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External Program Review Committee (EPRC) agenda

Date of meeting: 2-4 p.m. on August 5, 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 June (the July meeting was cancelled) and vote.

Updates to share

Direct care workforce shortage

The Disability Services Division has been working to better coordinate on workforce shortage issues. Recently the division has:

· Developed communications plans for five target audiences (service providers, lead agencies, people receiving services and families, direct support professionals and the general public)

· Explored promising practices to address the shortage

· Continued reviewing project proposals

· Met with other states to learn about best practices related to training and data (each month the meeting host, the Centers for Medicare and Medicaid Services (CMS), prepares a different topic)

· Reviewed webpage content for public posting

· Started reviewing labor market data submitted by service providers

New psychotropic medication manual for 245D service providers

The draft has been reviewed by other DHS divisions and licensed professionals who are familiar with medication administration. A draft will be ready for committee review in September.

Positive Support Transition Plan (PSTP)-related documents

· The quality checklist revisions have been submitted to Communications.

· The PSTP example is still under development. A draft will be ready for committee review before the end of the year, likely in October.

Intervention services

Disability Services staff will be doing a regional training on intervention services in August with providers and lead agencies.

BIRF 2.0

The form is mostly complete, with only a few revisions remaining. The next big step is to program the account creation, account deactivation, and security processes and settings to protect private information. Once the form features are developed, extensive testing will be necessary with the help of the EPRC and service providers. The go live date is set for December 2022.

Subcommittee updates

· Subcommittee meetings will no longer have public portions. All public business must now be discussed during whole committee meetings.

· The Requests subcommittee continues to check in with teams and to provide technical assistance.

· The Emergency Use of Manual Restraint (EUMR) subcommittee recommended discussing children in crisis, as noted in the next section.

Discussion

Children in crisis

DHS staff will share an update on what they are seeing and some of the steps being taken to address the problems.

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.

· Apps and social media can be helpful for supporting people in finding other people who share their interests near their community. Here is one example (posted on the MN Disability Hub) EPRC members can pass along to the teams they are supporting: Meetup - We are what we do

· 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).

· Several law changes were recently made related to telehealth. See lines 210.1, 228.8, and 228.21 of the HF 33 2nd Engrossment – 92nd Legislature, 2021 1st Special Session Bill Text for more information.

Community-Based Services Manual (CBSM)