External Program Review Committee (EPRC) minutes
Date of meeting: April 1, 2021
DSD liaisons: Stacie Enders and Linda Wolford
Type: Whole committee
Location: Remote only due to the COVID-19 health pandemic
Attendees: Kim Frost, Dan Baker, Liz Harri, Jodi Greenstein, Lindsay Nash, Laura Daire, Tatiana Kerestesh, Melanie Eidsmoe and Mary Piggott
Not present: Mike Boston, Susie Haben, Stacy Danov and Danielle Bishop
Public comments
There were no public comments during the meeting.
Vote
The committee will discuss the minutes from March and vote.
· Kim Frost: yes· Dan Baker: yes· Liz Harri: yes· Jodi Greenstein: yes· Lindsay Nash: abstain· Laura Daire: yes· Tatiana Kerestesh: yes· Melanie Eidsmoe: yes· Mary Piggott: yesNotes
· The committee went through the items listed on the meeting agenda. · Committee members were encouraged to reach out to people who may need assistance with scheduling a vaccination. · The committee is looking at ways to measure effective provider efforts, instead of only collecting data on negative things such as incident reports, service terminations, use of restraint, etc. o The committee could consider tracking quality of life information and desired alternative behaviors. It might help to look at if there is a difference in BIRFs from the old form to the new form. o Is quality of life being addressed better now with the new template? The committee could consider doing a random data pull to look at content changes the quality of life section. Dan Baker volunteered to help with that. However, providers have until the end of this year to switch to the new template, so we may not have access to this data for a while. o In the quality of life section, did the provider list something beyond freedom from challenging behavior? That section of the plan should include ideas from the person and reflect what they find important. o Committee members will need more time to think about this topic and to develop parameters.o Do providers have proactive strategies listed in the plan, instead of only reactive strategies?o Does the provider have a plan for teaching skills?o Is the provider using other positive supports?o How can we collect data efficiently? How will we use the data? o A small number of the new plans have been submitted with desired alternative behaviors that do not match the function of the behavior, specifically, plan authors have written things in the desired alternative behavior section like: the person will not engage in the interfering behavior. While that is certainly ideal, it does not address the function/reason for the behavior and is therefore unlikely to occur. Committee members may need to watch for content like that in the desired alternative behavior section of new plans and provide follow up to plan authors. · The committee reviewed the 2019-2020 EUMR Subcommittee Instruction Manual. There were no recommendations for changes. · Committee members were encouraged to attend and invite others to the upcoming webinar with MN-NEAT. MN-NEAT was developed in 2015 with a mission to educate people about assistive technology and how it can improve quality of life. On April 22 they will be hosting a webinar on smart home technology. See the DSD eList announcement for more details. · It was acknowledged that everyone continues to do the best they can in a difficult year. · The increased focus this past year on quality of life has been fantastic. There also seems to have been an increase in awareness and consideration of mental health. As a society we are becoming more aware of how much people need each other and how challenging loneliness can be. · The committee reviewed their 2020 Olmstead recommendations:
1. Recommendation: 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. a. Some parents may need more information about positive supports. Committee members were encouraged to share resources they have given to parents whose children receive community residential services, to help them understand positive supports. Members shared they mostly address this through conversation, as opposed to a handout, but they will do some searching for resources. 2. Recommendation: The committee continues to recommend helping service providers connect with other professionals that can inform supports and services.a. It is helpful to look at supports, beyond just Positive Support Services, that are specific to the person’s needs. This could include specialists such as trauma therapists, occupational therapists, art and music therapists, animal therapy, communication professionals, etc. 3. Recommendation: 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. a. DHS saw Behavior Intervention Report Forms go down for some people during Covid-19 because they enjoyed staying home more. Plan authors should ensure quality of life goals are specific to that person, and not based on our own values. 4. Recommendation: 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.a. Care teams should focus on quality of life too, instead of primarily focusing on the quantity of behaviors. They should ask: what matters to the person?5. Recommendation: 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. a. We will mention in our 2021 Olmstead report that we switched to virtual meetings due to Covid-19. 6. Recommendation: 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).
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