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External Program Review Committee (EPRC) agenda

Date: 2-4 p.m. Aug. 1, 2024

DSD liaisons: Stacie Enders 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 June and July 2024.

Updates to share

New positive supports rule training for providers licensed under Minn. Stat. 245A

· The DHS Community Capacity and Positive Support Team is collaborating with DHS Licensing, legal counsel, some service providers, Lindsay Nash and the DHS team that oversees psychiatric residential treatment facilities to create a new training video on Minn. Rule 9544 requirements for service providers licensed under Minn. Stat. 245A. This does not, however, include providers also licensed under Minn. Stat. 245D since those providers already have their own training materials and their regulations are slightly different.

Regional positive support capacity building meetings

· Committee members are invited to give any updates they may have on this topic. More information can be found at: Regional Capacity Building – Positive Supports.

Direct care workforce shortage

· H.R. 2941, which passed the federal Senate earlier this year, has been introduced by the House. It creates a standard occupational classification code for direct support professionals. For context, personal care aides and home health aides already have an SOC code. This will make it easier to collect data on the profession at the federal level. It might also make it easier for DEED to collect data on this profession.

· The Minnesota Nursing Home Workforce Standards Board (NHWSB) intends to adopt proposed expedited rules governing the minimum wage for nursing home workers. For more information, visit NHWSB rulemaking: Expedited rules -- wages | Minnesota Department of Labor and Industry.

· DEED recently shared regional employment information and data related to hiring in health care. There are around 36,000 vacancies in this sector, which includes “firms providing healthcare and social assistance to individuals.”

· The state Demographic Center shared key findings related to growing numbers of Minnesotans over the age of 65: Data by Topic: Aging / Minnesota State Demographic Center.

· Direct care professional job duties are made comparable to firefighters, 911 dispatchers, correctional guards and other higher paid professions on the new earned sick and safe time (ESST) law FAQs page:

“For most employees, if a weather event or public emergency closes an employer’s place of business, the employee can use ESST. However, during such emergencies, ESST cannot be used by employees whose duties require them to work during such events. Likewise, firefighters, peace officers, 911 dispatchers, correctional guards and public employees holding a commercial driver’s license cannot use ESST due to weather or public emergencies. An employee who is needed to maintain minimum staffing requirements may not use ESST during a weather or public emergency, if the employer has provided the employee sufficient notice that they are ineligible to use ESST in such a situation.”

· DHS is reviewing proposals from qualified responders to analyze prospective models to fund retirement benefits for self-directed Medicaid services direct support workers. DHS expects the term of any resulting contract to be from July 2024 to Dec. 1, 2024.

· PCA/CFSS training materials and tests have been translated into Spanish, Somali, Hmong and Russian.

Subcommittee updates

Requests for approval subcommittee

· One of the providers followed by this subcommittee decided to reach out to a different service provider to get additional expertise and assistance with a person’s functional behavior assessment.

Emergency use of manual restraint subcommittee

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

Discussion

Annual goals

· The committee will review their 2024 goals, which are listed in no particular order:

· Provide resources and guidance for improving communication skills.

The committee will work 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.

· 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 and 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 with living their best lives.

· 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.

· 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. 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

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

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