The County’s inability to support the alternative plan was influenced by the plan’s 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’s specific situation.
The provider’s 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. 
The uncertainties surrounding the pandemic were influenced by ongoing changes to requirements and timelines that were demonstrated by ongoing changes in the Governor’s orders.