Minnesota Minnesota

Community-Based Services Manual (CBSM)

Community-Based Services Manual (CBSM)


External Program Review Committee (EPRC) agenda

Date: 2-4 p.m. on May 2, 2024

DSD liaisons: Stacie Enders and Ari Dionisopoulos

Type: Whole committee

Location: Room 2222, Elmer L. Andersen Building, 540 Cedar Street, Saint 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 March 2024.

    Updates to share

    Direct care workforce shortage

  • · This proposed bill changes direct care staff compensation thresholds to allow providers to use funds dedicated to staff wages to instead cover remote monitoring technology costs (lines 14.19 through 15.15): S.F. No. 5335A-2 (senate.mn).
  • · The DHS internal workforce workgroup conducted its annual review of proposed workforce shortage projects. Top projects under consideration include, but are not limited to:
  • Examining ways to update existing statutes to expand worker protections to align standards with other health care/social service professions.
  • Considering child care support proposals to help direct care professionals who cover evening and holiday shifts.
  • Requesting a few staff for DHS whose main job responsibility will be to help examine and propose ways to reduce time spent on paperwork, so service providers can spend more time with people receiving support.
  • Developing a system for and requiring all direct care professionals to have an identification number, which is necessary if the state ever wants to create a tiered wage and unified training system.
  • Collecting data on the impact of the shortage, such as tracking the number of people who are sent to institutions, sent out of state, had their services terminated, etc. due to direct care workforce shortages.
  • · This MN Dept. of Employment and Economic Development (DEED) article discusses the potential for employee-owned businesses as many business owners prepare for retirement: What New University of Minnesota Extension Research Reveals About Business Owners’ Plans for the Future Transition of Their Firms (mn.gov).
  • · Equity training opportunity: this video from the new federal workforce strategies center does a nice job explaining equity and discrimination as it relates to the direct care workforce: Webinar: Promoting Equity for the Direct Care Workforce (2-14-22) (youtube.com).
  • · The National Association for Direct Support Professionals (NADSP) shared their federal legislative priorities:
  • Enhance federal Investments:
  • Build upon federal investments to expand access to and strengthen the Medicaid Home and Community-Based Services (HCBS) system, including expanding the workforce.
  • Assure effective implementation of new HCBS funding directed at expanding the workforce so that it leads to wage increases commensurate with the level of responsibility and complexity of the work of DSPs.
  • Assure that federal investments create career ladders and pipeline programs to expand the workforce and lead to opportunities for professional growth for all DSPs.
  • Create a Standard Occupational Code (SOC) for DSPs:
  • • Currently, there is no standard occupational code or SOC for DSPs. This limits the ability to gather data on numbers of DSPs and their wages. DSPs are often inaccurately classified in labor reports under other positions, such as a nursing assistant (CNA), home health aide (HHA) or personal care assistant (PCA).
  • • Pass the Recognizing the Role of Direct Support Professionals Act to ensure that the Department of Labor collects the data on the work and wages of DSPs. This bill passed the Senate in March 2024, we must pass HR 2941 the House of Representatives version of the Role of Direct Support Professionals Act, so the bill becomes law!
  • Increase flexibility for states:
  • Promote flexibility by allowing states to use funding from the American Rescue Plan Act (ARPA) to support the growth of the DSP workforce through:
  • · Training and Certification programs like NADSPs E-Badge Academy.
  • · Bonus payments to new and existing DSPs.
  • · Pipeline programs to address the DSP shortages in their states.
  • Promote economic mobility of DSPs by reducing systemic barriers and promoting career pathways:
  • Provide funding to increase management training for DSPs moving into supervisory roles to support career growth.
  • Expand data collection in states to ensure that rate changes are tracked to go directly to wage increases for DSPs.
  • Technology
  • Provide innovation funding for states to develop and explore emerging technology solutions to improve service delivery and optimize the experience of DSPs and the people with disabilities they serve.

    • Subcommittee updates

    Requests for approval subcommittee

    This subcommittee continues to support teams with developing positive support and other strategies to phase out the use of restraint.

    Emergency use of manual restraint subcommittee

    This subcommittee continues to routinely read incident reports and positive support plans. Subcommittee members follow up with providers as needed to offer support.

    Discussion

    Annual report

    The committee will review their draft 2023 annual report.

    Closing

    Committee members are welcome to ask questions or bring up other topics for discussion.

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