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’s 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.  

When 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’s 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’s mother wasn’t comfortable with her returning at that time.  The individual’s 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’s 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.  

Staff reported that the provider’s management team was involved with the termination notice and issued the termination in accordance with policy/rules.  No previous terminations were noted.   
