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External Program Review Committee (EPRC) agenda

Date of meeting: 2-4 p.m. Nov. 4, 2021

DSD liaisons: Stacie Enders, Linda Wolford and Ari Dionisopoulos

Type: Whole committee

Location: Remote only due to the COVID-19 health pandemic

Accommodations: If you need an accommodation for this meeting, you must notify a DSD liaison three days before the meeting by emailing PositiveSupports@state.mn.us or calling (651) 431-4300.

Common acronyms used by the committee

We ask committee members to avoid the use of acronyms. Here are common acronyms:

· BIRF: DHS form 5148: Behavioral Intervention Report Form

· CABC: Context, antecedent, behavior, consequence

· DHS: Minnesota Department of Human Services

· DSD: Disability Services Division

· EUMR: Emergency use of manual restraint

· FBA: Functional behavior assessment

· HCBS: Home and community-based services

· IRP: Interim Review Panel (Predecessor to the EPRC)

· MDH: Minnesota Department of Health

· PS Manual: DHS form 6810C: Guidelines for Positive Supports in DHS-Licensed Settings

· PSR: Positive Supports Rule: Minnesota Rule 9544

· PSTP: DHS form 6810: Positive Support Transition Plan

· RA or Request: DHS form 6810D: Request for Authorization of the Emergency use of Procedures

General reminders for committee members

· Before speaking, please state your name.

· Committee members are expected to:

o Be on time

o Read the minutes, agenda and supporting documents before each meeting

o Participate in ideas and conversations, as well as pause to allow others to share input

o Commit to spending the whole meeting time present and not engage in other activities during the meeting.

Technology

The first few minutes of every meeting will be dedicated to addressing any connectivity issues, to ensure everyone can hear other meeting participants.

Agenda items

Public comments

The committee encourages public participants to share their thoughts and ask questions about committee activities at the beginning of each meeting. The committee will continue on to the next agenda item when either 1) 30 minutes have passed or 2) when there are no additional comments or questions, whichever comes first.

Vote

The committee will discuss the minutes from October and vote.

Updates to share

Direct care workforce shortage

In January the Department of Employment and Economic Development (DEED) will be highlighting healthcare careers, including direct support professional positions. DHS will be helping with that campaign.

DEED reported that more Minnesotans have recently returned to work:

· Minnesota’s unemployment rate ticked down one-tenth of a percentage point to 3.7% in September due to people moving out of unemployment and into employment.

· Minnesota’s labor force participation rate inched up one-tenth of a percentage point to 67.9%.

Subcommittee updates

Requests for approval subcommittee:

· Their caseload has been mostly consistent for a while now. They have seen a reduction in requests but the reasons vary and include death, loss of provider services, change in providers, successful phase outs, and device modifications.

· This subcommittee welcomes the other subcommittee to ask what they would like to know about this group.

· This subcommittee has found it is helpful to review the good intention of the Positive Supports Rule when meeting with care teams. Sometimes the paperwork requirements can distract from the intent of the rule. The committee could consider making a recommendation to discontinue duplicative paperwork requirements that are not required in rule or statute.

Emergency use of manual restraint subcommittee:

· They continue to follow up with teams on the use of restraint and quality of life.

Discussion

New psychotropic medication manual for 245D service providers

The committee was unable to finish their edits at the last meeting and will continue their review at the November meeting.

Review of the committee’s 2020 Olmstead recommendations

Committee members will review their 2020 Olmstead recommendations and consider if there are any additional steps that can be taken each month to achieve them:

· The EPRC recommends continuing the past recommendation to collaborate and build connections with expanded support teams, so committee members can continue to assist with the development of effective fading plans on mechanical restraint, emergency manual restraint and other targeted interventions listed in PSTPs.

· The committee continues to recommend helping service providers connect with other professionals that can inform supports and services.

· As opportunities for edits arise, it might help to review public communication related to increasing community participation/integration, to better communicate that community activities and interactions with other people should not be forced on a person, and to better communicate that community integration efforts should meet the preferences of the person.

· The EPRC recommends continuing to focus their technical assistance on each person’s wellness and quality of life. Improved quality of life has been shown to reduce the occurrence of interfering behaviors.

· When it is safe to do so, given the Covid-19 risk, EPRC members will increase their in-person technical assistance to service providers who are using mechanical restraint.

· The EPRC recommends continuing to offer service providers, beyond the end of the Covid-19 pandemic, the ability to connect with committee members and other support providers or team members electronically, using secure communication tools. These tools have a variety of benefits including access to expertise for people who live in remote areas, quicker response times, and flexibility for team members (such as family members) who might not have easy access to transportation (note: this is not a comprehensive list of all the potential benefits).

Closing

· Committee members are welcome to share additional information and discuss.

· Members are invited to recommend topics for upcoming committee meetings.

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Community-Based Services Manual (CBSM)