External Program Review Committee (EPRC) minutes
Date: May 5, 2022
DSD liaisons: Stacie Enders and Linda Wolford
Type: Whole committee
Attendees: Jodi Greenstein, Dan Baker, Kim Frost, Tatiana Kerestesh, Mary Piggott, Lindsay Nash, Melanie Eidsmoe and Liz Harri
Not present: Stacy Danov, Danielle Bishop and Laura Daire
Agenda items
Public comments
There were no public comments during this meeting.
Vote
To approve the committee meeting minutes from April 2022:
· Jodi Greenstein: yes
· Dan Baker: yes
· Lindsay Nash: abstain
· Kim Frost: yes
· Tatiana Kerestesh: yes
· Liz Harri: yes
· Mary Piggott: yes
· Melanie Eidsmoe: yes
Updates to share
See the meeting agenda for more information.
Subcommittee updates
See the meeting agenda for more information. Discussion
· The committee continued reviewing Fredda Brown’s letter about the committee, the committee’s role, and how things have changed with Covid-19 and workforce shortage.o We’ve had some issues with providers reporting every use of PRN, even when not required to report, and being afraid to offer a PRN as prescribed.o We are working on a manual that will provide guidance on PRNs, chemical restraint, psychotropic meds, non-medical supports and much more.o We could think about in the future offering more guidance on chemical restraint and PRNs, though a lot will be covered in the manual.o How to communicate effectively with a psychiatrist: There are lots of good guidance tools, but psychiatrists may not be willing to read meeting minutes or other notes from teams.o We do not want to deny pharmaceutical support to people who use alternative forms of communication, such as challenging behaviors. o People need opportunities to make an informed choice.o Medical professionals need to take into account when a person cannot use words to communicate.o Appointments are often very brief and there’s a lot of information to convey – people might need to request more time with the doctor.o It’s important staff are trained on critical information to share with psychiatrists. A summary that provides essential information can be helpful. o We could target PRN and psych medication training to residential staff. o We should record the training, especially since there is high industry turnover. Recording visual and audio presentations right now isn’t an option, but should be available again in late summer.o It can be helpful to bring three copies of information – one for the nurse, one for the doctor and one to reference.o It’s important to look at medications in conjunction with non-medical positive behavior supports.· The committee developed guidelines for when to do in-person visits vs. virtual visits:o We will offer the person and their team a choice and consider the provider’s guidance.o We will keep in mind that for people who are medically fragile, bringing in COVID-19 could be dangerous to them. o We will consider a person’s housemates because COVID-19 could affect others in the house as well.o We will call the day of the visit to check that everyone is still healthy and comfortable with the visit.· The committee reviewed their subcommittee manuals for annual updates. The committee added the following content:o The committee’s guidelines on in-person vs. virtual visits will be added to the in-person instructions in both manuals. o The workforce shortage website will be added to the resources sections of both manuals.
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