Acute Care Advisory Council

Nov. 6, 2023

Draft minutes for council review

Members and participants

Council members present: Laura Arnold, Carol Backstrom, Randy Baumgard, Joshua Berg, Tom Delaney, Sheila Grisim, Brad Johnson, Natasha Merz, Nicole Muchek, Sara Nelson, Susan Pleasants, Jessica Simacek, Cindy St. George, Simon Warren

Council members absent: Jodi Donnay, Darringer Funches, Tim Middendorf, and two members as yet unassigned

Additional participants: Commissioner Harpstead, Stacy Danov (DHS), Dani Dunphy (UMN ICI facilitator), Rachel Freeman (UMN ICI facilitator), Margaret Moore (UMN ICI facilitator), Jennifer Jeffrey-Pearsall (UMN ICI facilitator), Amy Peterson (DHS), Rebecca (Becky) Melang (DHS), Tiffany Whitebird

Open meeting

1:00 p.m. waiting room participants entered the virtual meeting room.

Introductions and start of meeting

At 1:01 p.m., Rachel Freeman announced there would be recording and that we would start shortly.

At 1:03 p.m., Rachel Freeman provided a second recording announcement, recording begins.

At 1:04 p.m., Meeting convened.

Review agenda

Rachel Freeman started the meeting as facilitator. She described her role as facilitator, and shared the agenda outline. Both Commissioner Harpstead and Assistant Commissioner Merz were in attendance. Rachel Freeman introduced the other facilitators, Jennifer Jeffrey-Pearsall, Dani Dunphy and Margaret Moore as note taker. Stacy Danov from DHS was introduced as assisting with coordination (agenda is available online). The agenda was modified to provide time for Commissioner Harpstead to speak.

Introductions by commissioner

Commissioner Harpstead described how the Acute Care Transitions Advisory council that starts today is related to a priority admissions task force that the commissioner chairs with Attorney General Keith Ellison. Both groups are focused on supporting people as they move from hospital settings into the community. Commissioner Harpstead said, “It's going to take the whole community working together across all different sectors to figure out how to help people move from hospitals to appropriate community-based settings.” It is also likely that the recommendations from both the task force and this council will overlap since the task force is focused on behavioral health hospitals system run by the state. The commissioner described the work of the Department of Human Services (DHS) in finding and allocating funds to address this immediately while both the task force and this advisory council puts together more formal recommendations for moving forward.

Purpose of the council

Assistant Commissioner Merz summarized the information we have about barriers to transition into the community and the scope and scale of the work. The assistant commissioner pointed out that “We're also a very big state, very diverse state, and the resources available in one community or region may not be available in a in a different community or region.” This suggests that there needs to be a way to consider regional aspects needed in the recommendations that are made. The presentation shared included data that come from different systems that are reporting some of the most common concerns associated with children and adults experiencing long hospital stays. The lack of a unified way to measure the problem related to effective transitions was mentioned. Assistant Commissioner Merz talked about the need for a baseline understanding of who is experiencing barriers when transitioning back into the community. The major goal of the council is to gather information and summarize key recommendations for addressing systemic issues, measurement, policy, training, implementation, coordination and financial issues that can be targeted for change to improve outcomes for children and adults who experience barriers to transition back into the community (Presentation slides available online).

Council introductions and expectations for meetings

The next activity for the council members was led by Jennifer Jeffrey-Pearsall who asked members of the council to describe who is in the room, what voices and regions are represented by council members. The activity was placed on a Jamboard (an online program for collaborative writing) to support brainstorming and document the conversation by council members.

Council procedures

A question about council procedures was raised by Rachel Freeman. In particular, the question posed to the council was whether to make decisions using Robert’s Rules of Order as the format for council communications. General consensus among council members was that using Robert’s Rules of Order or key elements of the Robert’s Rules system is a necessary part of all future meetings to assure procedural and equitable decision making. Robert’s Rules were employed after this point as a “pilot” during the rest of the meeting.

There is an action requiring the facilitators to seek out information about what would constitute a quorum by the next meeting.

Another action is requesting that the facilitators make a fidelity list of key elements from Robert’s Rules to share with the council at the next meeting.

Use of designees

Members of the council discussed the desire to identify designees if the identified council member for the seat is unable to attend a meeting.

Motion: Brad Johnson moved to approve that the council be given the authority to send designees to vote if a council member needed to be absent.

Second: Sheila Grisim seconded the motion

Discussion: Voting participants need to be informed on the information about the vote.

Vote: Passed, 11 yes, 1 abstain

The facilitators will work with DHS to confirm that the designee motion can be finalized.

Learning more about members

Dani Dunphy led the next discussion that focused on why the acute care transitions topic and council work is important, and asked council members what information and expertise or experience each member brings to this work. People shared their perspectives using Jamboard.

Assigning the council chair

The topic of selecting a chair to help focus this work was the next agenda item and flowed also from the conversation about experience and perspective. The idea of a co-chair was discussed.

Motion: Sheila moved to nominate Josh as the chair of the council.

Second: Cindy St. John seconded the motion.

Discussion: None.

Vote: Passed,11 yes, 1 abstain.

Motion: Jessica Simacek moved to approve Laura Arnold as the co-chair of the council.

Second: Sheila Grisim seconded the motion.

Discussion: To use the process of roll call for voting

Vote: Passed, 11 yes, 1 abstain.

Discussion

The council discussed the types of communications that become public record and whether this meeting process would be open via streaming video.

An action for the facilitators is to seek clarification about the posting and feedback including all legal requirements and to set up next meetings accordingly.

Included in this discussion was the need to clearly determine our target audience(s) across population type and topic areas. The group talked about systemic issues and policies needed to ensure intervention strategies that reflect positive supports are made available across the state. The group determined that data are needed to drive these decisions.

Vision

The final activity was facilitated by Jennifer Jeffrey-Pearsall. Council members were asked to envision what the world would look if the concerns shared in the last activity are resolved. Council members created the vision on Jamboard to help guide both the definition of the problem and in order to know what it would look like to resolve all barriers and concerns.

Preparing for next meeting

The council discussed next steps and a plan for scheduling the next meeting.

The council was invited to share potential reports, summarized data, (de-identified) stories and representations of experience using multiple data sources as a way for council members to begin gathering information. All members are asked to bring examples/ideas to the next meeting to continue to focus and target this work.

For next meeting: Council members are given questions that they are asked to consider before the next meeting.

The council discussed the meeting schedule for the year. The timeline for completing the report is the end of October 2024 with target dates to be determined for next meeting.

Meeting adjourned at 3:58 p.m.

Motion: Josh moved that the meeting be adjourned

Second: Laura seconded

Supporting documents: meeting agenda, PowerPoint presentation, Zoom recording, meeting transcription, chat recording. All materials will be posted on the DHS Acute Care Transitions Council website.