he currently worked. · The SP “dropped off” belongings for a former client who was in jail and could not provide the exact date. Initially, the SP would not give the name of the former client and asked for this investigator to provide more information. The SP next provided the VA’s name and stated that the VA “asked about a relationship” and the SP told the VA that was “not appropriate.” The SP stated that s/he dropped off a check for the VA one time and another time dropped off belongings for the VA at the jail. The VA contacted the SP, by first calling the facility to get the SP’s facility office phone number, leaving voicemails, then “had gotten” the SP’s cell phone number. The SP was “not aware” how the VA got the SP’s personal phone number, later saying that the front desk staff person gave out the SP’s phone number to the VA. The VA did not have the SP’s new work number. · The relationship that the SP had with the VA while the VA was at the facility was “completely professional.” After the VA left the facility, the VA reached out and did not have anyone in the area to help him/her and the SP felt like s/he wanted to help the VA “out of the goodness of [the SP’s] heart.” The SP did not talk with management at the facility prior to helping the VA because the SP “no longer worked at” the facility. When asked if s/he worked at the facility when s/he brought the VA his/her belongings, the SP denied working at the facility during that time. (Investigator’s note: All in-person jail visits by the SP to the VA occurred while the SP was employed at the facility.) · The SP’s last day at the facility was October 26, 2023. The SP did not remember when the VA was arrested. The SP did not know all the details regarding the VA’s arrest. The SP had “no part” in that process other than to get the VA’s medications ready for discharge. The VA was not on the SP’s caseload. · The SP “did not have information” about money on the VA’s “texter.” When asked if the SP put money on the texter, the SP replied, “I don’t want to answer that question right now.” The SP cashed a check for the VA and “paid back” the VA. The SP said that this was one of the reasons for an in-person visit with the VA at the jail. · The SP denied bailing the VA out of jail. P2 was the only staff person who knew that the SP was “helping” the VA. The SP denied having “sexual contact” with the VA. (Investigator’s Note: P2 was contacted to ask for further information regarding this but P2 did not respond.) · The SP denied wanting to be in a relationship with the VA and did not know why there was information that s/he wanted to be. · The SP did not provide further information and responded “no comment” when asked further about the phone calls and text messages with the VA, cashing the VA’s check, or visiting the VA in jail. · Clients were not supposed to have cell phones while in the facility, but they would “sneak” them in there. Many clients had a “second” cell phone. If this rule was violated, the client was supposed to be put on an “electronics restriction.” The SP noticed that the VA had a second phone or second “sim card” at one point while the VA was in the facility. The SP said that s/he then told a supervisor and another staff person about this. The SP did not know if the VA was put on “electronics restriction” after that.
· The SP no longer had communication with the VA because the SP did not want contact from the VA anymore. The first week of December 2023, the VA threatened to go to the SP’s house, and it “scared me.” When asked how the VA knew where the SP lived, the SP stated that s/he lived near a business frequented by clients from the facility, and they would see the SP driving “constantly” and that clients were able to recognize the SP’s license plates. While the VA was in jail, the VA and the SP used the SP’s personal cell phone number labeled “Wifey” on the SP’s contact information in the jail communication log to communicate via text message. The content of the text messages from September 26 to October 8, 2023, from the SP to the VA were not sexually explicit, however text messages between the SP and the VA indicated that P2 was aware of the continued contact between the SP and the VA. Text messages between the SP and the VA discussed the VA’s belongings still being at the facility and that the SP and P2 “missed” the VA. On October 3, 2023, the VA asked the SP, “Let’s say if my life were different would you have ever considered letting me take you out?” The SP responded, “Ask me that again on November 1,” and “our conversation will go a lot differently.” The VA asked the SP what that date, “November 1,” meant and the SP told the VA s/he would “explain soon.” On October 9, 2023, text messages between the SP and the VA included the SP saying s/he could “feel myself falling for you,” and the VA requesting a photo from the SP with the SP agreeing and responding, “Assuming I have to keep it PG rated lol.” From October 11 to 25, 2023, the text messages between the SP and the VA were sexual in nature referencing each other’s genitals and suggesting sexual contact. In addition, both the SP and the VA told each other, “I love you,” and that they wanted to “be with” each other. Documentation from the jail and the SP’s timesheets at the facility provided the following information: · Two jail lobby visits from the SP to the VA occurred on October 1 and 8, 2023, with another attempted lobby visit by the SP on October 22, 2023, but the SP was turned away for unknown reasons. · The SP