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External Program Review Committee (EPRC) agenda

Date: 2-4 p.m. on Nov. 2, 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 and vote on the minutes from October.

Updates to share

Direct care workforce shortage

· Driver’s License for All began Oct. 1: The Driver's License for All law now allows Minnesotans to apply for a standard class D instruction permit, driver's license or a standard identification card without the need to show proof of legal presence in the United States. The driver’s license manual for the written exam has been translated into multiple languages, which you can find on their website, and the written exam will be available in eight languages at Department of Vehicle Services locations. An estimated 81,000 Minnesotans are now eligible for a driver's license with the law going into effect. This new law will help make the roads safer for everyone by providing a legal path for more drivers to learn how to operate a vehicle safely and become properly certified to drive. It will also help New Americans who don’t currently have access to a driver’s license be able to legally drive to good employment further away from home, buy car insurance and open a bank account, among other positive changes.

· The request for proposals (RFP) for the Long-Term Care Workforce Incentive Fund (WIF) administrator is now posted: The fund will provide annual incentive payments to recruit or retain direct care professionals in the long-term care field. DHS is seeking a qualified vendor to administer the fund.

· DHS issued a request for information (RFI) to gather information from organizations that work with new Americans: GEAR is interested in understanding organizations’ activities, relationships and experiences in assisting new Americans. Specifically, the GEAR team would like insight into how organizations support new Americans in securing employment, undergoing training and accessing education as they transition and build their lives in their new country. GEAR is collecting this information as they prepare to issue a request for proposal (RFP), which is made possible by recent action by the Minnesota Legislature. The funds will help provide specialized services and supports to new Americans to enter and maintain employment in the long-term care workforce.

· Creation of the Office of New Americans within the Department of Employment and Economic Development (DEED): Immigrants are an important group that support the direct care needs of Minnesotans. While immigrants make up 16 percent of the total labor force, they constitute 31 percent of the home care workforce, 22 percent of the residential care aide workforce and 22 percent of the nursing assistant workforce (source: PHI Direct Care Workers in the United States 2022). The Office of New Americans will foster immigrant and refugee inclusion in the workforce. For more information, see June’s Immigrant and Refugee Affairs Forum Highlights Legislative Outcomes, Caring Career Employment Opportunities, Public Safety Language Tool and More.

· New earned sick and safe time law: The Minnesota Department of Labor and Industry (DLI) has added an FAQs: Earned Sick and Safe Time webpage about the new earned sick and safe time law, which goes into effect Jan. 1, 2024. Questions and answers include example scenarios and different options employers may take to implement the law in their workplaces, including accrual, front loading and carryover provisions. DLI also posted a new Minnesota's Earned Sick and Safe Time video that gives an overview of the earned sick and safe time law. The video is also available in Somali and Spanish versions.

· Paid family and medical leave insurance for workers: Paid Family and Medical Leave is a new program launching for Minnesotans in 2026. It provides paid time off when a serious health condition prevents someone from working, when a person needs time to care for a family member or a new child, for certain military-related events or for certain personal safety issues. For more details, visit the Paid Family and Medical Leave website.

Subcommittee updates

Requests for approval subcommittee

This subcommittee received a new request this month and will be closing this meeting early to discuss.

Emergency use of manual restraint subcommittee

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

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 toward increasing positive support service capacity.

The Request for Proposals (RFP) for the Intervention Services Study has been posted online. The deadline to apply is Nov. 27, 2023. The RFP can be found on the Minnesota Supplier Portal webpage under “Bidding Opportunities” and then “Minnesota’s Commitment to Diversity and Inclusion.”

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.

Closed discussion

The subcommittee that reviews requests for approval will hold a closed discussion to review a new request.

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