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External Program Review Committee (EPRC) agenda

Date of meeting: 2-4 p.m. on April 1, 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) 508-2321.

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 March and vote.

Updates to share

Covid-19 vaccination

· Everyone is encouraged to reach out to people who may need assistance with scheduling a vaccination. See more information in the eList announcement Make a plan for your vaccine and plan to help others who may need help!

· Some people had success scheduling vaccines by logging into their health care portals.

Updates from the subcommittees

· Pending the development of the new Behavior Intervention Report Form system, the EUMR subcommittee is considering tracking 4 or 5 positive things providers are doing. The subcommittee hopes to have a more balanced approach to how we look at provider efforts, instead of only collecting data on negative things such as incident reports, service terminations, use of restraint, etc.

· There have been several incidents related to how staff respond to behaviors resulting from household task demands.

o Committee members can start conversations by asking the provider why household cleanliness is a priority. Do they feel pressure from others to keep homes a certain way? What is the story behind the task demand? After getting more information, subcommittee members could then offer some suggestions.

o During Covid, everyone might be paying more attention to cleanliness.

o Sometimes direct care staff need additional training to shift their focus from a parenting approach, to a staff/paid caregiver approach. It can take time to change that mindset.

Discussion

Annual update and clean-up of EPRC documents

The committee will review one item or topic per month until everything is updated for 2021. This month’s topic: updates to the 2019-2020 EUMR Subcommittee Instruction Manual.

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 – see the next page.

Recommendations made by the committee in their 2020 Olmstead report:

· 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).

Community-Based Services Manual (CBSM)