and the VA had jail “web visits”; one on October 22, 2023, three on October 23, 2023, and two on October 24, 2023. · Between October 3 and 22, 2023, there were 11 deposits from the SP’s name into the VA’s texting fund account, totaling $300 from a credit card. · On October 3, 2023, a deposit of $80, was made, deposited by the SP into the VA’s jail canteen account. This was during the SP’s shift at the facility. · The SP and the VA had three phone calls, one each on September 29, October 3, and 17, 2023, during the SP’s work shift at the facility while the VA was in jail. · From September 29 to October 25, 2023, the SP and the VA exchanged a total of 218 text messages during the SP’s work shifts at the facility while the VA was in jail. The facility's Employee Conduct Policy stated that staff persons were to maintain therapeutic relationships with clients. Staff persons were to report to a supervisor any relationship that was developing beyond professional boundaries. Staff persons were to not give clients their personal information and were to not have contact with former clients for at least two years. All staff persons interviewed for this investigation were trained on the VA’s care plans and the Reporting of Maltreatment of Vulnerable Adults Act. Conclusion: It was reported that the SP and the VA had a relationship while the VA received services from the facility and then after the VA discharged from the facility. The SP worked at the facility from June 2022 to October 26, 2023. The VA resided at and received services from the facility from July 10, 2023, until September 22, 2023, when s/he was arrested and went to jail. Other concerns were reported that happened while the VA was not receiving services including that the SP bailed the VA out of jail, that the SP accepted the VA’s Social Security/Disability checks, that the SP and the VA communicated with one another via text message, and that the SP verbally abused the VA to the point that the VA was emotionally distraught and attempted to end his/her life. After the VA was discharged from the facility, while s/he was in jail the SP brought the VA his/her belongings, visited the VA in jail three times, and communicated with the VA via phone calls, text messages, and web visits. The SP deposited money into the VA’s phone, canteen, and texter accounts to fund this. Initially, the text messages from September 26 to October 8, 2023, from the SP to the VA were not sexual in nature, but text messages on October 3, 2023, discussed the VA asking the SP about dating each other if things “went differently” with the SP replying, “Ask me that again on November 1,” and “our conversation will go a lot differently.” On October 9 the content of the text messages began to be sexually explicit in nature, referencing each other’s genitals, suggesting sexual contact, and the SP told the VA that s/he “loved” the VA. Regarding Neglect: The VA told the CP that the s/he had an “emotional” relationship with the SP but did not provide further details about when this occurred. The VA told this investigator that there was no “sneakiness” with the SP and the VA while the VA was at the facility and that the SP was there to help the VA. The SP did not bail the VA out of jail and the VA’s suicide attempts occurred prior to the VA residing at the facility. The SP and the VA communicated via text message while the VA was in jail. The VA asked the SP to cash one of the VA’s checks and the SP did. Information showed that the SP crossed professional boundaries with the VA after the VA was discharged from the facility which was not behavior expected from a caregiver providing services in a program licensed by the Department of Human Services and a violation of the facility's policy. However, given that this occurred while the VA was not a client at the facility so not considered a vulnerable adult, that the SP denied outside contact with the VA while the VA was residing at the facility, that conversations suggesting the SP and the VA entered into a relationship occurred after the VA was discharged from the facility, and that there was no further information to confirm or dispute the VA and the SP beginning a non-professional relationship while the VA was a client at the facility, there was not a preponderance of the evidence whether the SP failed to provide the VA with reasonable and necessary care and services. 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). Regarding Sexual Abuse: Although the CP said the VA said the VA and the SP had an “emotional” relationship, given that when interviewed by this investigator, that the VA and SP both denied sexual contact with one another at any time while the VA was at the facility and after the VA left the facility, and that there was no further information to confirm or dispute that sexual contact occurred, there was not a preponderance of evidence whether the SP had sexual contact with the VA. It was not determined whether sexual abuse occurred (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). Action Taken by Facility: The facility’s Internal Review showed that their policies and procedures were adequate and followed. There was no need for additional staff person training. This incident was not similar to past incidents and corrective action was not needed. Action Taken by Department of Human Services, Office of Inspector General: The SP was regulated by a health-related licensing board so that board was notified of the information obtained for this investigation.
|
