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External Program Review Committee (EPRC) agenda

Date: 2-4 p.m. on June 1, 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: Webex
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 May and vote.

Guest speakers

· Nicole Berning will share an overview of the Early Intensive Developmental and Behavioral Intervention (EIDBI) Benefit and what they are currently working on.

· Eileen Kelly will present on efforts to support people with traumatic brain injuries. (3 p.m.)

Updates to share

Direct care workforce shortage

The Positive Support Services rate increase did not pass, but DHS might request it again in the next legislative session.

However, many other changes passed that will affect the direct care workforce shortage. DHS will provide a full list of changes with links to more information in August or September. Here is a small sample of some changes:

· The HCBS Workforce Development Grant is now available to more direct care professionals.

· The employee-owned cooperatives project received an extension through June of 2025.

· Many different services received rate increases, and Respite Services were changed from a framework rate to a market rate.

DHS will start gathering feedback from interested parties on intervention services, as part of a study that passed during the session. The goal of the project is to expand capacity, improve quality and expand access to people who need the services but who do not currently qualify for them.

Subcommittee updates

Requests for approval subcommittee

This subcommittee continues to support teams with phasing out the use of mechanical restraint, but is struggling to communicate with a provider that is short-staffed.

Emergency use of manual restraint subcommittee

This subcommittee is in need of additional committee members. Several people have submitted applications and are currently being reviewed by DHS.

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:

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

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

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

o 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 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.

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