External Program Review Committee (EPRC) minutes
Date: June 2, 2022
DSD liaisons: Stacie Enders, Linda Wolford and Ari Dionisopoulos
Type: Whole committee
Attendees: Jodi Greenstein, Lindsay Nash, Kim Frost, Laura Daire, Dan Baker, Melanie Eidsmoe, Susie Haben, Liz Harri, Stacy Danov and Mary Piggott
Not present: Tatiana Kerestesh and Danielle Bishop
Agenda items
Public comments
There were no public comments at this meeting.
Vote
Vote to approve the committee’s May 2022 meeting minutes:
· Dan Baker: yes
· Laura Daire: abstain
· Lindsay Nash: yes
· Stacy Danov: yes
· Mary Piggott: yes
· Liz Harri: yes
· Susie Haben: yes
· Kim Frost: yes
· Jodi Greenstein: yes
· Melanie Eidsmoe: yes
Updates to share
Direct care workforce shortage
See the meeting agenda for more information. Positive Supports Rule (PSR) 100 assessmentDHS is working with the University of Minnesota’s Institute on Community Integration (ICI) to gather information for this project and to plan for public information sessions and a survey. They will want feedback from a variety of interested parties. The survey is just one way they are gathering input. Subcommittee updates
See the meeting agenda for more information. Discussion
· The committee reviewed the positive supports data in the Minnesota Olmstead Subcabinet May 2022 Quarterly Report. The state is not meeting the mechanical restraint goal, but using an aggregate form count for this data measurement does not show reductions in restraint duration or uses. The data can vary dramatically between quarters since mechanical restraint is only being used with a very small number of people. Since those cases are already closely monitored and assisted by experts in positive supports, it might make more sense to develop a different measure. · The committee reviewed recommendations from their most recent annual evaluation report and made the following comments: o The committee would like to see Technology for Home or similar services available to more people, particularly all people who need additional support with communicating. While technology devices alone can be very helpful to some people, for others, use of technology requires ongoing training, follow up and a hands-on approach to determine the right type. Creativity, flexibility and trying different things has been helpful to teams.o There was nothing new to share on this topic in June. o The committee would like to see increased access to telehealth and remote supports, as well as training and assistance when needed to address barriers to or knowledge gaps for using these types of supports. It might be helpful to providers to explore creative ways of using telehealth, particularly in relation to staffing shortages. Use of remote supports might lessen the need for in-person staff, and might help retain staff that would like the option to occasionally work from home. People should be given opportunities to try these supports before making a decision, and teams should collect data during that time to see what does and doesn’t work. Some people prefer more independence and engage in fewer interfering behaviors when given opportunities to be independent. a. DHS created a webpage with examples of remote support services: Remote support service functions.b. In June DHS will be sending out a direct support professional news announcement that will suggest exploring remote support opportunities as a way to not only offer different service options to people who use services, but also as a way to retain staff by giving them occasional opportunities to work from home. o EPRC members will increase their in-person or remote technical assistance with service providers who are using restraint. When determining which approach to take, members will use the least intrusive and most valuable approach to the entire team. a. Last month the committee developed guidelines for in-person meetings and added those to the committee manuals.b. In July, Stacie will share with the committee the most recent guidelines. Members are welcome to contact her sooner if they need to do an in-person meeting before July. o The committee recommends DHS do what is feasible to build capacity and ensure that qualified professionals are competent to develop and implement positive support transition plans (PSTPs) and other relevant support documents. a. People have asked for training on how to do PSTPs – DHS did a training like that but didn’t record. We should do it again and put the recording in TrainLink. We would like to do an inventory of trainings available to Minnesota providers and then develop a series of trainings on topics that might need more information, such as PSTPs and quality-of-life supports, psychotropic medication management, crisis management using positive supports, etc. DHS will start that work sometime later this year. EPRC members are welcome to help in creating those training videos. b. We are looking at the possibility of merging crisis, positive support and specialist services to make those services more available to a wider audience of people, to make them easier to understand and to ensure providers implement necessary supports in crisis settings. c. There is an upcoming training related to this topic. Here is the announcement: Virtual Training: When It's Time to Fade: Supporting People with High Risk Behaviors - NADSP. “This three-hour training session focuses on the very important topic of how to safely and effectively reduce restrictions and increases opportunities for individuals with intellectual or developmental disabilities (I/DD) who have histories of high risk behaviors. Often, direct support professionals are called upon to provide excellent support and supervision, in all types of settings, for individuals with I/DD who have histories of serious maladaptive behaviors such as severe aggression, sexual offending or fire setting. Often, as part of their support and supervision, these individuals are subject to certain restrictions, enhanced supervision or limitations on opportunities. But enhanced supervision is very expensive and we certainly do not want to subject individuals to restrictions any longer than is necessary. The question then becomes, ‘How do we fade restrictions, enhanced supervision or limits on opportunities while at the same time maintain our commitment to the safety of the individuals, staff and the public?’” o The committee recommends that DHS look at existing studies, or conduct a study if needed, on barriers that prevent the development and successful implementation of effective positive behavior supports as they relate to positive support plans.a. There will be several questions in the upcoming ICI survey that will collect information on this topic – thank you to Mary Piggott for coordinating that.
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