External Program Review Committee (EPRC) agenda

Date: 2-4 p.m. May 4, 2023

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=m18725c4007b15e4c653d9dc3ddd2064a

Access code: 2486 040 8341

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 April and vote.

Guest speaker

Sherray Greene will share information about Minnesota’s Mobile Crisis Mental Health Services. The committee may want to consider adding information about these services to the PSTP template to ensure all teams are informed about these resources now that there is one centralized statewide call line.

Updates to share

Upcoming free trainings on positive support practices

· Audience: Lead agency staff, providers, direct care professionals and other interested parties.

· Event dates: April 27, May 26, June 8 and June 22, 2023.

· Summary: Join DHS and the University of Minnesota Institute on Community Integration for a series of free virtual trainings to help organizations implement positive support practices. Content is based on input from the positive support listening sessions held this past winter.

· AASD and DSD eList: Virtual training sessions about using positive support practices

Project ECHO virtual series: Telehealth to support families of children with behavioral health and mental health needs (12 sessions)

· Hear from and share with University of Minnesota hub team members in developmental-behavioral pediatrics, child and adolescent psychiatry, social work, early childhood intervention and special education. Topics to be covered include but are not limited to supporting children with challenging behavior, mood disorders, supporting healthy brain development, fetal alcohol syndrome, hyper activity attention disorder and autism spectrum disorder.

· Meeting registration - Zoom

Direct care workforce shortage

· The House and Senate continue negotiations on many workforce topics.

· A statewide campaign to recruit all types of direct care professionals is starting in June. Paid advertising will run through August. The materials being developed are designed in a way they can be used beyond the paid campaign period.

· Follow Your Heart to a Caring Career | CareerForce (additional resources will be added by June)

· Follow Your Heart to a Caring Career, Employer resources | CareerForce (additional resources will be added in May)

· Direct care professionals can now apply for the enhanced rate training and stipends, as well as retention bonuses.

· To apply and see details of qualifications about the PCA training and stipends, PCAs should go to https://www.minnesotadswtraining.com/.

· To apply for the retention bonuses and view qualification requirements and details, direct care professionals can visit Retention Bonuses | The Odyssey Group.

Subcommittee updates

Requests for approval subcommittee

This subcommittee continues to support teams with phasing out the use of mechanical restraint.

Emergency use of manual restraint subcommittee

· The committee learned about a new condition: Smith-Magenis syndrome - About the Disease - Genetic and Rare Diseases Information Center (nih.gov).

· An interesting article was shared with the committee: Thousands receive diagnosis after 60 new diseases found - BBC News.

Discussion

Review of annual recommendations

The committee recommends DHS and committee representatives work toward the following goals (in no particular order) in 2023 to reduce the use of restraint:

2023 Goal 1: Provide resources and guidance for improving communication skills

The committee recommends expanding their 2022 goal related to communication. The new goal is to share existing or create new resources or materials for teams on how to support people with developing additional communication skills. The target audiences for this goal are service providers, lead agencies, direct care professionals and families because all members of the team have a role in supporting effective communication. Additional communication skills can be helpful in giving people greater control over their services and improving health outcomes. Many people who fall within the EPRC’s purview, due to use of restraint by license holders, need support with developing additional communication skills.

2023 Goal 2: Simplify and organize online DHS materials and training resources related to positive supports or intervention services

There are many materials related to positive supports online, but the materials are scattered and numerous, and it can be unclear to service providers where to find information. There are also some gaps in the information. The committee recommends:

· Reviewing all DHS-owned positive support materials and related topics.

· Organizing the materials by topic and grouping related materials in fewer locations to reduce search times.

· Identifying the most helpful materials and removing less helpful materials to reduce clutter.

· Identifying gaps in resources and developing new materials as needed to fill those gaps.

The goal of this project is to provide clear and easily accessible guidance to providers so they have the tools and knowledge they need to support people using services with living their best lives.

2023 Goal 3: Explore ways to improve access to positive support services

Waitlists for positive support services continue to be long, often taking several months to start services. This can be a safety concern for people and their teams when the person is engaging in serious aggressive or self-injurious behaviors. The committee recommends DHS continue working towards increasing positive support service capacity.

2023 Goal 4: Support efforts to improve the direct care workforce shortage

While many people have high-quality positive support plans, it can take months or even years to find positive support specialists or other direct caregivers to implement the plans or to provide general care. Additionally, turnover in these positions is common. As noted for 2023 Goal 3, this can be a safety concern for people and their teams. The committee recommends DHS continuing to support efforts to address the direct care workforce shortage, particularly efforts to improve wages and benefits for professionals who provide day-to-day care that reflects the complexity and skill needed to do the job well.

Closing

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