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External Program Review Committee (EPRC) agenda

Date: 2-4 p.m. Aug. 4, 2022

DSD liaisons: Stacie Enders, Linda Wolford and Ari Dionisopoulos

Type: Whole committee

Location: Room 2222, Elmer L. Andersen Building, 540 Cedar St., St. Paul, MN 55101

Meeting link: https://minnesota.webex.com/minnesota/j.php?MTID=m4979e1ff1145edb3178fc70a84446e64

Access code: 2480 111 4554

Accommodations: If you need an accommodation for this meeting, you must notify a DSD liaison three days before the meeting. Email PositiveSupports@state.mn.us or call (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

· DEED: Minnesota Department of Employment and Economic Development

· DHS: Minnesota Department of Human Services

· DLI: Minnesota Department of Labor and Industry

· DSD: Disability Services Division

· DSP: Direct support professional

· 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

· PCA: Personal care assistant

· PSR: Positive Supports Rule: Minnesota Rule 9544

· PSTP: DHS form 6810: Positive Support Transition Plan

General reminders for committee members

Before speaking, please state your name. Committee members are expected to:

· Be on time

· Read the minutes, agenda and supporting documents before each meeting

· Participate in ideas and conversations, as well as pause to allow others to share input

· 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 July and vote.

Updates to share

Direct care workforce shortage

· We will publish a request for proposals this month for a vendor to administer the workforce shortage grants that will, for direct care workers that make 200% or less of the federal poverty level, cover:

o The cost of trainings and employee time for the PCA enhanced rate program.

o Bonuses for direct care workers who have worked in the profession for at least two years with the same employer.

· We are developing the application form, data tracking sheets and advertisements this month for the employee-owned cooperatives grant project. The application will likely be open to the public starting in September.

· We are sending a survey to community residential settings to gauge what is happening across the state regarding workforce issues.

· The Institute on Community Integration, Human Services Research Institute and National Association of State Directors of Developmental Disabilities Services published a report: Community Supports in Crisis: No Staff, No Services.

Minnesota joins other states to roll out 988 mental health crisis lifeline

Starting Saturday, July 16, people facing a mental health crisis can dial 988 to connect to support. The change is part of a nationwide effort to transition the National Suicide Prevention Lifeline to a phone number people can more easily remember and access in times of crisis. The shift also includes an online chat feature and new texting option.

The new 988 dialing code will serve as a universal entry point, so people can reach a trained crisis counselor who can help regardless of where they live. Anyone can dial or text 988 24 hours a day, seven days a week, to reach crisis support or to use an online chat feature to connect with crisis support. People can also dial 988 if they are worried about a loved one who may need crisis support.

The Lifeline 10-digit number, 1-800-273-TALK (8255), will continue to be available and will route people to the same resources. People should call 911 if they suspect drug overdose or need immediate medical help.

Suicide is a serious and growing public health concern across the United States and in Minnesota. The number of suicide deaths and the suicide rate in Minnesota has increased consistently for 20 years.

Moving to a shorter dialing code is an important step to help reduce suicide, and it is part of a larger push to improve options for Americans facing a mental health crisis. In moments of crisis, it can be challenging to look for resources or even just remember what number to call.

About 988 in Minnesota

The Lifeline is a national network of more than 200 call centers. Minnesota has four Lifeline centers that connect callers to nearby or state-specific resources and services quickly and efficiently.

Minnesota calls may be routed to the Lifeline’s national backup centers when the four call centers are at capacity. The National Suicide Prevention Lifeline has several backup centers that answer the overflow of calls from across the country. This will not change level of service.

Interpretation services are available through calling the number. Currently, chat and text are only available in English.

To reach the Veterans Crisis Line, dial 988 and press 1. Calls will route to the same trained Veterans Crisis Line responders. The Veterans Crisis Line will still be available by chat (VeteransCrisisLine.net/Chat) and text (838255).

Subcommittee updates

Requests for approval subcommittee

This subcommittee is offering, but not requiring, an informal in-person visit with people and their teams since the subcommittee hasn’t seen them in a while.

Emergency use of manual restraint subcommittee

This subcommittee was happy to see a team working with new neighbors on how to respond to a person. Another team successfully phased out restraint after helping a person move to a new home.

Discussion

The committee will review recommendations from their most recent annual evaluation report:

· 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.

· 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 may 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.

· 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.

· 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 and other relevant support documents.

· 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.

Closing

Members are invited to share additional updates and to recommend topics for upcoming committee meetings.

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