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External Program Review Committee (EPRC) agenda

Date: 2-4 p.m. Dec. 1, 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: Webex

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 the last meeting and vote.

Updates to share

Direct care workforce shortage

· DHS staff are awaiting feedback on legislative budget bills and drafted language. Policy bills are currently being assembled by the Revisor’s office.

· ACL Launches National Center to Strengthen the Direct Care Workforce: This initiative will provide technical assistance to states and service providers, and facilitate collaboration with stakeholders to improve recruitment, retention, training and professional development of the direct care workers who provide the critical services that make it possible for people with disabilities and older adults to live in their own homes and communities.

· The National Governors Association published a new report: Addressing Wages of The Direct Care Workforce Through Medicaid Policies

Projects and initiatives mentioned in other meetings continue to move forward, even if an update is not listed here. Updates will be generally limited to new information only.

Subcommittee updates

Requests for approval subcommittee

This subcommittee discussed a recent regional lead agency meeting that one of the DHS members attended. Topics discussed at the lead agency meeting include:

· A man has been living in a hospital for a while now partly because his team members thought restraint can never be used by 245D-licensed providers.

· DHS staff explained the 11-month phase out option outlined in statute and shared the work of the EPRC. It was explained that a need for restraint to protect a person from harm should not result in a person living in a hospital instead of a community-based setting.

· DHS staff also talked about how teams need to work on phasing out the use of restraint or rights restrictions, but that the timeline for reduction varies from person to person due to individual support needs.

Emergency use of manual restraint subcommittee

This subcommittee noted that many of the teams they are working with are making progress with phasing out the use of restraint and improving quality of life.

Discussion

Updating online materials for service providers

The inventory list is not quite ready yet so the committee will look at this in 2023.

Review of annual recommendations

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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