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External Program Review Committee (EPRC) agenda

Date of meeting: 2-4 p.m. Sept. 2, 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 prior to 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 August and vote.

Updates to share

Direct care workforce shortage

Providers who are struggling to find staff for people who engage in interfering behaviors should consider expanding their licenses to become providers of Waiver Positive Support Services because they can then hire (or train their existing staff to be) Positive Support Specialists. Specialists can be paid higher wages than non-specialist staff. They work directly with the person needing supports to implement the positive behavior support plan, and they provide ongoing training and supervision of other staff. The provider would also need to hire a Positive Support Professional to oversee the work of the specialist, and businesses should keep in mind that the professional can also work with people served by other providers, giving the organization an opportunity to expand their business. EPRC members are encouraged to share this idea with service providers.

Subcommittee updates

· Requests subcommittee:

o One of the providers they have been working with for many years successfully phased out the use of a vehicle harness.

o They are sadden to report two people recently passed away due to illness.

· Emergency Use of Manual Restraint (EUMR) subcommittee: this subcommittee continues to provide technical assistance to service providers on phasing out the use of restraint and improving quality of life.

Free training opportunities

· The Use of Certified Community Behavioral Health Clinics (CCBHCs) as a Diversion Strategy: “Join us as we look at how a Demonstration CCBHC has implemented diversion strategies for people in crisis to decrease emergency department visits, decrease inpatient stays, and divert individuals from involvement with the criminal justice system. In this webinar you will learn about the relationships and communication processes this CCBHC has built with external entities such as hospitals and the police force. You will hear about the proactive steps the agency is taking, such as delivering “crisis intervention training” to the police and conducting primary care screening and monitoring for the clients they serve. And finally, agency leadership will share how they established relationships with social service agencies to mitigate social determinant of health issues for an individual that can contribute to increased ED visits and potential behavioral health crises.”

· MN DHS DirectCourse Online Learning Platform – Info Session: “The DirectCourse online training platform is available to all Minnesota Home and Community Based service providers, individuals and families who self-direct supports, DHS, County and Tribal staff. Please join us on September 22, 2021 at 10am CST to see a live demonstration and learn about the customizable online training available to meet regulatory requirements and advanced development frameworks…”

Discussion

New psychotropic medication manual for 245D service providers

The committee will review and edit a draft of this webpage/manual during the meeting. When the review is complete, it will be sent to Communications for publishing. See the meeting attachments for more information.

Review of Behavior Intervention Reporting Form (BIRF) data

The committee will review Positive Supports Goal One, Goal Two and Goal Three within the Quarterly Report on Olmstead Plan Measurable Goals, Data acquired through Jan. 31, 2021.

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)